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:To investigate the expression of miRNAs in thymus of patients with myasthenia gravis(MG)and the re-lated mechanism of action,so as to provide theoretical and experimental basis for clinical diagnosis and treatment.Methods:miRNA microarray technology was used to analyze the differential miRNA expression in MG patients thymus.Fluorescence quantitative PCR and in situ hybridization were used to verify the expression of miR-19a-3p in thymus tissue.The TALL-104 cell line was transfected with miR-19a-3p mimics to observe the effects of miR-19a-3p on cell proliferation,apoptosis and expressions of related molecules(BCL2 and SOCS3).Results:Compared to normal thymus tissue,a total of 282 differentially expressed miRNAs were detected in the thymus of MG patients,among which 103 were up-regulated and 179 were down-regulated.The target genes of differentially expressed miRNAs were mainly related to nuclear molecules,cytoplasmic membrane-like structures and organelle related molecules.Quantita-tive fluorescence PCR and in situ fluorescence hybridization confirmed that the expression of miR-19a-3p in MG patients thymus was significantly lower than that in normal control group.Compared with the control group,miR-19a-3p mimics transfection could signifi-cantly inhibit the apoptosis of TALL-104 cells,increase the expression of BCL2 and decrease the expression of SOCS3(P<0.05).Conclusion:The expression of miRNA in the thymus of MG patients is significantly different from that of non-MG patients,and miR-19a-3p inhibits T cell apoptosis through up-regulation of BCL2 and down-regulation of SOCS3.

Objective To investigate the molecular typing,virulence,and drug resistance characteristics of Staphylococcus aureus(SA)in bone and joint infections,providing basis for anti-infection treatment.Methods The SA strains isolated from inpatients with bone and joint infections in Beijing Jishuitan Hospital,Capital Medical University from January 2014 to December 2021 were collected.Multi-locus sequence typing(MLST)and Staphylococcal A protein(Spa)typing for all the strains and Staphylococcal cassette chromo-some mec(SCCmec)typing of methicillin-resistant Staphylococcus aureus(MRSA)were performed based on whole genome sequencing.The virulence genes and drug resistance genes of the strains were identified by online database.The antimicrobial susceptibility tests were carried by automatic microbiological assay system.Results MRSA accounted for 30.0％of the 100 isolated strains of SA.A total of 22 ST types and 39 Spa types were identified in the 100 strains of S.aureus,among which ST59(16.0％)and ST239(14.0％)were the dominant ST types,and t437(13.0％)and t030(10.0％)were the dominant Spa types.ST239-SCCmecⅢ-t030/t037 clone(46.7％)was the main epidemic clone in MRSA isolates.The biofilm gene(icaA,icaB,icaC,icaD,icaR),hemolysin gene(hlb,hld,hlgA,hlgB,hlgC),adhesion gene(clfA,clfB,fnbA,fnbB,ebp),and immune escape gene(adsA,sbi,scn)were widespread in all SA strains,with detection rates ranging from 89.0％to 100.0％.The detection rates of enterotoxin genes seb(43.3％),selk(93.8％)and selq(83.3％)in MRSA were significantly higher than those in methicillin-sensitive Staphylococcus aureus(MSSA)(all P＜0.05).In terms of drug-resistance characteristics,the detection rate of the resistance gene blaZ(87.0％)was the highest among all the S.aureus strains.In the isolated MRSA strains,the detection rate of resistance genes for erm(A),tet(M),aph(3')-Ⅲ,ant(6)-Ⅰa,ant(9)-Ⅰa,and aac(6')-aph(2")ranged from 43.3％to 50.0％,which were significantly higher than those in MSSA(all P＜0.05).The results of the drug-sensitivity test showed that the resistant rates of S.aureus strains to penicillin,erythromycin,and clindamycin were relatively high(89.0％,67.0％,and 51.0％,respectively).The resistant rates of MRSA to the antimicrobial agents commonly used in clinical practice were significantly higher than those of MSSA(all P＜0.05).Conclusion The molecular epidemiological char-acteristics of SA strains isolated from bone and joint infections were diversified in our hospital.ST239-SCCmecⅢ-t030/t037 was the most common epidemic clone among the strains.There were significant differences in the resistance genes and drug resistance rates be-tween MRSA and MSSA strains,for which clinical attention should be paid.

Objective:To explore the effect of multidisciplinary comprehensive nursing under the Green Intensive Nursing Model on the clinical outcomes of patients with post-traumatic epilepsy (PTE) .Methods:A convenience sampling method was used to select 120 patients with PTE admitted to the Department of Neurosurgery, Zhumadian Central Hospital, from January 2022 to May 2024. Patients were randomly divided into an intervention group ( n=60) and a control group ( n=60) using a computer-generated random number table. The control group received routine neurosurgical nursing, while the intervention group received multidisciplinary comprehensive nursing under the Green Intensive Nursing Model in addition to routine nursing. The Quality of Life in Epilepsy Inventory-31 (QOLIE-31), Hospital Anxiety and Depression Scale (HADS), Barthel Index, and Montreal Cognitive Assessment (MoCA) were used for evaluation. Seizure frequency, quality of life, anxiety and depression, activities of daily living, and cognitive-behavioral function were compared between the two groups after intervention. Results:At the 3-month follow-up, the intervention group had fewer seizures than the control group, and the difference was statistically significant ( P<0.05). After the intervention, the QOLIE-31 scores, Barthel Index, and MoCA scores of the intervention group were higher than those of the control group, while the HADS scores were lower, the differences were statistically significant ( P<0.05) . Conclusions:Multidisciplinary comprehensive nursing under the Green Intensive Nursing Model can reduce seizure frequency in PTE patients, improve their quality of life, decrease anxiety and depression, enhance daily living ability, and improve cognitive-behavioral function.

Objective To explore the effect of remote ischemic conditioning(RIC)combined with binaural beat music(BBM)train-ing in patients with cognitive dysfunction after cerebral infarction.Methods From June,2024 to January,2025,200 patients with cognitive dysfunction after cerebral infarction in the Affil-iated Hospital of North China University of Science and Technology were randomly divided into control group(n=50),RIC group(n=50),BBM group(n=50)and combined group(n=50).All the groups received stan-dardized routine training,RIC group received RIC,BBM group received BBM,and the combined group received RIC+BBM,for 14 days.They were assessed with Montreal Cognitive Assessment(MoCA)and Stroke-Specific Quality of Life Scale(SS-QOL)at baseline,day 14,and day 90.Results Two cases in the control group,four in RIC group,three in BBM group and three in the combined group dropped out.For MoCA scores,the inter-group effect,intra-group effect and interaction effect were all significant(F>13.463,P<0.001).After intervention,on both day 14 and day 90,the score of MoCA was higher in each in-tervention group than in the control group(P<0.05),and was higher in the combined group than in both BBM and RIC groups(P<0.05);and on day 90,it was higher in RIC group than in BBM group(P<0.05).For SS-QOL,the score increased with time in all the groups(χ2>75.182,P<0.001).After intervention,there was signif-icant difference at each time point among four groups(H>18.260,P<0.001).On day 14 and day 90,the score of SS-QOL was higher in the combined group than in the control and BBM groups(|Z|>3.149,P<0.05);on day 90,the score was higher in RIC group than in the control group(|Z|=3.590,P<0.05),and it was higher in the combined group than in RIC group(|Z|=3.186,P<0.05).Conclusion RIC,BBM and their combination all improved cognitive function after cerebral infarction.RIC was superior to BBM,and the combined intervention yielded the greatest benefit.Both RIC and the combined intervention im-proved quality of life,with the combined approach being the most effective.

Taking Xiaochaihu Decoction as an example,the application differences of classical prescriptions in modern medical context and Chinese medicine practice are compared and analyzed from the aspects of clinical application scope,understanding of pre-scription connotation,dosage specification,dosage form and decoction method.Strategies to solve the differences in efficacy are pro-posed:integrating the wisdom of classical prescriptions and reshaping the framework of Chinese medicine diagnosis and treatment;transforming the results of modern pharmacology and exploring the principles of classical prescriptions;controlling drug quality stand-ards and exploring new uses and dosages of classical prescriptions;keeping pace with the times in Chinese medicine decoction and strengthening management and control to ensure efficacy.It is believed that combining the essence of Chinese medicine with modern technology can make the application of classical prescriptions maintain traditional characteristics while meeting modern clinical require-ments.This can not only improve the adaptability of classical prescriptions to modern complex diseases,but also provide a reference for the modernization of traditional medicine.

Objective To investigate the clinical and diffusion imaging of brain damage in patients with neurosyphilis.Methods Eighty patients with neurosyphilis with brain damage were retrospectively selected as the study group,and were divided into mild group(n=38)and moderate to severe group(n=42)according to imaging results.Another 80 healthy subjects in the same period were selected as the control group.The values of apparent diffusion coefficient(ADC)and fractional anisotropy(FA)were compared among the three groups.Pearson test was used to analyze the correlation between ADC and FA values in various brain regions and cognitive function in patients with neurosyphilis brain damage.Results ADC values in parieto-occipital lobe,frontal lobe,basal gan-glia and hemioval center in moderate to severe group were significantly higher than those in mild group and control group,and FA values were significantly lower than those in mild group and control group(P<0.05).The results of Pearson analysis showed that the ADC and FA values of parieto-occipital lobe,frontal lobe and hemioval center were significantly correlated with Wechsler adult intel-ligence scale-revised of China(WAIS-RC)knowledge,WAIS-RC arithmetic,verbal fluency test(VFT),Montreal cognitive assess-ment(MoCA),forward digit span test(FDST),trail making test A(TMT-A)and trail making test B(TMT-B)scores(P<0.05).Conclusion The ADC and FA values of parieto-occipital lobe,frontal lobe,basal ganglia and hemioval center are closely related to the severity of brain damage,which is helpful for clinical diagnosis.

Objective To explore and identify the nutritional/inflammatory indicator with the highest predictive potential for overall survival(OS)in postoperative tumor patients so as to provide guidance for postoperative rehabilitation of tumor patients.Methods Data from 3 191 surgical patients were collected,including 15 nutritional/inflammatory indicators.The maximum selection rank statistic method was used to calculate the optimal cut-off values for continuous indicators.The Kaplan-Meier method was used to assess OS,and Cox proportional hazards models were used to analyze the association between the aforementioned 15 indicators and survival.The predictive value of these 15 indicators was evaluated with receiver operating characteristic(ROC)curves and C-index.Results Multivariate analysis showed that all 15 indicators were significantly associated with poorer OS in surgical patients(P＜0.05 for all).Time-dependent area under the curve(AUC)and C-index analysis indicated that 3 indicators with the highest predictive potential in OS in postoperative tumor patients were the nutritional risk index(NRI)(C-index:0.597),C-reactive protein-to-albumin ratio(CAR)(C-index:0.587),and C-reactive protein-to-lymphocyte ratio(CLR)(C-index:0.587).The optimal cut-off value for NRI was determined to be 104.31(i.e.,NRI＜104.31 suggests malnutrition)with the maximum selection rank statistic method,the optimal cut-off value for CAR to be 0.05(i.e.,CAR≥0.05 suggests a strong inflammatory response,often accompanied by malnutrition),and the optimal cut-off value for CLR to be 1.18(i.e.,CLR≥1.18 suggests a strong inflammatory response).Subgroup analysis indicated that NRI,CAR,and CLR had good correlation with tumor staging,and there were significant differences between tumor node metastasis(TNM)Ⅲ/Ⅳ stage patients and TNM Ⅰ/Ⅱ stage patients when there was a strong inflammatory response or malnutrition.Conclusion In postoperative tumor patients,NRI,CLR,and CAR have high prognostic value.Combining these with the patient's clinical stage,it enables more precise guidance for clinical diagnosis and treatment strategies.

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

To develop a novel polyamino acid-based nanohydrogel drug delivery system for dexamethasone to enhance its delivery efficiency to the inner ear.