The concept of syndrome differentiation and treatment is often misunderstood as "arbitrary empiricism" or dismissed as unjustifiable when judged by a single external indicator. To address it， this paper draws on hermeneutics， especially the idea that "tradition， understanding， and practice" are mutually generative， to elucidate the object levels， inferential pathways， and efficacy-based validation and correction mechanisms underlying this approach in the clinical process. It is argued that "syndrome" is not a substitute for a disease label or an isolated indicator， but rather a structured configuration of manifestations and an evolving trajectory of illness situated in a specific clinical context. The correlation of all four examinations and physician-patient dialogue form a reasoned chain for the selection of diagnoses， through which discrete signs and symptoms are organized into a syndrome judgment that can be articulated and debated. Therapeutic principles and prescriptions externalize clinical understanding and， through feedback from therapeutic effects， reflexively prompt re-differentiation， thereby forming a cyclical， self-corrective dynamic loop of "syndrome， treatment and effect". Accordingly， syndrome differentiation and treatment should not be regarded as a contingent accumulation of experience， but as a form of clinical rationality under multiple constraints， including classical methods， communal training， and clinical verification.

By reviewing the main perspectives in current scholarship on the characteristics of xiang （象） thinking， comparing their similarities and differences， this paper summarizes the features of xiang thinking as holism， functionality， and variability. Taking these three characteristics as the core and contrasting with conceptual thinking， it argues that under the influence of xiang thinking， traditional Chinese medicine （TCM） terminology shows three distinctive traits. Firstly， the unity of body and function， and the non-duality of dao （道） and its manifestations； Secondly， functionalization in referential use； Thirdly， a constructive， processual nature with inherent variability in reference. Based on this， this paper analyzes some contemporary misinterpretations of TCM terminology that detach from the subjectivity of xiang thinking， such as the conceptual thinking-influenced division and opposition of material qi and functional qi， and the reification of the functional zang-fu concepts. It is further proposed that， in the context of the linguistic turn in western philosophical studies emphasizing the subject's role in language construction， TCM terminology rooted in the xiang thinking realm of subject-object unity should uphold a culturally subjective stance and construct a knowledge system consistent with its own characteristics.

Objective To investigate the mechanism of benzyl isothiocyanate(BITC)combined with sorafenib(Sor)in the treatment of anaplastic thyroid cancer(ATC).Methods Two ATC cell lines,8505C and CAL-62,were treated with Sor at concentrations of 0,20,30,40,and 50 μmol/L.The cell survival rate was assessed using CCK-8 assay.The combined dose of BITC and Sor was determined by calculating combination index(CI).CAL-62 and 8505C cells were exposed to 10 μmol/L BITC(BITC group),10 μmol/L Sor(Sor group),or a combination of 10 μmol/L BITC and 10 μmol/L Sor(BITC+Sor group)for 24 hours.The control group was not treated.The effects of Sor and BITC on ATC cell viability were evaluated using the CCK-8 method.Apoptosis was analyzed via flow cytometry.Western blot assay was employed to detect the protein expression levels of LC3B Ⅱ,Beclin-1 and nuclear factor(NF)-κB.Real-time fluorescence quantitative PCR was used to quantify the mRNA levels of LC3B.Additionally,CAL-62 cells were subcutaneously injected into mice to establish tumor xenograft model.Mice were treated with BITC(100 mg/kg,intraperitoneal injection),Sor(30 mg/kg,intragastric administration)or a combination of BITC and Sor every other day for 21 days.Finally,the expression levels of LC3B Ⅱ,Beclin-1 and NF-κB in tumor tissue were analyzed by Western blot assay.Results Sor significantly inhibited the viability of CAL-62 and 8505C cells in a concentration-dependent manner.The combination index(CI)was 0.710 at BITC 10 μmol/L and Sor 10 μmol/L,indicating a moderate synergistic effect between the two drugs.In both 8505C and CAL-62 cells,compared with the control group,treatment with BITC or Sor resulted in the decreased cell viability,as well as reduced expression levels of Beclin-1 and NF-κB proteins(P＜0.05),and the apoptosis rate,LC3B mRNA and LC3B Ⅱ protein expression levels were significantly increased(P＜0.05).When BITC and Sor were combined,the cell viability,Beclin-1 and NF-κB protein expressions were further reduced compared to either drug alone,while the apoptosis rate,LC3B mRNA and LC3B Ⅱ protein expression levels were significantly elevated(P＜0.05).In the mouse xenograft tumor model,the BITC+Sor group exhibited increased LC3B Ⅱ expression,along with decreased Beclin-1 and NF-κB expression levels,tumor volume and tumor mass compared to the BITC or Sor groups(P＜0.05).Conclusion The combination of BITC and Sor can inhibit ATC cells through NF-κB pathway,induce autophagy and promote apoptosis in vitro and in vivo.

Objective:To investigate the inpact of thyroid cancer-derived cancer-associated fibroblasts(CAF) autophagy on papillary thyroid cancer(PTC).Methods:CAF and normal fibroblasts were isolated from cancerous and adjacent normal thyroid tissues from four PTC patients. Expressions of fibroblast activation protein(FAP) and α-smooth muscle actin in cells were assessed. Conditioned medium of CAF and normal fibroblasts were prepared and used to culture PTC cells. The effects of CAF and normal fibroblasts on survival, proliferation, migration, invasion and iodine uptake of PTC cells were evaluated through cell proliferation assay, cell scratch assay, cell invasion assay, and cell iodine uptake assay. The autophagy level of CAF was also evaluated. Autophagy inhibition and activation were used to regulate the autophagy of CAF, and then their effects on PTC cell proliferation, migration and invasion were further evaluated. The in vivo effect of CAF autophagy on PTC xenograft tumor growth was evaluated.Results:CAF exhibited higher FAP expression and basal autophagy levels. PTC cells co-cultured with CAF-conditioned media showed enhanced proliferation, migration, invasion, and reduced iodine uptake. Autophagy inhibition reduced these effects, while autophagy activation further promoted them. In vivo, inhibiting CAF autophagy suppressed tumor growth.Conclusions:CAF promotes PTC cell malignancy through autophagy activation, enhancing proliferation, migration, and invasion while reducing iodine uptake.

Objective To investigate the mechanism of benzyl isothiocyanate(BITC)combined with sorafenib(Sor)in the treatment of anaplastic thyroid cancer(ATC).Methods Two ATC cell lines,8505C and CAL-62,were treated with Sor at concentrations of 0,20,30,40,and 50 μmol/L.The cell survival rate was assessed using CCK-8 assay.The combined dose of BITC and Sor was determined by calculating combination index(CI).CAL-62 and 8505C cells were exposed to 10 μmol/L BITC(BITC group),10 μmol/L Sor(Sor group),or a combination of 10 μmol/L BITC and 10 μmol/L Sor(BITC+Sor group)for 24 hours.The control group was not treated.The effects of Sor and BITC on ATC cell viability were evaluated using the CCK-8 method.Apoptosis was analyzed via flow cytometry.Western blot assay was employed to detect the protein expression levels of LC3B Ⅱ,Beclin-1 and nuclear factor(NF)-κB.Real-time fluorescence quantitative PCR was used to quantify the mRNA levels of LC3B.Additionally,CAL-62 cells were subcutaneously injected into mice to establish tumor xenograft model.Mice were treated with BITC(100 mg/kg,intraperitoneal injection),Sor(30 mg/kg,intragastric administration)or a combination of BITC and Sor every other day for 21 days.Finally,the expression levels of LC3B Ⅱ,Beclin-1 and NF-κB in tumor tissue were analyzed by Western blot assay.Results Sor significantly inhibited the viability of CAL-62 and 8505C cells in a concentration-dependent manner.The combination index(CI)was 0.710 at BITC 10 μmol/L and Sor 10 μmol/L,indicating a moderate synergistic effect between the two drugs.In both 8505C and CAL-62 cells,compared with the control group,treatment with BITC or Sor resulted in the decreased cell viability,as well as reduced expression levels of Beclin-1 and NF-κB proteins(P＜0.05),and the apoptosis rate,LC3B mRNA and LC3B Ⅱ protein expression levels were significantly increased(P＜0.05).When BITC and Sor were combined,the cell viability,Beclin-1 and NF-κB protein expressions were further reduced compared to either drug alone,while the apoptosis rate,LC3B mRNA and LC3B Ⅱ protein expression levels were significantly elevated(P＜0.05).In the mouse xenograft tumor model,the BITC+Sor group exhibited increased LC3B Ⅱ expression,along with decreased Beclin-1 and NF-κB expression levels,tumor volume and tumor mass compared to the BITC or Sor groups(P＜0.05).Conclusion The combination of BITC and Sor can inhibit ATC cells through NF-κB pathway,induce autophagy and promote apoptosis in vitro and in vivo.

The form-qi-spirit life concept is the foundation of the theoretical system of traditional Chinese medicine(TCM).Ontologically,it defines the essential life substances that constitute the"human being,"exerting a profound influence on TCM health preservation and clinical practice.This study uses an integrated philological and phenomenological methodology grounded in classical texts such as the Inner Canon of Huangdi and Classic of Questioning.It systematically examines the epistemological basis of these core concepts.Form is apprehended through measurement,palpation,and dissection from the perspective of subject-object separation,and introspective realization from the perspective of subject-object unification.Qi is conceptualized through physicians' observations and abstractions of natural phenomena,as well as a profound examination of physiological and pathological manifestations.Spirit emerges from physicians' awareness and analysis of conscious activities amid the deconstruction of early deity worship.Form,qi,and spirit constitute the organic whole of human life,interconnected and mutually influential.This paper has stage-by-stage clarified the fundamental issue of"how to understand the form-qi-spirit life concept came into being."It contributes to consolidating the philosophical foundation of TCM theory and may provide a reference for related research.

The form-qi-spirit life concept is the foundation of the theoretical system of traditional Chinese medicine(TCM).Ontologically,it defines the essential life substances that constitute the"human being,"exerting a profound influence on TCM health preservation and clinical practice.This study uses an integrated philological and phenomenological methodology grounded in classical texts such as the Inner Canon of Huangdi and Classic of Questioning.It systematically examines the epistemological basis of these core concepts.Form is apprehended through measurement,palpation,and dissection from the perspective of subject-object separation,and introspective realization from the perspective of subject-object unification.Qi is conceptualized through physicians' observations and abstractions of natural phenomena,as well as a profound examination of physiological and pathological manifestations.Spirit emerges from physicians' awareness and analysis of conscious activities amid the deconstruction of early deity worship.Form,qi,and spirit constitute the organic whole of human life,interconnected and mutually influential.This paper has stage-by-stage clarified the fundamental issue of"how to understand the form-qi-spirit life concept came into being."It contributes to consolidating the philosophical foundation of TCM theory and may provide a reference for related research.

Objective:To investigate the inpact of thyroid cancer-derived cancer-associated fibroblasts(CAF) autophagy on papillary thyroid cancer(PTC).Methods:CAF and normal fibroblasts were isolated from cancerous and adjacent normal thyroid tissues from four PTC patients. Expressions of fibroblast activation protein(FAP) and α-smooth muscle actin in cells were assessed. Conditioned medium of CAF and normal fibroblasts were prepared and used to culture PTC cells. The effects of CAF and normal fibroblasts on survival, proliferation, migration, invasion and iodine uptake of PTC cells were evaluated through cell proliferation assay, cell scratch assay, cell invasion assay, and cell iodine uptake assay. The autophagy level of CAF was also evaluated. Autophagy inhibition and activation were used to regulate the autophagy of CAF, and then their effects on PTC cell proliferation, migration and invasion were further evaluated. The in vivo effect of CAF autophagy on PTC xenograft tumor growth was evaluated.Results:CAF exhibited higher FAP expression and basal autophagy levels. PTC cells co-cultured with CAF-conditioned media showed enhanced proliferation, migration, invasion, and reduced iodine uptake. Autophagy inhibition reduced these effects, while autophagy activation further promoted them. In vivo, inhibiting CAF autophagy suppressed tumor growth.Conclusions:CAF promotes PTC cell malignancy through autophagy activation, enhancing proliferation, migration, and invasion while reducing iodine uptake.

Post translational modifications(PTMs)can change the properties of a protein by covalent addition of functional groups to one or more amino acids,and influence almost all aspects of normal cell biology and pathogenesis.Lacty-lation is a novel identified PTM,and has been found in both histone and non-histone proteins.Since associated with the end product of glycolysis--lactate,lactylation modification could provide a new perspective for understanding the relationship be-tween metabolic reprogramming and epigenetic modifications.Accumulated evidences suggest that lactylation play important roles in tumor progression and links to poor prognosis in clinical studies.Histone lactylation can affect gene expression in tu-mor cells and immunological cells,further promoting tumor progression and immune suppression.Lactylation on non-histone proteins can also regulate tumor progression and drug resistance.In this review,we aimed to summarize the roles of lactylation in cancer progression,microenvironment interactions and immune suppression,try to identify new molecular targets for can-cer therapy and provide a new direction for combined targeted therapy and immunotherapy.

The concept of holographic law is widely reflected in the theory and clinical practice of traditional Chinese medicine （TCM）. From philosophical perspective， TCM encompasses rich holographic law concepts， such as the theory of qi as the fundamental essence， mutual rooting and mutual storage of yin and yang， and mutual storage and classifications of the five phases. Through philosophical exploration of holographic law in TCM， this paper aimed to elucidate the connection between holographic law and TCM， and analyze the value and limitations of holographic law in TCM. Future research on holographic law in TCM should not only philosophically scrutinize the relationship between the whole and its parts under the guidance of holographic law thinking， but also incorporate qualitative and quantitative studies by referring to modern disciplines such as anatomy， physiology， and pathology， in order to better understand and validate the holographic law concepts in TCM.