"Dietary inquiry" is a core component of the diagnostic system in traditional Chinese medicine （TCM）， which can be divided into three aspects including appetite， eating capacity， and food preference. Abnormalities in appetite are mainly attributed to dysfunction of the mind and impaired regulatory mechanisms. Clinical inquiry should focus on hunger sensation and the willingness to eat voluntarily. Treatment should aim to soothe the liver， regulate the spleen， nourish and calm the mind. Abnormalities in eating capacity are related to disorders of qi movement and structural dysfunction， for which inquiry should focus on whether food descends smoothly and on postprandial reactions， and the corresponding treatment is descending qi， relieving fullness， and promoting bowel movement and digestion. Abnormalities in food preference arise from damage caused by the five flavors and imbalance of visceral qi， for which inquiry should focus on dietary preferences and whether eating brings comfort. It is important to distinguish between "stomach preference" and "oral preference"， and treatment should carefully differentiate flavor tendencies and correct imbalances through appropriate dietary flavors. By refining the content of dietary inquiry， this study explores how different dimensions of eating status reflect the holistic concept and syndrome differentiation-based treatment in TCM， providing a reference for the clinical diagnosis and treatment of spleen and stomach diseases and related disorders.

"Dietary inquiry" is a core component of the diagnostic system in traditional Chinese medicine （TCM）， which can be divided into three aspects including appetite， eating capacity， and food preference. Abnormalities in appetite are mainly attributed to dysfunction of the mind and impaired regulatory mechanisms. Clinical inquiry should focus on hunger sensation and the willingness to eat voluntarily. Treatment should aim to soothe the liver， regulate the spleen， nourish and calm the mind. Abnormalities in eating capacity are related to disorders of qi movement and structural dysfunction， for which inquiry should focus on whether food descends smoothly and on postprandial reactions， and the corresponding treatment is descending qi， relieving fullness， and promoting bowel movement and digestion. Abnormalities in food preference arise from damage caused by the five flavors and imbalance of visceral qi， for which inquiry should focus on dietary preferences and whether eating brings comfort. It is important to distinguish between "stomach preference" and "oral preference"， and treatment should carefully differentiate flavor tendencies and correct imbalances through appropriate dietary flavors. By refining the content of dietary inquiry， this study explores how different dimensions of eating status reflect the holistic concept and syndrome differentiation-based treatment in TCM， providing a reference for the clinical diagnosis and treatment of spleen and stomach diseases and related disorders.

OBJECTIVE To optimize the forming process of Yindan huoxue tongyu granules， and evaluate the quality of the granules. METHODS Taking forming rate， angle of repose， moisture， moisture absorption rate and dissolution rate as indexes， single factor experiment combined with Plackett-Burman design was adopted to screen key process parameters； analytic hierarchy process combined with entropy weight method and Box-Behnken response surface method were used to optimize the molding process of Yindan huoxue tongyu granules， and the forming process was verified. The relative homogeneity index， bulk density， vibration density， Hausner ratio， angle of repose， moisture and hygroscopicity were used as secondary physical indexes to establish the physical fingerprints of 10 batches of Yindan huoxue tongyu granules to evaluate particle quality consistency. RESULTS The optimal molding process of Yindan huoxue tongyu granules was as follows： mannitol as the fixed excipient， the drug-assisted ratio was 1∶1（m/m） and the drying time was 1 h； 90% ethanol was used as wetting agent and the amount of it was 32%， the drying temperature was 70 ℃. The results of validation tests showed that the average comprehensive score was 97.45， which was close to the predicted value of 97.18. The similarities between the physical fingerprints of 10 batches of Yindan huoxue tongyu granules prepared by the optimal molding process and the reference physical fingerprint were all higher than 0.99. CONCLUSIONS The molding process is stable and feasible， and the quality of Yindan huoxue tongyu granules produced is stable and controllable.

AIM:To observe the changes of atrial fibrillation susceptibility,and the remodeling of atrial myo-cyte action potential,ultrarapid activation delayed rectifier potassium current(IKur)and transient outward potassium cur-rent(Ito)in elderly mice,and to explore the mechanism of atrial fibrillation from the single cell electrophysiological level.METHODS:The C57BL/6J mice were divided into old group(20 months old)and young group(4 months old).Atrial fi-brillation was induced by esophageal atrial pacing.The atrial myocytes were isolated,and action potential and ion currents were recorded with patch-clamp technique.The associated proteins were detected by Western blot technique.RE-SULTS:(1)Compared with young mice,the total incidence of atrial fibrillation was significantly increased in old mice(20.0%at 4 months old vs 60.0%at 20 months old,P<0.01).(2)The action potential duration of atrial myocytes in aged mice was shortened,and more significantly after stimulation.(3)The density of Ito and IKur in atrial myocytes of aged mice increased significantly,from(12.6±1.4)pA/pF to(21.7±1.1)pA/pF,and from(7.5±1.5)pA/pF to(13.3±2.1)pA/pF,respectively(P<0.01).After stimulation,the current increased more significantly,especially in older atrial cells.Compared with the young mice,the steady-state activation curve of Ito in the atrial myocytes of the aged mice shifted towards the depolarization,suggesting that activation of Ito channels in the aged mice increased at the same voltage stimula-tion.(4)Compared with young group,the expression of KV4.2(generating Ito)and KV1.5(generating IKur)proteins in the atrial tissue of the mice in old group was significantly increased,and the expression of caveolin-3 and end-binding protein 1(EB1)was up-regulated,suggesting that the increases in KV4.2 and KV1.5 total channel proteins and effective proteins in the cell membrane might contribute to the increase in the remodeling of potassium currents in the elderly atrial myo-cytes.CONCLUSION:The incidence of atrial fibrillation in elderly mice is significantly augmented,which may be related to the increases in Ito and IKur in atrial myocytes.The remodeling of potassium currents in elderly atrial myocytes is one of the electrophysiological bases leading to the shortening of action potential duration and the occurrence of atrial fibrillation.

Objective:To construct a meridian tapping exercise program for frail elderly, so as to provide daily healthcare options for frail elderly people.Methods:Guided by the theory of meridians and collaterals, data mining was conducted on the database of ancient Chinese medical literature to select acupoints and meridians for tapping. Through literature research, the exercise prescription was improved. A preliminary exercise prescription was formulated through literature review and revised through two rounds of expert consultation in December 2023.Results:The effective response rate for both rounds of expert consultation questionnaires was 7/7. The expert authority coefficients were 0.83 and 0.87, respectively, and the overall Kendall′s coefficient of concordance was 0.301 and 0.302 (both P<0.05). The final meridian tapping exercise for frail elderly comprised 2 primary indicators, 8 secondary indicators, and 23 tertiary indicators. Conclusions:The meridian tapping exercise for the frail elderly is scientific, reliable and practical, which can provide a choice for the frail elderly to carry out targeted traditional Chinese medicine exercises.

Objective To investigate the effect of combination therapy of evolocumab and statins on blood lipids,liver and renal functions and occurrence of cardiovascular events in elderly patients with multi-vessel coronary heart disease(CHD).Methods A total of 108 elderly patients with multi-vessel CHD admitted to our hospital from January 2022 to January 2023 were enrolled and randomly divided into statin group(54 cases)and combination group(atorvastatin+evolocumab,54 cases).The clinical efficacy,changes in blood lipids before and after treatment[TC,LDL-C and LP(a)],angina pectoris status[attack frequency and duration,Seattle angina questionnaire(SAQ)score],indicators of liver and renal functions(Scr,ALT,AST),endothelial function indi-cators(NO,ET-1),blood-related biochemical indicators[proprotein convertase subtilisin/kexin type 9(PCSK9),soluble intercellular adhesion molecule-1(sICAM-1)],and incidence rates of ad-verse drug reactions and major adverse cardiovascular events(MACE)within 1 year were com-pared between the two groups.Results The total efficacy was significantly higher in the combina-tion group than the statin group(94.4％vs 81.5％,P＜0.05).There were no statistical differences in the levels Scr,ALT and AST in both groups before and after treatment(P＞0.05).After treat-ment,the levels of TC,LDL-C and Lp(a),frequency and duration of angina attack,and levels of ET-1,PCSK9 and sICAM-1 were significantly decreased,while SAQ score and NO level were ob-viously increased in both groups(P＜0.01).The combination group had notably lower frequency and shorter duration of angina attack,reduced levels of TC,LDL-C and Lp(a),and ET-1,PCSK9 and sICAM-1,and higher SAQ score and elevated NO level when compared with the statin group(P＜0.01).No statistical difference was seen in the incidence of adverse drug reactions between the two groups(13.0％vs 9.3％,P＞0.05).Within 1 year after treatment,the incidence of MACE in the combination group was notably lower than that in the statin group(3.7％vs 16.7％,P＜0.05).Conclusion Evolocumab has a significant lipid-lowering effect on elderly patients with multi-vessel CHD.It can significantly promote lipid metabolism,alleviate angina pectoris symp-toms,and improve vascular endothelial function and the prognosis outcomes,with good safety,which is worthy of application.

Objective To observe the effects of transcranial direct current stimulation(tDCS)combined with music therapy on cognitive function and activities of daily living in patients with post-stroke cognitive impairment(PSCI).Methods This prospective study enrolled subacute stroke(2 weeks to 6 months after onset)patients with cognitive impairment admitted to the Rehabilitation Department of the First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital)from January 2023 to December 2024.Using the random number table,patients in the subacute early stage(2 weeks to＜3 months after stroke)and subacute late stage(3 months to 6 months after stroke)were respectively assigned to the experimental group and the control group.Baseline clinical data were collected,including gender,age,stroke type(intracerebral hemorrhage,cerebral infarction),lesion side(left,right),disease course,educational attainment,history of smoking and alcohol consumption,stroke area(basal ganglia,temporal lobe,frontal lobe),and National Institutes of Health stroke scale(NIHSS)score at admission.Both groups received conventional rehabilitation treatment.The experimental group additionally received tDCS treatment combined with music therapy intervention,which included active and passive music therapy.In contrast,the control group received only tDCS treatment in conjunction of conventional rehabilitation intervention.Both groups received treatment for 2 weeks.The Montreal cognitive assessment scale(MoCA),Rivermead behavioural memory test(RBMT),and digit span test(DST)were used to evaluate the overall cognitive function,memory,and attention of PSCI patients before and after treatment.The modified Barthel index(MBI)was used to evaluate the daily living activity ability of PSCI patients 2 weeks post-treatment.Results A total of 40 PSCI patients were included in this study,with 20 cases in each group.Among the participants,17 in the experimental group and 18 in the control group were in early stage of subacute stroke,while 3 in the experimental group and 2 in the control group were in the late stage of subacute stroke.(1)There were no statistically significant differences in the baseline clinical data of the two groups(all P＞0.05).(2)Before treatment,the MoCA,RBMT,and DST scores in the experimental group were(15.00±3.71),(2.90±1.07),and(4.05±1.47)points,respectively,while the corresponding scores in the control group were(13.45±2.61),(2.75±0.77),and(3.35±0.99)points.There were no statistically significant differences in the MoCA,RBMT,and DST scores between the two groups before treatment(all P＞0.05).Two weeks after treatment,the MoCA,RBMT,and DST scores in the experimental group were(19.05±4.35),(5.15±1.50),and(5.85±1.66)points,respectively,compared to(15.90±2.73),(3.45±1.15),and(4.35±1.18)points in the control group.The interaction effect of time and group(Ftime×group)was 15.716,45.762 and 14.140,respectively,all of which were statistically significant(all P＜0.01);the group main effect(Fgroup)was 4.876,7.140,and 7.074,respectively,all of which were statistically significant(all P＜0.05);the time main effect(Ftime)was 259.370,165.762,and 173.209,respectively,all of which were statistically significant(all P＜0.01).(3)Before treatment,the MBI scores of the experimental group and control group were(56.00±7.18)and(55.25±5.73)points,respectively,with no statistically significant difference between the two groups(P＞0.05).Two weeks after the treatment,the MBI scores of the experimental group and control group were(63.00±6.77)and(60.50±5.36)points,respectively.No statistically significant differences were observed in the interaction effect of time and group,or the main effect of group between the two groups after treatment(Ftime ×group=1.677,P＞0.05;Fgroup=0.751,P＞0.05).While a statistically significant difference was found in the main effect of time on the MBI scores between the experimental group and control group(Ftime=82.196,P＜0.01).Conclusion The combination of tDCS and music therapy can improve the cognitive function and daily living activity ability in patients with PSCI,and offering superior outcomes compared to tDCS treatment alone.

AIM:To observe the changes of atrial fibrillation susceptibility,and the remodeling of atrial myo-cyte action potential,ultrarapid activation delayed rectifier potassium current(IKur)and transient outward potassium cur-rent(Ito)in elderly mice,and to explore the mechanism of atrial fibrillation from the single cell electrophysiological level.METHODS:The C57BL/6J mice were divided into old group(20 months old)and young group(4 months old).Atrial fi-brillation was induced by esophageal atrial pacing.The atrial myocytes were isolated,and action potential and ion currents were recorded with patch-clamp technique.The associated proteins were detected by Western blot technique.RE-SULTS:(1)Compared with young mice,the total incidence of atrial fibrillation was significantly increased in old mice(20.0%at 4 months old vs 60.0%at 20 months old,P<0.01).(2)The action potential duration of atrial myocytes in aged mice was shortened,and more significantly after stimulation.(3)The density of Ito and IKur in atrial myocytes of aged mice increased significantly,from(12.6±1.4)pA/pF to(21.7±1.1)pA/pF,and from(7.5±1.5)pA/pF to(13.3±2.1)pA/pF,respectively(P<0.01).After stimulation,the current increased more significantly,especially in older atrial cells.Compared with the young mice,the steady-state activation curve of Ito in the atrial myocytes of the aged mice shifted towards the depolarization,suggesting that activation of Ito channels in the aged mice increased at the same voltage stimula-tion.(4)Compared with young group,the expression of KV4.2(generating Ito)and KV1.5(generating IKur)proteins in the atrial tissue of the mice in old group was significantly increased,and the expression of caveolin-3 and end-binding protein 1(EB1)was up-regulated,suggesting that the increases in KV4.2 and KV1.5 total channel proteins and effective proteins in the cell membrane might contribute to the increase in the remodeling of potassium currents in the elderly atrial myo-cytes.CONCLUSION:The incidence of atrial fibrillation in elderly mice is significantly augmented,which may be related to the increases in Ito and IKur in atrial myocytes.The remodeling of potassium currents in elderly atrial myocytes is one of the electrophysiological bases leading to the shortening of action potential duration and the occurrence of atrial fibrillation.

Based on the holistic view of "spleen-vessels-heart-spirit" system， this article explores the pathogenesis and progression of atrial fibrillation. It is proposed that the onset of atrial fibrillation is due to failure of the spleen to transport and disharmony of blood vessels； phlegm and blood stasis obstructing the collaterals and damage to the heart structure are the basis of its pathogenesis； the unclear mind and disorder of body and spirit are the causes of its progression. Based on the characteristics of pathological changes in different stages of the disease， it is proposed that early treatment should focus on restoring the middle jiao， clearing and promoting blood vessels， using modified Yigong Powder （异功散）； during the progression of the disease， treatment should remove blood stasis and phlegm， nourish heart and protect the pulse， using self-prescribed modified Mengshi Tongmai Decoction （礞石通脉汤）； meanwhile， calming mind and stabilizing palpitations， and regulating spirit should be sequentially incorporated， with self-prescribed Jiazao Ningmai Decoction （甲枣宁脉汤） or Shenying Dingji Decoction （参英定悸汤） and modified as appropriate. Clinical treatment should focus on the whole disease course of atrial fibrillation， implementing stage-based treatments to enable early intervention and holistic regulation.

ObjectiveTo observe the clinical efficacy and safety of Zhuyuwan in the treatment of hyperlipidemia. MethodsIn this study， hyperlipidemia patients treated in the Hospital of Chengdu University of Traditional Chinese Medicine （TCM） from September 2022 to December 2023 were randomly assigned into a control group and an observation group. Finally， 162 valid cases were included， encompassing 74 cases in the control group and 88 cases in the observation group. The control group was treated with atorvastatin calcium tablets， and the observation group with atorvastatin calcium tablets + Zhuyuwan extract granules. Both groups were treated for 8 weeks. The efficacy in terms of blood lipid level recovery， blood lipid levels， TCM syndrome distribution， efficacy in terms of TCM syndrome， and TCM symptom scores were compared between the two groups as well as between before and after treatment. Liver and kidney functions were monitored for safety assessment. ResultsIn terms of blood lipid level recovery， the total response rate in the observation group was 86.36% （76/88） and that in the control group was 86.49% （64/74）， with no statistically significant difference between the two groups. After treatment， both groups showed declines in levels of triglyceride （TG）， total cholesterol （TC）， and low-density lipoprotein cholesterol （LDL-C） （P<0.05） and elevations in the level of high-density lipoprotein cholesterol （HDL-C） （P<0.05）. Moreover， the observation group outperformed the control group in recovering the levels of TG， LDL-C， and HDL-C （P<0.05， P<0.01）. In terms of TCM syndrome， hyperlipidemia was mostly caused by phlegm turbidity and obstruction. The total response rate in terms of TCM syndrome in the observation group was 87.30% （55/63）， which was higher than that （63.46%， 33/52） in the control group （χ²=9.102， P<0.01）. After treatment， the scores of total TCM symptoms， primary symptoms， and secondary symptoms decreased in both groups （P<0.05）， and the observation group had lower scores than the control group （P<0.01）. The observation group was superior to the control group in alleviating obesity， chest tightness， and low food intake （P<0.05）. In terms of safety， the level of aminotransferase was slightly elevated in the control group， and no obvious adverse reaction was observed in the observation group， with no statistical significance in the incidence of adverse reactions. ConclusionZhuyuwan combined with atorvastatin can not only recover blood lipid levels and alleviate TCM symptoms but also reduce the occurrence of adverse reactions.