Dyadic interviews can deeply reveal the complex interaction between dyads(eg,patients and their caregivers),and their importance in the field of nursing qualitative research has become increasingly prominent.Through a comprehensive literature review,this paper systematically combs the relevant literature of dyadic interviews,elaborates on the concept and application areas of dyadic interviews,deeply discusses 5 major forms of dyadic interviews and the analysis methods of dyadic data,illustrates with specific examples.The aim is to provide methodological guidance for Chinese nursing researchers and promote the scientific and standardized application of this method in the field of nursing qualitative research.

ObjectiveTo analyze the research situation， hotspots， and trend of the compatibility of bitter and pungent medicinals in traditional Chinese medicine by knowledge mapping and provide reference for the inheritance and clinical application of this theory. MethodsThe literature on the compatibility of bitter and pungent medicinals was retrieved from 6 databases， including China National Knowledge Infrastructure （CNKI）， VIP， Wanfang Data， SinoMed， Web of Science， and PubMed. The literature was searched with the keywords of bitter medicinals， pungent medicinals， compatibility， Banxia Xiexin decoction， Zhuyu pills， and Zuojin pills. The search time ranged from January 1， 1984 to August 10， 2024. NoteExpress 3.7 was used for literature screening， and CiteSpace 6.1.R2 was used to visualize the number of publications， authors， institutional cooperation network， and the co-occurrence， clustering， time line， and burst of keywords. ResultsA total of 628 Chinese articles and 151 English articles related to the compatibility of bitter and pungent medicinals were included， and the annual number of publications rose with fluctuations. WEI Wei was the core author of Chinses articles and SHEN Tao and ZHAO Yanling were the core authors of English articles. China Academy of Chinese Medical Sciences formed a close cooperative network with many research institutions at home and abroad. The high-frequency keywords included pungent dispersing and bitter descending， Coptidis Rhizoma， Euodiae Fructus， Banxia Xiexin decoction， Zuojin pills， compatibility， spleen and stomach diseases， and gut microbiota， which mainly involved common prescriptions， diseases responding specifically to traditional Chinese medicine， mechanism research and so on. The keyword bursts concentrated in famous doctors' experience， network Meta-analysis， inflammatory bowel disease， diabetes mellitus， intestinal microbiota， etc. The compatibility of bitter medicinals and pungent medicinals was widely used in clinical practice. Based on pungent dispersing and bitter descending， the middle energizer was regulated for treating spleen and stomach diseases and inflammatory bowel disease. Bitter and pungent medicinals descending the turbid were used to treat diabetes mellitus and hyperlipidemia by lowering blood glucose and lipid levels. The mild bitter and slightly pungent medicinals were used as supplements to treat depression and COVID-19 by regulating Qi movement. ConclusionIn the past 40 years， the number of publications on the compatibility of bitter and pungent medicinals has been increasing， and the research team has begun to take form. Clinically， the compatibility of bitter and pungent medicinals is the main treatment for spleen and stomach diseases and glycolipid metabolic diseases. At present， the modern scientific essence of the compatibility of bitter and pungent medicinals is mainly explained based on famous doctors' experience inheritance， network meta-analysis， and intestinal flora.

ObjectiveTo observe the efficacy and safety of Zhuyuwan in the treatment of hyperlipidemia （syndrome of phlegm turbidity and obstruction） complicated with carotid atherosclerosis. MethodsA total of 120 patients with hyperlipidemia （syndrome of phlegm turbidity and obstruction） complicated with carotid atherosclerosis were randomly allocated into a treatment group and a control group， with 60 patients in each group. The control group orally took rosuvastatin calcium tablets， 10 mg each time， once a day. The treatment group took Zhuyuwan granules， 1 dose a day in 3 times. Both groups received diet and exercise guidance and were treated for 24 consecutive weeks. The traditional Chinese medicine （TCM） symptom scores were recorded before and after treatment. The levels of blood lipids ［total cholesterol （TC）， triglycerides （TG）， low-density lipoprotein cholesterol （LDL-C）， and high-density lipoprotein cholesterol （HDL-C）］， carotid color ultrasound ［carotid intima-media thickness （IMT）， plaque number， maximum plaque area， and maximum plaque thickness］， vascular intimal repair-related factors ［nitric oxide （NO）， endothelin-1 （ET-1）， soluble intercellular adhesion molecule 1 （sICAM-1）， and thromboxane B2 （TXB2）］， and oxidative stress-related indicators ［superoxide dismutase （SOD） and glutathione peroxidase （GSH-Px）］ were measured before and after treatment. The occurrence of adverse reactions was observed during treatment， and the clinical efficacy of the two groups was compared after treatment. ResultsThe trial was completed and 112 patients （57 in the treatment group and 55 in the control group） were included in the statistical analysis， and the general information of the two groups was comparable. The total response rate in the treatment group was 87.72% （50/57）， which was higher than that （74.55%， 41/55） in the control group （χ²=4.823， P<0.05）. After treatment， the scores of main TCM symptoms such as body obesity， chest tightness， and limb numbness， the scores of secondary symptoms such as palpitation， insomnia， tastelessness in the mouth， reduced appetite， tongue and pulse manifestation scores， and the total TCM symptom score decreased in both groups （P<0.05， P<0.01）. Moreover， the treatment group had lower scores of main symptoms such as body obesity， head heaviness， chest tightness， nausea， salivation， and limb numbness， scores of secondary symptoms such as tastelessness in the mouth and reduced appetite， and total TCM symptom score than the control group （P<0.05， P<0.01）. After treatment， both groups showed declines in TC， TG， LDL-C， IMT， plaque number， maximum plaque area， maximum plaque thickness， ET-1， sICAM-1， and TXB2 （P<0.05， P<0.01） and elevations in levels of HDL-C， NO， and SOD （P<0.05， P<0.01）. The treatment group had lower TC， TG， LDL-C， IMT， plaque number， maximum plaque area， maximum plaque thickness， ET-1， sICAM-1， and TXB2 （P<0.01） and higher levels of HDL-C， NO， SOD， and GSH-Px （P<0.05， P<0.01） than the control group. During treatment， adverse reactions occurred in 3 cases （5.26%， 1 case of dizziness， 1 case of acid reflux， and 1 case of constipation） in the treatment group and 4 cases （7.27%， 2 cases of upper respiratory tract infection， 1 case of abdominal pain， and 1 case of low back pain） in the control group. ConclusionZhuyuwan can effectively reduce blood lipid levels， inhibit the formation of carotid atherosclerotic plaque， and alleviate the syndrome of phlegm turbidity and obstruction by promoting vascular intima repair and improving the antioxidant function.

This article discusses the key pathogenesis of atherosclerosis （AS） based on the physiological characteristics and pathological changes of lipids and introduces the therapeutic effect of Zhuyuwan on AS， aiming to provide a theoretical basis for the treatment of cardiovascular diseases from the spleen. As essential substances， lipids have the same essence but different forms. They circulate throughout the body with body fluids under the action of Yang Qi to nourish the nutrient Qi and support the defensive Qi. Lipid metabolism disorder often leads to the obstruction of Qi movement， the accumulation of dampness and turbidity， and the generation of phlegm and blood stasis. It has been proven that the formation of vulnerable plaques in AS is attributed to the interaction of three pathogenic factors： deficiency of healthy Qi， phlegm-turbidity， and collateral stasis. Their pathological essence is closely related to abnormal lipid metabolism. As lipids constitute the thick and dense components of body fluids， their impaired dispersion may lead to phlegm-turbidity and blood stasis， the pathological process of which is predominantly ascribed to the dysfunction of the spleen in distributing essence. Therefore， AS is rooted in spleen-stomach disorder， manifests as plaques formed by pathological product accumulation in vessels， with lipid transport disorder as its core pathogenesis. Specifically speaking， the dysfunction of spleen in transportation with accumulation of dampness-turbidity marks the initial stage， and blood turbidity and coagulation and phlegm-nodules accumulating in vessels represent the intermediate phase. Cold accumulation and stagnated heat transforming into toxins represent the terminal stage. Zhuyuwan， first recorded in Taiping Holy Prescriptions for Universal Relief， contains equal proportions of Coptidis Rhizoma and Evodiae Fructus. Coptidis Rhizoma， bitter and cold， exerts descending and purging actions to assist stomach Qi in lowering turbidity. Evodiae Fructus， pungent-bitter and hot， disperses obstruction and promotes free flow to support spleen Qi in ascending the clear. The compatibility of Coptidis Rhizoma and Evodiae Fructus ascends the clear and descends the turbid to harmonize Yin and Yang， assisting the spleen in distributing essence and resolving lipid accumulation to reduce lipid levels. In terms of the therapeutic mechanism， Zhuyuwan modulates lipid metabolism by correcting immune-inflammation network imbalance， improving gut microbiota composition and metabolism， and enhancing reverse cholesterol transport. By analyzing the pathological characteristics of lipid transport disorder in AS， this study delves into the intrinsic connections between cardiovascular disease and lipid transport disorder， giving novel insights into the prevention and treatment of AS.

ObjectiveTo analyze the research situation， hotspots， and trend of the compatibility of bitter and pungent medicinals in traditional Chinese medicine by knowledge mapping and provide reference for the inheritance and clinical application of this theory. MethodsThe literature on the compatibility of bitter and pungent medicinals was retrieved from 6 databases， including China National Knowledge Infrastructure （CNKI）， VIP， Wanfang Data， SinoMed， Web of Science， and PubMed. The literature was searched with the keywords of bitter medicinals， pungent medicinals， compatibility， Banxia Xiexin decoction， Zhuyu pills， and Zuojin pills. The search time ranged from January 1， 1984 to August 10， 2024. NoteExpress 3.7 was used for literature screening， and CiteSpace 6.1.R2 was used to visualize the number of publications， authors， institutional cooperation network， and the co-occurrence， clustering， time line， and burst of keywords. ResultsA total of 628 Chinese articles and 151 English articles related to the compatibility of bitter and pungent medicinals were included， and the annual number of publications rose with fluctuations. WEI Wei was the core author of Chinses articles and SHEN Tao and ZHAO Yanling were the core authors of English articles. China Academy of Chinese Medical Sciences formed a close cooperative network with many research institutions at home and abroad. The high-frequency keywords included pungent dispersing and bitter descending， Coptidis Rhizoma， Euodiae Fructus， Banxia Xiexin decoction， Zuojin pills， compatibility， spleen and stomach diseases， and gut microbiota， which mainly involved common prescriptions， diseases responding specifically to traditional Chinese medicine， mechanism research and so on. The keyword bursts concentrated in famous doctors' experience， network Meta-analysis， inflammatory bowel disease， diabetes mellitus， intestinal microbiota， etc. The compatibility of bitter medicinals and pungent medicinals was widely used in clinical practice. Based on pungent dispersing and bitter descending， the middle energizer was regulated for treating spleen and stomach diseases and inflammatory bowel disease. Bitter and pungent medicinals descending the turbid were used to treat diabetes mellitus and hyperlipidemia by lowering blood glucose and lipid levels. The mild bitter and slightly pungent medicinals were used as supplements to treat depression and COVID-19 by regulating Qi movement. ConclusionIn the past 40 years， the number of publications on the compatibility of bitter and pungent medicinals has been increasing， and the research team has begun to take form. Clinically， the compatibility of bitter and pungent medicinals is the main treatment for spleen and stomach diseases and glycolipid metabolic diseases. At present， the modern scientific essence of the compatibility of bitter and pungent medicinals is mainly explained based on famous doctors' experience inheritance， network meta-analysis， and intestinal flora.

ObjectiveTo observe the efficacy and safety of Zhuyuwan in the treatment of hyperlipidemia （syndrome of phlegm turbidity and obstruction） complicated with carotid atherosclerosis. MethodsA total of 120 patients with hyperlipidemia （syndrome of phlegm turbidity and obstruction） complicated with carotid atherosclerosis were randomly allocated into a treatment group and a control group， with 60 patients in each group. The control group orally took rosuvastatin calcium tablets， 10 mg each time， once a day. The treatment group took Zhuyuwan granules， 1 dose a day in 3 times. Both groups received diet and exercise guidance and were treated for 24 consecutive weeks. The traditional Chinese medicine （TCM） symptom scores were recorded before and after treatment. The levels of blood lipids ［total cholesterol （TC）， triglycerides （TG）， low-density lipoprotein cholesterol （LDL-C）， and high-density lipoprotein cholesterol （HDL-C）］， carotid color ultrasound ［carotid intima-media thickness （IMT）， plaque number， maximum plaque area， and maximum plaque thickness］， vascular intimal repair-related factors ［nitric oxide （NO）， endothelin-1 （ET-1）， soluble intercellular adhesion molecule 1 （sICAM-1）， and thromboxane B2 （TXB2）］， and oxidative stress-related indicators ［superoxide dismutase （SOD） and glutathione peroxidase （GSH-Px）］ were measured before and after treatment. The occurrence of adverse reactions was observed during treatment， and the clinical efficacy of the two groups was compared after treatment. ResultsThe trial was completed and 112 patients （57 in the treatment group and 55 in the control group） were included in the statistical analysis， and the general information of the two groups was comparable. The total response rate in the treatment group was 87.72% （50/57）， which was higher than that （74.55%， 41/55） in the control group （χ²=4.823， P<0.05）. After treatment， the scores of main TCM symptoms such as body obesity， chest tightness， and limb numbness， the scores of secondary symptoms such as palpitation， insomnia， tastelessness in the mouth， reduced appetite， tongue and pulse manifestation scores， and the total TCM symptom score decreased in both groups （P<0.05， P<0.01）. Moreover， the treatment group had lower scores of main symptoms such as body obesity， head heaviness， chest tightness， nausea， salivation， and limb numbness， scores of secondary symptoms such as tastelessness in the mouth and reduced appetite， and total TCM symptom score than the control group （P<0.05， P<0.01）. After treatment， both groups showed declines in TC， TG， LDL-C， IMT， plaque number， maximum plaque area， maximum plaque thickness， ET-1， sICAM-1， and TXB2 （P<0.05， P<0.01） and elevations in levels of HDL-C， NO， and SOD （P<0.05， P<0.01）. The treatment group had lower TC， TG， LDL-C， IMT， plaque number， maximum plaque area， maximum plaque thickness， ET-1， sICAM-1， and TXB2 （P<0.01） and higher levels of HDL-C， NO， SOD， and GSH-Px （P<0.05， P<0.01） than the control group. During treatment， adverse reactions occurred in 3 cases （5.26%， 1 case of dizziness， 1 case of acid reflux， and 1 case of constipation） in the treatment group and 4 cases （7.27%， 2 cases of upper respiratory tract infection， 1 case of abdominal pain， and 1 case of low back pain） in the control group. ConclusionZhuyuwan can effectively reduce blood lipid levels， inhibit the formation of carotid atherosclerotic plaque， and alleviate the syndrome of phlegm turbidity and obstruction by promoting vascular intima repair and improving the antioxidant function.

This article discusses the key pathogenesis of atherosclerosis （AS） based on the physiological characteristics and pathological changes of lipids and introduces the therapeutic effect of Zhuyuwan on AS， aiming to provide a theoretical basis for the treatment of cardiovascular diseases from the spleen. As essential substances， lipids have the same essence but different forms. They circulate throughout the body with body fluids under the action of Yang Qi to nourish the nutrient Qi and support the defensive Qi. Lipid metabolism disorder often leads to the obstruction of Qi movement， the accumulation of dampness and turbidity， and the generation of phlegm and blood stasis. It has been proven that the formation of vulnerable plaques in AS is attributed to the interaction of three pathogenic factors： deficiency of healthy Qi， phlegm-turbidity， and collateral stasis. Their pathological essence is closely related to abnormal lipid metabolism. As lipids constitute the thick and dense components of body fluids， their impaired dispersion may lead to phlegm-turbidity and blood stasis， the pathological process of which is predominantly ascribed to the dysfunction of the spleen in distributing essence. Therefore， AS is rooted in spleen-stomach disorder， manifests as plaques formed by pathological product accumulation in vessels， with lipid transport disorder as its core pathogenesis. Specifically speaking， the dysfunction of spleen in transportation with accumulation of dampness-turbidity marks the initial stage， and blood turbidity and coagulation and phlegm-nodules accumulating in vessels represent the intermediate phase. Cold accumulation and stagnated heat transforming into toxins represent the terminal stage. Zhuyuwan， first recorded in Taiping Holy Prescriptions for Universal Relief， contains equal proportions of Coptidis Rhizoma and Evodiae Fructus. Coptidis Rhizoma， bitter and cold， exerts descending and purging actions to assist stomach Qi in lowering turbidity. Evodiae Fructus， pungent-bitter and hot， disperses obstruction and promotes free flow to support spleen Qi in ascending the clear. The compatibility of Coptidis Rhizoma and Evodiae Fructus ascends the clear and descends the turbid to harmonize Yin and Yang， assisting the spleen in distributing essence and resolving lipid accumulation to reduce lipid levels. In terms of the therapeutic mechanism， Zhuyuwan modulates lipid metabolism by correcting immune-inflammation network imbalance， improving gut microbiota composition and metabolism， and enhancing reverse cholesterol transport. By analyzing the pathological characteristics of lipid transport disorder in AS， this study delves into the intrinsic connections between cardiovascular disease and lipid transport disorder， giving novel insights into the prevention and treatment of AS.

Dyadic interviews can deeply reveal the complex interaction between dyads(eg,patients and their caregivers),and their importance in the field of nursing qualitative research has become increasingly prominent.Through a comprehensive literature review,this paper systematically combs the relevant literature of dyadic interviews,elaborates on the concept and application areas of dyadic interviews,deeply discusses 5 major forms of dyadic interviews and the analysis methods of dyadic data,illustrates with specific examples.The aim is to provide methodological guidance for Chinese nursing researchers and promote the scientific and standardized application of this method in the field of nursing qualitative research.

Objective: To understand the attitudes and perceptions of traditional Chinese medicine (TCM) practitioners in Beijing TCM hospitals regarding the use of Ephedra sinica Stapf (E. sinica, Ma Huang). Methods: A two-stage cross-sectional study was conducted using a questionnaire survey of TCM practitioners in Beijing TCM hospitals between April 2023 and March 2024. The questionnaire included demographic information, the clinical background of TCM practitioners, and the clinical application of E. sinica. Logistic regression analysis was used to analyze the relevant influencing factors when using E. sinica. Results: Of the 465 questionnaires collected, 441 were valid. Among these, 84.81% (374/441) reported having used E. sinica in clinical practice at least once. The commonly used doses of E. sinica—excluding the pediatric department—were 10 g for high doses, 6 g for medium, and 3 g for low. The three most frequently used formulas for E. sinica included Maxing Shigan decoction, Mahuang decoction, and Xiao Qing Long decoction. The most common TCM patterns treated with a high dose of E. sinica were wind-cold exterior pattern, wind-cold invading the lung, and wind and water combat with meridians congealed by cold. The top three Western medical diagnoses when using E. sinica for treatment were common cold, pneumonia, and upper respiratory tract infections. Nearly half of the respondents reported experiencing adverse reactions from the oral administration of E. sinica, with the most common being palpitations, insomnia, and restlessness. Starting with a low dose and gradually increasing it as appropriate was identified as an effective approach. Conclusion This study investigated the attitudes and perceptions of TCM practitioners in Beijing TCM hospitals regarding the dose–efficacy–adverse reaction relationship of E. sinica, providing a reference for the safe and effective clinical use of E. sinica.

ObjectiveTo investigate the possible mechanism of action and combination of medicinals of Zhuyu Pill （茱萸丸） in the treatment of atherosclerosis. MethodsThirteen normal C57BL/6J mice were used as blank group， and 40 ApoE^-/- mice of the same strain were randomly divided into model group， Huanglian （Coptis chinensis Franch.） group， Wuzhuyu （Tetradium ruticarpum） group， and Zhuyu Pill group， with 10 mice in each group. Except the blank group， the other groups were fed with high-fat diet for modeling， and the total modeling cycle was 12 weeks. After modelling， Huanglian group was given Huanglian solution 143.34 mg/（kg·d）， Wuzhuyu group with Wuzhuyu solution 301.78 mg/（kg·d）， Zhuyu Pill group with 261.07 mg/（kg·d） of Zhuyu Pill solution， blank group and model group were given 0.3ml of normal saline. Mice in all groups were gavaged for 12 weeks. The levels of total cholesterol （TC）， triglyceride （TG）， low density lipoprotein cholesterol （LDL-C） and fasting blood glucose were measured by biochemical method； fasting insulin in serum was detected by enzyme-linked immunosorbent assay （ELISA） and insulin resistance index was calculated； HE staining was used to observe the pathological and morphological changes of aortic tissue， liver and epididymal fat in mice， and oil red O staining was used to observe the lipid deposition of aortic tissue in mice， and the percentage of positive area of aortic HE staining， the percentage of positive area of aortic oil red O staining， the non-alcoholic fatty liver activity score （NAS） score， and the cross-sectional area of epididymal fat were calculated； serum levels of interleukin 1β （IL-1β） and interleukin 18 （IL-18） were detected by ELISA； protein expression of nucleotide-binding oligomerisation structural domain-like receptor family pyridoxal structural domain protein 3 （NLRP3） in aortic tissues was detected by Western blot； and immunofluorescence was used to detect the levels of apoptosis-associated granulocyte-like protein （ASC）， which contains the CARD structural domain （ASC） and cysteine-containing aspartic protease 1 （Caspase-1） protein expression； and real-time fluorescence PCR was used to detect NLRP3， ASC， Caspase-1， IL-1β， and IL-18 mRNA expression in mouse aortic tissues. ResultsCompared with blank group， serum TC， TG and LDL-C were increased， insulin was decreased， fasting blood glucose and insulin resistance index were increased in model group （P＜0.01）. Aortic plaque area increased， liver lipid deposition increased， epididymal fat cells volume increased， liver NAS score increased， and epididymal fat cross-sectional area increased. Serum IL-1β and IL-18 increased， and the expression levels of NLRP3， ASC， Caspase-1 protein and mRNA in aortic tissue increased （P＜0.01）. Compared with model group， serum TC， TG and LDL-C in Huanglian group， Wuzhuyu group and Zhuyu Pill group decreased， fasting insulin increased， fasting blood glucose and insulin resistance index decreased （P＜0.01）； aortic plaque area decreased significantly， liver lipid deposition decreased， liver NAS score decreased， epididymal fat cell volume decreased， epididymal fat cross section area decreased， serum IL-1β and IL-18 were decreased， the expression levels of NLRP3， ASC， Caspase-1 protein and mRNA in aortic tissue were decreased （P＜0.01）， and the improvement of all indexes in the Zhuyu Pill group was better than that in Huanglian and Wuzhuyu groups （P＜0.01）. ConclusionZhuyu Pill has a good therapeutic effect on atherosclerosis in mice， and the combination of Huanglian and Wuzhuyu has a synergistic effect， the mechanism of which may be related to regulation of the NLRP3/ASC/Caspase-1 aortic signaling pathway， and thus reducing the vascular inflammatory response.