ObjectiveChinese patent medicines for cardiovascular and cerebrovascular diseases are diverse and complex in their efficacy. The traditional classification method based on efficacy categories has certain limitations and cannot meet the clinical needs for individualized drug selection and variety comparison. This article， based on the formulation compatibility analysis technology of "Tangye Jingfa Tu"， clarifies the composition and efficacy characteristics of common Chinese patent medicines used for cardiovascular and cerebrovascular diseases， providing support for the precise selection of these medicines. MethodsFifty-six representative Chinese patent medicines， covering all the efficacy subcategories of "stasis-resolving agents" in the National Basic Medical Insurance， Work Injury Insurance， and Maternity Insurance Drug Catalogue （2023） （more than 50% of the total）， were selected for the study. Within the knowledge system of "Tangye Jingfa Tu"， the compatibility structure of herbal flavors and the proportion structure of herbal quantities for each Chinese patent medicine were determined. The correlation between these structures and the efficacy categories was analyzed to identify the similarities and differences among the selected Chinese patent medicines. Additionally， the efficacy was reclassified and compared according to the theoretical framework of tonifying and purging methods of five Zang organs in the "Tangye Jingfa Tu". ResultsThe representative Chinese patent medicines included in the analysis were Shexiang Baoxin pills， Danshen tablets， Qili Qiangxin capsules， Breviscapine tablets， etc.， covering all the efficacy subcategories of "stasis-resolving agents". Among the 56 representative Chinese patent medicines， salty flavor was the most common （48）， followed by pungent （33）， and sweet （26）. According to the dominant herbal flavor， salty flavor was the most common （37）， followed by pungent （9）， and sour （5）. According to the dominant herbal quantity， salty flavor was the most common （27）， followed by sour （7）， and pungent （5）. Furthermore， Chinese patent medicines with different efficacy subtypes showed different flavor characteristics. For example， most Qi-invigorating and blood-activating agents contained sweet drugs for tonifying the spleen （9/10）， most Qi-moving and blood-activating agents contained pungent drugs for tonifying the liver （7/8）， and all kidney-invigorating and blood-activating agents contained bitter drugs for tonifying the kidneys （6/6）. However， the efficacy classification of individual medicines did not always align with the compatibility characteristics of their formulas， as seen with Dengyin Naotong capsules. ConclusionThe formulations of Chinese patent medicines for cardiovascular and cerebrovascular diseases predominantly feature salty， sour， and pungent flavors， which largely conform to the therapeutic principles of "nourishing the heart with salt and soothing the heart with sour" and the liver-heart， heart-spleen mother-child treatment relationship shown in the "Tangye Jingfa Tu". Using the "Tangye Jingfa Tu" framework to conduct research on the structure and efficacy characteristics of Chinese patent medicines is objective and effective.

ObjectiveChinese patent medicines for cardiovascular and cerebrovascular diseases are diverse and complex in their efficacy. The traditional classification method based on efficacy categories has certain limitations and cannot meet the clinical needs for individualized drug selection and variety comparison. This article， based on the formulation compatibility analysis technology of "Tangye Jingfa Tu"， clarifies the composition and efficacy characteristics of common Chinese patent medicines used for cardiovascular and cerebrovascular diseases， providing support for the precise selection of these medicines. MethodsFifty-six representative Chinese patent medicines， covering all the efficacy subcategories of "stasis-resolving agents" in the National Basic Medical Insurance， Work Injury Insurance， and Maternity Insurance Drug Catalogue （2023） （more than 50% of the total）， were selected for the study. Within the knowledge system of "Tangye Jingfa Tu"， the compatibility structure of herbal flavors and the proportion structure of herbal quantities for each Chinese patent medicine were determined. The correlation between these structures and the efficacy categories was analyzed to identify the similarities and differences among the selected Chinese patent medicines. Additionally， the efficacy was reclassified and compared according to the theoretical framework of tonifying and purging methods of five Zang organs in the "Tangye Jingfa Tu". ResultsThe representative Chinese patent medicines included in the analysis were Shexiang Baoxin pills， Danshen tablets， Qili Qiangxin capsules， Breviscapine tablets， etc.， covering all the efficacy subcategories of "stasis-resolving agents". Among the 56 representative Chinese patent medicines， salty flavor was the most common （48）， followed by pungent （33）， and sweet （26）. According to the dominant herbal flavor， salty flavor was the most common （37）， followed by pungent （9）， and sour （5）. According to the dominant herbal quantity， salty flavor was the most common （27）， followed by sour （7）， and pungent （5）. Furthermore， Chinese patent medicines with different efficacy subtypes showed different flavor characteristics. For example， most Qi-invigorating and blood-activating agents contained sweet drugs for tonifying the spleen （9/10）， most Qi-moving and blood-activating agents contained pungent drugs for tonifying the liver （7/8）， and all kidney-invigorating and blood-activating agents contained bitter drugs for tonifying the kidneys （6/6）. However， the efficacy classification of individual medicines did not always align with the compatibility characteristics of their formulas， as seen with Dengyin Naotong capsules. ConclusionThe formulations of Chinese patent medicines for cardiovascular and cerebrovascular diseases predominantly feature salty， sour， and pungent flavors， which largely conform to the therapeutic principles of "nourishing the heart with salt and soothing the heart with sour" and the liver-heart， heart-spleen mother-child treatment relationship shown in the "Tangye Jingfa Tu". Using the "Tangye Jingfa Tu" framework to conduct research on the structure and efficacy characteristics of Chinese patent medicines is objective and effective.

Objective To construct an"Internet+TCM nursing service"talent cultivation model in Zhejiang Province and to evaluate its application effect.Methods Based on the literature review and expert panels,the"Internet+TCM nursing service"talent cultivation model was constructed in Zhejiang Province.A total of 63 trainees from 63 TCM and integrated traditional Chinese and Western medicine hospitals in the province were selected to carry out for 45 days of theoretical training and 9 days of clinical skills training.After the training,the training effect was evaluated by theoretical knowledge,TCM nursing skills,scenario simulation case assessment,trainees'satisfaction,as well as a survey on the results of practice.Results The constructed talent cultivation model contains course contents including theoretical learning,skill training and emergency home treatment management and corresponding assessment programs.Sixty-three trainees successfully completed the course with the theoretical score of(92.24±3.64),the skill score of(97.13±2.53),and the situational case score of(95.78±3.02).Fifty-five trainees(87.30％)were assessed as"excellent"and 8(12.70％)as"good".The trainees'satisfaction about the overall module design of the project was(4.93±0.23)and 415 cases of"Internet+TCM nursing service"were carried out.Conclusion The"Internet+TCM nursing service"talent cultivation model in Zhejiang Province has strong applicability and remarkable training effect,which can provide references for the implementation of"Internet+TCM nursing service"in other regions.

A 28-year-old woman presented with a 4-year history of fatigue and sleepiness and was found to have central hypothyroidism and mood disorder. The patient had normal thyroid volume and did not show any other pituitary axis involvement. Over the course of the disease, her symptom improvement matched with the free thyroxine (FT 4) rebound and the adjustment of antipsychotic medication. The patient′s grandmother had central hypothyroidism, and her mother and uncle had lowered or inappropriately normal thyroid stimulating hormone. Hence, genetic involvement was highly suspected, but whole exon sequencing did not reveal a pathogenic variant. Levothyroxine tablets were prescribed to maintain a normal median level of FT 4, and mood disorder medications were adjusted by specialists. Isolated central hypothyroidism is extremely rare, and we report this case aiming to raise awareness of this condition.

OBJECTIVE To provide a reference for medical institutions in selecting and establishing a traditional Chinese medicine （TCM） clinical pharmaceutical care mode that suits their clinical characteristics. METHODS Combining clinical cases， this paper introduces the workflow and service content of the joint consultation mode between TCM physicians and TCM clinical pharmacists in our hospital and analyzes its effectiveness. RESULTS The workflow of the pharmaceutical care mode in our hospital involves six stages：assessing the patient’s medication status， consultation rounds and formulating medication regimen， bedside education， pharmaceutical monitoring， pharmacist rounds， and extended pharmaceutical care. The care content primarily includes thoroughly collecting clinical information and evaluating the patient’s medication regimen before the consultation. During the consultation， TCM clinical pharmacists and TCM physicians jointly developed a dosage regimen tailored to the patient’s individual conditions. After the consultation， bedside medication education was conducted to ensure the correct use of medications and a pharmaceutical monitoring plan was developed and implemented， during which the patient’s post-consultation condition changes were monitored and timely feedback to the TCM physicians for medication plan adjustments was provided， offering extended pharmaceutical care post-consultation， including medication consultation， pharmaceutical outpatient services， and joint clinics. Since its implementation， nearly 1 000 inpatients have been served annually， with a 100% medical order review rate for patients taking TCM decoction pieces. Individualized medication education reached 78.80%， and patient’s degree of satisfaction was 100%. The prescription compliance rate of TCM decoction pieces in the wards increased from 89.33% before the implementation of the joint consultation to 97.08% afterward. Additionally， the mode provided TCM-related consultations to over 1 000 patients annually and compiled and provided nearly a hundred pharmaceutical documents to healthcare personnel. CONCLUSIONS By establishing the joint consultation mode between TCM physicians and TCM clinical pharmacists and conducting TCM clinicalpharmaceutical care， the level of rational use of TCMdecoction pieces has been promoted， demonstrating the value of TCM clinical pharmacists.

Objective To investigate the expression of circRAF1 in primary ovarian insufficiency(POI)and explore its effect on cell proliferation and apoptosis of human ovarian granulosa cells(GCs)line(KGN cells).Methods The expression of circRAF1 in GCs and serum of patients with normal ovarian reserve function(n = 50)and patients with POI(n = 50)were detected with RT-qPCR.The correlation of circRAF1 with ovarian reserve function indexes was analyzed.Small interfering RNA(siRNA)targeting circRAF1 was constructed and trans-fected into KGN cells,with the cell proliferation detected by CCK-8 and EdU assay,and the cell apoptosis detected by JC-1 and Tunel assay.The mRNA and protein levels of genes related to cell proliferation and apoptosis(FSHR,PCNA,Bcl-2,Casp-9,Bax)were detected by RT-qPCR and WB.Results The expression of circRAF1 decreased in GCs and serum of POI patients.The expression of circRAF1 was positively correlated with serum E2 and AMH levels(P<0.001),but negatively correlated with serum FSH and LH levels(P<0.001).At the same time,the expression of circRAF1 was positively correlated with AFC(P<0.001).Interfering with the expression of circRAF1 could inhibit the proliferation of KGN cells and promote their apoptosis.Conclusion The expression of circRAF1 in the GCs and serum of POI patients is down-regulated,which is correlated with the decline of ovarian reserve function.Interfering with circRAF1 can inhibit the proliferation of GCs and promote their apoptosis.

Objective:To investigate the effects of the Y-box binding protein 1(YBX1)on the proliferation and apoptosis of granulosa cells by regulating silent information regulator 1(SIRT1),and explore the differential ex-pression of YBX1 and SIRT1 of premature ovarian insufficiency(POI)patients and health controls,as well as its clinical significance.Methods:We recruited patients with POI and patients with normal ovarian function during in vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI)assisted pregnancy in the Department of Reproduc-tive Medical Center of the Fourth Affiliated Hospital of Jiangsu University from June 2022 to July 2023.The granu-losa cells and serum were collected.Western-Blot(WB)to detect YBX1 protein expression.Real-time quantitative polymerase chain reaction(RT-qPCR)to detect YBX1 and SIRT1 mRNA levels,and the correlation between the abundance of YBX1 and SIRT1 in serum and follicle stimulating hormone(FSH),luteinizing hormone(LH),estra-diol(E2),anti-Mullerian Hormone(AMH),and antral follicle count(AFC)were analyzed.5-bromo-2-deoxyuracil(EdU)and cell counting Kit-8(CCK8)were applied to detect cell proliferation;TdT-mediated dUTP-biotin nick end labeling assay(TUNEL)to detect cell apoptosis;RT-qPCR to detect cell proliferating cell nuclear antigen(PC-NA),B cell lymphoma 2(Bcl2),Bcl2 associated X protein(BAX),and cysteine-aspartate protease 3(Caspase-3)mRNA expression;RNA Immunoprecipitation(RIP)experiment to detect the interaction between YBX1 and SIRT1.Results:The expression of YBX1 protein and SIRT1 mRNA in granulosa cells and serum of POI patients were significantly lower than that of the control group(P＜0.05).The expression of YBX1 and SIRT1 mRNA in serum were negatively correlated with FSH,LH(r＜0,P＜0.05),and positively correlated with E2,AMH and AFC(r＞0,P＜0.05).Upregulating YBX1 in granulosa cells increased SIRT1 protein expression,SIRT1 mRNA stabili-ty,EdU positive rate,cell viability,PCNA mRNA expression level,Bcl2/BAX ratio(P＜0.05),while decreased Caspase-3 mRNA expression level,TUNEL positive rate(P＜0.05).Conclusions:The expression levels of YBX1 and SIRT1 in POI patients were significantly reduced and correlated with clinical ovarian function indicators.YBX1 can bind to SIRT1 mRNA and enhance its stability,which may promote the proliferation of granulosa cells,and in-hibit apoptosis.These findings suggested that YBX1 and SIRT1 are expected to become new targets for POI diag-nosis and treatment.

Objective:To investigate the effects of the Y-box binding protein 1(YBX1)on the proliferation and apoptosis of granulosa cells by regulating silent information regulator 1(SIRT1),and explore the differential ex-pression of YBX1 and SIRT1 of premature ovarian insufficiency(POI)patients and health controls,as well as its clinical significance.Methods:We recruited patients with POI and patients with normal ovarian function during in vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI)assisted pregnancy in the Department of Reproduc-tive Medical Center of the Fourth Affiliated Hospital of Jiangsu University from June 2022 to July 2023.The granu-losa cells and serum were collected.Western-Blot(WB)to detect YBX1 protein expression.Real-time quantitative polymerase chain reaction(RT-qPCR)to detect YBX1 and SIRT1 mRNA levels,and the correlation between the abundance of YBX1 and SIRT1 in serum and follicle stimulating hormone(FSH),luteinizing hormone(LH),estra-diol(E2),anti-Mullerian Hormone(AMH),and antral follicle count(AFC)were analyzed.5-bromo-2-deoxyuracil(EdU)and cell counting Kit-8(CCK8)were applied to detect cell proliferation;TdT-mediated dUTP-biotin nick end labeling assay(TUNEL)to detect cell apoptosis;RT-qPCR to detect cell proliferating cell nuclear antigen(PC-NA),B cell lymphoma 2(Bcl2),Bcl2 associated X protein(BAX),and cysteine-aspartate protease 3(Caspase-3)mRNA expression;RNA Immunoprecipitation(RIP)experiment to detect the interaction between YBX1 and SIRT1.Results:The expression of YBX1 protein and SIRT1 mRNA in granulosa cells and serum of POI patients were significantly lower than that of the control group(P＜0.05).The expression of YBX1 and SIRT1 mRNA in serum were negatively correlated with FSH,LH(r＜0,P＜0.05),and positively correlated with E2,AMH and AFC(r＞0,P＜0.05).Upregulating YBX1 in granulosa cells increased SIRT1 protein expression,SIRT1 mRNA stabili-ty,EdU positive rate,cell viability,PCNA mRNA expression level,Bcl2/BAX ratio(P＜0.05),while decreased Caspase-3 mRNA expression level,TUNEL positive rate(P＜0.05).Conclusions:The expression levels of YBX1 and SIRT1 in POI patients were significantly reduced and correlated with clinical ovarian function indicators.YBX1 can bind to SIRT1 mRNA and enhance its stability,which may promote the proliferation of granulosa cells,and in-hibit apoptosis.These findings suggested that YBX1 and SIRT1 are expected to become new targets for POI diag-nosis and treatment.

Objective:To investigate the effects of the Y-box binding protein 1(YBX1)on the proliferation and apoptosis of granulosa cells by regulating silent information regulator 1(SIRT1),and explore the differential ex-pression of YBX1 and SIRT1 of premature ovarian insufficiency(POI)patients and health controls,as well as its clinical significance.Methods:We recruited patients with POI and patients with normal ovarian function during in vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI)assisted pregnancy in the Department of Reproduc-tive Medical Center of the Fourth Affiliated Hospital of Jiangsu University from June 2022 to July 2023.The granu-losa cells and serum were collected.Western-Blot(WB)to detect YBX1 protein expression.Real-time quantitative polymerase chain reaction(RT-qPCR)to detect YBX1 and SIRT1 mRNA levels,and the correlation between the abundance of YBX1 and SIRT1 in serum and follicle stimulating hormone(FSH),luteinizing hormone(LH),estra-diol(E2),anti-Mullerian Hormone(AMH),and antral follicle count(AFC)were analyzed.5-bromo-2-deoxyuracil(EdU)and cell counting Kit-8(CCK8)were applied to detect cell proliferation;TdT-mediated dUTP-biotin nick end labeling assay(TUNEL)to detect cell apoptosis;RT-qPCR to detect cell proliferating cell nuclear antigen(PC-NA),B cell lymphoma 2(Bcl2),Bcl2 associated X protein(BAX),and cysteine-aspartate protease 3(Caspase-3)mRNA expression;RNA Immunoprecipitation(RIP)experiment to detect the interaction between YBX1 and SIRT1.Results:The expression of YBX1 protein and SIRT1 mRNA in granulosa cells and serum of POI patients were significantly lower than that of the control group(P＜0.05).The expression of YBX1 and SIRT1 mRNA in serum were negatively correlated with FSH,LH(r＜0,P＜0.05),and positively correlated with E2,AMH and AFC(r＞0,P＜0.05).Upregulating YBX1 in granulosa cells increased SIRT1 protein expression,SIRT1 mRNA stabili-ty,EdU positive rate,cell viability,PCNA mRNA expression level,Bcl2/BAX ratio(P＜0.05),while decreased Caspase-3 mRNA expression level,TUNEL positive rate(P＜0.05).Conclusions:The expression levels of YBX1 and SIRT1 in POI patients were significantly reduced and correlated with clinical ovarian function indicators.YBX1 can bind to SIRT1 mRNA and enhance its stability,which may promote the proliferation of granulosa cells,and in-hibit apoptosis.These findings suggested that YBX1 and SIRT1 are expected to become new targets for POI diag-nosis and treatment.

Objective:To investigate the effects of the Y-box binding protein 1(YBX1)on the proliferation and apoptosis of granulosa cells by regulating silent information regulator 1(SIRT1),and explore the differential ex-pression of YBX1 and SIRT1 of premature ovarian insufficiency(POI)patients and health controls,as well as its clinical significance.Methods:We recruited patients with POI and patients with normal ovarian function during in vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI)assisted pregnancy in the Department of Reproduc-tive Medical Center of the Fourth Affiliated Hospital of Jiangsu University from June 2022 to July 2023.The granu-losa cells and serum were collected.Western-Blot(WB)to detect YBX1 protein expression.Real-time quantitative polymerase chain reaction(RT-qPCR)to detect YBX1 and SIRT1 mRNA levels,and the correlation between the abundance of YBX1 and SIRT1 in serum and follicle stimulating hormone(FSH),luteinizing hormone(LH),estra-diol(E2),anti-Mullerian Hormone(AMH),and antral follicle count(AFC)were analyzed.5-bromo-2-deoxyuracil(EdU)and cell counting Kit-8(CCK8)were applied to detect cell proliferation;TdT-mediated dUTP-biotin nick end labeling assay(TUNEL)to detect cell apoptosis;RT-qPCR to detect cell proliferating cell nuclear antigen(PC-NA),B cell lymphoma 2(Bcl2),Bcl2 associated X protein(BAX),and cysteine-aspartate protease 3(Caspase-3)mRNA expression;RNA Immunoprecipitation(RIP)experiment to detect the interaction between YBX1 and SIRT1.Results:The expression of YBX1 protein and SIRT1 mRNA in granulosa cells and serum of POI patients were significantly lower than that of the control group(P＜0.05).The expression of YBX1 and SIRT1 mRNA in serum were negatively correlated with FSH,LH(r＜0,P＜0.05),and positively correlated with E2,AMH and AFC(r＞0,P＜0.05).Upregulating YBX1 in granulosa cells increased SIRT1 protein expression,SIRT1 mRNA stabili-ty,EdU positive rate,cell viability,PCNA mRNA expression level,Bcl2/BAX ratio(P＜0.05),while decreased Caspase-3 mRNA expression level,TUNEL positive rate(P＜0.05).Conclusions:The expression levels of YBX1 and SIRT1 in POI patients were significantly reduced and correlated with clinical ovarian function indicators.YBX1 can bind to SIRT1 mRNA and enhance its stability,which may promote the proliferation of granulosa cells,and in-hibit apoptosis.These findings suggested that YBX1 and SIRT1 are expected to become new targets for POI diag-nosis and treatment.