主题：之一：《柳叶刀》上的中医 -- 良金百辟

在死亡的时候，长久以来所熟悉的态度通常都会先表达出来，并导引再生的方向。同理，因为害怕自我将不存在，所以人们就对自我产生强烈的执著。这种执著形成两世之间中阴身的缘，对于身体的喜爱，反过来变成建立中阴身的原因。

因此，去世的心境很重要。即使我们曾经造恶业，如果死亡时是处于善的心境，将可改善我们的下一世；即使我们曾经善用生命，如果死亡时心境慌乱痛苦，就会产生不好的影响。这表示：死亡前的最后念头和情绪，对于我们的立即未来，会产生极端强有力的决定性影响。正如疯子的心被幻想整个占住，幻想会一再地回来；在死亡的那一刻，心是完全不设防的，暴露于当时主宰我们的任何念头。最后一个念头或情绪，会被极端放大，淹没我们的整个认知。因此，上师们强调当我们去世时，四周环境的品质非常重要。对于亲友，我们应该竭尽全力启发正面的情绪和神圣的感觉，如爱、慈悲和恭敬，尽量帮助他们「放下攀缘、欲望和执著」。

。。。。。。。。。。。。

放下执著 一个人去世时最理想的方式是放下内外的一切，在那个关键时刻，心没有什么欲望、攀缘和执著好牵挂。因此，在去世之前，必须尽力解脱我们对一切财物、朋友和亲人的执著。

-- 西藏生死书 第十四章　临终修习

PHY906, a four-herb Chinese medicine formula first described 1800 years ago, decreases gastrointestinal toxicity induced by the chemotherapeutic drug CPT-11 (irinotecan), as shown in a phase I/II clinical study. Similarly, in a murine colon 38 allograft model, PHY906 increased the antitumor activity of CPT-11 while decreasing animal weight loss caused by CPT-11. Here, we have further examined the effect of PHY906 on the intestinal toxicity caused by CPT-11 in mice. PHY906 did not protect against the initial DNA damage and apoptosis triggered by CPT-11 in the intestine, but by 4 days after CPT-11 treatment, PHY906 had restored the intestinal epithelium by promoting the regeneration of intestinal progenitor or stem cells and several Wnt signaling components. PHY906 also potentiated Wnt3a activity in human embryonic kidney–293 cells. Furthermore, PHY906 exhibited anti-inflammatory effects in mice by decreasing the infiltration of neutrophils or macrophages, tumor necrosis factor–α expression in the intestine, and proinflammatory cytokine concentrations in plasma. Chemical constituents of PHY906 potently inhibited nuclear factor κB, cyclooxygenase-2, and inducible nitric oxide synthase. Our results show that the herbal medicine PHY906 can counteract the toxicity of CPT-11 via several mechanisms that act simultaneously.

The use of complementary and alternative medicine (CAM) has become a core component of the daily challenges faced when treating cancer patients. PHY906 is a formulation of four herbal compounds traditionally used to treat nausea, vomiting, cramping, and diarrhea. Diarrhea is one of the major side effects of the cancer drug irinotecan. In this issue of Science Translational Medicine, Lam and colleagues report that administration of PHY906 with irinotecan in a mouse model of colon cancer resulted in a synergistic reduction in tumor burden, maintenance of body weight, and stem cell regeneration in the intestinal mucosa. Yet when considering CAM use in the treatment of cancer patients, one must take into account reproducibility of preclinical findings in clinical practice, quality assurance of herbal products, and potential toxicities associated with alternative therapies.

In 2008, the national Coping with Cancer project published a study showing that terminally ill cancer patients who were put on a mechanical ventilator, given electrical defibrillation or chest compressions, or admitted, near death, to intensive care had a substantially worse quality of life in their last week than those who received no such interventions. And, six months after their death, their caregivers were three times as likely to suffer major depression. Spending one’s final days in an I.C.U. because of terminal illness is for most people a kind of failure. You lie on a ventilator, your every organ shutting down, your mind teetering on delirium and permanently beyond realizing that you will never leave this borrowed, fluorescent place. The end comes with no chance for you to have said goodbye or “It’s O.K.” or “I’m sorry” or “I love you.”

Read more http://www.newyorker.com/reporting/2010/08/02/100802fa_fact_gawande?currentPage=all#ixzz0vfPtY8ED