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.

Objective The sample hospital is currently in the exploration stage of creating patient satisfaction service un-der the one-hospital and multi-district management mode.In order to improve the overall feeling of patients in the process of hos-pital treatment,the application effect of the existing all-round full-cycle patient service intelligent management platform in the hos-pital is quantitatively evaluated,so as to better improve the service mode.Methods A survey was conducted to collect satisfac-tion data from two groups:the experimental group,which utilized the comprehensive and full-cycle patient service intelligent man-agement platform for diagnosis and treatment services,and the control group,which followed the conventional patient admission and discharge process.The work efficiency number was obtained and calculated through the background of the system,including the average time to handle hospitalization procedures,the average waiting time for examination,the average time to handle dis-charge procedures,the time spent on each follow-up visit and the response rate of follow-up patients.The data were analyzed sta-tistically.Results The work efficiency of the experimental group was significantly better than that of the control group,and the satisfaction of hospitalized patients and staff was higher than that of the control group.Conclusion The application of the com-prehensive and full-cycle patient service intelligent management platform can improve the satisfaction of patients and staff,opti-mize the efficiency of treatment,and better serve the management mode of one hospital and multiple districts.

Objective Using network pharmacology research methods and animal pharmacology experiments,explore the mechanism of antidepressant effects of traditional Chinese medicine Citron and Bergamot.Methods Using the Traditional Chinese Medicine System Pharmacology Database and Analysis Platform(TCMSP),ETCM,Symmap,Swiss Target Prediction,and Uniprot data platforms,screen the active ingredients and corresponding gene targets of Citron and Bergamot.Obtain depression gene targets using OMIM,TTD,and Cenecards data platforms.Using Venny 2.1 online software,draw Venn diagrams of the intersection of active ingredients and gene targets.Draw network diagrams between drugs,active ingredients,targets,and diseases using Cytoscape 3.7.2 software.Construct a protein-protein interaction(PPI)network diagram using the STRING data platform for intersecting genes.Using the Metascape data platform,perform gene ontology(GO)function and Kyoto Encyclopedia of Genesand and Genomes(KEGG)pathway enrichment analysis.A rat depression model was established using chronic unpredictable mild stress(CUMS)combined with solitary care,and animal experiments were conducted to verify the BDNF/TrkB/CREB signaling pathway obtained from network pharmacology research.Results The research results of network pharmacology methods show that there are 57 antidepressant active ingredients in Citron,65 antidepressant active ingredients in Bergamot,and important active ingredients include Acetic acid,3,4,7-trimethoxycoumarin and Citric acid,etc.Through the data platform,2717 depression targets and 430 intersection targets were identified.Through PPI network analysis,key gene targets for antidepressant effects in Citron and Bergamot were identified,including TP53,Protein kinase B1,CREB-binding protein,Brain derived neurotrophic factor,etc.Through KEGG analysis,it was found that important signaling pathways include pathways in cancer,PI3K-Akt signaling pathway,Neurotrophin signaling pathway,etc.By observing the neurotrophic factor BDNF/TrkB/CREB signaling pathway in depressed rats,the results showed that the medium dose groups of Citron and Bergamot could significantly increase serum BDNF content(P<0.05),and each treatment group could improve the damage of hippocampal neurons in rats.The high and medium dose groups of Citron and Bergamot significantly increased the expression of BDNF protein in the hippocampal CA1 region(P<0.05,P<0.01).Except for the low-dose group,which showed no difference in TrkB mRNA gene expression,all other treatment groups significantly increased the mRNA gene expression levels of hippocampal BDNF,TrkB and CREB(P<0.01).The medium dose group of Citron and Bergamot increased the expression of BDNF protein in the hippocampus(P<0.01),while the medium and low dose groups significantly increased the relative expression of TrkB protein in the hippocampus(P<0.05).The medium dose group showed an increasing trend in the relative expression of CREB protein.Conclusion Traditional Chinese medicine Citron and Bergamot have therapeutic effects on depression models in rats,and the mechanism of action may be related to the BDNF/TrkB/CREB signaling pathway.

OBJECTIVE To observe the isolation rates and drug resistance rates of Acinetobacter baumannii strains isolated from intensive care unit(ICU)patients in 8 consecutive years so as to provide bases for reasonable clinical application of antibiotics and control of infections.METHODS The isolation rates and specimens from which the A.baumannii and carbapenem-resistant A.baumannii(CRAB)strains were isolated from ICU patients of the First People's Hospital of Changzhou between 2017 and 2024 were retrospectively analyzed.The trends of the drug resistance rates were observed.RESULTS Totally 2078(18.03％)strains of A.baumannii were isolated from the ICU patients from 2017 to 2024,and there was no significant difference in the changing trend among the years(x2=-1.573,P=0.116).Among the A.baumannii strains that were isolated from 2017 to 2024,58.08％were isolated from sputum,and 24.25％from lavage fluid specimens;the percentage of sputum specimens showed a downward trend in the 8 years(x2=-8.257,P＜0.001),while the percentage of lavage fluid speci-mens showed an upward trend(x2=12.964,P＜0.001).The isolation rate of the CRAB strains was 91.48％in 2017,92.61％in 2018,92.56％in 2019,82.53％in 2020,52.44％in 2021,showing a down-ward trend,and it began to rise in 2022-2024,there was significant difference(x2=-2.277,P=0.012).The isolation rates of the CRAB strains from both sputum and lavage fluid specimens showed downward trends and then upward trends(all P＜0.05).The drug resistance rates of the A.baumannii strains to piperacillin and minocycline showed slow upward trends,while the drug resistance rates to gentamicin and tigecycline showed downward trends,and there were significant differences(P＜0.05).The drug resistance rates of the A.bau-mannii strains to imipenem and meropenem remained more than 90％.CONCLUSIONS Acinetobacter spp is the major pathogen causing the hospital-acquired infection.The isolation rate of CRAB strains shows a downward trend then a upward trend in recent two years.It is necessary for the hospital to standardize the submission of spu-tum specimens and increase the aseptic submission.The A.baumannii strains show high drug resistance rates to the commonly used antibiotics.Polymyxin B,tigecycline and minocycline are the major antibiotics for treatment of CRAB infection.

Objective This study aimed to investigate the antimicrobial resistance profiles of bacterial strains isolated from pediatric intensive care units(PICU)in China for better antimicrobial therapy.Methods Clinical isolates were collected from 17 institutions,including tertiary care children's hospitals and pediatric department of tertiary general hospitals in China from January 1,2020 to December 31,2022.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2020.Results A total of 10 688 isolates were collected,including gram-positive organisms(39.2％)and gram-negative organisms(60.8％).The top three organisms were S.aureus(13.6％,1 453/10 688),A.baumannii(10.0％,1 067/10 688),and coagulase-negative Staphylococcus(9.9％,1 058/10 688).Multi-drug resistant organisms(MDROs)were very common in children.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant E.coli,carbapenem-resistant K.pneumoniae(CRKP),carbapenem-resistant A.baumannii(CRAB),and carbapenem-resistant P.aeruginosa(CRPA)was 41.1％,19.4％,8.8％,30.9％,67.4％,and 28.8％,respectively.Overall,more than 50％of Enterobacteriales isolates were resistant to cephalosporins,while nearly 25％of Enterobacteriales isolates were resistant to carbapenems.MDROs were highly resistant to commonly used antibiotics.More than 80％of CRE and CRAB strains were resistant to all beta-lactam antibiotics.CRE and CRAB showed low resistance rates to tigecycline and polymyxin.CRPA showed lower resistance rates to piperacillin,beta-lactamase inhibitor combinations than the resistance rates to third and fourth generation cephalosporins.All of the Staphylococcus and Enterococcus isolates were susceptible to vancomycin and tigecycline.None of PRSP strains isolated from meningitis and nonmeningitis samples were resistant to rifampicin,vancomycin,or linezolid.The prevalence of β-lactamase-negative ampicillin-resistant(BLNAR)strains was 43.3％in Haemophilus influenzae.Conclusions MDROs were prevalent in PICU.It is necessary to establish an effective multidisciplinary team(MDT)to control the antimicrobial resistance.

Objective To investigate the number and categories of cognitive subtypes in individuals with First-Episode Schizophrenia(FES)and to explore the potential neurobiological sleep characteristics associated with these distinct cognitive subtypes.Methods The cognitive functions of 45 patients withFES and 40 healthy controls(HCs)were assessed using the MATRICS Consensus Cognitive Battery(MCCB).Latent profile analysis was employed to identify and classify the cognitive subtypes of FES patients.Furthermore,a full-night polysom-nographic recording was conducted to quantify the characteristics of sleep spindle waves.Subsequently,differ-ences in sleep spindle wave features among the identified cognitive subtypes of FES were analyzed and compared.Results Latent Profile Analysis identified two cognitive subtypes among FES patients:a subtype characterized by severe cognitive impairment(SIS,n=32)and another with relatively preserved cognitive function(CRP,n=13).Compared to healthy controls(HCs,n=40),FES patients exhibited increased spindle wave amplitude dur-ing both N2 and N3 sleep stages.Further analysis revealed that the spindle wave duration during the N2 stage was significantly longer in the SIS subtype compared to both CRP and HCs.Similarly,in the N3 stage,the spindle wave duration was longer in SIS than in CRP.Additionally,spindle wave frequency during the N3 stage was higher in both SIS and HCs compared to CRP.Conclusions The results of this study suggest that variations in the fre-quency and duration of spindle waves among different cognitive subtypes may serve as potential neurobiological markers for distinguishing FES cognitive subtypes.

Objective To understand the economic losses due to healthcare-associated infection(HAI)in patients after Da Vinci robotic thoracic surgery,and provide basis for preventing and controlling HAI after robotic surgery.Methods Patients who underwent Da Vinci robotic surgery from April 2019 to April 2023 were retrospective stu-died.Patients were divided into HAI group and non-HAI group based on the occurrence of postoperative infection.Through 1∶1 propensity score matching(PSM),31 cases were included in each group,economic losses of two groups of patients were compared.Results A total of 921 patients who underwent Da Vinci robotic thoracic surgery were included in the study,51 cases with HAI(HAI group)and 870 without HAI(non-HAI group).After 1∶1 PSM,31 cases were included in each group.Four covariates were compared between two groups of patients before PSM,namely gender,age,comorbidities,and the American Society of Anesthesiologists(ASA)grading,all with statistically significant differences(all P＜0.05).After PSM,distribution of the above covariates reached equilib-rium between the two groups(both P＞0.05).The median total expense for HAI group before PSM during hospi-talization was 88 711.72 Yuan,while 78 509.46 Yuan for the non-HAI group.The direct economic losses caused by HAI after Da Vinci robot surgery was 10 202.26 Yuan,mainly increased by expense of medicine,nursing,laborato-ry diagnosis,etc.Difference in western medicine expense was the highest(8 839.12 Yuan),out of which expense of antimicrobial agents accounted for the highest proportion(73.55％).Difference in daily hospitalization expense between HAI-group and non-HAI group was 502.38 Yuan.Length of hospital stay of patients in HAI group and non-HAI group were(21.59±10.62)and(13.92±9.21)days,respectively,with statistical differences(all P＜0.05).Conclusion The occurrence of HAI in patients undergoing Da Vinci robotic thoracic surgery leads to direct economic losses,with obvious increases in expenses of nursing,laboratory diagnosis,western medicine(mainly an-timicrobial agents).Length of hospital stay of patients also prolongs.

Anti-leucine-rich glioma-inactivated 1 protein (LGI1) antibody-associated encephalitis is an autoimmune encephalitis mediated by LGI1 antibodies, which can occur in both adults and children. Its common clinical manifestations include epileptic seizures, cognitive and psychiatric disorders; rare symptoms include sleep disorders and autonomic disorders; and its characteristic manifestations are faciobrachial dystonic seizures and refractory hyponatremia. Since anti-LGI1 antibody-associated encephalitis is relatively rare in clinical practice, this article reviews the disease in terms of etiology and pathogenesis, clinical manifestations, auxiliary examinations, diagnosis and differential diagnosis, treatment, recurrence and prognosis. It aims to improve clinicians′ understanding of this disease, provide references for its early diagnosis and treatment, and thereby improve patients′ prognosis.

Objective:To conduct an integrative review of follow-up practices in post-bariatric surgery patients, clarify current follow-up strategies and influencing factors, and provide references for clinical practice and future research.Methods:An integrative review approach was employed. Systematic searches were conducted in PubMed, Web of Science, Cochrane Library, CINAHL, China National Knowledge Infrastructure, Wanfang, and VIP for studies related to post-bariatric surgery follow-up. The search period extended up to December 1, 2024. Data extraction and synthesis were performed by two independent researchers.Results:A total of 30 studies were included, comprising 12 non-randomized quantitative studies, 11 descriptive quantitative studies, three randomized controlled trials, three qualitative studies, and one mixed-method study. Among them, 15 studies explored factors contributing to loss to follow-up, which were mainly categorized into subjective psychological factors, objective barriers, demographic characteristics, and medical-related factors. A total of 12 studies evaluated the effectiveness of various follow-up strategies, showing that telemedicine and IoT-based remote follow-up models could improve patient adherence and reduce the risk of postoperative complications. Additionally, multidisciplinary collaborative models demonstrated superior outcomes in increasing follow-up rates, lowering complication rates, and improving excess weight loss compared to traditional management approaches. The use of financial incentives exhibited short-term effectiveness, with quantitative studies indicating sustained adherence for up to six months; however, qualitative studies suggested that while patients acknowledged financial incentives as a supportive measure, they perceived their impact on long-term motivation to be limited. Furthermore, routine monitoring, continuity of care led by dedicated personnel, and efficient team communication were identified as effective strategies to enhance follow-up adherence and postoperative management.Conclusions:Multiple factors influence follow-up adherence in post-bariatric surgery patients. Technology-driven remote follow-up and personalized support strategies have shown significant advantages in enhancing follow-up rates. Future efforts should focus on standardizing post-bariatric surgery follow-up protocols.

Objective To investigate the number and categories of cognitive subtypes in individuals with First-Episode Schizophrenia(FES)and to explore the potential neurobiological sleep characteristics associated with these distinct cognitive subtypes.Methods The cognitive functions of 45 patients withFES and 40 healthy controls(HCs)were assessed using the MATRICS Consensus Cognitive Battery(MCCB).Latent profile analysis was employed to identify and classify the cognitive subtypes of FES patients.Furthermore,a full-night polysom-nographic recording was conducted to quantify the characteristics of sleep spindle waves.Subsequently,differ-ences in sleep spindle wave features among the identified cognitive subtypes of FES were analyzed and compared.Results Latent Profile Analysis identified two cognitive subtypes among FES patients:a subtype characterized by severe cognitive impairment(SIS,n=32)and another with relatively preserved cognitive function(CRP,n=13).Compared to healthy controls(HCs,n=40),FES patients exhibited increased spindle wave amplitude dur-ing both N2 and N3 sleep stages.Further analysis revealed that the spindle wave duration during the N2 stage was significantly longer in the SIS subtype compared to both CRP and HCs.Similarly,in the N3 stage,the spindle wave duration was longer in SIS than in CRP.Additionally,spindle wave frequency during the N3 stage was higher in both SIS and HCs compared to CRP.Conclusions The results of this study suggest that variations in the fre-quency and duration of spindle waves among different cognitive subtypes may serve as potential neurobiological markers for distinguishing FES cognitive subtypes.