As an exclusive Miao medicine of Honwing Pharma （Guizhou） Co. Ltd.， Yifei Zhike capsules are both a prescription drug and an over-the-counter （OTC） drug. Its main ingredients include Ranunculus ternatus and Panax notoginseng. With the effects of nourishing Yin and moistening the lungs， as well as relieving cough and reducing phlegm， Yifei Zhike capsules are often used in the treatment of acute and chronic bronchitis， pulmonary tuberculosis， and other diseases. However， there is insufficient understanding of their efficacy， suitable syndromes， and safety in clinical practice， with a lack of relevant expert consensus on clinical application. To standardize their clinical application， 30 experts from the fields of respiratory medicine， pharmacy， and evidence-based medicine were invited to develop an Expert Consensus on the Clinical Application of Yifei Zhike Capsules （Consensus for short） through evidence-based medicine methods. The Consensus clarified the syndrome characteristics， disease stages， dosages， treatment courses， combined medication， and other norms in the treatment of acute/chronic bronchitis and pulmonary tuberculosis and could be applicable to clinical physicians and pharmacists in medical and health institutions at all levels. In disease diagnosis， it provided diagnostic criteria for traditional Chinese medicine and Western medicine and clarified that the suitable traditional Chinese medicine syndrome was the syndrome of Qi-Yin deficiency with intermingled phlegm-blood stasis. Clinical studies have confirmed that Yifei Zhike capsules combined with standard anti-tuberculosis therapy can effectively improve the symptoms of pulmonary tuberculosis patients， increase the sputum smear conversion rate， and promote the absorption of lesions. When treating acute cough caused by respiratory tract infections， Yifei Zhike capsules can increase the markedly effective rate and the seven-day disappearance rate of cough symptoms. Meanwhile， recommendations for specific usage， dosages， and treatment courses were given for different diseases， and it was pointed out that long-term medication required key monitoring of adverse reactions. In safety， the adverse reactions of Yifei Zhike capsules involved multiple aspects such as the digestive system and allergic reactions， and pregnant women and women during menstruation were prohibited from using it. In addition， modern research has shown that Yifei Zhike capsules have an adjuvant therapeutic effect on tuberculous pleurisy and may be effective for inflammatory and benign pulmonary nodules. However， further research should be conducted on the toxicological safety of long-term medication. The formulation of the Consensus provides a scientific basis for the rational clinical application of Yifei Zhike capsules， which helps to improve clinical efficacy and reduce medication risks.

As an exclusive Miao medicine of Honwing Pharma （Guizhou） Co. Ltd.， Yifei Zhike capsules are both a prescription drug and an over-the-counter （OTC） drug. Its main ingredients include Ranunculus ternatus and Panax notoginseng. With the effects of nourishing Yin and moistening the lungs， as well as relieving cough and reducing phlegm， Yifei Zhike capsules are often used in the treatment of acute and chronic bronchitis， pulmonary tuberculosis， and other diseases. However， there is insufficient understanding of their efficacy， suitable syndromes， and safety in clinical practice， with a lack of relevant expert consensus on clinical application. To standardize their clinical application， 30 experts from the fields of respiratory medicine， pharmacy， and evidence-based medicine were invited to develop an Expert Consensus on the Clinical Application of Yifei Zhike Capsules （Consensus for short） through evidence-based medicine methods. The Consensus clarified the syndrome characteristics， disease stages， dosages， treatment courses， combined medication， and other norms in the treatment of acute/chronic bronchitis and pulmonary tuberculosis and could be applicable to clinical physicians and pharmacists in medical and health institutions at all levels. In disease diagnosis， it provided diagnostic criteria for traditional Chinese medicine and Western medicine and clarified that the suitable traditional Chinese medicine syndrome was the syndrome of Qi-Yin deficiency with intermingled phlegm-blood stasis. Clinical studies have confirmed that Yifei Zhike capsules combined with standard anti-tuberculosis therapy can effectively improve the symptoms of pulmonary tuberculosis patients， increase the sputum smear conversion rate， and promote the absorption of lesions. When treating acute cough caused by respiratory tract infections， Yifei Zhike capsules can increase the markedly effective rate and the seven-day disappearance rate of cough symptoms. Meanwhile， recommendations for specific usage， dosages， and treatment courses were given for different diseases， and it was pointed out that long-term medication required key monitoring of adverse reactions. In safety， the adverse reactions of Yifei Zhike capsules involved multiple aspects such as the digestive system and allergic reactions， and pregnant women and women during menstruation were prohibited from using it. In addition， modern research has shown that Yifei Zhike capsules have an adjuvant therapeutic effect on tuberculous pleurisy and may be effective for inflammatory and benign pulmonary nodules. However， further research should be conducted on the toxicological safety of long-term medication. The formulation of the Consensus provides a scientific basis for the rational clinical application of Yifei Zhike capsules， which helps to improve clinical efficacy and reduce medication risks.

The compilation instructions for the Expert Consensus on Clinical Application of Yifei Zhike Capsules systematically expound the development background， methodological framework， and core achievements of this consensus. In view of the problems existing in the clinical application of Yifei Zhike Capsules， such as insufficient efficacy evidence and lack of standardized syndrome differentiation， the Institute of Basic Research in Clinical Medicine， China Academy of Chinese Medical Sciences took the lead and collaborated with 21 tertiary grade-A hospitals and research institutions across China to form a multidisciplinary expert group （comprising 30 experts in clinical medicine， pharmacy， and methodology）. The compilation work was carried out in strict accordance with the World Health Organization （WHO） guidelines， the GB/T 1.1-2020 standard， and the writing specifications for the explanatory notes of expert consensus on clinical application of Chinese patent medicines. Through systematic literature retrieval （including 32 studies， with 24 clinical studies）， Grading of Recommendations Assessment， Development and Evaluations （GRADE）-based evidence grading， and multiple rounds of discussions using the nominal group method （25 experts voted to determine 17 clinical questions）， 5 evidence-based recommendations and 11 expert consensus suggestions were formed. It is clarified that this medicine （Yifei Zhike Capsules） is applicable to the treatment of expectoration/hemoptysis in acute and chronic bronchitis and the adjuvant treatment of pulmonary tuberculosis. It is recommended that it can be used alone or in combination with anti-tuberculosis drugs. The safety evaluation shows that this medicine mainly induces the following adverse reactions： mild gastrointestinal reactions （such as nausea and abdominal pain） and rashes. The contraindicated populations include pregnant women and women during menstruation. The compilation process of the consensus underwent three rounds of expert letter reviews， two rounds of peer reviews， and quality control assessments to ensure methodological rigor and clinical applicability. In addition， through policy alignment， academic promotion， and a dynamic revision mechanism， the standardization of clinical application was promoted， providing a demonstration for the evidence-based transformation of characteristic therapies of Miao medicine.

Objective To investigate the relationship between sleep disorders and coronary heart disease through big data combined with Mendelian randomization analysis.Methods Data from 2005 to 2018 National Health and Nutrition Examination Survey in the United States were utilized.Logistic regression analysis was employed to evaluate the association between sleep disorders and coronary heart disease,while analyzing relevant influencing factors.A two-sample Mendelian randomization approach was implemented using Genome-Wide Association Studies to establish causal relationships.Results Logistic regression analysis demonstrated a significant association between sleep disorders and coronary heart disease(P＜0.001),with the neutrophil-to-lymphocyte ratio serving as a mediating factor in this relationship(P＜0.001).Mendelian randomization analysis revealed a positive correlation between sleep disorders and coronary heart disease(OR=1.030,95％CI:1.01-1.04).Conclusion Sleep disorders can increase the risk of coronary heart disease by activating inflammatory factors.

Objective To investigate the clinical significance of neutrophil-to-lymphocyte ratio(NLR),systemic immune-inflammatory index(SII),systemic inflammation response index(SIRI),and aggregate index of systemic inflammation(AISI)in chronic kidney disease(CKD)patients complicated with heart failure.Methods This study enrolled 190 CKD patients complicated with heart failure(case group)and 30 CKD patients without heart failure(control group)who treated in the outpatient and inpatient departments of Wenling Hospital of Traditional Chinese Medicine from January 2022 to December 2024.Differences in NLR,SII,SIRI,and AISI between the two groups were compared,and the relationship between these inflammatory markers and traditional Chinese medicine(TCM)syndrome types in CKD patients complicated with heart failure was analyzed.Logistic regression analysis and receiver operating characteristic(ROC)curve were used for evaluating the predictive efficacy of NLR,SII,SIRI,and AISI for illness severity of CKD complicated with heart failure.Results(1)The levels of NLR,SII,SIRI,and AISI in the case group were significantly higher than those in the control group(P＜0.01).(2)In CKD patients complicated with heart failure,NLR,SII,SIRI,and AISI were positively correlated with N-terminal pro-brain natriuretic peptide(NT-proBNP)levels(P＜0.01).(3)Among the CKD patients complicated with heart failure of fundamentally deficiency syndromes,spleen-kidney yang deficiency syndrome was the most prevalent,followed by spleen-kidney qi-yin deficiency syndrome,spleen-kidney qi deficiency syndrome,and yin-yang deficiency syndrome.Among the CKD patients complicated with heart failure of incidentally excess syndromes,blood stasis syndrome was the most common,followed by damp-heat syndrome,urinary toxin retention syndrome,and water-damp syndrome.(4)In CKD patients complicated with heart failure of fundamentally deficiency syndromes,NLR,SII,SIRI,and AISI levels ranked in the decreasing sequence in the syndromes of yin-yang deficiency,spleen-kidney yang deficiency,spleen-kidney qi-yin deficiency,and spleen-kidney qi deficiency;in the patients with incidentally excess syndromes,the levels ranked in the decreasing sequence in urinary toxin retention,damp-heat syndrome,blood stasis syndrome,and water-damp syndrome(P＜0.05).(5)Multivariate logistic regression identified NLR,SII,SIRI,and AISI as independent risk factors for illness severity of CKD complicated with heart failure(P＜0.01).(6)ROC curve analysis demonstrated high values of NLR,SII,SIRI,and AISI in differentiating illness severity of CKD complicated with heart failure(P＜0.01).Conclusion Inflammatory markers of NLR,SII,SIRI,and AISI exhibit significant correlation with illness severity of CKD complicated with heart failure,suggesting their potentiality as biological markers for TCM syndrome differentiation and disease progression assessment in this population.

Objective To investigate the correlation between insulin resistance markers[triglyceride-glucose(TyG)index],inflammatory indicators[neutrophil-to-lymphocyte ratio(NLR),C-reactive protein(CRP)],and traditional Chinese medicine(TCM)syndromes in patients with diabetic kidney disease(DKD)complicated by carotid atherosclerosis(CAS).Methods This retrospective study enrolled 300 DKD patients with CAS(case group)and 30 DKD patients without CAS(control group).Differences in TyG index,NLR,and CRP levels were compared between groups.The relationships between these markers and carotid intima-media thickness(IMT)/plaque area were analyzed,along with their variations across TCM syndromes.Logistic regression and receiver operating characteristic(ROC)curve analyses were performed to evaluate the predictive value of TyG index,NLR,and CRP for plaque stability and prognosis.Results(1)The TyG index,NLR,and CRP levels in patients with DKD and CAS were significantly higher than those in patients with DKD alone(P＜0.01).(2)The TyG index,NLR,and CRP were significantly positively correlated with IMT and plaque area(P＜0.01).(3)In patients with DKD combined with CAS,the TyG index,NLR,and CRP levels in those with unstable plaques were significantly higher than those with stable plaques(P＜0.01).(4)Among the distribution of TCM syndromes in patients with DKD combined with CAS,the qi and yin deficiency syndrome had the highest proportion(33.33％),followed by spleen and kidney yang deficiency syndrome(28.67％),yin and yang deficiency syndrome(22.00％),and turbid toxin and stasis obstruction syndrome(16.00％).(5)Among patients with DKD and CAS,the TyG index,NLR,and CRP levels in patients with different TCM syndromes decreased in the following order:turbid toxin and stasis obstruction syndrome,yin and yang deficiency syndrome,spleen-kidney yang deficiency syndrome,and qi and yin deficiency syndrome.(6)Logistic regression analysis results showed that TyG index,NLR,and CRP levels were closely associated with plaque stability in patients with DKD combined with CAS(P＜0.05 or P＜0.01).(7)ROC analysis showed that these markers have high prognostic value in DKD-CAS(P＜0.01).Conclusion TyG index,NLR,and CRP may serve as potential biomarkers for TCM syndrome differentiation and prognosis assessment in DKD-CAS.

Objective:To investigate the status of work-related musculoskeletal disorders (WMSDs) in male large-scale mechanical maintenance workers, and to explore the relationship between WMSDs and thyroid indexes.Methods:From April to July 2022, male front-line maintenance workers in a large-scale mechanical maintenance enterprise who participated in occupational health examination were selected as the study subjects ( n=2036). The occurrence of WMSDs was investigated by questionnaire. The levels of triiodothyronine (T3), thyroxine (T4) and thyroid stimulating hormone (TSH) in serum were detected. χ2 test, t-test and Mann-Whitney U test were used to detect thyroid diseases and hormone levels of workers in WMSDs group and non-WMSDs group, and binary logistic regression model was used to analyze the relationship between thyroid disease, T3, T4, TSH and WMSDs. Results:The incidence of WMSDs among the male large-scale mechanical maintenance workers was 73.18% (1490/2036). The rate of thyroid disease in WMSDs group was higher than that in non-WMSDs group [8.26% (123/1490) vs. 4.95% (27/546), χ 2=6.42, P=0.011], and the TSH value was lower than that in non-WMSDs group[1.66 (1.23, 2.26) μIU/ml vs. 1.75 (1.30, 2.42) μIU/ml, Z=-2.40, P=0.019]. There were no significant differences in the levels of T3, T4 and abnormal levels of 3 hormones between the two groups ( P>0.05). After accounting for individual and occupational factors, workers with thyroid disease had an increased risk of WMSDs ( OR=1.656, 95% CI: 1.072-2.559, P=0.023), while workers with increased TSH had a decreased risk of WMSDs ( OR=0.897, 95% CI: 0.823-0.977, P=0.013) . Conclusion:The incidence of WMSDs in male workers of large-scale mechanical maintenance is high, and its incidence may be related to thyroid index. Thyroid disease may be a risk factor for WMSDs, and increased TSH may be a protective factor for WMSDs.

Objective:To investigate the status of work-related musculoskeletal disorders (WMSDs) in male large-scale mechanical maintenance workers, and to explore the relationship between WMSDs and thyroid indexes.Methods:From April to July 2022, male front-line maintenance workers in a large-scale mechanical maintenance enterprise who participated in occupational health examination were selected as the study subjects ( n=2036). The occurrence of WMSDs was investigated by questionnaire. The levels of triiodothyronine (T3), thyroxine (T4) and thyroid stimulating hormone (TSH) in serum were detected. χ2 test, t-test and Mann-Whitney U test were used to detect thyroid diseases and hormone levels of workers in WMSDs group and non-WMSDs group, and binary logistic regression model was used to analyze the relationship between thyroid disease, T3, T4, TSH and WMSDs. Results:The incidence of WMSDs among the male large-scale mechanical maintenance workers was 73.18% (1490/2036). The rate of thyroid disease in WMSDs group was higher than that in non-WMSDs group [8.26% (123/1490) vs. 4.95% (27/546), χ 2=6.42, P=0.011], and the TSH value was lower than that in non-WMSDs group[1.66 (1.23, 2.26) μIU/ml vs. 1.75 (1.30, 2.42) μIU/ml, Z=-2.40, P=0.019]. There were no significant differences in the levels of T3, T4 and abnormal levels of 3 hormones between the two groups ( P>0.05). After accounting for individual and occupational factors, workers with thyroid disease had an increased risk of WMSDs ( OR=1.656, 95% CI: 1.072-2.559, P=0.023), while workers with increased TSH had a decreased risk of WMSDs ( OR=0.897, 95% CI: 0.823-0.977, P=0.013) . Conclusion:The incidence of WMSDs in male workers of large-scale mechanical maintenance is high, and its incidence may be related to thyroid index. Thyroid disease may be a risk factor for WMSDs, and increased TSH may be a protective factor for WMSDs.

Objective To investigate the relationship between sleep disorders and coronary heart disease through big data combined with Mendelian randomization analysis.Methods Data from 2005 to 2018 National Health and Nutrition Examination Survey in the United States were utilized.Logistic regression analysis was employed to evaluate the association between sleep disorders and coronary heart disease,while analyzing relevant influencing factors.A two-sample Mendelian randomization approach was implemented using Genome-Wide Association Studies to establish causal relationships.Results Logistic regression analysis demonstrated a significant association between sleep disorders and coronary heart disease(P＜0.001),with the neutrophil-to-lymphocyte ratio serving as a mediating factor in this relationship(P＜0.001).Mendelian randomization analysis revealed a positive correlation between sleep disorders and coronary heart disease(OR=1.030,95％CI:1.01-1.04).Conclusion Sleep disorders can increase the risk of coronary heart disease by activating inflammatory factors.

Background The current increasing trend of new cases of occupational noise-induced deafness indicates that the hearing loss of occupational population has not been effectively controlled in China. It is of great significance to study the characteristics of hearing loss among noise-exposed workers and its related factors. Objective To investigate characteristics and influencing factors of hearing loss among occupational noise-exposed workers in a large machinery maintenance enterprise, and to provide a scientific basis to prevent and control noise-induced hearing loss. Methods A cross-sectional survey was conducted to investigate male Han occupational noise-exposed workers in a large mechanical maintenance enterprise. We acquired demographic characteristics, occupational exposure history, and individual life behavior characteristics of the workers through questionnaires, collected occupational exposure level data from annual occupational disease hazard factor surveillance reports, obtained pure tone hearing threshold test data through occupational health examinations, and estimated individual noise exposure levels using cumulative noise exposure (CNE). According to the results of pure tone air conduction hearing threshold test, the workers were divided into a hearing loss group and a normal hearing group. The chi-square test was employed to compare the occupational exposure characteristics and individual life behavior characteristics between the two groups. Additionally, the trend chi-square test was utilized to analyze the changing trends of age, length of service, CNE, and hearing loss rate within the two groups. The relationship between high-frequency hearing loss in both ears and its related influencing factors was assessed by a multiple logistic regression model. Results The M (P₂₅, P₇₅) of CNE for the 2531 occupational noise-exposed workers was 97.51 (95.39, 99.96) dB(A)·year. The incidence of hearing anomaly, binaural high-frequency hearing anomaly, random ear high-frequency hearing anomaly, binaural low-frequency hearing anomaly, and random ear low-frequency hearing anomaly were 22.48%, 16.59%, 22.13%, 2.77%, and 3.52%, respectively. High-frequency hearing threshold increase was the main reason for hearing anomaly (98.42%). In comparison to the CNE ≤ 97 dB(A)·year group, the 97 dB(A)·year100 dB(A)·year group experienced a 36.4% and 52.3% increase in the risk of bilateral high-frequency hearing loss, respectively. The smoking group exhibited a 43.5% elevated risk of bilateral high-frequency hearing loss when compared to the non-smoking group. Conversely, the group frequently wearing hearing protection equipment demonstrated a 23.6% lower risk of bilateral high-frequency hearing loss in comparison to the group occasionally wearing protective equipment. The data suggested that CNE＞97 dB(A)·year and smoking might be independent risk factors for bilateral high-frequency hearing loss, and frequently wearing hearing protection equipment might be an important protective factor. Conclusion Increased CNE and smoking can elevate the risk of high-frequency hearing loss, while personal hearing protection can effectively reduce the risk of hearing loss.