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.

The philosophy of “treating disease before its onset” is a fundamental concept of traditional Chinese medicine (TCM), permeating its diagnostic and therapeutic framework, and is central to clinical practice. However, current TCM diagnostic and treatment models for the “pre-disease to disease” window period face several limitations, including the lack of comprehensive clinical parameters, difficulties in characterizing and integrating heterogeneous multimodal data, and insufficient dynamic precision in interventions and efficacy evaluations. To address these issues, guided by Professor Candong Li’s theory of TCM stateology, this study focuses on integrating objective multimodal data. It proposes a new model for personalized TCM diagnosis and treatment targeting the “pre-disease to disease” window period. This approach first proposes the idea of restructuring the conceptual framework of “symptom” and integrating multi-source heterogeneous data at macroscopic, mesoscopic, and microscopic levels to form a three-dimensional assessment indicator system. By integrating graph neural networks, convolutional neural networks, attention mechanisms, and knowledge graph-guided weight allocation, this approach enables collaborative representation, alignment, and fusion of multi-source data. Subsequently, it plans to construct a multimodal fusion model at both feature and decision levels, in order to establish mappings between indicators and TCM state elements, and to screen key indicators characterizing pathological evolution during the window period. Furthermore, it proposes a technical path for enhancing model interpretability using methods such as SHapley Additive exPlanations (SHAP) and Ablation-CAM++. Finally, with state assessment as the core, it proposes the concept of constructing a dynamic evaluation method for individualized diagnosis and treatment based on time-series data analysis using algorithms such as long short-term memory (LSTM) networks and gated recurrent units (GRUs). Moreover, a causal inference framework and semi-supervised learning strategies are introduced to enable quantitative evaluation of individual intervention effects and to provide interpretable therapeutic feedback, forming a complete technical path from data representation and fusion, weight adjustment, and interpretability analysis, to dynamic diagnosis feedback. This study aims to address deficiencies in the current TCM diagnosis and treatment model during the “pre-disease to disease” window period and to provide an operational framework for the clinical practice of TCM’s “treating disease before its onset”.

Background and Aims:The long non-coding RNA SOX2 overlapping transcript(SOX2-OT)is involved in the regulation of cancer cell cycle and proliferation.Bioinformatics analysis has revealed potential binding sites among miR-409-3p,SOX2-OT,and membrane binding protein annexin A2(ANXA2).This study aims to investigate the expression and functional role of the SOX2-OT/miR-409-3p/ANXA2 axis in gastric cancer cells.Methods:qRT-PCR was used to measure the expression levels of SOX2-OT,miR-409-3p,and ANXA2 mRNA in gastric cancer tissues and cell lines.Gastric cancer cells were transfected with SOX2-OT shRNA plasmid(sh-SOX2-OT),co-transfected with sh-SOX2-OT and miR-409-3p inhibitor,or co-transfected with sh-SOX2-OT and ANXA2 overexpression plasmid.The control groups included blank,shRNA-negative control,inhibitor-negative control,and overexpression plasmid-negative control.Expression levels of SOX2-OT,miR-409-3p,and ANXA2 mRNA,cell proliferation,migration/invasion,apoptosis,and protein expression of Ki-67,cleaved caspase-3,Bax,MMP-9,and ANXA2 were assessed.Dual-luciferase reporter assays were conducted to confirm the targeting relationships among miR-409-3p,SOX2-OT,and ANXA2.A xenograft tumor model in nude mice was used to evaluate the effect of SOX2-OT on gastric cancer tumor growth in vivo.Results:SOX2-OT and ANXA2 expression levels were significantly upregulated,while miR-409-3p was downregulated in gastric cancer tissues(vs.adjacent non-cancerous tissues)and gastric cancer cell lines(vs.normal gastric epithelial cells)(all P＜0.05).In gastric cancer cels,knockdown of SOX2-OT led to decreased expression of SOX2-OT and ANXA2 mRNA and increased expression of miR-409-3p(all P＜0.05),and this was accompanied by reduced proliferation and migration/invasion abilities,and increased apoptosis(all P＜0.05);protein levels of ANXA2,Ki-67,and MMP-9 were significantly decreased,whereas cleaved caspase-3 and Bax levels were significantly increased(all P＜0.05).These effects were reversed by co-transfection with the miR-409-3p inhibitor or ANXA2 overexpression plasmid(all P＜0.05).Dual-luciferase assays confirmed the direct targeting relationships among miR-409-3p,SOX2-OT,and ANXA2.In vivo,knockdown of SOX2-OT significantly inhibited tumor growth in nude mice,with reduced SOX2-OT and increased miR-409-3p expression,as well as decreased ANXA2 and Ki-67 protein positivity in xenograft tissues(all P＜0.05).Conclusion:SOX2-OT is upregulated in gastric cancer cells and may promote malignant behaviors by competitively binding miR-409-3p,thereby relieving its inhibition on ANXA2.The SOX2-OT/miR-409-3p/ANXA2 axis may represent a potential molecular target for gastric cancer therapy.

Background and Aims:The long non-coding RNA SOX2 overlapping transcript(SOX2-OT)is involved in the regulation of cancer cell cycle and proliferation.Bioinformatics analysis has revealed potential binding sites among miR-409-3p,SOX2-OT,and membrane binding protein annexin A2(ANXA2).This study aims to investigate the expression and functional role of the SOX2-OT/miR-409-3p/ANXA2 axis in gastric cancer cells.Methods:qRT-PCR was used to measure the expression levels of SOX2-OT,miR-409-3p,and ANXA2 mRNA in gastric cancer tissues and cell lines.Gastric cancer cells were transfected with SOX2-OT shRNA plasmid(sh-SOX2-OT),co-transfected with sh-SOX2-OT and miR-409-3p inhibitor,or co-transfected with sh-SOX2-OT and ANXA2 overexpression plasmid.The control groups included blank,shRNA-negative control,inhibitor-negative control,and overexpression plasmid-negative control.Expression levels of SOX2-OT,miR-409-3p,and ANXA2 mRNA,cell proliferation,migration/invasion,apoptosis,and protein expression of Ki-67,cleaved caspase-3,Bax,MMP-9,and ANXA2 were assessed.Dual-luciferase reporter assays were conducted to confirm the targeting relationships among miR-409-3p,SOX2-OT,and ANXA2.A xenograft tumor model in nude mice was used to evaluate the effect of SOX2-OT on gastric cancer tumor growth in vivo.Results:SOX2-OT and ANXA2 expression levels were significantly upregulated,while miR-409-3p was downregulated in gastric cancer tissues(vs.adjacent non-cancerous tissues)and gastric cancer cell lines(vs.normal gastric epithelial cells)(all P＜0.05).In gastric cancer cels,knockdown of SOX2-OT led to decreased expression of SOX2-OT and ANXA2 mRNA and increased expression of miR-409-3p(all P＜0.05),and this was accompanied by reduced proliferation and migration/invasion abilities,and increased apoptosis(all P＜0.05);protein levels of ANXA2,Ki-67,and MMP-9 were significantly decreased,whereas cleaved caspase-3 and Bax levels were significantly increased(all P＜0.05).These effects were reversed by co-transfection with the miR-409-3p inhibitor or ANXA2 overexpression plasmid(all P＜0.05).Dual-luciferase assays confirmed the direct targeting relationships among miR-409-3p,SOX2-OT,and ANXA2.In vivo,knockdown of SOX2-OT significantly inhibited tumor growth in nude mice,with reduced SOX2-OT and increased miR-409-3p expression,as well as decreased ANXA2 and Ki-67 protein positivity in xenograft tissues(all P＜0.05).Conclusion:SOX2-OT is upregulated in gastric cancer cells and may promote malignant behaviors by competitively binding miR-409-3p,thereby relieving its inhibition on ANXA2.The SOX2-OT/miR-409-3p/ANXA2 axis may represent a potential molecular target for gastric cancer therapy.

Objective: To summarize the long-term efficacy and safety of sacral neuromodulation (SNM) in treating refractory interstitial cystitis/bladder pain syndrome (IC/BPS)，so as to provide clinical evidence for this therapeutic approach. Methods: This study retrospectively analyzed the data of 27 patients with refractory IC/BPS treated at our hospital during Jan.2015 and Dec.2021.All patients underwent SNM Ⅱ.The therapeutic effects were evaluated with Global Response Assessment (GRA).The preoperative and postoperative daily urinary frequency，nocturia frequency，functional bladder capacity，O'Leary-Sant score，pelvic pain，urgency and frequency (PUF) score，quality of life (QoL) score，and visual analogue scale (VAS) score were compared. Results: During the follow-up of (55.55±16.33) months，12 patients showed no symptom relief (GRA≤4)，while 15 experienced symptom relief (GRA>4)，resulting in an efficacy rate of 55.56% (15/27).The average daily urination frequency decreased from (28.74±13.84) to (24.74±16.33) times,the O'Leary-Sant score decreased from (30.19±5.35) to (25.63±9.34)，PUF score decreased from (25.63±5.34) to (22.04±8.29)，QoL score decreased from (5.67±0.55) to (4.33±1.57)，and VAS score decreased from (8.04±1.91) to (5.33±3.09)，the differences were statistically significant (P<0.05). No complications such as incision infections or pain at the implant site were observed. Conclusion: SNM is safe and effective for refractory IC/BPS，but there is a risk of long-term failure.Therefore，patients should be discreetly selected.

Background: and Purpose Ruptured intracranial aneurysms (RIA) are associated with a mortality rate of up to 40% in the Chinese population, highlighting the critical need for targeted treatment interventions for at-risk individuals. Although the impact of aldehyde dehydrogenase 2 (ALDH2) gene mutations on susceptibility to intracranial aneurysms (IA) is well documented, the potential connection between ALDH2 rs671 single-nucleotide polymorphism (SNP) and RIA remains unexplored. Given the increased prevalence of ALDH2 gene mutations among Chinese Han individuals, it is clinically relevant to investigate the link between ALDH2 rs671 SNP and IA rupture. Methods: A prospective study was conducted on 546 patients diagnosed with IA to investigate the association between ALDH2 rs671 SNP and the risk of IA rupture. Results: The ALDH2 rs671 SNP (ALDH2*2) was significantly more prevalent in patients with unruptured IA (UIA) than in those with RIA (32.56% vs. 18.58%, P=0.004). Multivariate logistic regression analysis revealed that people with the ALDH2 mutation (ALDH2*1/*2 and ALDH2*2/*2 gene type) had a significantly reduced odds ratio (OR=0.49; 95% confidence level [CI] 0.27–0.88; P=0.018) for RIAs. Age-specific subgroup analysis indicated that the ALDH2 mutation provided a stronger protective effect in individuals aged 60 years and above with IA compared to those under 60 years old (OR=0.38 vs. OR=0.52, both P<0.05). Conclusion The incidence of RIA was significantly higher in individuals with a normal ALDH2 gene (ALDH2*1/*1) than in those with an ALDH2 rs671 SNP (ALDH2*1/*2 or ALDH2*2/*2). ALDH2 rs671 SNP may serve as a protective factor against RIA in the Chinese Han population.

Objective: This study aims to evaluate the clinical benefits of the integrated optical and magnetic surgical navigation system in assisting transforaminal endoscopic lumbar discectomy (TELD) for the treatment of lumbar disc herniation (LDH). Methods: A retrospective analysis was conducted on patients who underwent TELD for LDH at Beijing Chaoyang Hospital, Capital Medical University from November 2022 to December 2023. Patients treated with the integrated optical and magnetic surgical navigation system were defined as the navigation-guided TELD (Ng-TELD) group (30 cases), while those treated with the conventional x-ray fluoroscopy method were defined as the control group (31 cases). Record and compare baseline characteristics, surgical parameters, efficacy indicators, and adverse events between the 2 patient groups. Results: The average follow-up duration for the 61 patients was 11.8 months. Postoperatively, both groups exhibited significant relief from back and leg pain, which continued to improve over time. At the final follow-up, patients’ lumbar function and quality of life had significantly improved compared to preoperative levels (p < 0.05). The Ng-TELD group had significantly shorter total operation time (58.43 ± 12.37 minutes vs. 83.23 ± 25.90 minutes), catheter placement time (5.83 ± 1.09 minutes vs. 15.94 ± 3.00 minutes), decompression time (47.17 ± 11.98 minutes vs. 67.29 ± 24.23 minutes), and fewer intraoperative fluoroscopies (3.20 ± 1.45 vs. 16.58 ± 4.25) compared to the control group (p < 0.05). There were no significant differences between the groups in terms of efficacy evaluation indicators and hospital stay. At the final follow-up, the excellent and good rate of surgical outcomes assessed by the MacNab criteria was 98.4%, and the overall adverse event rate was 8.2%, with no statistically significant differences between the groups (p > 0.05). Conclusion This study demonstrates that the integrated optical and magnetic surgical navigation system can reduce the complexity of TELD, shorten operation time, and minimize radiation exposure for the surgeon, highlighting its promising clinical potential.

Objective: This study aims to evaluate the clinical benefits of the integrated optical and magnetic surgical navigation system in assisting transforaminal endoscopic lumbar discectomy (TELD) for the treatment of lumbar disc herniation (LDH). Methods: A retrospective analysis was conducted on patients who underwent TELD for LDH at Beijing Chaoyang Hospital, Capital Medical University from November 2022 to December 2023. Patients treated with the integrated optical and magnetic surgical navigation system were defined as the navigation-guided TELD (Ng-TELD) group (30 cases), while those treated with the conventional x-ray fluoroscopy method were defined as the control group (31 cases). Record and compare baseline characteristics, surgical parameters, efficacy indicators, and adverse events between the 2 patient groups. Results: The average follow-up duration for the 61 patients was 11.8 months. Postoperatively, both groups exhibited significant relief from back and leg pain, which continued to improve over time. At the final follow-up, patients’ lumbar function and quality of life had significantly improved compared to preoperative levels (p < 0.05). The Ng-TELD group had significantly shorter total operation time (58.43 ± 12.37 minutes vs. 83.23 ± 25.90 minutes), catheter placement time (5.83 ± 1.09 minutes vs. 15.94 ± 3.00 minutes), decompression time (47.17 ± 11.98 minutes vs. 67.29 ± 24.23 minutes), and fewer intraoperative fluoroscopies (3.20 ± 1.45 vs. 16.58 ± 4.25) compared to the control group (p < 0.05). There were no significant differences between the groups in terms of efficacy evaluation indicators and hospital stay. At the final follow-up, the excellent and good rate of surgical outcomes assessed by the MacNab criteria was 98.4%, and the overall adverse event rate was 8.2%, with no statistically significant differences between the groups (p > 0.05). Conclusion This study demonstrates that the integrated optical and magnetic surgical navigation system can reduce the complexity of TELD, shorten operation time, and minimize radiation exposure for the surgeon, highlighting its promising clinical potential.

Background: and Purpose Ruptured intracranial aneurysms (RIA) are associated with a mortality rate of up to 40% in the Chinese population, highlighting the critical need for targeted treatment interventions for at-risk individuals. Although the impact of aldehyde dehydrogenase 2 (ALDH2) gene mutations on susceptibility to intracranial aneurysms (IA) is well documented, the potential connection between ALDH2 rs671 single-nucleotide polymorphism (SNP) and RIA remains unexplored. Given the increased prevalence of ALDH2 gene mutations among Chinese Han individuals, it is clinically relevant to investigate the link between ALDH2 rs671 SNP and IA rupture. Methods: A prospective study was conducted on 546 patients diagnosed with IA to investigate the association between ALDH2 rs671 SNP and the risk of IA rupture. Results: The ALDH2 rs671 SNP (ALDH2*2) was significantly more prevalent in patients with unruptured IA (UIA) than in those with RIA (32.56% vs. 18.58%, P=0.004). Multivariate logistic regression analysis revealed that people with the ALDH2 mutation (ALDH2*1/*2 and ALDH2*2/*2 gene type) had a significantly reduced odds ratio (OR=0.49; 95% confidence level [CI] 0.27–0.88; P=0.018) for RIAs. Age-specific subgroup analysis indicated that the ALDH2 mutation provided a stronger protective effect in individuals aged 60 years and above with IA compared to those under 60 years old (OR=0.38 vs. OR=0.52, both P<0.05). Conclusion The incidence of RIA was significantly higher in individuals with a normal ALDH2 gene (ALDH2*1/*1) than in those with an ALDH2 rs671 SNP (ALDH2*1/*2 or ALDH2*2/*2). ALDH2 rs671 SNP may serve as a protective factor against RIA in the Chinese Han population.

Background: and Purpose Ruptured intracranial aneurysms (RIA) are associated with a mortality rate of up to 40% in the Chinese population, highlighting the critical need for targeted treatment interventions for at-risk individuals. Although the impact of aldehyde dehydrogenase 2 (ALDH2) gene mutations on susceptibility to intracranial aneurysms (IA) is well documented, the potential connection between ALDH2 rs671 single-nucleotide polymorphism (SNP) and RIA remains unexplored. Given the increased prevalence of ALDH2 gene mutations among Chinese Han individuals, it is clinically relevant to investigate the link between ALDH2 rs671 SNP and IA rupture. Methods: A prospective study was conducted on 546 patients diagnosed with IA to investigate the association between ALDH2 rs671 SNP and the risk of IA rupture. Results: The ALDH2 rs671 SNP (ALDH2*2) was significantly more prevalent in patients with unruptured IA (UIA) than in those with RIA (32.56% vs. 18.58%, P=0.004). Multivariate logistic regression analysis revealed that people with the ALDH2 mutation (ALDH2*1/*2 and ALDH2*2/*2 gene type) had a significantly reduced odds ratio (OR=0.49; 95% confidence level [CI] 0.27–0.88; P=0.018) for RIAs. Age-specific subgroup analysis indicated that the ALDH2 mutation provided a stronger protective effect in individuals aged 60 years and above with IA compared to those under 60 years old (OR=0.38 vs. OR=0.52, both P<0.05). Conclusion The incidence of RIA was significantly higher in individuals with a normal ALDH2 gene (ALDH2*1/*1) than in those with an ALDH2 rs671 SNP (ALDH2*1/*2 or ALDH2*2/*2). ALDH2 rs671 SNP may serve as a protective factor against RIA in the Chinese Han population.