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.

As the core vehicle for preserving and transmitting traditional Chinese medicine（TCM） academic thought and clinical experience， the establishment of a robust quality evaluation system for TCM clinical case reports is a crucial component in the current standardization and modernization of TCM. Based on the practical experience of constructing the China Clinical Cases Library of Traditional Chinese Medicine by the China Association of Chinese Medicine， this study conducted a comprehensive analysis of critical challenges， including insufficient authenticity and unfocused evaluation criteria. It proposed a three-dimensional evaluation framework grounded in the structure-process-outcome logic， encompassing three dimensions of authenticity and standardization， characteristics and advantages， application and translational impact. This framework integrated 12 key evaluation indicators in a systematic manner. The model preserved the academic characteristics of TCM syndrome differentiation and treatment， while aligning with modern scientific research standards， achieving a balance between individualized TCM experience and standardized evaluation. Concurrently， this study provided theoretical foundations and methodological guidance for evaluating the quality of TCM clinical cases， contributing significantly to the inheritance of TCM knowledge， evidence-based practice， and the reform of talent evaluation mechanisms.

Parkinson's disease (PD) is a neurodegenerative disorder characterized by the aggregation of α-synuclein (α-syn) and dysregulated synaptic vesicle (SV) recycling. Emerging evidence suggests that ferroptosis is the target of PD therapy. However, the identification of effective anti-ferroptosis treatments remains elusive. This study explores the therapeutic potential of low-intensity ultrasound (US) in modulating SV recycling and anti-ferroptosis in cellular and animal models of PD. We demonstrate that optimized US stimulation (610 kHz, 0.2 W/cm²) activates Piezo1 channel-mediated fast endophilin-mediated endocytosis, which promotes SV recycling and synaptic function, presenting with increased frequency and amplitude of both spontaneous excitatory synaptic currents and miniature excitatory postsynaptic currents. Repaired SV recycling in turn reduces the accumulation of α-syn expression and ferroptotic cell death. These findings support the potential of noninvasive ultrasonic neuromodulation as a therapeutic strategy for PD and lead to meaningful health outcomes for the aging population.
Animals ; Ferroptosis/physiology* ; Synaptic Vesicles/metabolism* ; Dopaminergic Neurons/metabolism* ; Ion Channels/metabolism* ; Mice ; Ultrasonic Waves ; Humans ; Male ; Mice, Inbred C57BL ; Endocytosis/physiology* ; alpha-Synuclein/metabolism*

Objective To explore the efficacy of hypofractionated radiotherapy at different time intervals after surgery for keloid,and to analyze the factors affecting the efficacy.Methods A total of 76 patients who underwent 20 Gy/5 postoperative radiotherapy regimen in the Fifth Affiliated Hospital of Zhengzhou University from January 2021 to June 2023 were selected as study subjects,and a total of 100 keloids were divided into effective group(n=79)and recurrence group(n=21).Regular follow-up and record of the patients after radiotherapy treatment effect and adverse effects,and multivariate Logistic was used to analyze factors of recurrence in keloid patients.Results Multivariate Logistic regression analysis found that postoperative radiotherapy time and scar incision length were related to recurrence after treatment,radiotherapy within 7h of surgery was an independent risk factor for recurrence after treatment(OR＞1,P=0.022),and scar incision≤5cm was an independent protective factor for recurrence after treatment(OR＜1,P=0.028).Conclusion Surgical excision combined with hypofractionated radiotherapy is one of the effective measures to prevent and treat keloid recurrence,though keloids on the trunk may need more effective treatment options.The recurrence rate of radiotherapy initiated 7-48h after surgery is relatively the lowest,and it is worthy of clinical promotion and application.

The construction of an information system for equipment budget management in public hospitals is an important measure to strengthen comprehensive budget management, serving as an important foundation for promoting the development of clinical disciplines and enhancing operational management. Since September 2023, a tertiary public hospital had explored the construction of equipment budget management informatization. This practice had established a supporting budget management information system, which included an equipment demand reserve library and a general use product library, linked performance evaluation indicators, implemented visualizing real-time project progress, and strengthened data governance. A series of measures had been taken to move management to equipment demand research, expand the time window for departments to fill in budget requirements, simplify the department application process, and achieve a closed-loop management of the entire chain of department equipment demand research, budget approval, and execution, ensuring the rationality and accuracy of the budget. By the end of 2024, the budget management information system had covered 87 departments and included 30 000 sets of equipment applications, providing detailed data support and critical management references for demand departments, equipment management departments, and hospital decision-makers, while improving the quality and efficiency of in-hospital equipment management. This practice could provide references for other public hospitals in China to optimize their equipment budget management.

Objective To investigate the expression levels and mutation status of phosphatidylinositol-4,5-bisphosphate3-kinase catalytic subunit alpha(PIK3CA)in endometrial cancer(EC)and evaluate its association with lymph node metastasis in EC.Methods We retrosepctively collected and analyzed EC genetic mutation testing data submitted to the Molecular Detection Center,The First Affiliated Hospital of Chongqing Medical University between July 2020 and June 2022.The mutation rate of PIK3CA gene was calculated based on the sequencing results of EC patients,and the correlation between PIK3CA mutations and clinical pathological parameters,as well as protein expression consistency,was analyzed accordingly.Results A total of 97 EC patients were enrolled in this study,and PIK3CA mutations were identified in approximately 48.5％(47 out of 97 cases).The rate of lymph node metastasis in patients with PIK3CA mutations was higher than that in patients with wild-type PIK3CA(21.3％vs.6.0％,P=0.027).Findings from univariate and multivariate logistic analyses indicated that histological subtype Ⅱ(odds ratio[OR]=5.51;95％CI,1.08-28.06;P=0.040),positive result for lymphovascular space invasion(LVSI)(OR=7.96;95％CI,1.37-46.44;P=0.021),and PIK3CA mutation(OR=8.58;95％CI,1.51-48.84;P=0.015)were independent risk factors for lymph node metastasis in EC.In addition,the receiver-operating characteristic(ROC)curves demonstrated that the combined use of clinicopathological parameters and PIK3CA mutations could more accurately predict lymph node metastasis in EC,with an area under the curve of 0.824(95％CI,0.678-0.970).It is noteworthy that there was a high consistency between PIK3CA mutations and its protein expression,and EC patients with positive expression of PIK3CA protein had a higher rate of lymph node metastasis(53.8％vs.9.1％,P=0.078).Conclusion PIK3CA somatic mutations are strongly correlated with lymph node metastasis in EC.

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.

Objective To explore the influencing factors of abnormal increase of plasma water-soluble vitamins in patients with parenteral nutrition(PN).Methods A total of 862 hospitalized patients receiving nutritional diagnosis and treatment were enrolled.Daily water-soluble vitamin supply and total urine output were monitored.If patients underwent renal replacement therapy(RRT),the ultrafiltration volume was recorded.Plasma concentrations of nine water-soluble vitamins(Vit-C,B1,B2,B3,B5,B6,B7,B9 and B12)were measured.According to the test results,patients were divided into the accumulation group and the non-accumulation group.Renal function(BUN,Cr,UA),inflammatory indicators(CRP,WBC,NEU,SII)and nutritional indicators(ALB,PA,Hb,LYM)were compared between the two groups.Logistic regression was used to analyze the independent risk factors for the accumulation of water-soluble vitamins.Results There was a high incidence of abnormal plasma water-soluble vitamin levels,including Vit-B2(36.08%),Vit-B6(16.01%)and Vit-B5(13.81%).Compared with the non-accumulation group,the Vit-B2 accumulation group had higher levels of age,BUN,Cr,UA and NEU,and lower levels of ALB,PA and urine volume.The Vit-B5 accumulation group had higher levels of BUN,Cr,UA and NEU,and lower levels of LYM,Hb,ALB,PA and urine volume.Patients in the Vit-B6 accumulation group was older,with increased levels of BUN,Cr and UA,and decreased levels of LYM,Hb,ALB,urine volume and vitamin intake(P＜0.05).Multivariate Logistic regression analysis showed that the elevated level of BUN was independent risk factors for Vit-B2 accumulation,the elevated BUN and reduced urine volume were independent risk factors for Vit-B5 accumulation,and elevated BUN and Cr,as well as reduced urine volume,were independent risk factors for Vit-B6 accumulation.Receiver operating characteristic curve analysis showed that the area under the curve for BUN in predicting Vit-B2,B5 and B6 accumulation were 0.659(95%CI:0.620-0.697),0.728(95%CI:0.675-0.781)and 0.785(95%CI:0.738-0.831),respectively,with high specificity but low sensitivity.Conclusion The serum levels of water-soluble vitamins are affected by renal function.When implementing parenteral nutrition water-soluble vitamins supplementation,the patient's renal function status should be evaluated,and the risk of abnormal elevation of Vit-B2,B5 and B6 should be vigilantly monitored.

Objective To explore the influencing factors of abnormal increase of plasma water-soluble vitamins in patients with parenteral nutrition(PN).Methods A total of 862 hospitalized patients receiving nutritional diagnosis and treatment were enrolled.Daily water-soluble vitamin supply and total urine output were monitored.If patients underwent renal replacement therapy(RRT),the ultrafiltration volume was recorded.Plasma concentrations of nine water-soluble vitamins(Vit-C,B1,B2,B3,B5,B6,B7,B9 and B12)were measured.According to the test results,patients were divided into the accumulation group and the non-accumulation group.Renal function(BUN,Cr,UA),inflammatory indicators(CRP,WBC,NEU,SII)and nutritional indicators(ALB,PA,Hb,LYM)were compared between the two groups.Logistic regression was used to analyze the independent risk factors for the accumulation of water-soluble vitamins.Results There was a high incidence of abnormal plasma water-soluble vitamin levels,including Vit-B2(36.08%),Vit-B6(16.01%)and Vit-B5(13.81%).Compared with the non-accumulation group,the Vit-B2 accumulation group had higher levels of age,BUN,Cr,UA and NEU,and lower levels of ALB,PA and urine volume.The Vit-B5 accumulation group had higher levels of BUN,Cr,UA and NEU,and lower levels of LYM,Hb,ALB,PA and urine volume.Patients in the Vit-B6 accumulation group was older,with increased levels of BUN,Cr and UA,and decreased levels of LYM,Hb,ALB,urine volume and vitamin intake(P＜0.05).Multivariate Logistic regression analysis showed that the elevated level of BUN was independent risk factors for Vit-B2 accumulation,the elevated BUN and reduced urine volume were independent risk factors for Vit-B5 accumulation,and elevated BUN and Cr,as well as reduced urine volume,were independent risk factors for Vit-B6 accumulation.Receiver operating characteristic curve analysis showed that the area under the curve for BUN in predicting Vit-B2,B5 and B6 accumulation were 0.659(95%CI:0.620-0.697),0.728(95%CI:0.675-0.781)and 0.785(95%CI:0.738-0.831),respectively,with high specificity but low sensitivity.Conclusion The serum levels of water-soluble vitamins are affected by renal function.When implementing parenteral nutrition water-soluble vitamins supplementation,the patient's renal function status should be evaluated,and the risk of abnormal elevation of Vit-B2,B5 and B6 should be vigilantly monitored.

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.