As the core vehicle for preserving and transmitting traditional Chinese medicine（TCM） academic thought and clinical experience， the establishment of a robust quality evaluation system for TCM clinical case reports is a crucial component in the current standardization and modernization of TCM. Based on the practical experience of constructing the China Clinical Cases Library of Traditional Chinese Medicine by the China Association of Chinese Medicine， this study conducted a comprehensive analysis of critical challenges， including insufficient authenticity and unfocused evaluation criteria. It proposed a three-dimensional evaluation framework grounded in the structure-process-outcome logic， encompassing three dimensions of authenticity and standardization， characteristics and advantages， application and translational impact. This framework integrated 12 key evaluation indicators in a systematic manner. The model preserved the academic characteristics of TCM syndrome differentiation and treatment， while aligning with modern scientific research standards， achieving a balance between individualized TCM experience and standardized evaluation. Concurrently， this study provided theoretical foundations and methodological guidance for evaluating the quality of TCM clinical cases， contributing significantly to the inheritance of TCM knowledge， evidence-based practice， and the reform of talent evaluation mechanisms.

ObjectiveTo compare the differences between wild Alpiniae Oxyphyllae Fructus（WAOF） and cultivated Alpiniae Oxyphyllae Fructus（CAOF） through a traditional quality evaluation system for medicinal materials. MethodsA total of 10 batches of WAOF and 12 batches of CAOF samples were collected from various regions of Hainan province. Relevant analytical methods from the 2020 edition of the Pharmacopoeia of the People's Republic of China were employed to observe the characteristics of WAOF and CAOF， followed by microscopic identification， thin-layer chromatography（TLC） identification， moisture content（toluene method）， total ash， acid-insoluble ash， water-soluble and alcohol-soluble extracts（hot dipping method）， water-soluble protein， total polysaccharides and total flavonoids（ultraviolet spectrophotometry）， and volatile oil content（method A under general rule 2204）. The contents of five active components（protocatechuic acid， chrysin， kaempferol， tectochrysin and nootkatone） were quantified using ultra-performance liquid chromatography（UPLC）， and the antioxidant activity was evaluated. Building upon traditional quality evaluation of AOF， quantitative measurements were conducted on its appearance traits including diameter， length， plumpness（diameter/length ratio）， and color. Canonical correlation analysis was performed using SPSS 26.0 to explore relationships between appearance traits and intrinsic quality. ResultsNo significant differences were observed between WAOF and CAOF in microscopic observation， TLC identification， moisture content， protocatechuic acid content， kaempferol content， odor， or antioxidant activity measured by 2，2ʹ-azino-bis（3-ethylbenzothiazoline-6-sulfonic acid）（ABTS） method. WAOF exhibited significantly higher levels in water-soluble extracts， alcohol-soluble extracts， total polysaccharide content， water-soluble protein content， 100-grain weight， length， and total color difference（ΔE^*ab） compared to CAOF（P<0.01）. In contrast， CAOF showed significantly higher levels of total ash， acid-insoluble ash， content of total flavonoids， volatile oil content， chrysin content， tectochrysin content， nootkatone content， diameter， plumpness， lightness（L^*）， red-green chromaticity（a^*）， yellow-blue chromaticity（b^*）， and antioxidant activity measured by 1，1-diphenyl-2-picrylhydrazyl（DPPH） method compared to WAOF（P<0.01）. Correlation analysis between 7 phenotypic traits and 8 quality traits revealed that among the phenotypic traits， plumpness， L^*， a^*， and b^* exerted significant influence on intrinsic quality. Among the quality traits， total flavonoids， volatile oils， nootkatone， chrysin， and tectochrysin contributed substantially to intrinsic quality. ConclusionPlumpness， L^*， a^*， and b^* of AOF significantly influence its intrinsic quality， and higher values of these parameters indicate relatively superior intrinsic quality. The comprehensive quality evaluation reveals that CAOF samples collected in this study are superior to their wild counterparts.

Small cell lung cancer （SCLC） is characterized by rapid onset， high invasiveness， and a strong tendency for recurrence and metastasis， which aligns with the pathogenic characteristics of wind pathogen in traditional Chinese medicine （TCM）. This paper explores the pathological mechanism and dynamic pattern identification and treatment of SCLC from the perspective of "internal wind in hidden circulation". It is proposed that the core pathogenesis of SCLC is rooted in depletion of healthy qi， with binding of phlegm， stasis， and toxin. When pathogenic factors become excessive， the ascending and descending of yang qi becomes disordered， transforming into wind. This leads to internal wind in hidden circulation， which moves erratically and damages healthy qi. In the limited stage， cancer toxin accumulates and internal wind arises covertly， treatment for which should focus on regulating qi and resolving toxin， defending against wind and resisting pathogen with modified Bufei Decoction （补肺汤） and Shengjiang Powder （升降散）. In the early extensive stage， phlegm and stasis generate wind， and internal wind spreads through collate-rals； treatment should resolve phlegm and dispel stasis， extinguish wind and resolve toxin， with modified Lingjiao Gouteng Decoction （羚角钩藤汤） combined with Tianma Gouteng Beverage （天麻钩藤饮）. During the treatment stage， there is qi and yin depletion， and deficient wind harassing the interior， for which it is recommended to boost qi and nourish yin， soften the liver and extinguish wind， with modified Zhengan Xifeng Decoction （镇肝熄风汤） combined with Qingzao Jiufei Decoction （清燥救肺汤）. In the progression stage， internal wind stirs again and cancer toxin scurries； treatment should focus on strengthening the healthy qi and replenishing essence， restraining wind and penetrating toxin， with modified Sanjia Fumai Decoction （三甲复脉汤）. In the terminal stage， yin and yang are on the verge of dissociation and depleted yang floats upward； treatment should constrain and astringe to prevent collapse， rescue yang and contain yin， with modified Dihuang Drink （地黄饮子） combined with Laifu Decoction （来复汤）.

Small cell lung cancer （SCLC） is characterized by rapid onset， high invasiveness， and a strong tendency for recurrence and metastasis， which aligns with the pathogenic characteristics of wind pathogen in traditional Chinese medicine （TCM）. This paper explores the pathological mechanism and dynamic pattern identification and treatment of SCLC from the perspective of "internal wind in hidden circulation". It is proposed that the core pathogenesis of SCLC is rooted in depletion of healthy qi， with binding of phlegm， stasis， and toxin. When pathogenic factors become excessive， the ascending and descending of yang qi becomes disordered， transforming into wind. This leads to internal wind in hidden circulation， which moves erratically and damages healthy qi. In the limited stage， cancer toxin accumulates and internal wind arises covertly， treatment for which should focus on regulating qi and resolving toxin， defending against wind and resisting pathogen with modified Bufei Decoction （补肺汤） and Shengjiang Powder （升降散）. In the early extensive stage， phlegm and stasis generate wind， and internal wind spreads through collate-rals； treatment should resolve phlegm and dispel stasis， extinguish wind and resolve toxin， with modified Lingjiao Gouteng Decoction （羚角钩藤汤） combined with Tianma Gouteng Beverage （天麻钩藤饮）. During the treatment stage， there is qi and yin depletion， and deficient wind harassing the interior， for which it is recommended to boost qi and nourish yin， soften the liver and extinguish wind， with modified Zhengan Xifeng Decoction （镇肝熄风汤） combined with Qingzao Jiufei Decoction （清燥救肺汤）. In the progression stage， internal wind stirs again and cancer toxin scurries； treatment should focus on strengthening the healthy qi and replenishing essence， restraining wind and penetrating toxin， with modified Sanjia Fumai Decoction （三甲复脉汤）. In the terminal stage， yin and yang are on the verge of dissociation and depleted yang floats upward； treatment should constrain and astringe to prevent collapse， rescue yang and contain yin， with modified Dihuang Drink （地黄饮子） combined with Laifu Decoction （来复汤）.

OBJECTIVE To formulate Guidelines for the standardized implementation of pharmacist-managed clinics （ 2026 edition ） in response to the challenges faced by such clinics in China， including uneven development， large discrepancies in service specifications， insufficient patient awareness， and limited medical insurance coverage. METHODS Led by the Pharmaceutical Affairs Professional Committee of the Chinese Hospital Association， the Evidence-based Pharmacy Professional Committee of the Chinese Pharmaceutical Association， and the Hospital Pharmacy Professional Committee of the Cross-strait Medical and Health Exchange Association， a total of 19 domestic hospital pharmacy experts were organized. Through a systematic review of national policies and literature research， current practical experience was summarized. Consensus on the contents of the guidelines was reached after in-depth discussions. RESULTS &CONCLUSIONS The guidelines covered five sections： definition and connotation of pharmacist-managed clinics， establishment requirements， implementation and management， post competency， and practical research. Firstly， the definition and connotation included three operational forms of pharmacist-managed clinics （independent mode， physician-pharmacist joint mode， and online pharmacist-managed clinic mode） and classified service modes （specialty-specific， drug-specific， and disease-specific pharmacist-managed clinics）. The establishment requirements were further refined， covering system construction （pharmaceutical service management system， quality control and assessment mechanism）， personnel qualifications （professional credentials， continuing education and professional training， etc）， service recipients， as well as service venues and facilities. Subsequently， the implementation and management of pharmacist-managed clinics were proposed， involving service procedures， intervention measures， documentation and records， patient education and follow-up， humanistic care， as well as risk management and quality control. Finally， post competency encompassed the competency requirements for pharmacists providing services in pharmacist-managed clinics， as well as the suggestions on teaching methods； practical research encouraged the conduct of high-quality pharmaceutical practice in the setting of pharmacist-managed clinics. The guidelines provide valuable guidance for the standardized implementation of pharmacist-managed clinics in China in terms of establishment， management， teaching， and research， fill the guideline gap in this field， and can promote the high-quality development of pharmacist-managed clinics.

AIM: To explore preoperative risk factors affecting residual astigmatism after Toric intraocular lens(IOL)implantation, and construct and verify a clinically applicable prediction model.METHODS: This retrospective study included patients who underwent Toric IOL implantation at Puyang Oilfield General Hospital and the Second People's Hospital of Puyang City from October 2023 to August 2025. Patients were categorized into two groups according to residual astigmatism at 3 mo postoperatively: >0.25 D group and ≤0.25 D group. Preoperative clinical data and ocular parameters of the two groups were collected and compared. Multivariate Logistic regression analysis was used to screen risk factors, and a nomogram prediction model was established accordingly. Receiver operating characteristic(ROC)curve, calibration curve, and Hosmer-Lemeshow test were adopted to evaluate discrimination, calibration, and clinical applicability of the model. Bootstrap method was applied for internal validation.RESULTS: Totally 103 patients(103 eyes)were included, with 72 patients(72 eyes)in the group with residual astigmatism ≤0.25 D, including 38 males and 34 females, with an average age of 67.35±6.12 y; There were 31 cases(31 eyes)in group with residual astigmatism >0.25 D, including 19 males and 12 females, with an average age of 69.87±6.45 y. The proportion of patients with a history of diabetes, as well as the values for axial length, horizontal corneal diameter, flat corneal curvature(K1), steep corneal curvature(K2), astigmatic axis and proportion of lens nuclear hardness grade III-IV were significantly higher in the residual astigmatism group >0.25 D than those in the residual astigmatism ≤0.25 D group(all P<0.05). Multivariate analysis identified increased horizontal corneal diameter, higher K1 value, higher K2 value, and higher lens nuclear hardness(grade III-IV)as independent risk factors for postoperative residual astigmatism >0.25 D(all P<0.05). The nomogram constructed from these factors demonstrated that the area under the ROC curve(AUC)was 0.794, with a sensitivity of 80.31% and a specificity of 75.20%. The concordance index(C-index)of internal validation was 0.865. Calibration curve and Hosmer-Lemeshow test(χ2=5.231, P=0.734)indicated good consistency between predicted and actual values of the model.CONCLUSION: The nomogram model established based on horizontal corneal diameter, K1, K2 and lens nucleus hardness exhibits favorable predictive performance. It can effectively predict the risk of residual astigmatism prior to Toric IOL surgery, providing reference for individualized clinical surgical planning.

Objective To investigate the suitable habitats of Phlebotomus chinensis in Gansu Province, so as provide insights into effective management of mountain-type zoonotic visceral leishmaniasis (MT-ZVL). Methods The geographical coordinates of locations where MT-ZVL cases were reported were retrieved in Gansu Province from 2015 to 2023, and data pertaining to 26 environmental variables were captured, including 19 climatic variables (annual mean temperature, mean diurnal range, isothermality, temperature seasonality, maximum temperature of the warmest month, minimum temperature of the coldest month, temperature annual range, mean temperature of the wettest quarter, mean temperature of the driest quarter, mean temperature of the warmest quarter, mean temperature of the coldest quarter, annual precipitation, precipitation of the wettest month, precipitation of the driest month, precipitation seasonality, precipitation of the wettest quarter, precipitation of the driest quarter, precipitation of the warmest quarter, and precipitation of the coldest quarter), five geographical variables (elevation, annual normalized difference vegetation index, vegetation type, landform type and land use type), and two population and economic variables (population distribution and gross domestic product). Twelve species distribution models were built using the biomod2 package in R project, including surface range envelope (SRE) model, generalized linear model (GLM), generalized additive model (GAM), multivariate adaptive regression splines (MARS) model, generalized boosted model (GBM), classification tree analysis (CTA) model, flexible discriminant analysis (FDA) model, maximum entropy (MaxEnt) model, optimized maximum entropy (MAXNET) model, artificial neural network (ANN) model, random forest (RF) model, and extreme gradient boosting (XGBOOST) model. The performance of 12 models was evaluated using the area under the receiver operating characteristic curve (AUC), true skill statistics (TSS), and Kappa coefficient, and single models with high performance was selected to build the optimal ensemble models. Factors affecting the survival of Ph. chinensis were identified based on climatic, geographical, population and economic variables. In addition, the suitable distribution areas of Ph. chinensis were predicted in Gansu Province under shared socioeconomic pathway 126 (SSP126), SSP370 and SSP585 scenarios based on climatic data during the period from 1991 to 2020, from 2041 to 2060 (2050s), and from 2081 to 2100 (2090s) . Results A total of 11 species distribution models were successfully built for prediction of potential distribution areas of Ph. chinensis in Gansu Province, and the RF model had the highest predictive accuracy (AUC = 0.998). The ensemble model built based on the RF model, XGBOOST model, GLM, and MARS model had an increased predictive accuracy (AUC = 0.999) relative to single models. Among the 26 environmental factors, precipitation of the wettest quarter (12.00%), maximum temperature of the warmest month (11.58%), and annual normalized difference vegetation index (11.29%) had the greatest contributions to suitable habitats distribution of Ph. sinensis. Under the climatic conditions from 1991 to 2020, the potential suitable habitat area for Ph. chinensis in Gansu Province was approximately 5.80 × 10⁴ km², of which the highly suitable area was 1.42 × 10⁴ km², and primarily concentrated in the southernmost region of Gansu Province. By the 2050s, the unsuitable and lowly suitable areas for Ph. chinensis in Gansu Province had decreased by varying degrees compared to that of 1991 to 2020 period, while the moderately and highly suitable areas exhibited expansion and migration. By the 2090s, under the SSP126 scenario, the suitable habitat area for Ph. chinensis increased significantly, and under the SSP585 scenario, the highly suitable areas transformed into extremely suitable areas, also showing substantial growth. Future global warming is conducive to the survival and reproduction of Ph. chinensis. From the 2050s to the 2090s, the highly suitable areas for Ph. chinensis in Gansu Province will be projected to expand northward. Under the SSP126 scenario, the suitable habitat area for Ph. chinensis in Gansu Province is expected to increase by 194.75% and 204.79% in the 2050s and 2090s, respectively, compared to that of the 1991 to 2020 period. Under the SSP370 scenario, the moderately and highly suitable areas will be projected to increase by 164.40% and 209.03% in the 2050s and 2090s, respectively, while under the SSP585 scenario, they are expected to increase by 195.98% and 211.66%, respectively. Conclusions The distribution of potential suitable habitats of Ph. sinensis gradually shifts with climatic changes. Intensified surveillance and management of Ph. sinensis is recommended in central and eastern parts of Gansu Province to support early warning of MT-ZVL.

Lung cancer is the most common malignant tumor worldwide, ranking first in both incidence and mortality rates. According to the latest statistics from the International Agency for Research on Cancer (IARC), approximately 2.5 million new cases and around 1.8 million deaths from lung cancer occurred in 2022, placing a tremendous burden on global healthcare systems. The high mortality rate of lung cancer is closely linked to its subtle early symptoms, which often lead to diagnosis at advanced stages. This not only complicates treatment but also results in substantial economic losses. Current treatment options for lung cancer include surgery, radiotherapy, chemotherapy, targeted drug therapy, and immunotherapy. Among these, immunotherapy has emerged as the most groundbreaking advancement in recent years, owing to its unique antitumor mechanisms and impressive clinical benefits. Unlike traditional therapies such as radiotherapy and chemotherapy, immunotherapy activates or enhances the patient’s immune system to recognize and eliminate tumor cells. It offers advantages such as more durable therapeutic effects and relatively fewer toxic side effects. The main approaches to lung cancer immunotherapy include immune checkpoint inhibitors, tumor-specific antigen-targeted therapies, adoptive cell therapies, cancer vaccines, and oncolytic virus therapies. Among these, immune checkpoint inhibitors and tumor-specific antigen-targeted therapies have received approval from the U.S. Food and Drug Administration (FDA) for clinical use in lung cancer, significantly improving outcomes for patients with advanced non-small cell lung cancer. Although other immunotherapy strategies are still in clinical trials, they show great potential in improving treatment precision and efficacy. This article systematically reviews the latest research progress in lung cancer immunotherapy, including the development of novel immune checkpoint molecules, optimization of treatment strategies, identification of predictive biomarkers, and findings from recent clinical trials. It also discusses the current challenges in the field and outlines future directions, such as the development of next-generation immunotherapeutic agents, exploration of more effective combination regimens, and the establishment of precise efficacy prediction systems. The aim is to provide a valuable reference for the continued advancement of lung cancer immunotherapy.

Aim To infer novel therapeutic and phar-macological targets related to lung cancer treatment through multiomics approaches,so as to provide new directions for developing more personalized and effec-tive treatment strategies.Methods Genome-wide as-sociation study(GWAS)data analysis,pan-cancer,single-cell,transcriptomics,and protein-protein interac-tion analysis were employed in this study.Results We analyzed biomarkers and therapeutic targets associ-ated with lung cancer.The study identified key bio-markers closely related to lung cancer progression and explored the interrelationships between these biomark-ers and viral infections.According to KEGG pathway annotation,the number of genes related to metabolic processes increased significantly.In particular,metab-olites such as alanine and isoleucine emerged as pivotal factors in therapeutic interventions.The IgD+CD24+and IgD+CD24-B cell subsets were identified as cen-tral elements in immune evasion and treatment re-sponse.Concurrently,the Lachnospiraceae and Prevo-tella were shown to modulate host immune responses and the tumor microenvironment by regulating short-chain fatty acid levels,thereby opening novel avenues for cancer research.Conclusions Through mul-tiomics analysis combined with transcriptomics and pro-teomics analysis,we identify several potential therapeu-tic targets for lung cancer,providing key insights for developing novel treatment strategies.

Innate immune system serves as the primary defense mechanism against pathogen infections,recognition of structural components of pathogens is referred to as pathogen-associated molecular patterns(PAMPs).Toll-like receptors(TLRs)are a family of transmembrane receptors that can identify PAMPs,which interact with myeloid differentiation factor 88(MyD88)and activate NF-κB dimerization,leading to the release of downstream inflammatory factors and ultimately triggering the adaptive immune system.Conse-quently,TLRs are regarded as adapters that regulate the transition from innate immunity to adaptive immunity.TLR/MyD88/NF-κB signaling pathway plays a crucial role in inflammatory diseases,infectious diseases and tumor immunity.This review article aims to explore the regulatory function of TLR/MyD88/NF-κB signaling pathway in host responses to viral,bacterial,and other microbial in-fections,providing novel insights into the immune response during the process of infection control.