Tripterygium wilfordii multiglucoside,the primary active constituent of the Chinese materia medica of Tripterygium wilfordii,has anti-inflammatory and immune-regulation properties and is widely used to treat kidney and rheumatic and immunological diseases.However,the potential adverse effects of Tripterygium wilfordii multiglucoside on pediatric gonadal development have limited its clinical application in pediatrics.According to the traditional Chinese medicine theory,the reproductive toxicity of Tripterygium wilfordii is closely associated with deficiency in kidney essence and tian gui disorder.Based on the"kidney essence-tian gui"theory,this study elucidates the transformation of"kidney essence to tian gui"through the qi transformation of"original noumenon to supreme ultimate,"which is synergistically regulated by the accumulation of kidney qi,consolidation of spleen qi,and conveyance and dispersion of liver qi.It is channeled through the interconnected pathways of the thoroughfare channel,conception channel,and governor channel.The physiological process of"kidney essence to tian gui"is damaged by the bitter,cold,and toxicity of Tripterygium wilfordii,leading to kidney asthenia,spleen deficiency,liver depression,and meridian stagnation,causing tian gui dysregulation.Therefore,this study offers traditional Chinese medicine prevention and treatment strategies for pediatric medication safety,including nourishing the kidney essence to replenish the tian gui source,enhancing the middle jiao to strengthen the tian gui guard,regulating liver qi to promote the operation of tian gui,and unblocking the thoroughfare channel,conception channel,and governor channel to ensure the unobstructed pathway of tian gui.

Tripterygium wilfordii multiglucoside,the primary active constituent of the Chinese materia medica of Tripterygium wilfordii,has anti-inflammatory and immune-regulation properties and is widely used to treat kidney and rheumatic and immunological diseases.However,the potential adverse effects of Tripterygium wilfordii multiglucoside on pediatric gonadal development have limited its clinical application in pediatrics.According to the traditional Chinese medicine theory,the reproductive toxicity of Tripterygium wilfordii is closely associated with deficiency in kidney essence and tian gui disorder.Based on the"kidney essence-tian gui"theory,this study elucidates the transformation of"kidney essence to tian gui"through the qi transformation of"original noumenon to supreme ultimate,"which is synergistically regulated by the accumulation of kidney qi,consolidation of spleen qi,and conveyance and dispersion of liver qi.It is channeled through the interconnected pathways of the thoroughfare channel,conception channel,and governor channel.The physiological process of"kidney essence to tian gui"is damaged by the bitter,cold,and toxicity of Tripterygium wilfordii,leading to kidney asthenia,spleen deficiency,liver depression,and meridian stagnation,causing tian gui dysregulation.Therefore,this study offers traditional Chinese medicine prevention and treatment strategies for pediatric medication safety,including nourishing the kidney essence to replenish the tian gui source,enhancing the middle jiao to strengthen the tian gui guard,regulating liver qi to promote the operation of tian gui,and unblocking the thoroughfare channel,conception channel,and governor channel to ensure the unobstructed pathway of tian gui.

Objective To investigate the clinical value of left ventricular global longitudinal strain (LVGLS) combined with the global register of acute coronary events (GRACE) score in predicting coronary microcirculation disorder (CMD) in patients with acute myocardial infarction (AMI) after emergency percutaneous coronary intervention (PCI). Methods A total of 90 patients with AMI were selected as the study objects (10 cases were lost in follow-up, 4 cases were screened for poor image quality), and 76 cases were finally included. Left ventricular myocardial contrast echocardiography (MCE) was performed in patients at 48 h after surgery. Patients were divided into non-CMD group (n=53) and CMD group (n=23) according to coronary microcirculation perfusion. Clinical data and echocardiographic data of the two groups were analyzed and compared. Multivariate Logistic regression analysis was used to screen the influencing factors of CMD occurrence, and receiver operating characteristic (ROC) curve was drawn to analyze its clinical predictive value. Results Of the 76 patients, 23(30.3%) cases had CMD. LVGLS and GRACE scores in the CMD group were higher than those in the non-CMD group, and the differences were statistically significant (P < 0.05). Multivariate Logistic regression analysis showed that LVGLS and GRACE score were independent predictors of CMD in AMI patients after emergency PCI. The area under the curve of CMD predicted by LVGLS was 0.858 (95%CI, 0.769 to 0.948). LVGLS combined with GRACE predicted that the area under the curve for CMD was 0.891 (95%CI, 0.815 to 0.967). Conclusion LVGLS is an independent predictor for early assessment of CMD occurrence in AMI patients after emergency PCI, and its combination with GRACE score can improve the accuracy of predicting CMD occurrence.