Osteoarthritis （OA） and stroke are common clinical diseases that reduce patients' quality of life and place a burden on families and society. Ruyi Zhenbaowan， a classic prescription in Tibetan medicine， have the functions of clearing heat， awakening the brain and opening orifices， relaxing tendons and promoting meridian circulation， and eliminating yellow water. Clinically， they are used to treat osteoarthritis， post-stroke sequelae， neuropathic pain， and other related conditions. Modern pharmacological studies have demonstrated their anti-inflammatory， analgesic， and nerve-repairing effects. However， current research remains insufficient regarding the appropriate indications， timing， and efficacy of this medicine in treating relevant diseases. To enhance clinicians' understanding of this medicine and promote its standardized and rational clinical use， a panel of national experts， including clinical specialists， Tibetan medicine practitioners， pharmacologists， and methodologists， formulated this consensus based on clinical experience and evidence-based practice. The Cochrane systematic review framework， the Grading of Recommendations Assessment， Development and Evaluation （GRADE） system， and the nominal group method were employed to generate seven graded recommendations and 19 consensus-based suggestions. These recommendations clearly define the key points in the clinical application of Ruyi Zhenbaowan， including therapeutic indications， dosage and administration， treatment duration， and medication safety. The consensus specifically addresses the clinical efficacy， appropriate timing of administration， dosage strategies， treatment cycles， and combination medication strategies for treating osteoarthritis and stroke and provides an overview of safety considerations. The aim is to provide standardized guidance for hospitals and healthcare institutions nationwide to ensure the rational application of Ruyi Zhenbaowan in the treatment of osteoarthritis and stroke， reduce medication-related risks， and further leverage its clinical advantages. This consensus has been approved and issued by the China Association of Chinese Medicine， with the standard number GS/CACM 369-2024.

Objective To explore characteristics of time-domain and time-frequency of task-related electroencephalogram(EEG)in patients with post-stroke aphasia(PSA).Methods From January,2018 to December,2021,18 PSA patients(PSA group)were recruited from Dongzhimen Hospi-tal,Beijing University of Chinese Medicine,and nine healthy subjects(control group)were recruited with matched gender,age and education level.EEG data based on the Chinese word-picture matching task were col-lected,and the average amplitude of N400 and event-related synchronization(ERS)/desynchronization(ERD)were analyzed.The PSA group was assessed with Chinese Rehabilitation Research Center Aphasia Examination(CRRCAE).Results The effect of N400 was significant on left frontal,central frontal,right frontal,left central and central areas.The average amplitude of N400 was higher on the frontal area in PSA group than in the control group,and it was low-er on right temporal-parietal area.For word-picture mismatching,average amplitude of N400 at FPZ was moder-ately correlated with auditory comprehension(r=0.483,P<0.05),the average amplitude of N400 at T8 was moderately correlated with repetition(r=0.584,P<0.05)and reading aloud(r=0.556,P<0.05),and the aver-age amplitude of N400 at P6 was moderately correlated with speaking(r=0.476,P<0.05)and reading(r=0.502,P<0.05).For word-picture matching,the average amplitude of N400 at P7 was moderately negatively cor-related with calculation(r=-0.481,P<0.05).Compared with the control group,the energy decreased in θ and αfrequency bands with absence of ERS in PSA group,and it increased in β frequency band with absence of ERD.Conclusion The activities of Chinese word-picture matching task-related EEG have been inhibited on right temporal-pa-rietal area for PSA patients,and it compensatively increases on frontal area,while the energy decreases in θ and αfrequency bands with ERS deficiency,and increases in β frequency band with ERD deficiency.

Objective To analyze the characteristics of brain functional networks in patients with post-stroke aphasia(PSA)during a Chinese word-picture matching task.Methods A total of 18 PSA patients in Dongzhimen Hospital from January,2018 to December,2021 were enrolled as PSA group,and nine healthy controls matched for sex,age and education were included as the control group.The Chinese Rehabilitation Research Center Aphasia Examination(CRRCAE)and task-state electroencephalogram(EEG)data based on a Chinese word-picture matching paradigm were collected.Source-space reconstruction was applied to EEG signals to construct functional connectivity matrices.Graph-theoretical analysis was used to com-pute global network properties,and network-based statistics were used to identify subnetwork differences be-tween groups.Correlations between global network properties and CRRCAE subscales were further analyzed.Results The global properties of each frequency band were higher in the control group(unmatched)than in PSA group and the control group(matched)(P<0.01).Subnetworks connections enhanced in the alpha band in the frontal,temporal,parietal,occipital lobes and limbic system(23 nodes,31 edges,P<0.05),and weakened connections in the frontal,temporal,limbic system and basal ganglia(20 nodes,26 edges,P<0.01)in PSA group;in the beta band,subnetwork connections enhanced in the frontal,temporal lobes,basal ganglia and limbic system(15 nodes,23 edges,P<0.01);in the theta band,subnetwork connections weakened in the left frontal and temporal lobes(10 nodes,11 edges,P<0.05),and enhanced in the right frontal and temporal lobes(7 nodes,7 edges,P<0.05).Under the matched condition,the global properties of the alpha and beta bands in PSA group were positive-ly correlated with reading(r=0.511 to 0.650,all P<0.05),and the local efficiency and average clustering coeffi-cient of the theta band were negatively correlated with repetition(r=-0.500 to-0.505,all P<0.05);under the unmatched condition,the local efficiency and average clustering coefficient of the alpha and beta bands in PSA group were positively correlated with reading(r=0.522 to 0.642,all P<0.05),and the global efficiency and lo-cal efficiency of the alpha band were positively correlated with auditory comprehension(r=0.486 to 0.496,all P<0.05).The comparison between the task state and the resting state further revealed that compensatory connec-tion enhanced in the alpha band in the frontal lobe and limbic system(6 nodes,5 edges,P<0.05)and in the beta band in the frontal,temporal,parietal,occipital lobes and limbic system(38 nodes,52 edges,P<0.01)in PSA pa-tients.Conclusion The core network damage characteristics of PSA patients are abnormally decreased global properties across multiple frequency bands and frequency-specific abnormal network reorganization,suggesting the overall brain network efficiency decline coexists with local compensation.This provides an objective basis for the neuroelec-trophysiological evaluation and targeted intervention of PSA.

Mild cognitive disorder is a condition that lies between normal age-related decline and dementia,primarily characterized by a decline in cognitive functions such as memory and executive function.In traditional Chinese medicine,it falls under the categories of"amnesia"and"consumptive disease,"closely linked to dysfunction of the"spirit."The principle that"yang qi nourishes the spirit when refined"originates from the Inner Canon of Yellow Emperor.It explains how the abundance and regulated circulation of yang qi influence the proper functioning of the human spirit.Yang qi generates,nourishes,and protects the spirit's functions,a process dependent on the unimpeded flow through the sanjiao and the xuanfu.Yang qi originates from kidney yang,circulates through sanjiao,nourishes the upper,middle,and lower zang-fu organs,generates vital substances,and regulates the opening and closing of xuanfu.This enables it to generate the spirit,nourish vital substances,and defend against external pathogens.These three elements coordinate and interact to facilitate the operation of spirit.With aging,excessive consumption of rich and greasy foods,or emotional distress,yang qi gradually becomes deficient.This impairs the circulation of qi and fluids within the"sanjiao-xuanfu,"hindering the transformation of qi,blood,and essence.Consequently,phlegm-dampness,static blood,and turbid toxins accumulate internally,disturbing the clear orifices.Among these factors,kidney yang deficiency impairs sanjiao qi transformation and deprives the xuanfu of nourishment,forming the foundational pathogenesis for mild cognitive disorder.Deficiency-induced stagnation,coupled with phlegm-stasis mutual entanglement,ascends to disturb the xuanfu,constituting a key factor in cognitive disorder onset.Clinically,treatment must adhere to the core pathogenesis of yang deficiency,adopting the therapeutic principle of"regulating the sanjiao and opening xuanfu."Restoring xuanfu patency and sanjiao function harmonizes qi and blood throughout the body,thereby restoring mental consciousness.This paper explores the relationship between yang qi and the spirit,examining the connections between yang qi,sanjiao,and xuanfu.It aims to provide new insights and approaches for the clinical diagnosis and treatment of mild cognitive disorder.

Objective To analyze the respective abnormal brain regions and commonly altered brain regions of spontaneous brain ac-tivity in post-stroke aphasia(PSA)and post-stroke depression(PSD),and to explore the potential pathological mechanisms underlying single disease and comorbidity.Methods Literatures were retrieved from PubMed,Embase,Web of Science,Cochrane Library,CNKI,Wanfang data,VIP and SinoMed,from establishment to April 19th,2025.Resting-state functional magnetic resonance imaging(fMRI)studies were included if they focused on patients with PSA or PSD,with healthy controls(HC)serving as control group,and amplitude of low-frequency fluctuation(ALFF),fractional amplitude of low-frequency fluctu-ation(fALFF)and regional homogeneity(ReHo)were adopted as outcome indicator.Data regarding differential brain regions were extracted from the original studies,and a neuroimaging meta-analysis was conducted using SDM-PSI V6.23 beta.Results A total of 17 articles on PSA(339 patients and 351 HC)and five articles on PSD(102 patients and 149 HC)were included.The spontaneous brain activity in the left cerebellar area 9,right middle temporal gyrus and right insula was significantly higher in PSA patients than in HC(P<0.05),while activity in the right cerebellar area 6,left medial superior frontal gyrus(SFGmed),left middle frontal gyrus and right anterior cingulate/paracingulate gyrus was lower(P<0.05).For PSD,spontaneous brain activity was elevated in the right cuneus gyrus and right superior occipital gyrus compared to HC(P<0.05),while it was reduced in the left SFGmed and left inferior pa-rietal lobe(P<0.05).Additionally,spontaneous brain activity in the left medial superior frontal gyrus was lower in both diseases compared to HC(P<0.05).Conclusion The pathological mechanism of PSA may involve a pattern of right-sided compensatory hyperfunction and left-sided inhibitory damage within the language-related network,accompanied by cross-hemispheric synergistic activity of the cerebellum.The occurrence of PSD may be attributed to hyperactivity of the right occipital net-work,and functional inhibition involving the left inferior parietal lobe.The inhibition observed in the left SFG-med(MNI coordinates x=0,y=26,z=44)likely represents the language-emotion integration hub,mediating the co-occurrence of PSA and PSD.

Mild cognitive disorder is a condition that lies between normal age-related decline and dementia,primarily characterized by a decline in cognitive functions such as memory and executive function.In traditional Chinese medicine,it falls under the categories of"amnesia"and"consumptive disease,"closely linked to dysfunction of the"spirit."The principle that"yang qi nourishes the spirit when refined"originates from the Inner Canon of Yellow Emperor.It explains how the abundance and regulated circulation of yang qi influence the proper functioning of the human spirit.Yang qi generates,nourishes,and protects the spirit's functions,a process dependent on the unimpeded flow through the sanjiao and the xuanfu.Yang qi originates from kidney yang,circulates through sanjiao,nourishes the upper,middle,and lower zang-fu organs,generates vital substances,and regulates the opening and closing of xuanfu.This enables it to generate the spirit,nourish vital substances,and defend against external pathogens.These three elements coordinate and interact to facilitate the operation of spirit.With aging,excessive consumption of rich and greasy foods,or emotional distress,yang qi gradually becomes deficient.This impairs the circulation of qi and fluids within the"sanjiao-xuanfu,"hindering the transformation of qi,blood,and essence.Consequently,phlegm-dampness,static blood,and turbid toxins accumulate internally,disturbing the clear orifices.Among these factors,kidney yang deficiency impairs sanjiao qi transformation and deprives the xuanfu of nourishment,forming the foundational pathogenesis for mild cognitive disorder.Deficiency-induced stagnation,coupled with phlegm-stasis mutual entanglement,ascends to disturb the xuanfu,constituting a key factor in cognitive disorder onset.Clinically,treatment must adhere to the core pathogenesis of yang deficiency,adopting the therapeutic principle of"regulating the sanjiao and opening xuanfu."Restoring xuanfu patency and sanjiao function harmonizes qi and blood throughout the body,thereby restoring mental consciousness.This paper explores the relationship between yang qi and the spirit,examining the connections between yang qi,sanjiao,and xuanfu.It aims to provide new insights and approaches for the clinical diagnosis and treatment of mild cognitive disorder.

Objective To analyze the respective abnormal brain regions and commonly altered brain regions of spontaneous brain ac-tivity in post-stroke aphasia(PSA)and post-stroke depression(PSD),and to explore the potential pathological mechanisms underlying single disease and comorbidity.Methods Literatures were retrieved from PubMed,Embase,Web of Science,Cochrane Library,CNKI,Wanfang data,VIP and SinoMed,from establishment to April 19th,2025.Resting-state functional magnetic resonance imaging(fMRI)studies were included if they focused on patients with PSA or PSD,with healthy controls(HC)serving as control group,and amplitude of low-frequency fluctuation(ALFF),fractional amplitude of low-frequency fluctu-ation(fALFF)and regional homogeneity(ReHo)were adopted as outcome indicator.Data regarding differential brain regions were extracted from the original studies,and a neuroimaging meta-analysis was conducted using SDM-PSI V6.23 beta.Results A total of 17 articles on PSA(339 patients and 351 HC)and five articles on PSD(102 patients and 149 HC)were included.The spontaneous brain activity in the left cerebellar area 9,right middle temporal gyrus and right insula was significantly higher in PSA patients than in HC(P<0.05),while activity in the right cerebellar area 6,left medial superior frontal gyrus(SFGmed),left middle frontal gyrus and right anterior cingulate/paracingulate gyrus was lower(P<0.05).For PSD,spontaneous brain activity was elevated in the right cuneus gyrus and right superior occipital gyrus compared to HC(P<0.05),while it was reduced in the left SFGmed and left inferior pa-rietal lobe(P<0.05).Additionally,spontaneous brain activity in the left medial superior frontal gyrus was lower in both diseases compared to HC(P<0.05).Conclusion The pathological mechanism of PSA may involve a pattern of right-sided compensatory hyperfunction and left-sided inhibitory damage within the language-related network,accompanied by cross-hemispheric synergistic activity of the cerebellum.The occurrence of PSD may be attributed to hyperactivity of the right occipital net-work,and functional inhibition involving the left inferior parietal lobe.The inhibition observed in the left SFG-med(MNI coordinates x=0,y=26,z=44)likely represents the language-emotion integration hub,mediating the co-occurrence of PSA and PSD.

Objective To explore characteristics of time-domain and time-frequency of task-related electroencephalogram(EEG)in patients with post-stroke aphasia(PSA).Methods From January,2018 to December,2021,18 PSA patients(PSA group)were recruited from Dongzhimen Hospi-tal,Beijing University of Chinese Medicine,and nine healthy subjects(control group)were recruited with matched gender,age and education level.EEG data based on the Chinese word-picture matching task were col-lected,and the average amplitude of N400 and event-related synchronization(ERS)/desynchronization(ERD)were analyzed.The PSA group was assessed with Chinese Rehabilitation Research Center Aphasia Examination(CRRCAE).Results The effect of N400 was significant on left frontal,central frontal,right frontal,left central and central areas.The average amplitude of N400 was higher on the frontal area in PSA group than in the control group,and it was low-er on right temporal-parietal area.For word-picture mismatching,average amplitude of N400 at FPZ was moder-ately correlated with auditory comprehension(r=0.483,P<0.05),the average amplitude of N400 at T8 was moderately correlated with repetition(r=0.584,P<0.05)and reading aloud(r=0.556,P<0.05),and the aver-age amplitude of N400 at P6 was moderately correlated with speaking(r=0.476,P<0.05)and reading(r=0.502,P<0.05).For word-picture matching,the average amplitude of N400 at P7 was moderately negatively cor-related with calculation(r=-0.481,P<0.05).Compared with the control group,the energy decreased in θ and αfrequency bands with absence of ERS in PSA group,and it increased in β frequency band with absence of ERD.Conclusion The activities of Chinese word-picture matching task-related EEG have been inhibited on right temporal-pa-rietal area for PSA patients,and it compensatively increases on frontal area,while the energy decreases in θ and αfrequency bands with ERS deficiency,and increases in β frequency band with ERD deficiency.

Objective To analyze the characteristics of brain functional networks in patients with post-stroke aphasia(PSA)during a Chinese word-picture matching task.Methods A total of 18 PSA patients in Dongzhimen Hospital from January,2018 to December,2021 were enrolled as PSA group,and nine healthy controls matched for sex,age and education were included as the control group.The Chinese Rehabilitation Research Center Aphasia Examination(CRRCAE)and task-state electroencephalogram(EEG)data based on a Chinese word-picture matching paradigm were collected.Source-space reconstruction was applied to EEG signals to construct functional connectivity matrices.Graph-theoretical analysis was used to com-pute global network properties,and network-based statistics were used to identify subnetwork differences be-tween groups.Correlations between global network properties and CRRCAE subscales were further analyzed.Results The global properties of each frequency band were higher in the control group(unmatched)than in PSA group and the control group(matched)(P<0.01).Subnetworks connections enhanced in the alpha band in the frontal,temporal,parietal,occipital lobes and limbic system(23 nodes,31 edges,P<0.05),and weakened connections in the frontal,temporal,limbic system and basal ganglia(20 nodes,26 edges,P<0.01)in PSA group;in the beta band,subnetwork connections enhanced in the frontal,temporal lobes,basal ganglia and limbic system(15 nodes,23 edges,P<0.01);in the theta band,subnetwork connections weakened in the left frontal and temporal lobes(10 nodes,11 edges,P<0.05),and enhanced in the right frontal and temporal lobes(7 nodes,7 edges,P<0.05).Under the matched condition,the global properties of the alpha and beta bands in PSA group were positive-ly correlated with reading(r=0.511 to 0.650,all P<0.05),and the local efficiency and average clustering coeffi-cient of the theta band were negatively correlated with repetition(r=-0.500 to-0.505,all P<0.05);under the unmatched condition,the local efficiency and average clustering coefficient of the alpha and beta bands in PSA group were positively correlated with reading(r=0.522 to 0.642,all P<0.05),and the global efficiency and lo-cal efficiency of the alpha band were positively correlated with auditory comprehension(r=0.486 to 0.496,all P<0.05).The comparison between the task state and the resting state further revealed that compensatory connec-tion enhanced in the alpha band in the frontal lobe and limbic system(6 nodes,5 edges,P<0.05)and in the beta band in the frontal,temporal,parietal,occipital lobes and limbic system(38 nodes,52 edges,P<0.01)in PSA pa-tients.Conclusion The core network damage characteristics of PSA patients are abnormally decreased global properties across multiple frequency bands and frequency-specific abnormal network reorganization,suggesting the overall brain network efficiency decline coexists with local compensation.This provides an objective basis for the neuroelec-trophysiological evaluation and targeted intervention of PSA.

Objective To explore the research path to construct knowledge representation,knowledge analysis,knowledge presentation and knowledge reasoning of ancient stroke medical cases based on knowledge element theory and knowledge graph.Methods A multi-layered knowledge representation system of medical cases was constructed,which included"knowledge body-knowledge element-semantics and semantic relationships",and knowledge element indexing system was used to parse the text into structured data.Combined with the attribute graph model for graph design,Neo4j was used to build a knowledge graph,and visual presentation and analysis were performed.Results A total of 517 medical cases from 86 ancient books were included,forming a knowledge representation system including 2 types of knowledge bodies,19 types of knowledge elements,27 types of semantics and 9 types of semantic relationships.The original knowledge graph had 19 node types(8 virtual nodes)and 15 relationship types,totaling 6363 nodes and 14697 relationships;the integrated knowledge graph had 11 node types and 11 relationship types,totaling 1229 nodes and 11456 relationships.Hierarchical subgraph visualization and node connectivity analysis methods completed implicit knowledge exploration and reasoning.Conclusion The knowledge representation system can guide the structured expression and semantic level analysis of ancient text,and provide systematic data support for the construction of knowledge graphs.The original knowledge graph of ancient and modern dual-mode knowledge graph focuses on the visual presentation of complex diagnosis and treatment ideas,which is conducive to improving the efficiency of medical cases review;integrating the knowledge graph to build a scale-free network and using group cases as the object can realize the tacit knowledge of stroke from a macro dimension excavation.