Parkinson's disease （PD） is a complex neurodegenerative disease involving multiple systems and neurotransmitters. Due to the high clinical heterogeneity of PD，it is urgent to establish a comprehensive and long-term traditional Chinese medicine （TCM） management model. In this paper，the conceptual framework of full-cycle management of PD is preliminarily constructed：based on the evolution of the pathophysiological mechanisms of protein deposition and neurotransmitter disorder in PD，the three-stage syndrome characteristics of the prodromal stage （predominant healthy Qi with subtle pathogenic factors），the early clinical stage （declining healthy Qi with growing pathogenic factors） and the middle and late stages （overwhelming pathogenic factors with deficient healthy Qi） are longitudinally described. Through the syndrome differentiation of visceral manifestations，the etiology and pathogenesis of PD motor and non-motor symptoms were comprehensively analyzed，while the matching treatment methods and prescriptions were inferred，and the modular scheme of the combining main symptoms，accompanying symptoms and secondary symptoms was proposed. The conceptual gap of TCM regarding motor complications （'variable syndrome'） and PD-related hyperpyrexia syndrome （'critical syndrome'） was explained. This framework reflects the characteristics of combination of disease and syndrome and overall constant motion，and provides new theories and research ideas for individualized and whole-process management of PD in TCM.

Parkinson's disease （PD） is a complex neurodegenerative disease involving multiple systems and neurotransmitters. Due to the high clinical heterogeneity of PD，it is urgent to establish a comprehensive and long-term traditional Chinese medicine （TCM） management model. In this paper，the conceptual framework of full-cycle management of PD is preliminarily constructed：based on the evolution of the pathophysiological mechanisms of protein deposition and neurotransmitter disorder in PD，the three-stage syndrome characteristics of the prodromal stage （predominant healthy Qi with subtle pathogenic factors），the early clinical stage （declining healthy Qi with growing pathogenic factors） and the middle and late stages （overwhelming pathogenic factors with deficient healthy Qi） are longitudinally described. Through the syndrome differentiation of visceral manifestations，the etiology and pathogenesis of PD motor and non-motor symptoms were comprehensively analyzed，while the matching treatment methods and prescriptions were inferred，and the modular scheme of the combining main symptoms，accompanying symptoms and secondary symptoms was proposed. The conceptual gap of TCM regarding motor complications （'variable syndrome'） and PD-related hyperpyrexia syndrome （'critical syndrome'） was explained. This framework reflects the characteristics of combination of disease and syndrome and overall constant motion，and provides new theories and research ideas for individualized and whole-process management of PD in TCM.

By consulting relevant literature of ancient herbal books and processing specifications， this paper made a systematic research and analysis of Ostreae Concha， including the name， producing area， harvesting， quality， historical evolution of processing， relevant processing specifications， modern processing technology， and changes in chemical composition and pharmacological effects before and after processing， in order to provide documentary evidence for the research on processing technology and the establishment of quality standards. According to the textual research， it is known that Ostreae Concha has a long history of being used in medicine， and there have been many aliases and local names in each historical period. Shennong's Classic of the Materia Medica（Shennong Bencaojing） began to use Muli as the correct name， which has continued to use to today， and there were also aliases such as Muge， Zuogu Muli and Haoke. Ostreae Concha has a wide range of localities and irregular harvesting periods. The ancients believed that its left shell was of superior quality， but this has not been seen in modern. And there were many kinds of processing methods of Ostreae Concha， such as grinding， roasting， calcining， frying， simmering， quenching and so on， and the calcining was still in use. The different editions of Chinese Pharmacopoeia from 1963 to 2020 contain only calcined Ostreae Concha， and the local processing specifications mainly include three kinds of processed products（calcined products， salt-soaked products and vinegar-soaked products）. Modern processing research mainly focuses on process optimization， changes in chemical composition and pharmacological effects， and the research methods are relatively single. Overall， there are currently issues such as inconsistent processing standards， unclear process parameters and imperfect quality standards， which are not conducive to the quality control and standardized clinical use of Ostreae Concha. Therefore， it is necessary to further investigate the pharmacological substance basis of Ostreae Concha and its processed products in order to elucidate the processing mechanism， standardize the processing technology and improve the quality standard.

Objective To investigate the risk factors of adverse events in elderly patients with painless gastroenteroscopy,and construct a nomogram model for predicting the risk of adverse events.Methods 302 patients who underwent painless gastroenteroscopy from September 2023 to March 2024 were retrospectively enrolled and randomly divided into training set(211 cases)and validation set(91 cases)according to the 7∶3 ratio.The training set was divided into adverse event group(64 cases)and non-adverse event group(147 cases)according to whether adverse events occurred.Multivariate Logistic regression analysis was used to screen the risk factors for adverse events in elderly painless gastroenteroscopy patients,R 3.4.3 software was used to construct a nomogram model,and the validation set was used for external verification.The nomogram model discrimination was evaluated by drawing the receiver operator characteristic curve(ROC curve),and the calibration curve was drawn to evaluate the calibration degree of the nomogram model.Results Univariate analysis showed that,the comparison of overweight or obesity,smoking,hypertension,coronary heart disease,education level,pre examination sleep time,and exercise habits between the adverse event group and the non-adverse event group were statistically significant(P＜0.05);Multivariate Logistic regression analysis showed that overweight or obesity(OR=4.821,95％CI:1.052～11.651),smoking(OR=1.056,95％CI:1.313～3.109),hypertension(OR=1.356,95％CI:1.175～2.677),and coronary heart disease(OR=1.385,95％CI:1.168～2.765)were risk factors for adverse events during painless gastroenteroscopy in elderly patients(P＜0.05);The areas under the ROC curves for the training and validation sets were 0.921 and 0.795,respectively.The sensitivity was 90.62％(95％CI:0.846～0.965)and 82.14％(95％CI:0.689～0.856),and the specificity was 74.83％(95％CI:1.056～2.939)and 76.19％(95％CI:1.245～4.161),indicating that the nomogram model had good discriminability;The Hosmer-Lemeshow goodness of fit test results showed that the nomogram model had a good fit(P＞0.05),and the calibration curves of the training and validation sets both showed that the nomogram model had a good consistency between the actual and predicting incidence of adverse events(P＞0.05).Conclusion Overweight or obesity,hypertension,cornary heart disease and smoking are independently correlated with adverse events in painless gastroenteroscopy,and the nomogram model constructed based on the above factors to predict the risk of adverse events in painless gastroenteroscopy has good predictive efficacy.

Objective To investigate the risk factors of adverse events in elderly patients with painless gastroenteroscopy,and construct a nomogram model for predicting the risk of adverse events.Methods 302 patients who underwent painless gastroenteroscopy from September 2023 to March 2024 were retrospectively enrolled and randomly divided into training set(211 cases)and validation set(91 cases)according to the 7∶3 ratio.The training set was divided into adverse event group(64 cases)and non-adverse event group(147 cases)according to whether adverse events occurred.Multivariate Logistic regression analysis was used to screen the risk factors for adverse events in elderly painless gastroenteroscopy patients,R 3.4.3 software was used to construct a nomogram model,and the validation set was used for external verification.The nomogram model discrimination was evaluated by drawing the receiver operator characteristic curve(ROC curve),and the calibration curve was drawn to evaluate the calibration degree of the nomogram model.Results Univariate analysis showed that,the comparison of overweight or obesity,smoking,hypertension,coronary heart disease,education level,pre examination sleep time,and exercise habits between the adverse event group and the non-adverse event group were statistically significant(P＜0.05);Multivariate Logistic regression analysis showed that overweight or obesity(OR=4.821,95％CI:1.052～11.651),smoking(OR=1.056,95％CI:1.313～3.109),hypertension(OR=1.356,95％CI:1.175～2.677),and coronary heart disease(OR=1.385,95％CI:1.168～2.765)were risk factors for adverse events during painless gastroenteroscopy in elderly patients(P＜0.05);The areas under the ROC curves for the training and validation sets were 0.921 and 0.795,respectively.The sensitivity was 90.62％(95％CI:0.846～0.965)and 82.14％(95％CI:0.689～0.856),and the specificity was 74.83％(95％CI:1.056～2.939)and 76.19％(95％CI:1.245～4.161),indicating that the nomogram model had good discriminability;The Hosmer-Lemeshow goodness of fit test results showed that the nomogram model had a good fit(P＞0.05),and the calibration curves of the training and validation sets both showed that the nomogram model had a good consistency between the actual and predicting incidence of adverse events(P＞0.05).Conclusion Overweight or obesity,hypertension,cornary heart disease and smoking are independently correlated with adverse events in painless gastroenteroscopy,and the nomogram model constructed based on the above factors to predict the risk of adverse events in painless gastroenteroscopy has good predictive efficacy.

Objective To construct a mindfulness-based self-care intervention program for patients with chronic heart failure(CHF)and their caregivers based on binary disease management theory and explore its small-scale application effect.Methods A prospective study was conducted on 100 pairs of CHF patients admitted to our hospital and their caregivers from January 2024 to October 2024.After excluding those with invalid survey data,92 pairs were finally included and randomly divided into an observation group and a control group,each consisting of 46 pairs.The control group received routine nursing care,while the observation group received the mindfulness-based self-care program based on binary disease management theory in addition to routine nursing care.The Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD),Self Compassion Scale(SCS),and Mindfulness Attention Awareness Scale(MAAS)were used to compare the anxiety,depression,self-care,and mindfulness levels of patients and caregivers at three time points:pre-intervention(T1),right post-intervention(T2),and one month post-intervention(T3).The Caregiver Positive Perception Scale(PAC)was used to evaluate the caregiver's positive perception at each time point.Results The HAMA and HAMD scores of patients and caregivers in the observation group were lower than those in the control group at T2 and T3,while the SCS scores were signifi-cantly higher(all P<0.05).Repeated-measures analysis of variance showed significant differences in HAMA,The mindfulness-based self-care intervention program based on binary disease management theory effectively reduces negative emotions in patients and caregivers,and improves mindfulness and self-care,showing clinical application potential.

ObjectiveTo explore the differences in the accumulation of secondary metabolites of Dendrobium nobile cultivated on epiphytic stones and trees， so as to elucidate the scientific connotation of "only those that grow on stones has superior quality"， and provide a direction for the cultivation and quality evaluation of D. nobile. MethodsUltra-performance liquid chromatography-triple quadrupole/linear ion trap mass spectrometry（UPLC-QTRAP-MS/MS）-based widely targeted metabolomics was used to detect the metabolites of D. nobile cultivated on epiphytic stones and trees. And the combination of principal component analysis（PCA）， hierarchical cluster analysis（HCA）， and orthogonal partial least squares-discriminant analysis（OPLS-DA） was performed for multivariate statistical analysis of metabolites. Differential metabolites were screened by variable importance in the projection（VIP） value≥1 and log₂fold change（FC）≥1 or ≤-1， and Kyoto Encyclopedia of Genes and Genomes（KEGG） enrichment analysis was conducted. ResultsA total of 1 267 metabolites were identified in the stems of D. nobile from the two cultivation modes， dominated by flavonoids（292）， phenolic acids（284）， and alkaloids（189）. Through OPLS-DA screening， 473 differential metabolites were obtained. Compared to epiphytic tree-cultivated D. nobile， epiphytic stone-cultivated D. nobile exhibited upregulation of flavonoids， phenolic acids， alkaloids， lignans and coumarins， while quinones and terpenoids were down-regulated. The differential metabolites mainly included flavonoid glycosides and alkaloids， and these differential metabolites significantly contributed to characterizing the two cultivation patterns. KEGG enrichment analysis revealed significant enrichment in pathways of flavone and flavonol biosynthesis， flavonoid biosynthesis， tyrosine metabolism， and phenylalanine metabolism in epiphytic stone-cultivated D. nobile. ConclusionEpiphytic stone cultivation is beneficial for the accumulation of phenolic acids， flavonoids， and alkaloids in D. nobile， indicating that the "only those that grow on stones has superior quality" documented in the materia medica has certain scientific basis， and the findings also provide a reference for quality evaluation and discrimination research between epiphytic stone and tree cultivated D. nobile.

ObjectiveTo establish the multi-technique characteristic profiles of Alumen by X-ray diffraction（XRD）， Fourier-transform infrared spectroscopy（FTIR） and thermogravimetric-differential thermal analysis（TG-DTA）， and to explore the spectral characteristics for rapid identification of Alumen and its potential adulterant， Ammonium alum. MethodsA total of 27 batches of Alumen samples from 8 production regions were collected for preliminary identification based on visual characteristics. The PDF standard cards of XRD were used to differentiate Alumen from A. alum， and the XRD characteristic profiles of Alumen were established， and then the common peaks were screened. Based on hierarchical clustering analysis（HCA） and orthogonal partial least squares-discriminant analysis（OPLS-DA）， the characteristic information that could be used for identification of Alumen was selected with variable importance in the projection（VIP） value>1. FTIR characteristic profiles of Alumen were established， and key wavenumbers for identification were screened by HCA and OPLS-DA with VIP value>1. Meanwhile， the thermogravimetric differences between Alumen and A. alum were analyzed by TG-DTA， and the thermogravimetric traits that could be used for identification were screened. ResultsAlumen and A. alum could not be effectively distinguished by traits alone. However， by comparing the PDF standard cards of XRD， 15 batches of Alumen and 12 batches of A. alum could be distinguished. In the XRD profiles， 10 characteristic peaks were confirmed， corresponding to diffraction angles of 14.560°， 24.316°， 12.620°， 32.122°， 17.898°， 34.642°， 27.496°， 46.048°， 40.697° and 21.973°. In the FTIR profiles， 4 wavenumber ranges（399.193-403.050， 1 186.010-1 471.420， 1 801.190-2 620.790， 3 612.020-3 997.710 cm^-1） and 12 characteristic wavenumbers（1 428.994， 1 430.922， 1 432.851， 1 434.779， 1 436.708， 1 438.636， 1 440.565， 1 442.493， 1 444.422， 1 446.350， 1 448.279， 1 450.207 cm^-1） were identified. In the TG-DTA profiles， there were characteristic decomposition peaks of ammonium ion and mass reduction features near 555.34 ℃ for A. alum. These characteristics could serve as important criteria for distinguishing the authenticity of Alumen. ConclusionXRD， FTIR and TG-DTA can be used to rapidly detect Alumen and A. alum， and combined with the discriminant features selected through chemometrics， the rapid and accurate identification of Alumen and A. alum can be achieved. The research findings provide new approaches for the rapid identification of Alumen.

ObjectiveTo investigate the processing technology of calcined Haematitum based on the concept of quality by design（QbD） and to assess its health risk. MethodsTaking whole iron content， Fe²⁺ dissolution content and looseness as critical quality attributes（CQAs）， and calcination temperature， calcination time， spreading thickness and particle size as critical process parameters（CPPs） determined by the failure mode and effect analysis（FMEA）， the processing technology of calcined Haematitum was optimized by orthogonal test combined with analytic hierarchy process-criteria importance through intercriteria correlation（AHP-CRITIC） hybrid weighting method. The contents of heavy metals and harmful elements were determined by inductively coupled plasma mass spectrometry， and the health risk assessment was carried out by daily exposure（EXP）， target hazard quotient（THQ） and lifetime cancer risk（LCR）， and the theoretical value of the maximum limit was deduced. ResultsThe optimal processing technology for calcined Haematitum was calcination at 650 ℃， calcination time of 1 h， particle size of 0.2-0.5 cm， spreading thickness of 1 cm， and vinegar quenching for 1 time［Haematitum-vinegar（10：3）］. The contents of 5 heavy metals and harmful elements in 13 batches of calcined Haematitum were all decreased with reductions of up to 5-fold. The cumulative THQ of 2 batches of samples was>1， while the cumulative THQ of all batches of Haematitum was>1. The LCR of As in 1 batches of Haematitum was 1×10^-6-1×10^-4， and the LCR of the rest was<1×10^-6， and the LCRs of calcined Haematitum were all<1×10^-6， indicating that the carcinogenic risk of calcined Haematitum was low， but special attention should still be paid to Haematitum medicinal materials. Preliminary theoretical values of the maximum limits of Cu， As， Cd， Pb and Hg were formulated as 1 014， 25， 17， 27， 7 mg·kg^-1. ConclusionThe optimized processing technology of calcined Haematitum is stable and feasible， and the contents of heavy metals and harmful elements are reduced after processing. Preliminary theoretical values of the maximum limits of Cu， As， Cd， Pb and Hg are formulated to provide a scientific basis for the formulation of standards for the limits of harmful elements in Haematitum.

ObjectiveBased on the concept of quality by design（QbD）， the processing process of calcined Pyritum was optimized， and its X-ray diffraction（XRD） fingerprint was established. MethodsThe safety， effectiveness and quality controllability of calcined Pyritum were taken as the quality profile（QTPP）， the color， hardness， metallic luster， phase composition， the contents of heavy metals and hazardous elements were taken as the critical quality attributes（CQAs）， and the calcination temperature， calcination time， paving thickness and particle size were determined as the critical process parameters（CPPs）. Differential thermal analysis， X-ray diffraction（XRD） and inductively coupled plasma mass spectrometry（ICP-MS） were used to analyze the correlation between the calcination temperature and CQAs of calcined Pyritum. Then， based on the criteria importance through intercriteria correlation（CRITIC）-entropy weight method， the optimal processing process of calcined Pyritum was optimized by orthogonal test. Powder XRD was used to analyze the phase of calcined Pyritum samples processed according to the best process， and the mean and median maps of calcined Pyritum were established by the superposition of geometric topological figures， and similarity evaluation and cluster analysis were carried out. ResultsThe results of single factor experiments showed that the physical phase of Pyritum changed from FeS₂ to Fe₇S₈ during the process of temperature increase， the color gradually deepened from dark yellow， and the contents of heavy metals and harmful elements decreased. The optimized processing process of calcined Pyritum was as follows：calcination temperature at 750 ℃， calcination time of 2.5 h， paving thickness of 3 cm， particle size of 0.8-1.2 cm， vinegar quenching 1 time［Pyritum-vinegar（10∶3）］. After calcination， the internal structure of Pyritum was honeycomb-shaped， which was conducive to the dissolution of active ingredients. XRD fingerprints of 13 batches of calcined Pyritum characterized by 10 common peaks were established. The similarities of the relative peak intensities of the XRD fingerprints of the analyzed samples were>0.96， and it could effectively distinguish the raw products and unqualified products. ConclusionTemperature is the main factor affecting the quality of calcined Pyritum. After processing， the dissolution of the effective components in Pyritum increases， and the contents of heavy metals and harmful substances decrease， reflecting the function of processing to increase efficiency and reduce toxicity. The optimized processing process is stable and feasible， and the established XRD fingerprint can be used as one of the quality control standards of calcined Pyritum.