[Objective]To explore the effects of ZHANG's empirical formula directional drug delivery combined with auricular acupressure in treatment for postoperative pain in hand trauma due to Qi stagnation and blood stasis.[Methods]A total of 152 postoperative patients with hand trauma with Qi stagnation and blood stasis who were hospitalized in the Department of Hand and Foot Surgery at Hangzhou Fuyang Hospital of Orthopedics of Traditional Chinese Medicine from September 2023 to January 2024 were selected.The patients were randomly divided into control group,directed group,acupressure group and combined group,with 38 cases in each group.The control group received routine nursing care;the directed group received ZHANG's empirical formula for directed transdermal medication in addition to the regular care;the acupressure group received auricular acupressure treatment in addition to the regular care;and the combined group received both ZHANG's empirical formula for directed transdermal medication and auricular acupressure treatment in addition to the regular care.The numerical rating scale(NRS)pain scores,peripheral blood circulation levels of the affected limb at different time points before and after intervention,clinical efficacy,cumulative use of analgesics within 72 hours post-surgery and the occurrence of adverse reactions were compared among the four groups.[Results]Thirty minutes after intervention,the NRS scores of both combined group and acupressure group were lower than those of the other groups(P<0.05).From 12 to 72 hours after intervention,the NRS scores of combined group remained significantly lower than those of the other groups(P<0.05).The effective rates were 80.6%in control group,85.7%in directed group,88.9%in acupressure group and 91.4%in combined group,with statistically significant differences among the four groups(P<0.05).After intervention,statistically significant differences were observed in peripheral blood circulation of the affected limbs among the four groups(P<0.05),and combined group demonstrated superior outcomes compared with the others.Additionally,significant differences were found in cumulative analgesic consumption within 72 hours of post-surgery(P<0.05),where the control group showed the highest usage while the acupressure group and combined group exhibited the lowest.No adverse reactions were observed in any enrolled patients.[Conclusion]ZHANG's empirical formula directional drug delivery combined with auricular acupressure can effectively alleviate post-operative pain due to Qi stagnation and blood stasis in hand trauma,reduce the cumulative analgesic consumption within 72 hours post-surgery,and improve peripheral blood circulation in the affected limb,making it worthy of further promotion and application in clinical practice.

[Objective]To explore the issues in the"14th Five-Year Plan"textbook Formulology and propose corrective suggestions,aiming to deepen students'understanding of formulology knowledge and contribute to the cultivation of high-quality and versatile talents in traditional Chinese medicine(TCM).[Methods]Through consulting the ancient books and literatures,the source research of the prescriptions involved in the teaching materials was carried out.Combined with clinical practice and TCM theory,the indications and functions of the formulas were analyzed to ensure the descriptions accurate and clinically significant.The explanation of formula composition was deepened from the perspectives of compatibility principles and drug interactions.The accuracy and logic of formula mnemonics(Fangge)were optimized.Ideological and political elements were skillfully integrated to cultivate students'medical ethics,professional and social responsibility.Suggestions were also made to address improper layout issues.[Results]The textbook was rich in content and systematic in structure,but minor issues remain in areas such as formula origins,indications and functions,formula explanation,formula mnemonics,ideological integration and layout.Through literature review,the origins of formulas such as Xijiao Dihuang Decoction,Sijunzi Decoction and Ganlu Xiaodu Pill were researched deeply,and the source information was corrected.The indications and functions of formulas like Houpo Wenzhong Decoction,Wumei Pill,and Suzi Jiangqi Decoction were reanalyzed,enhancing their clinical relevance.The new explanation of Daochi Powder,Shenqi Pill,Zhengan Xifeng Decoction,Sanren Decoction,Lianpo Decoction and Dahuang Mudan Decoction was introduced to enhance students'understanding of the principles of prescription compatibility and clinical application.The mnemonics for formulas like Puji Xiaodu Drink and Sanzi Yangqin Decoction were revised for greater accuracy and logic.Innovative ways of integrating ideological and political elements were adopted,which complemented formulary knowledge and promote the improvement of students'comprehensive quality.For layout issues,such as the misplaced"Application"section of Qingqi Huatan Pill,a comprehensive proofreading was recommended to ensure proper placement and coherence of all sections.[Conclusion]By exploring specific issues in the Formulology textbook under the"14th Five-Year Plan"—including formula origins,indications and functions,formula explanation,formula mnemonics,ideological and political education integration,and layout—and proposing targeted revisions,this initiative enhances the textbook's academic rigor and practicality.It provides high-quality educational resources for TCM education,thereby fostering the cultivation of well-rounded TCM professionals with solid theoretical foundations,specialized skills and comprehensive quality.

[Objective]To explore the mechanism of breast cancer occurrence,development and metastasis from the perspective of Qi-blood-colleteral transmission.[Methods]Starting from the classical Chinese medical texts and the etiology and pathogenesis of breast cancer,it analyses and elaborates the correlation between the metastasis of breast cancer and the transmission of Qi,blood and collaterals,and systematically analyses the treatment of breast cancer from the perspective of Qi,blood and collaterals,citing a clinical case to support it.[Results]Integrating antiquarian analysis,traditional meridian content and modern scholarly evidence-based surveys,it is found that breast cancer is located in the liver,Qi depression is the core factor of breast cancer,which produces toxin,caused by Qi and blood,mixed with phlegm and blood stasis,and finally reaches the deepest place of the body-collaterals.Therefore,for the treatment of breast cancer,depending on the stage of the disease,the diagnosis and treatment can be made based on the diagnosis and treatment.At the initial stage,the Qi should be adjusted to resolve the toxicity of depression,the blood should be dispersed to remove the toxicity of turbidity,and then gradually penetrate into the channels to remove the toxicity of stasis,and the medication should also be based on the three steps of Qi,blood,channels,and the treatment should be from shallow to deep.The syndrome differentiation of the attached case belonged to Qi deficiency and blood stasis,toxin and blood stasis blocking collaterals,with the method of supplementing Qi and activating blood circulation,detoxifying and removing blood stasis,searching collaterals and removing pathogens,finally the case achieved good effect and improved the lifequality.[Conclusion]The pathogenesis of breast cancer is preceded by Qi stagnation,the poison starts from Qi,enters the blood from Qi,the blood and the collaterals,and the collaterals'deficiency and toxicity are the important etiological mechanism for the emergence,development and metastasis of breast cancer.The treatment of breast cancer puts emphasis on clearing and resolving the toxicity of Qi,dispersing the turbid toxicity of blood,and searching and eliminating the toxicity of the stasis in the channel,which can provide new ideas for the treatment of breast cancer with traditional Chinese medicine.

[Objective]To explore data on traditional Chinese medicine formulas for the treatment of rheumatoid arthritis(RA),analyze medication patterns and provide ideas for the clinical staging treatment of RA.[Methods]Using the China Patent Publication Platform of the State Intellectual Property Office,the patent data of traditional Chinese medicine compounds for RA published from the establishment date of the database to November 2023 were systematically collected,and the frequency of drug application,nature and taste,and efficacy of the included traditional Chinese medicine formulas were analyzed.Correlation analysis,cluster analysis and latent structure analysis were used to explore the core prescriptions of traditional Chinese medicine in the treatment of different stages of RA.[Results]Two hundred and ninety-nine traditional Chinese medicine formulas were included,including 537 traditional Chinese medicines,with a total frequency of 3 739 times.The nature and flavor of the medicines are primarily categorized as warm,neutral,and cold.The channel tropism of the medicines is generally classified into the liver,spleen,kidney,and heart meridians.High-frequency traditional Chinese medicine can be classified into six primary categories and nine secondary subcategories.The high-frequency drug combinations used in association analysis included"Huangqi → Guizhi"and"Ruxiang → Myrrh".The cluster analysis of 58 high-frequency traditional Chinese medicines with frequency≥20 times was carried out,and the results showed that 6 clusters were formed.Among them,wind and dampness obstruction and deficiency of Qi and blood belonged to the pre-RA state,damp-heat obstruction belonged to the acute phase,cold dampness obstruction belonged to the chronic phase,phlegm stasis obstruction and liver and kidney deficiency belonged to the remission phase.[Conclusion]Traditional Chinese medicine formulas therapy for RA often starts from the three major causes of deficiency,evil and blood stasis,by using drugs that dispel wind and dampness,promote blood circulation and remove blood stasis,and nourish deficiency.It follows the principle of"treating the same disease differently"and emphasizes staged treatment,Which providing a certain reference for clinical treatment.

[Objective]To establish the high performance liquid chromatography(HPLC)characteristic chromatogram and multi-index contents determination method of Yunvjian,clarify the quantitative and qualitative transfer law from decoction pieces-references sample-granules.[Methods]The HPLC characteristic chromatogram of Yunvjian references sample and granules was established using Thermoscientific Syncronis aQ C18 chromatographic column(150 mm×4.6 mm,5 μm),acetonitrile(A)-0.1%phosphoric acid water(B)as mobile phase,detection wavelength as 240 nm,adopting gradient elution.Five index components,including rehmannioside D,neomangiferin,mangiferin,β-ecdysterone and acteoside,were selected to establish an HPLC method with detection wavelengths of 203 nm and 240 nm.The content of the index components and the transfer rate in different samples were calculated.[Results]The similarity of the HPLC characteristic chromatograms of 10 batches of the Yunvjian references samples and 3 batches of granules is all greater than 0.950.A total of 12 common peaks are attributed,and 6 of them are identified.All the 12 common peaks in the reference samples are stably transferred to the granules.The 5 index components showed excellent linearity(r≥0.9999)within their respective concentration ranges,and the average sample recovery rate is 99.16%～102.26%.The methodological investigation of the content determination meets the relevant requirements.During the process of preparing the Yunvjian from decoction pieces to granules,the transfer rates of the 5 components are 46.31%～52.30%,31.89%～41.46%,28.65%～33.85%,41.28%～48.59%and 49.59%～75.20%,respectively,all within the range of the average value±30%.[Conclusion]The HPLC characteristic chromatogram and content determination method established are accurate and reliable,and the quantitative and qualitative transfer law of decoction pieces-granules is relatively stable,which can provide an objective basis for the preparation development and quality control of Yunvjian.

[Objective]To investigate the mechanism of Wumen Gumibao Decoction in treating senile osteoporosis(SOP)of senescence accelerated mouse prone 6(SAMP6)mice.[Methods]SAM-resistant 1(SAMR1)mice was set as control group,SAMP6 mice were randomly divided into model group(SAMP6),Chinese medicine low dose group(SAMP6+Wumen Gumibao Decoction 7.5 g·kg-1)and Chinese medicine high dose group(SAMP6+Wumen Gumibao Decoction 15.0 g·kg-1),with 10 mice in each group.Mice in control group and model group were gavaged with equal volume of 0.9%sodium chloride solution,and the two groups of Chinese medicine were given Wumen Gumibao Decoction,once a day for 12 weeks.The changes of body mass were observed during the experiment.At the end of the experiment,hematoxylin-eosin(HE)staining was used to observe the pathological changes of the femur in mice.Micro computed tomography(Micro-CT)was used to observe the microstructure and parameters of the femur.The serum levels of calcium(Ca),phosphorus(P)was detected with biochemical method,and the serum levels of calcitonin(CT),procollagen type Ⅰ N-terminal propeptide(PⅠNP),bone γ-carboxyglutamic acid-containing protein(BGP),alkaline phosphatase(ALP),tartrate resistant acid phosphatase(TRACP),procollagen type Ⅰ C-terminal propeptide(PⅠCP),insulin-like growth factor-1(IGF-1),parathyroid hormone(PTH)were detected by enzyme-linked immunosorbent assay(ELISA).Immunohistochemical(IHC)staining was used to detect Wnt3α,phosphorylated-b-catenin(p-b-catenin),osteoprotegerin(OPG),receptor activator of nuclear factor-κB(RANK)and ligand of receptor activator of NF-κB(RANKL),secretory protein Dickkopf-1(DKK1)and glycogen synthase kinase 3b(GSK3b).[Results]Compared with control group,the cortical bone texture,direction and arrangement of bone cells in bone tissue of model group were disordered,and the trabecular structure was loose,showing a state of osteoporosis,bone microstructure parameters bone mineral density,bone volume/tissue volume ratio,trabecular number,trabecular thickness decreased significantly(P<0.05)and trabecular separation increased significantly(P<0.05).The serum levels of Ca,BGP,PⅠNP,CT and ALP were significantly decreased(P<0.05),and P,TRACP,PⅠCP and IGF-1 were significantly increased(P<0.05).In addition,the expression of Wnt3a as significantly down-regulated(P<0.05),and the expression of p-β-catenin,OPG,RANK,RANKL,DKK1 and GSK3β was significantly up-regulated(P<0.05).Compared with model group,Chinese medicine low and high dose groups can improve the pathological morphology of the femur to varying degrees,increase the number of bone trabeculae and reduced the fracture of bone trabeculae,and improved the related parameters of bone microstructure(P<0.05).The levels of serum Ca,CT,BGP,PⅠNP and ALP were increased(P<0.05),and the levels of P,TRACP,PⅠCP and IGF-1 were decreased(P<0.05),and PTH was increased(P<0.05).At the same time,it could up-regulate the expression of Wnt3α protein in the femur(P<0.05)and down-regulate the expression of p-β-catenin,OPG,RANK,RANKL,DKK1 and GSK3b protein(P<0.05).[Conclusion]Wumen Gumibao Decoction has the effect of significantly improving osteoporosis in SAMP6 mice,and its mechanism may be related to its regulation of Wnt/β-catenin and OPG/RANK/RANKL signaling pathways.

[Objective]To explore new pathways for cultural education in Chinese medicine institutions,delve deeply into the educational elements embedded in traditional Chinese medicine(TCM)culture,and establish a new educational system that gives full play to the advantages and characteristics of TCM culture.[Methods]Through the status analysis on TCM culture-based education in Chinese medicine institutions,based on the exploration of the main bodies,content,forms and effectiveness of education,concrete ideas and practical pathways for reforming the curriculum system and the practice system were advanced,and the achievements of student cultivation were listed as evidence.[Results]The practice of cultivating students through TCM culture in Chinese medicine institutions was confronted with multiple issues,including the need to strengthen collaborative education,the need to integrate education and teaching content,and the necessity to enhance the talent-nurturing mechanism through campus culture.Zhejiang Chinese Medical University has fostered a campus culture rich in TCM characteristics by establishing a curriculum and practical system that merges TCM culture into the five dimensions of education and constructs a comprehensive and interconnected support system.The social recognition won by the students at this university has fully proved the effectiveness in enhancing students'comprehensive qualities and fostering cultural confidence.[Conclusion]To fulfill the missions of moral and cultural education,Chinese medical universities must establish a new TCM culture-based educational system,with seamless cooperation of all departments throughout the entire educational process and the integration of the five dimensions of education.Through the aforementioned practice,Zhejiang Chinese Medical University has effectively addressed issues such as the lack of a collaborative education among all departments and how TCM culture can promote the"integration of the five dimensions of education",providing a paradigm for Chinese medicine institutions to carry out TCM culture-based education.

[Objective]To explore the pathogenesis of prostate cancer and the prevention and treatment with moxibustion based on the theory of"excessive fire dispersing Qi,and mild fire generating Qi".[Methods]Based on the original text of The Inner Canon of Huangdi,the theoretical connotation of"excessive fire dispersing Qi,and mild fire generating Qi",and its relationship with the pathogenesis of prostate cancer and the reinforcing and reducing of moxibustion were investigated.The application of moxibustion reinforcing and reducing,guided by classical theory,is established in the prevention and treatment of prostate cancer,and illustrated with typical medical cases to substantiate the argument.[Results]The concept of"excessive fire dispersing Qi,and mild fire generating Qi"describes the impact of physiological and pathological fire on the body's genuine Qi.Mild fire is gentle in nature and helps to generate the body's genuine Qi,while excessive fire is intense and can consume the body's genuine Qi.Dampness,heat,blood stasis,and toxins,which are factors that induce prostate cancer,cancer toxins and western medical treatments such as surgery,radiotherapy and chemotherapy can all manifest as"excessive fire"pattern,consume the body's genuine Qi,which cause the course of prostate cancer to present in different stages,such as the initial formation of cancer toxins,deficiency of genuine Qi with toxin accumulation and Yang deficiency with cold stagnation.The moxibustion of reinforcing technique is relatively gentle and suitable in temperature,embodying the momentum of"mild fire",while the moxibustion of reducing technique is relatively intense and high in temperature to expel pathogens,similar to the fierce momentum of"excessive fire".Guiding the treatment of prostate cancer with moxibustion based on"excessive fire dispersing Qi",and"mild fire generating Qi"should focus on nourishing the mild fire and suppressing the excessive fire,using moxibustion of reinforcing to nourish the deficiency with"mild fire generating Qi",and using moxibustion of reducing to suppress cancer toxins and reduce the consumption of Qi dynamics,highlighting the therapeutic effect in disease prevention and treatment,as well as in improving the adverse reactions of western medical treatment.In the medical case mentioned,the patient suffered from urinary incontinence due to the damage to genuine Qi caused by surgery and the failure to consolidate and control it properly.The patient was comprehensively diagnosed with a deficiency of both the spleen and kidney.In the treatment,mild moxibustion was used to strengthen the spleen,warm the kidney,and replenish and consolidate Qi.Emphasis was also placed on the combination of moxibustion and herbal medicine.After two months of treatment,the symptoms were brought under stable control.[Conclusion]Under the guidance of the theory that"excessive fire dispersing Qi,while mild fire generating Qi",moxibustion techniques are flexibly selected in order to drain excess to suppress"excessive fire"and tonify deficiency to enhance"mild fire",which is well-suited to the complex pathogenesis of prostate cancer,which is characterized by a combination of deficiency and excess.This method provides an important reference for the prevention and treatment of the disease.

[Objective]To summarize SUN Simiao's clinical experience in treating vomiting and explore the modern application of SUN's method for treating vomiting,taking diabetic gastroparesis vomiting(DGPV)as an example.[Methods]By excavating and organizing the special chapters or paragraphs related to vomiting in SUN Simiao's works Emergency Thousand Gold Prescriptions and Thousand Gold Wing Prescriptions,it comprehensively analyzes SUN's understanding of the causes and treatment of vomiting,and applies it to clinical practice based on the pathogenesis of DGPV.[Results]Vomiting is a common clinical symptom of digestive tract abnormalities.Although conventional western medicine treatment can temporarily alleviate vomiting,it is prone to recurrence.SUN Simiao had profound insights in the diagnosis and treatment of vomiting,believing that"abnormal lifting and descending of the middle-Jiao,upward invasion of stomach Qi""cold,heat,phlegm,water,food and various evils invading the middle-Jiao"and"long-term illness injuring the five Zang organs and insufficient Qi and blood"were the core pathogenesis of vomiting.Through inductive analysis of his works,six methods and corresponding prescriptions can be extracted:harmonizing the stomach and descending Qi to stop vomiting,warming Yang and dispelling cold to stop vomiting,resolving phlegm and promoting diuresis to stop vomiting,digesting food and resolving stagnation to stop vomiting,clearing heat and nourishing fluids to stop vomiting,and regulating organs and tonifying deficiency to stop vomiting.In the clinical treatment of DGPV,small prescriptions and corner herbs for treating vomiting should be used in a targeted manner based on the core pathogenesis of different stages.[Conclusion]SUN Simiao's thoughts on treating vomiting still have certain application value in modern medicine and provide guidance for clinical treatment of vomiting such as DGPV.

[Objective]To summarize Professor ZHANG Guangji's thoughts and clinical experience in the treatment of senile insomnia based on the theory of"treating senile diseases from the perspective of Fu-organs".[Methods]By sorting out the discussions of previous medical scholars on the theory of"treating senile diseases from the perspective of Fu-organs"and Professor ZHANG's clinical interpretation,this paper,from three aspects,including the meaning of"treating senile diseases from the perspective of Fu-organs",the theoretical basis and specific application of treating senile insomnia from the perspective of Fu-organs,combining with typical medical records observed in the clinic,explores the feasibility and practical ideas of treating senile insomnia from the perspective of Fu-organs.[Results]Professor ZHANG believes that the meaning of Fu-organs includes not only the six hollow organs but also the source of engendering transformation,as well as the blood vessels and Xuanfu(sweat pore).The theoretical basis for treating senile insomnia by"seeking treatment from the Fu-organs"lies in the fact that the smoothness of the Fu-organs is of great significance for the sleep health of the elderly,and the obstruction of the Fu-organs plays an important role in the occurrence of senile insomnia.Specifically,the obstruction of the stomach,blood vessels and sweat pore impedes the pathway where Yin and Yang converge,resulting in their inability to interact.This disruption affects both the onset and maintenance of sleep.Therefore,in treatment,it is essential to focus on maintaining the smooth circulation of the gastrointestinal tract,blood vessels and sweat pore,enabling the free flow of Yin and Yang.A medical case was presented here.An elderly patient with insomnia was diagnosed with the syndromes of liver Qi stagnation transforming into fire,blood stasis obstructing the collaterals,stomach Qi disharmony and obstruction of the Xuanfu(minute orifices).By adopting the treatment principles of soothing the liver and regulating the stomach,promoting blood circulation to remove stasis and opening the Xuanfu,and calming the mind,good therapeutic effects were achieved.Specifically,Zhishi Xiaopi Pills were used to smooth the Qi circulation in the stomach-related Fu-organs,Xuefu Zhuyu Decoction was employed to promote blood circulation in the blood-related Fu-organs,and Danzhi Xiaoyao Powder combined with acupuncture was utilized to open the Xuanfu.[Conclusion]The theory of"treating senile diseases from the perspective of Fu-organs"is feasible,and Professor ZHANG Guangji's clinical experience is unique,providing a certain perspective for the prevention and treatment of senile insomnia.