Heart failure(HF)is a complex clinical syndrome which develops from various heart diseases progressing to serious stages.HF is the terminal stage of various cardiovascular diseases,and has become a serious threat to public health and human life.Cardiac rehabilitation in HF patients has been proven to be feasible,while the study of cardiac rehabilitation in China is still at the preliminary stage.Nowadays,the integration of traditional Chinese and western medicine is widely used for cardiac rehabilitation.Professor Li Rong had over 20 years of clinical experience in treating HF and guiding cardiac rehabilitation for patients with HF.He focused on improving the prognosis and quality of life of the patients,and proposed the therapies with traditional Chinese medicine(TCM)characteristics to promote cardiac rehabilitation for HF.The therapies included the method of exhalation and inhalation for regulating breath,physical-breathing exercise,therapeutic diet,cultivation of spirit,TCM external therapy,five-note therapy,and natural environment therapy.The combination use of TCM,traditional qigong and conduction therapy,and modern cardiac rehabilitation techniques will provide new ideas for cardiac rehabilitation in HF patients by simpler,cheaper,and more convenient and effective methods,and will promote the innovation and development of cardiac rehabilitation with TCM characteristics.

Under the guidance of five-viscus correlation theory,and with reference to the clinical practice,this paper discusses the pathogenesis of cardiogenic asthma,i.e.long illness of the heart resulting in asthma,from the perspective of physiological characteristics of heart,which belongs to yin in essence and yang in function.And this paper also introduces the correlation between five zang-organs and cardiogenic asthma:asthma induced by heart failure involves the lung,has close relation with middle energizer(spleen and stomach),results from the comorbidity of heart and liver,and contributes to the disorders of kidney.It is believed that cardiogenic asthma injures the heart,results in internal blockage of blood stasis,so the original pathogenesis of cardiogenic asthma is due to the heart;unsmoothed blood circulation causes fluid retention in the chest and lung,and then the lung is involved.The failure of spleen and stomach in generation and transportation will cause the unsmoothed circulation of qi and blood,liver qi stagnation will result in the failure of liver blood in nourishment,and the intense kidney yin-fire will stir upward and attack heart yang.The factors mentioned above all are prone to result in the aggravation of cardiogenic asthma.Therefore,the treatment of cardiogenic asthma with traditional Chinese medicine should be focused on heart,and methods of replenishing qi,activating blood circulation,and inducing diuresis are used as the primary therapeutic approaches.Moreover,according to the organs involved in cardiogenic asthma,therapies of regulating the five viscera and restoring the balance of yin and yang are used for precise treatment,and the therapeutic effect will be enhanced.

Objective To evaluate the clinical efficacy and safety of Jiangzhi Hugan Soft Extract(composed of stir-fried Dioscoreae Rhizoma,Poria,Ginseng Radix et Rhizoma,Bupleuri Radix,Citri Sarcodactylis Fructus,Persicae Semen,Polygoni Cuspidati Rhizoma,etc.)in treating non-alcoholic fatty liver disease(NAFLD)with internal dampness-turbidity accumulation syndrome.Methods Sixty patients with NAFLD of dampness-turbidity accumulation syndrome treated at the Gastroenterology Department of Maoming Hospital of Guangzhou University of Chinese Medicine(Maoming Hospital of Traditional Chinese Medicine)from November 2023 to December 2024 were enrolled.The patients were divided into trial group and control group using stratified randomization,with 30 patients in each group.Both groups received lifestyle interventions(diet control and exercise),with the trial group additionally receiving Jiangzhi Hugan Soft Extract for 4 weeks.Outcomes included body mass index(BMI),liver function indicators[alanine aminotransferase(ALT),aspartate aminotransferase(AST),gamma-glutamyl transferase(GGT)],lipid profiles[total cholesterol(TC),triglycerides(TG)],traditional Chinese medicine(TCM)syndrome scores,efficacy evaluation,and safety assessment.Results(1)After 4 weeks of treatment,the overall response rate in the trial group was 93.33％(28/30),while that in the control group was 60.00％(18/30).The intergroup comparison(by rank sum test)showed that the efficacy of TCM syndrome in the trial group was significantly superior to that in the control group,with a statistically significant difference(P＜0.01).(2)After treatment,the BMI of patients in both groups was improved significantly compared to before treatment(P＜0.01).The improvement in BMI was significantly greater in the trial group than in the control group.The difference in the change of BMI between the two groups was statistically significant before and after treatment(P＜0.05).(3)After treatment,the levels of ALT,AST,and GGT in both groups decreased compared to before treatment(P＜0.01).The trial group showed a significantly greater reduction in ALT,AST,and GGT levels than the control group.The difference between the two groups was statistically significant before and after treatment(P＜0.05).(4)After treatment,both groups showed a significant decrease in TC and TG levels compared to pre-treatment levels(P＜0.05).The trial group demonstrated a more pronounced reduction in TC levels than the control group.The difference between the two groups was statistically significant before and after treatment(P＜0.05).(5)There were no significant adverse reactions occurring in either group during treatment,indicating a high level of safety.Conclusion Jiangzhi Hugan Soft Extract effectively improves BMI,liver function,and lipid profile in NAFLD patients with dampness-turbidity accumulation syndrome,demonstrating good clinical efficacy and high safety,warranting further clinical application.

Objective: To analyze the change trends in the body shape indicators and proportions of students in Harbin from 2010 to 2024, and to investigate ergonomic compatibility of functional dimensions of school desks and chairs with current student shape indicators, so as to provide a reference for revising furniture standards of desks and chairs. Methods: Between September and November of both 2010 and 2024, a combination of convenience sampling and stratified cluster random sampling was conducted across three districts in Harbin, yielding samples of 6 590 and 6 252 students, respectively. Anthropometric shape indicators cluding height, sitting height, crus length, and thigh length-and their proportional changes were compared over the 15-year period. The 2024 data were compared with current standard functional dimensions of school furniture. The statistical analysis incorporated t-test and Mann-Whitney U- test. Results: From 2010 to 2024, average height increased by 1.8 cm for boys and 1.5 cm for girls; sitting height increased by 1.5 cm for both genders; crus length increased by 0.3 cm for boys and 0.4 cm for girls; and thigh length increased by 0.5 cm for both genders. The ratios of sitting height to height, and sitting height to leg length increased by less than 0.1 . The difference between desk chair height and 1/3 sitting height ranged from 0.4-0.8 cm. Among students matched with size 0 desks and chairs, 22.0% had a desk to chair height difference less than 0, indicating that the desk to chair height difference might be insufficient for taller students. The differences between seat height and fibular height ranged from -1.4 to 1.1 cm; and the differences between seat depth and buttock popliteal length ranged from -9.8 to 3.4 cm. Among obese students, the differences between seat width and 1/2 hip circumference ranged from -20.5 to -8.7 cm, while it ranged from -12.2 to -3.8 cm among non obese students. Conclusion Current furniture standards basically satisfy hygienic requirements; however, in the case of exceptionally tall and obese students, ergonomic accommodations such as adaptive seating allocation or personalized adjustments are recommended to meet hygienic requirements.

OBJECTIVE To establish management index system for rational drug use of key monitoring drugs， and provide reference for the management of key monitoring drugs in the hospitals. METHODS First， the management index system for rational drug use of key monitoring drugs was drafted by collecting the evidence from related medical literature. Next， using a modified Delphi method， twenty experienced experts from the fields of pharmacy， medical practice， healthcare insurance， and finance were selected to participate in two rounds of questionnaire consultations. Based on the expert enthusiasm coefficient， authority coefficient， degree of opinion concentration， and degree of coordination， the final indicators were determined to establish a management index system for rational drug use of key monitored drugs in medical institutions. RESULTS The expert enthusiasm coefficients reached 100% in both rounds of consultation. In first-level， second-level and third-level indicators， the authority coefficients of experts were 0.89， 0.86 and 0.87， and coordination coefficients of the experts in importance score were 0.300 （P＜ 0.05）， 0.125 （P＜0.05） and 0.139 （P＜0.05）， respectively. The average score for the importance of all indicators reached over 3.5， in which the full score ratio ranged from 35% to 100%. Except that the variation coefficient of a third-level indicator “number of specifications purchased for key monitored drugs” was 0.26， the variation coefficients of rest indicators were less than or equal to 0.25. Based on the results of expert consultation， final version of the management index system established in this study， including two first-level indicators （drug procurement and use， and rational drug use）， five second-level indicators （such as the accessibility， cost-effectiveness） and twenty third-level indicators （such as the number of specifications purchased for key monitored drugs， the increase in the cost of key monitored drugs）. CONCLUSIONS The management index system established in this study possesses high reliability and strong operability， and may provide a reference for the management of key monitoring drugs in the hospitals.

OBJECTIVE To evaluate the quality of evidence in the systematic evaluation/meta-analysis of traditional Chinese medicine （TCM） for diabetes retinopathy （DR） based on the GRADE system. METHODS Chinese and English databases were searched to obtain the relevant studies of systematic evaluation/meta-analysis of traditional Chinese medicine in the treatment of DR. The search time was from the establishment of each database to January 13th， 2024. According to the inclusion and exclusion criteria， literature screening was conducted. After extracting relevant information from the included literature， the GRADE system was used to evaluate the quality level of the evidence body in the included studies， and the evidence of the outcome indicators was integrated and summarized. RESULTS A total of 51 studies were ultimately included， encompassing 135 outcome indexes. Among these， 19 indicators （14.1%） were of high quality， 87 （64.4%） were of medium quality， 26 （19.3%） were of low quality， and 3 （2.2%） were of very low quality. Overall， the evidence quality of the outcome indicators in the included studies was medium to low quality. The integrated results of evidence on the efficacy of outcome indexes showed that compared with conventional Western medicine， calcium dobesilate or placebo， TCM had significant advantages in improving overall efficacy， reducing bleeding spot area， reducing macular foveal thickness， and increasing visual improvement rate. In addition，the combination of TCM and conventional Western medicine or calcium dobesilate was significantly more effective than using conventional Western medicine or calcium dobesilate alone. CONCLUSIONS The overall quality of the evidence in the systematic evaluation/meta-analysis study on the treatment of DR with TCM is medium to low quality. Based on existing research findings， TCM demonstrates good clinical efficacy in the treatment of DR.

Various therapeuti modailities have been engineered for lung cancer treatment, but their clinic application is severely impeded by the poor therapy efficiency and immunosuppressive microenvironment. Herein, we fabricated a library of small molecule redox-labile nanoparticles (NPs) (i.e., diPTX-2C NPs, diPTX-2S NPs, and diPTX-2Se NPs) by the self-assembly of dimer paclitaxel (PTX) prodrug, and then utilized these NPs with the traditional Chinese medicine (TCM) Qi-Yu-San-Long-Fang (Q) for effective chemoimmunotherapy on Lewis lung carcinoma (LLC)-bearing mice models. Under the high concentration of glutathione (GSH) and H₂O₂, diPTX-2Se NPs could specifically release PTX in cancer cells and exert a higher selectivity and toxicity than normal cells. In LLC tumor-bearing mice, oral administration of Q not only effectively downregulated programmed death ligand-1 (PD-L1) expression, but also remodeled the immunosuppressive tumor immune microenvironment via the increase of CD4⁺ T and CD8⁺ T cell proportion and the repolarization of M2 into M1 macrophages in tumor tissues, collectively achieving superior synergistic treatment outcomes in combination with intravenous PTX prodrug NPs. Besides, we found that the combination regimen also demonstrated excellent chemoimmunotherapeutic performances on low-dose small established tumor and high-dose large established tumor models. This study may shed light on the potent utilization of Chinese and Western-integrative strategy for efficient tumor chemoimmunotherapy.

Objective : To investigate the factors affecting the outcome of high-risk human papillomavirus ( HR- HPV) infection in patients with normal cervix examined by colposcopy in Hefei area and the relationship between persistent HR-HPV infection and cervical cytology． Methods : Data of colposcopy patients were collected from 478 HR-HPV infected patients with normal cervix through colposcopy．Their age，number of sexual partners，contracep- tive methods and other relevant basic information were recorded．Vaginal interferon use，HR-HPV infection at year 1 and year 2，and cervical liquid-based cytology test ( LCT) results were tracked，univariate and multivariate ana- lyses were performed based on basic information，and ROC curves were plotted． Results : The HR-HPV clearance rate at 1 year was 59. 41% ，and the clearance rate at 2 years was 66. 75%．The other 12 types of infection ( 31， 33，35，39，45，51，52，56，58，59，66，68) were more common than the 16 and 18 types．Univariate and mult- ivariate analyses showed that age＞50 years，number of sexual partners ≥2，and history of cervical conectomy in- creased the risk of persistent HR-HPV infection ( χge = 21. 676，P ＜0. 001; χumber of sexual partners = 8. 262，P =0. 004; χistory of cervical conectomy = 11. 267，P = 0. 001 ) ． The risk of HR-HPV infection was significantly lower when condom or vaginal interferon was used ( χondom use = 10. 885，P = 0. 001; χnterferon use = 4. 099，P = 0. 043) ．The area under the ROC curve (AUC) of combined diagnosis of HR-HPV persistent infection was higher than that of single diagnosis，and the AUC of combined diagnosis was 0. 737．Persistent HR-HPV infection was an independent risk factor for abnormal LCT，and the AUC predicted by the model was 0. 755．No cancer was found in patients with persistent HR-HPV infection for 2 years，and the proportion of abnormal LCT was higher than that in patients with negative HR-HPV．The difference was statistically significant ( χ2 = 39. 64，P＜0. 001) ． Conclusion The combined ROC model constructed for patients＞50 years old，with multiple sexual partners，history of cervical surgery， no vaginal interferon use，and no condom use has certain value in predicting persistent HR-HPV infection，and per- sistent HR-HPV infection has predictive value in predicting LCT abnormalities．

Objective To investigate the protective effect and mechanism of schisandrin A(SA)on hydrogen peroxide(H2O2)-induced oxidative stress injury in renal tubular epithelial cells(HK-2).Methods HK-2 cells were cultured in vitro and divided into five groups:blank control group,model control group(treated with 600 μmol·L-1 H2O2 for 2 h),low-dose SA group(0.125 μmol·L-1 SA,24 h pretreatment+H2O2),medium-dose SA group(0.5 μmol·L-1 SA,24 h pretreatment+H2 O2),high-dose SA group(0.75 μmol·L-1 SA,24 h pretreatment+H2O2).The cell survival was assessed by CCK-8 assay;apoptosis level was tested by Annexin V-FITC/PI double staining;cell cycle distribution was detected by propidium iodide staining;oxidative markers(ROS,SOD,MDA,GSH,LDH)was determined with commercial kits;and apoptosis-related proteins(Bax,Bcl-2,Caspase-3,Cytochrome C)was evaluated by Western blot.Results Compared with the blank control,the model group reduced in cell viability and increased in apoptosis(P＜0.01),elevated in the ratio of G0/G1-phase cells and decreased in S-phase cells(P＜0.05),decreased in SOD activity and GSH content(P＜0.01),and increased in the levels of ROS,LDH,and MDA levels(P＜0.01).In all SA dose,cell apoptosis reduced(P＜0.01).In medium/high dose groups,the G0/G1-phase arrest reduced(P＜0.05).In high dose group,the S-phase cells ratio increased(P＜0.05).And in medium/high dose groups,ROS(P＜0.01)decreased in a dose-dependent manner.The SOD activity increased non-significantly in all SA groups.In SA medium/high dose groups,the LDH activity decreased in a dose-dependent manner.In all SA groups,GSH increased(P＜0.01)and MDA decreased,both in a dose-dependent manner.The Bax/Bcl-2 ratio significantly decreased(P＜0.05)in all SA groups.The caspase-3 activity decreased in medium/high dose group(P＜0.05);and Cytochrome C reduced in all SA groups(P＜0.05).Conclusion SA protects HK-2 cells against H2O2-induced oxidative injury by modulating oxidative stress,inhibiting apoptosis,and ameliorating cell cycle arrest.

Sinopodophyllum hexandruma is a traditional Chinese medicine in China,which is mostly distributed in Gansu,Shaanxi,Sichuan,Qinghai,Yunnan and Xizang,etc.In recent years,with the gradual deepening of the research on the chemical composition and pharmacology-toxicology of Sinopodophyllum hexandruma,its antitumour and antiviral pharmacodynamic evaluation has increasingly become a research hotspot in the industry.Based on the chemical structure,pharmacological properties and the theoretical basis of quality markers(Q-markers),this paper presents an in-depth literature review and analysis of the chemical composition,pharmacological activities and Q-markers of Sinopodophyllum hexandruma,and systematically explores and predicts the Q-markers of Sinopodophyllum hexandruma.It is proposed that Podophyllotoxin,picropodophyllotoxin,podophyllotoxinone,quercetin,kaempferol,quercetin-3-O-β-glucoside can be used as the Q-marker of Sinopodophyllum hexandruma.In the later stage,these index components can be selected to control the whole quality of Sinopodophyllum hexandrum,and provide some data support and theoretical reference for the quality evaluation of Sinopodophyllum hexandrum.