ObjectiveTo investigate the metabolic alterations of serum short chain fatty acids （SCFAs） in pediatric patients with atopic dermatitis （AD） and their correlation with different clinical phenotypes using targeted metabolomics. MethodsThis study enrolled 87 AD patients and 67 healthy controls （HC）. Serum levels of eight SCFAs were quantified by ultra-high-performance liquid chromatography-mass spectrometry. The associations between SCFAs and AD were assessed using various statistical methods. ResultsCompared with the HC group， levels of acetic acid （AA）， propionic acid （PA）， and caproic acid （CA） （P=0.002，P=0.002，P=0.043） decreased in the AD group. Logistic regression analysis identified AA （OR=0.449， 95% CI： 0.289–0.698） and PA （OR = 0.487， 95% CI： 0.324–0.732） as protective factors against AD. The combination of AA and PA yielded an area under the curve （AUC） greater than 0.7， indicating good diagnostic efficacy. Age-stratified analysis revealed that AA reduction was predominant in childhood， whereas PA reduction was predominant in adolescence. Pathway enrichment analysis showed significant enrichment of fatty acid biosynthesis （FDR=0.341， P=0.003） and vitamin K metabolism （FDR=1， P=0.039） pathways. Furthermore， subgroup analyses based on disease severity， personal/family history of atopy， and sex revealed no significant differences in SCFAs levels among the groups. ConclusionDifferential serum SCFAs and their enriched metabolic pathways may be implicated in the pathogenesis of AD.

AIM: To analyze the pathological features, immunophenotype, and imaging findings of conjunctival lymphangiectasia(CL), and to explore the etiological mechanisms and provide a theoretical basis for clinical diagnosis and treatment. METHODS:This single-center descriptive cross-sectional study enrolled postoperative specimens from patients with CL who underwent surgical treatment in the hospital between Feb. 2023 and Sept. 2025. Routine hematoxylin and eosin(HE)staining and immunohistochemical staining(D2-40, CD31, CD34, CK)were performed. Anterior segment optical coherence tomography(AS-OCT)was used to observe the lesion morphology. The pathological results were comprehensively analyzed combined with clinical data. RESULTS: A total of postoperative specimens from 32 eyes of 32 patients with CL were enrolled, including 23 females(72%)and 9 males(28%), with a mean age of 53.03±12.47 y. All patients presented with single or multiple transparent cystic elevations beneath the bulbar conjunctiva. The postoperative pathological manifestations were characterized by dilation of conjunctival lymphatic vessels lined with a single layer of flattened endothelial cells, accompanied by edema and inflammatory infiltration in the surrounding stroma. All cases were positive for D2-40, confirming a lymphatic origin; some cases also expressed CD31 and CD34. AS-OCT revealed the lesions as unilocular or multilocular cystic spaces with low reflectivity. After complete surgical resection, the mean follow-up period was 16.2 mo with no recurrence.CONCLUSION:CL is a benign ocular surface lesion characterized by lymphatic vessel dilation. The endothelium co-expresses lymphatic and some vascular markers, suggesting that CL may belong to the spectrum of vascular malformations. AS-OCT has adjunctive diagnostic value, and surgical resection has definitive therapeutic efficacy.

ObjectiveTo analyze the diversity and structural characteristics of microbial communities in the rhizosphere soil of healthy and diseased Andrographis paniculata and to explore the interactions of soil， plants， and microorganisms during the occurrence of diseases. MethodsThe physicochemical properties of the rhizosphere soil of healthy and diseased A.paniculata were determined， and the composition and diversity of bacterial and fungal communities in the rhizosphere soil were analyzed by Illumina high-throughput sequencing. Furthermore， the correlations between physicochemical properties and microorganisms of the rhizosphere soil were explored. ResultsThe content of total nitrogen， total potassium， and available potassium in the rhizosphere soil of diseased A. paniculata was significantly higher than that of healthy A. paniculata. The alpha diversity and richness （operational taxonomic units） of bacterial and fungal communities in the rhizosphere soil of diseased plants decreased compared with those of healthy plants. The microbial communities in the rhizosphere soil of healthy and diseased A. paniculata showed similar composition but different relative abundance. At the phylum level， the relative abundance of Proteobacteria and Chytridiomycota significantly increased， while that of Bacteroidota significantly decreased in the rhizosphere soil of diseased plants. At the genus level， the relative abundance of Sphingomonas， Pseudomonas， and Bryobacter significantly increased， while that of RB41 showed a significant decrease in the rhizosphere soil of diseased plants. The correlation analysis showed different correlations of microbial phyla with physicochemical properties of the rhizosphere soil between healthy and diseased plants. Organic matter， alkaline nitrogen， available phosphorus， and total potassium were correlated with the relative abundance of some dominant bacterial and fungal phyla in the rhizosphere soil of healthy plants， while available nitrogen and total phosphorus were correlated with the relative abundance of some dominant bacterial and fungal phyla in the rhizosphere soil of diseased plants. ConclusionThere are differences in the diversity and richness of microbial communities in the rhizosphere soil of healthy and diseased A. paniculata. The physicochemical properties of soil may have an impact on the rhizosphere microorganisms of A. paniculata， leading to the development of diseases. The results provide a scientific basis for the prevention and ecological management of A. paniculata diseases.

ObjectiveTo analyze the diversity and structural characteristics of microbial communities in the rhizosphere soil of healthy and diseased Andrographis paniculata and to explore the interactions of soil， plants， and microorganisms during the occurrence of diseases. MethodsThe physicochemical properties of the rhizosphere soil of healthy and diseased A.paniculata were determined， and the composition and diversity of bacterial and fungal communities in the rhizosphere soil were analyzed by Illumina high-throughput sequencing. Furthermore， the correlations between physicochemical properties and microorganisms of the rhizosphere soil were explored. ResultsThe content of total nitrogen， total potassium， and available potassium in the rhizosphere soil of diseased A. paniculata was significantly higher than that of healthy A. paniculata. The alpha diversity and richness （operational taxonomic units） of bacterial and fungal communities in the rhizosphere soil of diseased plants decreased compared with those of healthy plants. The microbial communities in the rhizosphere soil of healthy and diseased A. paniculata showed similar composition but different relative abundance. At the phylum level， the relative abundance of Proteobacteria and Chytridiomycota significantly increased， while that of Bacteroidota significantly decreased in the rhizosphere soil of diseased plants. At the genus level， the relative abundance of Sphingomonas， Pseudomonas， and Bryobacter significantly increased， while that of RB41 showed a significant decrease in the rhizosphere soil of diseased plants. The correlation analysis showed different correlations of microbial phyla with physicochemical properties of the rhizosphere soil between healthy and diseased plants. Organic matter， alkaline nitrogen， available phosphorus， and total potassium were correlated with the relative abundance of some dominant bacterial and fungal phyla in the rhizosphere soil of healthy plants， while available nitrogen and total phosphorus were correlated with the relative abundance of some dominant bacterial and fungal phyla in the rhizosphere soil of diseased plants. ConclusionThere are differences in the diversity and richness of microbial communities in the rhizosphere soil of healthy and diseased A. paniculata. The physicochemical properties of soil may have an impact on the rhizosphere microorganisms of A. paniculata， leading to the development of diseases. The results provide a scientific basis for the prevention and ecological management of A. paniculata diseases.

Lipid turbidity disease is a metabolic disease featuring lipid metabolism disorders caused by many factors such as social environment， diet， and lifestyle， which is closely related to many diseases in modern medicine， such as hyperlipidemia， obesity， fatty liver， atherosclerosis， metabolic syndrome， and cardiovascular and cerebrovascular diseases， with a wide range of influence and far-reaching harm. According to the Huangdi Neijing， lipid turbidity disease reflects the pathological change of the body's physiologic grease. Grease is the thick part of body fluids， which has the function of nourishing， and it is the initial state and source of important substances in the human body such as brain， marrow， essence， and blood. Once the grease of the human body is abnormal， it can lead to lipid turbidity disease. The Huangdi Neijing also points out the physiological relationship between the transportation and transformation of body fluids and the rise and fall of the spleen and stomach， which can deduce the pathological relationship between the occurrence of lipid turbidity disease and the abnormal rise and fall of the spleen and stomach functions. Lipid turbidity disease is caused by overconsumption of fatty and sweet foods or insufficient spleen and stomach endowments， leading to disorders of the function of promoting clear and reducing turbidity in the spleen and stomach. This leads to the transformation of thick grease in body fluids into lipid turbidity， which accumulates in the body's meridians， blood vessels， skin pores， and organs， forming various forms of metabolic diseases. The research team believed that the pathological basis of lipid turbidity disease was the abnormal rise and fall of the spleen and stomach and the obstruction of the transfer of grease. According to the different locations where lipid turbidity stays， it was divided into four common pathogenesis types： ''inability to distinguish between the clear and turbid， turbid stagnation in the Ying blood''， ''spleen not rising clear， turbid accumulation in the vessels''， ''spleen dysfunction， lipid retention in the pores''， ''spleen failure to transportation and transformation， and grease accumulation in the liver''. According to the pathogenesis， it could be divided into four common syndromes， namely， turbid stagnation in the Ying blood， turbid accumulation in the vessels， lipid retention in the pores， and grease accumulation in the liver， and the corresponding prescriptions were given for syndrome differentiation and treatment， so as to guide clinical differentiation and treatment of the lipid turbidity disease.

ObjectiveTo analyze the research situation， hotspots， and trend of the compatibility of bitter and pungent medicinals in traditional Chinese medicine by knowledge mapping and provide reference for the inheritance and clinical application of this theory. MethodsThe literature on the compatibility of bitter and pungent medicinals was retrieved from 6 databases， including China National Knowledge Infrastructure （CNKI）， VIP， Wanfang Data， SinoMed， Web of Science， and PubMed. The literature was searched with the keywords of bitter medicinals， pungent medicinals， compatibility， Banxia Xiexin decoction， Zhuyu pills， and Zuojin pills. The search time ranged from January 1， 1984 to August 10， 2024. NoteExpress 3.7 was used for literature screening， and CiteSpace 6.1.R2 was used to visualize the number of publications， authors， institutional cooperation network， and the co-occurrence， clustering， time line， and burst of keywords. ResultsA total of 628 Chinese articles and 151 English articles related to the compatibility of bitter and pungent medicinals were included， and the annual number of publications rose with fluctuations. WEI Wei was the core author of Chinses articles and SHEN Tao and ZHAO Yanling were the core authors of English articles. China Academy of Chinese Medical Sciences formed a close cooperative network with many research institutions at home and abroad. The high-frequency keywords included pungent dispersing and bitter descending， Coptidis Rhizoma， Euodiae Fructus， Banxia Xiexin decoction， Zuojin pills， compatibility， spleen and stomach diseases， and gut microbiota， which mainly involved common prescriptions， diseases responding specifically to traditional Chinese medicine， mechanism research and so on. The keyword bursts concentrated in famous doctors' experience， network Meta-analysis， inflammatory bowel disease， diabetes mellitus， intestinal microbiota， etc. The compatibility of bitter medicinals and pungent medicinals was widely used in clinical practice. Based on pungent dispersing and bitter descending， the middle energizer was regulated for treating spleen and stomach diseases and inflammatory bowel disease. Bitter and pungent medicinals descending the turbid were used to treat diabetes mellitus and hyperlipidemia by lowering blood glucose and lipid levels. The mild bitter and slightly pungent medicinals were used as supplements to treat depression and COVID-19 by regulating Qi movement. ConclusionIn the past 40 years， the number of publications on the compatibility of bitter and pungent medicinals has been increasing， and the research team has begun to take form. Clinically， the compatibility of bitter and pungent medicinals is the main treatment for spleen and stomach diseases and glycolipid metabolic diseases. At present， the modern scientific essence of the compatibility of bitter and pungent medicinals is mainly explained based on famous doctors' experience inheritance， network meta-analysis， and intestinal flora.

ObjectiveTo observe the clinical efficacy and safety of Zhuyuwan in the treatment of hyperlipidemia. MethodsIn this study， hyperlipidemia patients treated in the Hospital of Chengdu University of Traditional Chinese Medicine （TCM） from September 2022 to December 2023 were randomly assigned into a control group and an observation group. Finally， 162 valid cases were included， encompassing 74 cases in the control group and 88 cases in the observation group. The control group was treated with atorvastatin calcium tablets， and the observation group with atorvastatin calcium tablets + Zhuyuwan extract granules. Both groups were treated for 8 weeks. The efficacy in terms of blood lipid level recovery， blood lipid levels， TCM syndrome distribution， efficacy in terms of TCM syndrome， and TCM symptom scores were compared between the two groups as well as between before and after treatment. Liver and kidney functions were monitored for safety assessment. ResultsIn terms of blood lipid level recovery， the total response rate in the observation group was 86.36% （76/88） and that in the control group was 86.49% （64/74）， with no statistically significant difference between the two groups. After treatment， both groups showed declines in levels of triglyceride （TG）， total cholesterol （TC）， and low-density lipoprotein cholesterol （LDL-C） （P<0.05） and elevations in the level of high-density lipoprotein cholesterol （HDL-C） （P<0.05）. Moreover， the observation group outperformed the control group in recovering the levels of TG， LDL-C， and HDL-C （P<0.05， P<0.01）. In terms of TCM syndrome， hyperlipidemia was mostly caused by phlegm turbidity and obstruction. The total response rate in terms of TCM syndrome in the observation group was 87.30% （55/63）， which was higher than that （63.46%， 33/52） in the control group （χ²=9.102， P<0.01）. After treatment， the scores of total TCM symptoms， primary symptoms， and secondary symptoms decreased in both groups （P<0.05）， and the observation group had lower scores than the control group （P<0.01）. The observation group was superior to the control group in alleviating obesity， chest tightness， and low food intake （P<0.05）. In terms of safety， the level of aminotransferase was slightly elevated in the control group， and no obvious adverse reaction was observed in the observation group， with no statistical significance in the incidence of adverse reactions. ConclusionZhuyuwan combined with atorvastatin can not only recover blood lipid levels and alleviate TCM symptoms but also reduce the occurrence of adverse reactions.

ObjectiveTo observe the efficacy and safety of Zhuyuwan in the treatment of hyperlipidemia （syndrome of phlegm turbidity and obstruction） complicated with carotid atherosclerosis. MethodsA total of 120 patients with hyperlipidemia （syndrome of phlegm turbidity and obstruction） complicated with carotid atherosclerosis were randomly allocated into a treatment group and a control group， with 60 patients in each group. The control group orally took rosuvastatin calcium tablets， 10 mg each time， once a day. The treatment group took Zhuyuwan granules， 1 dose a day in 3 times. Both groups received diet and exercise guidance and were treated for 24 consecutive weeks. The traditional Chinese medicine （TCM） symptom scores were recorded before and after treatment. The levels of blood lipids ［total cholesterol （TC）， triglycerides （TG）， low-density lipoprotein cholesterol （LDL-C）， and high-density lipoprotein cholesterol （HDL-C）］， carotid color ultrasound ［carotid intima-media thickness （IMT）， plaque number， maximum plaque area， and maximum plaque thickness］， vascular intimal repair-related factors ［nitric oxide （NO）， endothelin-1 （ET-1）， soluble intercellular adhesion molecule 1 （sICAM-1）， and thromboxane B2 （TXB2）］， and oxidative stress-related indicators ［superoxide dismutase （SOD） and glutathione peroxidase （GSH-Px）］ were measured before and after treatment. The occurrence of adverse reactions was observed during treatment， and the clinical efficacy of the two groups was compared after treatment. ResultsThe trial was completed and 112 patients （57 in the treatment group and 55 in the control group） were included in the statistical analysis， and the general information of the two groups was comparable. The total response rate in the treatment group was 87.72% （50/57）， which was higher than that （74.55%， 41/55） in the control group （χ²=4.823， P<0.05）. After treatment， the scores of main TCM symptoms such as body obesity， chest tightness， and limb numbness， the scores of secondary symptoms such as palpitation， insomnia， tastelessness in the mouth， reduced appetite， tongue and pulse manifestation scores， and the total TCM symptom score decreased in both groups （P<0.05， P<0.01）. Moreover， the treatment group had lower scores of main symptoms such as body obesity， head heaviness， chest tightness， nausea， salivation， and limb numbness， scores of secondary symptoms such as tastelessness in the mouth and reduced appetite， and total TCM symptom score than the control group （P<0.05， P<0.01）. After treatment， both groups showed declines in TC， TG， LDL-C， IMT， plaque number， maximum plaque area， maximum plaque thickness， ET-1， sICAM-1， and TXB2 （P<0.05， P<0.01） and elevations in levels of HDL-C， NO， and SOD （P<0.05， P<0.01）. The treatment group had lower TC， TG， LDL-C， IMT， plaque number， maximum plaque area， maximum plaque thickness， ET-1， sICAM-1， and TXB2 （P<0.01） and higher levels of HDL-C， NO， SOD， and GSH-Px （P<0.05， P<0.01） than the control group. During treatment， adverse reactions occurred in 3 cases （5.26%， 1 case of dizziness， 1 case of acid reflux， and 1 case of constipation） in the treatment group and 4 cases （7.27%， 2 cases of upper respiratory tract infection， 1 case of abdominal pain， and 1 case of low back pain） in the control group. ConclusionZhuyuwan can effectively reduce blood lipid levels， inhibit the formation of carotid atherosclerotic plaque， and alleviate the syndrome of phlegm turbidity and obstruction by promoting vascular intima repair and improving the antioxidant function.

ObjectiveThe theory of homotherapy for heteropathy is one of the classical rules in traditional Chinese medicine. Taking this theory as a breakthrough point， this study employed gas chromatography-mass spectrometry （GC-MS） to elucidate the mechanism underlying the therapeutic effects of Zhuyuwan on both intrahepatic cholestasis （IC） and ulcerative colitis （UC） from the viewpoint of serum metabolic homeostasis. MethodsThe rat models of α-naphthylisothiocyanate （ANIT）-induced cholestasis and 2，4，6-trinitro-benzenesulfonic acid （TNBS）-induced UC were treated with low （0.6 g·kg^-1） and high （1.2 g·kg^-1） doses of Zhuyuwan by gavage. In the experiment regarding IC， 24 Sprague-Dawley （SD） rats were randomly assigned into four groups： normal， ANIT model， low-dose Zhuyuwan， and high-dose Zhuyuwan. In the experiment regarding UC， 24 SD rats were randomly allocated into four groups： normal， TNBS model， low-dose Zhuyuwan， and high-dose Zhuyuwan. Firstly， the two disease models and the intervention effects of Zhuyuwan on the two diseases were evaluated based on serum levels of biochemical indicators ［alanine aminotransferase （ALT）， aspartate transaminase （AST）， γ-glutamyltranspeptidase （γ-GT）， and total bile acid （TBA）］， colon damage score， colon weight index， disease activity index， and histopathological changes in rats. Secondly， the rat serum samples were analyzed by gas chromatography-mass spectrometry （GC-MS） to screen the common core pathways of the two disease models， and the expression of core genes in the pathways was determined by Real-time PCR， on the basis of which the biological mechanism of the treatment of the two disease models by Zhuyuwan was ultimately elucidated. ResultsThe results of the experiment regarding IC showed that the ANIT model group had higher ALT， AST， γ-GT， and TBA levels than the normal group （P<0.01）. Compared with the ANIT model group， the low-dose Zhuyuwan group showed declined ALT and TBA levels （P<0.01） and the high-dose Zhuyuwan group showed lowered ALT， TBA， AST， and γ-GT levels （P<0.01）. The results of the experiment regarding UC showed that compared with the normal group， the TNBS model group presented increases in the colonic damage score， colon weight index， and disease activity index （P<0.01）. Compared with the TNBS model group， the low-dose Zhuyuwan group showcased declines in colon weight index （P<0.01） and disease activity index （P<0.05）， and the high-dose Zhuyuwan group showed reductions in the colon damage score， colon weight index， and disease activity index （P<0.01）. GC-MS metabolomics analysis combined with qRT-PCR demonstrated that Zhuyuwan had a similar inverse regulatory effect on arginine metabolism disruption in the above two disease models. ConclusionZhuyuwan exhibited definite therapeutic effects on both IC and UC， and the regulation of arginine biosynthesis pathway is the core mechanism for the treatment of both diseases by Zhuyuwan.

ObjectiveTo analyze the research situation， hotspots， and trend of the compatibility of bitter and pungent medicinals in traditional Chinese medicine by knowledge mapping and provide reference for the inheritance and clinical application of this theory. MethodsThe literature on the compatibility of bitter and pungent medicinals was retrieved from 6 databases， including China National Knowledge Infrastructure （CNKI）， VIP， Wanfang Data， SinoMed， Web of Science， and PubMed. The literature was searched with the keywords of bitter medicinals， pungent medicinals， compatibility， Banxia Xiexin decoction， Zhuyu pills， and Zuojin pills. The search time ranged from January 1， 1984 to August 10， 2024. NoteExpress 3.7 was used for literature screening， and CiteSpace 6.1.R2 was used to visualize the number of publications， authors， institutional cooperation network， and the co-occurrence， clustering， time line， and burst of keywords. ResultsA total of 628 Chinese articles and 151 English articles related to the compatibility of bitter and pungent medicinals were included， and the annual number of publications rose with fluctuations. WEI Wei was the core author of Chinses articles and SHEN Tao and ZHAO Yanling were the core authors of English articles. China Academy of Chinese Medical Sciences formed a close cooperative network with many research institutions at home and abroad. The high-frequency keywords included pungent dispersing and bitter descending， Coptidis Rhizoma， Euodiae Fructus， Banxia Xiexin decoction， Zuojin pills， compatibility， spleen and stomach diseases， and gut microbiota， which mainly involved common prescriptions， diseases responding specifically to traditional Chinese medicine， mechanism research and so on. The keyword bursts concentrated in famous doctors' experience， network Meta-analysis， inflammatory bowel disease， diabetes mellitus， intestinal microbiota， etc. The compatibility of bitter medicinals and pungent medicinals was widely used in clinical practice. Based on pungent dispersing and bitter descending， the middle energizer was regulated for treating spleen and stomach diseases and inflammatory bowel disease. Bitter and pungent medicinals descending the turbid were used to treat diabetes mellitus and hyperlipidemia by lowering blood glucose and lipid levels. The mild bitter and slightly pungent medicinals were used as supplements to treat depression and COVID-19 by regulating Qi movement. ConclusionIn the past 40 years， the number of publications on the compatibility of bitter and pungent medicinals has been increasing， and the research team has begun to take form. Clinically， the compatibility of bitter and pungent medicinals is the main treatment for spleen and stomach diseases and glycolipid metabolic diseases. At present， the modern scientific essence of the compatibility of bitter and pungent medicinals is mainly explained based on famous doctors' experience inheritance， network meta-analysis， and intestinal flora.