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 explore the value of MRI subtraction technique(ST)for evaluating the efficacy of systemic therapy for advanced hepatocellular carcinoma(HCC)and predicting prognosis after combining with surgery.Methods Totally 35 patients with 39 HCC lesions who received systemic therapy+radical resection were retrospectively collected.Based on preoperative MRI,tumor activity ratio(recorded as tumor activityST)was obtained with ST,while tumor activity value(recorded as tumor activitypathology)was obtained through postoperative pathology,and their correlation was analyzed.The patients were regularly followed up after surgery,and the survival data were recorded.Receiver operating characteristic(ROC)curve was drawn to evaluate the efficacy of tumor activityST for predicting patients'survival status.Then the patients were divided into survival benefit group and no survival benefit group according to the cut-off value,and survival analysis was conducted.Results Tumor activityST was positively correlated with tumor activitypathology(r=0.900,P＜0.001).The median follow-up time was 32.93 months,during which 8 patients died,and the median survival time was 29.9 months.The area under the curve(AUC)of tumor activityST for predicting patients'survival status was 0.67,and the cut-off value was 0.36.Thirty patients with tumor activityST＜0.36 were enrolled in survival benefit group,while 5 patients≥0.36 were collected in no survival benefit group.The overall survival in survival benefit group was longer than that in no survival benefit group(P＜0.001).Conclusion MRI ST could be used to non-invasively evaluate the efficacy of systemic therapy for advanced HCC and predict prognosis after combining with surgery.

Objective To explore the value of MRI subtraction technique(ST)for evaluating the efficacy of systemic therapy for advanced hepatocellular carcinoma(HCC)and predicting prognosis after combining with surgery.Methods Totally 35 patients with 39 HCC lesions who received systemic therapy+radical resection were retrospectively collected.Based on preoperative MRI,tumor activity ratio(recorded as tumor activityST)was obtained with ST,while tumor activity value(recorded as tumor activitypathology)was obtained through postoperative pathology,and their correlation was analyzed.The patients were regularly followed up after surgery,and the survival data were recorded.Receiver operating characteristic(ROC)curve was drawn to evaluate the efficacy of tumor activityST for predicting patients'survival status.Then the patients were divided into survival benefit group and no survival benefit group according to the cut-off value,and survival analysis was conducted.Results Tumor activityST was positively correlated with tumor activitypathology(r=0.900,P＜0.001).The median follow-up time was 32.93 months,during which 8 patients died,and the median survival time was 29.9 months.The area under the curve(AUC)of tumor activityST for predicting patients'survival status was 0.67,and the cut-off value was 0.36.Thirty patients with tumor activityST＜0.36 were enrolled in survival benefit group,while 5 patients≥0.36 were collected in no survival benefit group.The overall survival in survival benefit group was longer than that in no survival benefit group(P＜0.001).Conclusion MRI ST could be used to non-invasively evaluate the efficacy of systemic therapy for advanced HCC and predict prognosis after combining with surgery.

Objective:To report the clinical, imaging, and pathological features of a case of MYH7 gene-related scapuloperoneal myosin storage myopathy. Methods:Clinical data were collected from a patient with MYH7 gene-related scapuloperoneal myosin storage myopathy who presented to Peking University First Hospital in February 2025. The patient was evaluated with muscle magnetic resonance imaging, muscle biopsy, and whole-exome sequencing. Results:The patient was a 52-year-old female, with a 12-year history of progressive difficulty in foot dorsiflexion, exercise-induced fatigue, and lower limb pain. Over the past 3 years, she developed proximal upper limb weakness and post-exertional myalgia. Physical examination revealed scapuloperoneal weakness distribution accompanied by sensorineural hearing loss. Electromyography demonstrated myogenic changes in the deltoid and tibialis anterior muscles. Serum creatine kinase levels were within normal limits. Lower limb magnetic resonance imaging showed mild atrophy of the thigh muscles and significant fatty infiltration in the tibialis anterior, extensor hallucis longus, and extensor digitorum longus. Tibialis anterior muscle biopsy revealed dystrophic-like changes with sub-sarcolemmal hyaline bodies containing abundant granulofilamentous material. Whole exome sequencing identified a heterozygous pathogenic variant of c.5352_5354del(p.K1784del) in the MYH7 gene. Conclusions:This patient is the first reported one in China with MYH7 gene-related scapuloperoneal myosin storage myopathy, exhibiting characteristic scapuloperoneal weakness, selective fatty infiltration of the anterior lower leg muscles on imaging and sub-sarcolemmal hyaline body pathological changes. The diagnosis of this disease relies on characteristic pathological findings and genetic test results.

OBJCTIVE To evaluate the therapeutic efficacy of intranasal administration of pirfeni-done in treating paraquat-induced pulmonary fibrosis in mice across treatment durations.METHODS Eight-week-old male C57BL/6 mice were randomly divided into six groups(n=8 per group):the normal control group(saline),pirfenidone control group,paraquat group,and three treatment groups receiving a combination of paraquat and pirfenidone for 15,10 and 5 d,respectively.Except the normal and pirfeni-done control groups,all the mice received intraperitoneal injection of paraquat(35 mg·kg-1)to induce pulmonary fibrosis.In the treatment groups,pirfenidone(20 mg·kg-1)was delivered intranasally once daily,beginning on days 1,6,and 11 post-paraquat exposure,until day 15.Fifteen days after paraquat exposure,pulmonary function tests,micro-CT imaging,and arterial blood gas analysis were performed.Histopathological changes and collagen fiber deposition in lung tissues were examined using HE and Masson staining respectively.The protein expression levels of fibrosis markers,including fibronectin(FN),collagen typeⅠ(CollⅠ),E-cadherin(E-cad),vimentin(Vim),and α-smooth muscle actin(α-SMA),were detected by Western blotting.Additionally,inflammatory and pro-fibrotic cytokines,such as tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),IL-8,IL-1β,and connective tissue growth factor(CTGF),were quantified using ELISA.RESULTS Compared with the normal control group,mice treated with paraquat exhibited significant respiratory alterations,including prolonged expiratory time(TE),increased enhanced pause(PENH),and reduced tidal volume(TV).CT imaging revealed reticular high-density shadows and ground-glass opacities in paraquat-treated mice.Blood gas analysis showed reduced partial pressure of oxygen(PaO2),oxygen saturation of blood(SaO2),fractional oxygen saturation of hemoglobin(FO2 Hb),and central venous oxygen saturation(ScvO2),along with increased partial pressure of carbon dioxide(PaCO2)and fractional deoxyhemoglobin saturation(FHHb),indicating that mice exposed to para-quat exhibited severe hypoxemia and hypercapnia.Histological evaluation highlighted pronounced lung interstitial thickening,alveolar collapse,inflammatory infiltration,and extensive fibrotic changes marked by collagen accumulation.Furthermore,exposure to paraquat significantly increased the protein levels of FN,CollⅠ,vimentin,and α-SMA,markedly reduced E-cadherin levels and elevated the levels of inflam-matory cytokines(TNF-α,IL-6,IL-8 and IL-1β)as well as the pro-fibrotic cytokine CTGF.Pirfenidone treat-ment demonstrated time-dependent efficacy,with the 15 d group showing the most significant improvements in pulmonary function as evidenced by reduced PENH levels and increased TV,EV and MV.CT imaging revealed a decrease in high-density opacities and improved lung transparency after pirfenidone treatment.In addition,arterial blood gas measurements indicated markedly elevated levels of PaO2,SaO2 and FO2 Hb.Histological analysis showed that pirfenidone alleviated lung interstitial thick-ening,reduced inflammatory cell infiltration,and decreased collagen deposition.At the molecular level,pirfenidone significantly reduced the protein expressions of FN,CollⅠ,Vim and α-SMA,while increasing E-cad levels.Furthermore,inflammatory cytokines,particularly IL-6 and IL-1β,were notably suppressed following pirfenidone intervention.CONCLUSION Intranasal administration of pirfenidone can exhibit potent time-dependent anti-fibrotic efficacy in paraquat-induced pulmonary fibrosis,with early interven-tions delivering the most substantial therapeutic benefits.

OBJCTIVE To evaluate the therapeutic efficacy of intranasal administration of pirfeni-done in treating paraquat-induced pulmonary fibrosis in mice across treatment durations.METHODS Eight-week-old male C57BL/6 mice were randomly divided into six groups(n=8 per group):the normal control group(saline),pirfenidone control group,paraquat group,and three treatment groups receiving a combination of paraquat and pirfenidone for 15,10 and 5 d,respectively.Except the normal and pirfeni-done control groups,all the mice received intraperitoneal injection of paraquat(35 mg·kg-1)to induce pulmonary fibrosis.In the treatment groups,pirfenidone(20 mg·kg-1)was delivered intranasally once daily,beginning on days 1,6,and 11 post-paraquat exposure,until day 15.Fifteen days after paraquat exposure,pulmonary function tests,micro-CT imaging,and arterial blood gas analysis were performed.Histopathological changes and collagen fiber deposition in lung tissues were examined using HE and Masson staining respectively.The protein expression levels of fibrosis markers,including fibronectin(FN),collagen typeⅠ(CollⅠ),E-cadherin(E-cad),vimentin(Vim),and α-smooth muscle actin(α-SMA),were detected by Western blotting.Additionally,inflammatory and pro-fibrotic cytokines,such as tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),IL-8,IL-1β,and connective tissue growth factor(CTGF),were quantified using ELISA.RESULTS Compared with the normal control group,mice treated with paraquat exhibited significant respiratory alterations,including prolonged expiratory time(TE),increased enhanced pause(PENH),and reduced tidal volume(TV).CT imaging revealed reticular high-density shadows and ground-glass opacities in paraquat-treated mice.Blood gas analysis showed reduced partial pressure of oxygen(PaO2),oxygen saturation of blood(SaO2),fractional oxygen saturation of hemoglobin(FO2 Hb),and central venous oxygen saturation(ScvO2),along with increased partial pressure of carbon dioxide(PaCO2)and fractional deoxyhemoglobin saturation(FHHb),indicating that mice exposed to para-quat exhibited severe hypoxemia and hypercapnia.Histological evaluation highlighted pronounced lung interstitial thickening,alveolar collapse,inflammatory infiltration,and extensive fibrotic changes marked by collagen accumulation.Furthermore,exposure to paraquat significantly increased the protein levels of FN,CollⅠ,vimentin,and α-SMA,markedly reduced E-cadherin levels and elevated the levels of inflam-matory cytokines(TNF-α,IL-6,IL-8 and IL-1β)as well as the pro-fibrotic cytokine CTGF.Pirfenidone treat-ment demonstrated time-dependent efficacy,with the 15 d group showing the most significant improvements in pulmonary function as evidenced by reduced PENH levels and increased TV,EV and MV.CT imaging revealed a decrease in high-density opacities and improved lung transparency after pirfenidone treatment.In addition,arterial blood gas measurements indicated markedly elevated levels of PaO2,SaO2 and FO2 Hb.Histological analysis showed that pirfenidone alleviated lung interstitial thick-ening,reduced inflammatory cell infiltration,and decreased collagen deposition.At the molecular level,pirfenidone significantly reduced the protein expressions of FN,CollⅠ,Vim and α-SMA,while increasing E-cad levels.Furthermore,inflammatory cytokines,particularly IL-6 and IL-1β,were notably suppressed following pirfenidone intervention.CONCLUSION Intranasal administration of pirfenidone can exhibit potent time-dependent anti-fibrotic efficacy in paraquat-induced pulmonary fibrosis,with early interven-tions delivering the most substantial therapeutic benefits.

Objective:To report the clinical, imaging, and pathological features of a case of MYH7 gene-related scapuloperoneal myosin storage myopathy. Methods:Clinical data were collected from a patient with MYH7 gene-related scapuloperoneal myosin storage myopathy who presented to Peking University First Hospital in February 2025. The patient was evaluated with muscle magnetic resonance imaging, muscle biopsy, and whole-exome sequencing. Results:The patient was a 52-year-old female, with a 12-year history of progressive difficulty in foot dorsiflexion, exercise-induced fatigue, and lower limb pain. Over the past 3 years, she developed proximal upper limb weakness and post-exertional myalgia. Physical examination revealed scapuloperoneal weakness distribution accompanied by sensorineural hearing loss. Electromyography demonstrated myogenic changes in the deltoid and tibialis anterior muscles. Serum creatine kinase levels were within normal limits. Lower limb magnetic resonance imaging showed mild atrophy of the thigh muscles and significant fatty infiltration in the tibialis anterior, extensor hallucis longus, and extensor digitorum longus. Tibialis anterior muscle biopsy revealed dystrophic-like changes with sub-sarcolemmal hyaline bodies containing abundant granulofilamentous material. Whole exome sequencing identified a heterozygous pathogenic variant of c.5352_5354del(p.K1784del) in the MYH7 gene. Conclusions:This patient is the first reported one in China with MYH7 gene-related scapuloperoneal myosin storage myopathy, exhibiting characteristic scapuloperoneal weakness, selective fatty infiltration of the anterior lower leg muscles on imaging and sub-sarcolemmal hyaline body pathological changes. The diagnosis of this disease relies on characteristic pathological findings and genetic test results.

AIM:To observe the efficacy and safe-ty of combined lipid-lowering strategies in the ini-tial stage of treatment in"very high-risk ASCVD"pa-tients in cardiology outpatient clinics in a real-world prospective cohort study.METHODS:Pa-tients with"very high-risk ASCVD"from January to June 2021 were consecutively enrolled and divided into three groups according to the actual lipid-low-ering treatment strategies:Atorvastatin group;Atorvastatin combine with ezetimibe group;Atorv-astatin combine with evolocumab group.The pri-mary observation endpoints were the changes in LDL-C,Lp(a),and non-HDL-C after one month of treatment,and the secondary endpoints were the changes in TC,TG,HDL-C,Hs-CRP,and safety indica-tors.RESULTS:The efficacy of the combined lipid-lowering strategy in the initial stage of treatment was significantly better than that of the Atorvas-tatin group:LDL-C,Log[Lp(a)],non-HDL-C,TC sig-nificantly decreased(all P＜0.05).Compared with the Atorvastatin combine with Ezetimibe group,LDL-C and Log[Lp(a)]decreased significantly in the Atorvastatin combine with Evolocumab group(P＜0.05),and TC and TG had decreased insignifi-cantly(P＞0.05).When"LDL-C＜1.4mmol/L or＜1.8 mmol/L"is used as the standard for lipid-low-ering compliance,the LDL-C compliance rates of the two groups of combined lipid-lowering treat-ments are higher than those of the atorvastatin sin-gle-drug group.The differences were all statistically significant(all P＜0.05);the LDL-C compliance rate of the atorvastatin combined with evolocumab group was higher than that of the atorvastatin com-bined with ezetimibe group,and the differences were statistically significant(All P＜0.05).When the reduction rate of"LDL dropped by more than 50％"alone or in combination were used as the standard,no one in the three groups could reach the stan-dard.The liver aminotransferase levels had no signif-icant changes among the 3 groups after treatment(all P＞0.05).Myocardial enzyme isoenzyme(CK-MB)decreased among the 3 groups insignificantly(P＞0.05).Compared with the Atorvastatin group,the blood sugar(BS)of the two combined lipid-low-ering groups decreased significantly(P＜0.05);The BS of the Atorvastatin+ezetimibe group significant-ly decreased than that of Atorvastatin combine with Evolocumab group(P＜0.05).CONCLUSION:The lipid-lowering effect and LDL-C compliance rate of patients with"very high-risk ASCVD"in the cardi-ology outpatient department after 1 month of com-bined lipid-lowering treatment were better than those of the atorvastatin monotherapy group.When LDL-C＜1.4 mmol/L or＜1.8 mmol/L is the lip-id-lowering target,the LDL-C compliance rate after 1 month of treatment in the atorvastatin combined with evolocumab group is higher than that of the combined atorvastatin and zetamibu group.When the"LDL drop by more than 50％"is used as the standard for lipid lowering,it is difficult to reach the standard within 1 month.Outpatient"very high-risk ASCVD"patients were treated with initial combined lipid-lowering therapy for 1 month with-out adverse reactions.The initial combined lipid-lowering strategy can be used for patients with"very high-risk ASCVD"in cardiology outpatient clinics who need to achieve LDL-C values early.Atorvastatin combined with evolocumab strategy can be recommended for those patients who re-quire LDL-C＜1.4 mmol/L or＜1.8 mmol/L within one month.

Peripheral neuropathies are commonly diagnosed in different clinical department of the hospital. The diagnosis is generated by a set of reasonable process based on the manifestations of patients. According to the age of onset, the speed of disease development and the symptoms of peripheral nerve lesions, the peripheral neuropathy is divided into a definite clinical subtype for a particular patient. On this basis, utility of the nerve conduction studies and electromyography is conducted to confirm the anatomical locations of peripheral neuropathy. The etiologic diagnosis is based on anatomical diagnosis of peripheral nerve with a reasonable choice of auxiliary tests, including serological testing, peripheral nerve imaging and biopsy. Genetic tests are chosen for patients with clinical suspective diagnosis of hereditary disease. Finally, therapy evaluation on the basis of etiologic diagnosis is important for forming a treatment plan.

To research and design a new type of distal radial artery puncture compression hemostatic device,to solve the problem of distal radial artery puncture and compression hemostat that has not been clinically applied in China.The hemostatic device was mainly composed of hemostatic part,pressure regulating part,fixing part and visual window.The hemostatic device can accurately compress the puncture point,and it was convenient for medical staff to observe the wound through the visual window,find out abnormal conditions such as bleeding or hematoma in time,and take measures to deal with them,which greatly improved the hemostatic effect and comfort of the postoperative puncture point.The new hemostatic device has the advantages of reasonable design and simple clinical operation,which is worthy of clinical promotion.