To explore the advantages of traditional Chinese medicine （TCM） and integrative TCM-Western medicine approaches in the treatment of diabetic microvascular complications （DMC）， refine key pathophysiological insights and treatment principles， and promote academic innovation and strategic research planning in the prevention and treatment of DMC. The 38th session of the Expert Salon on Diseases Responding Specifically to Traditional Chinese Medicine， hosted by the China Association of Chinese Medicine， was held in Beijing， 2024. Experts in TCM， Western medicine， and interdisciplinary fields convened to conduct a systematic discussion on the pathogenesis， diagnostic and treatment challenges， and mechanism research related to DMC， ultimately forming a consensus on key directions. Four major research recommendations were proposed. The first is addressing clinical bottlenecks in the prevention and control of DMC by optimizing TCM-based evidence evaluation systems. The second is refining TCM core pathogenesis across DMC stages and establishing corresponding "disease-pattern-time" framework. The third is innovating mechanism research strategies to facilitate a shift from holistic regulation to targeted intervention in TCM. The fourth is advancing interdisciplinary collaboration to enhance the role of TCM in new drug development， research prioritization， and guideline formulation. TCM and integrative approaches offer distinct advantages in managing DMC. With a focus on the diseases responding specifically to TCM， strengthening evidence-based support and mechanism interpretation and promoting the integration of clinical care and research innovation will provide strong momentum for the modernization of TCM and the advancement of national health strategies.

[This corrects the article DOI: 10.1016/j.apsb.2020.12.008.].

[This corrects the article DOI: 10.1016/j.apsb.2018.08.009.].

OBJECTIVE: To investigate the relationship between mean perfusion pressure (MPP) and the risk of sepsis-associated acute kidney injury (SA-AKI) and its prognosis, and to determine the optimal cut-off value of MPP for predicting SA-AKI. METHODS: A retrospective cohort study was conducted. The clinical data of adult patients with sepsis were collected from the Medical Information Mart for Intensive Care-IV 2.2 (MIMIC-IV 2.2) database. The patients were divided into two groups based on the occurrence of SA-AKI. Baseline characteristics, vital signs, comorbidities, laboratory indicators within 24 hours of intensive care unit (ICU) admission, and clinical outcome indicators were collected. Mean MPP was calculated using the average values of mean arterial pressure (MAP) and central venous pressure (CVP), MPP = MAP-CVP. Cox regression models were constructed, relevant confounding factors were adjusted, and multivariate Logistic regression analysis was used to investigate the associations between MPP and the risk of SA-AKI as well as ICU death. The predictive value of MPP for SA-AKI was evaluated using receiver operator characteristic curve (ROC curve) analysis, and the optimal cut-off value was determined. RESULTS: A total of 6 009 patients were ultimately enrolled in the analysis. Among them, SA-AKI occurred in 4 755 patients (79.13%), while 1 254 patients (20.87%) did not develop SA-AKI. Compared with the non-SA-AKI group, the MPP in the SA-AKI group was significantly lowered [mmHg (1 mmHg≈0.133 kPa): 62.00 (57.00, 68.00) vs. 65.00 (60.00, 70.00), P < 0.01], and the ICU mortality was significantly increased [11.82% (562/4 755) vs. 1.59% (20/1 254), P < 0.01]. Three Cox regression models were constructed: model 1 was unadjusted; model 2 was adjusted for gender, age, height, weight and race; model 3 was adjusted for gender, age, height, weight, race, heart rate, respiratory rate, body temperature, hemoglobin, platelet count, white blood cell count, anion gap, HCO₃^-, blood urea nitrogen, serum creatinine, Cl^-, Na⁺, K⁺, fibrinogen, international normalized ratio, blood lactic acid, pH value, arterial partial pressure of oxygen, arterial partial pressure of carbon dioxide, sequential organ failure assessment score, Charlson comorbidity index score, use of vasopressors, mechanical ventilation, and urine output. Multivariate Logistic regression analysis showed that when MPP was treated as a continuous variable, there was a negative correlation between MPP and the risk of SA-AKI in model 1 and model 2 [model 1: odds ratio (OR) = 0.967, 95% confidence interval (95%CI) was 0.961-0.974, P < 0.001; model 2: OR = 0.981, 95%CI was 0.974-0.988, P < 0.001], and also a negative correlation between MPP and the risk of ICU death (model 1: OR = 0.955, 95%CI was 0.945-0.965, P < 0.001; model 2: OR = 0.956, 95%CI was 0.946-0.966, P < 0.001). However, in model 3, there was no significant correlation between MPP and either SA-AKI risk or ICU death risk. when MPP was used as a multi-categorical variable, in model 1 and model 2, referring to MPP ≤ 58 mmHg, when 59 mmHg ≤ MPP ≤ 68 mmHg, as MPP increased, the risk of SA-AKI progressively decreased (OR value was 0.411-0.638, all P < 0.001), and the risk of ICU death also gradually decreased (OR value was 0.334-0.477, all P < 0.001). ROC curve showed that MPP had a certain predictive value for SA-AKI occurrence [area under the ROC curve (AUC) = 0.598, 95%CI was 0.404-0.746], and the optimal cut-off value was 60.5 mmHg. CONCLUSION MPP was significantly associated with the risk of SA-AKI, with an optimal cut-off value of 60.5 mmHg, and also demonstrated a significant correlation with the risk of ICU death.
Humans ; Acute Kidney Injury/physiopathology* ; Retrospective Studies ; Sepsis/physiopathology* ; Middle Aged ; Prognosis ; Male ; Female ; Aged ; Risk Factors ; Intensive Care Units ; Adult ; Logistic Models ; Proportional Hazards Models

The liver is the most common site of metastases from colorectal cancer,and its treatment is relatively difficult.Nowadays in China,selective internal radiotherapy(SIRT)with yttrium-90 microspheres for colorectal cancer liver metastasis(CRLM)has been employed in clinical practice.Although it has technical difficulties,this novel therapeutic mode of internal radiation therapy carries some unique advantages when compared with the traditional therapy.SIRT with yttrium-90 microspheres can effectively control the tumor progression and increase the volume of future liver remnant(FLR)for patients who are temporarily unable to receive surgical resection of the tumor,thus it can create conditions for subsequent R0 resection or radiation ablation.Combined with first-line and second-line chemotherapy,SIRT with yttrium-90 microspheres can improve the local regional response of liver metastases,thus providing patients with sufficient chemotherapy intervals.For patients whose chemotherapy failed and whose tumor is unresectable,SIRT with yttrium-90 microspheres can better control the tumor progression and prolong the survival of patients.SIRT with yttrium-90 microspheres combined with targeted therapy and immunotherapy also has broad application prospects.This paper aims to make a comprehensive review about the application and recent progress of yttrium-90 microspheres in treating CRLM.

Objective:To investigate effect of testosterone on polarization of M1 macrophages induced by lipopolysaccharide(LPS).Methods:CCK-8 method was used to detect effects of LPS and testosterone on RAW 264.7 cell viability.Morphological changes of cells were observed by optical microscope.mRNA expression levels of M1-type polarizing genes TNF-α,IL-1β and IL-6 in macro-phages were detected by qRT-PCR.Expression levels of M1-polarizing protein TNF-α and CD206 in macrophages were detected by immunofluorescence and Western blot.Secretion of inflammatory cytokines was detected by ELISA.Results:Testosterone could decrease mRNA expressions of TNF-α,IL-1β and IL-6 mRNA and protein expression of TNF-α.Finally,testosterone could decrease secretion of inflammation-related factors.Conclusion:Testosterone can inhibit LPS-induced transformation of macrophages to M1 polarization phenotype.

Objective: To assess the association between the metabolic score for insulin resistance index (METS-IR) and overactive bladder (OAB) in the US population，so as to explore the potential of METS-IR as a predictive tool for OAB risk and to provide insights for early screening and intervention strategies. Methods: Based on the data from the National Health and Nutrition Examination Survey (NHANES) 2005-2018，a cross-sectional design was employed，and multivariate logistic regression models were used to analyze the association between METS-IR and OAB. METS-IR was analyzed both as a continuous variable and categorized into quartiles. To further validate the association between METS-IR and OAB across diverse populations，subgroup analyses were conducted in participants stratified by clinical characteristics. Smooth curve fitting was employed to test the linearity of the METS-IR-OAB relationship. Results: Elevated METS-IR was associated with an increased risk of OAB (P<0.001)，and this positive correlation remained stable when METS-IR was categorized into quartiles (P<0.001). Subgroup analyses revealed that the association between METS-IR and OAB was more pronounced in females，participants younger than 55 years，and non-diabetic individuals (P<0.05). Furthermore，smooth curve fitting confirmed a linear positive correlation between METS-IR and OAB，with this linear relationship observed in both diabetic and non-diabetic groups. Conclusion: This study，based on the NHANES 2005-2018 database，found a linear positive correlation between METS-IR and OAB.

Objective:To determine the best scoring system for assessing the severity of perioperative aortic dissection.Methods:All data were obtained from the Medical Information Mart for Intensive Care-Ⅳ(MIMIC-Ⅳ) database in the United States. The predictive value of the Acute Physiology Score Ⅲ(APS Ⅲ), Oxford Acute Severity of Illness Score (OASIS), Sequential Organ Failure Assessment (SOFA), Simplified Acute Physiology Score Ⅱ(SAPS Ⅱ), and Charlson Comorbidity Index (CCI) scoring systems were evaluated using the receiver operating characteristic ( ROC) curve. The area under the curve ( AUC) was used to determine the best predictive score, and the ideal cutoff value of the score was calculated based on the Youden index. Patients were divided into high and low groups according to the cutoff value. The Kaplan- Meier curve was used to show the impact on the survival rate of patients with aortic dissection. Results:ROC curve analysis showed that APS Ⅲ( AUC: 0.803, 95% CI: 0.721-0.885) was superior to SAPS Ⅱ( AUC: 0.767, 95% CI: 0.654-0.880), OASIS( AUC: 0.760, 95% CI: 0.635-0.885), SOFA( AUC: 0.753, 95% CI: 0.649-0.857), and CCI( AUC: 0.670, 95% CI: 0.524-0.817) in assessing in-hospital mortality. Based on the ROC curve and the Youden index calculation, the ideal cutoff value of the APS Ⅲ score was 57.5. Kaplan- Meier survival analysis showed that patients in the high group of APS Ⅲ had a shorter 28-day survival time. Patients in the high group of APS Ⅲ had a higher incidence of postoperative complications, and correlation analysis showed that patients in the high group of APS Ⅲ had a longer hospital stay. Conclusion:The APS Ⅲ scoring system is more valuable in predicting the 28-day mortality and prognosis of patients with aortic dissection.

Objective:To investigate effect of testosterone on polarization of M1 macrophages induced by lipopolysaccharide(LPS).Methods:CCK-8 method was used to detect effects of LPS and testosterone on RAW 264.7 cell viability.Morphological changes of cells were observed by optical microscope.mRNA expression levels of M1-type polarizing genes TNF-α,IL-1β and IL-6 in macro-phages were detected by qRT-PCR.Expression levels of M1-polarizing protein TNF-α and CD206 in macrophages were detected by immunofluorescence and Western blot.Secretion of inflammatory cytokines was detected by ELISA.Results:Testosterone could decrease mRNA expressions of TNF-α,IL-1β and IL-6 mRNA and protein expression of TNF-α.Finally,testosterone could decrease secretion of inflammation-related factors.Conclusion:Testosterone can inhibit LPS-induced transformation of macrophages to M1 polarization phenotype.

Objective:To determine the best scoring system for assessing the severity of perioperative aortic dissection.Methods:All data were obtained from the Medical Information Mart for Intensive Care-Ⅳ(MIMIC-Ⅳ) database in the United States. The predictive value of the Acute Physiology Score Ⅲ(APS Ⅲ), Oxford Acute Severity of Illness Score (OASIS), Sequential Organ Failure Assessment (SOFA), Simplified Acute Physiology Score Ⅱ(SAPS Ⅱ), and Charlson Comorbidity Index (CCI) scoring systems were evaluated using the receiver operating characteristic ( ROC) curve. The area under the curve ( AUC) was used to determine the best predictive score, and the ideal cutoff value of the score was calculated based on the Youden index. Patients were divided into high and low groups according to the cutoff value. The Kaplan- Meier curve was used to show the impact on the survival rate of patients with aortic dissection. Results:ROC curve analysis showed that APS Ⅲ( AUC: 0.803, 95% CI: 0.721-0.885) was superior to SAPS Ⅱ( AUC: 0.767, 95% CI: 0.654-0.880), OASIS( AUC: 0.760, 95% CI: 0.635-0.885), SOFA( AUC: 0.753, 95% CI: 0.649-0.857), and CCI( AUC: 0.670, 95% CI: 0.524-0.817) in assessing in-hospital mortality. Based on the ROC curve and the Youden index calculation, the ideal cutoff value of the APS Ⅲ score was 57.5. Kaplan- Meier survival analysis showed that patients in the high group of APS Ⅲ had a shorter 28-day survival time. Patients in the high group of APS Ⅲ had a higher incidence of postoperative complications, and correlation analysis showed that patients in the high group of APS Ⅲ had a longer hospital stay. Conclusion:The APS Ⅲ scoring system is more valuable in predicting the 28-day mortality and prognosis of patients with aortic dissection.