Traditional Chinese medicine （TCM） thinking serves as a comprehensive cognitive approach of TCM in recognizing and solving problem. It encompasses specific techniques （methods）and particular structures （patterns） in application. Its essential characteristics include the holistic view of "harmony between humanity and nature"， the dialectical perspective of "differences and similarities in disease treatment"， and the practical outlook of "unity of knowledge and action". The methods of TCM thinking emphasizes the integration of multiple cognitive approaches， forming various modes of thinking such as TCM holistic thinking， TCM four-dimensional thinking， TCM Xiang （象） and numerical thinking， and TCM clinical thinking. Currently， TCM faces both opportunities and challenges. TCM thinking plays a crucial role in the inheritance and innovation pathways of TCM， such as "cultivating medicine through culture"， "leading medicine through pharmaceutical practices"， "boosting industries with pharmaceuticals"， and "benefiting the people through industry". At the same time， integrating TCM and modern technology not only enriches the connotation of TCM thinking， but also advances the innovation of TCM theories， addressing challenges in complex disease treatment， health management， and preventive healthcare. This integration promotes the continued prosperity of the TCM and accelerates its internationalization.

ObjectiveTo analyze the effects of new integration processing method in producing area and traditional method on the composition and pharmacological action of Polygoni Multiflori Radix Praeparata（PMRP）， and to illustrate the advantages of toxicity reducing and efficacy enhancing of the decoction pieces prepared by the new method. MethodFresh Polygoni Multiflori Radix（PMR） was taken from Dao-di producing area， and was processed by new integration processing method in producing area（steaming with black bean juice under pressure of 0.1 MPa and temperature at 120 ℃ for 10.5 h） and traditional method（steaming with black bean juice under water for 36 h）， respectively. Samples were collected during the processing process of the two methods， For new method， the samples were collected at 0.5， 3， 5.5， 8， 10.5 h， separately. For traditional method， the samples were collected every 4 h. High performance liquid chromatography（HPLC） was used to establish fingerprint and identify common peaks， the content of polysaccharides was determined by anthrone-sulfuric acid colorimetry at 627 nm， and the contents of anthraquinones and stilbene glycosides in different processed products were determined according to the methods under the item of determination of PMR and PMRP in the 2020 edition of Chinese Pharmacopoeia. In pharmacological experiments， 90 SD rats were randomly divided into 9 groups with 10 in each group（half of male and half of female）， including the blank group， and raw products， 24 h processed products under atmospheric pressure， 30 h processed products under atmospheric pressure， 8 h processed products under high pressure groups with low and high dosages（4.125， 16.5 g·kg^-1）. Rats were given the drug by gavage for 29 d with once a day， blood was collected from the abdominal aorta after the last administration， and the serum was isolated， the body mass and liver mass of rats were weighed and the organ index was calculated. The pathological change of liver tissue was observed by hematoxylin-eosin（HE） staining， and biochemical methods were used to detect the contents of aspartate aminotransferase（AST）， alanine aminotransferase（ALT）， alkaline phosphatase（ALP）， γ-glutamyltransferase（GGT）， lactic dehydrogenase（LDH） in serum which used as liver function indicators and the levels of superoxide dismutase（SOD）， malondialdehyde（MDA）， glutathione peroxidase（GSH-Px） in brain tissues which used as oxidation indicators. ResultA total of 14 common peaks were identified in the fingerprint of PMR， PMRP prepared by new method and traditional method， and three of the peaks were designated as stilbene glycoside， emodin and emodin methyl ether， respectively. The characteristic peak areas of each processed products changed significantly from 0 min to 25 min， indicating that different processing methods had an effect on the contents of components with high polarity in PMRP， and the trend of the changes of the two methods was similar， with the higher degree of change in the new method. The determination results showed that compared with the traditional method， the content of polysaccharide（a kind of beneficial component in PMRP obtained by the new method） significantly increased， while the contents of stilbene glycoside and bound anthraquinone（liver-damaging ingredients） significantly decreased. The pharmacological results showed that compared with the blank group， AST and LDH levels of male rats in the low and high dose groups of 24 h processed products under atmospheric pressure and AST level of male rats in the low and high dose groups of 8 h processed products under high pressure were significantly reduced（P<0.05， P<0.01）， while compared with the raw product groups with the same dose， AST and LDH levels of male rats in the low dose group of 30 h processed products under atmospheric pressure were significantly reduced（P<0.05， P<0.01）， the AST levels of male rats in the low and high dose groups of 8 h processed products under high pressure were significantly decreased（P<0.01）， and there was no statistical significance in the differences of biochemical indexes of female rats in each administration group as compared with those of the blank group. ConclusionThe new integration processing method in producing area of PMRP can reach the quality of relevant regulations in 8 h. The processed products obtained by this method have more advantages than the traditional method in terms of toxicity reducing and efficacy enhancing， and energy saving to avoid the loss of ingredients， which can provide ideas for the production of high-quality decoction pieces of PMRP， and the integration processing method in producing area of other roots and rhizomes of traditional Chinese medicines.

Objective To explore the influence of different hardness surfaces on gait coordination in patients with functional ankle instability(FAI). Methods Qualisys Infrared Optical Motion Capture System was used to test the coordination and variability of 15 FAI patients on the right side at Nanjing Normal University from May to July,2023.The gait cycle data were collect-ed and intercepted,and coupling angle(CA)and standard deviation of coupling angle(SDCA)were calculated by Matlab to compare the differences on different hardness surfaces. Results On coronal plane,CA of hip-ankle joint was higher on the hard surface than on the soft surface during middle stage of support and early stage of swing,and lower on its rest stages and the gait stages of hip-knee joint and knee-ankle joint than on the soft surface(P<0.01).On sagittal plane,CA of hip-ankle joint and knee-ankle joint was smaller on the hard surface than on the soft surface during middle and late stages of support,and larger than on the soft surface during their rest stages,and the gait stages of hip-knee joint(P<0.01).On horizontal plane,CA of hip-knee joint was lower on the hard surface than on the soft surface during the late stage of support,and higher than on the soft surface during its early stage of swing and bearing stage of hip-ankle joint(P<0.01).Compared with the hard surface,SDCA was smaller on the soft surface than on the hard surface only in the hip-ankle on the sagittal plane and during bearing stage of hip-knee joint,and was greater than on the hard surface for the rest(P<0.01). Conclusion FAI patients showed more distal dominance on soft surface than on hard surface during most gait cycle on 3D plane,i.e.,advantage of ankle varus and plantar flexion increased,and advantage of hip joint decreased;the coordination variability was generally higher on soft surface than on hard surface.These findings suggested that FAI patients may increase the risk of recurrent lateral ankle sprain walking on soft surface.

ObjectiveTo reveal the influence of Jianchangbang characteristic processing method on the change process of volatile components and the processing mechanism of reducing toxicity and increasing efficiency of Magnoliae Officinalis Cortex（MOC） by studying the changes in the composition and content of volatile components during the processing of ginger processed Xingpo pieces. MethodSamples of raw products， ginger juice moisturized products and stir-fried and heap moisturized products of MOC were taken according to the set time points， and headspace gas chromatography-mass spectrometry（HS-GC-MS） was used to determine the contents of volatile components in the samples， and the relative content of each component was obtained by peak area normalization. Principal component analysis（PCA） and orthogonal partial least squares-discriminant analysis（OPLS-DA） were performed on the sample data using SIMCA 14.1 software， and the differential components during the processing were screened with variable importance in the projection（VIP） value>1 as the indicator. ResultA total of 68 volatile components were identified in the samples， among which some of the chemical components with similar structures showed similar trends of changes， and there was also the phenomenon of interconversion between compounds. Compared with the raw products， the contents of 42 components in ginger juice moisturized products increased， while the contents of 25 components decreased， 19 components were unique， and 4 components were unique to the raw products. Compared with ginger juice moisturized products， MOC in the early stage of piling had three unique components， and the contents of 11 components such as cyclosativene and （+）-α-pinene increased， and the contents of 5 components such as tricyclic terpene and α-curcumene decreased， and ginger juice moisturized products had four unique components. Compared with the early stage of piling， in the later stage， the contents of 8 components such as （+）-α-pinene and camphene significantly increased， while the contents of 6 components such as linalool and α-selinene significantly decreased. During the processing of MOC， there were significant changes in the chemical composition of the samples before and after 20 days. The differences between ginger juice moistening and the early stage of piling， the early stage and the later stage of piling could be clearly distinguished. ConclusionDuring the preparation process of ginger processed Xingpo pieces， the addition of ginger juice can reduce the contents of stimulating components， and the contents of active components continue to increase in several stages， such as the addition of ginger juice， frying and heap moisturizing， the quality of the decoction pieces may change significantly at about 20 d of processing. This study can provide a research basis for exploring the processing mechanism of ginger processed Xingpo pieces.

AIM: To analyze the mechanism of Usher syndrome(USH)caused by Adgrv1 gene variation through the Hedgehog(Hh)signaling pathway.METHODS: Based on Adgrv1 gene variant mice(Adgrv1-/-), taking wild type(WT)C57BL/6 mice as controls, the expression of Adgrv1 gene and the structure of retina and cell cilia were analyzed by qRT-PCR, HE, transmission electron microscopy, and immunofluorescence. Additionally, the changes of key factors in the Hh signaling pathway caused by Adgrv1 gene variation were observed.RESULTS: The Adgrv1 gene was expressed in both the retina and primary cultured lung fibroblasts of Adgrv1-/- mice, but the expression levels were significantly decreased. The Adgrv1 gene variation can cause dissolution of the outer disc membrane of the retinal photoreceptors and significantly shorten the cilia length in primary lung fibroblasts. In the Hh signaling pathway, the expression of Ptch1 and Gli genes of Adgrv1-/- was significantly reduced, while the expression of PKA genes was increased.CONCLUSION:The Adgrv1 gene variation leads to shortened cell cilia and dissolution of the outer disc membrane of the retinal photoreceptors, resulting in retinitis pigmentosa, which is related to decreased expression of PTCH1 and GLI1 proteins in the Hh pathway.

BACKGROUND: Weather conditions are a possible contributing factor to age-related macular degeneration (AMD), a leading cause of irreversible loss of vision. The present study evaluated the joint effects of meteorological factors and fine particulate matter (PM_2.5) on AMD. METHODS: Data was extracted from a national cross-sectional survey conducted across 10 provinces in rural China. A total of 36,081 participants aged 40 and older were recruited. AMD was diagnosed clinically by slit-lamp ophthalmoscopy, fundus photography, and spectral domain optical coherence tomography (OCT). Meteorological data were calculated by European Centre for Medium-Range Weather Forecasts (ECMWF) reanalysis and were matched to participants' home addresses by latitude and longitude. Participants' individual PM_2.5 exposure concentrations were calculated by a satellite-based model at a 1-km resolution level. Multivariable-adjusted logistic regression models paired with interaction analysis were performed to investigate the joint effects of meteorological factors and PM_2.5 on AMD. RESULTS: The prevalence of AMD in the study population was 2.6% (95% CI 2.42-2.76%). The average annual PM_2.5 level during the study period was 63.1 ± 15.3 µg/m³. A significant positive association was detected between AMD and PM_2.5 level, temperature (T), and relative humidity (RH), in both the independent and the combined effect models. For PM_2.5, compared with the lowest quartile, the odds ratios (ORs) with 95% confidence intervals (CIs) across increasing quartiles were 0.828 (0.674,1.018), 1.105 (0.799,1.528), and 2.602 (1.516,4.468). Positive associations were observed between AMD and temperature, with ORs (95% CI) of 1.625 (1.059,2.494), 1.619 (1.026,2.553), and 3.276 (1.841,5.830), across increasing quartiles. In the interaction analysis, the estimated relative excess risk due to interaction (RERI) and the attributable proportion (AP) for combined atmospheric pressure and PM_2.5 was 0.864 (0.586,1.141) and 1.180 (0.768,1.592), respectively, indicating a synergistic effect between PM_2.5 and atmospheric pressure. CONCLUSIONS This study is among the first to characterize the coordinated effects of meteorological factors and PM_2.5 on AMD. The findings warrant further investigation to elucidate the relationship between ambient environment and AMD.
Humans ; Adult ; Middle Aged ; Cross-Sectional Studies ; Air Pollutants/analysis* ; Particulate Matter/analysis* ; China/epidemiology* ; Macular Degeneration/etiology* ; Meteorological Concepts

ObjectiveBy comparing the differences in composition and content of volatile components between Atractylodis Macrocephalae Rhizoma（AMR）and bleaching AMR， bran-fried AMR and bran-fried bleaching AMR， the effect of processing with rice-washed water on the volatile components in AMR and bran-fried AMR were investigated. MethodHeadspace gas chromatography-mass spectrometry（HS-GC-MS）was used to determine the volatile components in raw products， bran-fried products and their processed products with rice-washed water. GC conditions were programmed temperature（starting temperature of 50 ℃， rising to 140 ℃ at 10 ℃·min^-1， maintained for 5 min， then rising to 210 ℃ at 4 ℃·min^-1）， splitting ratio of 10∶1， high purity helium as the carrier gas and a solvent delay time of 3 min. MS conditions were an electron bombardment ion source（EI） with an electron collision energy of 70 eV， ion source temperature of 230 ℃， and the detection range of m/z 20-650. The relative contents of the components were determined by the peak area normalization method， the obtained sample data were subjected to principal component analysis（PCA） and orthogonal partial least squares-discriminant analysis（OPLS-DA） by SIMCA 14.1 software， and the differential components of AMR and bleaching AMR， and bran-fried AMR and bran-fried bleaching AMR were screened according to variable importance in the projection（VIP） value>1 and P<0.05. ResultA total of 71 volatile components were identified， including 53 in AMR， 50 in bleaching AMR， 51 in bran-fried AMR， and 44 in bran-fried bleaching AMR. OPLS-DA results showed that there were significant differences between AMR and bleaching AMR， bran-fried AMR and bran-fried bleaching AMR， but not between AMR samples from different origins. The compound composition of AMR and bleaching AMR， bran-fried AMR and bran-fried bleaching AMR did not change， but the contents of monoterpenes and sesquiterpenes changed significantly. ConclusionSignificant changes in the contents of volatile components were observed in AMR and bleaching AMR， bran-fried AMR and bran-fried bleaching AMR， among them， 1，2-dimethyl-4-methylidenecyclopentene， 9，10-dehydro-isolongifolene， γ-elemene， zingiberene， atractylone， silphinene， modhephene and （1S，4S，4aS）-1-isopropyl-4，7-dimethyl-1，2，3，4，4a，5-hexahydronaphthalene can be used as candidate differential markers of volatile components of AMR before and after processing with rice-washed water.

Objective:To observe the effect of combining scalp acupuncture with feedback training on muscle tone, motor ability, plantar pressure distribution and joint range of motion of stroke survivors with lower limb spastic paralysis.Methods:A total of 212 stroke survivors were randomly divided into a combination group ( n=70), an exercise group ( n=70) and a scalp acupuncture group ( n=72) according to a random number table. All of the patients received routine medication and 120 minutes of rehabilitation training six days a week for 8 consecutive weeks. The rehabilitation training included guidance on good posture, posture change training, balance training and gait training. The scalp acupuncture and exercise groups were additionally provided with 40 minutes of scalp acupuncture and lower limb intelligent feedback training, while the combination group was given both. Muscle tension, balance and lower extremity movement were quantified before and after the training, and a gait evaluation system was used to detect the plantar pressure distribution on the affected side and the range of motion range of the lower limb joints during walking. Results:After the treatment, significant differences were observed in the average modified Ashworth scores, modified Berg scale scores, Fugl-Meyer lower extremity ratings and modified Barthel Index scores compared with before the treatment. The average scores of the combination group were then significantly better than those of the other two groups. The average load bearing ratios of the affected toes, metatarsal bones Ⅰ-V, medial arch, external arch, medial heel and external heel had improved significantly in all of the groups, with the improvement of the combination group again significantly greater than those of the other groups. The same pattern of improvement was observed in the groups′ average pelvic rotation angles, hip flexion angles, knee flexion angles and ankle dorsiflexion angles.Conclusion:Combining scalp acupuncture with intelligent feedback can significantly improve lower extremity functioning after a stroke. That should improve performance in the activities of daily living of stroke survivors.

Objective:To explore the influence of multidimensional integration and 360° support on the function of family and marriage, and quality of life in women patients with systemic lupus erythematosus.Methods:Totally 196 patients with systemic lupus erythematosus from Department of Rheumatology and Immunology, The Second Affiliated Hospital of the Air Force Medical University from August 2016 to November 2017 were included. According to random number table method, these patients were divided into observation group and control group as 98 cases each. Conventional care and hospital discharge were used for control group. On the basis of this, multidimensional integration and 360° support were used for patients of observation group. The function of family and marriage, quality of life in patients were assessed before and after 3 months of the intervention. The treatment adherence was evaluated in 3 months and 6 months after intervention.Results:Before intervention, the marriage family function score, marital satisfaction, conflict resolution methods and the relationship with friends and family, husband and wife exchange scores of the observation group were (2.3 ± 0.5), (24.6 ± 6.1), (25.7 ± 7.1), (28.2 ± 6.9), (28.8 ± 6.9) points, respectively. Three months after intervention, these scores were (2.5 ± 0.7), (31.6 ± 5.0), (31.7 ± 5.3), (28.1 ± 6.8), (29.0 ± 7.1) points, respectively. There was statistically significant difference between before and after the intervention ( t values were -2.371 - 8.631, P < 0.01). These scores of control group before the intervention were (2.3 ± 0.6), (24.5 ± 6.2), (25.2 ± 7.2), (32.5 ± 6.0), (33.9 ± 6.3) points, respectively. Three months after intervention, these scores were (2.3 ± 0.4), (24.5 ± 6.2), (26.1 ± 6.9), (29.1± 4.8), (28.5 ± 7.2) points. Significant differeces were found between before and after the intervention in control group ( t values were -3.878-6.323, P < 0.05 or 0.01). There was statistically significant difference between the two groups after the intervention ( t values were 2.675-8.631, P<0.01). As for observation group, planning (62.8 ± 27.2 vs. 75.5 ± 25.4) and intimate relationship (62.8 ± 25.2 vs. 78.2± 24.9) in quality of life were obviously difference before and after 3 months of intervention ( t values were 3.050, 3.639, P < 0.01). As for control group, planning (62.5 ± 27.6 vs. 65.7 ± 24.9) and intimate relationship (65.8 ±25.2 vs. 63.5 ± 23.8) in quality of life were obviously difference before and after 3 months of intervention ( t values were 2.375, 3.132, P < 0.01). There was statistically significant difference between the two groups after the intervention ( t values were 3.050, 3.639, P < 0.01). The treatment adherence of observation group was significant better than control group. After 6 months intervention, the treatment adherece of observation group was 83.67% (82/98), while the treatment adherece of control group was 44.89% (44/98), significant differences were found btween the two groups ( χ2 value was 0.511, P < 0.01). Conclusion:Multidimensional integration and 360° support obviously improved function of family and marriage, improved the understanding of disease, and self-management ability of patients. Therefore, it can increase the treatment adherence and improve quality of life in SLE patients.