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.

Objective To explore the functional connectivity(FC)changes of hippocampus and amygdala in type 2 diabetes mellitus(T2DM)patients with erectile dysfunction(DMED),and the central pathological neural mechanisms underlying DMED.Methods 61 T2DM patients who visited Department of Endocrinology,Nanjing First Hospital,Nanjing Medical University from January 2020 to December 2021 were selected and divided into a simple T2DM group(n=30)and a combined DMED group(n=31).Another 47 healthy individuals were selected as control group(NC).The international erectile function scale(IIEF-5)was used to evaluate the erectile function.Resting-state functional magnetic resonance imaging(rs-fMRI)data were acquired from all participants.MRI data were preprocessed by the DPABI software package.Bilateral hippocampus and amygdala were selected as regions of interest(ROI)and the whole brain FC values were calculated.The FC values of brain regions between groups were tested by two-sample t-test with REST software package.Results Left hippocampus as ROI:compared with the NC group,FC values of the left superior temporal gyrus increased in the T2DM group,FC values of the left superior frontal gyrus,left inferior temporal gyrus,left posterior central gyrus and rectus gyrus decreased in the DMED group.Compared with the T2DM group,FC values of the left inferior parietal gyrus,left supramarginal gyrus,left middle occipital gyrus and right posterior central gyrus decreased in the DMED group.Right hippocampus as ROI:compared with the NC group,FC values of the right middle temporal gyrus and right rolandic operculum increased while FC values of the right calcarine fissure decreased in the T2DM group;FC values of bilateral anterior cingulate gyrus,right middle temporal gyrus and left rectus gyrus decreased in the DMED group.Compared with the T2DM group,FC values of the left middle frontal gyrus,left inferior parietal gyrus and right inferior temporal gyrus decreased in the DMED group.Left amygdala as ROI:compared with the NC group,FC values in the left parahippocampal gyrus,left fusiform gyrus and right insula increased in the T2DM group;FC value of the left middle temporal gyrus decreased in the DMED group.Compared with the T2DM group,FC values of the left middle frontal gyrus and left supramarginal gyrus decreased in the DMED group.Right amygdala as ROI:compared with the NC group,FC values of the left insula,right parahippocampal gyrus,right superior temporal gyrus and right supramarginal gyrus increased while FC values in the right caudate decreased in the T2DM group;FC values of the right middle frontal gyrus,left rectus gyrus and left middle occipital gyrus decreased in the DMED group.Compared with the T2DM group,FC values of the left middle frontal gyrus and left inferior parietal gyrus decreased in the DMED group.Conclusions DMED patients have abnormalities in the hippocampus,amygdala and other brain regions,especially the frontal lobe functional cortex,which may be related to changes in their brain function.

Objective To explore the functional connectivity(FC)changes of hippocampus and amygdala in type 2 diabetes mellitus(T2DM)patients with erectile dysfunction(DMED),and the central pathological neural mechanisms underlying DMED.Methods 61 T2DM patients who visited Department of Endocrinology,Nanjing First Hospital,Nanjing Medical University from January 2020 to December 2021 were selected and divided into a simple T2DM group(n=30)and a combined DMED group(n=31).Another 47 healthy individuals were selected as control group(NC).The international erectile function scale(IIEF-5)was used to evaluate the erectile function.Resting-state functional magnetic resonance imaging(rs-fMRI)data were acquired from all participants.MRI data were preprocessed by the DPABI software package.Bilateral hippocampus and amygdala were selected as regions of interest(ROI)and the whole brain FC values were calculated.The FC values of brain regions between groups were tested by two-sample t-test with REST software package.Results Left hippocampus as ROI:compared with the NC group,FC values of the left superior temporal gyrus increased in the T2DM group,FC values of the left superior frontal gyrus,left inferior temporal gyrus,left posterior central gyrus and rectus gyrus decreased in the DMED group.Compared with the T2DM group,FC values of the left inferior parietal gyrus,left supramarginal gyrus,left middle occipital gyrus and right posterior central gyrus decreased in the DMED group.Right hippocampus as ROI:compared with the NC group,FC values of the right middle temporal gyrus and right rolandic operculum increased while FC values of the right calcarine fissure decreased in the T2DM group;FC values of bilateral anterior cingulate gyrus,right middle temporal gyrus and left rectus gyrus decreased in the DMED group.Compared with the T2DM group,FC values of the left middle frontal gyrus,left inferior parietal gyrus and right inferior temporal gyrus decreased in the DMED group.Left amygdala as ROI:compared with the NC group,FC values in the left parahippocampal gyrus,left fusiform gyrus and right insula increased in the T2DM group;FC value of the left middle temporal gyrus decreased in the DMED group.Compared with the T2DM group,FC values of the left middle frontal gyrus and left supramarginal gyrus decreased in the DMED group.Right amygdala as ROI:compared with the NC group,FC values of the left insula,right parahippocampal gyrus,right superior temporal gyrus and right supramarginal gyrus increased while FC values in the right caudate decreased in the T2DM group;FC values of the right middle frontal gyrus,left rectus gyrus and left middle occipital gyrus decreased in the DMED group.Compared with the T2DM group,FC values of the left middle frontal gyrus and left inferior parietal gyrus decreased in the DMED group.Conclusions DMED patients have abnormalities in the hippocampus,amygdala and other brain regions,especially the frontal lobe functional cortex,which may be related to changes in their brain function.

Objective:To evaluate the effect of tutorial system for medical undergraduates in a non-affiliated hospital of a medical university in Jiangsu.Methods:32 senior medical undergraduates in non-affiliated hospitals were divided into two groups. The experimental group adopted tutor-guided teaching, and the control group adopted traditional teaching. Professional theoretical knowledge, clinical ability, operational ability, foreign language level, basic research ability and participation of scientific research activities of students in the two groups were evaluated. SPSS 19.0 was used for t test, chi-square test and U test. Results:The results of operational ability ( t=3.537, P=0.000), the number of papers that had been read ( t=6.961, P=0.000), quality of these ( U=68.000, P=0.017), the number of literature reviews that had been written and reading notes ( χ2=4.747, P=0.000), participation in scientific research activities ( t=6.788, P=0.009) of students in the experimental group were better and higher than those in the control group. In the same period, there was no significant difference between the two groups in the scores of theoretical exam, clinical competence and foreign language tests. Conclusion:The implementation of tutorial system for medical students in non-affiliated hospitals is an effective measure to improve the quality of training. We should make full use of the short intership, to improve the comprehensive quality of students by establishing perfect rules, regulations and teaching evaluation system, and educate students in accordance with their own ability.

Objective To investigate the impact of combined postoperative transcatheter arterial chemoembolization (TACE) with antiviral therapy in hepatitis B-related hepatocellular carcinoma (HBV-HCC) patients with high risks of recurrence.Methods Fifty-three consecutive patients who underwent curative resection of HBV-HCC between January 2014 to February 2016 were enrolled.These patients were assigned to either the adjuvant antiviral therapy combined with TACE group (n =32),the treatment group or the no adjuvant treatment group (n =21,the control group).The recurrence-free survival (RFS) and overall survival (OS) were analyzed.Results There was no significant difference between the two groups in clinical characteristics (P＞0.05).The recurrence-free survival (RFS) (mean±S.D.) was (20.1 ± 1.8) months in the treatment group and (18.7±2.4) months in the control group (P=0.752).The 1-,2-and 3-year RFS rates of the treatment group and the control group were 65.6％ vs.57.1％,31.3％ vs.28.6％ and 15.6％ vs.14.3％,respectively (P＞0.05).The overall survival (OS) (mean±S.D.) was (26.8± 1.7) months in the treatment group and (21.1±2.2) months in the control group (P=0.037).The 1-,2-and 3-year RFS rates were 65.6％ vs.57.1％,31.3％ vs.28.6％ and 15.6％ vs.14.3％ in the treatment group and the control group,respectively.The 1-,2-,and 3-year OS rates were 87.5％ vs.66.7％,59.4％ vs.38.1％ and 43.8％ vs.19.0％ in the treatment group and the control group,respectively.Conclusion Antiviral therapy in combination with TACE did not decrease the RFS rate,but it improved the OS rate in HCC patients with high risks of recurrence.

Objective To investigate the clinical application of Glissonean pedicle transection method in hepatocellular carcinoma. Methods We analyzed the clinical data of 232 cases of hepatocellular carcinoma underwent hepatic resection in our department from April 2009 to April 2013. Eighty-nine cases underwent hepatic resection by Glissonean pedicle transection method, and 143 cases underwent Pringle maneuver. Results There was no significant differences in the operation time and blood loss between the two groups (P > 0.05). However, the postoperative hospital stay time and the postoperative complications in group A were better than those in group B(P<0.05). Levels of ALT and AST in group A increased significantly slowly than those in group B. The 1, 3-year disease-free survival rates in the two groups were 87.4%, 71.1% and 85.1%, 60.0%, respectively. The 1, 3-year survival rates were 93.3%, 73.5% and 93.4%, 65.0%, respectively, with no significant differences (P>0.05). Conclusion Glissonean pedicle transection method has many advantages including effectively preventing the intraoperative bleeding, maximally reserving the remaining of liver function, decreasing the rate of tumor spread and metastasis. Meanwhile, it is a safe and effective technique for hepatectomy without dissection of the hepatic artery, portal vein and bile duct in the hepatoduodenal ligament.

Objective To investigate the effective connectivity of limbic circuit in patients with major depressive disorder when they recognized dynamic positive face expressions,aiming to discuss the possible mechanism of emotion processing in depressed patients.Methods Eighteen depressive patients and eighteen well-matched healthy control volunteers participated in the experiment.All subjects were asked to recognize the emotion face during the magnetoencephalograph (MEG) scanning.The regions of interested (ROI) brain areas included the orbital frontal cortex (OFC),the anterior cingulated cortex (ACC),the amygdala (AMYG),the hippocampus and the insula.The MEG data were preprocessed by the SPM8 software and further analyzed by the Granger casual model (GCM).The non-parameter permutation was used to compare the value of effective connectivity between the healthy controls and the depressed patients.Results Compared with healthy controls,the effective connectivity from the ACC to the AMYG (P=0.0052),from the OFC to the AMYG(P=0.0046),from the Hippocampus to the ACC (P=0.0016),and from the ACC to the Hippocampus (P=0.0042)was significantly reduced in depressed patients.Conclusion The depressed patients display decreased interaction of the limbic circuit during the happy facial emotion processing,indicating that the depressed patients are unable to deal with the positive stimuli,and to certain extent,explaining the abnormal neuropathophysiological mechanism of positive stimuli in MDD.

Objective To investigate the interconnection of the executive control network in major depressive disorder when they recognized the sad facial stimuli,and to discuss the aberrant mechanism of emotion processing.Methods Twenty major depressive patients and 20 well-matched healthy volunteers participated in the experiment.The brain actions of all subjects were recorded by the magnetoencephalography (MEG) when they were required to distinguish the emotion face.Based on prior knowledge,the interested brain area consisted of the primary visual cortex (V1),the orbitofrontal cortex(OFC),the dorsolateral prefrontal cortex (DLPFC),the anterior cingulated cortex (ACC).Then constructing three competing models to select an optimal model by the method of dynamic causal model(DCM),finally the differences of the effective connections of the optimal model between the depressed patients and healthy controls were analyzed.Results According to the results of Bayesian model selection (BMS),model 1 had the most exceedance probability of 0.80 with the features that there were bidirectional modulatory connections between the OFC,ACC and DLPFC.Given the best model,the parameters of effective connectivity of the optimal model were extracted,and then two-sample t-test over the model 1 was adopted.The modulatory effective connectivity from the OFC to the DLPFC in both hemisphere(t=-2.73,P=0.0096;t=-3.01,P=0.0046) and the OFC to the ACC (t=-2.93,P=0.0057) in the left hemisphere were significantly reduced in MDD.Conclusion There exists abnormal function of executive control network in depressed patients,the decreased effective connections between the OFC and the DLPFC,as well as the OFC and the ACC,may have correlation with the negative

Objective To explore the differences of the global efficiency of the brain structural networks between the male paranoid schizophrenia and male healthy and its relationship with the psychotic symptoms of the schizophrenia.Methods The diffusion tensor imaging data were obtained from 27 male paranoid schizophrenia patients and 28 male healthy controls.The whole cerebral cortex was parcellated into 90 regions by the anatomical label map.Tractography was performed in the whole cerebral cortex of each subject to reconstruct white matter tracts of the brain using fiber assignment by continuous tracking(FACT) algorithm.And then the brain structural binary networks were constructed using the complex network theory.The average global efficiency of the brain network and the global efficiency of the nodes of both groups were examined by two sample t-test and its relationship with the psychotic symptoms in the male paranoid schizophrenia was explored by the correlation analysis.Results Compared with control group,the average global efficiency of the brain network of the patients decreased significantly (7.87±0.56,8.17±0.56,P=0.005),and the global efficiency of the nodes in the brain network of the patient decreased significantly in the left superior frontal gyrus (orbital part) (P=0.00025),the left superior parietal gyrus (P=0.00011),the left cuneus (P=0.00012) and the left putamen (P=0.00032),all survived FDR correction.Significant negative correlation was found between the global efficiency of the left putamen and the total scores (r=-0.43,P=0.03),the positive scores (r=-0.41,P=0.03) and the cognitive scores (r=-0.40,P=0.04) of PANSS.Conclusion The decreased global efficiency of the left frontal,parietal and occipital lobes and the subcortical structures lead to the occurrence of schizophrenia.And the reduced efficiency of the subcortical structures is associated with the positive symptoms and the abnormal cognitive function of the patients.

Objective To explore the differences of the degree indicating the density of the connectivity of nodes between the brain structural white matter networks in the first-episode (FD),recurrent (RD) depressed patients and the healthy control (HC) subjects.Method The diffusion tensor imaging data were obtained from 29 FD patients,20 RD patients and 57 HC subjects.The whole cerebral cortex was divided into 90 regions by the anatomical label map.Fiber tracking was performed in the whole cerebral cortex of each subject to reconstruct white matter tracts of the brain using the fiber assignment by continuous tracking algorithm.And then the brain structural networks were constructed using the complex network theory.The nodal degree of the brain networks of FD and RD were compared with that of HC,and then the correlations between the degree of the significant nodes and the clinical features of patients were explored.Result The degree of the nodes in the networks of FD descended significantly in the left putamen (11.83 ± 2.28) when compared with HC (13.95 ± 2.33;t =-4.02;P =0.000 13,survived correction).That of RD descended significantly (the right dorsolateral superior frontal gyrus (7.80 ± 1.43);the left putamen (11.75±2.07 when compared with HC (9.70 ± 2.89,13.95 ± 2.33;t=-3.81,-3.73;P =0.000 31,0.000 37,survived correction).That of RD descended significantly in the right dorsolateral superior frontal gyrus (7.80 ± 1.43) when compared with FD (9.62 ± 1.78;t =-3.80;P =0.000 42,survived correction).The distribution of the hub regions in the patient and healthy were similar and the left putamen was the same hub region for both groups.Significant negative correlations were found between the degree of the right dorsolateral superior frontal gyrus and the number of episodes (r =-0.42,P =0.002 6) and the course of the disease (r =-0.41,P =0.003 7) in the patient.Conclusions The degree of the connectivity between the frontal region and putamen are possibly decreased in the depressed patient.The left putamen is in the importance role in the brain network and the damage of its connected fibers may be the common structural changes in both FD and RD.The damage of the fibers connected to the frontal region is related with the recurrent course of the depressed patients.