The purpose of this paper is to explore the decoction and dosing methods of rhubarb root and rhizome in classical prescriptions and to provide a reference basis for the clinical use of rhubarb root and rhizome. By collating the relevant classical prescriptions of rhubarb root and rhizome in Shanghan Lun and Jingui Yaolüe, the relationship between its decoction and dosing methods and the syndrome was analyzed. The decoction of rhubarb root and rhizome in classical prescriptions can be divided into three categories: simultaneous decoction, decoction later, and other methods (impregnation in Mafei decoction, decoction with water from the well spring first taken in the morning, and pills). If it enters the blood level or wants to slow down, rhubarb root and rhizome should be decocted at the same time with other drugs. If it enters the qi level and wants to speed up, rhubarb root and rhizome should be decocted later. If it wants to upwardly move, rhubarb root and rhizome should be immersed in Mafei decoction. If it wants to suppress liver yang, rhubarb root and rhizome should be decocted with water from the well spring first taken in the morning. If the disease is prolonged, rhubarb root and rhizome should be taken in pill form. The dosing methods of rhubarb root and rhizome can be divided into five categories: draught, twice, three times, before meals, and unspecified. For acute and serious illnesses with excess of pathogenic qi and adequate vital qi, we choose draught. For gastrointestinal diseases, we choose to take the medicine twice. For achieving a moderate and long-lasting effect, we choose to take the medicine three times. If the disease is located in the lower part of the heart and abdomen, we choose to take it before meals. The use of rhubarb root and rhizome in clinical practice requires the selection of the appropriate decoction and dosing methods according to the location of the disease, the severity of the disease, the patient′s constitution, and the condition after taking the medicine.

" Lijie and yellowish sweating" originates from the chapter on stroke and arthralgia diseases in Synopsis of Golden Chamber. Later generations typically interpret it as yellow fluid oozing from painful joints, a characteristic manifestation of arthralgia. In Western medicine, Lijie corresponds to diseases such as gouty arthritis, with its primary clinical manifestations being redness, swelling, heat, and painful joints, most often without yellow fluid discharge. Therefore, the interpretation of " Lijie and yellowish sweating" contradicts the clinical manifestations often observed in this disease. Thus, this article reinterprets the meaning of " Lijie and yellowish sweating" from the pathogenesis of " sweat exposure to water, as if water harms the heart" , combined with the viewpoints of other medical practitioners. Determining the meaning of " yellowish sweating" is crucial for understanding the pathogenesis of arthralgia and clarifying the relationship between arthralgia and yellowish sweating. ZHANG Zhongjing mentioned arthralgia and " yellowish sweating" together, not to differentiate between the two diseases but to emphasize the common pathogenesis of the two, namely, the cold and dampness injuring the heart, blood, and vessels. This paper proposes a new explanation of " Lijie and yellowish sweating" , which suggests that " yellowish sweating" is not confined to the joints but can be found all over the body. The pathogenesis of " Lijie and yellowish sweating" lies in the insufficiency of the liver and kidney and exogenous water dampness, leading to disharmony between nutrient qi and defensive qi and between yin and yang. Primary treatment should harmonize yingfen and weifen, as well as tonify and replenish the liver and kidney. The clinical selection of medicines can be considered Guizhi Decotion, a type of formula. The pathogenesis of " Lijie and yellowish sweating" is complex, and clinical treatment should be comprehensively considered to achieve the best therapeutic effect.

Traditional Chinese Medicine (TCM), as a treasure of the Chinese nation, plays a significant role in maintaining public health. In 2019, the Central Committee of the Communist Party of China and the State Council proposed for the first time the establishment of a TCM registration and evaluation evidence system that integrates TCM theory, "personal experience" and clinical trials (referred to as the "Three-in-One" System) to promote the inheritance and innovation of TCM. Subsequently, the National Medical Products Administration issued several guiding principles to advance the improvement and implementation of this system. Owing to the complexity of its implementation, there are still differing understandings within the TCM industry regarding the positioning of the "Three-in-One" Registration and Evaluation Evidence System, as well as the connotation and value orientation of the "personal experience." To address this, Academician WANG Qi, President of the TCM Association, China International Exchange and Promotion Association for Medical and Healthcare and TCM master, led a group of academicians, TCM masters, TCM pharmacology experts and clinical TCM experts to convene a "Seminar on Promoting the Implementation of the ′Three-in-One′ Registration and Evaluation Evidence System for Chinese Medicinals." Through extensive discussions, an expert consensus was formed, clarifying the different roles of the TCM theory, "personal experience" and clinical trials within the system. It was further emphasized that the "personal experience" is the core of this system, and its data should be derived from clinical practice scenarios. In the future, the improvement of this system will require collaborative efforts across multiple fields to promote the high-quality development of the Chinese medicinal industry.

This article summarized the experience of national TCM master Wang Qingguo in treating liver cirrhosis with triplet herbs.Professor Wang believes that the etiology and pathogenesis of liver cirrhosis are always based on the disorders of liver,spleen and kidney function,the dampness and heat retention is an important factor of the disease.When the disease enters the collaterals,blood stasis runs through the development of the disease,qi,blood and water are both pathological products and pathogenic factors.Therefore,supporting the healthy qi and eliminating pathogens,and treating both manifestation and root cause of disease are important treatment principles for liver cirrhosis.Professor Wang takes the whole as the main principle and selects triplet herbs that are suitable for the pathogenesis at different stages of disease development.He emphasizes the three methods of soothing the liver and promoting dampness,removing blood stasis and diuresis,and supporting the healthy qi and eliminating pathogens.He flexibly applies the treatment,and the clinical efficacy is remarkable.

The theory of "yang transforming qi and yin shaping up body" comes from Huangdi Neijing (Inner Canon of Yellow Emperor),which describes the basic form of human metabolism dominated by "yang transforming qi":the effect of " yang transforming qi" leads the energy metabolism of human body,while the effect of "yin shaping up body" leads the material metabolism. Metabolic syndrome is a clinical syndrome with metabolic disorders of protein,fat and carbohydrate. The theory of "yang transforming qi and yin shaping up body" has a strong guiding value for the pathogenesis analysis and clinical differentiation and treatment of metabolic syndrome. Yin and yang represent the two basic trends of the change and development of things,and the functions of "transforming qi" and "shaping up body" are the main manifestations of them in metabolism. From this perspective,this paper suggests that the key pathogenesis of metabolic syndrome should be "insufficiency of yang transforming qi and impairment of yin shaping up body" based on the mutual assistance of yin and yang. On this basis we take "coordinating yin-yang and promoting the reproduction of them" as the main directions of therapy,which provides a new idea for the treatment of metabolic syndrome.

Objective:To evaluate the effectiveness of Z-plasty combined with auricular cartilage grafting in the correction of cryptotia.Methods:A retrospective analysis was conducted on the clinical data of cryptotia patients who underwent Z-plasty combined with auricular cartilage grafting at the Department of Ear Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, from January 2020 to December 2023. The surgery consisted of five steps: design of the Z-plasty flap, harvesting of auricular cartilage from the conchal cavity, dissection and reshaping of the auricular cartilage, transplantation of auricular cartilage, and skin coverage with flap transfer. Early and late complications were recorded according to postoperative follow-up, and the external ear morphology was evaluated by both plastic surgeons and the patients’ guardians using a Likert 4-point scale (the higher the score, the better the auricular morphology). Normally distributed data were presented as Mean±SD.Results:A total of 32 patients were included in the study, comprising 23 males and 9 females, aged 5 to 14 years, with an average age of 7.3 years. Two children were lost to follow-up, and 30 completed long-term follow-up, with follow-up periods ranging from 6 to 24 months, averaging 9.3 months. Early complications included hematoma in 2 cases [6.3%(2/32)] and flap vascular compromise in 1 case[3.1%(1/32)]. Late complications primarily involved hypertrophic scars in 2 cases[6.7%(2/30)], with no recurrence of deformity. After the operation, the cranioauricular sulcus on the upper pole of the auricle were significantly deepened, and the patients could wear masks and glasses. The average score for the external ear morphology was 3.5±0.5 by plastic surgeons and 3.5±0.5 by patients.Conclusion:Z-plasty combined with auricular cartilage grafting provides satisfactory result in the correction of cryptotia, with few postoperative complications and high patient satisfaction, making it suitable for the treatment of cryptotia.

Objective:To evaluate the effectiveness of Z-plasty combined with auricular cartilage grafting in the correction of cryptotia.Methods:A retrospective analysis was conducted on the clinical data of cryptotia patients who underwent Z-plasty combined with auricular cartilage grafting at the Department of Ear Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, from January 2020 to December 2023. The surgery consisted of five steps: design of the Z-plasty flap, harvesting of auricular cartilage from the conchal cavity, dissection and reshaping of the auricular cartilage, transplantation of auricular cartilage, and skin coverage with flap transfer. Early and late complications were recorded according to postoperative follow-up, and the external ear morphology was evaluated by both plastic surgeons and the patients’ guardians using a Likert 4-point scale (the higher the score, the better the auricular morphology). Normally distributed data were presented as Mean±SD.Results:A total of 32 patients were included in the study, comprising 23 males and 9 females, aged 5 to 14 years, with an average age of 7.3 years. Two children were lost to follow-up, and 30 completed long-term follow-up, with follow-up periods ranging from 6 to 24 months, averaging 9.3 months. Early complications included hematoma in 2 cases [6.3%(2/32)] and flap vascular compromise in 1 case[3.1%(1/32)]. Late complications primarily involved hypertrophic scars in 2 cases[6.7%(2/30)], with no recurrence of deformity. After the operation, the cranioauricular sulcus on the upper pole of the auricle were significantly deepened, and the patients could wear masks and glasses. The average score for the external ear morphology was 3.5±0.5 by plastic surgeons and 3.5±0.5 by patients.Conclusion:Z-plasty combined with auricular cartilage grafting provides satisfactory result in the correction of cryptotia, with few postoperative complications and high patient satisfaction, making it suitable for the treatment of cryptotia.

Colorectal cancer is a common malignant tumor of the digestive system globally, with both its incidence and mortality rates increasing annually in China. In recent years, there has been exponential growth in technology based on artificial intelligence, leading to significant advancements in the field of medical imaging diagnosis. Particularly in the application of colonoscopy, CT and magnetic resonance imaging (MRI), artificial intelligence, leveraging its advanced image recognition and feature analysis capabilities, has provided new perspectives for the diagnosis of colorectal cancer, thereby driving the realization of precision medicine. Currently, various artificial intelligence algorithms are either under development or optimization, such as performance comparisons of various artificial intelligence-assisted systems, the collaborative application of multiple algorithms, and integration with other omics. Additionally, challenges persist in the integration difficulty, interpre-tability and credibility, as well as cost and resource limitations of AI in clinical practice, necessitating further standardization and improvement. The authors explore the current status and progress of artificial intelligence in endoscopic and imaging diagnosis of colorectal cancer from four aspects: colonoscopy, CT, MRI and other imaging examination for reference and reference by peers.

Objective:To investigate mechanisms of IL-17D on cytotoxic function of CD93+CTL in lung tumor microenviron-ment(TME)and promotion of Platycodon grandiflorum(PG).Methods:Lung of B16 melanoma model mice and control mice were treated with PG or IL-17D,and lung tumor clone formation was observed.IL-17D expression change in lung was detected by single cell sequencing,immunofluorescence staining and flow cytometry.Single cell sequencing and flow cytometry were used to detect CD93+CTL content,cytotoxic phenotype and functional factors changes,including CD107a,perforin,granzyme B,chemokine CCL2,CXCL9 and their ligand CCR2 and CXCR3.Western blot and RT-PCR were used to detect effect of Platycodonopsis saponin D on IL-17D and its transcriptional regulator NRF2 expressions in EL4 cells.Results:Pulmonary CD93+CTL highly expressed cytotoxic effectors such as perforin and CD107a and chemokine receptors CXCR3 and CCR2 than CD93-CTL,while there was no significant difference in secretion of granzyme B.In mouse lung tumor model,pulmonary IL-17D and CD93+CTL were significantly decreased(P<0.001);in tumor-bearing mice after IL-17D backfill assay,or after 10 days of treatment with PG,proportion and absolute number of IL-17D and CD93+CTL in lungs were significantly increased(P<0.05),and tumor clones were significantly reduced;meanwhile,tumor-local expressions of cytokines CCL2,CXCL9,which are related to recruitment and function of CD93+CTL,and IL-17D were significantly upregulated.Up-regulation of IL-17D and its transcriptional regulator NRF2 by PG was verified in vitro experiments on EL4 cell line by PD.Conclusion:Traditional Chinese medicine PG and its extracts can up-regulate expression of IL-17D in lungs,improve infiltration and cytotoxic function of CD93+CTL and antagonize malignant progression of lung tumors,this is an important phar-macological mechanism of PG in improving immune TME of tumors in lung.

Objective:To investigate the effect of ultra-early enteral nutrition (UEEN) support on the prognosis of young and middle-aged postoperative patients with cerebral hemorrhage.Methods:The clinical data of young and middle-aged patients (aged 18-59 years) admitted to Tianjin Fifth Central Hospital from January 2020 to June 2023 after surgery for intracerebral hemorrhage were retrospectively analyzed, and the general data, nutritional indexes, gastrointestinal complications, neurological function recovery and long-term prognosis of the patients were recorded. According to the time of initiation of enteral nutrition (EN) support, patients were divided into UEEN group (EN implementation within 12 hour after surgery) and early enteral nutrition (EEN) group (EN implementation within 24 to 48 hour after surgery). The differences of the above indexes between the two groups were analyzed and compared.Results:A total of 64 young and middle-aged postoperative patients with cerebral hemorrhage were enrolled, including 32 cases in the UEEN group and 32 cases in the EEN group. There were no significant differences in gender, age, proportion of hypertension and diabetes, Glasgow coma score (GCS) on admission and surgical methods between the two groups. In terms of nutritional indexes, serum total protein, albumin and hemoglobin levels of patients in both groups on day 7 after admission were lower than those on day 1, and higher than those on day 3, and the above indexes levels in UEEN group were significantly higher than those in EEN group on day 7 [total protein (g/L): 63.05±5.79 vs. 59.02±6.63, albumin (g/L): 40.40±5.26 vs. 37.66±4.63, hemoglobin (g/L): 133.33±12.58 vs. 123.80±22.12, all P < 0.05]. In terms of gastrointestinal complications, the incidence of stress ulcer in the UEEN group within 14 days after admission was significantly lower than that in the EEN group [12.5% (4/32) vs. 31.3% (10/32), P < 0.05], but there was no statistically significant difference in feeding intolerance symptoms between the two groups. In terms of neurological recovery and long-term prognosis, GCS scores and Barthel index scores of 14 days after admission were higher than those of 1 day after admission, but there was no statistical significance between the two groups. Six months after surgery, Glasgow outcome scale (GOS) and Barthel index score of the UEEN group were significantly higher than those of the EEN group (GOS score: 3.81±1.06 vs. 3.18±1.07, Barthel index score: 60.78±7.24 vs. 54.52±5.13, both P < 0.05). Conclusion:UEEN support can improve the nutritional level of young and middle-aged postoperative patients with cerebral hemorrhage, reduce the occurrence of postoperative gastrointestinal complications, promote the recovery of neurological function, and improve the long-term prognosis.