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 conduct a clinical comprehensive evaluation of five marketed thrombopoietin receptor agonists （TPO-RA） approved in China， providing quantitative evidence for drug selection and therapeutic decision-making in medical institutions. METHODS Relevant data on Romiplostim for injection， Eltrombopag olamine tablets， Herombopag olamine tablets， Avatrombopag maleate tablets， and Lusutrombopag tablets were collected. Based on the Chinese Rapid Guide for Drug Evaluation and Selection in Medical Institutions （Second Edition）， 12 formulations of these five TPO-RA were scored quantitatively and comparatively across five dimensions： pharmacological characteristics， efficacy， safety， cost-effectiveness， and other attributes. RESULTS The comprehensive scores of the 12 formulations ranged from 62.56 to 75.50 points， with most scoring ≥70 points. Using the highest-scoring formulation for each generic name as a representative， the overall rankings of the five TPO-RA were as follows： Lusutrombopag tablets （75.50 points）， Eltrombopag olamine tablets （75.10 points）， Avatrombopag maleate tablets （70.40 points）， Romiplostim for injection （63.93 points）， and Herombopag olamine tablets （63.52 points）. Lusutrombopag tablets scored relatively high in pharmacological characteristics， safety， and cost-effectiveness， while Eltrombopag olamine tablets performed well in efficacy and cost-effectiveness. The other formulations showed varying scores across evaluation dimensions. CONCLUSIONS The five TPO-RA demonstrate favorable overall clinical value， with Lusutrombopag tablets and Eltrombopag olamine tablets ranking higher in comprehensive scores， these two drugs should be prioritized in drug selection and formula optimization by medical institutions.

Objective To explore the influence of the medical and health management model based on artificial intelligence (AI) on type 2 diabetes mellitus (T2DM) combined with masked hypertension (MH). Methods A total of 342 patients with T2DM admitted to the hospital from May 2021 to August 2024 were selected as research subjects, and the incidence rate of MH was counted. All patients were classified into the reference group (routine management) and the study group (AI+medical health management) according to the random number table method, with 171 cases in each group. The self-management, glycolipid metabolism and ambulatory blood pressure were compared between both groups before and after intervention. Results Among the 342 patients with T2DM, MH occurred in 34 cases, with an incidence rate of 9.94% (34/342). The self-management ability in the two groups was improved after 6 months and 12 months of intervention, and the self-management ability was higher in the study group (P<0.05). After 6 months and 12 months of intervention, the glucolipid metabolism indexes in both groups were optimized, and the improvements in the study group were greater (P<0.05). The daytime average systolic blood pressure and diastolic blood pressure, 24 h average systolic blood pressure and diastolic blood pressure were decreased in both groups after 6 months and 12 months of intervention, and the study group showed lower indexes (P<0.05). Conclusion T2DM are prone to MH. AI medical and health chronic disease management can enhance patients' self-management ability, help improve glucose and lipid metabolism, lower blood pressure, and help reduce the risk of MH.

OBJECTIVE To evaluate the efficacy of oral and facial muscle functional training in treating adult obstructive sleep apnea(OSA)and to identify clinical indicators influencing treatment outcomes.METHODS Through a prospective cohort study,patients diagnosed with OSA in the study unit were recruited to undergo a 3-month myofunctional therapy,including soft palate-related muscles,tongue muscles,buccal muscles,and labial muscles in multiple muscle groups,once a day,five times a week,with the use of offline clinic guidance,and the APP program video follow up training for effective training.Data were collected on multiple dimensions including physical signs,sleep breathing monitoring parameters,and airway measurements from imaging studies.Treatment efficacy was assessed by comparing subjective and objective sleep indicators before and after training.Patients were categorized into effective and ineffective groups based on treatment outcomes.Differences in baseline clinical indicators between these groups were analyzed using univariate and multivariate regression analyses.RESULTS The study finally included 58 people,51 males and 7 females,age(38.36±8.96)years,BMI(27.14±3.68)kg/m2,AHI of the enrolled patients was reduced from(31.27±22.28)times/h pre-training to(26.27±21.38)times/h post-training,the minimum oxygen saturation was increased from(78.43±10.07)%to(80.50±10.06)%,snoring index decreased from(62.80±75.20)times/h to(36.40±43.19)times/h,and ESS score decreased from 7.00±5.31 pre-training to 5.50±3.17.By comparing the effective and ineffective groups,it was found that there was a statistically significant difference in the tongue position and ESS scores between the two groups(both P<0.05),while no significant differences were found in gender,age,neck circumference,posterior soft palate area,uvula area,posterior tongue area,or posterior epiglottic area(all P>0.05).Univariate logistic regression analysis indicated that tongue position,AHI,and ESS scores were factors affecting the efficacy of oral and facial muscle function training.Multivariate regression analysis revealed that AHI was an independent prognostic factor for this training in OSA patients.CONCLUSION Oral and facial muscle function training can improve both subjective and objective sleep breathing indices in OSA patients.Tongue position,AHI,and ESS scores may serve as prognostic factors for OSA treatment,aiding in guiding subsequent individualized intervention therapies.

OBJECTIVE To investigate the regulatory effect of vitamin D3(VD3)-mediated TIPE2 on macrophage function and phenotype in chronic rhinosinusitis with nasal polyps(CRSwNP).METHODS Peripheral blood samples were collected from 100 CRSwNP patients and 100 patients with simple nasal septum deviation.RT-qPCR and Western blot were used to measure the expression of TIPE2 and Arg-1,and chemiluminescence was used to measure VD3 concentration.In the J774A.1 macrophage cell line,TIPE2 was silenced,and in CRSwNP model mice,TIPE2 was overexpressed,followed by treatment with overexpressed TIPE2 combined with VD3.Western blot was used to measure the expression of TIPE2 and Arg-1,and ELISA was used to measure the expression of IL-4 and IL-13.RESULTS In the CRSwNP group,VD3 levels decreased,while TIPE2 and Arg-1 levels increased(all P<0.05).Arg-1 and TIPE2 were positively correlated(r2=0.994,P<0.05),and both were negatively correlated with VD3 levels(r2=0.652,P<0.05;r2=0.745,P<0.05).Silencing TIPE2 in J774A.1 cells led to a decrease in Arg-1,IL-4,and IL-13 levels(all P<0.05).In CRSwNP mice,overexpression of TIPE2 resulted in decreased VD3 and increased Arg-1,IL-4,and IL-13 levels,which were reversed by VD3 treatment(all P<0.05).CONCLUSION VD3 inhibits the expression of Arg-1,IL-4,and IL-13 in CRSwNP by downregulating TIPE2 expression.

Objective:To analyze the etiological composition and clinical characteristics of infant hypertension，and provide reference for its diagnosis and treatment.Methods:This is a retrospective case-control study.Retrospective investigation and analysis were conducted on the clinical data of infants discharged from Beijing Children's Hospital Affiliated to Capital Medical University with a diagnosis of "hypertension" from June 1，2016 to September 30，2021，including clinical manifestations，auxiliary examinations，treatment plans，and prognosis.Results:A total of 74 eligible children were collected，including 42 male infants（56.8%）and 32 female infants（43.2%）.A total of 67 cases（90.5%）had clear secondary factors，including 35 cases of kidney disease（47.3%），12 cases of connective tissue disease（16.2%），and 9 cases of hematological tumor disease（12.2%）.At the beginning of the disease，cardiac ultrasound showed that 54 cases（73.0%）had ventricular wall thickening，including mild thickening in 31 cases（57.4%），moderate thickening in 11 cases（20.3%），and severe thickening in 12 cases（22.2%）.After grouping by etiology，the incidence of proteinuria and severe hypertension in the renal hypertension group，as well as those receiving multiple antihypertensive drugs，was significantly higher than that in the non-renal hypertension group（ χ 2=28.493， P<0.001； χ 2=17.283， P<0.001； χ 2=17.358， P<0.001）；Renal disease was risk factor for severe hypertension in infants according to univariate and multivariate logistic regression analysis respectively（ OR=11.176，95% CI：2.882~43.339， P<0.001； OR=11.669，95% CI：2.921~46.624， P<0.001）.Thirty-one children had follow-up records for 6 months or more，and 13（41.9%）still required antihypertensive treatment，of whom 26（83.9%）were no longer recorded as having elevated blood pressure. Conclusion:Infant hypertension is mainly secondary，with a high proportion of renal factors and predisposition to severe hypertension，which requires multiple antihypertensive drugs for control.Active antihypertensive treatment and removal of secondary factors during the acute phase are helpful for controlling hypertension in infants，but further research is needed on treatment options and long-term prognosis.

BACKGROUND:Studies have shown that patients with premature ovarian failure have changes in the structure of intestinal flora and that imbalance of intestinal microbiota may be one of the important mechanisms in the development of premature ovarian failure. OBJECTIVE:To investigate the effect of Liuwei Dihuang Wan on oxidative stress and intestinal microbiota in premature ovarian failure mice induced by cyclophosphamide. METHODS:Forty-five female ICR mice were randomized into three groups:blank group(normal mice),model group(premature ovarian failure mice),and Liuwei Dihuang Wan group.A mouse model of premature ovarian failure was prepared by one-time intraperitoneal injection of cyclophosphamide(120 mg/kg)in the latter two groups.After successful modeling,the Liuwei Dihuang Wan group was intragastrically administered for 28 continuous days,and the other two groups were intragastrically administered with the same amount of normal saline for 28 days.Mouse body mass was recorded weekly and ovarian index was calculated.The development of mouse follicles was observed using hematoxylin-eosin staining.ELISA method was used to detect serum levels of anti-Mullerian hormone,estradiol,follicle stimulating hormone,superoxide dismutase,glutathione peroxidase,and malondialdehyde.Meanwhile,the gut microbiome of all mice was detected through 16S rDNA sequencing. RESULTS AND CONCLUSION:The mice in the model group had loose hair,decreased vigor and grip strength,almost no increase in body mass,and decreased ovarian index.Whereas,the mouse body mass and ovarian index were increased after treatment with Liuwei Dihuang Wan(P<0.05).The estrous cycle of mice in the model group was disorganized;Liuwei Dihuang Wan could restore the estrous cycle and reduce the number of atretic follicles in mice with premature ovarian failure.The serum levels of follicle stimulating hormone and malondialdehyde in the model group significantly increased(P<0.01),while the levels of estradiol,anti-Mullerian hormone,superoxide dismutase,and glutathione peroxidase significantly decreased(P<0.01).Liuwei Dihuang Wan could significantly decrease the serum levels of follicle stimulating hormone and malondialdehyde(P<0.01),and increase the levels of estradiol,anti-Mullerian hormone,superoxide dismutase,and glutathione peroxidase.According to the 16S rDNA sequencing results,Liuwei Dihuang Wan could regulate the abundance and diversity of intestinal microbiota,and increase the relative abundance of beneficial bacteria.KEGG pathway analysis showed that the intestinal microbiota and metabolic pathways,biosynthesis of secondary metabolites,microbial metabolism in different environments,and biosynthesis of amino acids were regulated by Liuwei Dihuang Wan.To conclude,the changes in the structure of intestinal microbiome may be one of the potential mechanisms of Liuwei Dihuang Wan in treating premature ovarian failure.Liuwei Dihuang Wan can regulate the structure of intestinal microbiome,increase the number of beneficial bacteria,reduce the number of harmful bacteria,and thus improve the balance of intestinal microbiota.This regulatory effect helps to reduce oxidative stress levels and further inhibit ovarian oxidative stress in mice with premature ovarian failure.

Objective:To explore the core factors of self-management and quality of life (QOL) in patients with chronic obstructive pulmonary disease (COPD) and the internal relationship between these two constructs.Methods:A convenience sampling method was used to enroll 210 COPD patients who visited the Fifth Affiliated Hospital, Sun Yat-sen University from January to December 2022. Data were collected using Self-Management Scale and 36-item Short-Form. A relationship network between self-management and QOL was constructed via network analysis, and centrality indicators and network stability were calculated.Results:A total of 210 questionnaires were distributed, and 205 valid questionnaires were recovered, with an effective recovery rate of 97.6%. Emotional management was identified as the core node in both the overall network and the self-management subnetwork (2.064), while vitality was the core node in the QOL subnetwork (0.730). The relationship between self-management and QOL was mainly manifested through the strong association between emotional management and role-emotion.Conclusions:Emotional management is the core factor in the relationship between self-management and QOL in COPD patients. The overall network of self-management and QOL is influenced by the strong association between emotional management and role-emotion.

Objective:To define the concept of proactive health behavior.Methods:Literature related to proactive health behavior was retrieved from China National Knowledge Infrastructure, Wanfang Data, VIP, SinoMed, PubMed, Web of Science, Embase, and Ovid databases, with a retrieval time frame from database inception to March 1, 2025. Walker and Avant's concept analysis method was used to analyze the concept of proactive health behavior.Results:A total of 46 articles related to proactive health behavior were included. Proactive health behavior encompasses five key attributes: self-initiation, long-term persistence, multidimensional integration, future orientation, and overcoming barriers. Antecedents include individual factors, supportive factors, and environmental factors. Outcomes include promoting individual health and improving quality of life, enhancing personal health literacy, reducing disease burden, and fostering a proactive health atmosphere.Conclusions:The concept attributes of proactive health behavior were clarified through concept analysis. Future researchers may develop proactive health behavior assessment tools and construct intervention strategies based on their connotation.

Endometrial carcinoma (EC) is one of the most common gynecologic malignancies, with the majority of patients diagnosed at an early stage. Surgery is the primary treatment modality, and postoperative risk stratification plays a key role in guiding adjuvant therapy decisions. Lymphovascular space invasion (LVSI) is an important pathological feature that affects the prognosis of patients and serves as one of the key factors in risk stratification. This review summarizes the prognostic significance of LVSI in patients with early-stage EC and its impact on the selection of adjuvant therapies, aiming to provide new insights for exploring precise and individualized diagnosis and treatment.