To thoroughly implement the strategic deployment outlined in the Opinions of the Central Committee of the Communist Party of China and the State Council on Promoting the Inheritance and Innovative Development of Traditional Chinese Medicine regarding research on dominant diseases of traditional Chinese medicine and to uphold the development philosophy of equal emphasis on traditional Chinese medicine and western medicine，the China Association of Chinese Medicine has fully played a leading academic role by systematically organizing and conducting a series of academic youth salons on clinical dominant diseases of traditional Chinese medicine. On September 13，2024，the 36^th Youth Salon on Clinical Dominant Diseases was successfully held in Nanjing，focusing on the advantages of traditional Chinese medicine and the integrative traditional Chinese medicine and western medicine in the diagnosis and treatment of erectile dysfunction （ED）. The conference brought together leading experts from traditional Chinese medicine，western medicine，and interdisciplinary fields，facilitating in-depth multidisciplinary discussions that led to key consensus on optimizing traditional Chinese medicine treatment protocols for ED，researching and developing new drugs of traditional Chinese medicine，and advancing interdisciplinary development in traditional Chinese medicine. This salon systematically sorted out the clinical strengths and distinctive features of traditional Chinese medicine in the diagnosis and treatment of ED. Based on current research foundations and clinical needs，it identified key directions for future scientific layout and scientific research tackling： （1） Standardization of syndrome differentiation system of traditional Chinese medicine for ED. （2） Optimization and standardization of intervention methods of integrated traditional Chinese medicine and western medicine. （3） High-quality clinical research guided by evidence-based medicine. （4） In-depth analysis of the pharmacological mechanisms of traditional Chinese medicine in the treatment of ED. （5） Clinical translation and application promotion of new drugs of traditional Chinese medicine. （6） Interdisciplinary integration and innovation in traditional Chinese medicine. For each research direction，key focus areas，expected objectives，and clinical value were further refined，along with the establishment of a scientifically sound priority funding level evaluation system. Therefore，building on the series of salons on the ED-focused dominant diseases of traditional Chinese medicine，this paper provides standardized guidance for clinical practice of traditional Chinese medicine in ED management，effectively contributing to the high-quality development of traditional Chinese medicine. It serves as a valuable reference for national scientific and technological strategic layout， research and development decision-making in new drugs of traditional Chinese medicine，research topic planning，and clinical guideline formulation.

The Synopsis of Golden Chamber(Jinui Yaolue)first identified consumption as the primary pathogenesis of male infertility.The core mechanism underlying infertility owing to consumption lies in the deficiency of bodily fluids(Jin and Ye)and blood,referred to as fluid-blood deficiency.This condition links the overall vitality of the body's righteous qi with fertility,permeating the entire disease course and serving as the central focus for treatment with classical formulas(Jingfang).Although the causes of consumptive disease differ between ancient and modern times—ranging from physical labor and famine in historical contexts to mental stress,disordered dietary and sleep patterns,and delayed marriage or childbearing in contemporary society,the pathogenesis consistently converges on fluid-blood deficiency.Modern patients often present with mild symptoms owing to improved living conditions,which can obscure the underlying consumptive disease.Therefore,accurate diagnosis requires meticulous attention to subtle clinical signs,including specific symptoms,pulse manifestations,and complexion changes.Clinical differentiation of the two stages of fluid-blood deficiency is essential.The first stage,characterized as an early-stage fluid-blood deficiency,presents with middle energizer weakness,impaired pivot function,and upper heat-lower cold patterns.Treatment at this stage emphasizes fortifying the middle energizer(Jianzhong),harmonizing yin-yang,and restoring fluid-blood production,as demonstrated by the use of formulas like Guizhi Decoction and its variants.The second stage is advanced fluid-blood deficiency,marked by triple energizer qi collapse and phlegm-blood stasis obstruction.In accordance with the principle from Jingui Yaolue of"gentle tonification while resolving stagnation"(Huan Zhong Bu Xu),treatment focuses on warming the lower energizer,consolidating fluids-blood,dissolving stasis,and relieving abdominal fullness in the middle energizer.For this stage,Tianxiong Powder is recommended in cases dominated by cold,Dahuang Zhechong Pill in cases dominated by phlegm-stasis,and Shenqi Pill in cases involving dual yin-yang deficiency.

Objective:To verify the clinical efficacy of using radial extracorporeal shock wave therapy(rESWT)with a combination of low-to-moderate energy flow density(EFD)in the treatment of erectile dysfunction(ED).Method:Thirty-six patients with ED were randomly divided into two groups,with 18 patients in each group.The rESWT group received 16 sessions of rESWT(twice weekly for 8 weeks),while the control group took oral tadalafil 5 mg once daily for 8 weeks.The 5-item International Index of Erectile Function(IIEF-5)and Erection Hardness Score(EHS)were evaluated before treatment,at 1 month and 2 months during treatment,and at 1 month,3 months,and 6 months after the completion of treatment.Result:The overall comparison of IIEF-5 and EHS scores between the rESWT group and the control group at various time points showed significant differences(P<0.001).For the rESWT group,the IIEF-5 score after 1 month of treatment was significantly higher than that before treatment(P<0.001)but lower than that of the control group(P<0.05).After 2 months,it was significantly higher than at 1 month(P<0.001)with no differ-ence compared to the control group(P>0.05).There were no significant differences were observed at the 1-month and 3-month follow-ups compared to the 2-month treatment(P>0.05).At 3 months of follow-up,the score was higher than that of the control group(P<0.05).At 6 months of follow-up,the score was higher than that before treatment(P<0.05).For the control group,the IIEF-5 score,there were no differences be-tween 1 and 2 months of treatment(P>0.05),but both were significantly higher than before treatment(P<0.001).At 1 month of follow-up,the score was lower than at 2 months of treatment(P<0.01).There was no difference in EHS between the rESWT group and the control group(P>0.05),but the rESWT group was treat-ed for 2 months and followed up for 1 month,which was higher than that before treatment(P<0.05).Conclusion:The combined use of low-to-moderate EFD rESWT can achieve the same efficacy comparable to Tadalafil in ED treatment and demonstrates superior durability of response,indicating its broader clinical appli-cation.

The Synopsis of Golden Chamber(Jinui Yaolue)first identified consumption as the primary pathogenesis of male infertility.The core mechanism underlying infertility owing to consumption lies in the deficiency of bodily fluids(Jin and Ye)and blood,referred to as fluid-blood deficiency.This condition links the overall vitality of the body's righteous qi with fertility,permeating the entire disease course and serving as the central focus for treatment with classical formulas(Jingfang).Although the causes of consumptive disease differ between ancient and modern times—ranging from physical labor and famine in historical contexts to mental stress,disordered dietary and sleep patterns,and delayed marriage or childbearing in contemporary society,the pathogenesis consistently converges on fluid-blood deficiency.Modern patients often present with mild symptoms owing to improved living conditions,which can obscure the underlying consumptive disease.Therefore,accurate diagnosis requires meticulous attention to subtle clinical signs,including specific symptoms,pulse manifestations,and complexion changes.Clinical differentiation of the two stages of fluid-blood deficiency is essential.The first stage,characterized as an early-stage fluid-blood deficiency,presents with middle energizer weakness,impaired pivot function,and upper heat-lower cold patterns.Treatment at this stage emphasizes fortifying the middle energizer(Jianzhong),harmonizing yin-yang,and restoring fluid-blood production,as demonstrated by the use of formulas like Guizhi Decoction and its variants.The second stage is advanced fluid-blood deficiency,marked by triple energizer qi collapse and phlegm-blood stasis obstruction.In accordance with the principle from Jingui Yaolue of"gentle tonification while resolving stagnation"(Huan Zhong Bu Xu),treatment focuses on warming the lower energizer,consolidating fluids-blood,dissolving stasis,and relieving abdominal fullness in the middle energizer.For this stage,Tianxiong Powder is recommended in cases dominated by cold,Dahuang Zhechong Pill in cases dominated by phlegm-stasis,and Shenqi Pill in cases involving dual yin-yang deficiency.

Objective:To verify the clinical efficacy of using radial extracorporeal shock wave therapy(rESWT)with a combination of low-to-moderate energy flow density(EFD)in the treatment of erectile dysfunction(ED).Method:Thirty-six patients with ED were randomly divided into two groups,with 18 patients in each group.The rESWT group received 16 sessions of rESWT(twice weekly for 8 weeks),while the control group took oral tadalafil 5 mg once daily for 8 weeks.The 5-item International Index of Erectile Function(IIEF-5)and Erection Hardness Score(EHS)were evaluated before treatment,at 1 month and 2 months during treatment,and at 1 month,3 months,and 6 months after the completion of treatment.Result:The overall comparison of IIEF-5 and EHS scores between the rESWT group and the control group at various time points showed significant differences(P<0.001).For the rESWT group,the IIEF-5 score after 1 month of treatment was significantly higher than that before treatment(P<0.001)but lower than that of the control group(P<0.05).After 2 months,it was significantly higher than at 1 month(P<0.001)with no differ-ence compared to the control group(P>0.05).There were no significant differences were observed at the 1-month and 3-month follow-ups compared to the 2-month treatment(P>0.05).At 3 months of follow-up,the score was higher than that of the control group(P<0.05).At 6 months of follow-up,the score was higher than that before treatment(P<0.05).For the control group,the IIEF-5 score,there were no differences be-tween 1 and 2 months of treatment(P>0.05),but both were significantly higher than before treatment(P<0.001).At 1 month of follow-up,the score was lower than at 2 months of treatment(P<0.01).There was no difference in EHS between the rESWT group and the control group(P>0.05),but the rESWT group was treat-ed for 2 months and followed up for 1 month,which was higher than that before treatment(P<0.05).Conclusion:The combined use of low-to-moderate EFD rESWT can achieve the same efficacy comparable to Tadalafil in ED treatment and demonstrates superior durability of response,indicating its broader clinical appli-cation.

Objective: To provide the mechanism-based pharmacotherapy of the Huatan Qushi formula (HTQS formula), for the health management and treatment of non-alcoholic fatty liver disease (NAFLD). Methods: A rat model of NAFLD was employed to examine the efficacy and safety of the HTQS formula. In vivo active components and potential mechanisms of the HTQS formula were identified using UPLC‒MS/MS combined with network pharmacology. The influence of the HTQS formula on the dominating proteins in PI3K/Akt pathway was validated in vivo using western blot. Finally, 16S rRNA sequencing of the gut microbiome was conducted followed by targeted metabolomics detecting fecal short-chain fatty acids (SCFAs) and bile acids to determine the impact of the HTQS formula on gut microbiota. Results: The HTQS formula reduced weight gain and hepatic steatosis in NAFLD rats and decreased serum total cholesterol (TC), triglycerides, blood glucose, and insulin resistance (IR) without causing liver or kidney injury. We detected 28 components using UPLC‒MS/MS and identified 439 shared targets between NAFLD and the HTQS formula. Primarily, we focused on the PI3K/Akt signaling pathway based on protein‒protein interaction network analysis. We validated that the HTQS formula inhibited liver steatosis and inflammation by increasing the phosphorylation levels of PI3K, AKT, P27, GSK3β in the PI3K/Akt signaling pathway. 16S rRNA sequencing revealed that the HTQS formula reduced the abundance of the genus Family_XIII_AD3011_group, which was positively correlated with IR and taurodeoxycholic acid. In addition, Lachnospiraceae_UCG_010 inversely correlated with TC and five bile acids, which could be essential to the therapeutic effect of the HTQS formula against NAFLD. Conclusions The HTQS formula proved to be an effective pharmacotherapy for NAFLD without causing liver or kidney injury. Multiple potent components of the HTQS formula could alleviate liver steatosis and lipid metabolism disorder by modulating the PI3K/Akt signaling pathway and restoring gut microbiota composition.

Objective: To investigate the clinical manifestations, pathological features, and treatment of oral and maxillofacial pyogenic granulomas induced by camrelizumab. Methods: A case of pyogenic granuloma of the gums and lips caused by camrelizumab was reported along with a literature review. Results: After 4 months of treatment with camrelizumab for liver cancer, the patient developed systemic reactive capillary hyperplasia (RCH), followed by multiple masses on the lower lip and gingiva. After periodontal therapy, the masses on the lower lip and the gingiva were removed, and camrelizumab administration was stopped. The pathological result was gingival pyogenic granuloma/granulomatous hemangioma. No new masses were found in the oral cavity during postoperative follow-up. A review of the literature showed that RCH is the most common adverse drug reaction to camrelizumab but it occurs infrequently in the oral cavity. At present, the etiology of RCH has not been clarified, but the research has shown that camrelizumab may trigger tissue proliferation into hemangiomas by activating vascular endothelial cells, and the combined use of camrelizumab is safer than single use. RCH is self-limiting and most cases resolve spontaneously after discontinuation of the drug. If the mass causes dysfunction, surgical excision is feasible. Conclusion Camrelizumab can cause oral and maxillofacial reactive capillary hyperplasia complicated by pyogenic granuloma.

Objective:To evaluate the value and identify the prognosic factors of postoperative radiotherapy (PORT) in completely resected stage Ⅲ(pN 2) lung adenocarcinoma patients with epidermal growth factor receptor (EGFR) wild-type who received adjuvant chemotherapy. Methods:Clinical data of 172 patients with stage Ⅲ(pN 2) EGFR wild-type lung adenocarcinoma who underwent radical resection and adjuvant chemotherapy from 2009 to 2016 were retrospectively analyzed. All patients received platinum-based adjuvant chemotherapy combining two drugs for>4 cycles, and divided into the PORT group and the non-PORT group. The survival rate was calculated by Kaplan- Meier method and log-rank test, and multivariate prognostic analysis was performed by Cox’s regression model. Results:Among 172 patients, the median overall survival (OS), 3-year and 5-year OS rates were 40 months, 55.9% and 28.3%, respectively. The median disease-free survival (DFS), 3-year and 5-year DFS rates were 17 months, 24.5% and 13.0%, respectively. DFS was significantly improved in the PORT group (29 months vs. 13 months, P=0.001), whereas OS did not significantly differ between two groups (51 months vs. 38 months, P=0.151). In subgroup analysis, DFS of patients with multistation N 2 or the number of N 2 metastases of≥3 or skip N 2 in the PORT group was significantly longer ( P<0.05), whereas PORT exerted no significant effect on OS ( P>0.05). Conclusions:For patients with completely resected stage Ⅲ(N 2) EGFR wild-type lung adenocarcinoma receiving adjuvant chemotherapy, PORT might increase DFS and have a trend toward longer OS. However, these findings remain to be validated by large sample size investigations.

Background: Metabolic diseases pose considerable burden on the healthcare system worldwide, indi-cating the significance of prevention and treatment. In constitution theory of traditional Chinese med-icine, phlegm-dampness constitution (PDC) is the common basis of metabolic diseases. In clinical practice, Huatan Qushi (HTQS) decoction targeting on PDC can effectively improve metabolic indicators. However, its underlying biochemical mechanism still remains unclear.Methods: Eight PDC participants received HTQS decoction for three months. Their blood was collected at baseline and 1 and 3 months after intervention started. Related biomedical indicators were detected. High-throughput sequencing and RT-qPCR were used for validation. Due to the missing data, repeated measures with missing values in mixed models were used. Results: After 3-month treatment, HDL-C level increased (P<.001) and FBG, FINS, and HbA1c all showed decreasing trend at different time points (all P < .05). After miRNA high-throughput sequencing, compared with the baseline, differential miRNAs at 1 and 3 months were screened, and target gene prediction and KEGG pathway enrichment analysis were performed. The results displayed that metabolic disease-related pathways mainly included pathways in cancer, PI3K-Akt signaling pathway, etc. Further, RT-qPCR showed that hsa-miR-1237-3p differed statistically (P =.008). Then we validated the target genes of hsa-miR-1237-3p in the"Pathways in Cancer"pathway including SDF1, AC, CRK, and HGF, also known as upstream target genes of PI3K/AKT pathway. The results showed that two indicators of CRK and HGF were in statistical significance (P=.045 and P=.036, respectively). Conclusion: PDC serves as a common basis for various metabolic diseases. Through adjusting PDC, HTQS decoction can improve biomedical indicators including blood glucose, HbA1c, insulin, and HDL-C. The target pathway is"Pathways in cancer". Specifically, HTQS decoction acts on targets of CRK and HGF by regulating hsa-miR-1237-3p, and probably exerts effects on their downstream PI3K/AKT pathway.

Objective    To investigate the learning curve of non-tube and early oral feeding procedure following McKeown minimally invasive esophagectomy (MIE). Methods    We analyzed the clinical data of 38 patients (26 males, 12 females, aged 42–79 years) with esophageal cancer who received non-tube and early oral feeding procedure after surgery at the Affiliated Tumor Hospital, Zhengzhou University from November 2017 to August 2018. They suffered upper thoracic esophageal cancer (n=4), middle thoracic esophageal cancer (n=22) or lower thoracic esophageal cancer (n=12). Results    McKeown MIE was successfully performed on 38 patients. Oral feeding began 1.7 (1-4) days after surgery in the 38 patients with non-tube. Pneumonia/atelectasis occurred in 5 patients (13.1%), respiratory failure in 1 patient (2.6%), arrhythmia in 3 patients (7.9%), hoarseness in 5 patients (13.1%), anastomotic fistula in 1 patient (2.6%), cervical incision infection in 1 patient (2.6%), pneumomediastinum and infection in 1 patient (2.6%) and gastric emptying disorder in 2 patients (5.2%). No death was observed. After 26 patients with McKeown MIE were treated with enhanced recovery after surgery procedure, the operation time and complications could reach a relatively stable state and entered a plateau phase of learning curve. Conclusion    Non-tube and early oral feeding procedure following MIE is technically safe and feasible. It can shorten hospital stay, relieve the discomfort of placement of nasogastric and nutrition tube and may reduce the incidence of complications. The learning curve of non-tube and early oral feeding procedure following MIE is  about 26 cases.