The inheritance, innovation, and development of traditional Chinese medicine have received high attention from the country. However, the development of grassroots traditional Chinese medicine diagnosis and treatment in China is still uneven, and the operational efficiency of traditional Chinese medicine diagnosis and treatment services in different institutions varies greatly.

By analyzing the operation of traditional Chinese medicine diagnosis and treatment services in grassroots medical institutions in Tianjin in 2021, this study provides a reference for the development of traditional Chinese medicine in grassroots medical institutions.

In 2021, a comprehensive survey method was used to collect relevant data from a total of 270 primary healthcare institutions in 16 administrative regions of Tianjin (Dis1-6 being the six districts within the city, Dis7-10 being the four districts around the city, Dis11 being the Binhai New Area, and Dis12-16 being the five districts in the suburbs), and two methods, BCC and CCR models in Data Envelopment Analysis (DEA) and Stochastic Frontier Analysis (SFA), were comprehensively applied to analyze the operational efficiency of traditional Chinese medicine diagnosis and treatment services in institutions from different perspectives. Through literature research, the input indicators of the DEA model were set as the number of traditional Chinese medicine practitioners, the number of traditional Chinese medicine beds, and the number of traditional Chinese medicine diagnosis and treatment equipment; The output indicators were set as traditional Chinese medicine medical income, number of traditional Chinese medicine diagnosis and treatment personnel, number of discharged patients mainly using traditional Chinese medicine, and number of on-site traditional Chinese medicine service personnel. The SFA model was consistent with the indicators set by DEA, except for the addition of total income as an output indicator.

The operation of traditional Chinese medicine diagnosis and treatment services in grassroots medical and health institutions in 7 districts was effective, Dis9 DEA was weakly effective, and DEA was ineffective in 8 districts. There were 8 districts with increasing returns to scale, 7 districts with unchanged returns to scale, and Dis3 showing decreasing returns to scale. There were 8 non DEA effective regions, and all 3 input indicators in each region have redundancy. The phenomenon of insufficient income from traditional Chinese medicine and medical services in the output indicators was more serious in each region. The efficiency of Dis1-6 technology in SFA results (0.733-0.838) was within the high efficiency range; Dis7-10 technology efficiency (0.691-0.912), 3 high efficiency zones and 1 medium efficiency zone; Dis11 technology efficiency of 0.885 was in the high efficiency zone; Dis12-16 (0.399-0.849) had 3 high efficiency zones and 2 medium efficiency zones. The DEA results were basically consistent with the SFA results, indicating that the number of traditional Chinese medicine practitioners had a positive impact on operational efficiency.

The overall operational efficiency of traditional Chinese medicine diagnosis and treatment services in grassroots medical institutions in various districts of Tianjin is relatively low, but the overall development trend is positive and has regional characteristics. Overall, Dis1-6 is better than Dis7-10, and Dis7-10 is better than Dis11-16. Each district should plan reasonably according to the actual situation, avoid excessive resource input and insufficient output, and especially increase support for Binhai New Area and the five districts in the suburbs.

This study provides a review of the current status of service capabilities, strategies for improving service capabilities, and improvement measures of grassroots traditional Chinese medicine clinics in Haizhou District, Lianyungang City. It describes the current work status of grassroots traditional Chinese medicine clinics in the construction of characteristic departments, family doctor contract services, and medical prevention integration. It is found that there are problems in the operation of traditional Chinese medicine clinics, such as uneven resource allocation, non-standard management, insufficient facilities and equipment, and the need to improve service capabilities. A survey and analysis were conducted on the construction of traditional Chinese medicine clinics in 19 grassroots medical and health institutions to identify common and individual problems. Targeted suggestions and improvement st rategies were proposed to enhance the service capabilities of traditional Chinese medicine clinics, form a characteristic of medical prevention integration, and give full play to the functions and roles of grassroots medical care. Residents received high-quality traditional Chinese medicine services in the community.

General practitioners of traditional Chinese medicine (TCM), known as the "gatekeepers" of residents' health, provide continuous services to them. Recently, China has rolled out a series of policies aimed at supporting the growth of the workforce of TCM general practitioners and has made it a key development indicator, which holds great importance for advancing the TCM cause.

In alignment with the development goals outlined in the "14th Five-Year Plan" for the Development of TCM, this study analyzes the current status of the TCM general practitioner workforce in China, explores the optimization of statistical methodologies for TCM general practitioners, and proposes corresponding countermeasures and suggestions.

Based on data from the China Health Statistics Yearbook from 2021 to 2023 and special survey data, the difference between the actual number of TCM general practitioners in 2020 and 2022 and the planned number for 2025 was calculated. The completion rate of the planning targets was then computed based on these differences. A comparative method was used to analyze the data.

In 2022, the number of TCM general practitioners per 10 000 population was 0.75, representing an increase of 13.27% compared to 2020, with an average annual growth rate of 6.43%. There were significant regional disparities in the distribution of TCM general practitioners per 10 000 population, with the eastern, central, and western regions decreasing in that order, at 0.88, 0.68, and 0.61 respectively. The national completion rate for the TCM general practitioner workforce plan was 66.76%, indicating good overall progress. A total of 17 provinces (municipalities, autonomous regions) achieved a completion rate of 40% or higher for their TCM general practitioner workforce planning targets, with 11 of them exceeding their targets. Additionally, 14 provinces (municipalities, autonomous regions) made slower progress, including 9 provinces where the completion rate was negative. Based on special assessment data, calculations were made for TCM general practitioners from the perspectives of functional positioning and scope of practice, with 9 provinces and 20 provinces achieving their planning targets ahead of schedule, respectively.

Currently, the statistical count of TCM general practitioners is directly influenced by the number of general practitioners, leading to significant impacts on the count of TCM general practitioners when there are changes in the statistical criteria for general practitioners. It is necessary to further clarify the definition and statistical scope of TCM general practitioners, and strengthen the monitoring and evaluation of TCM general practitioner indicators to ensure the smooth achievement of planning targets.

Based on the case of the Central Health Center, the ROCCIPI framework was used to identify and analyze the problems of integrating traditional Chinese medicine (TCM) into grassroots township health centers from seven dimensions. On this basis, it puts forward the strategy of implementing precision strategy, building connotative ability, strengthening TCM awareness and promoting multi-platform communication, in order to better realize the integration of TCM into modern primary health.

The research on traditional Chinese medicine policies in China's academic circles became increasingly active and the connotations became richer. However, most of the existing research focused on a certain specific field of traditional Chinese medicine policies, lacking all-round comprehensive research. By systematically retrieving China's traditional Chinese medicine-related policies and journal literature from 2011 to 2023 and obtaining the comprehensive statistical system data of traditional Chinese medicine, this article analyzed Chinese medicine policies from the 12th Five-Year Plan to the 14th Five-Year Plan from the perspectives of Chinese medicine, health care, scientific research, education, industry and culture, reviews relevant Chinese medicine policies and measures, sorts out the development status. It found that China had problems such as insufficient basic Chinese medicine service ability, imperfect Chinese medicine health care network, imperfect education model, and weak scientific research strength. It also proposed to strengthen the traditional Chinese medicine medical system, strengthen health care for treating non-sick patients, strengthen the construction of scientific research forces, integrate and innovate the education model, strengthen the supervision of the traditional Chinese medicine industry, and promote the dissemination of traditional Chinese medicine culture and health education.

There is growing evidence that highly educated young people from economically developed regions are becoming the main users of traditional Chinese medicine (TCM) .

This study adopts a combined variable-centered and person-centered approach grounded in the Unified Theory of Acceptance and Use of Technology (UTAUT) model to explore the factors influencing acceptance of TCM. It examines variables such as demographics, chronic disease status, health literacy, traditional cultural identity, and scientific thinking, with a particular emphasis on parents' willingness to seek TCM pediatric treatments for their children.

From July to September 2023, a total of 717 parents were conveniently sampled from a kindergarten, primary school, and middle school in Guangdong Province and surveyed via the self-developed DiggMind online psychological assessment platform. Parents' demographic variables (i.e., gender, age, education, occupation, residence, and chronic illness) were collected, and the six dimensions of the UTAUT model as well as three additional influencing variables (i.e., health literacy, traditional cultural identity, and scientific thinking) were measured using a 6-point Likert scale (with higher scores indicating greater alignment with the respondent's situation). The data were analyzed using path analysis, latent profile analysis, and Logistic regression analysis.

The UTAUT model accounted for 72% of the variance in intentions and actual behaviors related to the use of TCM pediatrics. The latent profile analysis of the six dimensions of the UTAUT model—performance expectancy, social influence, facilitating conditions, risk awareness, usage intention, and usage behavior—showed that the current sample was optimally categorized into four subgroups. These subgroups, reflecting increasing levels of acceptance toward TCM pediatrics, were labeled as "Resistant""Skeptical""Accepting"and "Firmly Committed". Parents' scientific thinking and traditional cultural identity demonstrated a significantly positive impact on the acceptance of TCM pediatrics (P<0.05), whereas variables such as education level, type of residence, and occupational prestige showed no statistically significant effects (P>0.05) .

This study reveals that the true driving force behind the "higher intellectuals" group's trust in TCM culture lies in their intrinsic qualities, rather than external factors such as education, occupation, or residence. These findings serve as a bridge facilitating the integration of modern scientific theories with traditional medical practices.

With the rapid development of the society, the detection rate of dyslipidemia in children has gradually increased. At present, there are few data on the application of traditional Chinese medicine (TCM) constitution identification in sub-health of children, and there is a lack of clinical correlation data analysis.

To observe the trend of changes in TCM constitution and blood lipid metabolism in children, and to analyze the correlation between them, thus providing relevant basis for subsequent continuous monitoring research.

Sourced from the Shanghai Child and Adolescent Health Cohort (SCAHC), a total of 2 080 healthy primary school students in the second and third grade from Pudong New Area, Shanghai were selected as the research subjects. Using the＂Zhaoming System＂that was independently developed by Shanghai University of Traditional Chinese Medicine, physical information of included subjects in 2021 (first year) and 2022 (second year) was collected. Based on the TCM constitution classification of facial complexion and tongue appearance, clinical symptoms and signs and questionnaire information, children were divided into five types of constitution, including the spleen-deficiency constitution, balanced constitution, Qi-stagnation constitution, deficiency-heat constitution, and excess heat constitution (unbalanced constitution referred to all constitutions except for the balanced constitution). Blood samples were collected to detect on triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and total cholesterol (TC). To analyze and compare the incidence of blood lipid abnormalities in children of different genders, as well as the distribution characteristics and changes of TCM constitution in different ages and genders. Multivariate Logistic regression analysis was performed to explore the correlation between TCM constitution and dyslipidemia in children.

Among the 2 080 children, 1 122 (53.9%) were males and 958 (46.1%) were females, with an average age of (8.2±0.4) years. There were 522 children with dyslipidemia (25.09%), including 272 males (52.1%) and 250 females (47.9%). In 2021, there were 815 (39.2%) cases of the balanced constitution and 1 265 (60.8%) cases of the unbalanced constitution. In 2022, 764 (36.7%) children had a balanced constitution and 1 316 (63.3%) had a unbalanced constitution. There was a statistically significant difference in the distribution of TCM constitution in children between 2021 and 2022 (χ²=106.28, P<0.001). The detection rate of unbalanced constitution in boys was significantly higher than that in girls (χ²₂₀₂₁=14.073, P<0.001; χ²₂₀₂₂=20.090, P<0.001). Multivariate Logistic regression analysis, after excluding demographic factors such as gender and age, showed that elevated HDL-C in children was a contributing factor to the occurrence of balanced constitution (OR=1.624, 95%CI=1.258-2.097, P<0.001), and deficiency-heat constitution (OR=0.654, 95%CI=0.499-0.858, P=0.002) .

Through analyzing the changing trend in TCM constitution and blood lipid metabolism in children from the SCAHC cohort, an increased HDL-C promotes the occurrence of balanced constitution but inhibits the occurrence of deficiency-heat constitution.

Alzheimer's disease (AD) is a common neurodegenerative disease in the elderly population. It's typical clinical manifestation is progressive memory impairment. Ferroptosis, rising as a new research direction on AD biological mechanism in recent years, mainly studies on iron-dependent programmed cell death. A large amount of evidence has shown that AD is closely related to ferroptosis in the brain. However, the exact mechanism of the role ferroptosis has played in AD is still unclear. One of the most popular research results indicates that AD might be induced by iron metabolism disorders, lipid peroxidation, and amino acid metabolism, thereby affecting the deposition of iron ions in the brain. So far, some effective chemical components of traditional Chinese herbs as cures of AD have been studied in depth, such as rhodiola rosea, polygala root, ginkgo biloba, poria cocos, etc. These traditional Chinese herbs have shown remarkable effects in the treatment of AD by means of targeting ferroptosis. In this context, this review systematically elaborates on the metabolism of iron in the brain, the characteristics of ferroptosis, and focuses on the metabolic regulation mechanism of ferroptosis. Meanwhile, this review also discusses the connection between ferroptosis and AD. Furthermore, it lists the effective compositions in traditional Chinese herbs that can improve AD by inhibiting ferroptosis, so as to provide reference information for the development and research of ferroptosis inhibitors in the future.

As China's Traditional medicine is included in the ICD-11 code, the rational allocation of basic TCM medical resources is the guarantee to promote the integration of traditional Chinese medicine and western medicine and the universal coverage of high-quality medical resources. The uneven layout and service capabilities of grassroots medical institutions have led to a widespread imbalance in the supply and demand of medical resources in urban and rural areas.

Understand the development status of traditional Chinese medicine services in rural areas of China, scientifically evaluate the coverage and accessibility of grassroots traditional Chinese medicine diagnosis and treatment, provide new ideas for optimizing the spatial resource allocation of grassroots traditional Chinese medicine services, and propose optimization strategies accordingly.

Based on the seventh national population census data and path planning data, the concept of medical service radius is introduced to calculate the diagnosis and treatment scope of different levels of traditional Chinese medicine medical institutions under walking mode. Using methods such as spatial kernel density index and spatial standard deviation ellipse to reveal the spatial fairness of the supply and demand capacity of traditional Chinese medicine medical services. Based on the above results, propose types and measures for optimizing the layout of traditional Chinese medicine medical resources.

As of 2022, there are a total of 699 medical institutions in Zengcheng District, including 18 traditional Chinese medicine medical institutions with beds. There were significant differences in the distribution of beds in traditional Chinese medicine medical institutions in different townships and streets. Meanwhile, the number of beds per thousand population in Zhongtan Town was 14.31, ranking first among all streets. The number of beds per thousand people in Yongning Street ranks last, with only 0.89 beds. Traditional Chinese medicine medical institutions in Zengcheng District had shown a clear dual center pattern, with weak accessibility to traditional Chinese medicine services for residents in the central part of Zhongxin Town, the northern part of Paitan Town, and the southwestern part of Shitan Town. The supply capacity of traditional Chinese medicine services varies greatly among different townships. There was still a certain degree of inconsistency between the spatial distribution of traditional Chinese medicine medical institutions and the overall spatial clustering of urban residents. There were differences in the radius of traditional Chinese medicine services between different townships.

Since the implementation of the development strategy of traditional Chinese medicine, China's Traditional medicine has been protected and developed. We should adopt a more scientific strategy to closely integrate traditional Chinese medicine services with the development of the city and the needs of residents. We should actively adopt a differentiated strategy of increasing facility points, combining resource transfer and sinking, and integrating traditional Chinese medicine information technology for diagnosis and treatment across regions, gradually achieving a true strategy of full coverage and equal emphasis on traditional Chinese and Western medicine.

In the context of "comprehensively promoting the construction of a healthy China" and "actively responding to the national strategy of aging population", scientific evaluation of the performance of community embedded integrated medical and nursing care with characteristics of TCM is the key to improving the quality of integrated medical and nursing care.

Evaluate the performance of community embedded integrated medical and nursing care with characteristics of TCM and analyze main obstacles, providing practical basis for government departments to formulate relevant policies and carry out performance evaluation of it.

In November 2022, the performance evaluation index system for community embedded integrated medical and nursing care with characteristics of TCM was transformed into three questionnaires: basic information of the institution, satisfaction of staff and the elderly. From November 2022 to January 2023, a questionnaire survey method was used to collect basic data from 10 sample institutions, as well as satisfaction data from staff and the elderly. From February to March 2023, the TOPSIS method was used to evaluate the performance of community embedded integrated medical and nursing care with characteristics of TCM, and the obstacle degree model was used to analyze the main obstacle factors of service performance.

The overall embeddedness, structural embeddedness, relationship embeddedness, and embedded performance C_n of the 10 institutions are ranked consistently, 7 institutions have the same ranking of cognitive embedding and embedding performance C_n, and the ranking is consistent with the service performance C_n of each institution. The main obstacles to the performance of community embedded integrated medical and nursing care with characteristics of TCM are C33 (number of TCM health care guidance services), C44 (elderly satisfaction), C8 (institutions and partners adhere to win-win cooperation), C37 (the proportion of TCM non pharmacological therapy rehabilitation nursing personnel), C39 (number of elderly people served) .

The embeddedness, structural embeddedness, and relational embeddedness of community embedded integrated medical and nursing care with characteristics of TCM have a positive impact on its embedding performance. Cognitive embedding has a basic positive impact on embedding performance. Government departments should clarify their functional positioning, strengthen policy support, improve the evaluation system, pay attention to dynamic evaluation, and guide and promote the high-quality development of community embedded integrated medical and nursing care with characteristics of TCM. Institutions with characteristics of TCM should strengthen their structural embedding, relationship embedding, and cognitive embedding with partners, in order to continuously improve their service performance, to meet the diversified and multi-level health care service needs of the elderly in home communities. At the same time, should grasp the degree of embedding, so as not to produce the negative effect of embedding.

Clinical practice guidelines can standardize medical behaviors, improve the quality of medical services, rationalize resource allocation, and safeguard the rights of patients. However, all of these are achieved based on the rigorous design, scientific formulation, and standardized reporting of guidelines. With the nation's high attention to the standardization of traditional Chinese medicine, many clinical practice guidelines for traditional Chinese medicine or integrated traditional Chinese and Western medicine have been published. Traditional Chinese medicine orthopedics, as a discipline with obvious advantages in specialization in the field of traditional Chinese medicine, is witnessing a rapid increase in the number of clinical practice guidelines, prompting the discipline to gradually move towards standardization, modernization, and internationalization. However, many issues are increasingly emerging in this context, attracting widespread attention from researchers. This article systematically reviews and summarizes the current status and challenges of the development of clinical practice guidelines in orthopedics of traditional Chinese medicine, and proposes targeted strategies. Currently, the development of clinical practice guidelines in orthopedics of traditional Chinese medicine faces many challenges, including inaccurate positioning of clinical problems, a lack of high-quality clinical evidence, insufficient standardization in guideline formulation, a shortage of multidisciplinary talent development, and various issues regarding guideline updating and implementation. In future research, professional societies/associations should strengthen guidance on guideline formulation. Researchers should focus on improving the quality of original research, enhance learning and research in guideline methodology, prioritize guideline updating and adaptation, and promote the dissemination and implementation of guidelines, aiming to develop high-quality guidelines and promote the standardization of orthopedics of traditional Chinese medicine.

Treatment based on syndrome differentiation is the core diagnostic and therapeutic thinking of traditional Chinese medicine (TCM), which is the key to determine clinical efficacy. Nowadays, research based on clinical data is the main method to explore the law of TCM syndrome and treatment, but the internal relationship of the key factors of "disease-syndrome-formula-medicine-effect" has not been truly and comprehensively analyzed, resulting in low clinical value of research results. Therefore, the author systematically sorted out the core problems of poor matching between electronic medical record and clinical research, the effect of data governance on data accuracy, difficulties to discover the law of TCM syndrome and treatment by data analysis methods. In addition, in the context of data driven, the big data platform of TCM clinical research should be established, and the data governance and analysis technology with artificial intelligence as the core should be developed, so as to realize the integration of clinical practice and research, providing new ideas and methods for the research of the law of TCM syndrome and treatment and promoting the development of TCM.

Establishing the advantageous diseases in the field of traditional Chinese orthopedics treated with manual therapy will promote the development of manual techniques and dominant discipline. However, the current evaluation and selection lack a quantitative evaluation process based on evidence-based medicine.

To systematically review systematic reviews of diseases in the field of traditional Chinese orthopedics treated with manual therapy using evidence mapping methodology and explore the advantageous diseases in this field.

Computerized searches were conducted in PubMed, Embase, Cochrane Library, Web of Science, SinoMed, China National Knowledge Infrastructure, Wanfang Data, and VIP database to collect systematic reviews of diseases in the field of traditional Chinese orthopedics treated with manual therapy from inception to March 5, 2023. The evidence distribution characteristics were presented using a combination of charts and text.

A total of 126 systematic reviews published from 2003 to 2023 were included, showing an overall increasing trend in the quantity of relevant studies both domestically and internationally. Methodological quality assessment results indicated that 13 reviews were of moderate quality, 64 were of low quality, and 49 were of very low quality. The evidence map showed that the research evidence in the field of traditional Chinese orthopedics treated with manual therapy mainly focused on 18 clinical diseases, including cervical spondylosis, low back pain, knee osteoarthritis, lumbar disc herniation, ankle sprain, adhesive capsulitis of the shoulder, cervicogenic headache, atlantoaxial subluxation, distal radius fracture, lateral epicondylitis of the humerus, carpal tunnel syndrome, lumbar sprain, scoliosis, hip osteoarthritis, fibromyalgia syndrome, myofascial pain syndrome, rotator cuff injury, and supracondylar fracture of the humerus, demonstrating beneficial or potentially beneficial effects.

Manual therapy is widely used in the clinical practice of traditional Chinese orthopedics. However, due to methodological shortcomings and a lack of research evidence on safety and cost-effectiveness, future efforts should focus on multi-level inter-agency cooperation to establish sound evaluation standards and systems, improve research quality, update research evidence, and further explore the advantages of manual therapy in the field of traditional Chinese orthopedics.

Traditional Chinese medicine (TCM) is effective in the treatment of sepsis-induced acute lung injury (ALI) /acute respiratory distress syndrome (ARDS). However, the lack of standard and uniform outcome indicators in the design of most published clinical trials makes it difficult to combine and compare the results of similar studies, causing the impossibility of generating high-quality evidence to guide clinical decision-making.

To analyze the use of outcome indicators in randomized controlled trials on TCM for sepsis-induced ALI/ARDS from 2017 to 2022.

CNKI, Wanfang Data, SinoMed, PubMed, Embase, Web of Science and Cochrane Library were searched for RCTs on sepsis-induced ALI/ARDS, with the intervention group treated with TCM combined with other drugs or conventional treatment, and no restrictions in the control group. The ROB.2 tool of the Cochrane Review Group was used to assess the quality of literature and the classification of outcome indicators was summarized.

39 papers were included after screening, including 1 (2.56%) with low risk of bias, 3 (7.69%) with high risk of bias and 35 (89.74%) with concerns of bias. The outcome indicators in 5 RCTs were reported with a quality score of ≥5, indicating the complete reporting of outcome indicators. A total of 106 outcome indicators were reported and used for 443 times, including physicochemical testing outcome (55 types, 51.89%), TCM syndrome/sign outcome (2 types, 1.89%), symptom and syndrome outcome (13 types, 12.26%), long-term prognosis outcome (19 types, 17.92%), quality of life outcome (7 types, 6.60%), safety event outcome (8 types, 7.55%) and economic evaluation outcome (2 types, 1.89%). There were four outcome indicators with utilization rate>50%, including oxygenation index (82.05%), Acute Physiology and Chronic Health Evaluation Scoring System (58.97%), mechanical ventilation duration (51.28%) and interleukin-6 (51.28%). The composite outcome indicators of effective rate or TCM syndrome efficacy were used in 21 papers, involving a total of 12 times of effective rate, TCM syndrome score of 8 times and TCM symptom efficacy of 6 times. The total 106 outcome indicators were summarized and categorized sequentially including overall evaluation indicators (36 types, 33.96%), common indicators (36 types, 33.96%) and different focus indicators (34 types, 32.08%) .

At present, the selection of outcome indicators in RCTs on TCM for sepsis-induced ALI/ARDS is still nonstandard, mainly manifests in unclear differentiation between primary and secondary outcome indicators, trivialization of endpoint indicators, lack of follow-up data and characteristic indicators of TCM. A core outcome set of TCM outcome indicators for septic induced ALI/ARDS should be constructed to promote the high-quality development of TCM in the future.

The effective evaluation of scientific and technological achievements in traditional Chinese medicine (TCM) is of great significance in promoting the innovative development of TCM. Previous evaluations of scientific and technological achievements in TCM often used a generalized evaluation method, leading to problems such as inappropriate indicators and limited dimensions, which is not conducive to reflecting the multiple values of achievements in a scientific and comprehensive way. Consequently, there is an urgent need to establish categorized and multi-dimensional evaluation index system for the evaluation of scientific and technological achievements in TCM in the new period.

To establish a scientific, categorized, reliable and comprehensive evaluation index system that reflects the principles of TCM and highlights its unique advantages aiming at the scientific and technological achievements in TCM, in accordance with the contemporary requirements for scientific and technological evaluation in China.

This study began in November 2022 and was completed in May 2023. A preliminary index framework was developed through literature review and focus group discussions. Delphi expert consultation was then conducted over two rounds to determine the evaluation indexes and points. The hierarchical analysis method was used to calculate the weight of each index.

The final evaluation index system of scientific and technological achievements in TCM clinical research comprised 10 threshold indicators, 4 primary indicators, 17 secondary indicators, and 17 evaluation points. After testing, the positive coefficient of experts in both rounds of Delphi method implementation was 100%, the authority coefficient was 0.94 and 0.93, respectively. The Kendall's W consistency test for each level of indicators yielded two-tailed significance (P<0.05), indicated high levels of expert positivity and authority, strong consistency of expert opinion, and reliable consulting results.

This study constructs a scientific, reasonable, reliable and easy-to-operate evaluation index system for scientific and technological achievements in TCM clinical research. The indexes cover a wide range with highly differentiated weights and TCM characteristics, which is conducive to highlighting the core strengths while comprehensively considering the multiple value of the results. Additionally, the associated evaluation points, enhancing the operationalization of the index system, may potentially serve as a valuable reference for related evaluation activities.

Ischemic stroke is the most common cerebrovascular accident and is increasingly becoming a serious global health problem. Mitochondrial quality control disorder is an important mechanism of neuronal death induced by cerebral ischemia, and the maintenance of mitochondrial function is essential for promoting neuronal survival and improving neurological function. Mitochondrial quality control mainly involves mitochondrial oxidative stress, mitochondrial dynamics, mitochondrial autophagy, mitochondrial biogenesis, etc., which is an important condition for stabilizing the normal structure of mitochondria and exerting the normal function of mitochondria. In recent years, Traditional Chinese Medicine (TCM) has significantly improved the clinical symptoms of patients with ischemic stroke by affecting the structure and function of mitochondria through multi-perspective, multi-pathway, multi-target regulation of mitochondrial quality control, which has received extensive attention from scholars. This article summarizes the experimental studies and clinical observations on the application of effective compound components of TCM and TCM compound to regulate mitochondrial quality control in the treatment of ischemic stroke in recent years, further explains the pathogenesis of ischemic stroke, clarifies the regulatory mechanism of TCM on mitochondrial quality control, and summarizes the scientific connotation and shortcomings of TCM in the treatment of ischemic stroke, in order to provide ideas and methods for further clinical application of TCM in the treatment of ischemic stroke.

Intestinal stem cells and Paneth cells interact with each other to maintain intestinal homeostasis and function, the interaction between intestinal stem cells and Paneth cells is regulated by mitochondria-related functions and energy conversion. The unique advantages of traditional Chinese medicine (TCM) in the treatment of intestinal diseases are also reflected in its effects on mitochondria and energy metabolism. This paper explores the influence of mitochondrial function and energy metabolism on the interaction between intestinal stem cells and Paneth cells, as well as the possible targets related to mitochondria in the treatment of intestinal diseases by TCM, summarizes the regulatory effects of TCM on mitochondria and energy metabolism, thereby restoring intestinal homeostasis and alleviating disease, with an aim to provide reference and theoretical basis for the research related to the TCM treatment of intestinal stem cells and Paneth cells based on mitochondria.

Intestinal stem cells are an important part of maintaining the stability of intestinal barrier function, which is closely related to intestinal homeostasis, intestinal epithelial renewal, and repair of intestinal damage. Normal physiological activities of the human body cannot be separated from energy intake and metabolism, and the differentiation fate of stem cells is affected by energy metabolism, and impaired intestinal barrier is associated with the development of many intestinal diseases. Therefore, this paper focuses on intestinal stem cells, takes energy metabolism and metabolites as the background to investigate how energy metabolism and metabolites regulate the function and activity of stem cells, thus regulating the function of intestinal barrier and providing ideas for the treatment of various intestinal diseases; in addition, with the in-depth research of modern medical science in protecting intestinal barrier, the theory of traditional Chinese medicine (TCM) that cares for spleen and stomach is gradually showing its scientific validity, with the hope of providing ideas for the subsequent research.

The integration of Traditional Chinese Medicine (TCM) and Western Medicine in a multidisciplinary approach is the future direction for the diagnosis and treatment of Cancer-Related Fatigue (CRF). However, the lack of standard criteria for syndrome differentiation and treatment selection limits the application of TCM in Western and international contexts. Patients with CRF often experience fatigue associated with metabolic and energy balance abnormalities, with thyroid function playing a critical role in the body's energy metabolism and regulation.

To analyze the TCM syndrome characteristics of CRF and explore their correlation with thyroid function levels, providing a reference for the integrated diagnosis and treatment of CRF and mechanism research in both TCM and western medicine.

The study included cancer patients who visited the oncology outpatient and inpatient departments of the China Academy of Chinese Medical Sciences Xiyuan Hospital in 2021. General information of the patients was collected. The Chinese version of the Revised Piper Fatigue Scale (RPFS-CV) was used to assess patients' fatigue. Thyroid function tests, including triiodothyronine (T₃), thyroxine (T₄), free triiodothyronine (FT₃), free thyroxine (FT₄), thyroid-stimulating hormone, anti-thyroid peroxidase antibody (TPO-Ab), and thyroglobulin antibody, were collected on the day of or the day after enrollment. TCM syndrome characteristics of CRF patients were collected through a self-designed CRF TCM Four-Diagnostic Information Form. Spearman's rank correlation analysis was used to explore the correlation between RPFS-CV fatigue scores and thyroid function indicators. Point biserial correlation analysis was used to investigate the correlation between RPFS-CV fatigue scores, thyroid function indicators, and TCM syndrome characteristics of CRF.

A total of 159 CRF patients were included. The most common types of cancer were lung cancer (50 cases, 31.4%), breast cancer (23 cases, 14.5%), head and neck tumors (21 cases, 13.2%), rectal cancer (21 cases, 13.2%), and colon cancer (18 cases, 11.3%). The median diagnosis duration was 2.15 (3.16) years; 88 patients (55.3%) experienced recurrence or metastasis, with 40 patients (45.5%) having local recurrence and 38 patients (43.2%) having oligometastasis. The median duration of metastasis was 1.50 (2.83) years; 91 patients (57.2%) were in advanced stages, 101 patients (63.5%) had received antitumor treatment, and 57 patients (35.8%) had undergone chemotherapy. In TCM syndromes, deficiency syndromes with a frequency over 10% were Qi deficiency, heart deficiency, and spleen deficiency; among excess syndromes, those occurring more than 20 times were Qi stagnation and damp-cold. Syndromes with a median RPFS-CV fatigue score over 4 were, in descending order, damp-cold, Qi stagnation, spleen deficiency, heart deficiency, liver deficiency, damp-heat, and Qi deficiency. RPFS-CV fatigue scores were positively correlated with Qi deficiency, spleen deficiency, heart deficiency, liver deficiency, damp-cold, and Qi stagnation (P<0.05). RPFS-CV fatigue scores were negatively correlated with FT₃ and T₃ (P<0.05). Qi deficiency was positively correlated with T₄, Kidney deficiency with TPO-Ab, and Qi stagnation with FT₄ (P<0.05) ; Damp-heat was negatively correlated with T₃ and T₄ (P<0.05) .

The fatigue condition of CRF patients is closely related to TCM syndrome characteristics and thyroid function levels. Further research will help deepen the understanding of these correlations and promote the collaborative development of TCM and western medicine in the management of CRF disease.

Faced with the increasingly severe trend of population aging and the threat of non communicable chronic diseases, China actively guides and promotes the development of community embedded integrated medical and nursing care service with characteristics of traditional Chinese medicine (TCM). However, there are limited studies on performance evaluation in this field in the existing literature. The construction of a set of scientific and effective performance evaluation index system for community embedded integrated medical and nursing care service with characteristics of TCM has important theoretical significance and practical value.

To construct a performance evaluation index system for community embedded integrated medical and nursing care service with characteristics of TCM, determine the weights for indicators of each level, so as to provide reference for the formulation of relevant policies and the performance evaluation of community embedded integrated medical and nursing care service with characteristics of TCM.

From September to October 2022, a two-dimensional theoretical framework of "embedded-performance" for the community embedded integrated medical and nursing care service with characteristics of TCM was established through literature research and based on the embeddedness theory and the structure-process-outcome theoretical model. From October to November 2022, an index system was constructed based on the two-dimensional theoretical framework of "embedded-performance", with methods of literature research, Delphi method, and field investigation. In December 2022, the analytic hierarchy process was applied to determine the weight coefficients and test the logical consistency of indicators at all levels.

A performance evaluation index system for community embedded integrated medical and nursing care service with characteristics of TCM, containing 2 dimensions of embeddedness and embedded performance, 6 primary indicators, 19 secondary indicators, and 45 tertiary indicators was constructed. The primary indicators with the highest weight were A5 (service process) and A6 (service outcome), while the secondary and tertiary indicators with the highest combined weight were B17 (service output), B19 (service satisfaction), and C44 (elderly satisfaction). All judgment matrices have passed the consistency test with CR<0.1.

The two-dimensional theoretical framework of "embedded-performance" for community embedded integrated medical and nursing care with characteristics of TCM has strong applicability and feasibility. The performance evaluation index system constructed based on this theoretical framework has a high concentration of expert opinions, strong scientific, rationality, systematicness, hierarchy, and application value, which can provide reference for government departments to formulate relevant policies, and is an effective tool for conducting performance evaluation of community embedded integrated medical and nursing care service with characteristics of TCM.

Primary traditional Chinese medicine (TCM) health service has been attracting continuously improving attention. However, primary TCM health service system still has problems, which have constrained the development of TCM in China.

To analyze the current situation of primary TCM health service system in China and explore the strategies to continuously improve the capacity of primary TCM health service.

In December 2022, data were retrieved from the China Health Statistics Yearbook, National Statistics of Traditional Chinese Medicine, the official websites of the National Bureau of Disease Control and Prevention and the National Center for Cardiovascular Diseases. The index system was constructed from the three levels of health input, service output and health needs, and the combination of rank-sum ratio method and the WHO health system performance module framework was used to comprehensively evaluate the current situation of primary TCM health service.

In terms of health input, from 2017 to 2021, the number of primary healthcare institutions providing TCM health services except for township health centers has increased, and the number of TCM clinical departments beds in community health service centers (stations), township health centers, and outpatient clinics has shown an increasing trend, but the proportion of TCM clinical departments beds in outpatient clinics to the total number of outpatient departments has decreased; the proportion of TCM practicing (assistant) physicians in community health service centers (stations), township health centers and clinics has increased significantly, while the proportion of TCM practicing (assistant) physicians in village clinics remained stable, and the proportion of TCM practicing (assistant) physicians in outpatient clinics decreased by years; in the past five years, the absolute value of financial input for primary healthcare institutions has steadily increased, while the financial allocation for TCM organizations has fluctuatingly decreased. In terms of service output, from 2017 to 2021, the proportion of TCM consultations to the total consultations in various institutions has steadily increased according to a certain increase (except for TCM outpatient clinics), while the proportion of TCM consultations in village clinics alone has always remained above 30.0%; in addition to township health centers, the per capita burden of consultations of TCM practicing (assistant) physicians in other primary healthcare institutions was generally on a downward trend. The comprehensive evaluation found that 2017, 2018 and 2021 were in a suitable state of resource allocation, while 2019 and 2020 were in an unbalanced state of resource allocation.

At present, the construction of primary TCM health service system in China has been effectively implemented, but there are still some problems in the process of orderly promotion. Problems such as insufficient resources for primary TCM, unbalanced service and utilization, insufficient advantages of TCM, imperfect personnel training mechanism and low financial input have constrained the development TCM. In order to promote the continuous improvement of the health service capacity of primary TCM health service institutions, it is necessary to consolidate the functions of government, further promote TCM culture, establish incentive mechanism to optimize the training mode of talents, strengthen the close integration of TCM health services with health insurance policies, and build a TCM medical association supported by "information integration".

Community health service institutions play an important role in the protection of people's health, the application of community traditional Chinese medicine services can significantly improve the quality of life for the patients, and alleviate the problems of the accessibility and affordability for the health care. The bliometric analysis on traditional Chinese medicine services in community health service institutions can provide a basis and direction for further improving the capacity of community traditional Chinese medicine services.

To explore the development process, research hotspots and frontiers of traditional Chinese medicine services provided by community health service institutions in China based on the bibliometric analysis and scientific knowledge mapping analysis.

On January 1, 2023, CNKI, Wanfang Data and VIP were searched for relevant literature from inception to 2022-12-31. Excel software was used for the statistical analysis of annual publication volume, source journals and source institutions, CiteSpace 6.1.R6 software was used for the research collaborative network of institutions, clustering analysis and burst analysis of keywords. Frequency analysis and co-occurrence network analysis of authors and keywords were carried out with VOSviewer software.

A total of 920 papers were included, as for their sources, 270 journals and 38 universities were involved, represented by Journal of Traditional Chinese Medicine (80 articles), Beijing University of Chinese Medicine and Guangzhou University of Chinese Medicine (14 articles) with the highest number of articles. A total of 449 research institutions were involved, and the institution with the highest number of articles was Beijing University of Chinese Medicine (23 articles). SHI Yongxing (27 articles) and BAO Yong (18 articles) were the top 2 authors. Twelve clusters could be formed by the co-occurrence analysis of authors, and there was close collaboration among authors within the same cluster, but a wide collaborative network had not been formed yet. A total of 1 252 keywords were involved in this study, forming 13 clusters labeled with "Traditional Chinese Medicine" and "Community", etc. Researches on "constitution of traditional Chinese medicine" and "diabetes mellitus" are expected to become frontiers in this field.

Traditional Chinese medicine services in community health service institutions in China is in a period of stable development, however, there are still deficiencies in the richness of research methods, formation of collaborative networks with greater influence and scale. It is necessary to strengthen cooperation among community health service institutions, as well as the cooperation between universities and community health service institutions, by combining multidisciplinary research methods.

The most effective prevention strategy for atherosclerotic cardiovascular disease (ASCVD) is primary management, with the core measure of risk assessment. The existing prediction models for ASCVD for the elderly are not able to guide TCM primary management well. Therefore, it is necessary to integrate TCM elements into the development of prediction models to guide the primary management of ASCVD with combined traditional Chinese and western medicine.

To construct and validate the ASCVD prediction model for the elderly based on TCM constitution.

A total of 1 418 elderly people who underwent physical examination at Huayuan Street Community Health Service Center, Chentangzhuang Street Community Health Service Center, Xiangyang Road Street Community Health Service Center and Daqiuzhuang Town Central Health Center in 2017 were included as the study subjects. General data of the study subjects were collected and constitution identification was performed. The incidence of ASCVD (clinical outcome) was followed up from 2017 to 2022. The follow-up will end at 2022-11-30. The data of the subjects were randomly divided into a training set (n=1 127) and validation set (n=291) according to 8∶2. In the training set, the conventional ASCVD prediction model for the elderly (model 1) and the conventional ASCVD+constitution prediction model for the elderly (model 2) were constructed by using the forward stepwise method. The nomogram of ASCVD prediction model for the elderly based on TCM constitution was plotted. The calibration curve was plotted and the Hosmer-Lemeshow goodness of fit test was performed to determine the calibration of the model. The receiver operating characteristic curve was plotted and the area under the curve (AUC) was calculated to determine the discrimination of the model. AUC, Net Reclassification Index (NRI), Integrated Discrimination Improvement (IDI), and Decision Curve Analysis (DCA) were used to compare model 2 with model 1 to evaluate the improvement efficacy of model 2.

There was no significant difference in the general data between the training set and validation set (P>0.05). The results of multivariate analysis showed that model 1 included 7 predictors of gender, age, waist circumference, systolic blood pressure, triacylglycerol (TG), BMI, systolic blood pressure×hypertension medication history. model 2 included 8 predictors of gender, age, waist circumference, systolic blood pressure, TG, BMI, systolic blood pressure×hypertension medication history, and constitution type. Hosmer-Lemeshow goodness-of-fit test showed good fit of model 2; Delong test results showed that AUC of model 2 was higher than that of model 1 (Z=2.741, P=0.006), NRI=0.511 (95%CI=0.359-0.663, P<0.001), IDI=0.038 (95%CI=0.024-0.051, P<0.001), suggesting that the addition of constitution predictors could improve the accuracy of model prediction. The clinical utility comparison results showed that the net benefit of model 2 to predict severe ASCVD events in the elderly was better than model 1 at a threshold probability of 5% to 74%.

In this study, a ASCVD prediction model for the elderly was constructed including 8 predictor variables of gender, age, waist circumference, systolic blood pressure, TG, BMI, systolic blood pressure×hypertension medication history, and constitution type. After testing, the differentiation and calibration performed well, which was better than the conventional prediction model, and can be applied to the individualized risk assessment of ASCVD in the elderly and guide the primary management of ASCVD with combined traditional Chinese and western medicine.

With the change of disease spectrum and the development of modern medical model, traditional Chinese medicine (TCM) is playing an important role in disease prevention, health care and rehabilitation. It is necessary to further promote the development of prevention of disease in TCM and vigorously promote the unique role of TCM in maintaining and promoting people's health. However, popularization and education of the concept of prevention of disease in TCM among community residents remains unclear.

To understand the overall awareness, trust, and adoption behavior of prevention of disease in TCM of community residents in Guangzhou, and explore the influencing factors of community residents' trust in prevention of disease in TCM services.

From April to August 2022, a stratified cluster sampling method was used to interview 652 community residents from 12 streets in 4 administrative regions of Guangzhou city based on geographic location (central city, urban-rural areas, and suburbs) and economic factors by questionnaires. The survey included residents' basic information, awareness and access to knowledge of prevention of disease in TCM, as well as their demand, utilization and trust in it. The influencing factors of community residents' trust in prevention of disease in TCM services were explored by binary Logistic regression analysis.

Among the 652 community residents, 67.79% (442/652) were aware of prevention of disease in TCM, 77.91% (508/652) trusted prevention of disease in TCM services, 69.63% (454/652) had received traditional TCM physiotherapy, and only 6.59% (43/652) had received prevention of disease in TCM services more than 4 times in the past year. Univariate correlation analysis showed that age (χ²=9.218), household type (χ²=19.356), marriage status (χ²=2.490), occupation (χ²=17.889), and medical insurance payment type (χ²=13.516) were influencing factors of residents' trust in prevention of disease in TCM services. Binary Logistic regression analysis showed that household type (non-agricultural, agricultural to resident, and non-agricultural to resident) was an influential factor for community residents' trust in prevention of disease in TCM services (OR=2.646, 5.593, 10.502) .

The overall awareness (67.79%) and trust (77.91%) of prevention of disease in TCM among community residents in Guangzhou are relatively high, but the actual number of services received is insufficient, with a phenomenon of knowledge-attitude-practice separation. Community residents with non-agricultural household type have a higher level of trust, while those with agricultural household type have a lower level of trust. During popularization and services of prevention of disease in TCM, it is necessary to fully utilize the residents' preferred forms, as well as to target specific groups, so as to cultivate the health habits of prevention of disease in community residents.

Community-acquired pneumonia (CAP) is one of the common infectious diseases, especially in elderly patients, with atypical clinical symptoms, which is susceptibility to serious complications, lacks effective treatment measures, and often has a poor prognosis.

To investigate the effect of traditional Chinese medicine (TCM) syndrome differentiation therapy on the quality of life and efficacy satisfaction of elderly patients with CAP discharged from hospital (within 1 week) .

This study was designed as a multicentre, randomized double-blind placebo clinical study. Elderly CAP post-discharge patients admitted to the respiratory departments of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Henan Chest Hospital, Henan People's Hospital, Zhengzhou Hospital of Traditional Chinese Medicine and Zhengzhou People's Hospital from April 2018 to January 2020 were selected as the study subjects and divided into the experimental group and control group by using a central randomized group enrolment model. The patients in the experimental group were treated with corresponding TCM granules based on syndrome differentiation, and the lung-tonifying spleen-invigorating phlegm-reducing formula was given for syndrome of phlegm-dampness due to qi deficiency, and the qi-supplementing yin-nourishing lung-clearing formula was given for qi and yin deficiency and phlegm-heat syndrome. The control group was given a placebo with the same appearance, weight, color, and smell as the Chinese medicine granules. The treatment course was 2 months, and the follow-up was up to 6 months. The quality of life evaluated by the Chinese version of the Quality of Life Rating Scale (SF-36) and efficacy satisfaction evaluated by the Efficacy Satisfaction Questionnaire for CAP (ESQ-CAP) were compared between the two groups before the treatment, 1 month after the treatment, 2 months after the treatment, 3 months after the follow-up, and 6 months after the follow-up.

Among the 120 subjects included, 8 were dislodged and 112 were finally included that met the protocol set, including 54 cases in the experimental group and 58 cases in the control group. There was no significant difference in gender, age, time after discharge, TCM syndrome differentiation, CUBR-65 score, and underlying diseases between the two groups before treatment (P>0.05) . The main effects of the group were significant on SF-36 physiological function domain score (F_group=5.057, P_group=0.027) , general health domain score (F_group=7.286, P_group=0.008) , and role limitations due to emotional problems domain score (F_group=6.858, P_group=0.010) . Comparison between the two groups showed that SF-36 physical function domain score of the experimental group was higher than that of the control group at 2 months of treatment, 3 months of follow-up, and 6 months of follow-up (P<0.05) ; SF-36 general health status domain and role limitations due to emotional problems domain scores of the experimental group were higher than those of the control group at 1 and 2 months of treatment, 3 and 6 months of follow-up (P<0.05) ; the SF-36 domain score for role limitations due to mental health was higher than that of the control group (P<0.05) at 3 and 6 months of follow-up. The main effect of group on ESQ-CAP daily living and ability domain score (F_group=16.218, P_group<0.001) , convenience domain score (F_group=25.013, P_group<0.001) , and ESQ-CAP total score (F_group=13.843, P_group<0.001) was significant. The ESQ-CAP daily living and ability domain scores were higher in the experimental group than the control group at 2 months of treatment, 3 and 6 months of follow-up (P<0.05) . At 1 and 2 months of treatment and 3 and 6 months of follow-up, ESQ-CAP convenience domain score and ESQ-CAP total score were higher in the experimental group than in the control group (P<0.05) . At 3 months of follow-up, the ESQ-CAP overall efficacy domain score was higher in the experimental group than the control group (P<0.05) .

The TCM syndrome differentiation therapy scheme can improve the quality of life and efficacy satisfaction of elderly patients with CAP after discharge.

Myelosuppression is one of the most common adverse effects of chemotherapy for lung cancer, in response to chemotherapy-related myelosuppression, modern medicine mostly adopts symptomatic treatment, but there are many limitations.

To investigate the effects of press-needle therapy on pevention of myelosuppression after chemotherapy of lung cancer patients based on the midnight-noon ebb-flow point selection theory.

A total of 142 non-small cell lung cancer (NSCLC) patients during first chemotherapy hospitalized in the respiratory department of Northern Jiangsu People's Hospital from July 2020 to June 2022 were selected and randomly divided into the control group (n=47) , press-needle group (n=48) and timing group (n=47) according to a prior computer-generated random number table and the developed allocation scheme. The control group received routine care measures, the press-needle group received press-needle therapy at acupoints such as Geshu acupoint, Pishu acupoint and Weishu acupoint on the basis of routine care measures, the timing group received press-needle therapy between 7 a.m. and 11 a.m on the day using midnight-noon ebb-flow method on the basis of routine care measures. The changes of blood routine indicators reflecting myelosuppression and the comfort scores before chemotherapy and 3rd, 7th, 14th, 21st days of chemotherapy were observed in the three groups.

The white blood cell count and neutrophil count in the press needle group and timing group were higher than the control group, and the white blood cell count and neutrophil count in the timing group were higher than the press needle group on the 7th and 14th days of chemotherapy (P< 0.05) ; the platelet count in the press needle group and timing group were higher than the control group on the 7th and 14th days of chemotherapy (P< 0.05) . The comfort scores in the press needle group and timing group were higher than the control group on the 7th and 14th days of chemotherapy (P< 0.05) , the comfort scores in the timing group were higher than the press needle group on the 14th day of chemotherapy (P< 0.05) .

The timing press-needle therapy based on the midnight-noon ebb-flow point selection theory can effectively prevent myelosuppression, improve blood routine indicators including white blood cell count, neutrophil count and platelet count, and promot comfort in NSCLC patients after chemotherapy.

The 72nd World Health Assembly reviewed and adopted the International Classification of Diseases Eleventh Revision (ICD-11) , which for the first time included traditional medicine originating from traditional Chinese medicine (TCM) in its chapter coding, of which the code for wasting thirst disorder is SD71 (TM1) . At present, wasting thirst disorder is a high clinical prevalence disease, with middle-aged and older adults being the high incidence population, and TCM constitutions bias are risk factors for wasting thirst disorder. There was no research on the burden of TCM diseases and risk factors.

Based on the ICD-11 chapter on traditional medicine and the national standards of TCM, the burden of wasting thirst disorder among middle-aged and elderly in Guangzhou was calculated and attributed to the TCM constitutions. The role of TCM constitutions monitoring in health management was evaluated, providing reference for the prevention and treatment of wasting thirst disorder by TCM and the application of constitutions theory.

A cross-sectional survey was conducted in 2020 to investigate the prevalence of wasting thirst disorder and the distribution of TCM constitutions among middle-aged and elderly in Guangzhou. The comprehensive theory of Global Burden of Disease (GBD) , calculate the years of life lost (YLL) , years lived with disability (YLD) , and disability adjusted life year (DALY) of wasting thirst disorder in the middle-aged and elderly population in Guangzhou were used to evaluate the disease burden of wasting thirst disorder. Relative risk (RR) was used to assess the risk of different TCM constitutions for wasting thirst disorder in middle-aged and elderly people.

A total of 1 576 middle aged and older adults in central Guangzhou were surveyed, 55 were lost, 1 521 valid questionnaires were recovered, and the effective response rate was 96.51%. Among them, 782 were male, aged 62 (56, 69) years; 739 were female, aged 62 (55, 70) years. The prevalence of wasting thirst disorder among middle-aged and elderly people in Guangzhou was 13.08%, with a standardized prevalence of 12.64%. The most distributed constitution among middle-aged and elderly people in Guangzhou were phlegm-dampness constitution, qi-deficiency constitution, and damp-heat constitution; among them, the most distributed constitutions in patients with wasting thirst disorder were phlegm-dampness constitution, yin-deficiency constitution, and qi-deficiency constitution. The DALY rate of wasting thirst disorder burden was 86.46‰, with a YLL rate of 4.86‰ and a YLD rate of 81.60‰. The proportion of single constitution and composite constitution was 48.98% and 51.02%, respectively. Yin-deficiency constitution was the risk constitution of wasting thirst disorder (RR=1.73, P<0.01) , which led to a disease burden of 33 092 DALY, with a DALY rate of 10.98, accouting for 12.70% of the disease burden in the middle-aged and elderly population with wasting thirst disorder. In terms of different age groups, phlegm-dampness constitution (RR=1.62, P<0.05) and yin-deficiency constitution (RR=1.80, P<0.05) were risk constitutions in the age group of 60-69 years, in which phlegm-dampness constitution resulted in a wasting thirst disorder burden of 18 530 DALY, with a DALY rate of 18.75‰, accounting for 21.63% burden of wasting thirst disorder in this age group; yin-deficiency constitution led to wasting thirst disorder burden of 10 520 DALY, with a DALY rate of 10.65‰, accounting for 12.28% of burden of wasting thirst disorder in this age group; the disease burden caused by the combination of phlegm-dampness constitution and yin-deficiency constitution was 26 780 DALY, with a DALY rate of 27.10 ‰, accounting for 31.26% of the burden of wasting thirst disorder in this age group. For different genders, male phlegm-dampness constitution (RR=2.29, P<0.01) and female yin-deficiency constitution (RR=2.27, P<0.01) were risk constitutions for wasting thirst disorder. The disease burden caused by phlegm-dampness constitution in middle-aged and elderly males was 45 017 DALY, resulting in a DALY rate of 30.96‰, accounting for 36.82% of the burden of wasting thirst disorder in middle-aged and elderly males. The burden of wasting thirst disorder caused by female yin-deficiency constitution was 28 753 DALY, resulting in a DALY rate of 18.43‰, accounting for 20.79% of the burden of wasting thirst disorder among middle-aged and elderly females.

The prevalence of wasting thirst disorder among middle-aged and older adults aged≥50 in Guangzhou is relatively high, with heavy disease burden. Yin-deficiency and phlegm-dampness constitutions are risk constitutions for wasting thirst disorder in middle-aged and elderly people. TCM constitutions monitoring and management can effectively reduce the burden of wasting thirst disorder .

Postoperative cognitive dysfunction (POCD) is one of the major causes of increased postoperative morbidity and mortality in patients. The inflammatory response and ferroptosis are the principal hypotheses of the mechanism of POCD development. But the mechanism of electroacupuncture to improve learning and memory function in POCD patients is unclear.

To observe the effect of electroacupuncture on learning, memory, inflammatory cytokines and ferroptosis of hippocampal neurons in aged rats with POCD, so as to explore the mechanism of improving POCD by electroacupuncture.

From January 2022 to February 2023, 72 SD rats aged 18 to 20 months were selected and divided into 3 groups according to random number table method of control group (n=24) , model group (n=24) and electroacupuncture group (n=24) . According to the observation time points of 3 and 7 days postoperative, the rats in each group were divided into 2 the subgroups (3 d postoperative subgroup in control group, 7 d postoperative subgroup in control group, 3 d postoperative subgroup in model group, 7 d postoperative subgroup in model group, 3 d postoperative subgroup in electroacupuncture group, 7 d postoperative subgroup in electroacupuncture group) , with 12 rats in each group. POCD model was established by exploratory laparotomy, and Baihui and Neiguan points were stimulated by electroacupuncture. The Morris water maze device was used to detect the behavioral performance of rats. The contents of interleukin (IL) 6, IL-10, tumor necrosis factor alpha (TNF-α) in serum and hippocampus were detected by enzyme-linked immunosorbent assay, and lipid peroxides (LPO) and Fe²⁺ in hippocampus were detected. The protein expression levels of acyl coenzyme A synthetase long-chain family member 4 (ACSL4) , ferritin heavy chain 1 (FTH1) and lysophosphatidylcholine acyltransferase-3 (LPCAT3) in hippocampus were detected by Western Blotting. The ultrastructure of hippocampal neurons was observed by transmission electron microscopy.

Group and time had no interaction effect on the escape latency of cognitive function training at 3 and 7 d postoperatively (P_interaction>0.05) , the main effect of training time on the escape latency of cognitive function training was significant (P_time<0.05) , and the main effect of group on the escape latency was not significant (P_group>0.05) . The escape latency of 3 d postoperative subgroup in model group was higher than that of 3 d postoperative subgroup in control group and 3 d postoperative subgroup in electroacupuncture group. The frequency of crossing platform and target quadrant residence time of 3 d postoperative subgroup in model group were lower than those of 3 d postoperative subgroup in control group and 3 d postoperative subgroup in electroacupuncture group; the frequency of crossing platform in 3 d postoperative subgroup in electroacupuncture group was lower than that of 3 d postoperative subgroup in control group (P<0.05) . The escape latency of 7 d postoperative subgroup in model group was higher than that of 7 d postoperative subgroup in control group and 7 d postoperative subgroup in electroacupuncture group, the frequency of crossing platform was lower than that of 7 d postoperative subgroup in control group, and the target quadrant residence time was lower than that of 7 d postoperative subgroup in control group and 7 d postoperative subgroup in electroacupuncture group (P<0.05) . Serum IL-6 and TNF-α in 3 d postoperative subgroup in model group were higher than those in 3 d postoperative subgroup in control group and 3 d postoperative subgroup in electroacupuncture group (P<0.05) . TNF-α in 3 d postoperative subgroup in electroacupuncture group was higher than that in 3 d postoperative subgroup in control group (P<0.05) , and IL-10 was higher than that in 3 d postoperative subgroup in control group and 3 d postoperative subgroup in model group (P<0.05) . Serum IL-6 was higher in 7 d postoperative subgroup in model group than in 7 d postoperative subgroup in control group, and TNF-α was higher than 7 d postoperative subgroup in control group and 7 d postoperatively subgroup in electroacupuncture group, and IL-10 was higher in 7 d postoperative subgroup in electroacupuncture group than the 7 d postoperative subgroup in control group and 7 d postoperatively subgroup in model group (P<0.05) . The levels of hippocampal IL-6 and TNF-α in 3 d postoperative subgroup in model group were higher than those of 3 d postoperative subgroup in control group and 3 d postoperative subgroup in electroacupuncture group, and the level of IL-10 was higher than that of 3 d postoperative subgroup in control group and 3 d postoperative subgroup in model group (P<0.05) . Hippocampal IL-6 and TNF-α levels in 7 d postoperative subgroup in model group were higher than those in 7 d postoperative subgroup in control group and 7 d postoperative subgroup in electroacupuncture group, and IL-10 in 7 d postoperative subgroup in electroacupuncture group was higher than that in 7 d postoperative subgroup in contol group and 7 d postoperative subgroup in model group (P<0.05) . Fe²⁺, LPO, ACSL4 and LPCAT3 in 3 d postoperative subgroup in model group were higher than those in 3 d postoperative subgroup in control group and 3 d postoperative subgroup in electroacupuncture group, Fe²⁺, LPO, ACSL4 and LPCAT3 in 3 d postoperative subgroup in electroacupuncture group were higher than those in 3 d postoperative subgroup in control group; FTH1 in 3 d postoperative subgroup in model group was lower than that in 3 d postoperative subgroup in control group and 3 d postoperative subgroup in electroacupuncture group, FTH1 in 3 d postoperative subgroup in electroacupuncture group was lower than that in 3 d postoperative subgroup in control group (P<0.05) . Fe²⁺, LPO, ACSL4 and LPCAT3 in 7 d postoperative subgroup in model group were higher than those in 7 d postoperative subgroup in control group and 7 d postoperative subgroup in electroacupuncture group, FTH1 in 7 d postoperative subgroup in model group was lower than that in 7 d postoperative subgroup in control group and 7 d postoperative subgroup in electroacupuncture group (P<0.05) . In 3 d and 7 d postoperative subgroups in model group, the structure of double nuclear membrane of cell nucleus was clear in the hippocampal field of vision, and the perinuclear space was not significantly widened, with irregular shape and uneven surface; the chromatin in the nucleus was concentrated and marginalized; a small amount of mitochondrial membranes in the cytoplasm were broken and the membrane structure disappeared; part of the endoplasmic reticulum expanded obviously; some myelin sheaths were broken and disorganized. The 3 d and 7 d postoperative subgroups in electroacupuncture group improved significantly compared with 3 d and 7 d postoperative subgroups in model group.

The imbalance of inflammatory cytokines and ferroptosis of neurons may be the important etiological mechanism for the development of POCD. Electroacupuncture can improve the learning and memory abilities in aged rats with POCD, and the mechanism of its brain protection may be related to the regulation of systemic and central inflammatory cytokines and the pathway of ferroptosis in neurons.

Primary care physicians (PCPs), who play a crucial role in providing primary healthcare services, utilize clinical practice guidelines as valuable tools for guiding their practice. By investigating these physicians' awareness and usage of guidelines, we can offer innovative strategies for promoting guideline adherence and enhancing physicians' training. This, in turn, can ultimately improve the quality of primary healthcare.

To explore the level of awareness and the current status of reference use of traditional Chinese medicine (TCM) guidelines for diabetes among PCPs, and to identify the influencing factors.

From September 22 to October 29, 2021, an online questionnaire survey was conducted among physicians affiliated with the Specialist Committee for Primary Diabetes Care of China Association of Chinese Medicine, using the snowball sampling method to ensure a broader representation of physicians. The questionnaire consists of three parts: basic information, current status and needs of physicians in using TCM for diabetes prevention and treatment, and a survey on physicians' current awareness and needs regarding diabetes guidelines. Ordered multiclass Logistic regression analysis was used to identify the influencing factors of PCPs' awareness and usage of TCM guidelines for diabetes.

A total of 382 questionnaires were collected from PCPs, 35.34% (135/382) of the physicians were very familiar or fairly familiar with TCM guidelines for diabetes, while 28.80% (110/382) of the physicians referred to these guidelines regularly for diabetes management. The results of the univariate analysis showed that, PCPs with differences in gender, specialty, department, number of diabetic patients treated per week, evaluation of TCM treatment efficacy, availability of TCM herbs and Chinese patent drugs in physicians' institutions, and physicians' awareness of guidelines, showed statistically significant differences in their reference status of TCM guidelines for diabetes (P<0.05). The results of the ordered multinomial Logistic regression analysis showed that, the factors influencing PCPs' awareness of TCM guidelines for diabetes included PCPs' evaluation of TCM treatment efficacy (OR=5.783, 95%CI=1.283-26.102), availability of TCM herbs and Chinese patent drugs in physicians' institutions (OR=2.399, 95%CI=1.548-3.717), and their previous participation in specialized training on diabetes prevention and control guidelines (OR=1.751, 95%CI=1.149-2.667). The factors influencing PCPs' reference to TCM guidelines for diabetes included the physicians' level of familiarity with the guidelines [very or fairly familiar (OR=15.721, 95%CI=7.584-32.557), somewhat familiar (OR=5.392, 95%CI=2.841-10.237) ], work experience less than 5 years (OR=14.083, 95%CI=1.390-142.594), different specialties [TCM (OR=6.869, 95%CI=1.483-31.849), integrated Chinese and western medicine (OR=6.613, 95%CI=1.551-28.219) ], and geographical regions [northeast (OR=2.962, 95%CI=1.064-8.240), southeast (OR=2.686, 95%CI=1.004-7.178) ].

The awareness and reference usage of TCM guidelines for diabetes among PCPs need to be improved. Factors such as guideline awareness, work experience, professional orientation, and geographical region play a significant role in influencing physicians' utilization of the guidelines. In the future, training for PCPs should be strengthened, particularly focusing on the northwest and southwest regions, and PCPs with a background in TCM should receive more training on TCM-related guidelines for diabetes prevention and treatment.

Oral traditional Chinese medicine (TCM) has been widely used in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD), but the outcome measures of relevant clinical trials have not been standardized and regulated.

To screen the published randomized controlled trials (RCTs) of oral TCM in the treatment of AECOPD, summarize the literature characteristics and outcome measures, so as to provide reference for the design of clinical trials and the selection of outcome measures for the treatment of AECOPD with TCM.

CNKI, Wanfang Data, VIP, SinoMed, PubMed, Embase, Web of Science, Cochrane Library, ClinicalTrials.gov and Chinese Clinical Trial Registry were systematically searched by computer to obtain RCTs and clinical trial registration protocols for the treatment of AECOPD with oral TCM from January 2018 to October 2022. After independent screening of the literature and extraction of data by 2 researchers, qualitative analysis was used to describe the selection of outcome measures in the enrolled studies.

A total of 578 studies were enrolled, including 574 RCTs with reported trial results and 4 clinical trial registration protocols. A total of 51 508 patients were involved in 574 RCTs. In the inclusion criteria, 88 studies limited the classification of disease, and 361 studies limited the TCM syndrome type, 6 studies reported the blinding method, and 6 studies mentioned the follow-up. A total of 4 030 outcome measures were covered and the number of outcome measures in a single article ranged from 1 to 24. According to the functional attributes, the outcome measures were classified into 8 measure domains: TCM symptoms/syndromes, symptoms/signs, physical and chemical tests, quality of life, long-term prognosis, economic evaluation, safety evaluation and others. The measure domain with the highest reporting rate was physical and chemical tests, and the top 5 outcome measure items reported in terms of frequency were: response rate (11.5%), forced expiratory volume in 1 s (FEV₁) (7.5%), TCM symptom/syndrome score (7.0%), FEV₁/Forced Vital Capacity (FVC) (6.8%), FVC (4.6%). Four hundred and forty-five studies reported the composition of response rate, and the top 5 measures with reporting rate were symptoms (423), signs (281), TCM syndrome score (203), laboratory tests (89), and pulmonary function (71) .

The RCTs of oral TCM in the treatment of AECOPD involved a large number and a wide range of outcome measures. The included literature focused on the effects of oral TCM on the symptoms and signs, physical and chemical test indicators, quality of life, long-term prognosis, economic evaluation and safety outcomes of patients with AECOPD in varying degrees. However, the selection of outcome measures remains problematic in multiple ways: unclear prioritization of outcome measures; focusing on clinical endpoints with insufficient attention to clinical endpoints; insufficient attention to health economics indicators; different sources and judgment criterias of reference of response. In the future studies, researchers can design the rational outcome measures by refering to the published core outcome set (COS) to improve the quality of TCM clinical research.

Menopause will cause series of pathophysiologic changes and long-term complications (coronary heart disease, cerebrovascular disease, osteoporosis, etc.), among which coronary heart disease is a major health threat.

To investigate the effects of menopausal status and aging on common risk factors for coronary heart disease (CHD) in middle-aged women, such as increased carotid intima-media thickness (CIMT), hypertension, dyslipidemia, diabetes, and obesity.

A total of 556 healthy premenopausal women aged 45 to 54 years who received regular physical examinations at the physical examination center of Beijing Shijitan Hospital affiliated to Capital Medical University in 2018 were initially selected, with 89 excluded according to relevant criteria, and 467 women were finally included as study subjects. The included subjects were divided into the pre-menopausal group (n=176) and postmenopausal group (n=291) according to whether they were postmenopausal during a 3-year follow-up period. Changes in BMI, waist circumference, blood glucose, blood pressure, blood lipids and other indicators were monitored, inter- and intra-group comparisons were performed before and after the follow-up period. Multivariate Logistic regression analysis was used to explore the effects of menopausal status and age on the incidence of risk factors for coronary heart disease in middle-aged women.

The average age of 467 subjects was (47.6±2.3) years old. Compared with baseline, waist circumference, uric acid (UA), total cholesterol (TC), triglyceride (TG), and low density lipoprotein cholesterol (LDL-C) levels increased, fasting blood glucose (FBG) level decreased after 3 years (P<0.05). The results of inter-group comparison showed that there was no significant difference in waist circumference, BMI, TG, FBG and high density lipoprotein cholesterol (HDL-C) levels between the two groups after three years (P<0.05) ; the levels of UA, TC and LDL-C in the menopausal group were higher than those in the pre-menopausal group, and the difference was statistically significant (P<0.05). The results of intra-group comparison showed that the waist circumference in the two groups after 3 years was higher than baseline (P<0.05) ; the levels of UA, TC and TG in the pre-menopausal group after 3 years were higher than the baseline (P<0.05) ; the levels of UA, TC, TG and LDL-C in the postmenopausal group after 3 years were higher than the baseline (P<0.05). Multivariate Logistic regression analysis showed that age ≥50 years old was a high-risk factor for increased CIMT in middle-aged women (OR=2.475, 95%CI=1.049-5.838, P=0.038) .

The changes in waist circumference and TG in middle-aged women are mainly affected by age, the changes of LDL-C are mainly affected by menopausal status, and the changes of TC and UA are affected by both menopausal status and increased age. Age ≥50 years is a high risk factor for increased CIMT in middle-aged women, and the changes of metabolic indicators such as UA, TC and LDL-C precede changes in CIMT after menopause.

Coronary microvascular disease (CMVD) is currently a research hotspot in the field of cardiovascular disease, traditional Chinese medicine (TCM) has unique advantages and significant efficacy in the treatment of CMVD, but there are problems in relevant clinical trials, such as inconsistencies in the diagnostic and efficacy criteria, exploring the core outcome set of TCM in the treatment of CMVD is conducive to the development of high-quality evidence in the future.

To analyze the application of outcomes measures in randomized controlled trials (RCTs) of CMVD treated with TCM, and propose corresponding questions and recommendations.

CNKI, SinoMed, VIP, Wanfang, PubMed, Embase and Cochrane Library were systematically searched for RCTs of CMVD treated with TCM from inception to February 09, 2023. The basic information, interventions and outcome measures in RCTs of CMVD treated with TCM were extracted, the Cochrane systematic review manual bias risk assessment tool was used to evaluate the bias risk of the included literature and the Excel software was used to statistically analyze the outcome measures.

A total of 88 articles were included, involving 2 clinical trial registration protocols and 1 English literature. Cochrane systematic review manual bias risk assessment showed that the included literature were evaluated as unclear in terms of random sequence generation, allocation concealment, blinding of participants and personnel, blinding of outcome assessors, and other bias; mostly low risk in terms of outcome data completeness and selective reporting. A total of 18 RCTs were analyzed for TCM syndromes of patients diagnosed with CMVD, involving 6 RCTs related to blood stasis due to qi deficiency, 3 RCTs related to intermingled phlegm and blood stasis. A total of 115 outcome measures were obtained by statistical analysis, the total frequency was 571 times, which can be divided into 7 categories, including clinical efficacy, physicochemical testing, signs and symptoms, TCM syndrome points, quality of life, long-term prognosis, and safety testing. The frequency of total clinical efficacy rate was the highest (46 times), 3 months was the most commonly used intervention node. and the highest frequency of composite outcome measures was the clinical efficacy combined with physicochemical testing.

It was found that the overall quality of RCTs of TCM in the treatment of CMVD was generally low, and there are some problems in the outcome measures, such as the lack of standardized TCM syndrome diagnosis criteria and efficacy criteria, and the lack of long-term prognosis monitoring. In the future, it is also necessary to conduct high-quality RCTs, combined with the characteristics of TCM treatment, to construct a standardized core outcome set of TCM in the treatment of CMVD.

Community traditional Chinese medicine (TCM) service is an important step in promoting the construction of Healthy China. There are abundant academic research results in the field of community TCM service in China, but there is a lack of collation of these research results. Systematically sorting out the relevant literature in the field of community TCM service by using the method of bibliometrics can provide a macroscopic understanding of the research progress and hotspots in this field and reference for future research.

To sort out the hotspots and development trends of community TCM service research in China by using bibliometric methods.

On May 2 in 2022, CNKI, Wanfang Data Knowledge Service Platform and VIP were searched for relevant research literature on community TCM service research in China from January 2000 to April 2022. By using CiteSpace software, the visual analysis of the co-occurrence of authors included in the literature, keywords co-occurrence, clustering, timeline distribution, and burst terms were performed and the relevant graphs were plotted.

A total of 1 440 papers were included, and the publication volume of community TCM services in China showed an overall increasing trend, with 75 papers (5.2%) published in 2000—2005, 382 papers (26.5%) in 2006—2011, and 983 papers (68.3%) in 2012—2022. The top three authors in the publication volume were Shi Yongxing (25 articles), Bao Yong (16 articles), and Liu Deng (14 articles). The top 5 high-frequency keywords in terms of centrality were "TCM" "Chinese medicine" "community" "general practitioner" and "general practice". The keyword clustering analysis formed 12 cluster labels, and the top three clusters by scale were "community" "TCM" and "general practitioner". The timeline distribution suggested that clusters such as "community" "TCM" "general practitioner" and "TCM nursing" were research hotspots in this field. From the perspective of burst terms, "family doctor" has the highest burst value (8.07), and "elderly people" "diabetes" "family doctor" "medical consortium" "general practice of TCM" and the "integrated medical care and elderly services" are future research directions.

The current status of community TCM service in China, development of TCM general practitioners and community TCM nurses, and the improvement of TCM service capabilities of community health care institutions are research hotspots. In the future, more attention will be paid to the digital compact TCM medical consortium based on the Internet platform and the contracted family doctor service model with the participation of TCM general practitioners, so as to better utilize the characteristics and advantages of community TCM services in integrated medical care and elderly services.

With the accumulation of high-quality evidence, the clinical effectiveness of acupuncture for migraine has been increasingly recognized. Numerous acupuncture clinical studies in China highlight and validate various acupuncture intervention schemes through clinical trials. Integrating and selecting these advantageous schemes to guide clinical practice has become a new focus in acupuncture research.

To conduct multicriteria decision making (MCDM) by using technique for order preference by similarity to an ideal solution (TOPSIS) method based on Meta-analysis, screen optimized treatment plan (OTP) of acupuncture for migraine and explore the ideas for constructing OTPs of acupuncture.

Wanfang Data, VIP, CNKI, SinoMed, PubMed, Web of Science, and EmBase were searched by computer for randomized controlled trials (RCTs) on acupuncture treatment for migraine published before April 2022. Two researchers independently screened the literature, extracted basic characteristics of literature〔author, year of publication, sample size, cure rate, efficiency rate and visual analogue score (VAS), etc.〕, and assessed the quality of the RCTs by using modified Jadad scale. Acupuncture treatment plans for migraine were summarized based on the characteristics of the included RCTs, and Meta-analysis was performed. The relative risk (RR) of cure rate and efficiency rate, and the mean difference (MD) of VAS scores for each plan were extracted based on the Meta-analysis results. The treatment frequency and score of the modified Jadad scale were calculated for each plan using sample size as the weight. The data were all included in the MCDM analysis, the weights of different decision criterion were determined using the entropy weight method. The TOPSIS method was finally used to select OTP of acupuncture for migraine.

A total of 17 RCTs were included and categorized into 8 types of treatment plans of acupuncture for migraine (Tongyuan acupuncture, six-spirit points, bone-nearby acupuncture, conventional acupuncture, Gallbladder Meridian acupoints, head acupoints, penetration needling method and Siguan acupoints) according to the results of Meta-analysis. The TOPSIS evaluation indicated that the treatment plan of acupuncture focusing primarily on head acupoints is OTP, involving needling the head acupoints of Fengfu, Touwei, Toulinqi, Taiyang, Shuaigu, and Fengchi once daily or every other day, with an average treatment number of 11, with the main advantages of shorter treatment time and significant reduction in VAS.

The OTP of acupuncture for migraine screened and constructed in the study can provide reference for clinical application. The utilization of the entropy weight-TOPSIS method based on Meta-analysis presents a novel approach for constructing the OTPs of acupuncture for migraine.

Learning and memory impairment is a common dysfunction after stroke, which seriously affects the overall recovery of patients. Electroacupuncture at Shenting and Baihui has definite efficacy in patients with cognitive dysfunction after stroke, but its mechanism of action remains uncertain.

To observe the effect of electroacupuncture on hippocampal neuronal protection and brain-derived nerve growth factor (BDNF) /tyrosine receptor kinase B (TrkB) /phosphatidylinositol-3-hydroxykinase (PI3K) /protein kinase B (Akt) signaling pathway in rats with learning and memory impairment after middle cerebral artery occlusion reperfusion (MCAO/R) .

A total of 60 8-week-old healthy male SD rats were selected from May 2021 to March 2022, and 24 rats were divided into the blank group (n=12) and sham operation group (n=12), and the other 36 rats were constructed as MCAO/R model. The 24 rats with successful modeling were randomly divided into the model group (n=12) and electroacupuncture group (n=12). The electroacupuncture treatment was performed at Shenting and Baihui points in the electroacupuncture group. Zea-Longa score was used to observe the degree of neurological impairment in each group. Spatial probe test was used to evaluate the spatial learning and memory ability of the rats. TTC staining was used to observe the volume of brain infarction in rats. RT-PCR was used to measure the mRNA levels of BDNF, TrkB, PI3K and Akt, Western blotting was used to detect the protein levels of BDNF and TrkB and the levels of p-PI3K/PI3K and p-Akt/Akt.

Zea-Longa score of the model group and electroacupuncture group was significantly different from the blank group and sham operation group at 2 h after surgery (P<0.05), and Zea-Longa score of the model group was significantly different from the blank group, sham operation group and electroacupuncture group at 7 and 14 days after treatment (P<0.05). During the 9th to 13th day of treatment, the escape latency in the model group was higher than the sham operation group (P<0.05), and lower in the electroacupuncture group than the model group (P<0.05). The frequency of crossing the effective region of the platform in the model group was lower than the blank group and sham operation group (P<0.05), and higher in the electroacupuncture group than the model group (P<0.05). The volume of cerebral infarction in blank group, sham operation group, model group and electroacupuncture group was 0, 0, (36.7±6.3) % and (24.0±2.2) %, respectively, and the volume of cerebral infarction in the electroacupuncture group was lower than the model group (P<0.05). The mRNA levels of BDNF, TrkB, PI3K and Akt in the model group were lower than the blank group and sham operation group (P<0.05), and higher in the electroacupuncture group than the model group (P<0.05). Compared with sham operation group, the protein levels of BDNF and TrkB (P<0.01, P<0.001), the levels of p-PI3K/PI3K and p-Akt/Akt (P<0.01, P<0.05) in model group were decreased; compared with the model group, the protein levels of BDNF and TrkB and the levels of p-PI3K/PI3K and p-Akt/Akt in electroacupuncture group were increased (P<0.05) .

Electroacupuncture may reduce the symptom of neurological function deficits and improve the learning and memory ability of rats after cerebral ischemia reperfusion by upregulating the expression of BDNF/TrkB/PI3K/Akt pathway related proteins.

Acupuncture is one of the non-pharmacological methods for the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS). The progression of research evidence on acupuncture for OSAHS to high quality islimited by the defects in the outcome indicators of randomized controlled trials (RCTs) of acupuncture for OSAHS. Therefore, it is of reference value to analyze the outcome indicators of RCTs of acupuncture for OSAHS.

To analyze the outcome indicators of RCTs of acupuncture for OSAHS in the past 10 years, clarify the existing problems and provide suggestions for the guidance of further studies.

CNKI, Wanfang Data, VIP, SinoMed, PubMed, Embase, Cochrane Library, Web of Science, Clinical Trials.gov were searched for the RCTs of acupuncture for OSAHS from 2012-01-01 to 2022-11-18 with a combination of subject terms and free terms. The Cochrane Risk of Bias Assessment Tool was used to evaluate the quality of the included literature and sort out outcome indicators.

A total of 2 085 relevant papers were obtained from the preliminary search, and 12 papers were included after duplicating and multiple screening, and the outcome indicators were classified into traditional Chinese medicine (TCM) syndrome indicators, clinical symptom indicators, clinical efficacy indicators, neuroimaging indicators, polysomnography indicators, other examination indicators, serological indicators, life quality indicators and safety indicators. The most frequently reported outcome indicators were polysomnography indicators, followed by clinical symptom indicators.

The outcome indicators of RCTs of acupuncture for OSAHS have problems such as indistinguishable priorities, various clinical symptom indicators, inadequate application of serological indicators, limited safety evaluation, lack of standard for TCM characteristic syndrome differentiation indicators and long-term efficacy and economic evaluation. It is recommended to conduct more high-quality researches to strengthen the connection between TCM characteristic syndrome differentiation indicators, modern science and technology indicators and clinical studies, unify standard of syndrome differentiation of OSAHS, strengthen the awareness of conducting economic and safe clinical researches, so as to establish a core set of indicators of acupuncture treatment for OSAHS.

Menopausal hormone therapy (MHT) can effectively relieve menopausal symptoms, but its treatment options are diverse, and it is essential to make treatment decisions meeting women's needs. However, the current investigation on the quality of shared decision making between doctors and patients (SDM) in menopausal hormone therapy needs to be supplemented.

To analyze the quality of SDM in MHT among menopausal syndrome patients and explore its influencing factors, so as to provide a theoretical basis for achieving quality clinical care for menopausal population.

A total of 101 patients with menopausal syndrome from Center for Gynecological Endocrinology and Reproduction in Peking Union Medical College Hospital from October 2022 to January 2023 were selected as study subjects. The study was conducted using the questionnaire method, which consisted of general demographic information, treatment-related information and SDM quality survey. The Chinese version of 9-items shared decision making questionnaire (SDM-Q-9) was used to assess the SDM quality of patients. Multiple linear regression analysis was used to explore the influencing factors of SDM quality in MHT among patients with menopausal syndrome. Multiple linear regression analysis was used to explore the influencing factors of the quality of SDM in MHT among patients with menopausal syndrome.

The average score of SDM quality was 89.75. Patients with children, considered MHT to be very effective, with symptoms of hot flushes and sweating, insomnia and mood fluctuations, advised by doctors to receive MHT had better degree of participation in SDM (P<0.05). Multiple linear regression analysis showed that patients with children (β=0.26, P=0.005), hot flushes and sweating (β=0.19, P=0.044), insomnia (β=0.23, P=0.017) and recommendation by doctors (β=0.21, P=0.025) are influencing factors of SDM quality in MHT of patients with menopausal syndrome, which could explain 23.7% of the variation in SDM quality.

SDM quality is relatively good in MHT among menopausal syndrome patients. Patients with children, hot flashes and sweating, insomnia, and recommendation for use by doctors are influencing factors of SDM quality in MHT among menopausal syndrome patients. Doctors should take the initiative to include patients in SDM, so that patients can realize that they are the principal leader of their health and make SDM consistent with their needs and values in conjunction with doctors.

Prevention of disease in Traditionnal Chinese Medicine (TCM) is a distinguishing advantage of TCM health management services, however, the holistic health state of the patients remains to be elucidated and evaluated.

To evaluate the health-related quality of life (HRQoL) and its influencing factors in patients with prevention of disease in TCM.

From May to June 2022, a stratified cluster sampling method was used to randomly select a district-level TCM hospital from each of the four administrative regions of Guangzhou (Liwan District, Tianhe District, Baiyun District, Huadu District) as the research site. The EQ-5D-5L scale was used to investigate the patients with prevention of disease in TCM by questionnaire in primary care, and the health utility value was calculated according to the Chinese EQ-5D utility score system. The influencing factors of health utility value and EQ-VAS score were analyzed by using optimal scale regression analysis.

A total of 660 questionnaires were completed in this survey, including 630 valid questionnaires, with a effective recovery rate of 95.45%. Among the 630 investigated patients with prevention of disease in TCM, 185 patients (29.4%) visited for daily health care, 242 patients (38.4%) visited at the initial stage of disease for discomfort, 218 patients (34.6%) visited for avoiding exacerbation of current illness, 67 patients (10.6%) visited for post-illness rehabilitation physiotherapy. The top three conditions for prevention of disease in TCM were insomnia disorder, epigastric pain and arthralgia. The EQ-5D-5L health utility value for the investigated patients was 0.942 (0.893, 1.000), and the EQ-VAS score was 80 (70, 90). All five dimensions based on the ranking of difficulties frequency were pain/discomfort (50.2%), anxiety/depression (46.9%), daily activities (14.4%), mobility (9.9%) and self-care (6.0%). The influencing factors of health utility value based on the ranking of importance were the main causes of most recent prevention of disease in TCM (0.366), age (0.281), comorbidities of TCM conditions (0.145), occupation (0.111) and education level (0.098). The influencing factors of EQ-VAS score based on the ranking of importance were marital status (0.378), understanding of prevention of disease in TCM (0.353), age (0.176) and monthly income (0.092) .

The HRQoL of patients with prevention of disease in TCM in primary care in Guangzhou is at a medium level. The health utility values were relatively low in patients suffered from TCM conditions such as lung cancer, stroke, chronic obstructive pulmonary disease, osteoporosis and breast cancer, aged 60 and above, comorbid with 2 or more TCM conditions, with manual labour and lower education level. The self-rated health status was relatively poor in patients absence from marriage, unaware of prevention of disease in TCM, aged 60 and above, with higher monthly income. HRQoL should be applied reasonably as an important outcome indicator. Attention should be paid to the population with poor HRQoL among patients with prevention of disease in TCM, the promotion and dissemination of the concept and connotation of prevention of disease in TCM should be strengthened.

The development of traditional Chinese medicine (TCM) has been listed as a national development strategy with vigorous improvement of TCM service capacity in primary care institutions as the important elements, however, there are few studies on the disease spectrum of TCM in community health service institutions.

To analysis the TCM disease spectrum in outpatient clinics of contracted residents by family doctors in Shenzhen community health service centers (abbreviated as CHSC) and understand the capability of TCM in Shenzhen health centers, thus providing a theoretical basis for promoting the development of TCM in primary care in China.

From May to June 2022, the records of outpatient consultations with treatment cost of 10 Shenzhen CHSCs from 2021-01-01 to 2021-06-30 were extracted by the unified information platform of the Health Commission of Shenzhen Municipality (Hangchuang Community Health Service Center Business System) . The 385 138 records with purpose of TCM treatment, matching diagnosis and treatment costs, first diagnosis can be coded in Classification and Codes of Diseases and ZHENG of Traditional Chinese Medicine (TCD) were collected. The disease spectrum was analyzed based on the classification of disease in TCD, mainly involving department categories, specialty system classifications, and TCM disease terms.

A total of 385 138 records of TCM diagnosis and treatment were selected in this study, including 170 077 (44.16%) male cases and 215 061 (55.84%) female cases, with an average age of (36.7±9.4) years. All of the 7 TCD categories of disease spectrum were involved, including internal medicine accounting for 56.98% (219 445 cases) , pediatrics accounting for 20.56% (79 201 cases) , otolaryngology accounting for 12.45% (47 965 cases) , gynecology accounting for 7.95% (30 620 cases) , surgery accounting for 1.51% (5 797 cases) , orthopedics accounting for 0.37% (1 407 cases) and ophthalmology accounting for 0.18% (703 cases) . Apart from the specialty system classifications of tumor diseases, cancer diseases in each category, classifications of middle canthal disease, black eye disease, pupillary disease, traumatic eye disease in Ophthalmology, the disease spectrum involves all specialty system classifications in 7 categories. The cumulative diagnosis and treatment volume of several disease spectrums accounted for 90.00% of the total diagnosis and treatment in each category. The top 5 system diseases in the spectrum included respiratory system diseases accounting for 54.19% (208 701 cases) , musculoskeletal system diseases accounting for 19.05% (73 369 cases) , gynecological system diseases accounting for 7.95% (30 620 cases) , cardiovascular and cerebrovascular system diseases accounting for 7.15% (27 539 cases) , and the digestive system diseases accounting for 4.98% (19 162 cases) . Patients aged <15 years and 15-24 years mainly suffered from diseases related to the respiratory and digestive systems, and the incidence of diseases such as paralysis, dizziness, headache, insomnia, fatigue were increased with the increase of age; cold ranked the first for patients aged below 45 years, the paralysis of muscle and joint pain ranked the first for patients aged above 45 years.

The TCM diseases spectrum in Shenzhen CHSCs is wide, but the categories are relatively concentrated and single, mainly involving internal medicine, concentrating on respiratory system diseases, musculoskeletal system diseases, gynecological system diseases, cardiovascular and cerebrovascular system diseases, and digestive system diseases. It is necessary to strengthen and expand the TCM diagnosis and treatment capabilities in CHSCs to better meet diverse health needs of the residents.

Heart rate variability (HRV) is commonly used to evaluate the short-term prognosis of coronary artery diseaseas a well-known non-invasive indicator of cardiac autonomic function. Percutaneous coronary intervention (PCI) is a commonly usedsuigical treatment of coronary artery disease, however, major adverse cardiac event (MACE) such as malignant arrhythmias and recurrent myocardial infarction are common after suigical treatment. Although dual antiplatelet therapy (DAPT) can reduce the occurrence of MACE to a certain extent, it is prone to be complicated with gastrointestinal bleeding, and unable to consistently improve the prognosis of PCI. Ocular acupuncture can effectively reduce the duration and frequency of chest pain, and exercise therapy can enhance the function of heart and blood vessels. The application of ocular acupuncture and exercise combination therapy (OAECT) after PCI remains to be explored.

To investigate the effect of OAECT on postoperative heart rate variability and prognosis of patients treated with PCI.

A total of 32 CHD patients after PCI with moderate and low risk attending Hospital of Chengdu University of Traditional Chinese Medicine were selected and randomly divided into the OAECT group and drug treatment group in a 1∶1 allocation ratio. Patients in the OAECT group received OAECT in addition to DAPT, patients in the drug treatment group received DAPT alone, patients in both 2 groups completed the 2-week intervention. The data of patients was collectedas follows: (1) Baseline indicators: gender, age, height, weight, blood pressure, respiratory rate, interval between onset and intervention, education level, occupation, severity of coronary artery disease, and number of underlying diseases. (2) Main indicators: HRV within 24 h after PCI and on the day of the end of 2-week intervention, including the standard deviation of all normal to normal RR intervals (SDNN) , standard deviation of all 5-minute RR intervals (SDANN) , mean of the standard deviation of all NN intervals for all 5-min segment of 24 hours (SDNN index) , root mean square of difference between adjacent NN intervals (rMSSD) , percent of NN50 in the total number of NN intervals (PNN50) , high frequency (HF) , low frequency (LF) low frequency/high frequency (LF/HF) values. Prognosis at 2, 4, and 8 weeks after the intervention assessed by MACE, including cardiac or all-cause deaths, malignant arrhythmias such as ventricular tachycardia and ventricular fibrillation, severe heart failure, recurrent myocardial infarction, repeat PCI and chest pain recorded by telephone and outpatient consultations. (3) Secondary indicators: C-reactive protein (CRP) , N-terminal pro B type natriuretic peptide (NT-proBNP) , creatine kinase isoenzyme (CK-MB) , high-sensitivity troponin I (hs-TnI) . (4) Safety indicators: the occurrence of complications after PCI such as subcutaneous hematoma, skin lesions, muscle soreness, respiratory abnormalities and stroke, all the outcome indicators were measured within 24 hours after PCI and on the day of the end of 2-week intervention.

There was no significant difference in LF/HF, SDNN, SDANN, SDNN index, LF, HF, RMSSD and PNN50 between the 2 groups (P>0.05) . There were significant differences in LF/HF, SDNN and SDANN (P<0.05) .CRP was higher in the drug treatment group than OAECT group after 2 weeks (P<0.05) ; there was no significant difference in NT-proBNP, CK-MB and hs-TnI between the 2 groups (P>0.05) . The incidence rates of MACE and adverse reactions in the OAECT group were lower than DAPT group (P<0.05) .

OAECT is more effective than drug treatment in improving HRV with a lower incidence rate of MACE and better prognosis for patients after PCI.