Compilation instruction for Expert Consensus on Clinical Application of Binghuang Fule Ointment elaborates on the formulation methods and evidence-based basis of the consensus. To address the problems of insufficient evidence on efficacy， vague indications， and a lack of uniform standard for Binghuang Fule Ointment in clinical application， 34 experts from 29 medical institutions across China participated in the compilation under the lead of the Institute of Basic Research in Clinical Medicine and Xiyuan Hospital， China Academy of Chinese Medical Sciences， as well as China-Japan Friendship Hospital. The compilation strictly adhered to the WHO Handbook for Guideline Development （GB/T 1.1—2020）， and the Guidance of Instructions for Compiling Expert Consensus on Clinical Practice of Chinese Patent Medicine. Through multidisciplinary collaboration， the compilation was completed using the Grading of Recommendations Assessment， Development and Evaluations （GRADE） evidence grading system. The detailed workflow included various key links. In clinical question construction， 15 items were screened by the nominal group method. In evidence retrieval， Chinese and English databases， along with gray literature， were covered to obtain 116 clinical and 33 pharmaceutical studies. In safety assessment， drug monitoring data and clinical research results were integrated， clarifying local adverse skin reactions and contraindications. Ultimately， 8 recommendations were formed by the GRADE grid method， while 16 consensus suggestions were reached via the majority vote rule. The results showed that the Binghuang Fule Ointment was applicable to eczema， psoriasis， neurodermatitis， tinea pedis， and other diseases. The Consensus also elucidated the syndrome differentiation points， usage and dosage for different diseases （such as adjustment of course and application frequency）， as well as the indications of combination medication. Additionally， safety assessment suggested that the Ointment should be used with caution in individuals with skin ulceration or hypersensitivity. To ensure methodological rigor， the compilation process went through three rounds of internal and external expert reviews， while a comprehensive analysis was conducted by literature analysis， the Delphi method， and other methods. This compilation instruction provided methodological support for the clinical transformation of the Consensus through key links， including project initiation， international registration， informed consent， conflict-of-interest statements， evidence evaluation， and popularization. The Consensus will be continuously improved through a dynamic revision mechanism in the future.

Compilation instruction for Expert Consensus on Clinical Application of Binghuang Fule Ointment elaborates on the formulation methods and evidence-based basis of the consensus. To address the problems of insufficient evidence on efficacy， vague indications， and a lack of uniform standard for Binghuang Fule Ointment in clinical application， 34 experts from 29 medical institutions across China participated in the compilation under the lead of the Institute of Basic Research in Clinical Medicine and Xiyuan Hospital， China Academy of Chinese Medical Sciences， as well as China-Japan Friendship Hospital. The compilation strictly adhered to the WHO Handbook for Guideline Development （GB/T 1.1—2020）， and the Guidance of Instructions for Compiling Expert Consensus on Clinical Practice of Chinese Patent Medicine. Through multidisciplinary collaboration， the compilation was completed using the Grading of Recommendations Assessment， Development and Evaluations （GRADE） evidence grading system. The detailed workflow included various key links. In clinical question construction， 15 items were screened by the nominal group method. In evidence retrieval， Chinese and English databases， along with gray literature， were covered to obtain 116 clinical and 33 pharmaceutical studies. In safety assessment， drug monitoring data and clinical research results were integrated， clarifying local adverse skin reactions and contraindications. Ultimately， 8 recommendations were formed by the GRADE grid method， while 16 consensus suggestions were reached via the majority vote rule. The results showed that the Binghuang Fule Ointment was applicable to eczema， psoriasis， neurodermatitis， tinea pedis， and other diseases. The Consensus also elucidated the syndrome differentiation points， usage and dosage for different diseases （such as adjustment of course and application frequency）， as well as the indications of combination medication. Additionally， safety assessment suggested that the Ointment should be used with caution in individuals with skin ulceration or hypersensitivity. To ensure methodological rigor， the compilation process went through three rounds of internal and external expert reviews， while a comprehensive analysis was conducted by literature analysis， the Delphi method， and other methods. This compilation instruction provided methodological support for the clinical transformation of the Consensus through key links， including project initiation， international registration， informed consent， conflict-of-interest statements， evidence evaluation， and popularization. The Consensus will be continuously improved through a dynamic revision mechanism in the future.

SkinPro Ointment is an emulsion-based preparation derived from a traditional Tibetan medical empirical formula and developed using modern pharmaceutical technology. It is an exclusive patented product of Tibet Hairong Tangguo Pharmaceutical Co. Ltd. and has been listed as a National Protected Traditional Chinese Medicine Variety， the Pharmacopoeia of the People's Republic of China， and classified as a Category B product in the National Basic Medical Insurance Catalog. The ointment possesses the functions of clearing heat and drying dampness， activating blood circulation and dispelling wind， relieving itching and reducing inflammation. Clinically， it is used for skin pruritus caused by dampness-heat accumulation or blood-heat with wind-dryness， as well as pruritic skin diseases such as neurodermatitis， eczema， tinea pedis， and psoriasis. To clarify the standards for its clinical application and promote rational drug use， a consensus working group comprising 34 national experts in dermatology， evidence-based medicine， and pharmacy was established. Through expert interviews， the nominal group technique， and questionnaire surveys， 15 clinical issues were identified. The Grading of Recommendations Assessment， Development and Evaluation （GRADE） evidence grading system was employed to assess the quality of evidence， leading to the formulation of the Expert Consensus on the Clinical Application of SkinPro Ointment. This consensus specifies that the intended users are physicians and pharmacists in medical institutions at all levels. It standardizes the clinical application of the ointment， including syndrome characteristics， dosage and course of treatment， combination therapy， precautions， and contraindications. Recommendations and consensus suggestions were formed addressing the 15 clinical issues， covering the following key areas： ①Indications and TCM syndromes： In TCM， the ointment mainly treats conditions such as "damp sores" （Shichuang）， "white scaling" （Baibi）， "collar sores" （Shelingchuang）， and "damp foot Qi" （Jiaoshiqi）， corresponding to eczema， psoriasis， neurodermatitis， and tinea pedis in Western medicine. The relevant TCM syndromes are identified as dampness-heat accumulation or blood-heat with wind-dryness. ②Usage and dosage： For external use， apply to the affected area 3 times daily. The dosage should follow the fingertip unit （FTU） principle. A treatment course of 1-2 weeks is recommended for mild to moderate cases； for serious cases， the course should be followed as prescribed by a physician. ③Combined therapy： The ointment can be used as monotherapy for mild cases. For moderate to severe cases， combination therapy is recommended， with reference to relevant clinical guidelines. ④Safety： Common adverse reactions include skin rashes， pruritus， and erythema. The ointment is contraindicated in patients with broken skin or obvious exudation at the affected area， as well as in patients with known hypersensitivity to any of its components. Contact with sensitive areas such as the eyes and oral mucosa should be avoided. Modern research shows that the ointment also has potential efficacy in other dermatological conditions， such as adult atopic dermatitis， tinea cruris， exfoliative keratolysis， acne vulgaris， and Malassezia folliculitis. This consensus provides a scientific basis for promoting the rational clinical use of SkinPro Ointment， improving its therapeutic efficacy， and reducing medication risks. Future updates will be dynamically revised according to emerging clinical issues and new evidence.

Atherosclerosis （AS） is a chronic and inflammatory vascular disease. Macrophages are common immune cells and play an important role in the development of AS. In recent years， research has found that the formation of AS plaques is closely related to pathological and physiological processes such as macrophage polarization， energy metabolism， and lipid phagocytosis. This review aims to summarize the mechanism of macrophages in the development of AS， and to explore potential therapeutic methods for delaying AS by regulating macrophages， providing new ideas for the treatment and research of AS.

ObjectiveTo systematically investigate the identification characteristics of medicinal amber， elucidate its microscopic features， crystal structural properties， and elemental composition， and thereby provide a scientific foundation for quality control and authenticity verification. MethodsThirty-nine batches of amber samples were collected and analyzed through integrated techniques including morphological analysis， microscopic identification， powder X-ray diffraction （XRD）， Raman spectroscopy， Fourier-transform infrared （FTIR） spectroscopy， and inductively coupled plasma mass spectrometry （ICP-MS） to evaluate their morphological attributes， phase composition， molecular vibrational modes， and trace element profiles. Among them， the XRD experiment used Cu Kα radiation （λ=1.540 6 Å）， with a scanning angle range of 10° to 70° （2θ） and a step size of 0.02°， the Raman spectroscopy experiment employed a 785 nm laser， with a spectral measurement range of 3 400 to 50 cm^-1， a laser power of 300 mW， a laser intensity of 30%， and a scanning time of 100 to 1 000 ms， the infrared spectroscopy experiment used a carbon-sulfur lamp， with a scanning range of 4 000 to 500 cm^-1， a resolution of 4 cm^-1， and 3 scans， the ICP-MS experiment utilized frequency power of 1.2 kW， a double-pass cyclonic spray chamber， a sample introduction system flow rate of 0.7-1.0 L·min^-1， and an auxiliary gas flow of 0.2 L·min^-1. ResultsUnder orthogonal polarized light microscopy， medicinal amber exhibited an isotropic homogeneous structure， with partial samples containing inorganic impurities such as AsS and SiO₂. FTIR spectra revealed characteristic absorption peaks at 2 932-2 939 cm^-1 （C-H stretching vibrations）， 1 705-1 728 cm^-1 （C=O stretching vibrations）， and 880-887 cm^-1 （C=C deformation vibrations）， confirming the oxidative polymerization of terpenoid resin. Raman spectroscopy further identified distinctive peaks at 2 925 cm^-1， 2 870 cm^-1 （saturated C-H stretching）， and 1 648 cm^-1 （C=C stretching）， consistent with the structural features of oxidized-polymerized resin. ICP-MS analysis demonstrated that S， Al， Si， Fe， Na， and Ca were the predominant trace elements in medicinal amber. ConclusionThis study comprehensively evaluated medicinal amber's morphological attributes， phase composition， molecular vibrational modes， and trace elements through multimodal analytical techniques. The findings establish data support for establishing quality standards for medicinal amber and distinguishing it from synthetic resin imitations.

ObjectiveTo systematically investigate the identification characteristics of medicinal amber， elucidate its microscopic features， crystal structural properties， and elemental composition， and thereby provide a scientific foundation for quality control and authenticity verification. MethodsThirty-nine batches of amber samples were collected and analyzed through integrated techniques including morphological analysis， microscopic identification， powder X-ray diffraction （XRD）， Raman spectroscopy， Fourier-transform infrared （FTIR） spectroscopy， and inductively coupled plasma mass spectrometry （ICP-MS） to evaluate their morphological attributes， phase composition， molecular vibrational modes， and trace element profiles. Among them， the XRD experiment used Cu Kα radiation （λ=1.540 6 Å）， with a scanning angle range of 10° to 70° （2θ） and a step size of 0.02°， the Raman spectroscopy experiment employed a 785 nm laser， with a spectral measurement range of 3 400 to 50 cm^-1， a laser power of 300 mW， a laser intensity of 30%， and a scanning time of 100 to 1 000 ms， the infrared spectroscopy experiment used a carbon-sulfur lamp， with a scanning range of 4 000 to 500 cm^-1， a resolution of 4 cm^-1， and 3 scans， the ICP-MS experiment utilized frequency power of 1.2 kW， a double-pass cyclonic spray chamber， a sample introduction system flow rate of 0.7-1.0 L·min^-1， and an auxiliary gas flow of 0.2 L·min^-1. ResultsUnder orthogonal polarized light microscopy， medicinal amber exhibited an isotropic homogeneous structure， with partial samples containing inorganic impurities such as AsS and SiO₂. FTIR spectra revealed characteristic absorption peaks at 2 932-2 939 cm^-1 （C-H stretching vibrations）， 1 705-1 728 cm^-1 （C=O stretching vibrations）， and 880-887 cm^-1 （C=C deformation vibrations）， confirming the oxidative polymerization of terpenoid resin. Raman spectroscopy further identified distinctive peaks at 2 925 cm^-1， 2 870 cm^-1 （saturated C-H stretching）， and 1 648 cm^-1 （C=C stretching）， consistent with the structural features of oxidized-polymerized resin. ICP-MS analysis demonstrated that S， Al， Si， Fe， Na， and Ca were the predominant trace elements in medicinal amber. ConclusionThis study comprehensively evaluated medicinal amber's morphological attributes， phase composition， molecular vibrational modes， and trace elements through multimodal analytical techniques. The findings establish data support for establishing quality standards for medicinal amber and distinguishing it from synthetic resin imitations.

The inflammatory status in patients with chronic kidney disease(CKD)is closely associated with cardiovascular events,infections,and other complications,and is a powerful indicator for prognosis assessment.The core view of the"gut-kidney axis"theory reveals the relationship among inflammatory state,microbiota dysbiosis,and deterioration of renal function.The microbiota alters the microenvironment through structural changes and metabolites with different properties,subsequently leading to microbiota translocation,inducing inflammatory lesions,and damaging the kidneys.Recent studies have proposed that targeted microbiota intervention strategies such as probiotics,prebiotics,and synbiotics can modulate the microbiota structure,regulate the microenvironment,relieve renal inflammation,and affect the progression of renal disease,representing a potentially promising research direction in the future.This review discusses the characteristics of how intestinal microbiota influence the inflammatory status in CKD,focusing on the research progress of targeted microbiota intervention,aiming to discuss the effectiveness and scientific basis of these strategies,providing a foundation for the treatment of CKD and the expansion of targeted microbiota research,as well as offering references for the clinical application of probiotics,prebiotics,and synbiotics.

Tumor is the main lethal type of major diseases that human beings are facing nowadays.Traditional therapies,such as chemotherapy,surgery,radiotherapy,etc,have been the mainstay of tumor treatment for a long time,and still have their own limitations in terms of effectiveness.In recent years,immunotherapy for tumors has attracted much attention with the rise of strategies such as immune checkpoint inhibitors,chimeric antigen receptor T-cell(CAR-T)relay therapy,and anti-tumor vaccines.Among them,CAR-T cell therapy,as a breakthrough tumor immunotherapy method,can precisely target tumors at the cellular and molecular levels by modifying the patient's own T cells to express recombinant antigen receptors targeting specific tumor antigens,breaking the restriction of the major histocompatibility complex(MHC)of the natural T cells themselves.It can precisely target tumors at the cellular and molecular levels,and thus can efficiently and specifically identify and kill cancer cells,providing a new perspective for treatment.Since the approval of the first CAR-T therapy by the US Food and Drug Administration(FDA)in 2017,in addition to still maintaining significant advantages in the field of classical multiple hematologic malignancies,it has also made outstanding progress in the treatment and clinical trials of some solid tumors and autoimmune diseases,among others.This paper will briefly review the current principles,applications,challenges and directions of development of CAR-T technology.

Objective: To investigate the correlation of chemerin levels in the serum and intestinal mucosal with in- testinal mucosal inflammation in IBS-D mice . Methods: A total of 128 female C57BL/6J mice were randomly di- vided into IBS-D group and control group , with 64 mice in each group . Wire Restraint Stress method (WRS) was used to construct an animal model of IBS-D . Enzyme-linked immunosorbent assay was used to detect serum and co- lonic mucosal chemerin levels in mice . Hematoxylin-eosin (HE) staining was used to observe colonic mucosal in- flammation . Geboes value was used to evaluate the severity of colonic mucosal inflammation . Results: In the IBS- D group , the concentration of serum chemerin increased and reached the peak in the first week of the experiment ( t = 6. 538 , P < 0. 001) , and the concentration of colonic mucosa chemerin increased and reached the peak in the fourth week of the experiment ( t = 8 . 104 , P < 0. 001) ; in the first week of experiment , the colonic mucosa of IBS- D mice showed inflammatory reaction , which was the most significant in the fifth week (P < 0. 05) . Geboes score was ( 1 . 75 ±0. 50) vs (0. 55 ±0. 52) . Conclusion There is a temporal sequence between the elevation of serum and intestinal mucosal chemerin levels and the severity of intestinal mucosal inflammation , and it is hypothesized that the elevated serum and intestinal mucosal chemerin levels correlate with the onset and progression of intestinal mucosal inflammation .

Objectives: This study evaluates the efficacy of a new temporomandibular joint (TMJ) capsule suspension technique for stabilizing the TMJ after free fibular flap reconstruction of the mandibular condyle. Patients and Methods: Patients undergoing the TMJ capsule suspension technique during free fibular flap reconstruction after mandibulectomy with condylectomy (study group; n=9) were compared with a control group (n=9). Mandibular movement trajectory and surface electromyographic signals of bilateral masseters were recorded. The neocondyle–disc relationship was examined with magnetic resonance imaging (MRI) at 6 months after surgery. Results: Maximal mouth opening and bilateral marginal movement distances were comparable between the two groups (P>0.05). The asymmetry index of the condyle path length was significantly higher in controls (P=0.02). Bilateral mouth opening trajectories were symmetric in 7 patients and deviated to the affected side in 2 patients in the study group; they deviated to the affected side in all controls. The mean electromyographic values of the masseter on the affected side in resting, maximum bite, and chewing states were comparable between the two groups (P=0.13, P=0.65, and P=0.82, respectively). On MRI at 6 months, the thicknesses of the anterior, medial, and posterior bands and TMJ disc length were similar on the affected and normal sides in the study group (P=0.57, P=0.13, P=0.48, and P=0.87, respectively). Conclusion The proposed TMJ capsule suspension technique could improve postoperative TMJ structure and function after fibular free flap reconstruction following mandibulectomy with condylectomy.