This paper focuses on extreme environments and systematically analyzes sleep disorders caused by multiple pathogenesis,including circadian rhythm disorder,yin-yang imbalance and qi-blood disorder under weightlessness,emotional depression due to environmental changes,abnormal diet and excretion,and six excesses pathogenic factors,in accordance with the theory of correspondence between nature and human.It proposes harmonizing yin and yang as the core therapeutic principle and guiding framework,with specific methods including calming rebellious qi-blood,regulating qi movement,harmonizing heart and kidney,and dredging and regulating blood vessels,thus forming the"one guiding principle and four specific methods"treatment strategy.Additionally,by integrating the modified application of classic formulas,a diagnostic and therapeutic approach targeting multi-dimensional pathogenesis is established.This study aims to promote the in-depth integration of Traditional Chinese Medicine(TCM)in extreme environmental medicine through TCM theories and innovative application of prescriptions,provide TCM-characterized solutions for health management of workers in extreme environments,and facilitate the transformation of extreme environmental medicine toward the modern medical model of"prevention-treatment integration".

Objective To investigate the effects and possible mechanisms of the growth differentia-tion factor 15(GDF-15)/glial-derived neurotrophic factor receptor alpha-like(GFRAL)pathway on the progression of atherosclerosis in ApoE-/-mice.Methods Eight 8-week-old male ApoE-/-mice were randomly divided into control group and rGDF-15 group.The mice in the control group received an injection of phosphate-buffered saline via tail vein once a week after 4 weeks of high-fat diet feeding,and those in the rGDF-15 group received an injection of recombinant GDF-15(0.05 mg/kg)via tail vein once a week after 4 weeks of high-fat diet feeding.The mice were fed with high-fat diet for another 8 weeks,the body weight was monitored during this period.After 12 weeks'feeding,the mice were euthanized.Another 4 normal mice(at the same age,20 weeks old)were subjected and served as normal control group.The levels of fasting blood glucose,blood lip-ids,cortisol,and aldosterone were compared among the three groups.Oil red O staining was used to evaluate plaque size in the aorta,and immunohistochemistry was employed to assess the expression of GDF-15 and GFRAL in the brain tissue.Results The serum level of GDF-15 was higher in the rGDF-15 group than in the control group(52.59±2.90 ng/ml vs 20.09±1.27 ng/ml,P＜0.01).The weight of mice was significantly lower in the rGDF-15 group than the con-trol group during Week 11(28.60±0.22 g vs 29.47±0.25 g,P＜0.01)and 12(28.98±0.22 g vs 30.35±0.13 g,P＜0.01).The rGDF-15 group had a statistically lower level of triglycerides(0.22±0.02 mmol/L vs 0.38±0.09 mmol/L,P＜0.05),lighter plaque burden[(22.22±2.58)％vs(31.61±3.51)％,P＜0.01],and enhanced expression levels of GDF-15 and GFRAL in the brain tissue(0.088±0.007 vs 0.030±0.006,0.031±0.003 vs 0.010±0.001,P＜0.01).The levels of cor-tisol and aldosterone in the control group and rGDF-15 group were significantly higher than those in the normal group(P＜0.01).The aldosterone level in the rGDF-15 group was significantly re-duced compared to the control group(22.013.67 mg/ml vs 87.29±8.63 mg/ml,P＜0.01).Conclusion GDF-15 may regulate body weight and triglyceride and aldosterone levels through GFRAL,and then affect the progression of atherosclerosis.

Objective To analyze the effects of rapid rehabilitation surgical procedures on recovery and stress response in patients undergoing hepatectomy.Methods Retrospective analysis of 60 patients with liver resection in Zhujiang Hospital of Southern Medical University from January 2012 to December 2015,40 males and 20 females.According to the rehabilitation method,it was divided into intervention group (n=30) and control group (n=30).The operation time,intraoperative blood loss,postoperative complications,and interleukin-6 (IL-6),C-reactive protein (CRP),and white blood cell count (WBC) on days 1st,3rd,and 5 th before and after surgery were compared between the two groups.Results Both groups completed the operation successfully.There was no significant difference in intraoperative blood loss and operation time between the two groups (P＞0.05).The duration of postoperative ventilation and postoperative hospitalization in the intervention group was less than that in the control group,and the incidence of postoperative complications (23.3％ vs.50.0％) and the first and second day after surgery were lower than those in the control group,with statistically significant differences (P＜0.05).On the first,third and fifth days after surgery,IL-6 and CRP in the intervention group were lower than those in the control group,respectively (64.96± 24.10) μg/L vs.(286.74±67.98) μg/L,(60.52±18.31)μg/L vs.(162.33±52.62) μg/L,(31.61± 9.42) μg/L vs.(77.44±24.54)μg/L and (24.64±17.45) mg/L vs.(41.46±20.79) mg/L,(81.11± 36.58) mg/L vs.(117.23±44.80) mg/L,(44.90±22.31) mg/L vs.(65.27±38.05) mg/L,the differences were statistically significant (P＜0.05).Conclusion The concept of rapid rehabilitation surgery applied to patients with hepatectomy can reduce postoperative stress response,reduce postoperative complications,and accelerate the recovery process.