1.Intervention Strategies for Heart Failure with Preserved Ejection Fraction Using Combined Classical Formulas Based on the Theory of "Disease of Both Blood and Water"
Yuzhi JIA ; Qingyong HE ; Jie WANG ; Xin ZHAO ; Ziyi WANG ; Dongmei LI ; Junqiao AN
Journal of Traditional Chinese Medicine 2026;67(4):370-374
Based on the theory of "disease of both blood and water" in Essentials from the Golden Cabinet (《金匮要略》), and in combination with the dynamic syndrome evolution of heart failure with preserved ejection fraction (HFpEF), this paper systematically clarifies the pathomechanism of HFpEF, characterized by yang deficiency as the root, blood stasis as the pivotal factor and water retention as the manifestation. Accordingly, the therapeutic principles have been proposed, which are warming yang and banking up original qi to consolidate the root, activating blood and unblocking collaterals to smooth the mechanism, and promoting urination and regulating pivot to remove the branch. On this basis, a compound formula structure of "one monarch, one minister and one assistant" is established, forming an integrated intervention strategy that synergistically combines the three methods of warming yang, activating blood, and promoting urination through combined classical formulas. Zhenwu Decoction (真武汤), which warms yang and dissolves rheum, is used to consolidate the root and directly target the source of yang deficiency, serving as the monarch; Guizhi Fuling Pills (桂枝茯苓丸), which activates blood, promotes urination and unblocks the pivot, assists in interrupting the binding of blood stasis and water retention, serving as the minister; Tingli Dazao Xiefei Decoction (葶苈大枣泻肺汤), which regulates qi, disperses retained fluids, and eliminates the manifestation, alleviates acute water-retention symptoms, serving as the assistant. This compound formula is warming without being drying, diuretic without being drastic, and dispels stasis without consuming blood, thereby achieving the therapeutic effects of warming yang, activating blood, and promoting urination.
2.Interpretation of Middle-regulating Formulas Based on Fuxing Jue
Junqiao AN ; Yixin MA ; Dongmei LI ; Qingyong HE
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(3):265-272
The Dunhuang manuscript Fuxing Jue takes the "Tangye Jingfa Tu" as the core of its theory on prescription and compatibility. Its medication principles mainly include the "five elements principle of tonifying and purging" and the "five elements principle of elimination and transformation". Based on the differentiation of deficiency and excess in the five Zang organs, it flexibly applies medicinal properties, usage, and flavor transformation for tonifying and purging, forming its unique method of medication and compatibility. In Taiyin disease, "fullness syndrome" often occurs together with "diarrhea", and these two conditions also serve as the primary indications for the middle-regulating formulas. Among them, Lizhong Wan (Tang) mainly address Taiyin deficiency. The three Xiexin Tang (Banxia Xiexin Tang, Gancao Xiexin Tang, Shengjiang Xiexin Tang) address Taiyin deficiency accompanied by pathogenic excess. The Sini Tangand Tongmai Sini Tang primarily treat dysfunction of the liver, spleen, and kidney with impaired opening and closing of Taiyin, manifesting as diarrhea. The medicinal flavors of middle-regulating formulas are pungent, sweet, and bitter, acting directly on the spleen of Taiyin. The pungent flavor induces purging of the spleen, sweet flavor tonifies the spleen, and bitter flavor eliminates lumps. When the constituent medicinal units of middle-regulating formulas are unified, the ratio of pungent to sweet flavors reflects the tonic and purgative strength of the formula. In addition, the two decoction methods, "short-term decoction to extract Qi" and "long-term decoction to extract flavor", also influence the formula's tonifying and purgative effects. Based on the composition of flavors and special decoction methods, this article discusses the differences in the use of middle-regulating formulas for treating "“fullness syndrome" versus "diarrhea". Dysfunction of the spleen can give rise to various diseases. Therefore, middle-regulating formulas are not limited to treating "deficiency, cold, and dampness" syndromes. Later generations of physicians further modified Lizhong Tang to treat "excess, heat, and dryness" syndromes, laying a solid foundation for more flexible and effective clinical application of middle-regulating formulas.
3.Interpretation of Middle-regulating Formulas Based on Fuxing Jue
Junqiao AN ; Yixin MA ; Dongmei LI ; Qingyong HE
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(3):265-272
The Dunhuang manuscript Fuxing Jue takes the "Tangye Jingfa Tu" as the core of its theory on prescription and compatibility. Its medication principles mainly include the "five elements principle of tonifying and purging" and the "five elements principle of elimination and transformation". Based on the differentiation of deficiency and excess in the five Zang organs, it flexibly applies medicinal properties, usage, and flavor transformation for tonifying and purging, forming its unique method of medication and compatibility. In Taiyin disease, "fullness syndrome" often occurs together with "diarrhea", and these two conditions also serve as the primary indications for the middle-regulating formulas. Among them, Lizhong Wan (Tang) mainly address Taiyin deficiency. The three Xiexin Tang (Banxia Xiexin Tang, Gancao Xiexin Tang, Shengjiang Xiexin Tang) address Taiyin deficiency accompanied by pathogenic excess. The Sini Tangand Tongmai Sini Tang primarily treat dysfunction of the liver, spleen, and kidney with impaired opening and closing of Taiyin, manifesting as diarrhea. The medicinal flavors of middle-regulating formulas are pungent, sweet, and bitter, acting directly on the spleen of Taiyin. The pungent flavor induces purging of the spleen, sweet flavor tonifies the spleen, and bitter flavor eliminates lumps. When the constituent medicinal units of middle-regulating formulas are unified, the ratio of pungent to sweet flavors reflects the tonic and purgative strength of the formula. In addition, the two decoction methods, "short-term decoction to extract Qi" and "long-term decoction to extract flavor", also influence the formula's tonifying and purgative effects. Based on the composition of flavors and special decoction methods, this article discusses the differences in the use of middle-regulating formulas for treating "“fullness syndrome" versus "diarrhea". Dysfunction of the spleen can give rise to various diseases. Therefore, middle-regulating formulas are not limited to treating "deficiency, cold, and dampness" syndromes. Later generations of physicians further modified Lizhong Tang to treat "excess, heat, and dryness" syndromes, laying a solid foundation for more flexible and effective clinical application of middle-regulating formulas.
4.Treatment Principles and Paradigm of Diabetic Microvascular Complications Responding Specifically to Traditional Chinese Medicine
Anzhu WANG ; Xing HANG ; Lili ZHANG ; Xiaorong ZHU ; Dantao PENG ; Ying FAN ; Min ZHANG ; Wenliang LYU ; Guoliang ZHANG ; Xiai WU ; Jia MI ; Jiaxing TIAN ; Wei ZHANG ; Han WANG ; Yuan XU ; .LI PINGPING ; Zhenyu WANG ; Ying ZHANG ; Dongmei SUN ; Yi HE ; Mei MO ; Xiaoxiao ZHANG ; Linhua ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(5):272-279
To explore the advantages of traditional Chinese medicine (TCM) and integrative TCM-Western medicine approaches in the treatment of diabetic microvascular complications (DMC), refine key pathophysiological insights and treatment principles, and promote academic innovation and strategic research planning in the prevention and treatment of DMC. The 38th session of the Expert Salon on Diseases Responding Specifically to Traditional Chinese Medicine, hosted by the China Association of Chinese Medicine, was held in Beijing, 2024. Experts in TCM, Western medicine, and interdisciplinary fields convened to conduct a systematic discussion on the pathogenesis, diagnostic and treatment challenges, and mechanism research related to DMC, ultimately forming a consensus on key directions. Four major research recommendations were proposed. The first is addressing clinical bottlenecks in the prevention and control of DMC by optimizing TCM-based evidence evaluation systems. The second is refining TCM core pathogenesis across DMC stages and establishing corresponding "disease-pattern-time" framework. The third is innovating mechanism research strategies to facilitate a shift from holistic regulation to targeted intervention in TCM. The fourth is advancing interdisciplinary collaboration to enhance the role of TCM in new drug development, research prioritization, and guideline formulation. TCM and integrative approaches offer distinct advantages in managing DMC. With a focus on the diseases responding specifically to TCM, strengthening evidence-based support and mechanism interpretation and promoting the integration of clinical care and research innovation will provide strong momentum for the modernization of TCM and the advancement of national health strategies.
5.Clinical Application of Qili Qiangxin Capsules in Prevention and Treatment of Chronic Heart Failure: A Review
Dongmei LI ; Ziyi WANG ; Yuzhi JIA ; Xiaoping ZHENG ; Jia SUN ; Lei WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(20):306-313
This study systematically dissects the core pathogenesis of chronic heart failure (CHF) featured by internal deficiency and external excess,imbalance of Qi,blood,Yin,and Yang,and intermingling of phlegm,blood stasis,and fluid retention. According to the traditional Chinese medicine (TCM) therapeutic principles of simultaneously treating root cause and symptoms,regulating Yin and Yang,replenishing Qi and activating blood,and promoting urination to relieve edema,this article deeply explores the formula-syndrome correspondence of Qili Qiangxin (QLQX) capsules in the treatment of CHF,providing a solid theoretical basis for the multi-effect characteristics of this drug. CHF is a common critical cardiovascular disease in clinical practice,and its pathological process involves multiple links including myocardial injury,neurohumoral disturbance,and ventricular remodeling. Its TCM pathogenesis is complex and involves multiple Zang-Fu organs,making it difficult for a single therapeutic method to achieve comprehensive coverage. QLQX capsules,formulated based on classical TCM theory,perfectly matches the pathogenic characteristics of CHF. Modern pharmacological studies have confirmed that QLQX capsules possess definite cardiotonic,diuretic,and vasodilatory effects. The active ingredients of QLQX capsules can rapidly and effectively alleviate the core clinical symptoms such as chest tightness,shortness of breath,decreased exercise tolerance,limb edema,palpitations,and fatigue of CHF patients by enhancing myocardial contractility and coronary blood flow,improving renal water excretion function,dilating peripheral blood vessels,and reducing cardiac load,thereby significantly improving patients' quality of life. On the basis of analyzing the symptomatic treatment of CHF with QLQX capsules,this study further expounds that the drug can intervene in ventricular remodeling through multiple pathways and targets,regulate the pathological mechanism of CHF,improve vascular endothelial function,mediate the activation of related signaling pathways,inhibit the transdifferentiation of cardiac fibroblasts,and regulate myocardial energy metabolism,thus delaying disease progression. QLQX capsules exert significant benefits in reducing composite cardiac events,improving New York Heart Association (NYHA) cardiac function classification,left ventricular ejection fraction (LVEF),6-minute walking distance (6MWD),and quality of life,demonstrating favorable clinical value. With the TCM pathogenesis of CHF as the guiding principle and modern pharmacology as the evidence,this study systematically clarifies the core advantage of QLQX capsules in treatment based on syndrome differentiation and multi-target synergy through the in-depth integration of TCM theory and modern pharmacology. It provides academic support with both theoretical depth and practical value for TCM intervention in CHF,and contributes TCM wisdom and schemes to the construction of a chronic disease management system with Chinese characteristics.
6.Clinical Application of Qili Qiangxin Capsules in Prevention and Treatment of Chronic Heart Failure: A Review
Dongmei LI ; Ziyi WANG ; Yuzhi JIA ; Xiaoping ZHENG ; Jia SUN ; Lei WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(20):306-313
This study systematically dissects the core pathogenesis of chronic heart failure (CHF) featured by internal deficiency and external excess,imbalance of Qi,blood,Yin,and Yang,and intermingling of phlegm,blood stasis,and fluid retention. According to the traditional Chinese medicine (TCM) therapeutic principles of simultaneously treating root cause and symptoms,regulating Yin and Yang,replenishing Qi and activating blood,and promoting urination to relieve edema,this article deeply explores the formula-syndrome correspondence of Qili Qiangxin (QLQX) capsules in the treatment of CHF,providing a solid theoretical basis for the multi-effect characteristics of this drug. CHF is a common critical cardiovascular disease in clinical practice,and its pathological process involves multiple links including myocardial injury,neurohumoral disturbance,and ventricular remodeling. Its TCM pathogenesis is complex and involves multiple Zang-Fu organs,making it difficult for a single therapeutic method to achieve comprehensive coverage. QLQX capsules,formulated based on classical TCM theory,perfectly matches the pathogenic characteristics of CHF. Modern pharmacological studies have confirmed that QLQX capsules possess definite cardiotonic,diuretic,and vasodilatory effects. The active ingredients of QLQX capsules can rapidly and effectively alleviate the core clinical symptoms such as chest tightness,shortness of breath,decreased exercise tolerance,limb edema,palpitations,and fatigue of CHF patients by enhancing myocardial contractility and coronary blood flow,improving renal water excretion function,dilating peripheral blood vessels,and reducing cardiac load,thereby significantly improving patients' quality of life. On the basis of analyzing the symptomatic treatment of CHF with QLQX capsules,this study further expounds that the drug can intervene in ventricular remodeling through multiple pathways and targets,regulate the pathological mechanism of CHF,improve vascular endothelial function,mediate the activation of related signaling pathways,inhibit the transdifferentiation of cardiac fibroblasts,and regulate myocardial energy metabolism,thus delaying disease progression. QLQX capsules exert significant benefits in reducing composite cardiac events,improving New York Heart Association (NYHA) cardiac function classification,left ventricular ejection fraction (LVEF),6-minute walking distance (6MWD),and quality of life,demonstrating favorable clinical value. With the TCM pathogenesis of CHF as the guiding principle and modern pharmacology as the evidence,this study systematically clarifies the core advantage of QLQX capsules in treatment based on syndrome differentiation and multi-target synergy through the in-depth integration of TCM theory and modern pharmacology. It provides academic support with both theoretical depth and practical value for TCM intervention in CHF,and contributes TCM wisdom and schemes to the construction of a chronic disease management system with Chinese characteristics.
7.Evaluation of the effect of integrated interventions on comorbidity of myopia and obesity among primary and secondary school students in Tongzhou District in Beijing
YANG Gang, YANG Dongmei, SONG Yi, LI Jing, WEN Han, CHE Jingyue, DONG Yanhui
Chinese Journal of School Health 2025;46(1):39-44
Objective:
To evaluate the intervention effectiveness of co-occurrence and prevention for myopia and obesity among primary and secondary school students, so as to provide a scientific basis for the development of comprehensive intervention measures in myopia and obesity.
Methods:
From September 2022 to September 2023, a cluster random sampling method was used to select 6 primary schools and 6 junior high schools from Tongzhou District, Beijing. Participants were randomly assigned to an intervention group (914 before intervention and 754 after intervention) and a control group (868 before intervention and 652 after intervention), with an expected duration of one academic year. Based on the RE-AIM framework, integrate resources from families, schools, communities, and medical institutions to develop a school-based intervention technology packagefor the co-occurrence and prevention of myopia and obesity in children. The intervention group received intervention according to the comprehensive intervention technology package, while the control group did not receive any intervention measures. Relevant health indicators during the baseline period and after intervention were measured and collected, and groups were compared by Chi quest test, t-test and Wilcoxon rank sum test.
Results:
After intervention, the uncorrected visual acuity of primary and secondary school students in the intervention group (4.79±0.30) and the control group (4.77±0.33) both decreased compared to those before intervention (4.80±0.30, 4.90±0.32) ( t =-7.00,-5.24); the decrease in uncorrected visual acuity in the intervention group was smaller than that in the control group( t =5.33)( P <0.01). After intervention, body mass index, waist circumference, hip circumference, and body fat percentage of primary and secondary school students in the intervention group decreased compared to those before intervention. However, the changes in these indicators were not statistically significant ( t/Z =-0.03, - 0.36,- 0.30,- 0.01, P >0.05); the above indicators in the control group increased compared to those before intervention, but only hip circumference and body fat percentage showed statistically significant changes ( t/Z =2.17, 2.62, P <0.05). After intervention, both the intervention group and the control group showed increases in systolic and diastolic blood pressure compared to those before intervention(intervention group: t =2.16,5.29; control group: t =6.84,5.07); the intervention group had lower systolic and diastolic blood pressure than the control group( t = -5.27 , -2.08)( P <0.05). After intervention, the intervention and the control groups had statistically significant differences in cognitive accuracy(92.48%, 69.33%) in terms of "outdoor exercise can prevent myopia" and "having 5 servings of adult fist sized vegetables and fruits every day" ( χ 2=6.30, 7.86, P <0.05). There was a statistically significant difference in the proportion of primary and secondary school students in the intervention group (40.98%) and the control group (35.43%) for "who did not drink sugary drinks for every day in the past 7 days" ( χ 2=4.32, P <0.05). After intervention, the intervention group and the control group showed increases in "school outdoor activity duration on school days" and "outdoor activity duration on rest days" compared to those before intervention ( t/Z =-13.32,-9.71;- 2.59,-2.69);the behavior rate of "visual acuity measurement frequency at least once every 3 months" in the intervention group (46.68%) and the control group (52.76%) increased compared to those before intervention (36.43%, 44.01%), and the increases in the intervention group were greater than that in the control group ( χ 2=17.52,11.08) ( P <0.05).
Conclusions
Comprehensive intervention measures have significant intervention effects on controlling the occurrence and development of comorbidity of myopia and obesity in children. It could actively promote collaboration and cooperation among families, schools, communities and medical institutions to reduce the occurrence of myopia and obesity among primary and secondary school students.
8.Impact of vestibular dysfunction on cognitive function
Ruiqi ZHANG ; Yanli ZHAO ; Dongmei ZHANG ; Wenyan LI ; Peixia WU
Chinese Journal of Clinical Medicine 2025;32(2):218-224
Objective To investigate the impact of vestibular dysfunction on various domains of cognitive function, providing a basis for developing comprehensive vestibular-cognitive intervention strategies. Methods A total of 33 patients with confirmed unilateral vestibular dysfunction treated at Eye & ENT Hospital, Fudan University between June 2024 and December 2024. Vestibular function was assessed using vestibular evoked myogenic potential (VEMP), caloric testing, video head impulse test (vHIT), and sensory organization test (SOT). Cognitive function was evaluated using mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA), Stroop color-word test, trail making test (TMT), and auditory verbal learning test (AVLT). Subjective symptoms were assessed using dizziness handicap inventory (DHI). Results In the vestibular function assessment of patients, abnormalities in caloric testing, utricle VEMP and saccule VEMP results were most common, with rates of 87.9%, 57.6%, and 66.7%, respectively; SOT abnormality primarily characterized by impaired vestibular function (21.2%). Spearman correlation analysis showed age, years of education, hearing ability, and emotional state were associated with overall or specific domains of cognitive function in patients. Greater vestibular dysfunction severity was associated with longer TMT-A time (r=0.443,P=0.010), most severe damage of short-term (r=-0.405,P=0.019) and long-term delayed recalls (r=-0.537,P=0.001). Patients with 31-60 of DHI scores showed longer TMT-A time than patients with 0-30 of DHI scores (P=0.033). Conclusions Patients with vestibular dysfunction exhibit significant impairment in low-frequency semicircular canal and utricle function, which affects attention allocation, information processing speed, and memory performance in cognitive tasks.
9.Characteristic ion Identification of Different Original Haliotidis Concha and Its Counterfeits
Xiaojie LIANG ; Guowei LI ; Lin ZHOU ; Qiping HU ; Muxiang LUO ; Jiehao TANG ; Xiangdong CHEN ; Liye PAN ; Dongmei SUN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(11):263-269
ObjectiveTo establish a method for the identification of Haliotidis Concha and its counterfeits, and to improve its quality evaluation method. MethodsA total of 17 batches of Haliotis discus hannai, 4 batches of H. ruber, 3 batches of H. laevigata, 3 batches of H. ovina, 3 batches of H. diversicolor, 3 batches of H. asinina, 3 batches of H. iris were collected. Ultra-high performance liquid chromatography-quadrupole/electrostatic field orbitrap high-resolution mass spectrometry(UPLC-Q-Exactive-Orbitrap-MS/MS) was used to analyze the hydrolysates of different original Haliotidis Concha and its counterfeits, and the potential characteristic ions of each species were screened by Venn diagram. UPLC-triple quadrupole tandem mass spectrometry(UPLC-QqQ-MS/MS) was used to validate the characteristic ions, and the specific detection method of the characteristic ions was established. ResultsA total of 1 182, 167, 47, 89, 104, 203, 424 potential characteristic ions were screened from H. discus hannai, H. ruber, H. laevigata, H. ovina, H. diversicolor, H. asinina and H. iris, respectively. And 9 characteristic ions were selected. The precision, stability and repeatability of the 9 characteristic ions in the established identification method met the requirements. Different original Haliotidis Concha and its counterfeits could detect their own characteristic ions, including m/z 631.83-886.48(double charge) and m/z 631.83-443.74(double charge) of H. discus hannai, m/z 699.28-232.11(double charge) and m/z 699.28-544.27(double charge) of H. ruber, m/z 535.76-752.37(double charge) and m/z 535.76-548.28(double charge) of H. laevigata, m/z 708.35-442.28(double charge) and m/z 708.35-215.14(double charge) of H. ovina, m/z 561.33-614.86(triple charge), m/z 561.33-468.28(triple charge), m/z 608.29-618.32(double charge) and m/z 608.29-390.21(double charge) of H. diversicolor, m/z 769.85-274.10(double charge), m/z 769.85-532.75(double charge), m/z 827.43-646.36(single charge), m/z 827.43-257.12(single charge) of H. asinina, and m/z 468.24-576.29(double charge) and m/z 468.24-505.26(double charge) of H. iris. ConclusionIn this study, a total of 9 characteristic ions are screened from 6 kinds of original Haliotidis Concha and its counterfeits, and a specific identification method is established, which is helpful to solve the limitations of the existing quality evaluation methods of Haliotidis Concha, and provide a basis for the production, circulation and medication quality.
10.Characteristic ion Identification of Different Original Haliotidis Concha and Its Counterfeits
Xiaojie LIANG ; Guowei LI ; Lin ZHOU ; Qiping HU ; Muxiang LUO ; Jiehao TANG ; Xiangdong CHEN ; Liye PAN ; Dongmei SUN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(11):263-269
ObjectiveTo establish a method for the identification of Haliotidis Concha and its counterfeits, and to improve its quality evaluation method. MethodsA total of 17 batches of Haliotis discus hannai, 4 batches of H. ruber, 3 batches of H. laevigata, 3 batches of H. ovina, 3 batches of H. diversicolor, 3 batches of H. asinina, 3 batches of H. iris were collected. Ultra-high performance liquid chromatography-quadrupole/electrostatic field orbitrap high-resolution mass spectrometry(UPLC-Q-Exactive-Orbitrap-MS/MS) was used to analyze the hydrolysates of different original Haliotidis Concha and its counterfeits, and the potential characteristic ions of each species were screened by Venn diagram. UPLC-triple quadrupole tandem mass spectrometry(UPLC-QqQ-MS/MS) was used to validate the characteristic ions, and the specific detection method of the characteristic ions was established. ResultsA total of 1 182, 167, 47, 89, 104, 203, 424 potential characteristic ions were screened from H. discus hannai, H. ruber, H. laevigata, H. ovina, H. diversicolor, H. asinina and H. iris, respectively. And 9 characteristic ions were selected. The precision, stability and repeatability of the 9 characteristic ions in the established identification method met the requirements. Different original Haliotidis Concha and its counterfeits could detect their own characteristic ions, including m/z 631.83-886.48(double charge) and m/z 631.83-443.74(double charge) of H. discus hannai, m/z 699.28-232.11(double charge) and m/z 699.28-544.27(double charge) of H. ruber, m/z 535.76-752.37(double charge) and m/z 535.76-548.28(double charge) of H. laevigata, m/z 708.35-442.28(double charge) and m/z 708.35-215.14(double charge) of H. ovina, m/z 561.33-614.86(triple charge), m/z 561.33-468.28(triple charge), m/z 608.29-618.32(double charge) and m/z 608.29-390.21(double charge) of H. diversicolor, m/z 769.85-274.10(double charge), m/z 769.85-532.75(double charge), m/z 827.43-646.36(single charge), m/z 827.43-257.12(single charge) of H. asinina, and m/z 468.24-576.29(double charge) and m/z 468.24-505.26(double charge) of H. iris. ConclusionIn this study, a total of 9 characteristic ions are screened from 6 kinds of original Haliotidis Concha and its counterfeits, and a specific identification method is established, which is helpful to solve the limitations of the existing quality evaluation methods of Haliotidis Concha, and provide a basis for the production, circulation and medication quality.


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