Refractory ulcers are common intractable clinical conditions with complex pathogenesis. Traditional Chinese medicine （TCM） attributes their pathogenesis to the "insufficiency of yang in transforming qi， and disorder of yin in forming substances". Professor Lu Jingen， building upon the theory of Gu's Surgery School， innovatively proposed the local qi （Juqi） theory， emphasizing that the dysfunction of local qi is a key pathological mechanism underlying refractory wound healing. This theory suggests that the fluctuation of local qi directly affects tissue repair ability： deficient yang leads to weak local qi movement， while imbalanced yin and fluids result in inadequate nourishment of local qi. Moreover， external pathogenic factors such as damp-heat， blood stasis and toxicity obstruct and block the flow of local qi， creating a vicious cycle of deficiency， stasis， and toxicity. The treatment should focus on regulating local qi. For internal treatment， the approach involves tonifying qi， warming yang， and resolving blood stasis to invigorate local qi， nourishing yin and blood to strengthen and moisten local qi， and expelling pathogenic factors while regulating qi and unblocking collaterals to restore the flow of local qi. For external treatment， the innovative development of local oxygen therapy as a "modern qi supplementation method" is introduced， with the research team also releasing the standardized procedure for local oxygen therapy for the first time.