Recently, photodynamic therapy (PDT) has gained considerable attention as a promising therapeutic approach for the treatment of psoriasis. Unfortunately, the activation of high mobility group box 1 protein (HMGB1) by PDT triggers innate and adaptive immune responses, which exacerbate skin inflammation. Herein, we combined glycyrrhizic acid (GA), a natural anti-inflammatory compound and immunomodulator derived from the herb Glycyrrhiza uralensis Fisch., with PDT actuated by the photosensitizer chlorin e6 (Ce6) by co-loading them in GA-based lipid nanoparticles coated with a catechol-modified quaternary chitosan salt (GC NPs/QCS-C). GC NPs/QCS-C exhibited high drug loading efficacy, uniform size distribution, an ideal topical adhesive property, enhanced skin retention and penetration in psoriasis-like lesions, and high intracellular uptake in epidermal cells compared with the counterparts. Subsequently, the transdermal administration of GC NPs/QCS-C followed by near-infrared laser radiation in an imiquimod-induced psoriasis-like mouse model significantly ameliorated psoriasis symptoms, promoted the apoptosis of hyperproliferative epidermal cells, and alleviated the inflammatory cascade. The significant therapeutic outcomes of GC NPs/QCS-C were attributed to the synergistic effects of GA and PDT on modulating immune cell recruitment and inhibiting dendritic cell maturation. Our results demonstrated that the topical bio-adhesive nanosystem that combines GA and Ce6 offers a synergistic chemo-phototherapeutic strategy for psoriasis treatment.

Hepatic stellate cells (HSCs) are the primary fibrogenic cells in the liver, and their activation plays a crucial role in the development and progression of hepatic fibrosis. Here, we report that retinoid X receptor-alpha (RXRα), a unique member of the nuclear receptor superfamily, is a key modulator of HSC activation and liver fibrosis. RXRα exerts its effects by modulating calcium/calmodulin-dependent protein kinase kinase β (CaMKKβ)-mediated activation of AMP-activated protein kinase-alpha (AMPKα). In addition, we demonstrate that K-80003, which binds RXRα by a unique mechanism, effectively suppresses HSC activation, proliferation, and migration, thereby inhibiting liver fibrosis in the CCl₄ and amylin liver NASH (AMLN) diet animal models. The effect is mediated by AMPKα activation, promoting mitophagy in HSCs. Mechanistically, K-80003 activates AMPKα by inducing RXRα to form condensates with CaMKKβ and AMPKα via a two-phase process. The formation of RXRα condensates is driven by its N-terminal intrinsic disorder region and requires phosphorylation by CaMKKβ. Our results reveal a crucial role of RXRα in liver fibrosis regulation through modulating mitochondrial activities in HSCs. Furthermore, they suggest that K-80003 and related RXRα modulators hold promise as therapeutic agents for fibrosis-related diseases.

Objective To investigate the relationship between the levels of macrophage migration inhibito-ry factor(MIF),lipoprotein-associated phospholipase A2(Lp-PLA2)and chemokine CC motif ligand 3(CCL3)in peripheral blood and severity of disease and complication of acute kidney injury in neonatal sepsis.Methods A total of 112 children with NS admitted to this hospital from May 2021 to May 2024 were selected as the research objects.According to the neonatal acute physiology score Ⅱ(SNAP-Ⅱ score),they were di-vided into mild group(71 cases)and severe group(41 cases),and according to whether the children were complicated with AKI,they were divided into AKI group(47 cases)and non-AKI group(65 cases).In addi-tion,112 healthy neonates who underwent physical examination in the hospital during the same period were selected as the control group.The levels of MIF,Lp-PLA2 and CCL3 in peripheral blood were detected in each group.Pearson correlation analysis was used to analyze the correlation between the levels of MIF,Lp-PLA2 and CCL3 in peripheral blood and the severity of NS.Multivariate Logistic regression was used to analyze the influencing factors of AKI in children with NS.The receiver operating characteristic(ROC)curve was drawn to evaluate the predictive value of peripheral blood MIF,Lp-PLA2 and CCL3 for the severity of NS and the complication of AKI in NS.Results The levels of MIF,Lp-PLA2 and CCL3 in the severe group were higher than those in the mild group and the control group(P<0.05),and those in the mild group were higher than those in the control group(P<0.05).The severe group had a significantly higher SNAP-Ⅱ score than the mild group(P<0.05).The levels of MIF,Lp-PLA2 and CCL3 in peripheral blood of NS children were posi-tively correlated with SNAP-Ⅱ score(r=0.512,0.463,0.547,P<0.05).The area under the curve(AUC)of peripheral blood MIF,Lp-PLA2 and CCL3 in the diagnosis of severe NS was 0.782,0.772 and 0.753,respec-tively.The AUC of combined diagnosis was 0.888,which was higher than that of individual indicators(P<0.05).The levels of MIF,Lp-PLA2 and CCL3 in AKI group were higher than those in non-AKI group(P<0.05).Neonatal asphyxia,high levels of MIF,Lp-PLA2,and CCL3 were risk factors for AKI in children with NS(P<0.05).The AUC of MIF,Lp-PLA2 and CCL3 in predicting AKI in children with NS were 0.770,0.759 and 0.757,respectively.The AUC of the combined prediction of MIF,Lp-PLA2 and CCL3 was 0.910,which was higher than that of each index alone(P<0.05).Conclusion The levels of MIF,Lp-PLA2 and CCL3 in peripheral blood of children with NS are increased,which are closely related to the aggravation of NS and the development of AKI.The combined detection of MIF,Lp-PLA2 and CCL3 has a high value in the as-sessment of the severity of NS and the risk of AKI.

Objective To investigate the clinical efficacy of Xinxuetong Oral Liquid in the treatment of patients with acute coronary syndrome(ACS).Methods A total of 80 patients with ACS of blood stasis syndrome who were hospitalized in Shunde Hospital of Guangzhou University of Chinese Medicine from January 2023 to September 2023 were randomly divided into the treatment group and control group according to random number table method,40 patients in each group.The patients in the two groups were given conventional western medicine treatment including lifestyle guidance,percutaneous coronary intervention(PCI),and conventional western medicine therapy.Additionally,the treatment group was treated with Xinxuetong Oral Liquid.The course of treatment for the two groups covered eight weeks.Before and after treatment the two groups were observed in the changes of traditional Chinese medicine(TCM)syndrome score,blood stasis syndrome score,angina pectoris score,blood lipid indicators,carotid ultrasonography indicators,echocardiography indicators,and serum levels of trimethylamine-N-oxide(TMAO),nitric oxide(NO),endothelin 1(ET-1),interleukin 8(IL-8),serine/threonine-protein kinase 1(AKT-1),and vascular endothelial growth factor A(VEGF-A).After treatment,the efficacy on TCM syndrome efficacy and the safety of the regimen in the two groups were evaluated.Results(1)During the trial,there were two cases of loss to follow-up and one case of withdrawal due to pneumonia,and eventually a total of 77 patients completed the full course of treatment,among which 39 patients were in the treatment group and 38 patients were in the control group.(2)After eight weeks of treatment,the total effective rate of the treatment group was 89.74％(35/39),and that of the control group was 63.16％(24/38).The intergroup comparison(tested by chi-square test)showed that the effective rate of TCM syndrome efficacy in the treatment group was significantly superior to that in the control group(P＜0.01).(3)After treatment,the scores of TCM symptoms such as chest pain,chest distress,symptom aggravation at night,and palpitation in the two groups,as well as the score of gloomy complexion in the treatment group,were significantly decreased compared with those before treatment(P＜0.05 or P＜0.01),and the decrease of scores of chest distress,symptom aggravation at night,and palpitation in the treatment group was significantly superior to that in the control group(P＜0.05 or P＜0.01).(4)After treatment,the blood stasis syndrome score and angina pectoris symptom score of the two groups of patients were significantly decreased compared with those before treatment(P＜0.01),and the decrease in the treatment group was significantly superior to that in the control group(P＜0.01).(5)After treatment,the serum TMAO,ET-1,IL-8,AKT-1,and VEGF-A levels in the two groups were significantly decreased compared with those before treatment(P＜0.01),and the serum NO level was significantly increased compared with that before treatment(P＜0.01).The decrease of serum TMAO,ET-1,IL-8,and AKT-1,VEGF-A levels and the increase of serum NO level in the treatment group were significantly superior to those of the control group(P＜0.05 or P＜0.01).(6)After treatment,the total cholesterol(TCHO)and low-density lipoprotein cholesterol(LDL-C)levels of the two groups(P＜0.01)and the triglyceride(TG)level of the treatment group(P＜0.05)were decreased significantly compared with those before treatment,while the high-density lipoprotein cholesterol(HDL-C)level of the treatment group was increased significantly compared with that before treatment(P＜0.01).No obvious changes of TG and HDL-C levels before and after treatment were shown in the control group(P＞0.05).The comparison of blood lipid indicators after treatment between groups showed that there were no statistically significant differences(P＞0.05).(7)After treatment,the carotid ultrasonography indicators of carotid intima-media thickness(IMT)and Crouse score of the carotid plaque in the two groups were significantly improved compared with those before treatment(P＜0.01).However,there was no statistical significance in the comparison of the two indicators between the two groups after treatment(P＞0.05).(8)The observation of echocardiography indicators showed that only the post-treatment left ventricular diameter(LVd)of the treatment group was significantly larger than that before treatment(P＜0.05),while no obvious changes of the other echocardiography indicators before and after treatment were shown in the two groups(P＞0.05).The comparison between the groups after treatment also showed no statistically significant differences(P＞0.05).(9)During the treatment,no serious drug-induced adverse reactions or drug-related severe cardiovascular events and complications occurred in the two groups.Conclusion The combination of Xinxuetong Oral Liquid with conventional western medicine treatment exerts certain efficacy and safety on improving the clinical symptoms of patients with ACS of blood stasis syndrome,and its therapeutic mechanism may be related to the improvement of blood lipid levels,inflammatory response,and TMAO level.

[Objective]To summarize ZHANG Zhicong's academic experience in his books and medical activities taken place in Lvshantang,and to provide reference for the study of traditional Chinese medical academy education.[Methods]By studying ZHANG Zhicong's works,such as Lvshantang Leibian,Collected Commentaries on Suwen,Collected Commentaries on Lingshu,Collected Commentaries on Treatise on Exogenous Febrile Disease,and referring to relevant literature,this paper analyzes the paradigm of the traditional Chinese medical academy education,discusses mainly from four aspects of the establishment background of the traditional Chinese medical academy education,the specific model of Lvshantang and the academic experience of its master ZHANG Zhicong,the influence of Lvshantang education,and the traditional Chinese medical academy education inheritance.[Results]Lvshantang was born in the context of popularization of academies,the gathering of medical experts in Qiantang,and the joint teaching activities of LU Fu and LU Zhiyi.The teaching modes of Lvshantang,including self-study,teaching research and lecture system,explored the basic mode of academy education integrating teaching,research,diagnosis and treatment for traditional Chinese medicine.The curriculum of Lvshantang reflected ZHANG Zhicong's academic thoughts of respecting the classics by maintaining faithful to the ancient text,the old theory,six-meridian Qi-transformation,difficulties before easy ones and collective annotation.The academy education had a large scope of influence.The development of Lvshantang enriched the Qiantang medical school,promoted the prosperity of maintaining the old theory school,started the collective annotation of medical books and left a series of classical annotation monographs for the later generations.Under the influence of ZHANG Zhicong's lectures,GAO Shizong,ZHONG Xuelu,CHEN Xiuyuan continued the academy-style educational model,which had a profound impact on the establishment of modern Chinese medicine specialized schools.[Conclusion]The traditional Chinese medical academy education began to establish norm in Lvshantang,which was founded by ZHANG Zhicong in Qiantang in the Qing Dynasty.To summarize ZHANG Zhicong's academic views in Lvshantang is helpful to understand the changes in the content and mode of the traditional Chinese medical academy education,and the academy education helps the inheritance and development of the traditional Chinese medicine.

Thoracolumbar spine fracture often leads to severe pain, functional impairments, and neurological deficits, for which open reduction and internal fixation can effectively restore the spinal structural stability. Open decompression and reduction with internal fixation can help relieve spinal cord compression and improve spinal function in cases of concomitant cord injury. Although spinal stability can be restored through surgery, patients often face chronic pain and functional impairments postoperatively. A postoperative rehabilitation program is critical in optimizing therapeutic outcomes, reducing complications, and minimizing the risk of secondary injuries. However, current rehabilitation methods, such as physical therapy, functional training, and pain management, are confronted with problems in clinical practice, including significant variation in efficacy, poor patient adherence, and prolonged rehabilitation period. There is an urgent need for a unified rehabilitation strategy to address these problems. To this end, the Spinal Trauma Group of the Orthopedic Physicians Branch of the Chinese Medical Association and the Spine Health Professional Committee of the Chinese Human Health Technology Promotion Association organized experts from relevant fields to formulate Evidence-based guidelines for rehabilitation treatment after internal fixation of thoracolumbar spine fracture in adults ( version 2025) by integrating evidences from clinical researches and advanced rehabilitation concepts at home and abroad. A total number of 14 recommendations concerning the rehabilitation treatment with multimodal analgesia, psychological intervention, deep vein thrombosis prevention, core muscle and extremity exercise, appropriate use of braces, early weight-bearing, device-aided rehabilitation exercise, neuroregulatory therapy, rehabilitation team were put forward, aiming to standardize the post-operative rehabilitation process following internal fixation, promote the functional recovery, and enhance patients′ quality of life.

Acute symptomatic osteoporotic thoracolumbar compression fracture (ASOTLF) can lead to chronic low back pain, kyphosis deformity, pulmonary dysfunction, loss of mobility, and even life-threatening complications. Vertebral augmentation is currently the mainstream treatment method for this condition. In 2019, the Editorial Board of Chinese Journal of Trauma and the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association collaboratively led the development of Clinical guideline for vertebral augmentation for acute symptomatic osteoporotic thoracolumbar compression fractures. Six years later, with advances in clinical diagnosis and treatment techniques as well as accumulating evidence in related fields, the 2019 guideline requires updating. To this end, the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association, the Spinal Health Professional Committee of China Human Health Science and Technology Promotion Association, and the Minimally Invasive Orthopedics Professional Committee of Shaanxi Medical Doctor Association have organized experts in the field to develop the Clinical guideline for vertebral augmentation of acute symptomatic osteoporotic thoracolumbar compression fractures ( version 2025) , based on the latest evidence-based medical researches. This guideline incorporates 3 recommendations retained from the 2019 version with updated strength of evidence, along with 12 new recommendations. It provides recommendations from six aspects of diagnosis, pain management, treatment option selection, prevention of postoperative complications, anti-osteoporosis therapy, and postoperative rehabilitation, aiming to provide a reference for standard treatment of vertebral augmentation for ASOTLF in hospitals at all levels.

[Objective]To summarize ZHANG Zhicong's academic experience in his books and medical activities taken place in Lvshantang,and to provide reference for the study of traditional Chinese medical academy education.[Methods]By studying ZHANG Zhicong's works,such as Lvshantang Leibian,Collected Commentaries on Suwen,Collected Commentaries on Lingshu,Collected Commentaries on Treatise on Exogenous Febrile Disease,and referring to relevant literature,this paper analyzes the paradigm of the traditional Chinese medical academy education,discusses mainly from four aspects of the establishment background of the traditional Chinese medical academy education,the specific model of Lvshantang and the academic experience of its master ZHANG Zhicong,the influence of Lvshantang education,and the traditional Chinese medical academy education inheritance.[Results]Lvshantang was born in the context of popularization of academies,the gathering of medical experts in Qiantang,and the joint teaching activities of LU Fu and LU Zhiyi.The teaching modes of Lvshantang,including self-study,teaching research and lecture system,explored the basic mode of academy education integrating teaching,research,diagnosis and treatment for traditional Chinese medicine.The curriculum of Lvshantang reflected ZHANG Zhicong's academic thoughts of respecting the classics by maintaining faithful to the ancient text,the old theory,six-meridian Qi-transformation,difficulties before easy ones and collective annotation.The academy education had a large scope of influence.The development of Lvshantang enriched the Qiantang medical school,promoted the prosperity of maintaining the old theory school,started the collective annotation of medical books and left a series of classical annotation monographs for the later generations.Under the influence of ZHANG Zhicong's lectures,GAO Shizong,ZHONG Xuelu,CHEN Xiuyuan continued the academy-style educational model,which had a profound impact on the establishment of modern Chinese medicine specialized schools.[Conclusion]The traditional Chinese medical academy education began to establish norm in Lvshantang,which was founded by ZHANG Zhicong in Qiantang in the Qing Dynasty.To summarize ZHANG Zhicong's academic views in Lvshantang is helpful to understand the changes in the content and mode of the traditional Chinese medical academy education,and the academy education helps the inheritance and development of the traditional Chinese medicine.

Thoracolumbar spine fracture often leads to severe pain, functional impairments, and neurological deficits, for which open reduction and internal fixation can effectively restore the spinal structural stability. Open decompression and reduction with internal fixation can help relieve spinal cord compression and improve spinal function in cases of concomitant cord injury. Although spinal stability can be restored through surgery, patients often face chronic pain and functional impairments postoperatively. A postoperative rehabilitation program is critical in optimizing therapeutic outcomes, reducing complications, and minimizing the risk of secondary injuries. However, current rehabilitation methods, such as physical therapy, functional training, and pain management, are confronted with problems in clinical practice, including significant variation in efficacy, poor patient adherence, and prolonged rehabilitation period. There is an urgent need for a unified rehabilitation strategy to address these problems. To this end, the Spinal Trauma Group of the Orthopedic Physicians Branch of the Chinese Medical Association and the Spine Health Professional Committee of the Chinese Human Health Technology Promotion Association organized experts from relevant fields to formulate Evidence-based guidelines for rehabilitation treatment after internal fixation of thoracolumbar spine fracture in adults ( version 2025) by integrating evidences from clinical researches and advanced rehabilitation concepts at home and abroad. A total number of 14 recommendations concerning the rehabilitation treatment with multimodal analgesia, psychological intervention, deep vein thrombosis prevention, core muscle and extremity exercise, appropriate use of braces, early weight-bearing, device-aided rehabilitation exercise, neuroregulatory therapy, rehabilitation team were put forward, aiming to standardize the post-operative rehabilitation process following internal fixation, promote the functional recovery, and enhance patients′ quality of life.

Acute symptomatic osteoporotic thoracolumbar compression fracture (ASOTLF) can lead to chronic low back pain, kyphosis deformity, pulmonary dysfunction, loss of mobility, and even life-threatening complications. Vertebral augmentation is currently the mainstream treatment method for this condition. In 2019, the Editorial Board of Chinese Journal of Trauma and the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association collaboratively led the development of Clinical guideline for vertebral augmentation for acute symptomatic osteoporotic thoracolumbar compression fractures. Six years later, with advances in clinical diagnosis and treatment techniques as well as accumulating evidence in related fields, the 2019 guideline requires updating. To this end, the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association, the Spinal Health Professional Committee of China Human Health Science and Technology Promotion Association, and the Minimally Invasive Orthopedics Professional Committee of Shaanxi Medical Doctor Association have organized experts in the field to develop the Clinical guideline for vertebral augmentation of acute symptomatic osteoporotic thoracolumbar compression fractures ( version 2025) , based on the latest evidence-based medical researches. This guideline incorporates 3 recommendations retained from the 2019 version with updated strength of evidence, along with 12 new recommendations. It provides recommendations from six aspects of diagnosis, pain management, treatment option selection, prevention of postoperative complications, anti-osteoporosis therapy, and postoperative rehabilitation, aiming to provide a reference for standard treatment of vertebral augmentation for ASOTLF in hospitals at all levels.