To promote the high-quality development of healthcare in the highland areas and to enable traditional Chinese medicine(TCM)to make a more prominent contribution to the healthcare of the people in these areas,it is imperative to clarify the roles of TCM in the formation of the healthcare system in the past and present,as well as the direction of innovative development of TCM in the plateau in the future.To this end,this paper first systematically reviews the literature to summarize the influence of TCM on the cultural background,theoretical framework,and practical system of Tibetan medicine during its origin,development,and maturation;then,through the example of typical cases,it elaborates on the direct practical applications of TCM in the prevention and treatment of a series of highland diseases from the perspectives of pathogenesis,therapeutic principles,unique drugs,and techniques;finally,it deeply reflects on a series of problems restricting the integration,inheritance,and innovative development of TCM in the highland areas and puts forward targeted suggestions to enable TCM to serve and safeguard the health of people living in the plateaus better together with the local ethnic medicine.

To promote the high-quality development of healthcare in the highland areas and to enable traditional Chinese medicine(TCM)to make a more prominent contribution to the healthcare of the people in these areas,it is imperative to clarify the roles of TCM in the formation of the healthcare system in the past and present,as well as the direction of innovative development of TCM in the plateau in the future.To this end,this paper first systematically reviews the literature to summarize the influence of TCM on the cultural background,theoretical framework,and practical system of Tibetan medicine during its origin,development,and maturation;then,through the example of typical cases,it elaborates on the direct practical applications of TCM in the prevention and treatment of a series of highland diseases from the perspectives of pathogenesis,therapeutic principles,unique drugs,and techniques;finally,it deeply reflects on a series of problems restricting the integration,inheritance,and innovative development of TCM in the highland areas and puts forward targeted suggestions to enable TCM to serve and safeguard the health of people living in the plateaus better together with the local ethnic medicine.

Objective To investigate the clinical manifestations of traditional Chinese medicine(TCM)and their associations with TCM constitutions in individuals who have migrated to plateau areas,and to provide a scientific basis for plateau health management.Methods Migrants living in areas above 3000 m were selected as research subjects.Data were collected by using TCM symptom assessment scales and constitution assessment scales.Descriptive statistical analysis was conducted to determine the incidence and severity of symptoms among individuals with different migration durations,and core symptoms were identified.Factor analysis was performed by using SPSS software to extract symptom clusters and explore the correlation between core symptoms and TCM constitutions.Results Among individuals who migrated to plateau areas,the incidence of discomfort symptoms was 83.44％.The five most common symptoms were dry skin(67.94％),forgetfulness(56.03％),dry mouth(52.06％),yellow urine(48.73％),and insomnia(47.14％).In the top 10 symptoms with the highest increase in incidence,yellow urine(33.51％)and forgetfulness(26.33％)were both present in the top 10 symptoms across different migration durations.Factor analysis extracted 5,2,4,and 6 symptom clusters from the overall population,individuals who migrated within 1 year,those who migrated for 1-2 years,and those who migrated over 2 years,respectively.Qi-deficiency constitution(QDC),blood stasis constitution(BSC),qi stagnation constitution(QSC),phlegm-dampness constitution(PDC),and dampness-heat constitution(DHC)were significantly positively correlated with forgetfulness.Conclusion Migrating to plateau areas can induce discomfort symptoms,and both the number and incidence of symptoms increase with longer migration durations.The number and incidence of high-frequency symptoms(incidence≥30％)increase with prolonged migration time.There are differences in the composition and severity of symptom clusters across different migration durations.QDC,BSC,QSC,PDC,and DHC are closely related to forgetfulness and can be considered risk constitutions for forgetfulness.Timely attention to changes in symptom clusters and constitutions can help prevent and mitigate the occurrence and development of symptoms.

Objective:This study by using the method of network pharmacology to screen the active constituent and related targets of Epimedii Folium aims to explore the mechanisms of the reinforcing effect of Epimedii Folium on kidney in the treatment of PCOS. Methods:By retrieving data from TCMSP datebase, screened out the active constituent of Epimedii Folium and the information of the targets corresponding to each active constituent; by using the gene database of NCBI, translated the information of the targets into gene names; by retrieving data from GeneCards datebase, extracted the genes related to PCOS; related targets of Epimedii Folium in the treatment of PCOS were obtained by Venn tool; by using Cytoscape 3.7.2 software, constructed a network diagram of Epimedii Folium-active constituents-targets-PCOS; by using STRING database, constructed the protein interaction network; then carried out GO enrichment analysis of related targets by Geneontology database and carried out pathway enrichment analysis of related targets by KEGG database. Results:There were 23 active constituents of Epimedii Folium and 132 related targets treating PCOS. The Epimedii Folium could play the reinforcing effect on kidney mainly by regulating the biological processes like steroid hormone receptor activity, as well as KEGG pathways such as Estrogen signaling pathway, GnRH signaling pathway, GnRH secretion, HIF-1 signaling pathway and VEGF signaling pathway in treating PCOS. Conclusion:From the perspective of network pharmacology, this study preliminarily analyzed the related targets and pathways of reinforcing effect on kidney of Epimedii folium in the treatment of PCOS, providing reference for further experiments and application inclinics.

Objective To explore the possible mechanism of activating blood circulation and removing blood stasis herbs in the treatment of endometriosis (EM) with network pharmacology approach. Methods Seven kinds of commonly used activating blood circulation and removing blood stasis herbs, such as: peach kernel, safflower, zeilan, salvia miltiorrhiza, leonuri, radix cyathulae, and wang buliuxing were selected as the research subjects. TCMSP platform, a database of traditional Chinese medicine chemical ingredients, was used to retrieve the effective ingredients of 7 herbs. The targets of the effective ingredients were obtained through the Targets information software. GeneCards database was used to collect EM related target genes. Venn diagram tool was used to obtain the target genes of active ingredients of activating blood circulation and removing blood stasis herbs. Cytoscape 3.6.0 software was used to construct the active ingredient-target-disease network. KEGG database was used to analyze the signal pathways of target gene enrichment. Results A total of 94 active ingredients and 119 targets of 7 herbs were screened. Quercetin, luteolin and kaempferol were the key active components. PTGS2, PTGS1, NCOA2 and NCOA1 were the key targets. The 7 herbs have 20 related KGEE pathways, involving sex hormones, inflammation, apoptosis and angiogenesis. PI3K-Akt signaling pathway, IL-17 signaling pathway, TNF signaling pathway were the main pathways. Conclusion The treatment of EM with activating blood circulation and removing blood stasis herbs has the characteristics of multiple components, multiple targets and multiple pathways, which can relieve the pain, inflammation and menstrual disorders symptoms of EM.

Objective    To analyze the risk factors of the death associated with infective endocarditis, and to evaluate the timing of surgical treatment of infective endocarditis. Methods    We retrospectively analyzed the clinical data of 62 patients with infective endocarditis in our hospital between August 2015 and August 2017. There were 43 males and 19 females at age of 19–75 (46.1±16.6) years. The clinical data were divided into a death group and a survival group, a paravalvular leakage group and a no periannular leakage group, an emergency operation group and a non-emergency operation group.The risk factors of infective endocarditis and the choice of operation time were analyzed. Results    Three of the 62 patients (4.8%) died after surgery. Postoperative perivalvular leakage (regurgitation over 2 mm) in 8 patients, accounting for 12.9% of the total. Univariate analysis showed that albumin content, creatinine level, total cardiopulmonary bypass time and ascending aorta occlusion time were significantly associated with early postoperative mortality (P<0.05). The results of logistic analysis showed that age, preoperative albumin level, creatinine level, total cardiopulmonary bypass time, and ascending aorta occlusion time were significantly associated with early postoperative perivascular leakage (P<0.05), and long ascending aorta occlusion time is an independent risk factor for early death (P<0.05). There was no statistical difference in early death and the perivalve leakage between the emergency operation and the non emergency operation. Conclusion    Patients with infective endocarditis should accept early surgical treatment. The choice of surgical approach should be selected according to the actual situation of patients. And we should pay more attention to albumin and creatinine levels in preoperative patients. In the operation, to shorten extracorporeal circulation  time and aortic clamping time can improve the prognosis of patients.