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.

To summarize the clinical experience of Professor LIU Jinmin in treatment for epilepsy. It is believed that main pathogenesis of epilepsy is yangming failure to close and vital activity loss control， so a therapeutic approach focused on restoring the closure of yangming and regaining vital activity was proposed for the treatment of epilepsy. For excess syndrome， the treatment focuses on draining excess and descending qi， promoting purgation and restoring spirit. When yangming dryness-heat predominates， the approach involves unblock the bowels and regulating the spirit， descending qi and reducing fire， with modified Chengqi Decoction （承气汤） as prescription； when yangming phlegm-fire predominates， the treatment focuses on clearing heat and resolving phlegm， calming mind and suppressing fright， with modified Qingxin Wendan Decoction （清心温胆汤） as prescription； when yangming blood stasis predominates， the approach involves breaking up blood stasis and promoting purgation， eliminating stasis and awakening the mind， with Taoren Chengqi Decoction （桃核承气汤） as prescription. For deficiency syndrome， the treatment emphasizes tonifying deficiency and raising qi， strengthening the stomach and nourishing the spirit. When center qi deficiency and sinking of clear qi of the nutrients from food， the approach involves replenishing and uplifting qi while nourishing vital activity， with modified Liujunzi Decoction （六君子汤） as prescription； when yin deficiency and fluid consumption， the treatment focuses on nourishing stomach and tonifying yin， promoting fluid production and calming the spirit， with modified Maimendong Decoction （麦门冬汤） combined with Yiwei Decoction （益胃汤） as prescriptions. In clinical situations of deficiency-excess complex， it is essential to distinguish the primary condition from the secondary， applying both supplementing and draining methods flexibly to achieve optimal treatment.

OBJECTIVE To observe the epidemiological characteristics,virulence and drug resistance genes in Kleb-siella oxytoca complex(KOX)strains isolated from the children in Suzhou so as to provide theoretical bases for clinical prevention and control.METHODS The clinical distribution and drug resistance of 101 strains of KOX that were isolated from Children's Hospital of Soochow University from Jan.2021 to Mar.2024 were retrospectively analyzed.Fifty strains were randomly selected to detect the expressions of 18 types of virulence genes and 12 types of drug resistance genes.RESULTS Of the 97 strains of KOX isolated from hospitalized children,32.67％from i-solated from sputum,27.72％from stools and 24.74％from urine;45.54％were isolated from hematology de-partment,18.81％from neonatology department and 10.89％from ICU.The strains expressed a variety of viru-lence genes,among which the ironophore-related genes entB(82.00％),irp-1(64.00％),irp-2(64.00％),ybtS(64.00％)and fyuA(64.00％)were dominant.Carbapenem-sensitive KOX(CS-KOX)strains were susceptible to most of the antibiotics,while the drug resistance rates of the CR-KOX strains to most of the antibiotics were relatively high.The detection rates of extended-spectrum β-lactamase gene CTX(56.52％)and carbapenemase gene NDM(78.26％)were relatively high among the CR-KOX strains;38.89％(7/18)of the strains expressed NDM gene and meanwhile expressed other carbapenemase genes.CONCLUSIONS The KOX strains isolated from the hospitalized children in Suzhou carry a variety of virulence and drug resistance genes,and there is risk of trans-mission of CR-KOX in the hospital.Therefore,it is necessary to attach great importance to the surveillance of drug-resistant strains for the long-term hospitalized children and raise the awareness of infection control so as to prevent the transmission of such bacteria.

Objective:To construct an indicator system for entrustable professional activities (EPAs) in the general practice enhancement stage of pediatric specialist physician training.Methods:A draft indicator system for EPAs in the general practice enhancement stage of pediatric physician training was developed through core EPAs working group discussion, literature review, nominal group discussion, and expert consultation. Subsequently, the indicator system was preliminarily implemented and revised.Results:The core EPAs working group consisted of nine specialist physician trainers. In the initial brainstorming stage, a "potential list" of 30 activities was established. After literature review and collation, the draft indicator system included eight EPAs. Through nominal group discussion, the connotation of the draft was enriched, and the importance of the EPAs was ranked and modified. Finally, through expert consultation, the EPAs for the general practice enhancement stage of pediatric specialist physician training were determined. These included basic operations for the treatment of critically ill children, identification and management of critical illnesses, referral of critically ill children, perioperative management, in-hospital consultation, medical and teaching management and system improvement, doctor-patient communication and dispute handling, and response to public health events. During the preliminary implementation stage, a total of nine specialist physicians who participated in the training were evaluated. Based on the problems found in the pre-evaluation, the indicators of EPAs were revised, and a corresponding curriculum training system was developed.Conclusions:Through multiple rounds of nominal group discussion and expert consultation, the indicator system for EPAs in the general practice enhancement stage of pediatric specialist physician training was formulated. The system was preliminarily implemented and revised, and a curriculum system was constructed.

OBJECTIVE To observe the epidemiological characteristics,virulence and drug resistance genes in Kleb-siella oxytoca complex(KOX)strains isolated from the children in Suzhou so as to provide theoretical bases for clinical prevention and control.METHODS The clinical distribution and drug resistance of 101 strains of KOX that were isolated from Children's Hospital of Soochow University from Jan.2021 to Mar.2024 were retrospectively analyzed.Fifty strains were randomly selected to detect the expressions of 18 types of virulence genes and 12 types of drug resistance genes.RESULTS Of the 97 strains of KOX isolated from hospitalized children,32.67％from i-solated from sputum,27.72％from stools and 24.74％from urine;45.54％were isolated from hematology de-partment,18.81％from neonatology department and 10.89％from ICU.The strains expressed a variety of viru-lence genes,among which the ironophore-related genes entB(82.00％),irp-1(64.00％),irp-2(64.00％),ybtS(64.00％)and fyuA(64.00％)were dominant.Carbapenem-sensitive KOX(CS-KOX)strains were susceptible to most of the antibiotics,while the drug resistance rates of the CR-KOX strains to most of the antibiotics were relatively high.The detection rates of extended-spectrum β-lactamase gene CTX(56.52％)and carbapenemase gene NDM(78.26％)were relatively high among the CR-KOX strains;38.89％(7/18)of the strains expressed NDM gene and meanwhile expressed other carbapenemase genes.CONCLUSIONS The KOX strains isolated from the hospitalized children in Suzhou carry a variety of virulence and drug resistance genes,and there is risk of trans-mission of CR-KOX in the hospital.Therefore,it is necessary to attach great importance to the surveillance of drug-resistant strains for the long-term hospitalized children and raise the awareness of infection control so as to prevent the transmission of such bacteria.

Objective:To construct an indicator system for entrustable professional activities (EPAs) in the general practice enhancement stage of pediatric specialist physician training.Methods:A draft indicator system for EPAs in the general practice enhancement stage of pediatric physician training was developed through core EPAs working group discussion, literature review, nominal group discussion, and expert consultation. Subsequently, the indicator system was preliminarily implemented and revised.Results:The core EPAs working group consisted of nine specialist physician trainers. In the initial brainstorming stage, a "potential list" of 30 activities was established. After literature review and collation, the draft indicator system included eight EPAs. Through nominal group discussion, the connotation of the draft was enriched, and the importance of the EPAs was ranked and modified. Finally, through expert consultation, the EPAs for the general practice enhancement stage of pediatric specialist physician training were determined. These included basic operations for the treatment of critically ill children, identification and management of critical illnesses, referral of critically ill children, perioperative management, in-hospital consultation, medical and teaching management and system improvement, doctor-patient communication and dispute handling, and response to public health events. During the preliminary implementation stage, a total of nine specialist physicians who participated in the training were evaluated. Based on the problems found in the pre-evaluation, the indicators of EPAs were revised, and a corresponding curriculum training system was developed.Conclusions:Through multiple rounds of nominal group discussion and expert consultation, the indicator system for EPAs in the general practice enhancement stage of pediatric specialist physician training was formulated. The system was preliminarily implemented and revised, and a curriculum system was constructed.

Objective:To analyze the correlation between serum glycated hemoglobin (HbA 1c), γ-glutamyltranspeptidase(γ-GT) and intercellular adhesion factor-1 (ICAM-1) levels and cognitive impairment in elderly patients with hyperlipidemia complicated with cardiovascular disease. Methods:In this retrospective cohort study, 158 elderly patients who underwent examination and were diagnosed with hyperlipidemia complicated with cardiovascular disease at Beijing Anzhen Hospital Affiliated with Capital Medical University from January to December 2022 were selected as study subjects. The simple mental state scale (MMSE) was assessed in the subjects in combination with the subject′s level of education. Illiteracy≤17 points, primary school≤20 points, middle school and above≤24 points were classified as cognitive impairment group (67 cases), the rest were were classified into the non-cognitive impairment group (91 cases); and another 50 healthy elderly people who received physical examination in the same period were selected as the control group. The blood samples in the three groups were extracted to measure serum HbA 1c, γ-GT and ICAM-1. The correlation between HbA 1c, γ-GT and ICAM-1 levels with cognitive impairment were analyzed. Results:The serum levels of HbA 1c, γ-GT and ICAM-1 in the cognitive impairment group were all significantly higher than those in the non-cognitive impairment group and the control group [5.41%±1.04% vs 4.82%±0.95%, 4.39%±0.86%; (52.01±10.96) vs (41.28±9.23), (25.03±7.17) U/L; (336.61±85.36) vs (286.93±72.53), (143.52±64.20) g/ml], and the MMSE score was significantly lower [(20.19±2.85) vs (25.30±1.24), (27.14±1.56) points] (all P<0.05). Serum levels of HbA 1c, γ-GT and ICAM-1 were all significantly negatively correlated with MMSE score ( r=-0.512, -0.498, -0.563) (all P<0.05). The areas under the receiver operating characteristic curves (AUCs) for serum HbA 1c, γ-GT, and ICAM-1 levels in the assessment of cognitive dysfunction were 0.657, 0.816, and 0.691, respectively (all P<0.05). The optimal cut-off values were 5.115%, 47.65 U/L, and 304.58 g/ml, respectively. Conclusion:Serum HbA 1c, γ-GT and ICAM-1 levels in elderly patients with hyperlipidemia complicated with cardiovascular disease are negatively correlated with cognitive impairment, and have certain value for the evaluation and early diagnosis of cognitive impairment.

Objective:To explore the facilitators and barriers in implementing the orthokeratology lens-wearing education guidance program from the perspectives of children, their families, and medical and nursing staff.Methods:Based on phenomenological research, purposive sampling was used to select five medical workers, 18 children wearing orthokeratology lenses and family members from the Optometry Center of Peking University Third Hospital as interviewees for semi-structured interviews. Colaizzi's 7-step method was used to analyze interview data.Results:Two themes (facilitators and barriers) were extracted, among which facilitators included two sub-themes (strong demand for educational guidance, trust in medical and nursing staff), and barriers consisted of two sub-themes (patient factors, external support factors) .Conclusions:In promoting the educational guidance intervention program for wearing orthokeratology lenses, medical and nursing staff need to fully play the role of facilitators, analyze and solve barriers, and ultimately promote the smooth implementation of the intervention program.

Objective:To explore the possible reasons for diffuse uptake of 131I in both lungs of differentiated thyroid cancer (DTC) patients after 131I treatment. Methods:A retrospective case series study was conducted. Forty-six DTC patients who received 131I treatment at Shanxi Province Cancer Hospital from June 2015 to June 2021 were collected, and whole body scan of these patients showed diffuse uptake of 131I in both lungs on the 7th day after treatment. Based on SPECT/CT fusion images, thyroid globulin levels, and thyroid globulin antibody (TgAb) levels, the possible reasons for diffuse uptake of 131I in both lungs were analyzed. Results:SPECT/CT fusion images showed no abnormal density shadows in 10 patients; stimulating thyroglobulin (sTg) was (11±4) ng/ml, TgAb was (1.2±0.5)%, inhibitory thyroglobulin was (5.3±1.5) ng/ml; the possible reason for diffuse uptake of 131I in both lungs was the presence of early small metastatic nodules that cannot be detected by conventional CT scans, and these nodules absorbed 131I. SPECT/CT fusion images showed multiple round nodules in both lungs in 36 patients; sTg was (281±10) ng/ml, TgAb was (1.7±0.7) %; the reason for diffuse uptake of 131I in both lungs was the uptake of 131I by metastatic lesions in both lungs. Conclusions:Different degrees of tumor metastasis may be the cause of diffuse uptake of 131I in both lungs of DTC patients after 131I treatment.

Objective:To evaluate the impact of self-crosslinked hyaluronic acid (SCH) gel on endometrium recovery after artificial abortion.Methods:A multicenter, prospective randomized controlled trial was conducted across 18 hospitals from December 2021 to February 2023, involving 382 women who underwent artificial abortion. Participants were randomly allocated to receive either treatment with SCH gel (SCH group) or no treatment (control group) in a 1∶1 ratio. The primary outcome was endometrium thickness in 14 to 18 days after the first postoperative menstruation. Secondary outcomes included changes in menstrual volume during the first postoperative menstruation, menstruation resumption within 6 postoperative weeks, time to menstruation resumption, duration of the first postoperative menstruation, and incidence of dysmenorrhea.Results:Baseline characteristics of participants were comparable between the two groups (all P>0.05), with 95.3% (182/191) in SCH group and 92.7% (177/191) in the control group completed the study. The postoperative endometrial thickness in SCH group was significantly greater than that in the control group [(9.78±3.15) vs (8.95±2.32) mm; P=0.005]. SCH group also had significantly fewer participants with reduced menstrual volume [23 cases (12.6%, 23/182) vs 31 cases (17.5%, 31/177); P=0.038]. Although SCH group experienced less dysmenorrhea during the first postoperative menstrual period, this difference was not statistically significant [28.5% (51/179) vs 37.1% (65/175); P=0.083]. Outcomes were similar between SCH group and the control group regarding the proportion of participants who resumed menstruation within 6 weeks postoperatively, time to menstruation resumption, and duration of the first postoperative menstruation ( P=0.792, 0.485, and 0.254, respectively). No serious adverse events were observed during the study period, and no adverse events were attributed to SCH gel treatment. Conclusion:The application of SCH gel after artificial abortion is safe and might aid in the recovery of the endometrium.