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 estimate the radiation dose to caregivers and the public from 177Lu- peptide receptor radionuclide therapy (PRRT) for pediatric neuroblastoma patients and determine the duration of contact restrictions, in order to provide a reference for relevant radiation protection measures. Methods:A retrospective study was conducted by collecting data from 18 pediatric neuroblastoma patients, aged between 3 and 13 (6.72±2.72), who received 177Lu-1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid-D-Phe1-Tyr3-Thr8-octreotide (DOTATATE) treatment at the Nuclear Medicine Department of Shandong Cancer Hospital from June 2023 to July 2023. Absorbed dose rate in air at 0, 0.1, 0.5, 1 and 2 m from the patients was measured using a radiation-survey at 1, 4, 24, 48 and 96 h after administration. The whole-body region of interest was delined using HERMES software. Subsequently, curve regression fitting was performed using a biexponential function model. By incorporating hypothesized social contact durations, the effective doses received by family members and the public in contact with patients were estimated. Additionally, MIM software was used to outline the whole-body VOI to obtain the total volume of lesions, and the Pearson or Spearman correlation coefficient was employed to analyze the relationship between the absorbed dose rate in air and clinical indicators as well as the total volume of lesions. Results:The 177Lu-DOTATATE administration dose was (4 353.42±1 451.51) MBq. All patients were discharged from hospital 24 h after 177Lu-DOTATATE administration. At the time of discharge, patients had excreted (76.70±3.99)% of the administered activity, and the absorbed dose rate in air at 0.1, 1 and 2 m from the patients were (32.74±6.98), 3.68(3.01, 4.70) and (1.22±0.51) μSv/h, respectively. After being discharged, the radiation doses to caregivers from children aged 2-5 years and 5-13 years were (2.47±1.80) mSv and (0.88±0.47) mSv, respectively. The contact restriction duration was 2 d for nighttime sleeping with family members and 1 d for contact with other children. On the day of discharge, patients should limit their time on public transportation within 4 h and do not need to restrict private transportation. Conclusions:To ensure the effective dose kept within the safety limits stipulated by current regulations, it is necessary to implement contact restrictions for patients’ family members and the public. After implementing preventive measures, 177Lu-DOTATATE treatment is a safe radionuclide therapeutic option.

Objective:To estimate the radiation dose to caregivers and the public from 177Lu- peptide receptor radionuclide therapy (PRRT) for pediatric neuroblastoma patients and determine the duration of contact restrictions, in order to provide a reference for relevant radiation protection measures. Methods:A retrospective study was conducted by collecting data from 18 pediatric neuroblastoma patients, aged between 3 and 13 (6.72±2.72), who received 177Lu-1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid-D-Phe1-Tyr3-Thr8-octreotide (DOTATATE) treatment at the Nuclear Medicine Department of Shandong Cancer Hospital from June 2023 to July 2023. Absorbed dose rate in air at 0, 0.1, 0.5, 1 and 2 m from the patients was measured using a radiation-survey at 1, 4, 24, 48 and 96 h after administration. The whole-body region of interest was delined using HERMES software. Subsequently, curve regression fitting was performed using a biexponential function model. By incorporating hypothesized social contact durations, the effective doses received by family members and the public in contact with patients were estimated. Additionally, MIM software was used to outline the whole-body VOI to obtain the total volume of lesions, and the Pearson or Spearman correlation coefficient was employed to analyze the relationship between the absorbed dose rate in air and clinical indicators as well as the total volume of lesions. Results:The 177Lu-DOTATATE administration dose was (4 353.42±1 451.51) MBq. All patients were discharged from hospital 24 h after 177Lu-DOTATATE administration. At the time of discharge, patients had excreted (76.70±3.99)% of the administered activity, and the absorbed dose rate in air at 0.1, 1 and 2 m from the patients were (32.74±6.98), 3.68(3.01, 4.70) and (1.22±0.51) μSv/h, respectively. After being discharged, the radiation doses to caregivers from children aged 2-5 years and 5-13 years were (2.47±1.80) mSv and (0.88±0.47) mSv, respectively. The contact restriction duration was 2 d for nighttime sleeping with family members and 1 d for contact with other children. On the day of discharge, patients should limit their time on public transportation within 4 h and do not need to restrict private transportation. Conclusions:To ensure the effective dose kept within the safety limits stipulated by current regulations, it is necessary to implement contact restrictions for patients’ family members and the public. After implementing preventive measures, 177Lu-DOTATATE treatment is a safe radionuclide therapeutic option.

Objective This study aims to reveal the effects of the Yiqi Huoxue Formula(YQHXF)on the function of the pulmonary alveolar-capillary barrier in rats with acute lipopolysaccharide-induced lung injury and to explore the potential mechanism.Methods Sixty adult male SD rats were randomly assigned to the sham operation,model,dexamethasone(5 mg/kg,gavage),Yiqi Huoxue Formula low-dose(3.6 g/kg,gavage),medium-dose(7.2 g/kg,gavage)and high-dose(14.4 g/kg,gavage)groups.The rats in the sham group received intratracheal instillation of normal saline,and those in other groups received intratracheal instillation of lipopolysaccharide(LPS,5 mg/kg)for the modeling of ALI.The rats in the sham and model groups were administered normal saline by gavage,and those in the other groups were administered the corresponding drugs once a day for 7 days.Specimens were collected 12 h after the last administration.Pathological changes in lung tissue were observed under a light microscope.The wet/dry weight ratio of the lung and the total protein concentration in the bronchoalveolar lavage fluid(BALF)were measured.Immunofluorescence staining was used to measure the protein expression of zonula occludens-1(ZO-1).Western blotting was used to measure protein levels of occludin,aquaporin-1(AQP-1),and AQP-5.Results Compared with the sham group,the model group showed an increased histopathological score of the lung tissue,lung wet/dry weight ratio,and protein concentration in BALF(P<0.01).Yiqi Huoxue Formula medium-and high-dose groups were lower than those in the model group(P<0.05,P<0.01).Compared with the sham group,the model group downregulated the expression of ZO-1,occludin,AQP-1,and AQP-5(P<0.01).Yiqi Huoxue Formula medium-and high-dose groups upregulated the protein levels compared with the model group(P<0.01).Conclusion The findings suggest that the Yiqi Huoxue Formula can improve the dysfunction of the pulmonary alveolar-capillary barrier in the rat model of ALI induced by LPS,and its mechanism is related to regulating tight junction protein(ZO-1,occludin)and aquaporin(AQP-1,AQP-5)expression.

Objective:To evaluate changes in operational effectiveness after the implementation of ambulatory surgical management in pars plana vitrectomy (PPV).Methods:A retrospective clinical study. 17 528 surgeries in 10 895 eyes of 10 895 patients who underwent minimally invasive PPV on an ambulatory and/or inpatient basis at Tianjin Medical University Eye Hospital from August 2015 to June 2023 were included in this study. Among them, 5 346 eyes in 5 346 cases were male; 5 549 eyes in 5 549 cases were female. The age ranged from 0 to 95 years, with the mean age of (57.74±13.15) years. 6 381 surgeries in 3 615 eyes from August 2015 to December 2018 (the initial period of day surgery) were used as the control group; 11 147 surgeries in 7 280 eyes from January 2019 to June 2023 (the expanded period of day surgery) were used as the observation group. According to the management mode of ambulatory surgery, the observation group was subdivided into the decentralized management group (January 2019 to December 2020) and the centralized management group (January 2021 to June 2023), with 2 905 and 4 375 eyes and 4 646 and 6 501 surgeries, respectively. Changes in the percentage of day surgery, average hospitalization days, and average unplanned reoperation rate were compared. The Mann-Whitney U test was used to compare numerical variables between groups; the chi-square test or Fisher's exact test was used to compare categorical variables. Results:The number of cases of daytime PPV performed in the observation group and control group was 7 852 (70.44%, 7 852/11 147) and 24 (0.38%, 24/6 381) cases, respectively, and the average hospitalization days were 1 (1) and 5 (3) d. Compared with the control group, the observation group had a significantly higher percentage of day surgery ( χ2=8 051.01) and a considerably lower mean hospitalization day ( Z=4 536 844.50), and the differences were statistically significant ( P<0.000 1). The mean hospitalization days in the decentralized and centralized management groups were 2 (3) and 1 (0) d, respectively, and unplanned reoperations were 34 (0.73%, 34/4 646) and 171 (2.63%, 171/6 501) eyes, respectively. Compared with the decentralized management group, average hospitalization days was significantly lower ( Z=1 436.94) and unplanned reoperation rate was significantly higher ( χ2=54.10) were significantly lower in the centralized management group, both of which were statistically significant ( P<0.000 1). Conclusion:PPV ambulatory management model can significantly reduce the average hospitalization day, but also results in higher rates of unplanned reoperations.

【Objective】 To investigate the anemia status of infants and toddlers aged 6 - 24 months in Linxia Hui Autonomous Prefecture, Gansu Province, and to comprehensively evaluate the differences in feeding behaviors between anaemic and normal children through the infant and child feeding index (ICFI) and feeding knowledge scores, so as to provide reference for the guidance of infants and young children feeding in ethnic minority areas and the promotion of children′s growth and development. 【Methods】 Taking infants and young children aged 6 - 24 months in Linxia Prefecture as the study subjects, a multi-stage random sampling method was used to select children who met the requirements from 5 townships and 5 villages in 7 counties in 2019 and 2020.Periphral blood samples were collected to test the level of hemoglobin, so as to determine the anemia status.Meanwhile, physical examination was performed and a questionnaire survey of guardians was conducted to analyze the association betweenanaemia and feeding patterns 【Results】 A total of 3 901 infants and children were included in this study, of whom 729 (18.70%) were anaemic, with a mean ICFI score of 12.56±2.70 and a mean feeding knowledge score of 1.97±1.01.There was no statistically significant association of low feeding knowledge score and low ICFI with anaemia after adjusting for confounders (P>0.05), Unqualified meat addition in ICFI was a risk factor for anaemia (OR=1.355, P=0.042), while non-bottle feeding in the past 24 hours (OR=0.762, P=0.021), and breastfeeding in the past 24 hours of infants and toddlers aged 12 - 24 months (OR=0.228, P=0.018) were protective factor for anemia in infants and toddlers aged 12 - 24 months. 【Conclusions】 The average prevalence of anemia in infants and toddlers aged 6 - 24 months in Linxia Hui Autonomous Prefecture of Gansu Province is high, but the level of infant feeding and the level of feeding knowledge of caregivers are low.Early adherence to breastfeeding, timely addition of supplementary food, and more comsumpution of meat for children are conducive to preventing anemia.

Objective To retrieve,evaluate and summarise evidence on home exercise rehabilitation in patients with stage Ⅱ coronary heart disease(CHD)undergoing cardiac rehabilitation and to provide a reference for healthcare professionals to instruct the patients for home-based exercise rehabilitation.Methods Following the"6S"evidence hierarchy model and a top-down search strategy,a systematic search was conducted across databases of Guidelines International Network(GIN),Scottish Intercollegiate Guidelines Network(SIGN),National Institute for Health and Clinical Excellence(NICE),American Association of Cardiovascular and Pulmonary Rehabilitation(AACVPR),American Heart Association(AHA),European Society of Cardiology(ESC),BMJ Best Practice,UpToDate,Joanna Briggs Institute(JBI)evidence-based healthcare database,PubMed,Web of Science,Cochrane Library,EBSCON,SinoMed,China National Knowledge Infrastructure(CNKI),and Wanfang Data Knowledge Service Platform for guidelines,expert consensus,evidence summaries,systematic reviews,primary study and clinical decisions regarding home-based exercise rehabilitation for patient with CHD phase Ⅱ cardiac rehabilitation.Literature included the articles published on databases from the inception to December 2023.Two researchers independently evaluated the quality of acquired literature and the extracted and integrated the evidence.Results A total of 15 articles were retrieved,including 5 guidelines,3 expert consensuses,2 evidence summaries,3 systematic reviews and 2 clinical decisions.A total of 23 best evidence statements were summarised and further reduced to 5 topics:exercise benefits,exercise assessment,exercise prescription,safety and monitoring,and health education.Conclusion This study summarises the best evidence for home-based exercise rehabilitation in patients with phase Ⅱ cardiac rehabilitation.It recommends that healthcare professionals should consider the clinical context rehabilitation,by taking into account of the needs and preferences of patients and their families,when applying the evidence and developing appropriate and individualised plans for exercise hence to promote the recovery of patients.

The coronary plaque burden represents an essential tool for evaluating coronary blood flow and cardiovascular outcomes. However, the concept of "coronary plaque burden" does not accurately reflect the complex pathological progression of coronary artery disease. In this review, various aspects of the total coronary atherosclerosis burden are present, including its mechanics, geometrical characteristics, plaque morphology, coronary artery calcium deposition, and coronary inflammation, to provide a complete view. Different tools used to evaluate the coronary atherosclerosis burden are also assessed according to the most recent studies. Compelling evidence is provided by our findings to advocate for a comprehensive use of the term "coronary atherosclerosis burden" .

The coronary plaque burden represents an essential tool for evaluating coronary blood flow and cardiovascular outcomes. However, the concept of "coronary plaque burden" does not accurately reflect the complex pathological progression of coronary artery disease. In this review, various aspects of the total coronary atherosclerosis burden are present, including its mechanics, geometrical characteristics, plaque morphology, coronary artery calcium deposition, and coronary inflammation, to provide a complete view. Different tools used to evaluate the coronary atherosclerosis burden are also assessed according to the most recent studies. Compelling evidence is provided by our findings to advocate for a comprehensive use of the term "coronary atherosclerosis burden" .

Objective This study aims to reveal the effects of the Yiqi Huoxue Formula(YQHXF)on the function of the pulmonary alveolar-capillary barrier in rats with acute lipopolysaccharide-induced lung injury and to explore the potential mechanism.Methods Sixty adult male SD rats were randomly assigned to the sham operation,model,dexamethasone(5 mg/kg,gavage),Yiqi Huoxue Formula low-dose(3.6 g/kg,gavage),medium-dose(7.2 g/kg,gavage)and high-dose(14.4 g/kg,gavage)groups.The rats in the sham group received intratracheal instillation of normal saline,and those in other groups received intratracheal instillation of lipopolysaccharide(LPS,5 mg/kg)for the modeling of ALI.The rats in the sham and model groups were administered normal saline by gavage,and those in the other groups were administered the corresponding drugs once a day for 7 days.Specimens were collected 12 h after the last administration.Pathological changes in lung tissue were observed under a light microscope.The wet/dry weight ratio of the lung and the total protein concentration in the bronchoalveolar lavage fluid(BALF)were measured.Immunofluorescence staining was used to measure the protein expression of zonula occludens-1(ZO-1).Western blotting was used to measure protein levels of occludin,aquaporin-1(AQP-1),and AQP-5.Results Compared with the sham group,the model group showed an increased histopathological score of the lung tissue,lung wet/dry weight ratio,and protein concentration in BALF(P<0.01).Yiqi Huoxue Formula medium-and high-dose groups were lower than those in the model group(P<0.05,P<0.01).Compared with the sham group,the model group downregulated the expression of ZO-1,occludin,AQP-1,and AQP-5(P<0.01).Yiqi Huoxue Formula medium-and high-dose groups upregulated the protein levels compared with the model group(P<0.01).Conclusion The findings suggest that the Yiqi Huoxue Formula can improve the dysfunction of the pulmonary alveolar-capillary barrier in the rat model of ALI induced by LPS,and its mechanism is related to regulating tight junction protein(ZO-1,occludin)and aquaporin(AQP-1,AQP-5)expression.