ObjectiveTo explore the potential mechanism of Xiaoqinglong Decoction （小青龙汤， XD） in the treatment of allergic rhinitis. MethodsForty-five rats were randomly assigned to a control group， a model group， a loratadine group， low-， medium- and high-dose XD groups， and low-， medium- and high-dose Mahuang Decoction and Cang'erzi Powder （麻黄汤合苍耳子散， MDCP） groups. Except for the control group， rats were administered with ovalbumin （OVA） and aluminum hydroxide via intraperitoneal injection for 14 days to establish an allergic rhinitis model. After the 14th-day injection， nasal stimulation was continued with 20 μl of 10% OVA solution to maintain the model. Rats in the control group and the model group received 10 ml/（kg·d） of saline， whereas those in the loratadine group were administered with 0.9 mg/（kg·d） of loratadine. The low-， medium- and high-dose XD groups were administered XD at the dose of 2.7， 5.4， and 10.8 g/（kg·d）， respectively. The low-， medium- and high-dose MDCP groups were administered MDCP at the dose of 2.43， 4.86， and 9.72 g/（kg·d）， respectively. All treatments were administered by gavage once daily for 7 consecutive days. One hour after the final gavage， nasal symptom scores were recorded for all group of rats. The next day， serum levels of immunoglobulin E （IgE）， interleukin-4 （IL-4）， and interleukin-13 （IL-13） were measured. HE staining was used to observe the pathological morphology of the nasal mucosal tissue. Quantitative reverse transcription PCR （RT-qPCR） and Western Blot were performed to assess mRNA and protein expression of thymic stromal lymphopoietin （TSLP） and OX40 ligand （OX40L） in the nasal mucosa. ResultsCompared to the control group， total nasal symptom score in the model group significantly increased （P＜0.01）. HE staining revealed disrupted and adhered cilia， thickened basement membranes， and extensive inflammatory cell infiltration in the nasal mucosa. Serum levels of total IgE， IL-4， and IL-13， as well as TSLP and OX40L mRNA and protein expression in the nasal mucosa， were significantly elevated in the model group （P＜0.05 or P＜0.01）. Compared to the model group， the total nasal symptom scores in all drug intervention groups were significantly reduced； the serum total IgE levels in the loratadine group， the low- and medium-dose XD groups， and the low- and high-dose MDCP groups were significantly reduced； and the serum levels of IL-4 and IL-13 in the high-dose XD group and the high-dose MDCP group decreased （P＜0.05 or P＜0.01）. Nasal mucosal structure was improved. Except for the low-dose MDCP group， all other intervention groups showed a significant reduction in TSLP and OX40L mRNA expression in the nasal mucosa （P＜0.01）. All doses of XD and the medium- and high-dose MDCP groups significantly decreased the protein levels of TSLP and OX40L （P＜0.05）. The medium-dose XD group exhibited more improvement of nasal symptom scores and greater suppression of expression of TSLP and OX40L mRNA， and TSLP protein levels compared to the loratadine group （P＜0.05）. ConclusionXD may protect nasal mucosa of rats and alleviate allergic rhinitis by suppressing the TSLP/OX40L pathway， thereby attenuating Th2-mediated immune responses.

ObjectiveTo explore the potential mechanism of Xiaoqinglong Decoction （小青龙汤， XD） in the treatment of allergic rhinitis. MethodsForty-five rats were randomly assigned to a control group， a model group， a loratadine group， low-， medium- and high-dose XD groups， and low-， medium- and high-dose Mahuang Decoction and Cang'erzi Powder （麻黄汤合苍耳子散， MDCP） groups. Except for the control group， rats were administered with ovalbumin （OVA） and aluminum hydroxide via intraperitoneal injection for 14 days to establish an allergic rhinitis model. After the 14th-day injection， nasal stimulation was continued with 20 μl of 10% OVA solution to maintain the model. Rats in the control group and the model group received 10 ml/（kg·d） of saline， whereas those in the loratadine group were administered with 0.9 mg/（kg·d） of loratadine. The low-， medium- and high-dose XD groups were administered XD at the dose of 2.7， 5.4， and 10.8 g/（kg·d）， respectively. The low-， medium- and high-dose MDCP groups were administered MDCP at the dose of 2.43， 4.86， and 9.72 g/（kg·d）， respectively. All treatments were administered by gavage once daily for 7 consecutive days. One hour after the final gavage， nasal symptom scores were recorded for all group of rats. The next day， serum levels of immunoglobulin E （IgE）， interleukin-4 （IL-4）， and interleukin-13 （IL-13） were measured. HE staining was used to observe the pathological morphology of the nasal mucosal tissue. Quantitative reverse transcription PCR （RT-qPCR） and Western Blot were performed to assess mRNA and protein expression of thymic stromal lymphopoietin （TSLP） and OX40 ligand （OX40L） in the nasal mucosa. ResultsCompared to the control group， total nasal symptom score in the model group significantly increased （P＜0.01）. HE staining revealed disrupted and adhered cilia， thickened basement membranes， and extensive inflammatory cell infiltration in the nasal mucosa. Serum levels of total IgE， IL-4， and IL-13， as well as TSLP and OX40L mRNA and protein expression in the nasal mucosa， were significantly elevated in the model group （P＜0.05 or P＜0.01）. Compared to the model group， the total nasal symptom scores in all drug intervention groups were significantly reduced； the serum total IgE levels in the loratadine group， the low- and medium-dose XD groups， and the low- and high-dose MDCP groups were significantly reduced； and the serum levels of IL-4 and IL-13 in the high-dose XD group and the high-dose MDCP group decreased （P＜0.05 or P＜0.01）. Nasal mucosal structure was improved. Except for the low-dose MDCP group， all other intervention groups showed a significant reduction in TSLP and OX40L mRNA expression in the nasal mucosa （P＜0.01）. All doses of XD and the medium- and high-dose MDCP groups significantly decreased the protein levels of TSLP and OX40L （P＜0.05）. The medium-dose XD group exhibited more improvement of nasal symptom scores and greater suppression of expression of TSLP and OX40L mRNA， and TSLP protein levels compared to the loratadine group （P＜0.05）. ConclusionXD may protect nasal mucosa of rats and alleviate allergic rhinitis by suppressing the TSLP/OX40L pathway， thereby attenuating Th2-mediated immune responses.

Objective To comparatively observe the value of 131I whole-body scanning(WBS)and 131I-SPECT/CT for evaluating residual thyroid tissue,lymph node and distant metastasis,as well as risk of recurrence of differentiated thyroid cancer(DTC)after surgical resection and initial radioactive iodine(RAI)treatment.Methods Totally 367 DTC patients who underwent initial RAI treatment after surgical resection and then 131I-WBS and 131I SPECT/CT scanning were retrospectively collected.131I-WBS and 131I SPECT/CT were compared for identifying residual thyroid,lymph node and distant metastases.According to follow-up results,the risk of DTC recurrence was evaluated based on 131I-WBS and 131I-SPECT/CT,respectively.Results Residual thyroid was detected in 353 cases and suspected in 3 cases with 131 I-WBS,which was diagnosed in 349 cases with 131I-SPECT/CT,and no significant difference was found between 2 methods(P=0.289).131I-WBS detected 36 cases with and suspected 67 cases with lymph node metastases,312 without distant metastases,while 131I-SPECT/CT diagnosed lymph node metastases in 52 cases;131I-WBS detected 20 cases with and suspected 35 cases with distant metastases,while 131I-SPECT/CT diagnosed 60 cases with distant metastases but could not diagnose in 3 cases,304 without distant metastases.The detection rate of 131I-SPECT/CT for lymph node and distant metastasis were both higher than that of 131I-WBS(P=0.018,P＜0.001).During follow-up period,there were 94 cases with low risk,155 with medium risk and 118 with high risk of DTC recurrence according to 131I-SPECT/CT,while 116 cases of low risk,137 of medium risk and 114 of high risk based on 131I-SPECT/CT,and the evaluating results were different between 2 methods in 40 cases(40/367,10.90％).Conclusion Compared with 131I-WBS,131I-SPECT/CT had better clinical value for evaluating lymph node and distant metastases and assessing recurrence risk of DTC after initial RAI treatment.

OBJECTIVE To understand the healthcare-seeking behavior of patients with AIDS co-infected with tu-berculosis and analyze the factors influencing delayed consultation and diagnosis,and to provide a theoretical basis for the implementation of interventional tuberculosis control measures.METHODS Two hundred and two patients with AIDS complicated with tuberculosis who were first admitted to Yunnan Infectious Diseases Hospital from Jan.2020 to Dec.2023 were selected,and their clinical data were collected through the inpatient medical record system.Multivariate logistic regression model was used to analyze the factors influencing delayed consultation and diagnosis.RESULTS Time of admission,place of residence,presence of lung cavities,distribution of lung lesions,intermediate hospital visited,sputum culture results,etiological situation,CD4+/CD8+cell ratio,and CD8+cell counts were the factors influencing delayed consultation(P<0.05).The initial diagnosis and Gene-Xpert results were the factors influencing delayed diagnosis(P<0.05).Multivariate logistic regression analysis showed that ad-mission in 2021(OR=3.842,95%CI:1.651-8.966),and presence of lung cavity(OR=8.007,95%CI:1.381-6.436),single lung lesion accumulation(OR=0.637,95%CI:0.049-8.267)were risk factors for delayed consultation.A 10%reduction in body mass(OR=2.070,95%CI:1.056-4.059)and negative Gene-Xpert re-sults(OR=1.667,95%CI:0.688-4.038)were risk factors for delayed diagnosis.CONCLUSIONS The issues of delayed medical consultation and diagnosis in patients with AIDS complicated with tuberculosis remain severe,with different factors influencing the delay.Special attention should be paid to the screening for latent tuberculosis infection in people infected with HIV.When experiencing suspicious symptoms,patients should go be encouraged to take exams at designated tuberculosis hospitals,repeatedly collect sputum samples and monitor changes in body mass,all of which are positively significant in reducing delays.

Objective To collect oral exhaled odor spectrum of patients of chronic atrophic gastritis(CAG)with yin deficiency syndrome and detect their gut microbiota;To elucidate the mechanism of odor changes from the perspective of gut microbiota changes;To provide a basic research for the objectification of TCM olfactory diagnosis in CAG.Methods Totally 110 patients with CAG,including 55 patients with CAG yin deficiency syndrome,55 patients with CAG non-yin deficiency syndrome,and 30 healthy individuals were collected.The electronic nose technology was used to collect the oral exhaled odor spectrum of all subjects,and an improved Transformer model was used to identify the breath odor spectrum of CAG yin deficiency syndrome patients and healthy individuals,CAG non-yin deficiency syndrome patients and healthy individuals,CAG yin deficiency syndrome patients and CAG non-yin deficiency syndrome patients.At the same time,16S rRNA high-throughput sequencing method was used to detect the gut microbiota of the subjects'fecal samples,and the correlation analysis between the odor spectrum characteristics of CAG yin deficiency syndrome and gut microbiota was conducted.Results ① Analysis and recognition of odor spectrum characteristic.Amplitude characteristics:The response curves A,C,D,G,H,I and J of the odor spectrum in the CAG yin deficiency syndrome group and the CAG non-yin deficiency syndrome group were all lower in amplitude than those in the healthy group(P<0.01,P<0.05).Slope characteristics:The slopes of response curves A,B,C,D,E,G,H,I and J in the odor spectrum of the CAG yin deficiency syndrome group and the CAG non-yin deficiency syndrome group were lower than those of the healthy group(P<0.01,P<0.05).Pattern recognition:The accuracy of pattern recognition between the CAG yin deficiency syndrome group and the healthy group reached 0.904,with an area under ROC curve(AUC)of 0.91;the accuracy of pattern recognition between the CAG non-yin deficiency syndrome group and the healthy group reached 0.885,AUC=0.89;the accuracy of pattern recognition between the CAG yin deficiency syndrome group and the CAG non-yin deficiency syndrome group reached 0.747,AUC=0.75.② Species composition:At the genus level,compared with the healthy group,the abundance of Actinomyces,Escherichia-Shigella and Tyzzerella in the CAG yin deficiency syndrome group increased(P<0.05),while the abundance of Prevotella,Sutterella and Subdoligranulum decreased(P<0.05);the abundance of[Ruminococcus]_gnavus_group and Escherichia-Shigella in the CAG non-yin deficiency syndrome group increased significantly(P<0.01),while the abundance of Prevotella and Subdoligranulum decreased(P<0.05).Compared with the CAG yin deficiency syndrome group,the non-yin deficiency syndrome group showed significant enrichment of the Dialister(P<0.05).③ Correlation analysis between odor spectrum characteristics and gut microbiota in CAG yin deficiency syndrome:This study identified 17 bacterial genera that showed positive and negative correlations with the amplitude and slope characteristics of the odor spectrum in CAG yin deficiency syndrome,namely Lachnospiraceae_NK4A136_group,Lachnospiraceae_ND3007_group,Faecalibacterium,UCG-002,UCG-005,Coprococcus,CAG-352,Parabacteroides,Actinomyces,Streptococcus,Anaerostipes,Blautia,Dorea,[Eubacterium]_hallii_group,Phascolarctobacterium,Clostridium_sensu_stricto_1,Enterobacter.The above-mentioned bacterial genera could be classified into the following bacterial families:Trichomonas,Clostridia,Porphyromonas,Actinobacteria,Ruminococcus,Streptococcus,Bacteroidetes,Clostridium,Veillonellaceae and Enterobacteriaceae.Conclusion The use of electronic nose technology can accurately identify the oral exhaled odor of patients with CAG yin deficiency syndrome,CAG non-yin deficiency syndrome,and healthy individuals;the odor spectrum characteristics of patients with CAG yin deficiency syndrome are correlated with multiple bacterial genera,and the changes in related metabolites and gases produced by the disruption of their gut microbiota may be one of the biological bases for the changes in oral exhaled odor in CAG yin deficiency syndrome.

Objective Chronic atrophic gastritis(CAG)is often accompanied by intestinal flora disorder and intestinal symptoms,forming the phenomenon of"stomach disease involving intestine".This study explored the dynamic correlation between intestinal symptoms and qi-stagnation degree in patients with CAG qi-stagnation syndrome and analyzed the characteristics of gut microbiota from the perspective of"spleen-stomach system serving as the pivotal hub of qi movement"in TCM.Methods According to the syndrome element differentiation method,410 patients with CAG were divided into four groups:non-qi-stagnation group,mild qi-stagnation group,moderate qi-stagnation group and severe qi-stagnation group.Correlation analysis and 16S intestinal flora sequencing technology were used to analyze the correlation and differential flora between the degree of CAG qi-stagnation and intestinal symptoms.Results Patients with CAG qi-stagnation syndrome were often accompanied by intestinal symptoms such as frequent flatulence,poor defecation and alternating loose-constipated stools.The frequency of cases was significantly positively correlated with the degree of qi-stagnation"non-mild-moderate-severe"(P<0.05).There was a difference in the abundance of gut microbiota between the four groups of CAG qi-stagnation none,mild,moderate and severe.The relative abundance of Streptococcus,Subdoligranulum,Eubacterium_coprostanoligenes_group and Haemophilus was positively correlated with the degree of qi-stagnation.The relative abundance of Ruminococcus_torques_group and Butyricicoccus showed a negative correlation,and Haemophilus was statistically significant among the four groups(P<0.05).Conclusion This study can provide clinical evidence and micro-mechanism for the connotation of"gastrointestinal co-morbidities"and"different diseases with the same syndrome",which may open up new ideas for clinical diagnosis and treatment.

Objective To collect oral exhaled odor spectrum of patients of chronic atrophic gastritis(CAG)with yin deficiency syndrome and detect their gut microbiota;To elucidate the mechanism of odor changes from the perspective of gut microbiota changes;To provide a basic research for the objectification of TCM olfactory diagnosis in CAG.Methods Totally 110 patients with CAG,including 55 patients with CAG yin deficiency syndrome,55 patients with CAG non-yin deficiency syndrome,and 30 healthy individuals were collected.The electronic nose technology was used to collect the oral exhaled odor spectrum of all subjects,and an improved Transformer model was used to identify the breath odor spectrum of CAG yin deficiency syndrome patients and healthy individuals,CAG non-yin deficiency syndrome patients and healthy individuals,CAG yin deficiency syndrome patients and CAG non-yin deficiency syndrome patients.At the same time,16S rRNA high-throughput sequencing method was used to detect the gut microbiota of the subjects'fecal samples,and the correlation analysis between the odor spectrum characteristics of CAG yin deficiency syndrome and gut microbiota was conducted.Results ① Analysis and recognition of odor spectrum characteristic.Amplitude characteristics:The response curves A,C,D,G,H,I and J of the odor spectrum in the CAG yin deficiency syndrome group and the CAG non-yin deficiency syndrome group were all lower in amplitude than those in the healthy group(P<0.01,P<0.05).Slope characteristics:The slopes of response curves A,B,C,D,E,G,H,I and J in the odor spectrum of the CAG yin deficiency syndrome group and the CAG non-yin deficiency syndrome group were lower than those of the healthy group(P<0.01,P<0.05).Pattern recognition:The accuracy of pattern recognition between the CAG yin deficiency syndrome group and the healthy group reached 0.904,with an area under ROC curve(AUC)of 0.91;the accuracy of pattern recognition between the CAG non-yin deficiency syndrome group and the healthy group reached 0.885,AUC=0.89;the accuracy of pattern recognition between the CAG yin deficiency syndrome group and the CAG non-yin deficiency syndrome group reached 0.747,AUC=0.75.② Species composition:At the genus level,compared with the healthy group,the abundance of Actinomyces,Escherichia-Shigella and Tyzzerella in the CAG yin deficiency syndrome group increased(P<0.05),while the abundance of Prevotella,Sutterella and Subdoligranulum decreased(P<0.05);the abundance of[Ruminococcus]_gnavus_group and Escherichia-Shigella in the CAG non-yin deficiency syndrome group increased significantly(P<0.01),while the abundance of Prevotella and Subdoligranulum decreased(P<0.05).Compared with the CAG yin deficiency syndrome group,the non-yin deficiency syndrome group showed significant enrichment of the Dialister(P<0.05).③ Correlation analysis between odor spectrum characteristics and gut microbiota in CAG yin deficiency syndrome:This study identified 17 bacterial genera that showed positive and negative correlations with the amplitude and slope characteristics of the odor spectrum in CAG yin deficiency syndrome,namely Lachnospiraceae_NK4A136_group,Lachnospiraceae_ND3007_group,Faecalibacterium,UCG-002,UCG-005,Coprococcus,CAG-352,Parabacteroides,Actinomyces,Streptococcus,Anaerostipes,Blautia,Dorea,[Eubacterium]_hallii_group,Phascolarctobacterium,Clostridium_sensu_stricto_1,Enterobacter.The above-mentioned bacterial genera could be classified into the following bacterial families:Trichomonas,Clostridia,Porphyromonas,Actinobacteria,Ruminococcus,Streptococcus,Bacteroidetes,Clostridium,Veillonellaceae and Enterobacteriaceae.Conclusion The use of electronic nose technology can accurately identify the oral exhaled odor of patients with CAG yin deficiency syndrome,CAG non-yin deficiency syndrome,and healthy individuals;the odor spectrum characteristics of patients with CAG yin deficiency syndrome are correlated with multiple bacterial genera,and the changes in related metabolites and gases produced by the disruption of their gut microbiota may be one of the biological bases for the changes in oral exhaled odor in CAG yin deficiency syndrome.

Objective Chronic atrophic gastritis(CAG)is often accompanied by intestinal flora disorder and intestinal symptoms,forming the phenomenon of"stomach disease involving intestine".This study explored the dynamic correlation between intestinal symptoms and qi-stagnation degree in patients with CAG qi-stagnation syndrome and analyzed the characteristics of gut microbiota from the perspective of"spleen-stomach system serving as the pivotal hub of qi movement"in TCM.Methods According to the syndrome element differentiation method,410 patients with CAG were divided into four groups:non-qi-stagnation group,mild qi-stagnation group,moderate qi-stagnation group and severe qi-stagnation group.Correlation analysis and 16S intestinal flora sequencing technology were used to analyze the correlation and differential flora between the degree of CAG qi-stagnation and intestinal symptoms.Results Patients with CAG qi-stagnation syndrome were often accompanied by intestinal symptoms such as frequent flatulence,poor defecation and alternating loose-constipated stools.The frequency of cases was significantly positively correlated with the degree of qi-stagnation"non-mild-moderate-severe"(P<0.05).There was a difference in the abundance of gut microbiota between the four groups of CAG qi-stagnation none,mild,moderate and severe.The relative abundance of Streptococcus,Subdoligranulum,Eubacterium_coprostanoligenes_group and Haemophilus was positively correlated with the degree of qi-stagnation.The relative abundance of Ruminococcus_torques_group and Butyricicoccus showed a negative correlation,and Haemophilus was statistically significant among the four groups(P<0.05).Conclusion This study can provide clinical evidence and micro-mechanism for the connotation of"gastrointestinal co-morbidities"and"different diseases with the same syndrome",which may open up new ideas for clinical diagnosis and treatment.

Objective:To explore the impact of the two-way referral model on compliance and prognosis in patients with heart failure.Methods:This bidirectional cohort study enrolled chronic heart failure (CHF) patients treated at Qilu Hospital of Shandong University or designated primary hospitals between March 2018 and March 2022. Patients were categorized into two groups based on referral status: two-way referral group (participating in the referral model with≥1 follow-up visit at primary hospitals) and the core hospital group (receiving treatment and follow-up exclusively at Qilu Hospital). Baseline clinical characteristics were collected and compared between groups. Patients underwent followed-up, with primary endpoints including follow-up rate, drug (β-blockers, angiotension converting enzyme inhibitor (ACEI)/angiotensin Ⅱ receptor blockers (ARB)/angiotensin receptor-neprilysin inhibitor (ARNI), sodium-glucose cotransporter 2 inhibitors and mineralocorticoid receptor antagonists) utilization rate and target dose achievement rate. Secondary endpoints encompassed changes from baseline in left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDd), and N-terminal pro-brain natriuretic peptide (NT-proBNP), plus cardiovascular mortality and heart failure rehospitalization. Generalized linear mixed models analyzed longitudinal trends in LVEF, LVEDd, and NT-proBNP levels. Kaplan-Meier curves and Cox regression evaluated LVEF recovery rates, supplemented by subgroup analyses. Multivariate logistic regression was used to identify factors influencing target dose achievement rate for β-blockers and ACEI/ARB/ARNI therapies in CHF patients.Results:A total of 357 patients were enrolled, aged 53 (41, 63) years, including 256 males (71.7%). 157 patients were in the two-way referral group and 200 patients in the core hospital-treated group. Compared with the core hospital-treated group, the two-way referral group had lower baseline LVEF (28 (22, 34)% vs. 31 (23, 36)%, P=0.021) and systolic blood pressure (116 (104, 125) mmHg vs. 121 (109, 134) mmHg (1 mmHg=0.133 kPa), P=0.010). The 12-month follow-up rate of the two-way referral group was higher than the core hospital-treated group (73.8% vs. 56.0%, P=0.004). No significant between-group differences were observed in drug utilization rate of β-blockers, ACEI/ARB/ARNI, or sodium-glucose cotransporter 2 inhibitors during follow-up (all P>0.05), while mineralocorticoid receptor antagonists use showed a declining trend in both groups. Although the core hospital-treated group had higher target dose achievement rates for β-blockers (65.4% vs. 49.3%, P=0.042) and ACEI/ARB/ARNI (79.8% vs. 65.8%, P=0.046) than the two-way referral group, multivariate logistic regression indicated that the two-way referral model was not a negative predictor for these outcomes (all P>0.05). Both groups showed improved NT-proBNP, LVEDd, and LVEF from baseline (all P<0.001) with no significant difference in trends between groups (all P>0.05). There was no significant difference in the composite incidence (7.6% vs. 6.5%, P=0.674) and cumulative incidence (log-rank P=0.684) of cardiovascular death and heart failure rehospitalization at 12 months between two groups. Conclusion:The two-way referral model demonstrates advantages in improving medication adherence, drug utilization rates, and targetdoseachievement rates among CHF patients. This model not only promotes cardiac functional recovery but also reduces risks of cardiovascular mortality and heart failure rehospitalization, achieving comparable therapeutic and management outcomes to those observed in core hospital-treated patients.

This paper focuses on extreme environments and systematically analyzes sleep disorders caused by multiple pathogenesis,including circadian rhythm disorder,yin-yang imbalance and qi-blood disorder under weightlessness,emotional depression due to environmental changes,abnormal diet and excretion,and six excesses pathogenic factors,in accordance with the theory of correspondence between nature and human.It proposes harmonizing yin and yang as the core therapeutic principle and guiding framework,with specific methods including calming rebellious qi-blood,regulating qi movement,harmonizing heart and kidney,and dredging and regulating blood vessels,thus forming the"one guiding principle and four specific methods"treatment strategy.Additionally,by integrating the modified application of classic formulas,a diagnostic and therapeutic approach targeting multi-dimensional pathogenesis is established.This study aims to promote the in-depth integration of Traditional Chinese Medicine(TCM)in extreme environmental medicine through TCM theories and innovative application of prescriptions,provide TCM-characterized solutions for health management of workers in extreme environments,and facilitate the transformation of extreme environmental medicine toward the modern medical model of"prevention-treatment integration".