The construction of identifying concepts in traditional Chinese medicine （TCM） represents a fundamental and prerequisite task for establishing an independent knowledge system of TCM. By defining the principles for the extraction and the methods for constructing TCM identifying concepts， this paper proposes that such concepts should possess the characteristics of being framework-oriented， autonomous， extensible， inheritable， and cross-disciplinary， and should follow a structural framework of "worldview-thinking mode-methodology". Based on this framework， typical TCM identifying concepts， including qi， yin-yang， five elements， visceral manifestation， meridians and collaterals， body fluids， xiang （manifestation）， four diagnostic methods， pattern differentiation， preventive treatment of disease， treating disease by seeking the root cause， prescription-syndrome， four natures and five flavors， and combination of medicinals， are extracted from four classical texts，i.e. The Inner Canon of Yellow Emperor （《黄帝内经》）， The Classic of Difficult Issues （《难经》）， Treatise on Cold Damage and Miscellaneous Diseases （《伤寒杂病论》）， and Shen Nong's Classic of the Materia Medica （《神农本草经》）. Their interrelationships are further elucidated. Exploring a pathway for constructing TCM identifying concepts will not only facilitate the development of an independent know-ledge system of TCM and promote its inheritance and innovative development， but also provide a reference for the establishment of independent knowledge systems in other disciplines.

The construction of identifying concepts in traditional Chinese medicine （TCM） represents a fundamental and prerequisite task for establishing an independent knowledge system of TCM. By defining the principles for the extraction and the methods for constructing TCM identifying concepts， this paper proposes that such concepts should possess the characteristics of being framework-oriented， autonomous， extensible， inheritable， and cross-disciplinary， and should follow a structural framework of "worldview-thinking mode-methodology". Based on this framework， typical TCM identifying concepts， including qi， yin-yang， five elements， visceral manifestation， meridians and collaterals， body fluids， xiang （manifestation）， four diagnostic methods， pattern differentiation， preventive treatment of disease， treating disease by seeking the root cause， prescription-syndrome， four natures and five flavors， and combination of medicinals， are extracted from four classical texts，i.e. The Inner Canon of Yellow Emperor （《黄帝内经》）， The Classic of Difficult Issues （《难经》）， Treatise on Cold Damage and Miscellaneous Diseases （《伤寒杂病论》）， and Shen Nong's Classic of the Materia Medica （《神农本草经》）. Their interrelationships are further elucidated. Exploring a pathway for constructing TCM identifying concepts will not only facilitate the development of an independent know-ledge system of TCM and promote its inheritance and innovative development， but also provide a reference for the establishment of independent knowledge systems in other disciplines.

The evaluation of Dao-di herbs has long relied on an origin-centric model defined by three generations of herbal classics and a century of historical use. However， under the background of modern industrialization， expanded cultivation regions， and diversified production modes in the Chinese medicinal material industry， this model has shown increasing limitations. This article systematically elaborates on the urgent need and core pathways for a paradigm shift in evaluating Dao-di herbs. Three key transformations are proposed： ① The evaluation benchmark should shift from determining quality by origin to defining genuineness by characteristics， focusing on stable and reproducible clusters of traits reflecting excellence morphology and high quality rather than single geographical labels. ② Quality control methods need to advance from empirical and descriptive identification to modern standardized parameters， addressing the challenges of subjectivity， insufficient quantification， and difficulties in implementation and regulation inherent to conventional descriptive approaches. ③ The grading system should evolve from experience-based selection of superior goods to scientific quantitative grading standards grounded in models linking excellence morphology and high quality （superior efficacy）. Furthermore， this article proposes a novel evaluation model centered on quality consistency as the quantitative core. By digitizing characteristics， establishing correlation models， and introducing statistical indicators such as the proportion rate of excellent shape， high quality， and superior effect （P） and the standard deviation of characteristic expression （S）， a quality stability index （QSI） is constructed. This framework aims to establish an objective， verifiable， and universally applicable grading and evaluation system for Dao-di herbs. This transformative research provides a theoretical foundation for integrating traditional knowledge with modern scientific methods and building a new paradigm for quality management of Chinese medicinal materials that incorporates both Chinese characteristics and international recognition.

OBJECTIVE: To evaluate the effectiveness of the innervated medial plantar flap for reconstructing soft tissue defects, particularly in the weight-bearing zone, after resection of foot tumors. METHODS: A retrospective analysis was conducted on 12 patients with malignant skin and soft tissue tumors of the foot treated between October 2023 and December 2024. The cohort included 8 males and 4 females, aged 42-67 years (mean, 57.5 years). Tumor types comprised malignant melanoma (5 cases), squamous cell carcinoma (4 cases), arsenical keratosis (2 cases), and tumor-induced osteomalacia (1 case). Soft tissue defects located in the heel weight-bearing region in 10 cases and non-weight-bearing ankle region in 2 cases, with defect sizes ranging from 4.0 cm×3.0 cm to 6.0 cm×4.0 cm. Preoperative photon-counting CT angiography (PC-CTA) was performed to assess the medial plantar artery and its perforators. All patients underwent radical tumor resection with confirmed negative margins. The resulting defects were reconstructed using a innervated medial plantar flap incorporating sensory branches of the medial plantar nerve. The flap donor site was covered with a split-thickness skin graft harvested from the ipsilateral inguinal region. RESULTS: The operation was successfully completed in all 12 patients. All flaps survived completely without vascular compromise, partial necrosis, or total loss. Incisions healed primarily without dehiscence or infection. Minor skin graft necrosis occurred at the donor site in 3 patients, which healed within 2-3 weeks with routine dressing changes. No donor site complication (e.g., tendon or nerve injury) occurred. Patients were followed up 2-16 months (mean, 10.3 months). At last follow-up, there was no tumor recurrence. Flaps exhibited good color and texture match with surrounding tissue, restored sensation, and all feet achieved normal weight-bearing activity. CONCLUSION The innervated medial plantar flap, precisely designed based on PC-CTA localization, provides reliable blood supply and effective sensory restoration. It is an ideal method for reconstructing soft tissue defects after foot tumor resection, especially in the heel weight-bearing region.
Humans ; Male ; Middle Aged ; Female ; Plastic Surgery Procedures/methods* ; Adult ; Aged ; Retrospective Studies ; Soft Tissue Neoplasms/surgery* ; Surgical Flaps/blood supply* ; Foot/surgery* ; Skin Neoplasms/surgery* ; Soft Tissue Injuries/surgery* ; Carcinoma, Squamous Cell/surgery* ; Treatment Outcome ; Skin Transplantation/methods* ; Melanoma/surgery*

(+)-Borneol, the main component of "Natural Borneol" in the Chinese Pharmacopoeia, is a high-end spice and precious medicine. Plant extraction cannot meet the increasing demand for (+)-borneol, while microbial biosynthesis offers a sustainable supply route. However, its production was extremely low compared with other monoterpenes, even with extensively optimizing the mevalonate pathway. We found that the key challenge is the complex and unusual dephosphorylation reaction of bornyl diphosphate (BPP), which suffers the side-reaction and the competition from the cellular dephosphorylation process, especially lipid metabolism, thus limiting (+)-borneol synthesis. Here, we systematically optimized the dephosphorylation process by identifying, characterizing phosphatases, and balancing cellular dephosphorylation metabolism. For the first time, we identified two endogenous phosphatases and seven heterologous phosphatases, which significantly increased (+)-borneol production by up to 152%. By engineering BPP dephosphorylation and optimizing the MVA pathway, the production of (+)-borneol was increased by 33.8-fold, which enabled the production of 753 mg/L under fed-batch fermentation in shake flasks, so far the highest reported in the literature. This study showed that rewiring dephosphorylation metabolism was essential for high-level production of (+)-borneol in Saccharomyces cerevisiae, and balancing cellular dephosphorylation is also helpful for efficient biosynthesis of other terpenoids since all whose biosynthesis involves the dephosphorylation procedure.

Ligusticum sinense cv.Fuxiong derived from"Xiongqiong",and in the Song Dynasty's Tai Ping Hui Min He Ji Ju Fang,it was already distinguished from Chuanxiong Rhizoma in usage.Doctors in the Ming Dynasty further clarified the differences in efficacy between the two.However,with the widespread circulation of Chuanxiong Rhizoma,Ligusticum sinense cv.Fuxiong gradually became marginalized,serving as a substitute,and is now only cultivated and used in small quantities within Jiangxi Province.This article reviewed the prescriptions and the ancient Chinese medical books that have records of Ligusticum sinense cv.Fuxiong,analyzed its specific applications alongside Chuanxiong Rhizoma in prescriptions and case studies to elucidate their differences in efficacy:Ligusticum sinense cv.Fuxiong is pungent and has strong dispersing power and is good at unblocking meridians and promoting qi circulation,which is suitable for excessive syndromes;Chuanxiong Rhizoma is good at promoting blood circulation and relieving pain,and is good at regulating and nourishing,which is suitable for patients with deficiency syndromes,aiming to provide insights and recommendations for the further development and rational clinical medication of Ligusticum sinense cv.Fuxiong.

Promoting the international acceptance of clinical studies about traditional Chinese medicine (TCM) interventions is a key strategy for internationalization of TCM. However, the complexities of TCM interventions—in terms of the theories, practice patterns, and components—pose challenges to the design and implementation of clinical studies that are well accepted by the international community. This article summarized the current status of clinical studies about TCM interventions that were published in international journals, explored underlying barriers hindering the international acceptance, and discussed potential strategies for future development.

Promoting the international acceptance of clinical studies about traditional Chinese medicine (TCM) interventions is a key strategy for internationalization of TCM. However, the complexities of TCM interventions—in terms of the theories, practice patterns, and components—pose challenges to the design and implementation of clinical studies that are well accepted by the international community. This article summarized the current status of clinical studies about TCM interventions that were published in international journals, explored underlying barriers hindering the international acceptance, and discussed potential strategies for future development.

Promoting the international acceptance of clinical studies about traditional Chinese medicine (TCM) interventions is a key strategy for internationalization of TCM. However, the complexities of TCM interventions—in terms of the theories, practice patterns, and components—pose challenges to the design and implementation of clinical studies that are well accepted by the international community. This article summarized the current status of clinical studies about TCM interventions that were published in international journals, explored underlying barriers hindering the international acceptance, and discussed potential strategies for future development.