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 improve the research capacity and research enthusiasm of dispensing pharmacists in pharmacy intravenous admixture services （PIVAS）， facilitate their career development， and further promote the sustainable development of hospital pharmacy disciplines. METHODS A full-chain pharmacy practice research path covering topic orientation， topic evaluation， and implementation was explored and constructed for PIVAS. Multiple approaches including framework condensation for topic selection， department empowerment and improved incentive mechanisms were adopted to systematically boost the research competence and enthusiasm of PIVAS dispensing pharmacists. Four dimensions of indicators， including PIVAS research output， operational level， career development of staff and external influence， were compared between the pre-implementation period （2020- 2022） and post-implementation period （2023-2025） to evaluate the implementation effect of the path. RESULTS After the application of the PIVAS pharmacy practice research path， the number of published papers and comprehensive quality score of papers increased by 150.00% and 161.90% respectively compared with those before implementation. The number of approved research projects and comprehensive quality score of projects rose by 166.67% and 225.00%， and the number of authorized patents increased by 100.00%. The monthly number of external errors decreased from （0.42±0.18） pieces/month pre-implementation to （0.28±0.23） pieces/month post-implementation （P＞0.05）. Dispensing efficiency was elevated from （121.83±2.48） bags/（hour· person） to （139.00±3.46） bags/（hour·person） （P＜0.05）. The research participation rate of PIVAS dispensing pharmacists grew from 15.00% to 50.00%， and the overall satisfaction rate of staff increased from 55.00% to 85.00% （P＜0.05）. Within the 3 years after path implementation， our hospital PIVAS received a total of 22 trainees from external medical institutions， and the number of external institutional visits increased by 374.07% versus the pre-implementation stage. CONCLUSIONS The constructed pharmacy practice research path for PIVAS can significantly improve PIVAS research output， operational efficiency and external influence， and effectively promote the career growth of dispensing pharmacists working in PIVAS.

Purpose To analyze and discuss the clinicopathological,molecular pathological characteristics,as well as diagnostic and prognostic features of pleomorphic xanthoastrocytoma(PXA)according to the new WHO classifi-cation.Methods 79 cases of PXA were collected to analyze their pathological and clinical data.Immunohistochemis-try using the EnVision method was employed to detect the expression of CD34,ATRX,Rb,Olig-2,H3K27M,H3K27me3,IDH1 R132H,BRAF VE1 and Ki67.Sanger sequencing was used to detect mutations in H3F3A and IDH1/2.Fluorescence quantitative PCR was used to detect the BRAF V600E mutation and TERT promoter region al-terations.Fluorescence in situ hybridization(FISH)was used to detect CDKN2A and EGFR alterations.The relation-ship between clinical,pathological,molecular genetics data,and prognosis was analyzed.Results The patients'ages ranged from 9 to 69 years,with an average age of 36.4 years.Most tumors were located in the temporal lobe,frontal lobe and parietal lobe.Among the 79 cases,42 were classified as grade 2 PXA and 37 as grade 3 PXA.The tumor cells exhibited pleomorphic changes,with perivascular lymphocytic sheaths and eosinophilic bodies frequently ob-served.Grade 3 PXA exhibited more mitotic figures(average of 11.8/10 HPF),and was usually accompanied by nec-rosis,focal marginal infiltration and microvascular proliferation.Immunohistochemistry and molecular characteristics revealed frequent positivity for CD34,BRAF V600E mutation(68.1％),and CDKN2A homozygous deletion(36.8％)in PXA.Some cases showed TERT gene mutation and absent Rb expression.Univariate survival analysis in-dicated that necrosis,focal marginal infiltration,and CNS WHO grade were related to overall survival,while focal infil-tration and CNS WHO grade were the independent risk factors.Conclusion The prognosis of CNS WHO grade 3 PXA is wrose than that of grade 2 PXA.Accurate diagnosis of PXA requires the combination of the morphological features,immunohistochemical staining,and multiple molecular tests.

The"ying-wei imbalance"theory originates from Inner Canon of Yellow Emperor,which refers to the dynamic pathological process of yingfen and weifen circulation,distribution,posture,strength,and weakness due to internal and external disturbance,emphasizing that"ying-wei imbalance"is the key to disease occurrence.The sanjiao,as the"envoy of primordial qi,"is central to yingfen and weifen,and the coordinated operation of yingfen and weifen depends on the promotion of the qi of sanjiao.Therefore,based on the yingfen and weifen theory and sanjiao differentiation and treatment,this paper discusses the etiology and pathogenesis of chronic pulmonary heart disease,as well as the syndrome differentiation approach."Ying-wei imbalance"is the core of this mechanism:in the early stage,the loss of yingfen and weifen nutrition,combined with the deficiency of the qi of sanjiao,allows exogenous pathogens to invade the lungs.During progression,dysfunction in the transportation function of yingfen and weifen,along with the stagnation of the qi of sanjiao,results in pulmonary and cardiac involvement,accompanied by phlegm accumulation and stagnation.The end stage is characterized by the failure of both ying and wei,along with dysfunction of the sanjiao and zang-fu organs,which interact to form a pathological chain of"qi disease involving body."Accordingly,the treatment principle of"harmonizing yingfen and weifen,giving sanjiao treatment"was proposed.This is implemented through three therapeutic strategies:"harmonizing""returning",and"astringing"aimed at restoring balance.In the early stage,treatment focuses on tonifying the lungs and consolidating the exterior to eliminate pathogenic factors and activate stagnation.The selected formula is Buyuan Decoction with modifications to harmonize sanjiao.During the developmental stage,treatment focuses on promoting collaterals and dispersing phlegm,utilizing the modified Xuefu Zhuyu Decocotion to facilitate the restoration of function to the sanjiao.In the final stage,Fuyang Decoction,with modifications,is used to resolve fluid retention and nourish both qi and blood.Discussions are closely focused on the syndrome differentiation system of"sanjiao-yingfen and weifen,"in order to offer a novel perspective on the management of chronic pulmonary heart disease.

The menopausal age is one of the important menopausal factors, and women of different menopausal ages have different risks of diabetes. This study reviewed the evidence from prospective studies on the association between the age at natural menopause and diabetes risk, both domestically and internationally, and presented its research design and main findings. Advanced menopause, especially premature and early menopause, will increase the risk of diabetes in postmenopausal women. The research on the influence of delayed menopause on the incidence of diabetes is still insufficient. Many factors may modify the association between menopausal age and the risk of diabetes.

OBJECTIVE To observe the clinical efficacy of Ziyu Prescription in the treatment of polycystic ovary syndrome relat-ed infertility of kidney deficiency and its effect on endometrial receptivity.METHODS A total of 120 patients with polycystic ovary syndrome related infertility of kidney deficiency were enrolled and randomly divided into a control group and a treatment group,with 60 cases in each group.After excluding dropout cases and excluded cases,56 cases were completed in each group.The control group was treated with letrozole and placebo,while the treatment group was treated with letrozole and Ziyu Prescription.The treatment course of both groups was 3 menstrual cycles.The clinical pregnancy rate and ultrasound Salle score during the implantation window were the main outcome indicators.The traditional Chinese medicine(TCM)syndrome score and serum estradial(E2),testosterone(T),anti-Müllerian hormone(AMH),luteinizing hormone(LH),follicle-stimulating hormone(FSH),homeostatic model assessment of insulin resistance(HOMA-IR),serum E2 and progesterone(P)levels during the implantation window were used as secondary outcome indica-tors.Multivariate Logistic regression and ROC curve analysis were used to evaluate the effect and predictive ability of ultrasound Salle score on pregnancy outcome.Multiple linear regression was used to evaluate the effect of estrogen and progesterone levels during the implantation window on ultrasound Salle score.RESULTS After treatment,the clinical pregnancy rate and ultrasound Salle score during the implantation window in the treatment group were significantly higher than those in the control group(P＜0.05,P＜0.01).The total TCM syndrome score of the treatment group was significantly lower than that of the control group(P＜0.01);the ser-um T,LH/FSH,and HOMA-IR levels of the treatment group were significantly lower than those of the control group(P＜0.05,P＜0.01);the serum E2 and P levels of the treatment group were significantly higher than those of the control group during the implanta-tion window period(P＜0.01).Multivariate Logistic regression analysis and ROC curve analysis showed that ultrasound Salle score was significantly positively correlated with pregnancy rate and had a high predictive value for pregnancy outcome.Multiple linear regression analysis found that there was a linear relationship between the ultrasound Salle score and E2 and P during the implantation window peri-od,and the P level had a greater impact.CONCLUSION Ziyu Prescription can improve the clinical pregnancy rate of patients with polycystic ovary syndrome related infertility of kidney deficiency,effectively improve their endometrial receptivity,regulate the levels of sex hormones and glucose metabolism,reduce the TCM syndrome score,and improve the reproductive quality of patients.

Objective:To evaluate the effectiveness of splenic circulation control technology in minimally invasive radical resection surgery for pancreatic neck/body cancer.Methods:This is a retrospective case series study. Retrospective analysis of clinical data of 12 patients who underwent laparoscopic or robotic radical resection for pancreatic neck/body cancer at the Department of Gastrointestinal and Pancreatic Surgery,Zhejiang Provincial People′s Hospital between January 2024 and January 2025. There were 7 males and 5 females,with mean age of 68 years (range: 52 to 79 years). Clinical data including preoperative,intra-operative and postoperative outcomes were analyzed. Postoperative follow-up was conducted via outpatient visits and telephone interviews,with the follow-up ending on April 1,2025.Results:All 12 patients underwent minimally invasive radical resection of pancreatic neck/body cancer using splenic circulation control technology,consisted of 3 laparoscopic and 9 robotic procedures. The mean operative time was 185 minutes (range: 140 to 315 minutes),and the average blood loss was 100 ml (range: 30 to 300 ml). Two cases involved combined organ resection.There was no conversion to open surgery. Postoperative complications were observed in 2 patients. One patient developed grade B pancreatic leakage,managed by ultrasound-guided puncture.The patient was discharged with drainage tube. The other patient experienced chylous leakage,recovered with conservative treatment. No delayed gastric emptying,hemorrhage or reoperations were observed. The median postoperative hospital stay was 13 days (range: 8 to 20 days).Conclusion:The splenic circulation control technique is simple and safe,and shows certain application prospects in minimally invasive radical resection of pancreatic neck and body cancer.

Purpose To analyze and discuss the clinicopathological,molecular pathological characteristics,as well as diagnostic and prognostic features of pleomorphic xanthoastrocytoma(PXA)according to the new WHO classifi-cation.Methods 79 cases of PXA were collected to analyze their pathological and clinical data.Immunohistochemis-try using the EnVision method was employed to detect the expression of CD34,ATRX,Rb,Olig-2,H3K27M,H3K27me3,IDH1 R132H,BRAF VE1 and Ki67.Sanger sequencing was used to detect mutations in H3F3A and IDH1/2.Fluorescence quantitative PCR was used to detect the BRAF V600E mutation and TERT promoter region al-terations.Fluorescence in situ hybridization(FISH)was used to detect CDKN2A and EGFR alterations.The relation-ship between clinical,pathological,molecular genetics data,and prognosis was analyzed.Results The patients'ages ranged from 9 to 69 years,with an average age of 36.4 years.Most tumors were located in the temporal lobe,frontal lobe and parietal lobe.Among the 79 cases,42 were classified as grade 2 PXA and 37 as grade 3 PXA.The tumor cells exhibited pleomorphic changes,with perivascular lymphocytic sheaths and eosinophilic bodies frequently ob-served.Grade 3 PXA exhibited more mitotic figures(average of 11.8/10 HPF),and was usually accompanied by nec-rosis,focal marginal infiltration and microvascular proliferation.Immunohistochemistry and molecular characteristics revealed frequent positivity for CD34,BRAF V600E mutation(68.1％),and CDKN2A homozygous deletion(36.8％)in PXA.Some cases showed TERT gene mutation and absent Rb expression.Univariate survival analysis in-dicated that necrosis,focal marginal infiltration,and CNS WHO grade were related to overall survival,while focal infil-tration and CNS WHO grade were the independent risk factors.Conclusion The prognosis of CNS WHO grade 3 PXA is wrose than that of grade 2 PXA.Accurate diagnosis of PXA requires the combination of the morphological features,immunohistochemical staining,and multiple molecular tests.

The menopausal age is one of the important menopausal factors, and women of different menopausal ages have different risks of diabetes. This study reviewed the evidence from prospective studies on the association between the age at natural menopause and diabetes risk, both domestically and internationally, and presented its research design and main findings. Advanced menopause, especially premature and early menopause, will increase the risk of diabetes in postmenopausal women. The research on the influence of delayed menopause on the incidence of diabetes is still insufficient. Many factors may modify the association between menopausal age and the risk of diabetes.

Objective:To investigate the association between serum uric acid trajectories and the risk of renal function decline and diabetic kidney disease(DKD) incidence in elderly patients with type 2 diabetes mellitus.Methods:This retrospective cohort study included 5 037 elderly patients with type 2 diabetes mellitus aged 60 years and above who underwent at least three health examinations between 2019 and 2023, with 2019 as the baseline. Latent growth mixture modeling(LGMM) was employed to identify distinct serum uric acid trajectories. Renal function changes and DKD incidence were followed from 2020 to 2023. Binary logistic regression models were used to assess the association between serum uric acid trajectories and the risks of renal function decline and DKD.Results:Two distinct serum uric acid trajectory groups were identified based on model selection criteria: A stable group( n=4 485, 89.04%) and an inverted U-shaped group( n=552, 10.96%). After adjusting for potential confounders, compared with the stable trajectory group, the inverted U-shaped group showed a significantly increased risk of estimated glomerular filtration rate(eGFR) <60 mL·min -1·(1.73 m 2) -1, ≥25% decline in eGFR, doubling of serum creatinine, and DKD events, with OR(95% CI) of 1.99(1.28-3.09), 2.27(1.65-3.13), 1.52(1.09-3.02), and 1.52(1.27-1.82), respectively(all P<0.05). In addition, multivariate analysis indicated that elevated baseline serum uric acid levels were also associated with an increased risk of adverse renal outcomes and DKD incidence; However, the magnitude of the associations was lower than that observed for serum uric acid trajectory groups. Conclusions:An inverted U-shaped serum uric acid trajectory is significantly associated with an increased risk of renal function progression and DKD in elderly patients with type 2 diabetes mellitus. These findings highlight the importance of long-term dynamic monitoring of serum uric acid levels to facilitate early identification and intervention for high-risk individuals.