As the core vehicle for preserving and transmitting traditional Chinese medicine（TCM） academic thought and clinical experience， the establishment of a robust quality evaluation system for TCM clinical case reports is a crucial component in the current standardization and modernization of TCM. Based on the practical experience of constructing the China Clinical Cases Library of Traditional Chinese Medicine by the China Association of Chinese Medicine， this study conducted a comprehensive analysis of critical challenges， including insufficient authenticity and unfocused evaluation criteria. It proposed a three-dimensional evaluation framework grounded in the structure-process-outcome logic， encompassing three dimensions of authenticity and standardization， characteristics and advantages， application and translational impact. This framework integrated 12 key evaluation indicators in a systematic manner. The model preserved the academic characteristics of TCM syndrome differentiation and treatment， while aligning with modern scientific research standards， achieving a balance between individualized TCM experience and standardized evaluation. Concurrently， this study provided theoretical foundations and methodological guidance for evaluating the quality of TCM clinical cases， contributing significantly to the inheritance of TCM knowledge， evidence-based practice， and the reform of talent evaluation mechanisms.

Migraine is a common chronic neurological disease，faces still certain limitations in the design of some clinical trials of migraine in China. Based on the principle of “PICO” in clinical research， this article summarizes the core contents of Guidelines for controlled trials of preventive treatment of episodic migraine in adults published by International Headache Society and its Clinical Trials Standing Committee， including subject selection， key points of trial design， and endpoint evaluation indicators. This article also discusses the deficiencies in current clinical trial design， so as to provide a basis for the design of clinical trials for migraine.

Migraine is a chronic episodic neurovascular disease with a distinct"episode-remission"feature.According to the theory of traditional Chinese medicine,migraine belongs to the class of diseases including"Toutong"and"Toufeng".Disorder of qi and blood,especially blood stasis due to qi deficiency,lie at the basis of migraine pathogenesis.The physiological function of the neurovascular unit is strongly related to qi and blood.Focusing on the neurovascular unit,this paper expounds the physiological basis of the theory of qi and blood from the perspective of microenvironment homeostatic disorder and the interaction of various cell components,and discusses the scientific connotation of the pathogenesis of qi and blood in migraine.Disordered homeostasis of the neurovascular unit is involved in the pathology of migraine and tallies with the pathogenesis of qi and blood in migraine,which is mainly reflected in dysfunction of astringing,defending,and transforming due to qi deficiency,as well as pathogenic toxin accumulation and blood stasis.The explanation based on homeostasis of the neurovascular unit due to qi and blood pathogenesis in migraine is helpful to understand the development of migraine integrally and to provide guidance for traditional Chinese medicine treatment and research of migraine from the theory of qi and blood.

Objective By comparing the changes in cerebral blood flow,neuronal morphology in brain tissue,and the levels of serum oxidation and inflammatory factors in models of cerebral hypoperfusion,three experimental rat models were assessed for their suitability as subjects of studies on the mechanisms and therapeutic drugs of cerebrovascular diseases and neurodegenerative diseases.Methods A total of 88 male SD rats were randomly divided into a sham operation group(n=16),classic bilateral common carotid artery occlusion group(classic 2-VO group,n=24),modified 2-VO group(n=24),and intraluminal thread technique group(n=24).Bilateral common carotid artery ligation was performed on the classic 2-VO group,while blood was drawn from the common carotid artery before ligation in the modified 2-VO group(1 mL/100 g).Middle cerebral artery occlusion was performed on the intraluminal thread technique group.In the sham operation groups of the first two models,the common carotid artery was separated but not ligated,while the proximal end of the common carotid artery and the external carotid artery were ligated;in addition,the bolt thread was not inserted in the sham group of the intraluminal thread technique group.Cerebral blood flow,infarct volume,serum inflammatory factor levels,hematoxylin and eosin-stained morphology,and ultrastructure of the hippocampal tissue were assessed at 1,3,and 7 days after the operations.Results Laser speckle interferometry showed a decrease in cerebral blood flow of the modified 2-VO group that was more obvious than that of the other two groups.On day 7,only the modified 2-VO group still had significant differences in cerebral blood flow compared with the sham group,and it remained in a state of hypoperfusion(cerebral blood flow decreased by 30％compared with that before the operation).TTC staining showed that infarcts in the striata of the three groups gradually increased with time after the operation;4 rats(about 26.7％)in the modified 2-VO group and 10 rats(about 66.7％)in the intraluminal thread technique group had infarcts in both the cortex and striatum.ELISA showed that the levels of inflammatory factors,such as TNF-α,IL-1 β,and hs-CRP,in the three groups were increased after the operations,and levels of the pro-oxidation factor ROS were also increased.In contrast,levels of the antioxidant factor SOD decreased.On postoperative day 7,there was no significant difference in the hs-CRP of the classic 2-VO and intraluminal thread technique groups compared with that of the sham group.However,the modified 2-VO group still exhibited significant differences in all the above indicators compared with the sham group.Hematoxylin and eosin staining showed that the modified 2-VO group had more severe damage to the hippocampal CA1 and CA3 regions compared with the other groups.Transmission electron microscopy demonstrated that the modified 2-VO group showed more severe damage to the mitochondrial and endoplasmic reticulum in the hippocampal region compared with the other groups.Conclusions A cerebral hypoperfusion model was successfully established.Compared with the classic 2-VO and intraluminal thread techniques,the modified 2-VO method can induce more complete cerebral hypoperfusion and more severe neural damage within the same time frame,resembling the pathological state of human cerebral hypoperfusion more closely.

ObjectiveTo compare the effect of acupuncture and speech rehabilitation on motor aphasia after stroke with speech rehabilitation alone. Methods49 patients with aphasia were divided into treatment group (27 cases) and control group (22 cases) randomly. The cases in treatment group were treated with acupuncture and speech rehabilitation. The cases in control group were treated with speech rehabilitation alone. They were assessed before and 1 month, 3 months after treatment. ResultsThere was no significant difference between treatment group and control group 1 month after treatment (P>0.05), but was significant in auditory comprehension, speaking, reading, dictation and description (P<0.05) 3 months after treatment. ConclusionThe acupuncture can facilitate the recovery of motor aphas after stroke.

Objective: To determine the appropriate time of early administration of dopamine (DA) before nitroglycerin (GTN) for establishing rat model with vasomotor abnormalities. Methods: Rats were divided into 5 groups: normal group, DA Group and other 3 groups in accordance with DA at different time points (10, 30, 45 min) plus GTN .Common carotid artery (CCA) blood flow velocity was dynamically measured with pulsed Doppler flow probe to evaluate the influence of DA, GTN on blood flow velocity rate(BFVR). Results:The blood flow velocity rate induced by DA of All medication administration was different from the normal group within 10 minutes(P < 0.05). However, the differences were not statistically significant after 11 min(P > 0.05). The BFVR of 10min interval group had differences with the DA group at 45min, 50min, 55min, 60min, 65min and 70min(P < 0.05 or P < 0.01). CCA BFVR of 45 min interval group was statistically significant different from the DA group at 80, 85, 90, 95 min and 100 min(P < 0.05). No statistically significant differences existed between CCA BFVR of 30min interval group and DA group (P > 0.05). Conclusion: Subcutaneous injection of DA, 45m in after injection of GTN can induce vasomotor abnormalities in rat with phase characters. The model may be useful for vasoactive screening of anti-migraine drugs.

Objective To research the effects and mechanism of gastrodin against migraine and on single amine neurotransmitter. Methods The model of nitroglycerin migraine was made after rat treated by gastrodin for 5 days, the time points of ear rubescence and the times of scratch head were observed to take as evaluation index of pharmacodynamic action, the concentration of 5-HT, NE and DA were measured in the brain with HPLC. Results Gastrodin could obviously prevent the attack of migraine and increase the concentration of 5-HT, DA and NE in the brain. Conclusions The effects of gastrodin against migraine is related with the concentration of 5-HT, DA and NE in the brain, gastrodin can regulate neurosystematic functions and enhance the secretion and metabolism of neurotransmitters.