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.

BACKGROUND:Inhibitory control and drug craving are the core elements of evaluating drug withdrawal in methamphetamine addicts,which has attracted much attention in academic circles.As we all know,in order to achieve complete abstinence from drug addiction,the key is to restore the damaged inhibition and control function of drug addicts and effectively reduce the craving for drugs. OBJECTIVE:To systematically analyze the relationship between exercise and methamphetamine abstinence inhibitory control and drug craving,to find out an effective exercise intervention scheme that can promote methamphetamine abstinence,and to further explore the internal mechanism of exercise,in order to provide theoretical support and applied reference for the future use of exercise in drug withdrawal. METHODS:CNKI,WanFang,VIP,Web of Science,and PubMed databases were searched for relevant literature using the keywords of"exercise,physical activity,methamphetamine,inhibitory function,craving,addiction"in Chinese and"sport*,exercise,methamphetamine,drug craving,executive function,addiction"in English.According to the inclusion and exclusion criteria,86 documents were finally included for review. RESULTS AND CONCLUSION:In terms of inhibitory control in methamphetamine abstinent individuals,either acute and long-term moderate-intensity aerobic exercise or acute high-intensity interval training can significantly improve the inhibitory control capacity of methamphetamine abstinent individuals.For long-term aerobic exercise,aerobic group exercise or full-body comprehensive exercise is more effective.If the exercise format is power cycling,it is recommended to increase the frequency of exercise intervention.In terms of the drug craving intensity in methamphetamine abstinent individuals,acute moderate-intensity aerobic exercise and resistance training,as well as long-term moderate-intensity,high-intensity,or progressive load aerobic and resistance training,can effectively reduce the drug craving in methamphetamine abstinent individuals.Exercise exerts intrinsic regulatory effects on methamphetamine-mediated addiction.Exercise can influence the expression of tyrosine hydroxylase in the brain's ventral tegmental area,thereby stimulating the expression of dopamine receptor coupling proteins and promoting dopamine synthesis in the brain's reward regions,thereby compensating for dopamine depletion caused by methamphetamine addiction.Furthermore,exercise can also regulate protein kinase A inhibitors,affecting the protein kinase A signaling pathway mediated by dopamine D1 receptors,by inhibiting protein kinase A,thus affecting cAMP response element-binding protein and regulating methamphetamine addiction.Additionally,exercise can also,at the genetic level,affect the expression of the c-fos gene in the brain's nucleus accumbens region,activate a subset of glutamatergic neurons in this area,generate a rewarding effect,and thus improve methamphetamine addiction.Although current research has confirmed the relationship between exercise and methamphetamine addiction and has clarified the brain mechanisms underlying the effects of exercise,whether there are other brain regulatory pathways for the effects of exercise remains to be explored through more scientifically rigorous animal or human experiments,starting from the cellular or molecular level.

Objective To explore the relationship between serum soluble semaphorin 4D(sSema4D),CXC chemokine ligand 12(CXCL12)levels and left ventricular diastolic function in young and middle-aged patients with essential hypertension.Methods A total of 148 young and middle-aged patients with essential hyperten-sion admitted to a hospital from November 2020 to November 2022 were selected as the study subjects,and were grouped into left ventricular diastolic dysfunction group(n=41)and normal left ventricular diastolic function group(n=107)according to their left ventricular diastolic function.The serum levels of sSema4D and CXCL12 were detected by enzyme-linked immunosorbent assay.Pearson correlation analysis was applied to analyze the correlation between the serum levels of sSema4D and CXCL12 and the left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular septal thickness(IVST),left ventricular end-diastolic posterior wall thickness(LVPWT),left ventricular ejection fraction(LVEF),E peak/A peak(E/A)and maximum velocity of tricuspid regurgitation(TRVmax).The predictive value of ser-um sSema4D and CXCL12 levels in left ventricular diastolic dysfunction in young and middle-aged patients with essential hypertension was analyzed by receiver operating characteristic(ROC)curve.Results There were significant differences in diastolic blood pressure and gender between the left ventricular diastolic dys-function group and the left ventricular diastolic function normal group(P＜0.05).Compared with the normal left ventricular diastolic function group,serum levels of sSema4D,CXCL12 in the left ventricular diastolic dys-function group were obviously increased,and the difference was statistically significant(P＜0.05).Compared with normal left ventricular diastolic function group,IVST and LVPWT in the left ventricular diastolic dys-function group were significantly increased,and E/A was significantly decreased,with statistical significance(P＜0.05).Pearson correlation analysis showed that serum sSema4D and CXCL12 levels were positively cor-related with LVEDD,IVST and LVPWT(P＜0.05),and negatively correlated with E/A(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of serum sSema4D and CXCL12 combined in pre-dicting left ventricular diastolic dysfunction in young and middle-aged patients with essential hypertension was 0.894(95％CI:0.833-0.939),which was significantly greater than that of sSema4D alone in predicting left ventricular diastolic dysfunction in young and middle-aged patients with essential hypertension(Z=3.142,P=0.002)and CXCL12 alone predicted the AUC of left ventricular diastolic dysfunction in young and middle-aged patients with essential hypertension(Z=3.268,P=0.001).Conclusion Serum sSema4D and CXCL12 levels are associated with left ventricular diastolic function in young and middle-aged patients with essential hypertension.

Objective:To explore the clinical application value of DNA image cytometry ploidy analysis (DNA-ICM) in the pathological diagnosis of malignant pleural effusion.Methods:A retrospective case series study was conducted. The clinical data of 101 patients with pleural effusion from October to December 2021 in Shanxi Bethune Hospital were retrospectively analyzed. Liquid-based cytology (LBC) and DNA-ICM were performed on pleural effusion specimens. The sensitivity and specificity of the two methods were compared with the clinical diagnosis, imaging, biopsy, and follow-up results of the patients.Results:Among the pleural effusions of 101 patients, 39 were malignant pleural effusions and 62 were benign pleural effusions. The sensitivity of LBC and DNA-ICM in diagnosing malignant tumor cells in pleural effusions was 74.7% and 94.9%, respectively, and the specificity was 98.4% and 83.9%, respectively; the combination of the two had an increased diagnostic positivity rate compared with that of LBC alone [36.6% (37/101) vs. 28.7% (29/101)]. Seven cases with positive DNA-ICM but negative LBC result were followed up, and 1 case was diagnosed as small cell lung cancer. Conclusions:DNA-ICM can effectively improve the positive cytology detection rate of pleural effusion, and the combined detection of DNA-ICM and LBC can reduce the underdiagnosis rate of cytology, which is of great clinical value in the pathological diagnosis of malignant pleural effusion.

Gastrointestinal stromal tumors (GIST) are the most common mesenchymal-derived tumors of the gastrointestinal tract. Tyrosine kinase inhibitors (TKIs) are the cornerstone of GIST therapy, but mutations in resistance genes pose many problems for treatment, especially the heterogeneity of KIT resistance mutations. In recent years, with the release of a number of GIST related drug research and experimental results, the great potential of targeted therapy, immunotherapy and combination therapy to treat GIST in different directions has been revealed, providing more therapeutic directions for GIST. This article will review the experimental research and future direction in recent years.

This article is to illustrate the connection between neutrophil extracellular traps （NETs） and stasis-toxin interactions during the development of liver cancer， and to provide ideas for the prevention and treatment of liver cancer. It is believed that the mechanism of tumor-related thrombosis formation caused by NETs is closely related to "stasis" in traditional Chinese medicine （TCM）， and the continuous maintenance or enhancement of tumor microenvironment by NETs is closely related to "toxin" in TCM； the strong coagulation-promoting effect of NETs makes the local microenvironment， which can be regarded as the toxin caused by blood stasis； the changes of tumor microenvironment induced by NETs further induced platelet aggregation， which may present a state of stasis caused by toxin； the pathological changes of liver cancer caused by NETs can be regarded as the microscopic manifestation of the mechanism of stasis-toxin interaction of liver cancer.

Caprine enterovirus(CEV)is one of the most important infectious diarrheal diseases for goats.In order to understand the prevalence of CEV in different areas of Jiangsu province,410 goat fecal samples(212 diarrhea and 198 non-diarrhea samples)were collected from goat farms in 8 re-gions.127 CEV positive samples were detected by RT-PCR,and the positive rates varied greatly from 12.50％to 62.50％among different areas,with a total positive rate as 30.98％.Through the significance analysis of the positive rate of diarrhea and non-diarrhea samples,CEV was found to be one of the important pathogens causing diarrhea in goats.The results of homology and genetic evolution analysis for the 5'-UTR sequences showed that the EV-G5、G7、G21、G22 and G23 were epidemic types in Jiangsu province,and G21-G23 are new found CEV types.The homologies of 5'-UTR,VP1 and 2AB genes with the classical CEV strains in China were 78.6％-95.8％,56.9％-95.0％and 77.9％-98.4％,respectively.Of these sequences,the 5'-UTR and 2AB gene of HaiMen-SJH strain was significantly different from other sequences,and belonged to an independent branch in the genetic evolution trees.According to the results of epidemiological survey,the infection of CEV was widespread in most areas of Jiangsu province,and the epidemic types and situation varied in different areas.This study will enrich the epidemiological data of CEV in China,and provide the-oretical basis for the targeted prevention and control of new enterovirus infections in sheep.

Objective To investigate the effects of long-term exposure to three new types of light emitting diode (LED) sources on the behavior, learning, and memory of rats. Methods A total of 160 specific pathogen-free SD rats were divided into eight groups as followed, trichromatic fluorescent lamps color temperature control group, violet-chip full-spectrum white LED group, blue-chip white LED group, and blue-chip full-spectrum white LED group based on the light sources types, with color temperature of 4 000 K and 6 500 K groups in each group using the 4×2 factorial design. There were 20 rats in each group, with half of the rats were males and half females. Rats were exposed to artificial lighting, and the illumination was set at 750 lx. The rats in each group were exposed to different lighting environments for 12 hours per day for 24 weeks. The open-field and step-down tests were conducted in rats after 24 weeks exposure, followed by sacrifice of rats and measurement of organ coefficients. Differences in body weight, organ coefficients, and neurobehavioral indexes of rats in different groups were compared. Results The spleen coefficient of female rats decreased in blue-chip white LED of 6 500 K color temperature group, and the liver coefficient of male rats decreased in the violet-chip full-spectrum white LED of 4 000 K color temperature, blue-chip full-spectrum white LED of 4 000 K color temperature, and blue-chip full-spectrum white LED of 6 500 K color temperature groups, compared with the same-sex rats in trichromatic fluorescent lamps with same-color temperature control group (all P<0.05). The result of different types of light sources compared in the open-field test showed that the index of total distance and movement speed of female rats in the blue-chip full-spectrum white LED group were lower than those in the other three groups, and the time cost to the central area was longer than that in the blue-chip white LED group and the violet-chip full-spectrum white LED group (all P<0.05). The total distance and movement speed of male rats in the blue-chip full-spectrum white LED group were longer or higher than those in the violet-chip full-spectrum white LED group (all P<0.05). Based on the comparison of color temperature, the time and total distance of male rats in 6 500 K color temperature group were lower than that in the 4 000 K color temperature group (both P<0.05). In the step-down test, both male and female rats in the blue-chip full-spectrum white LED group made more errors compared with other three groups with the same gender (all P<0.05). Conclusion Based on the experimental conditions of this study, the blue-chip full-spectrum white light LED affects behavior, learning and memory of the rats, and trichromatic fluorescent lamp has the lowest effect on neurobehavior. The color temperature also affects behavior of the rats, and high color temperature has higher risk.

Objective:To explore the effects of low position lateral supramalleolar flap carrying periosteum and proximal leg propeller flap in relay repair of electric burn wounds of forefoot.Methods:A retrospective observational study was conducted. From January 2019 to January 2022, 12 patients with electric burn wounds of forefoot meeting the inclusion criteria were admitted to the Sixth Hospital of Shanxi Medical University, including 10 males and 2 females, aged 23-65 years. After debridement, the wound with an area of 6.0 cm×3.0 cm to 15.0 cm×7.0 cm was repaired with the lateral supramalleolar flap carrying part of the periosteum of the distal tibia and fibula with the rotation point moved down to the front of the ankle joint. The area of the cutted flap was 6.5 cm×3.5 cm-15.5 cm×7.5 cm. At the same stage, the donor site wound of lateral supramalleolar flap was repaired with peroneal artery or superficial peroneal artery perforator propeller flap in relay, with the relay flap area of 3.0 cm×1.5 cm-15.0 cm×4.0 cm. After operation, the survival of the lateral supramalleolar flap and relay flap, and the wound healing of the relay flap donor site were observed. During follow-up, the shapes of the lateral supramalleolar flap and its donor site were observed.Results:After operation, one patient developed secondary blisters in the superficial skin distal to the lateral supramalleolar flap, which healed after dressing change, and the lateral supramalleolar flap and relay flaps survived well in the other patients; the donor site wound of the relay flap healed well. During follow-up of 12-18 months, the lateral supramalleolar flaps were in good shape and not bloated, with only linear scar left in the donor site of the flap.Conclusions:The low position lateral supramalleolar flap carrying periosteum can repair electric burn wounds of forefoot with advantages including reliable blood supply, low rotation point, and better repair effects. The use of relay flap to repair the donor site of lateral supramalleolar flap can reduce the damage to the appearance and function of the donor site.

Objective:To investigate the biomechanical properties of anterior pelvic ring external fixators of two new configurations [iliac crest (IC)+anterior inferior iliac spine (AIIS), anterior superior iliac spine(ASIS)+AIIS] in the treatment of Tile type C1 pelvic fracture.Methods:A 3-dimensional finite element model of Tile type C1 pelvic ring injury (unilateral longitudinal sacral fracture and ipsilateral pubic fracture) was produced. The pelvis was fixed with external fixators of IC, AIIS, combination of IC and AIIS, combination of ASIS and AIIS, and S 1 sacroiliac screw in 5 types of models. In the simulated bipedal standing position and semi-recumbent position, the longitudinal displacement and back rotation angle displacement of the midpoint on the upper surface of S 1 were quantified and compared. Under the simulated left-right compression load state, the lateral displacements of the highest point of the lateral sacral fracture and the highest point of the lateral pubic fracture end were quantified and compared. Under the simulated anterior-posterior shear load state, the backward displacements of the highest point of the lateral sacral fracture end and the highest point of the lateral pubic fracture end were quantified and compared. Results:(1) In the simulated bipedal standing position under the vertical and longitudinal load state, the results of the longitudinal downward displacement of the midpoint on the upper surface of S 1 were consistent with the backward rotation angle displacement, and the order from largest to smallest was IC, AIIS, ASIS+AIIS, IC+AIIS and S 1 sacroiliac screw. The longitudinal downward displacement of IC was significantly larger than that of other models. The longitudinal downward displacement and backward rotation angle displacement of ASIS+AIIS and IC+AIIS were similar, and the latter was smaller. (2) In the simulated semi-recumbent position under the vertical and longitudinal load state, the results of the longitudinal downward displacement and backward rotation angle displacement of the midpoint on the upper surface of S 1 were also consistent, and the order from largest to smallest was IC, AIIS, ASIS+AIIS, IC+AIIS and S 1 sacroiliac screw. (3) Under the simulated left-right compression load state, the results of the lateral displacement of the highest point of the lateral sacral fracture end were consistent with that of the highest point of the lateral pubic fracture end, and the order from largest to smallest was S 1 sacroiliac screw, IC, AIIS, ASIS+AIIS and IC+AIIS. Among them, Among them, The lateral displacement of S 1 sacroiliac screw and IC was larger. The lateral displacement of ASIS+AIIS and IC+AIIS was similar, and the latter was smaller, significantly smaller than that of other models. (4) Under the simulated anterior-posterior shear load state, the results of the backward displacement of the highest point of the lateral sacral fracture end and the highest point of the lateral pubic fracture end were also consistent, and the order from largest to smallest was IC, AIIS, ASIS+AIIS, IC+AIIS and S 1 sacroiliac screw. Among them, the backward displacement of IC and AIIS was larger. The backward displacement of ASIS+AIIS and IC+AIIS was similar, and the latter was smaller. Conclusions:For type C1 pelvic fracture, the biomechanical stabilities of IC+AIIS and ASIS+AIIS are superior to those of IC or AIIS, with ASIS+AIIS being slightly inferior to IC+AIIS. Compared with S 1 sacroiliac screw, IC or AIIS, the lateral stabilities of IC+AIIS and ASIS+AIIS are particularly prominent. The two new external fixator configurations in this study are worthy of clinical application.