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 prepare a progressive gradient-aperture scaffold composed of silk fibroin(SF)-chitosan(CS)-nano-hydroxyapatite(nHAp)for osteochondral repair.Method:The SF solution, CS solution and nHA suspension were mixed in vitro at equal proportions.The progressive gradient osteochondral(OC)scaffold-1(2%), scaffold-2(3%)and scaffold-3(4%)was respectively prepared by using centrifugation, vacuum freeze-drying, chemical cross-linking and three shaping steps.General conditions, porosity, hot water dissolution rate, water swelling rate, compression water swelling rate, water swelling rate after dissolution, mechanical properties, internal structure observation and pore size were measured.Rat bone marrow mesenchymal stem cells(BMSCs)were cultured and the scaffold extract was prepared.The effect of scaffold extract on the proliferation of BMSCs was detected by the cell counting kit-8(CCK-8)method.BMSCs were co-cultured with the scaffold, and the distribution and morphology of the cells around the scaffold were observed.Results:The structure of scaffold was regular in each group and the porosity was more than 80%.Along with the increase of the material concentration, the water swelling rate of the scaffold was decreased gradually( P<0.05). Compared with before compression, the water swelling rate of scaffold-1 was decreased after compression( P<0.05). There was no significant difference in the hot water dissolution rate among all groups( all P>0.05), and the complete dissolution of the scaffold-1, scaffold-2 and scaffold-3 in vitro required 65.9, 60.9, and 73.9weeks, respectively.The elastic modulus of scaffolds in above three groups were 0.0955, 0.1762 and 0.3468 MPa, respectively.The examination results of scanning electron microscope(SEM)showed that the internal structure of scaffold was honeycomb in each group, the pore shape was regular, which showed an inter-connected pore network.The pore distribution was gradually dense and the pore diameter gradually decreased from the cartilage side to the osteogenic side( P<0.05), and the nHAp content increased gradually.The scaffold extract had no obvious toxicity to the growth and proliferation of BMSCs in each group.After BMSCs were seeded on scaffolds and co-cultured for 5 days, the cells grew well without obvious cell death or morphological abnormalities. Conclusions:In this study, a progressive gradient pore size OC scaffold is successfully prepared with good physical properties and biocompatibility, which is expected to be a new bio-mimetic composite scaffold material for repairing OC defects.

Objective To study the clinical efficacy of Bushen Huoxue decoction in the treatment of varicocele infertility and its influence on epididymis function and sperm vitality. Methods A total of 98 patients with varicocele infertility who were treated in our hospital from August 2016 to July 2018 were selected. The patients were randomly divided into control group of 49 cases and study group of 49 cases. The patients in the control group were treated with Maizhiling plus Wuzi Yanzong pill; the patients in the study group were treated with Bushen Huoxue decoction. After 12 weeks of treatment, the clinical efficacy of the patients was evaluated. The semen quality (including semen volume, sperm density, sperm motility, forward-moving sperm), sex hormones, and seminal plasma neutral α-glucosidase in the two groups were compared before and after treatment. After the end of treatment, the patients were followed up for 3 months to observe the pregnancy of the patients' spouse. Results After treatment, the total effective rate of the study group was87.76％, and the total effective rate of the control group was 69.39％. The semen quality, sex hormone and neutral α-glucosidase levels in the study group were better than those in the control group (P<0.05). Conclusion Bushen Huoxue decoction has a significant clinical effect in treating varicocele infertility. It can improve the semen quality, improve testosterone level and seminal plasma neutral α-glucosidase level, and improve the fertility of patients with varicocele.It is worthy of clinical promotion.

Objective To investigate the influence of laparoscopic radical gastrectomy for gastric cancer or colon cancer on immune indices and micrometastasis.Methods According to the treatment method,80 cases of gastric cancer or colon cancer in the Second Hospital of Shanxi Medical University from May 2016 to May 2017 were divided into observation group and control group,with 40 cases in each group.The observation group was treated with laparoscopic radical gastrectomy for gastric cancer or colon cancer,and the control group was treated with open stomach cancer or colon cancer radical operation.The changes of immune indicators of peripheral blood and micrometastasis of peritoneal lavage fluid were compared between the two groups.Results Compared with the preoperative immune indicators in peripheral blood of the two groups of IgG [(8.1 ±2.6)g/L],IgA[(1.6 ±0.9)g/L],IgM[(0.8 ± 0.2)g/L],C3[(0.7 ±0.3)g/L]and C4[(0.2 ±0.1)g/L]levels were decreased at first and then increased,and at 7d after operation,the levels[(10.5 ±2.3)g/L,(2.4 ±0.5)g/L,(1.3 ±0.6)g/L,(1.2 ±0.4)g/L,(0.5 ± 0.2)g/L]were closed to the preoperative levels.The level of IL-10[(98.8 ±32.4)g/L]increased obviously first,and then gradually decreased.The differences of C3 and IL-10 in the two groups were statistically significant at different time points,between the two groups and between different points(F=3.6786,5.769,4.668,4.625,9.375,5.354,all P<0.05).The other indicators were only statistically different among different time points(F=3.578,4.137,3.966,all P <0.05).At the end of the surgery,the CEA and DDC of the two groups were significantly increased,and the CEA[(1165.2 ±386.5)ng/L vs.(1788.6 ±725.5)ng/L]and DDC[(102.5 ±36.5)ng/L vs.(150.5 ±57.2)ng/L] levels and added value in the observation group were significantly lower than those in the control group,the differences were statistically significant(t=6.543,5.669,5.712,4.935,all P<0.05).Conclusion Laparoscopic radical gastrectomy for gastric cancer or colon cancer can improve the immune indices of the patients and reduce the index of micrometastasis in the peritoneal lavage fluid.

Small RNAs(sRNAs) play a significant role in the regulation of bacterial growth.When sensing certain environmental cues such as fluctuation of nutrient concentration, temperature, pH, and osmolarity, sRNAs can influence the expression of target genes.The formation of biofilms is initiated by bacteria transitioning from the planktonic to the surface-associated mode of growth, which is a self-produced extracellular matrix composed of proteins, polysaccharides, and DNA.Recent evidences have shown that small RNA plays an important role in the regulation of bacterial biofilm formation.sRNAs have key roles in biofilm formation process by base pairing with target mRNAs or interaction with modulating proteins.This review discussed the regulation mechanism and pathway of sRNAs in bacterial biofilms formation, and summarized three classical regulatory models of sRNAs in bacterial biofilms formation, this review also gives the research status and development direction of sRNAs in bacterial biofilms formation.

Objective To evaluate the outcome and safety of endoscopic submucosal dissection (ESD) versus endoscopic mucosal resection (EMR) in the management of esophageal mucosal lesion.Methods The clinical data of 70 patients with esophageal mucosal lesion were analyzed.Twenty-five patients were treated by ESD (ESD group) and 45 patients were treated by EMR (EMR group).The enbloc resection rate,tissue healing resection rate,operation time,complication and recurrence rate were compared between two groups.Results The enbloc resection rate,tissue healing resection rate in ESD group were significantly higher than those in EMR group [60.0％(15/25) vs.48.9％(22/45),48.0％(12/25) vs.40.0％ (18/45)] (P ＜0.05).The local recurrence rate in ESD group was lower than that in EMR group [4.0％ (1/25) vs.20.0％ (9/45)] (P ＜ 0.05).The severe complication such as delayed hemorrhage,perforation,stenosis between two groups had no significant difference (P ＞ 0.05).The operation time in ESD group was (64.3 ±27.1) min,and significantly longer than that in EMR group [(27.6 ± 14.1) min] (P ＜0.05).Conclusions Compare with EMR,ESD has better enbloc resection rate,tissue healing resection rate,and lower recurrence rate.It is more safe and effective in the therapy of esophageal mucosal disease.

Objective:To explore the effect and mechanism of miRNA sponge on the epithelial-mesenchymal transition (EMT) of gastric carcinoma cell lines SGC7901. Methods:Synthetic ZEB2 3'UTR plasmid and siRNA targeting ZEB2 were transfected into the SGC7901 cell line by Lipofectamine 2000. Real-time quantitative polymerase chain reaction was performed to evaluate the expres-sion levels of miR-200a/b/c. Finally, the migratory, invasive, and proliferative activities of the gastric carcinoma cells in vitro were ana-lyzed by the scratch test, the Transwell cell invasion, and the cell cloning assay. The expression of the target protein was detected by Western blot. Results:Compared with the control group, the expressions of miR-200a/b/c significantly decreased, and their migration, invasion, and proliferation capabilities were considerably higher after they were transfected with ZEB2 3'UTR. Although the expres-sions of miR-200a/b/c significantly increased, the migratory, invasive, and proliferative activities of SGC7901 cells also degraded after they were transfected with siRNA targeting ZEB2. The expression of ZEB2 increased, and that of E-cadherin decreased at the protein level after they were transfected with ZEB2 3'UTR. The protein expression of Vimentin in SGC7901 cells significantly increased. The indicators show the opposite trend when cells were transfected with siZEB2, and the differences between the control and mutation groups were insignificant. Conclusion:ZEB2 3'UTR can regulate EMT course by regulating the miR-200a/b/c expression in gastric car-cinoma, consequently regulating the invasion and migration of carcinoma cells.

Objective To explore the effects of zinc finger E-box binding protein (ZEB)2 3′UTR gene transfection on proliferation, invasion and migration in human gastric epithelial cell line GES-1. Methods The synthetic ZEB2 3′UTR and miR-200b micmics were transfected into GES-1 cell line by lipofectamine 2000. We set up control grop, the mutation group and ZEB2 3′UTR group. Real-time quantitative PCR was performed to evaluate the expression levels of miR-200a/b/c and ZEB1/ZEB2 mRNAs after transfection.And then we set up control group, ZEB2 3′UTR group, ZEB2 3′UTR+negative control group and ZEB2 3′UTR+miR-200b micmics group. The protein expression levels of ZEB1, ZEB2, matrix metallopro-teinases (MMP) 2/9 and proliferating cell nuclear antigen (PCNA) were detected by Western blot assay. The invasion and mi-gration capability were analyzed by transwell assay and wound healing test. MTT assay was used to detect the proliferation ability. Results Compared with control group and mutation group, the expressions of miR-200a/b/c were significantly de-creased, especially for miR-200b. And the expressions of ZEB1/ZEB2 were significantly increased at both mRNA and pro-tein levels after transfected with the ZEB2 3′UTR, enhancing the capability of migration,invasion,and proliferation (P <0.05). Compared with ZEB2 3′UTR group, the capabilities of proliferation,invasion and migration were significantly lower in combined group. Conclusion ZEB2 3′UTR can increase the ability of cell proliferation, invasion and metastasis through regulating the levels of miR-200a/b/c, and then influence the regulation of transcription of the target gene, which could lead to malignant transformation of GES-1 cells.

OBJECTIVETo study the periodontal health status of Hui and Han adults in Ningxia Hui autonomous region, thus to provide scientific basis for the establishment of oral health care policies in this region.

METHODS2 628 adults in Ningxia Hui autonomous region were investigated in this study according to the criterion issued by World Health Organization on the basic methods of oral health investigation and China oral health third epidemiological survey protocol. The inspection item included gingival bleeding (bleeding on probing, BOP), dental calculus, probing depth (PD) and attachment loss (AL). SPSS 15.0 statistical software was applied to analyze the results.

RESULTS1) The positive rate of BOP sites, detection rate of calculus and PD were peaked in 36-45 and 46-59 years old, but in the > or = 60 age group rather lower. The prevalence of periodontitis and the percentage of AL > or = 4 mm sites were increased with the adults' age. 2) In addition to the percentage of AL > or = 4 mm sites, the differences of the other indicators between the genders were not statistically significant. 3) The positive rate of BOP sites, detection rate of calculus, PD, the prevalence of periodontitis and the percentage of AL > or = 4 mm sites were higher for the mountain areas than the plain areas. 4) Hui population's positive rate of BOP sites, detection rate of calculus, PD, the prevalence of periodontitis and the percentage of AL > or = 4 mm sites were significantly lower than the Han population in Ningxia.

CONCLUSIONThe periodontal health status of adults in Ningxia Hui autonomous region is associated with age, gender, nationality and region.