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 Proctor's reporting guideline for implementation strategies represents a landmark framework in the field of implementation science, aiming to address the issue of inconsistent reporting in implementation research by standardizing the naming, definition, and operationalization of implementation strategies, thereby enhancing the credibility and utility of research findings. This paper provides an in-depth interpretation of the core connotations of this reporting guideline and illustrates its application in developing interview outlines and specifying implementation strategies, using a brief smoking cessation intervention project as a case study. Through this reporting guideline, abstract recommendations for implementation are systematically transformed into clear, multidimensional operational guides, significantly improving the transparency of strategy connotations and the replicability of actual execution. Meanwhile, the case study highlights the flexibility of the guideline, which allows researchers to adapt the content and format of strategies based on local resources and cultural contexts, thus enhancing practical adaptability while maintaining scientific rigor. However, the application of Proctor's reporting guideline still faces challenges, primarily manifested in the potential confusion surrounding the constructs of temporality and dose in practice, as well as the challenges that the inherent flexibility of the guideline may pose to the assessment of fidelity and effectiveness. Despite these limitations, the reporting guideline remains a vital tool for implementation research; future efforts should focus on optimizing its application—through refining operational guidelines, standardizing flexible adaptations, and involving stakeholders—to better guide implementation studies and continuously promote high-quality development in the field.

Objective To investigate the general characteristics and treatment processes of patients with advanced esophageal cancer (EC) treated in county- or prefecture-level hospitals in high-incidence areas of EC in China. Methods In this retrospective observational study, electronic medical records of patients with advanced EC were collected from six medical centers in high-incidence areas. Eligible patients had advanced EC and whose first medical contact was documented between January 1, 2022, and June 1, 2024. Descriptive statistical analyses were conducted to evaluate patient characteristics and treatment plans. Results A total of 322 EC patients were included, of whom 230 were male (71.4%). The median age was 69 years. Among the 270 patients with available tumor diagnosis information, 264 patients (97.8%) presented with EC-specific symptoms. Of the 281 patients with pathological data, esophageal squamous cell carcinoma was the predominant type, accounting for 254 cases (90.4%). Among 235 patients with information on the initial diagnostic method, 220 (93.6%) were diagnosed through endoscopy. A total of 216 patients (67.1%) with advanced disease progressed from early or locally advanced stages. Surgical treatment was performed in 126 patients (39.1%), of whom 123 (97.6%) achieved R0 resection, and 71 (56.3%) of them received perioperative treatment. Definitive chemoradiotherapy was administered to 116 patients (36.0%). The median disease-free survival for patients undergoing radical surgery was 13.9 months, while that for patients treated with definitive chemoradiotherapy was 10.6 months. At the advanced stage, lymph node metastasis was observed in 250 patients (77.6%), with mediastinal lymph node metastasis being the most common type. Organ metastasis occurred in 176 patients (54.7%), most frequently involving the lungs, liver, and bones. Most patients (79.8%, 229/287) were from the county or city where the hospoital was loacted, 77.9% (232/298) were covered by resident basic medical insurance, and 88.7% (274/309) of patients initiated advanced treatment at the participating hospitals. Conclusion This study reveals the unique epidemiological, clinical, and pathological characteristics of patients with EC in high-incidence areas of China. The results provide an important reference for further exploration of this disease and its management.

Objective To explore the relevant factors affecting the efficacy of traditional Chinese medicine in treating MG,and to develop and validate a nomogram model,in order to personalize the prediction of the probability of benefits for MG patients after traditional Chinese medicine treatment,further guide clinical physicians in targeted medication,and provide guidance for the traditional Chinese medicine treatment of MG.Method Retrospective analysis of MG patients who visited the Affiliated Hospital of Changchun University of Traditional Chinese Medicine from March 2018 to June 2022,13 clinical factors were selected to evaluate the results.To acquire independent factors,univariate and multivariate Logistic analyses were performed.The area under the receiver operating characteristic curve,Harrell's concordance index,calibration curve,and decision curve analyses were used to evaluate the predictive ability,accuracy,and clinical practicability of the prediction model.Results A total of 204 cases were included,divided into derivation cohort 139 cases and temporal validation cohort 65 cases.Multivariate Logistic regression showed 4 independent predictors affecting effectiveness of traditional Chinese medicine in treating MG,including age at onset,repetitive nerve stimulation positive,oral immunosuppressant and anxiety/depression.AUC values for the model group and validation group were 0.76(95%CI:0.68-0.84)and 0.83(95%CI:0.71-0.95),respectively,and based on calibration curve and decision curve analysis,we concluded that the nomogram showed excellent performance.Conclusion MG patients may experience a decrease in short-term efficacy with age,positive RNS,concomitant emotional abnormalities,or recent history of immunosuppressive therapy.This nomogram effectively predicts the possibility of short-term effective traditional Chinese medicine treatment in MG patients.

Toxic Chinese herbal medicines(TCHMs)both represent a unique class of therapeutic agents that exhibit both potent efficacy("using toxins to combat pathogens and often curing critical con-ditions")and pose safety concerns("potentially causing severe harm").Balancing clinical effectiveness with safe applications remains a priority of research for these substances.This review summarizes the hepatotoxic mechanisms,research progress,detoxification strategies and clinical challenges associated with TCHMs documented in the 2025 Pharmacopoeia of the People's Republic of China(Volume Ⅰ)in the hope of providing evidence-based insights into the safe and rational clinical use of these hepatotoxic herbs.

AIM:Flow cytometry was used to evaluate the effects of short-term storage conditions(fresh,frozen at-80℃for 7 d,and stored at 4℃for 7 d)on the median fluorescence intensity(MFI)of antibodies and the percentage of immune cell subsets in mouse peripheral blood mononuclear cells(PBMCs)and splenocytes.METHODS:The PBMC and splenocyte suspensions from six male Kunming mice were collected and analyzed under three different processing con-ditions to compare differences in the antibody MFI and percentages of monocyte subsets(Ly-6clow/Ly-6cmedium/Ly-6chigh),macrophages(M1/M2),and dendritic cells.RESULTS:Both tissue and antibody specificity were demonstrated by changes in the antibody MFI values.Following storage at-80℃,the MFIs of certain antibodies(such as CD45 and F4/80 in PBMCs,and CD115,Ly-6c,F4/80,CD80 and MHC-II in the spleen)were similar to those of the fresh groups,where-as after storage at 4℃,the MFIs of other antibodies(such as 7-AAD,CD115,Ly-6c and MHC-II in PBMCs,and CD11b,CD206 and CD11c in the spleen)were closer to those of the fresh groups.The MFI of most of the examined anti-bodies varied significantly following storage.Both storage conditions significantly reduced the viability of PBMCs and sple-nocytes.In PBMCs stored at 4℃,the percentages of total monocytes,Ly-6cmedium/Ly-6chigh monocytes,total macrophages,and dendritic cells were similar to those in the fresh group.Compared with the fresh group,both storage groups presented significantly lower percentages of M1 macrophages and dendritic cells(P<0.05).There were no statistically significant differences in the percentages of total monocytes,Ly-6cmedium monocytes,Ly-6chigh monocytes,total macrophages,M1 and M2 macrophages,or dendritic cells in the spleen among the three groups(P>0.05).The percentage of Ly-6clow monocytes did not differ substantially(P>0.05)between the fresh and-80℃frozen groups but was significantly lower in the 4℃storage group than in the fresh group(P<0.05).CONCLUSION:The storage conditions of the samples had a substantial effect on the flow cytometry results(antibody MFI and cell subset percentages)of the PBMCs and splenic cells,with tissue specificity.If the percentage of immune cell subgroups(particularly monocytes/macrophages/dendritic cells)in PBMCs is highly important,storage at 4℃for 7 d is preferable.If the MFI values of specific antibodies(such as CD45 and F4/80)are important,freezing at-80℃may be more appropriate.If the MFI values of most antibodies or the percentages of criti-cal subgroups(such as total monocytes/Ly-6chigh/total macrophages/dendritic cells)in splenic cells need to be close to those of fresh samples,4 ℃ storage for 7 d is more effective.Freezing at-80℃is preferable if the MFI values of particular anti-bodies(such as CD115 and Ly-6c)need to be determined.

Objective To explore the relevant factors affecting the efficacy of traditional Chinese medicine in treating MG,and to develop and validate a nomogram model,in order to personalize the prediction of the probability of benefits for MG patients after traditional Chinese medicine treatment,further guide clinical physicians in targeted medication,and provide guidance for the traditional Chinese medicine treatment of MG.Method Retrospective analysis of MG patients who visited the Affiliated Hospital of Changchun University of Traditional Chinese Medicine from March 2018 to June 2022,13 clinical factors were selected to evaluate the results.To acquire independent factors,univariate and multivariate Logistic analyses were performed.The area under the receiver operating characteristic curve,Harrell's concordance index,calibration curve,and decision curve analyses were used to evaluate the predictive ability,accuracy,and clinical practicability of the prediction model.Results A total of 204 cases were included,divided into derivation cohort 139 cases and temporal validation cohort 65 cases.Multivariate Logistic regression showed 4 independent predictors affecting effectiveness of traditional Chinese medicine in treating MG,including age at onset,repetitive nerve stimulation positive,oral immunosuppressant and anxiety/depression.AUC values for the model group and validation group were 0.76(95%CI:0.68-0.84)and 0.83(95%CI:0.71-0.95),respectively,and based on calibration curve and decision curve analysis,we concluded that the nomogram showed excellent performance.Conclusion MG patients may experience a decrease in short-term efficacy with age,positive RNS,concomitant emotional abnormalities,or recent history of immunosuppressive therapy.This nomogram effectively predicts the possibility of short-term effective traditional Chinese medicine treatment in MG patients.

With the rapid development of artificial intelligence(AI),how to digitize the teaching of Medical Immunology is a new challenge posed by the times and education.This study is based on the advanced teaching model of Medical Immunology,which includes lectures-PAD class-flipped classrooms-expert lecture.By introducing knowledge mapping and AI teaching assistant into the entire learning process,the students not only deepen their understanding of the knowledge system of Medical Immunology,but also ex-ercise their ability to apply immunological knowledge to solve practical clinical problems,enhance their self-learning ability,expres-sion ability,communication ability,on-site performance ability,and cultivate a spirit of unity,cooperation,and exploration.The practice of empowering Medical Immunology teaching with digital intelligence achieves the integration of theory and application,the linkage between in class and out of class teaching,the connection between commonalities and individualities,and the union of abili-ties and qualities in Medical Immunology teaching.It also provides practical basis for exploring the implementation path of digital intel-ligence empowerment in Medical Immunology teaching.

AIM:To explore suitable methods for the induction and cryopreservation of mouse bone marrow-derived macrophages(BMDMs).METHODS:Mouse fibroblasts(L929 cells)were cultured under varying conditions of temperature,seeding density,and serum concentration.The concentration of macrophage colony-stimulating factor(M-CSF)in the cell supernatant was measured using ELISA to determine the optimal conditions.Mouse bone marrow cells were extracted,and a differential adherence method was employed to pre-culture the bone marrow cells for 4 h,followed by flow cytometry to assess the proportion of resident macrophages.Flow cytometry was utilized to assess the ratio of F4/80 positive cells among the suspended and adherent cells.Induction of BMDMs was conducted using L929 cell supernatant or recombinant M-CSF for 7 d,and flow cytometry was applied to evaluate the proportion of F4/80 and CD11b double-positive cells.The morphologic changes during cell induction were observed under an inverted microscope,and the phagocytic ca-pacity and inflammatory response levels of BMDMs derived from C57BL/6N and C57BL/6J mice were evaluated using neu-tral red and ELISA methods.The cells were immediately cryopreserved after extraction,and then induced after recovery,or cryopreserved after successful induction and recovered.The cell morphology was observed under an inverted micro-scope,cell viability was assessed using the CCK-8 method,and phagocytic ability was measured using the neutral red method.RESULTS:The M-CSF concentration in the supernatant from L929 cells cultured at 33℃,10%fetal bovine se-rum(FBS)for 7 d was rich.Following 4 h of pre-culture,the proportion of F4/80 positive cells in adherent cells was sig-nificantly higher than that in suspended cells(P＜0.01).After 7 d of induction with L929 cell supernatant or recombinant M-CSF,the proportions of F4/80+CD11b+cells showed no significant difference(P＞0.05).Compared with the BMDMs derived from C57BL/6J mice,those from C57BL/6N mice exhibited stronger phagocytic capacity(P＜0.01),and released lower levels of TNF-α(P＜0.01)and IL-6(P＜0.05),and higher levels of IL-1β(P＜0.05).Compared with the BMDMs that were induced after recovery from initial cryopreservation,those cryopreserved immediately after extraction and in-duced upon recovery exhibited better macrophage morphology,higher cell viability(P＜0.01),and enhanced phagocytic ability(P＜0.01).CONCLUSION:The supernatant from L929 cells cultured at 33℃,10%FBS for 7 d is rich in M-CSF,successfully inducing bone marrow cells to differentiate into mouse BMDMs.The differential adherence method for pre-culturing can eliminate resident macrophages from the original bone marrow.The phagocytic capacity and inflammato-ry response levels differ between BMDMs derived from the C57BL/6N and C57BL/6J mouse subtypes.Cryopreserving bone marrow cells immediately after extraction and subsequently inducing them upon recovery is a preferable method for BMDM cryopreservation.

Objective To analyze risk factors of acute cardio-cerebrovascular accidents in elderly patients with lower extremity fracture,and to construct a risk prediction diagram model.Methods A retrospective analysis was conducted on the clinical data of 510 elderly patients with lower extremity fractures,and the patients were divided into the occurrence group and the non-occurrence group based on the occurrence of acute cardiovascular and cerebrovascular accidents during the postoperative hospitalization.Univariate and multivariate Logistic regression analysis was used to analyze risk factors affecting acute cardiovascular and cerebrovascular accidents in elderly patients with lower extremity fracture,and the risk prediction model was constructed and verified.Results A total of 52 cases of acute cardio-cerebrovascular accidents occurred during hospitalization in 510 patients(10.20%).Age,ASA grade Ⅲ ratio,preoperative concurrent cerebrovascular disease,postoperative pneumonia ratio and postoperative bed time≥5 days ratio were higher in the occurrence group than those in the non-occurrence group(P＜0.05).Multivariate Logistic regression analysis showed that age,ASA grade Ⅲ,preoperative concurrent cardiovascular and cerebrovascular disease,and postoperative pneumonia were risk factors for acute cardio-cerebrovascular accidents in elderly patients with lower limb fracture(P＜0.05).Multivariate Logistic regression analysis was used to screen risk factors as predictive variables to build a risk early warning histogram model for acute cardio-cerebrovascular accidents.The total score ranged from 103 to 168 points,corresponding to a risk range of 0.1 to 0.9 points.Receiver operating characteristic curve(ROC)curve results showed that the area under the curve(AUC)of this model for predicting acute cardiovascular and cerebrovascular accidents was 0.980(95%CI:0.964-1.000),and discrete choice approach(DCA)showed that when the risk threshold was 0.2-0.6,the prediction model of this column graph had a good clinical advantage.Conclusion The risk diagram model constructed based on risk factors has good predictive value for the occurrence of acute cardio-cerebrovascular accidents after lower extremity fracture in elderly patients.