Modern medicine has made remarkable achievements in safeguarding people's life and health, however, it is increasingly found that in the face of complex diseases, selective targeting of single target is often difficult to produce a comprehensive rehabilitation effect, and is prone to induce drug resistance, toxic side effects. Traditional Chinese medicine (TCM) has a long history of clinical application, and its clinical value in the treatment of complex diseases such as cardiovascular and cerebrovascular diseases, digestive diseases, skin diseases, rheumatism and immunity diseases, and adjuvant treatment of tumors has been proven to have obvious advantages. However, its modern research is relatively lagging behind, and in the face of the aging society and the characteristics of the modern disease spectrum, the traditional knowledge-driven research paradigm seems to be stuck in a bottleneck and difficult to make greater breakthroughs. Focusing on the key issues of TCM development in the new era, the clinical value-oriented strategy becomes to be a new research paradigm of TCM inheritance and innovation development, and dominant diseases would be the focus of the TCM inheritance and innovation development, which has been highly valued in recent years by the TCM academia and the relevant national management departments. Based on the clinical value, a series of policies are formulated for the selection and evaluation of the TCM dominant diseases (TCMDD), and exploratory researches about the clinical efficacy characteristics, the modern scientific connotation interpretation were carried out. The clinical value-oriented research paradigm of TCMDD inheritance and innovation development has been initially formed, which is characterized by strong policy support as the guarantee, systematic and standardized selection and evaluation methods as the driving force, scientific and effective research on internal mechanisms as the expansion, and effective clinical guidelines and principles as the transformation, which is of great value in promoting the high-quality development of the industries and undertaking of TCM. In this paper, the main policy support, selection and evaluation methods, therapeutic effect characterization, and modern scientific connotation research strategies of TCMDD in recent years have been comprehensively sorted out, with a view to providing the healthy and benign development of the research on TCMDD.

Cognitive dysfunction is one of the common central nervous systems (CNS) complications of diabetes mellitus, which seriously affects the quality of life of patients and results in a huge economic burden. The glymphatic system dysfunction mediated by aquaporin-4 (AQP4) loss or redistribution in perivascular astrocyte endfeet plays a crucial role in diabetes-induced cognitive impairment (DCI). However, the mechanism of AQP4 loss or redistribution in the diabetic states remains unclear. Accumulating evidence suggests that peripheral insulin resistance target tissues and CNS communication affect brain homeostasis and that exosomal miRNAs are key mediators. Glucose and lipid metabolism disorder is an important pathological feature of diabetes mellitus, and skeletal muscle, liver and adipose tissue are the key target insulin resistance organs. In this review, the changes in exosomal miRNAs induced by peripheral metabolism disorders in diabetes mellitus were systematically reviewed. We focused on exosomal miRNAs that could induce low AQP4 expression and redistribution in perivascular astrocyte endfeet, which could provide an interorgan communication pathway to illustrate the pathogenesis of DCI. Furthermore, the mechanisms of exosome secretion from peripheral insulin resistance target tissue and absorption to the CNS were summarized, which will be beneficial for proposing novel and feasible strategies to optimize DCI prevention and/or treatment in diabetic patients.

Objective:To investigate the predictive value of serum neuron axon guidance factor-1（Netrin-1）combined with bispectral index（BIS）for delayed encephalopathy in patients with carbon monoxide（CO）poisoning.Methods:A total of 128 patients with CO poisoning admitted to the First Hospital of Shanxi Medical University from January 2018 to November 2020 were prospectively selected as the subjects of this study，and they were divided into delayed encephalopathy after acute carbon monoxide poisoning（DEACMP）group（ n=53）and non-DEACMP group（ n=75），according to whether DEACMP occurred three months after discharge. Enzyme-linked immunosorbent assay was used to detect the patients’ serum Netrin-1 level，and the BIS value was calculated. The Netrin-1 and BIS at different time points in the two groups were compared，and the receiver operating characteristic（ROC）curve and area under the curve（AUC）of study subjects were used to evaluate Netrin-1，BIS，and Netrin-1 combined with BIS in predicting delayed encephalopathy in CO poisoning patients after receiving hyperbaric oxygen therapy. Multivariate logistic regression analysis was used to analyze the risk factors affecting delayed encephalopathy after CO poisoning. Results:The serum Netrin-1 levels and BIS values of the DEACMP group at 1，3，and 5 d after admission were significantly lower than those of the non-DEACMP group（ P<0.05）. The ROC curve results showed that the areas under the Netrin-1 and BIS curves were 0.785 and 0.810，respectively；the cut-off values were 395 and 62，respectively；the sensitivity were 70.62% and 78.69%；and the specificity were 77.85% and 86.64%，respectively. The AUC，sensitivity，and specificity of Netrin-1 combined with BIS were 0.896，85.69%，and 98.52%，respectively. Compared with using Netrin-1 or BIS alone，Netrin-1 combined with BIS was better in predicting delayed encephalopathy in CO poisoning patients after hyperbaric oxygen therapy. Multivariate logistic regression analysis showed that Netrin-1 < 395 ng/ml and BIS < 62 were the risk factors of delayed encephalopathy in CO poisoning patients after hyperbaric oxygen therapy（ P<0.05）. Conclusion:Netrin-1 and BIS are reduced in DEACMP patients，and BIS combined with Netrin-1 has significant clinical value in predicting the occurrence of delayed encephalopathy in CO poisoning patients after hyperbaric oxygen therapy.

Objective:To investigate the predictive value of serum neuron axon guidance factor-1（Netrin-1）combined with bispectral index（BIS）for delayed encephalopathy in patients with carbon monoxide（CO）poisoning.Methods:A total of 128 patients with CO poisoning admitted to the First Hospital of Shanxi Medical University from January 2018 to November 2020 were prospectively selected as the subjects of this study，and they were divided into delayed encephalopathy after acute carbon monoxide poisoning（DEACMP）group（ n=53）and non-DEACMP group（ n=75），according to whether DEACMP occurred three months after discharge. Enzyme-linked immunosorbent assay was used to detect the patients’ serum Netrin-1 level，and the BIS value was calculated. The Netrin-1 and BIS at different time points in the two groups were compared，and the receiver operating characteristic（ROC）curve and area under the curve（AUC）of study subjects were used to evaluate Netrin-1，BIS，and Netrin-1 combined with BIS in predicting delayed encephalopathy in CO poisoning patients after receiving hyperbaric oxygen therapy. Multivariate logistic regression analysis was used to analyze the risk factors affecting delayed encephalopathy after CO poisoning. Results:The serum Netrin-1 levels and BIS values of the DEACMP group at 1，3，and 5 d after admission were significantly lower than those of the non-DEACMP group（ P<0.05）. The ROC curve results showed that the areas under the Netrin-1 and BIS curves were 0.785 and 0.810，respectively；the cut-off values were 395 and 62，respectively；the sensitivity were 70.62% and 78.69%；and the specificity were 77.85% and 86.64%，respectively. The AUC，sensitivity，and specificity of Netrin-1 combined with BIS were 0.896，85.69%，and 98.52%，respectively. Compared with using Netrin-1 or BIS alone，Netrin-1 combined with BIS was better in predicting delayed encephalopathy in CO poisoning patients after hyperbaric oxygen therapy. Multivariate logistic regression analysis showed that Netrin-1 < 395 ng/ml and BIS < 62 were the risk factors of delayed encephalopathy in CO poisoning patients after hyperbaric oxygen therapy（ P<0.05）. Conclusion:Netrin-1 and BIS are reduced in DEACMP patients，and BIS combined with Netrin-1 has significant clinical value in predicting the occurrence of delayed encephalopathy in CO poisoning patients after hyperbaric oxygen therapy.

Objective:To investigate the expression of microRNA125a in infiltrating macrophages during myocardial ischemia reperfusion, and to analyze the effect of microRNA125a on the polarization of infiltrating macrophages during myocardial ischemia reperfusion.Methods:The rat model of myocardial ischemia-reperfusion was established. Myocardial injury tissues were taken, infiltrated macrophages were isolated, and RNA was extracted. qRT-PCR was used to detect M1 and M2 markers in macrophages and evaluate the types of infiltrated macrophages. Subsequently the expression level of microRNA125a in infiltrating macrophages was detected. Finally, the effect of microRNA125a on macrophage polarization was further elucidated.Results:Macrophages in myocardium of ischemia reperfusion showed high expression of M1 markers (TNF-alpha and IL-8), presenting M1 macrophages. At the same time, microRNA125a was also highly expressed in this macrophage. Knockdown or overexpression of microRNA125a in macrophages in vitro can affect the macrophages polarization.Conclusions:Macrophages in myocardial ischemia reperfusion are M1 type, and microRNA125a is highly expressed in this macrophage and promotes its migration to M1 type.