OBJECTIVE: Traditional Chinese medicine (TCM) incorporates traditional diagnostic methods and several major treatment modalities including Chinese herbal medicine, Chinese patent medicine, and non-pharmacological methods such as acupuncture and tuina. Even though TCM is used daily by more than 70,000 healthcare facilities and over 700,000 clinical practitioners in China, there is a poor understanding of the extent to which TCM diagnostic methods are used, how different treatment modalities are deployed in general, and what major factors may affect the integration of TCM and Western medicine. This study aimed to fill this void in the literature. METHODS: In the 2021 National Healthcare Improvement Evaluation Survey, we included three questions gauging the perception and practices of TCM amongst physicians working in TCM-related facilities, investigating the frequency of their deployment of TCM diagnostic methods, and predominant TCM treatment methods. Our empirical analysis included descriptive statistics, intergroup chi-square analysis, and binary logistic regression to examine the association between different types of facilities and individual characteristics and TCM utilization patterns. RESULTS: A total of 7618 clinical physicians comprised our study sample. Among them, 84.27% have integrated TCM and Western medicine in their clinical practice, and 80.77% of TCM practitioners used the 4 diagnostic methods as a tool in their clinical practice. Chinese herbal medicine was the most widely utilized modality by Chinese TCM physicians (used by 88.49% of respondents), compared with the Chinese patent medicine and non-pharmacological TCM methods, which were used by 73.14%, and 69.39%, respectively. Herbal tea as an out-of-pocket health-maintenance intervention is also a notable practice, recommended by 29.43% of physicians. Significant variations exist across certain institutions, departments, and individual practitioners. CONCLUSION Given that most of the surveyed physicians integrated TCM with Western medicine in their clinical practices, the practice of "pure TCM" appears to be obsolete in China's tertiary healthcare institutions. Notably, remarkable variation exists in the use of different TCM modalities across institutions and among individuals, which might be related to and thus limited by the practitioners' experience. Future research focusing on the efficacy and safety of TCM interventions for specific diseases, the development of standardized clinical guidelines, and the enhancement of TCM education and training are called for to optimize TCM-Western medicine integration. Please cite this article as: Guo R, Zeng D, Zhao Q, Zhang XY, Zhang XK, Liu YL. How are different traditional Chinese medicine modalities deployed by clinical practitioners in China? Findings from a national survey. J Integr Med. 2025; 23(1): 36-45.
Medicine, Chinese Traditional/statistics & numerical data* ; Humans ; China ; Surveys and Questionnaires ; Female ; Male ; Physicians/statistics & numerical data* ; Practice Patterns, Physicians'/statistics & numerical data* ; Adult ; Middle Aged

In recent years,significant breakthroughs have been achieved in the immunotherapy for Alzheimer's disease.In line with global advancements,two anti-amyloid-β monoclonal antibodies have been approved and successfully launched in China for clinical use.Lecanemab and Donanemab were officially used in June 2024 and April 2025 in China,respectively.In order to standardize the rational and safe application of anti-amyloid-β monoclonal antibodies for Alzheimer's disease in China,this article integrates recom-mendations from the clinical trials and real-world experience from the author's team and domestic peers to further update the recom-mendations for the clinical use of anti-amyloid-β monoclonal antibody based on the 2024 version.It includes indications for therapy,pre-treatment evaluation and preparation,administration protocols and safety measures during treatment,and post-treatment monitor-ing strategies.

The theory of"spleen and stomach deficiency and excess transformation"originates from Huangdi Neijing,which is based on the five elements theory.It systematically elucidates the physiological interconnections and pathological transmission relationships among spleen,stomach,and the five zang and six fu viscera.This theory was continuously developed and refined by later physicians.It was first systematically summarized and deepened by LI Dongyuan in his work Piwei Lun,which elaborates on the pathological transmission relationships of other zang-fu viscera after spleen and stomach deficiency.From the perspective of LI Dongyuan's theory of"spleen and stomach deficiency and excess transformation",this paper discusses the pathological relationships between spleen-earth,lung-metal,and kidney-water,and proposes that spleen-earth deficiency is the pathological basis for the onset of allergic rhinitis.Based on the pathological evolution following spleen-earth deficiency,the traditional Chinese medicine syndromes of allergic rhinitis were categorized into three types:earth deficiency with metal weakness,earth dryness with metal desiccation,and water cold with metal excess and earth decline.The treatment of allergic rhinitis should prioritize the spleen-earth,employing acrid and dispersing herbs with light properties to elevate the spleen,sweet-warm and sour-astringent herbs to tonify the spleen,and diuretic and dampness-resolving herbs to activate the spleen,thereby restoring spleen-earth function.Simultaneously,treatment should regulate lung-metal and kidney-water according to different pathological evolutions,incorporating cold-cool or acrid-warm herbs as appropriate,combining cold and warm properties,and treating both the manifestation and root cause of the disease.

Under the background of deepening the reform of medical and health system,the reform of public hos-pital salary system reform faces the dual challenges of realizing the value of knowledge and maintaining public wel-fare.Based on the public value theory,it constructs a synergistic analytical framework of"knowledge value and pub-lic welfare"to reveal the internal logic and realization path of public hospital pay system reform.Through the mecha-nisms of policy design reconstruction,assessment system innovation,remuneration structure optimization and multi-dimensional collaborative governance,the current systemic obstacles such as incentive alienation,misalign-ment of assessment,and insufficient financial compensation can be effectively solved.It is necessary to build a pub-lic value target,construct a synergistic system of"constraints and incentives",and activate the main motivation of medical staff to form a closed loop of"target-setting-mechanism-driven-practice-feedback"value cycle.It pro-vides a theoretical innovation path for the reform of public hospital remuneration system,and has important reference value for balancing the efficiency and fairness of medical services.

Objective To explore and analyze the incentive changes before and after the implementation of the annual salary system in public hospitals to provide guidance for the implementation.Methods Using the principal-agent theory,construct the structure and model of government,hospitals and doctors,and analyze the salary incentive before and after the implementation of the annual salary system.Results Former doctors"seek profit"and hospital"income orientation"conflict with the government public welfare goals;after implementation,doctors transfer"public welfare"and hospital and government goals seek"public welfare coordination",but there are also new problems such as insufficient incentives.Conclusion If public hospitals successfully implement the annual salary system,they should adopt fine parameter design,supporting system and dynamic equilibrium mechanism.

The theory of"spleen and stomach deficiency and excess transformation"originates from Huangdi Neijing,which is based on the five elements theory.It systematically elucidates the physiological interconnections and pathological transmission relationships among spleen,stomach,and the five zang and six fu viscera.This theory was continuously developed and refined by later physicians.It was first systematically summarized and deepened by LI Dongyuan in his work Piwei Lun,which elaborates on the pathological transmission relationships of other zang-fu viscera after spleen and stomach deficiency.From the perspective of LI Dongyuan's theory of"spleen and stomach deficiency and excess transformation",this paper discusses the pathological relationships between spleen-earth,lung-metal,and kidney-water,and proposes that spleen-earth deficiency is the pathological basis for the onset of allergic rhinitis.Based on the pathological evolution following spleen-earth deficiency,the traditional Chinese medicine syndromes of allergic rhinitis were categorized into three types:earth deficiency with metal weakness,earth dryness with metal desiccation,and water cold with metal excess and earth decline.The treatment of allergic rhinitis should prioritize the spleen-earth,employing acrid and dispersing herbs with light properties to elevate the spleen,sweet-warm and sour-astringent herbs to tonify the spleen,and diuretic and dampness-resolving herbs to activate the spleen,thereby restoring spleen-earth function.Simultaneously,treatment should regulate lung-metal and kidney-water according to different pathological evolutions,incorporating cold-cool or acrid-warm herbs as appropriate,combining cold and warm properties,and treating both the manifestation and root cause of the disease.

Under the background of deepening the reform of medical and health system,the reform of public hos-pital salary system reform faces the dual challenges of realizing the value of knowledge and maintaining public wel-fare.Based on the public value theory,it constructs a synergistic analytical framework of"knowledge value and pub-lic welfare"to reveal the internal logic and realization path of public hospital pay system reform.Through the mecha-nisms of policy design reconstruction,assessment system innovation,remuneration structure optimization and multi-dimensional collaborative governance,the current systemic obstacles such as incentive alienation,misalign-ment of assessment,and insufficient financial compensation can be effectively solved.It is necessary to build a pub-lic value target,construct a synergistic system of"constraints and incentives",and activate the main motivation of medical staff to form a closed loop of"target-setting-mechanism-driven-practice-feedback"value cycle.It pro-vides a theoretical innovation path for the reform of public hospital remuneration system,and has important reference value for balancing the efficiency and fairness of medical services.

Objective To explore and analyze the incentive changes before and after the implementation of the annual salary system in public hospitals to provide guidance for the implementation.Methods Using the principal-agent theory,construct the structure and model of government,hospitals and doctors,and analyze the salary incentive before and after the implementation of the annual salary system.Results Former doctors"seek profit"and hospital"income orientation"conflict with the government public welfare goals;after implementation,doctors transfer"public welfare"and hospital and government goals seek"public welfare coordination",but there are also new problems such as insufficient incentives.Conclusion If public hospitals successfully implement the annual salary system,they should adopt fine parameter design,supporting system and dynamic equilibrium mechanism.

Bone defect has always been a major clinical challenge because of its great difficulty and long period of treatment. Drynariae Rhizoma is a commonly used medicine in osteology and traumatology of traditional Chinese medicine， and its active ingredients（mainly flavonoids） facilitate osteoblast differentiation of bone marrow mesenchymal stem cells， osteoclast proliferation， vascular-osteogenic coupling， and inhibit osteoclast activity to promote bone mineralization， and repair and reconstruction of bone defect. As a good substitute for bone regeneration drugs， the active constituents of Drynariae Rhizoma can be loaded on scaffold materials of tissue engineering， which greatly improves the bioavailability of the drug. Meanwhile， the sustained-release microspheres also solve some problems such as sudden drug release from the scaffolds， and the composite scaffolds with active ingredient of Drynariae Rhizoma prepared by them have good ossification activity and osteoinduction， with precise bone repair effects， which meet the diverse performance requirements of bone grafts and have a promising clinical application prospect.

Administration oral mucosal drug delivery has the advantages of high patient acceptance, rapid onset of action, convenient, etc., and it can avoid the first-pass effect of the drug in the liver. Nevertheless, the design of oral mucosal drug delivery systems is inherently challenging due to the distinctive physicochemical properties of certain drugs and the specific physiological environment of the oral cavity. Natural polysaccharide chitosan-based materials exhibit favorable characteristics, including non-toxicity or low toxicity and biodegradability. These materials can effectively inhibit bacterial growth, enable controlled drug release, and enhance mucosal adhesion. Consequently, chitosan-based materials have been the subject of extensive research in the field of oral mucosal drug delivery systems. This paper offers a comprehensive overview of oral mucosal drug delivery systems, reviews relevant studies on chitosan-based materials, and discusses future prospects for their application.