In order to further promote the standardization of the integrated traditional Chinese and western medicine treatment of atopic dermatitis(AD),the team of Professor Chen Dacan,who is honored as the Qihuang Scholar,developed the Clinical Practice Guidelines for Integrated Traditional Chinese and Western Medicine in Atopic Dermatitis(hereinafter referred to as Guidelines for AD).This paper detailed the process of development of Guidelines for AD,and analyzed the characteristics of Guidelines for AD,as well as the difficulties and countermeasures encountered during such a time.The development of Guidelines for AD follows the methodology of international guidelines for clinical trial.Experts specializing in various disciplines,such as traditional Chinese medicine,western medicine,integrated traditional Chinese and western medicine,and methodology,composed an expert group and a working group.On the basis of systematic literature research,the clinic experiences of frontline experts were well-summarized,and the draft of Guidelines for AD was formed after several meetings and discussions.In the process of developing Guidelines for AD,quite a number of problems were encountered,and the project team found the corresponding countermeasures after analyzing these problems.The countermeasures became the characteristics of Guidelines for AD:the integration of traditional Chinese medicine therapies and western medicine therapies,and the evaluation of the evidence of integrated traditional Chinese and western medicine solved the problem of traditional Chinese and western medicine diagnosis and treatment of AD lacking standardization;the adequately combination of the evidence with the experience of clinical practice solved the problems of the low overall level and the insufficiency of traditional Chinese medicine evidence for AD;the establishment of management goals and strategies for AD after taking the advantages of both traditional Chinese medicine and western medicine into account was in line with the international treatment and management concepts;the formulation of individualized traditional Chinese and western medicine therapy based on the integration of traditional Chinese medicine therapy and western medicine therapy met the clinical needs of patients with different characteristics of AD.The development process of Guidelines for AD and the analysis of problems and countermeasures during such a time will provide reference and reflection for the subsequent establishment of clinical guidelines for the integrated traditional Chinese and western medicine in other diseases.

Atopic dermatitis （AD） is a common pruritic and chronic inflammatory dermatosis in clinical practice and is one of the diseases responding specifically to traditional Chinese medicine （TCM）. With the launch of biological agents and small molecule drugs and the development and implementation of guidelines of diagnosis and treatment， clinical pathways of treatment of moderate to severe AD， and consensus on the whole-process management of AD， the clinical efficacy of moderate to severe AD has been significantly improved. However， there are still many unmet clinical needs that require more effective methods to meet. In response to the Opinions of the CPC Central Committee and the State Council on Facilitating the Inheritance， Innovation， and Development of Traditional Chinese Medicine and the spirit of the National Conference on TCM， the China Association of Chinese Medicine organized more than 20 experts in TCM dermatology， Western medicine dermatology， interdisciplinary fields， and industries to discuss the difficulties and advantages of TCM in the treatment of AD. TCM treatment for AD can not only improve rash and relieve itching but also solve many concomitant syndromes. The abundant external treatment methods of TCM have advantages for different special populations and rash characteristics. The concept of treating disease before its onset in TCM is in line with the chronic disease management mode of prevention and treatment of atopic march and prevention of recurrence. In addition， TCM therapy can reduce the use of topical glucocorticoids and has good safety. Regarding the comorbidity of AD， equal emphasis on TCM and Western medicine and multidisciplinary joint treatment should be advocated to achieve maximum benefit for patients. The exchange of TCM and Western medicine has clarified the positioning and advantages of TCM intervention in AD， providing guidance for clinical and scientific research.

By consulting relevant literature of ancient herbal books and processing specifications， this paper made a systematic research and analysis of Ostreae Concha， including the name， producing area， harvesting， quality， historical evolution of processing， relevant processing specifications， modern processing technology， and changes in chemical composition and pharmacological effects before and after processing， in order to provide documentary evidence for the research on processing technology and the establishment of quality standards. According to the textual research， it is known that Ostreae Concha has a long history of being used in medicine， and there have been many aliases and local names in each historical period. Shennong's Classic of the Materia Medica（Shennong Bencaojing） began to use Muli as the correct name， which has continued to use to today， and there were also aliases such as Muge， Zuogu Muli and Haoke. Ostreae Concha has a wide range of localities and irregular harvesting periods. The ancients believed that its left shell was of superior quality， but this has not been seen in modern. And there were many kinds of processing methods of Ostreae Concha， such as grinding， roasting， calcining， frying， simmering， quenching and so on， and the calcining was still in use. The different editions of Chinese Pharmacopoeia from 1963 to 2020 contain only calcined Ostreae Concha， and the local processing specifications mainly include three kinds of processed products（calcined products， salt-soaked products and vinegar-soaked products）. Modern processing research mainly focuses on process optimization， changes in chemical composition and pharmacological effects， and the research methods are relatively single. Overall， there are currently issues such as inconsistent processing standards， unclear process parameters and imperfect quality standards， which are not conducive to the quality control and standardized clinical use of Ostreae Concha. Therefore， it is necessary to further investigate the pharmacological substance basis of Ostreae Concha and its processed products in order to elucidate the processing mechanism， standardize the processing technology and improve the quality standard.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Early identification of adolescent depression requires objective biomarkers. This study investigated the functional near-infrared spectroscopy (fNIRS) activation patterns and mismatch negativity (MMN) characteristics in adolescents with first-episode mild-to-moderate depression. We enrolled 33 patients and 33 matched healthy controls, measuring oxyhemoglobin (Oxy-Hb) concentration in the frontal cortex during verbal fluency tasks via fNIRS, and recording MMN latency/amplitude at Fz/Cz electrodes using event-related potentials (ERP). Compared with healthy controls, the depression group showed significantly prolonged MMN latency [Fz: (227.88 ± 31.08) ms vs. (208.70 ± 25.35) ms, P < 0.01; Cz: (223.73 ± 29.03) ms vs. (204.18 ± 22.43) ms, P < 0.01], and obviously reduced Fz amplitude [(2.42 ± 2.18) μV vs. (5.65 ± 5.59) μV, P = 0.03]. A significant positive correlation was observed between MMN latencies at Fz and Cz electrodes ( P < 0.01). Oxy-Hb in left frontopolar prefrontal channels (CH15/17) was significantly decreased in patient group ( P < 0.05). Our findings suggest that adolescents with depression exhibit hypofunction in the left prefrontal cortex and impaired automatic sensory processing. The combined application of fNIRS and ERP techniques may provide an objective basis for early clinical identification.
Humans ; Spectroscopy, Near-Infrared/methods* ; Adolescent ; Prefrontal Cortex/physiopathology* ; Evoked Potentials/physiology* ; Depression/physiopathology* ; Female ; Male ; Oxyhemoglobins ; Electroencephalography

Peptide-based radiopharmaceuticals targeting integrin α5β1 show promise for precise tumor diagnosis and treatment. However, current peptide-based radioligands that target α5β1 demonstrate inadequate in vivo performance owing to limited tumor retention. The use of PEGylation to enhance the tumor retention of radiopharmaceuticals by prolonging blood circulation time poses a risk of increased blood toxicity. Therefore, a PEGylation strategy that boosts tumor retention while minimizing blood circulation time is urgently needed. Here, we developed a PEGylation-enabled peptide multidisplay platform (PEGibody) for PR_b, an α5β1 targeting peptide. PEGibody generation involved PEGylation and self-assembly. [⁶⁴Cu]QM-2303 PEGibodies displayed spherical nanoparticles ranging from 100 to 200 nm in diameter. Compared with non-PEGylated radioligands, [⁶⁴Cu]QM-2303 demonstrated enhanced tumor retention time due to increased binding affinity and stability. Importantly, the biodistribution analysis confirmed rapid clearance of [⁶⁴Cu]QM-2303 from the bloodstream. Administration of a single dose of [¹⁷⁷Lu]QM-2303 led to robust antitumor efficacy. Furthermore, [⁶⁴Cu]/[¹⁷⁷Lu]QM-2303 exhibited low hematological and organ toxicity in both healthy and tumor-bearing mice. Therefore, this study presents a PEGibody-based radiotheranostic approach that enhances tumor retention time and provides long-lasting antitumor effects without prolonging blood circulation lifetime. The PEGibody-based radiopharmaceutical [⁶⁴Cu]/[¹⁷⁷Lu]QM-2303 shows great potential for positron emission tomography imaging-guided targeted radionuclide therapy for α5β1-overexpressing tumors.

OBJECTIVE To analyze the pathogenic characteristics and clinical features of patients with invasive pul-monary aspergillosis(IPA)and summarize the risk factors for poor prognosis.METHODS The clinical data of 89 patients diagnosed with IPA based on microbial identification of Aspergillus from sputum or bronchoalveolar lav-age fluid cultures and diagnostic criteria,who were admitted to Zhongda Hospital Southeast University from Aug.2022 to Jul.2024 and were queried by electronic case system,were analyzed retrospectively.The distribu-tion of Aspergillus pathogens and clinical features of patients with IPA were analyzed,and the risk factors for poor prognosis were summarized.RESULTS A total of 107 Aspergillus strains were isolated from 89 cases,including 55 strains of Aspergillus fumigatus(51.40％),30 strains of Aspergillus flavus(28.04％)and 10 strains of As-pergillus niger(9.34％).There were 63 m ale patients(70.79％),and 34 cases had poor prognosis.Baseline pe-ripheral blood lymphocyte count(＜0.645×109)(OR=6.653,95％CI:2.013-21.990,P=0.002)and ICU admission(OR=8.303,95％CI:1.283-53.741,P=0.026)were identified as risk factors for poor prognosis in patients with IPA.Receiver operating characteristic curve analysis showed that the cut-off point for baseline pe-ripheral blood lymphocyte count in predicting prognosis in patients with IPA was 0.645 ×109/L,with a sensitivity of 85.22％and a specificity of 69.67％.CONCLUSIONS Baseline peripheral blood lymphocyte count and ICU ad-mission are risk factors for poor prognosis in patients with IPA.The alert value for baseline peripheral blood lym-phocyte count is 0.645 × 109/L,which has good predictive value for the occurrence of poor prognosis.

Objective:To explore the value of magnetic resonance diffusion kurtosis imaging (DKI) in the assessment of the condition and prognosis of neonatal acute bilirubin encephalopathy (ABE).Methods:A retrospective selection was made of 196 neonates with acute hyperbilirubinemia who were hospitalized in the Second Affiliated Hospital of Shantou University Medical College from June 2021 to September 2023 as the research subjects. According to the presence or absence of brain injury, they were divided into the ABE group ( n=112) and the non-ABE group ( n=84). Based on the neonatal Bilirubine-induced Neurological Dysfunction (BIND) scoring system, children in the ABE group were divided into the mild group ( n=50, score 1-3 points), the moderate group ( n=33, score 4-6 points), and the severe group ( n=29, score 7-9 points). The clinical data and DKI parameters among each group were analyzed. Univariate and multivariate analyses were used to evaluate the influencing factors of prognosis in children with ABE. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of DKI parameters for the prognosis of children with ABE. Results:The birth weight and gestational age in the ABE group were significantly lower than those in the non-ABE group, and the peak value of total bilirubin (TBIL) was significantly higher than that in the non-ABE group (all P<0.05). There was no statistically significant difference in fractional anisotropy (FA) values and mean diffusivity (MD) values among each group of children (all P>0.05). The mean kurtosis (MK) values, axial kurtosis (KA) values, and radial kurtosis (KR) values of children with ABE in the severe group were significantly higher than those in the other groups (all P<0.05). After Spearman correlation analysis, the FA value and MD value of children with ABE were not correlated with the severity of the disease (all P>0.05), while the MK value, KA value and KR value were positively correlated with the severity of the disease (all P<0.05). The patients were followed up for 12 months. Among them, 87 cases had a normal prognosis and 25 cases had a poor prognosis, including 2 cases of cerebral palsy, 5 cases of hearing loss, 4 cases of movement disorders, 12 cases of cerebral palsy combined with hearing loss, and 2 cases of movement disorders combined with hearing loss. The results of univariate analysis showed that there were statistically significant differences in birth weight, peak TBIL, BIND score, MK value, KA value, and KR value between the two groups of children with different prognoses (all P<0.05). The results of Cox multivariate regression analysis showed that birth weight, peak TBIL, BIND score, MK value, KA value, and KR value were independent influencing factors for poor prognosis in children with ABE (all P<0.05). The results of the ROC curve showed that the area under the curve and specificity of the MK value in predicting the poor prognosis of children with ABE were significantly higher than those of the KA and KR values (all P<0.05). Conclusions:The DKI parameters MK value, KA value, and KR value are sensitive indicators reflecting the severity of brain injury and predicting prognosis in children with ABE, among which the MK value has the highest predictive value.

OBJECTIVE To analyze the pathogenic characteristics and clinical features of patients with invasive pul-monary aspergillosis(IPA)and summarize the risk factors for poor prognosis.METHODS The clinical data of 89 patients diagnosed with IPA based on microbial identification of Aspergillus from sputum or bronchoalveolar lav-age fluid cultures and diagnostic criteria,who were admitted to Zhongda Hospital Southeast University from Aug.2022 to Jul.2024 and were queried by electronic case system,were analyzed retrospectively.The distribu-tion of Aspergillus pathogens and clinical features of patients with IPA were analyzed,and the risk factors for poor prognosis were summarized.RESULTS A total of 107 Aspergillus strains were isolated from 89 cases,including 55 strains of Aspergillus fumigatus(51.40％),30 strains of Aspergillus flavus(28.04％)and 10 strains of As-pergillus niger(9.34％).There were 63 m ale patients(70.79％),and 34 cases had poor prognosis.Baseline pe-ripheral blood lymphocyte count(＜0.645×109)(OR=6.653,95％CI:2.013-21.990,P=0.002)and ICU admission(OR=8.303,95％CI:1.283-53.741,P=0.026)were identified as risk factors for poor prognosis in patients with IPA.Receiver operating characteristic curve analysis showed that the cut-off point for baseline pe-ripheral blood lymphocyte count in predicting prognosis in patients with IPA was 0.645 ×109/L,with a sensitivity of 85.22％and a specificity of 69.67％.CONCLUSIONS Baseline peripheral blood lymphocyte count and ICU ad-mission are risk factors for poor prognosis in patients with IPA.The alert value for baseline peripheral blood lym-phocyte count is 0.645 × 109/L,which has good predictive value for the occurrence of poor prognosis.