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.

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.

Objective To systematically evaluate the effectiveness of acupuncture in treating chronic cough and analyze its acupoint selection patterns.Methods Randomized controlled trials(RCTs)on acupuncture for chronic cough were retrieved from databases including CNKI,VIP,Wan Fang Data,CBM,PubMed,and Web of Science,Cochrane Library and Embase from their inception to April 2025.Original data from the included studies were extracted.Meta-analysis was performed to compare the acupuncture treatment group with the western medicine control group[using leukotriene receptor antagonists(LTRAs)and/or glucocorticoids]on outcomes including cough symptom scores,serum tumor necrosis factor-α(TNF-α)levels,pulmonary function indicators[forced vital capacity(FVC)and forced expiratory volume in the first second(FEV1)],overall clinical effectiveness,and incidence of adverse reactions.Publication bias was assessed using funnel plots,and descriptive analysis of the acupoint prescriptions from the included studies was conducted using Rstudio software to summarize the patterns of acupoint selection for chronic cough.Results A total of 10 studies involving 806 patients were included.Meta-analysis results showed that acupuncture was superior to the western medicine control group in improving cough symptom scores,reducing serum TNF-α levels,enhancing pulmonary function(FVC and FEV1),increasing overall clinical effectiveness,and reducing adverse reactions,with statistically significant differences.Further analysis of the 10 included studies revealed that the most frequently used acupoints were Feishu(BL13)(n=9 times),Zusanli(ST36)(n=7 times),Lieque(LU7)(n=6 times),and Pishu(BL20)(n=5 times).The most frequently utilized meridians were the Bladder Meridian of Foot-Taiyang(BL)(n=10 times),the Stomach Meridian of Foot-Yangming(ST)(n=7 times),and the Lung Meridian of Hand-Taiyin(LU)(n=7 times).Acupoints were primarily located on the lower back(36.92%),upper limbs(26.15%),and lower limbs(21.53%).Conclusion Acupuncture is effective in treating chronic cough.The acupoint prescriptions for chronic cough should follow the principles of symptomatic point selection and anterior-posterior point pairing,emphasizing the back-shu and front-mu point pairing method,as well as the upper-lower point pairing method.Points are predominantly selected from the Bladder meridian(BL),lung meridian(LU),and stomach meridian(ST).

Laparoscopic common bile duct exploration(LCBDE), as a safe and feasible surgical procedure for the treatment of choledocholithiasis, has been widely applied in clinical practice.However, due to the generally declined organ function, comorbidities, and polypharmacy associated with elderly patients, there is currently no unified consensus on the application of LCBDE in elderly patients with choledocholithiasis.This review aims to summarize the current status of LCBDE for the treatment of choledocholithiasis in the elderly patients, in order to provide reference for clinicians to select appropriate treatment strategies.

ObjectiveTo investigate the safety and feasibility of intra-biliary drainage tube placement after laparoscopic common bile duct exploration in elderly patients with choledocholithiasis， and to provide more options for surgical procedures in the clinical management of elderly patients with choledocholithiasis. MethodsA retrospective analysis was performed for the clinical data of 52 elderly patients with choledocholithiasis who were admitted to Department of Hepatobiliary Surgery， Affiliated Dalian Friendship Hospital of Dalian Medical University， from November 2021 to October 2024. According to the biliary drainage method after surgery， the patients were divided into internal drainage group with 24 patients and T-tube drainage group with 28 patients， and there were 19 patients in each group after propensity score matching. The two groups were compared in terms of perioperative parameters and postoperative complications. The Wilcoxon rank-sum test was used for comparison of continuous data between two groups， and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. ResultsCompared with the T-tube drainage group， the internal drainage group had a significantly shorter length of postoperative hospital stay and a significantly lower volume of postoperative bile loss （Z=-2.845 and -5.633， both P<0.05）， while there were no significant differences between the two groups in time of operation， intraoperative blood loss， and drainage tube indwelling time （all P>0.05）. There were no significant differences between the two groups in postoperative bile leak， stone recurrence， biliary stricture， and drainage tube-related complications， and the internal drainage group had a significantly lower total complication rate than the T-tube drainage group ［1 （5.3%） vs 7 （36.8%）， P<0.05］. ConclusionFor elderly patients with choledocholithiasis， intra-biliary drainage tube placement after laparoscopic common bile duct exploration can shorten the length of postoperative hospital stay， reduce bile loss， and lower the incidence rate of postoperative complications， thereby helping to accelerate postoperative recovery.

Objective To systematically evaluate the effectiveness of acupuncture in treating chronic cough and analyze its acupoint selection patterns.Methods Randomized controlled trials(RCTs)on acupuncture for chronic cough were retrieved from databases including CNKI,VIP,Wan Fang Data,CBM,PubMed,and Web of Science,Cochrane Library and Embase from their inception to April 2025.Original data from the included studies were extracted.Meta-analysis was performed to compare the acupuncture treatment group with the western medicine control group[using leukotriene receptor antagonists(LTRAs)and/or glucocorticoids]on outcomes including cough symptom scores,serum tumor necrosis factor-α(TNF-α)levels,pulmonary function indicators[forced vital capacity(FVC)and forced expiratory volume in the first second(FEV1)],overall clinical effectiveness,and incidence of adverse reactions.Publication bias was assessed using funnel plots,and descriptive analysis of the acupoint prescriptions from the included studies was conducted using Rstudio software to summarize the patterns of acupoint selection for chronic cough.Results A total of 10 studies involving 806 patients were included.Meta-analysis results showed that acupuncture was superior to the western medicine control group in improving cough symptom scores,reducing serum TNF-α levels,enhancing pulmonary function(FVC and FEV1),increasing overall clinical effectiveness,and reducing adverse reactions,with statistically significant differences.Further analysis of the 10 included studies revealed that the most frequently used acupoints were Feishu(BL13)(n=9 times),Zusanli(ST36)(n=7 times),Lieque(LU7)(n=6 times),and Pishu(BL20)(n=5 times).The most frequently utilized meridians were the Bladder Meridian of Foot-Taiyang(BL)(n=10 times),the Stomach Meridian of Foot-Yangming(ST)(n=7 times),and the Lung Meridian of Hand-Taiyin(LU)(n=7 times).Acupoints were primarily located on the lower back(36.92%),upper limbs(26.15%),and lower limbs(21.53%).Conclusion Acupuncture is effective in treating chronic cough.The acupoint prescriptions for chronic cough should follow the principles of symptomatic point selection and anterior-posterior point pairing,emphasizing the back-shu and front-mu point pairing method,as well as the upper-lower point pairing method.Points are predominantly selected from the Bladder meridian(BL),lung meridian(LU),and stomach meridian(ST).

Laparoscopic common bile duct exploration(LCBDE), as a safe and feasible surgical procedure for the treatment of choledocholithiasis, has been widely applied in clinical practice.However, due to the generally declined organ function, comorbidities, and polypharmacy associated with elderly patients, there is currently no unified consensus on the application of LCBDE in elderly patients with choledocholithiasis.This review aims to summarize the current status of LCBDE for the treatment of choledocholithiasis in the elderly patients, in order to provide reference for clinicians to select appropriate treatment strategies.

Objective To determine the chemical constituents in BSLYT by ultra-high performance liquid chromatography-mass spectrometry(UHPLC-MS/MS),and to establish a high-performance liquid chromatographic fingerprint of the material basis of BSLYT and the content determination of its six main constituents,mononoside,loganin,oroxin A,oroxin B,baicalein and astilbin,providing a reference for the quality control.Methods The mass spectrometry data were used to establish the fingerprints.The content of the main components in the BSLYT samples was calculated by using the external method,and the discrepency between different batches of samples were analyzed by combining with chemometric methods.Results A total of 69 compounds were identified by mass spectrometry,and 13 compounds were identified after comparison with high-performance liquid chromatography(HPLC).The similarity of the baseline characterization profiles of the 15 batches of BSLYT substances was above 0.90,and a total of 27 common peaks were identified.Cluster analysis(CA)classified the substance benchmarks into 2 classes,S1,S2,S5,S8,S9,S13,and S15 were clustered into one class,and S3,S4,S6,S7,S10-S12,and S16 were clustered into one class.By combining PCA and OPLS-DA,the chemical components affecting the baseline classification of the substances were screened and attributed to wood butterfly,cornelian cherry and cocos nigra,respectively.The contents of six components were determined by MICS,which ranged from 0.31%-0.51%,0.12%-0.22%,0.09%-0.19%,0.09%-0.24%,0.07%-0.18%,and 0.08%-0.29%for mononoside,loganin,oroxin A,oroxin B,baicalein and astilbin respectively.Conclusion The fingerprint and multi-indicator content determination method established in this paper are accurate and stable,which provide a basis for the quality control of the material benchmark of Kidney and Pharynx Formula and its related preparations.

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.

Spinal surgical site infection (SSI), especially deep SSI after internal fixation is difficult in treatment, with long course of disease and poor prognosis. At present, there are many controversies in the diagnosis and treatment of spinal SSI, with unsatisfactory overall efficacy of its diagnosis and treatment. Besides, no diagnosis and treatment guideline based on evidence-based medicine has been in existence. To this end, the Spinal Infection Group of the Orthopedic Branch of the Chinese Medical Doctor Association and the Spinal Infection Group of the Spinal Surgery Branch of the Chinese Rehabilitation Medicine Association jointly organized relevant experts to formulate Evidence-based clinical guideline for the diagnosis and treatment of surgical site infection in spinal trauma ( version 2024) based on an evidence-based approach. A total of 10 recommendations were proposed on the diagnosis and treatment of spinal SSI, so as to provide a clinical reference for the diagnosis and treatment of spinal SSI.