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.

Objective To investigate the impact of graft type on perioperative outcomes and long-term prognosis in patients undergoing surgical repair of post-myocardial infarction ventricular septal rupture (VSR) with concurrent coronary artery bypass grafting (CABG). Methods A retrospective analysis was conducted on clinical data from patients who underwent VSR repair and concurrent CABG at Fuwai Hospital between 2005 and 2022. Patients were divided into an arterial graft group and a saphenous vein graft (SVG)-only group based on the type of bypass grafts used. Clinical outcomes were compared between the two groups. Results A total of 92 patients were included, comprising 56 males and 36 females, with a mean age of (62.4±7.9) years. The arterial graft group consisted of 60 patients, and the SVG-only group consisted of 32 patients. There were no statistical differences between the two groups in age, gender, body mass index, past medical history, time interval from myocardial infarction to surgery, or culprit vessel distribution (P>0.05). A higher proportion of patients in the SVG-only group received preoperative intra-aortic balloon pump (IABP) support (56.3% vs. 35.0%, P=0.049). However, cardiopulmonary bypass time, aortic cross-clamp time, and early mortality rates were similar between the two groups (P>0.05). Follow-up data revealed no statistically significant differences in cumulative 10-year survival (82.8% vs. 80.0%, P=0.940) or freedom from major adverse cardiovascular and cerebrovascular events (49.6% vs. 58.6%, P=0.491) between the SVG-only and arterial graft groups. Furthermore, graft type did not significantly affect long-term mortality in patients with a culprit vessel in the left anterior descending artery or those with multivessel disease. Conclusion In patients undergoing delayed repair of VSR with concomitant CABG, the use of arterial or saphenous vein grafts does not significantly impact perioperative outcomes or long-term prognosis. Future research should further explore the benefits of different revascularization strategies to optimize treatment for this population.

BackgroundPersistent cognitive impairment is prevalent among patients with stable schizophrenia. While serum total bile acid （TBA） level in acute-phase patients are known to be associated with cognitive dysfunction， the relationship between serum TBA and multi-dimensional cognitive functions in stable phase patients remains unclear. ObjectiveTo investigate the correlation between serum TBA level and cognitive function in patients with stable schizophrenia， and to evaluate its predictive value for cognitive impairment， thereby providing a serological biomarker for the timely identification and objective assessment of cognitive dysfunction. MethodsA cross-sectional study was conducted on 137 inpatients with stable schizophrenia at The Fourth People's Hospital of Yancheng from March to December 2024. All participants met the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5）. Cognitive function was evaluated using the Chinese Brief Cognitive Test （C-BCT）， patients were categorized into four groups： normal cognition （n=28）， mild impairment （n=28）， moderate impairment （n=47）， and severe impairment （n=34）. Fasting venous blood samples were collected， and serum TBA level was quantified using an enzymatic cycle assay. Spearman correlation analysis was ultilized to determine the relationship between serum TBA level， overall cognitive function， and specific cognitive domains. Binary Logistic regression model was used （adjusting for covariates such as age， gender， and disease duration） to analyze the impact of serum TBA level on overall and individual cognitive functions. The predictive value of serum TBA level for overall cognitive impairment was evaluated using receiver operating characteristic （ROC） curve. ResultsSerum TBA levels differed significantly among the four groups （H=18.677， P<0.01）. Specifically， serum TBA levels in both the moderate and severe cognitive impairment groups were significantly higher than those in the normal cognitive group （adjusted P<0.01）. Serum TBA level was positively correlated with the severity grading of overall cognitive impairment （r_s=0.354， P<0.05）， and negatively correlated with T-scores on the trail making test （r_s=-0.328， P<0.05）， continuous performance test （r_s=-0.247， P<0.05）， digit span （r_s=-0.265， P<0.05）， and symbol coding （r_s=-0.221， P<0.05）. Binary Logistic regression analysis identified serum TBA level as an independent risk factor for overall cognitive impairment （OR=1.322， 95% CI： 1.021 - 1.713， P=0.034）， with a particularly robust predictive ability for impaired information processing speed （OR=1.325， 95% CI： 1.057 - 1.661， P=0.015）. The area under ROC curve （AUC） for serum TBA level in predicting overall cognitive impairment was 0.738， with a sensitivity of 60.61% and a specificity of 78.64%. ConclusionIn patients with stable schizophrenia， elevated serum TBA levels are associated with worse overall cognitive function， as well as deficits in information processing speed， attention， working memory， and executive function. Serum TBA serves as an independent risk factor and exhibits moderate predictive value for overall cognitive impairmen，particularly in the domain of information processing speed. ［Funded by Yancheng Municipal Health Commission Medical Research Project （number， YK2024141）］

Background Bufei Huoxue Capsule (BHC) has gradually been used in clinical practice to treat patients with pneumoconiosis in recent years. However, the comprehensive evaluation of its efficacy and safety is lacking. Objective To systematically assess the therapeutic potential of BHC for pneumoconiosis. Methods By searching 9 databases, e.g. China National Knowledge Infrastructure, Wanfang Database, VIP Chinese Science and Technology Journals Database, SinoMed, Yiigle, PubMed, Embase, Cochrane Library, and Web of Science, randomized controlled trials (RCTs) related to the use of BHC for the treatment of pneumoconiosis were identified. The search covered the period from the inception of these databases to August 31, 2025. This systematic review conformed to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) 2020. The included studies underwent quality appraisal by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Subgroup analysis and sensitivity analysis were applied to assess the robustness of results and explore the potential heterogeneity among the studies. Results A total of 19 RCTs were included and all were reported in Chinese. The therapy containing BHC showed a superior impact on forced expiratory volume in one second (FEV₁) (95%CI: 0.38, 0.66; I²=69%, P<0.05), FEV₁% (95%CI: 3.37, 5.72; I²=12%, P<0.05), forced vital capacity (FVC) (95%CI: 0.34, 0.45; I²=0%, P<0.05), FEV₁/FVC% (95%CI: 6.29, 10.35; I²=21%, P<0.05), 6-minute walking distance (6MWD) score (95%CI: 16.32, 27.64; I²=22%, P<0.05), St. George's Respiratory Questionnaire (SGRQ) score (95%CI: −1.47, −1.05; I²=13%, P<0.05), and total effective rate (95%CI: 2.71, 6.78; I²=0%, P<0.05) in patients with pneumoconiosis. In addition, BHC had less adverse reactions reported (95%CI: 0.69, 1.74; I²=0%, P=0.70). Conclusions Combined BHC therapy can significantly improve the lung function and the quality of life in patients with pneumoconiosis, with a good safety profile. However, high-quality RCTs with multicenter, large-sample, double-blind, and standardized protocols still need to be conducted in the future to provide more reliable evidence.

Purpose: Erectile dysfunction (ED) is a common male sexual dysfunction. Gut microbiota plays an important role in various diseases. To investigate the effects and mechanisms of intestinal flora dysregulation induced by high-fat diet (HFD) on erectile function. Materials and Methods: Male Sprague–Dawley rats aged 8 weeks were randomly divided into the normal diet (ND) and HFD groups. After 24 weeks, a measurement of erectile function was performed. We performed 16S rRNA sequencing of stool samples. Then, we established fecal microbiota transplantation (FMT) rat models by transplanting fecal microbiota from rats of ND group and HFD group to two new groups of rats respectively. After 24 weeks, erectile function of the rats was evaluated and 16S rRNA sequencing was performed, and serum samples were collected for the untargeted metabolomics detection. Results: The erectile function of rats and the species diversity of intestinal microbiota in the HFD group was significantly lower, and the characteristics of the intestinal microbiota community structure were also significantly different between the two groups. The erectile function of rats in the HFD-FMT group was significantly lower than that of rats in the ND-FMT group. The characteristics of the intestinal microbiota community structure were significantly different. In the HFD-FMT group, 27 metabolites were significantly different and they were mainly involved in the several inflammation-related pathways. Conclusions Intestinal microbiota disorders induced by HFD can damage the intestinal barrier of rats, change the serum metabolic profile, induce low-grade inflammation and apoptosis in the corpus cavernosum of the penis, and lead to ED.

Colorectal inflammatory cancer transformation poses a major risk to patients with colitis.Patients with chronic intestinal inflammation have an approximately 2-3 fold increased risk of developing colorectal cancer(CRC).Unfortunately,there is currently no effective intervention available.Huangqin decoction(HQD),a well-known traditional Chinese medicine(TCM)formula,is frequently clinically prescribed for treating patients with colitis,and its active ingredients have effective antitumour efficacy.Nonetheless,the mechanism of HQD-mediated prevention of colorectal inflammatory cancer transformation remains unclear.A strategy integrating metagenomic,lipidomic,and messenger RNA(mRNA)sequencing analysis was used to investigate the regulatory effects of HQD on the gut microbiome,metabolism and potential mechanisms involved in colorectal inflammatory cancer transformation.Our study revealed that HQD suppressed colorectal inflammatory cancer transformation,which was associated with enhanced in-testinal barrier function,decreased the inflammatory response,and regulation of the gut microbiome.Notably,cohousing experiments revealed that the transfer of the gut microbiome from HQD-treated mice largely inhibited the pathological transformation of colitis.Moreover,gut microbiome transfer from HQD-treated mice primarily resulted in the altered regulation of fatty acid metabolism,especially the remodeling of arachidonic acid metabolism,which was associated with the amelioration of pathological transformation.Arachidonic acid metabolism and the key metabolic enzyme arachidonic acid 12-lipoxygenase(ALOX12)were affected by HQD treatment,and no obvious protective effect of HQD was observed in Alox12-/-mice,which revealed that ALOX12 was a critical mediator of HQD protection against colorectal inflammatory cancer transformation.In summary,multiple omics analyses were applied to produce valuable data and theoretical support for the application of HQD as a promising intervention for the transformation of inflammatory CRC.

Objective To observe the effectiveness and safety of DiaSphere embolized microsphere TACE for treating primary hepatocellular carcinoma(HCC).Methods Totally 188 patients with HCC were prospectively enrolled and randomly assigned to research group(n=93)and control group(n=95),who underwent TACE with DiaSphere embolized microspheres and Embosphere embolized microspheres,respectively.The incidence of TACE-related adverse events were recorded.The therapeutic efficacy 1 month after the first TACE,also 1 and 3 months after the last TACE,and liver functions 1 month after the first and last TACE were compared between groups.Results In research group,there were 69 cases underwent 1 time TACE,22 cases underwent 2 times and 2 cases underwent 3 times TACE,while in control group,there were 82 cases underwent 1 time and 13 cases underwent 2 times TACE,respectively.No statistical difference of the incidence of adverse events was found between groups(77.42%[72/93]vs.76.84%[73/95],P=1.000).One month after the first TACE,7 cases in research group and 11 cases in control group were lost to follow-up,respectively.One month after the last TACE,12 cases were lost to follow-up in both groups,and 3 months after the last TACE,28 cases were lost to follow-up in both groups.No significant difference of objective response rate nor disease control rate was found between groups at the above time points(all P＞0.05).One month after the first and last TACE,liver function indicators were not different between groups(all P＞0.05).Conclusion Both the short-term efficacy and safety of TACE with DiaSphere embolized microspheres for treating HCC were good.

Objective:To prepare mesothelin-loaded paclitaxel (PTX) phase change nanoparticles and evaluate their targeting effect and therapeutic effect on ovarian cancer.Methods:PTX-loaded phase-change nanoparticles PTX-NPs were prepared by the thin-film hydration method, and targeted mesothelin-loaded PTX phase-change nanoparticles Ab-PTX-NPs were prepared by attaching anti-mesothelin antibody to the nanoparticles using the biotin-affinity method. Zeta potential and particle size were determined by applying a zeta potential and a particle size analyzer, and the encapsulation rate and the amount of drug loading of PTX was measured by applying a UV spectrophotometer. Flow cytometry was used to detect the connectivity of anti-mesothelin antibody with PTX-NPs. The phase transition of Ab-PTX-NPs was induced by low-power focused ultrasound, and its ultrasonography imaging was observed; laser scanning confocal microscopy and flow cytometry were used to detect the targeting ability of Ab-PTX-NPs on ovarian cancer SKOV3 cells. The targeting and killing ability of Ab-PTX-NPs on ovarian cancer SKOV3 cells was observed by in vitro targeting assay and apoptosis detection assay. The ovarian cancer model of BALB/c nude mice was constructed to observe the distribution of Ab-PTX-NPs in vivo as well as the effects on blood biochemistry and important organs of nude mice. Results:Ab-PTX-NPs were successfully prepared with a zeta potential of -(8.37±2.71) mV, a diameter of (690.46±28.75) nm, an encapsulation rate of (88.2±4.4)% for PTX, a drug loading capacity of (27.3±0.9)%, and a linkage rate of (94.9±2.8)% between anti-mesothelin antibody and PTX-NPs. Low-intensity focused ultrasound could successfully induce phase transition of Ab-PTX-NPs to realize ultrasonography imaging, and 6 W was the optimal excitation power for low-intensity focused ultrasound. Ab-PTX-NPs showed excellent targeting and killing ability to SKOV3 cells, and the apoptosis and necrosis rate of SKOV3 cells in the Ab-PTX-NPs group reached 79.6%. In vivo imaging showed that the fluorescence intensity at the tumor site of nude mice in the Ab-PTX-NPs group was significantly higher than that in the PTX-NPs group. Biosafety assay showed that 15 d after Ab-PTX-NPs administration, the serum aspartate aminotransferase, alanine aminotransferase, creatine kinase, low-density lipoprotein, blood creatinine, and urea nitrogen concentrations of nude mice were (174.163±20.596)U/L, (33.297±2.573)U/L, (1 959.978±72.212)U/L, (22.033±5.030)μmol/L, (0.393±0.058)mmol/L, and (26.405±4.957)mmol/L, which were not significantly different from those of the phosphate buffer solution (PBS) group, the NPs group, and the PTX-NPs group. The organs such as the heart, the liver, the spleen, the lungs and the kidneys remained intact, and what was seen by the naked eye and microscope was similar with those of the PBS group, NPs group and PTX-NPs group. Conclusion:Ab-PTX-NPs were successfully prepared, which had good ovarian cancer targeting ability and killing effect and effectively reduced the toxicity of PTX.

Objective:To investigate the preferences and influencing factors of Traditional Chinese Medicine(TCM)health management services among community healthcare workers,providing a reference for promoting and spreading TCM health management services in communities.Methods:Based on a discrete choice experiment,a questionnaire survey was conducted among 596 community healthcare workers across 9 administrative districts in Beijing.A mixed logit model was used to analyze their preferences.Results:Changes in post-tax monthly income,expected efficacy,single-service duration,technical difficulty,patient compliance,and insurance coverage significantly influenced community doctors'service preferences.Changes in post-tax monthly income had the highest relative importance(35.11%),followed by insurance coverage(34.87%).Preferences varied among healthcare workers with different professional titles,backgrounds,weekly working hours,and whether the service was included in performance evaluations.Conclusion:Both economic and non-economic factors influence community healthcare workers'service preferences to varying degrees.Optimizing the combination of TCM health management service attributes can enhance community healthcare workers'willingness to provide such services.It is recommended to use a combination of economic and non-economic incentive measures and develop differentiated strategies for healthcare workers with different characteristics to meet their service preferences and promote the development of TCM health management services in communities.

The 69-year-old male patient developed new-onset atrial fibrillation(AF)2 days after coronary artery bypass grafting(CABG),and it recurred 2 days later.The clinical pharmacist reviewed domestic and international literature,taking into account the patient's medical history,age,and symptoms,and after assessing the risks of thrombosis and bleeding,recommended a triple antithrombotic therapy with rivaroxaban,aspirin,and ticagrelor,which the physician accepted.During hospitalization,the patient maintained sinus rhythm(70-100 beats/min)without bleeding complications.When the patient was discharged,considering that prolonged triple antithrombotic therapy could increase the risk of bleeding and that related coagulation parameters could not be monitored outside the hospital,the clinical pharmacist recommended discontinuing ticagrelor and continuing antithrombotic therapy with aspirin and rivaroxaban.The patient was instructed to follow up one month after surgery for re-evaluation and adjustment of the antithrombotic treatment,which was adopted by the physician.Clinical pharmacists assisted physicians in developing individualized antithrombotic treatment plans for patients and provided pharmaceutical care to the patients'treatment process,which effectively controlled the condition and ensured that the patients'medication was safe and effective.This case could provide a reference for the management of antithrombotic therapy in patients with new-onset AF after CABG.