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.

ObjectiveTo explore the effect and mechanism of tumor necrosis factor alpha （TNF-α）-regulated circular RNA Williams Beuren syndrome chromosomal region 22 （circWBSCR22） on the malignant behaviors of cervical cancer cells. MethodsHuman cervical cancer HeLa cells were treated with TNF-α. Reverse transcription quantitative polymerase chain reaction （RT-qPCR） was used to detect the expression level of circWBSCR22. Nuclear-cytoplasmic RNA separation experiments were conducted to determine the localization of circWBSCR22 in cells. Cell migration， invasion， viability， and proliferation were assessed through Transwell assay， tetrazolium salt （MTT） assay， and colony formation assay， respectively. Dual-luciferase reporter gene assays were performed to verify the targeting relationship between microRNA-512-5p （miR-512-5p） and circWBSCR22 or family with sequence similarity 60A （FAM60A）. RT-qPCR was used to detect the RNA levels of miR-512-5p and FAM60A. Western blot was used to detect the protein level of FAM60A. ResultsCompared with the Control group， the expression level of circWBSCR22 in HeLa cells treated with TNF-α increased （P<0.05）. About 66% of circWBSCR22 was found in the cytoplasm. Compared with the control group， the migration （P<0.01） and invasion （P<0.01） of HeLa cells transfected with circWBSCR22 were enhanced， but the cell activity and cell proliferation were not significantly affected （P>0.05）. The double luciferase reporter gene assay showed that the relative luciferase activity of the co transfected circWBSCR22-WT and miR-512-5p groups was lower than that of the co transfected circWBSCR22-WT and miR-NC groups （P<0.01）. Compared with the control group， the expression level of miR-512-5p in HeLa cells transfected with circWBSCR22 decreased （P<0.01）. Compared with the control group， the migration （P<0.01） and invasion （P<0.05） ability of HeLa cells transfected with miR-512-5p decreased. Double luciferase reporter gene assay showed that compared with the co transfected FAM60A 3´-UTR-WT and miR-NC groups， the fluorescence activity of the co transfected FAM60A 3´-UTR-WT and miR-512-5p groups decreased （P<0.01）.Compared with the control group， the expression levels of FAM60A mRNA （P<0.05） and protein （P<0.01） in HeLa cells transfected with miR-512-5p decreased. Compared with the control group， the migration （P<0.01） and invasion （P<0.01） of cervical cancer HeLa cells transfected with FAM60A were enhanced. Compared with the control group， the expression levels of FAM60A mRNA （P<0.01） and protein （P<0.05） in the cells transfected with circWBSCR22 increased. The results of rescue experiment showed that compared with the pcDNA+miR-NC group， the expression levels of FAM60A RNA （P<0.01） and protein （P<0.001） in the pcDNA+miR-512-5p group decreased， and the ability of migration （P<0.01） and invasion （P<0.05） decreased； Compared with pcDNA+miR-512-5p group， the expression levels of FAM60A RNA （P<0.01） and protein （P<0.001） in circWBSCR22+miR-512-5p group increased， and the ability of migration （P<0.01） and invasion （P<0.05） was enhanced. ConclusionTNF-α promotes the migration and invasion of cervical cancer cells through the circWBSCR22/miR-512-5p/FAM60A regulatory axis.

Neuroinflammation secondary to traumatic brain injury (TBI) is a key factor affecting the prognosis and neural repair of patients. In recent years, nanomedicine and nano delivery system (NDDS) has shown great potential in neuroinflammation after TBI due to their controlled release, good biocompatibility, and ability to cross the blood-brain barrier. This article reviews the recent advance in mechanism of neuroinflammation after TBI and regulatory role of various NDDS in neuroinflammation after TBI, with the aim of providing references for treatment of neuroinflammation after TBI.

OBJECTIVE To analyze the status of targeted monitoring of the health care-associated infections in in-tensive care unit(ICU)of a three-A hospital of northwest China in recent 7 years so as to provide bases for formu-lating effective prevention and control measures for the health care-associated infections.METHODS The related data were successively collected from the ICU hospitalized patients of the Second Affiliated Hospital of Air Force Medical University who were under the targeted monitoring by nosocomial infection real-time monitoring system from Jan.2017 to Dec.2023.The data included the incidence of infections,infection sites,use of catheters,inci-dence of catheter-related infections,and distribution and prevalence trend of pathogens.RESULTS A total of 49,137 hospitalized patients from five ICU wards of respiratory medicine department,neurosurgery department,neurology department,thoracic surgery department and critical care medicine department were under the monito-ring,1446(1681 case-times)of whom had health care-associated infections,with the infection rate 2.94％,the case-time infection rate 3.42％.The respiratory system was the major infection site of the patients with the health care-associated infections.Among the patients with instrument-associated infections,20.70％had ventilator-asso-ciated pneumonia(VAP),5.71％had urinary catheter-associated urinary tract infection(CAUTI),and 1.96％had catheter-related bloodstream infection(CRBSI).Totally 405 strains of non-repetitive pathogens were isolated from 477 patients with instruments-associated infections,78.77％of which were gram-negative bacteria.The iso-lation rate of multidrug-resistant organisms(MDROs)was 44.12％,and Acinetobacter baumannii was the pre-dominant species of pathogen isolated from the patients with VAP.CONCLUSIONS The targeted monitoring of health care-associated infections may facilitate the awareness of dynamic changes of the infections in a accurate and timely manner so as to provide bases for developing effective prevention and control measures for the health care-associated infection.It is necessary to strengthen the prevention and control of the infections in critical care medi-cine department,neurosurgery department as well as the lower respiratory tract infections and prevent the MDROs infection in the meantime.

Objective:To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for the treatment of ileocecal valve lipoma.Methods:A retrospective cohort study was performed on data of ileocecal lipoma patients who underwent ESD at the Endoscopy Center of Zhongshan Hospital, Fudan University from December 2013 to June 2023. According to the lesion location, the patients were divided into ileocecal valve group and cecum group. The operation time, operation speed, en bloc resection rate, complications, and follow-up outcomes between the two groups were compared.Results:A total of 59 patients with ileocecal lipoma were enrolled, including 31 patients in the ileocecal valve group and 28 patients in the cecum group.There were no significant differences in gender, age, specimen size, or lesion size between the two groups ( P>0.05). Lipomas in both the ileocecal valve group and the cecum group were successfully resected by ESD. The en bloc resection rates were 100.0% (31/31) and 92.9% (26/28) respectively, and the difference was not statistically significant ( χ2=0.033, P=0.133). Median operative duration significantly differed between the two groups ( ileocecal valve group 26 min VS cecum group 20 min, Z=-0.136, P=0.027), as did resection speed (ileocecal valve group 0.14 cm2/min VS cecum group 0.24 cm2/min, Z=-0.223, P=0.022). Adverse events included one postoperative fever in the ileocecal valve group and one delayed bleeding in the cecum group. During the median follow-up of 38 months (7-106 months), there was no case of residual tumor or recurrence. Conclusion:Despite technical challenges in ESD of ileocecal valve lipoma, it is still a safe, feasible and effective treatment method.

Objective:To evaluate lung ultrasound (LUS) for assessing lung aeration heterogeneity in neonatal respiratory distress syndrome (NRDS) across gestational ages and analyze its correlation with oxygenation.Methods:This retrospective cohort study enrolled 125 ventilated NRDS neonates from the neonatal intensive care unit of Hebei Children's Hospital (from March 2023 to May 2024), who were stratified as <32 gestational weeks ( n=47) and ≥32 gestational weeks ( n=78). All underwent LUS, chest X-ray, and blood gas analysis within 2 h of admission. The lung ultrasound score (LUSsc) quantified impaired lung volume percentage (graded: A=normal, B=coalescent B-lines, C=dense B-lines/focal consolidation, D=lobar consolidation). Aeration heterogeneity was measured by coefficient of variation (CV, within-patient) and Gini-Simpson index (between-patients), while oxygenation was assessed by arterial oxygen partial pressure/inhaled oxygen concentration (P/F). Group comparisons, including basic information, lung aeration, and lung aeration heterogeneity, used two independent sample t-tests, Mann-Whitney U tests, Chi square tests, or Wilcoxon tests; partial correlation analyzed aeration-oxygenation relationships. Results:(1) Analysis of impaired lung volume percentage revealed similar distribution patterns between groups, with the <32-week cohort ( n=47, 564 lung segments) showing proportions of 15.6% (88/564), 14.9% (84/564), 35.5% (200/564), and 34.0% (192/564) for graded patterns A through D, respectively, while the ≥32-week cohort ( n=78, 936 segments) demonstrated corresponding proportions of 15.7% (147/936), 16.3% (153/936), 31.7% (297/936), and 36.2% (339/936), with no statistically significant difference between groups ( Z=－0.24, P=0.812). (2) Within-patient heterogeneity analysis revealed no significant CV difference between <32-week group and ≥32-week group [0.33 (0.20-0.84) vs. 0.43 (0.21-0.73), Z=－0.99, P=0.321]. (3) Between-patient heterogeneity was significantly higher in the ≥32-week group, as reflected by the Gini-Simpson index [0.12 (0.09-0.14) vs. 0.09 (0.06-0.14), Z=－1.99, P=0.046], with heterogeneous aeration predominantly located in non-gravity-dependent regions—specifically the left upper lung in the <32-week group and anterior lungs in the ≥32-week group. (4) Correlation analyses demonstrated significantly inverse relationships between CV and LUSsc in <32-week and ≥32-week groups ( r=－0.912, P<0.001; r=－0.886, P<0.001), while the ≥32-week group additionally showed positive CV-P/F correlation ( r=0.373, P=0.001) and inverse LUSsc-P/F association ( r=－0.287, P=0.013). Conclusions:LUS effectively evaluates aeration and its heterogeneity in early NRDS. Infants ≥32 weeks exhibit greater between-patient heterogeneity, with ventilation parameters correlating significantly with oxygenation status.

Pregnancy with chronic kidney disease (CKD), particularly in stages 4-5, carries high risks of adverse outcomes including maternal renal failure, preeclampsia/eclampsia, fetal growth restriction, and preterm birth. This report described a 26-year-old woman with congenital solitary kidney, polycystic ovaries, and uterine septum due to PAX2 gene variant, complicated by CKD stage 4. Through multidisciplinary team precision management and individualized treatment strategies, including timely initiation of dialysis, the patient successfully maintained pregnancy until 34 +1 weeks and delivered a female infant via cesarean section. This case summarizes key management experiences for end-stage renal disease in pregnancy, highlighting early risk assessment, precise nutritional management, hemodialysis protocol optimization, and the crucial role of multidisciplinary collaboration, providing valuable references for managing CKD-complicated pregnancies.

AIM: To investigate timing of glucocorticoids use in the treatment of syphilitic uveitis.METHODS: A retrospective study was conducted in 110 patients(134 eyes)with syphilitic uveitis diagnosed from January 2008 to January 2021, of whom 24 were binocular. The time from onset to treatment was 1 d to 3 mo. They were divided into three groups according to the treatment, including 98 eyes with completed clearely fundus lesions and no abnormalities in fundus fluorescein angiography(FFA)+ indocyanine green angiography(ICGA)+ optical coherence tomography(OCT)after treated with antibiotics alone for 1 to 2 wk in single antibiotics group, 26 eyes with in completely cleared fundus lesions and retinal vessels wall staining observed by FFA or choroidal weak fluorescence observed by ICGA after standard antisyphilitic treatments for 1 to 2 wk in first antibiotics followed by hormones group, and 10 eyes treated according to uveitis at other hospital in the absence of a clear cause of disease, that was intravenously dripped with 250 mL of normal saline and 10 mg of dexamethasone once a day for 7 to 10 d in total, then clearly diagnosed as syphilitic uveitis by Treponema pallidum particle agglutination(TPPA)test after receiving treatment for 10 to 14 d in hormones followed by antibiotics group. The best corrected visual acuity, slit-lamp examination, fundus photography, OCT, FFA, ICGA and prognosis of the three groups of patients were compared.RESULTS: There were statistically significant difference in the best corrected visual acuity, optic disc, retinal vasculitis, choroidal weak fluorescence, and RPR titer before and after treatment of the three groups of patients. The prognosis of the hormones followed by antibiotics group was lower than that in the single antibiotics group and antibiotics followed by hormones group, and the proportion of “good” prognosis in the antibiotics followed by hormones group was larger than that in other groups.CONCLUSION: Early diagnosis and regular treatment of syphilitic uveitis has a good overall prognosis, and giving large doses of glucocorticoids before thorough antisyphilitic treatments is not conducive to the recovery of disease. In patients with residual lesions after standard antisyphilitic, the application of small doses of glucocorticoids is helpful for the recovery of the disease.

Objective To analyze the predictive value of changes in serum Notch1 and interferon γ-induced protein 10(IP-10)expression in children with bronchial asthma for airway remodeling.Methods A total of 120 children with bronchial asthma treated from August 2021 to December 2023 were selected and divided into the acute exacerbation group and the clinical remission group based on their disease status.Additionally,60 healthy children who underwent the physical examination during the same period were selected as the control group.The levels of Notch1 and IP-10 in the blood of the subjects were measured,and airway remodeling and pulmonary function indicators were assessed.Pearson correlation analysis was used to examine the correlation between serum IP-10,Notch1,and airway remodeling indicators.Receiver operating characteristic curve analy-sis was conducted to evaluate the predictive value of Notch1 and IP-10 for airway remodeling.Results There were statistically significant differences in the levels of Notch1 and IP-10 among the acute exacerbation group,clinical remission group,and control group,and the levels of Notch1 and IP-10 were highest in the acute exac-erbation group and lowest in the control group,with statistically significant differences(P＜0.05).The poste-rior and outer diameters of bronchial tubes ratio(T/D)and wall area percent(WA)levels in the acute exacer-bation group were obvious higher than those in the clinical remission group,and the differences were statisti-cally significant(P＜0.05).The forced expiratory volume in one second(FEV1)and FEV1/forced vital ca-pacity levels in the acute exacerbation group were lower than those in the clinical remission group,and the differences were statistically significant(P＜0.05).IP-10 and Notch1 were obvious positively correlated with airway remodeling indicators T/D and WA(P＜0.05).The area under the curve of IP-10 and Notch1 for pre-dicting airway remodeling in pediatric patients were both greater than 0.85,indicating high application value.Conclusion The levels of Notch1 and IP-10 increase during acute exacerbation of asthma and are closely relat-ed to airway remodeling and decreased lung function.Notch1 and IP-10 have high accuracy in predicting airway remodeling.

Objective:To understand trends and hotspots of TCM research papers published in journals with high IF basing on a bibliometric analysis.Methods:TCM research papers published between January 1, 2014 and December 31, 2024 from 80 journals with IF higher than 16.0 were retrieved from medical, life sciences and comprehensive journals in Journal Citation Reports of 2024. CiteSpace 6.3.R1 and Excel 2021 were used to analyze and visualize annual publication volume, research fields, features of clinical study, institutes, funds and keywords.Results:A total of 51 papers were included, showing an increasing trend in annual publication volume; the main research areas were pharmacology, acupuncture&moxibustion and internal medicine. Multi-center randomized controlled trials were the main clinical studies; China Academy of Chinese Medical Sciences was the leading institute in terms of publication volume; 84 funds were involved, including National Natural Science Foundation of China. Keywords that appeared most frequently were TCM, efficacy, double blind, electroacupuncture, stimulation and management.Conclusion:The number and quality of TCM research papers are improved simultaneously; future research needs to deepen international cooperation, and pay attention to the integration of TCM diagnosis and treatment characteristics and modern scientific research methods.