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 construct a framework for risk identification and mechanistic explanation of conduct problems in adolescents, so as to provide a basis for formulating effective prevention strategies. Methods: In October 2025, a total of 2 126 junior and senior high school students from Zibo City in Shandong Province, Zhengzhou City in Henan Province, and Shenzhen City in Guangdong Province were selected as the study subjects using a combination of convenience sampling and random cluster sampling. The instruments included the Adolescent Conduct Problem Tendency Questionnaire, Barratt Impulsiveness Scale, Callous- Unemotional Traits Scale, Parenting Style Scale, Family Adaptation, Partnership, Growth, Affection, and Resolve Scale, Perceived School Climate Scale, and the School Context Subscale of the Multiple Violence Exposure Scale. Machine learning algorithms and response surface methodology (RSM) were employed to reveal the non linear interactive effects of risk factors on adolescent conduct problems. Results: Impulsive personality ranked first in feature importance, followed by neglectful parenting style and perceived school climate. Impulsive personality and neglectful parenting style both positively predicted rule breaking ( B =0.42, 0.16) and aggression tendencies( B =0.41,0.14), with the interaction effect between the two being significantly negative in both cases ( B =-0.19,-0.08); impulsive personality ( B =0.33) and perceived school climate ( B =0.47) positively predicted addiction tendency, with the interaction term being significantly negative ( B =-0.16)(all P <0.05). For rule breaking tendency, the congruence slope (0.58), congruence curvature (-0.16), incongruence slope (0.26), and incongruence curvature (0.22) all reached statistical significance (all P <0.05). For addiction tendency, the congruence slope (0.79), incongruence slope (-0.15), and incongruence curvature (0.34) all reached statistical significance (all P <0.05). For aggression tendency, the congruence slope (0.55), incongruence slope (0.26), and incongruence curvature (0.15) all reached statistical significance(all P <0.05). Conclusion Impulsive personality is the core driver of rule breaking and aggression tendencies, with neglectful parenting style playing a moderating role; perceived school climate is the core driver of addiction tendency and exhibits an interactive inhibition effect with impulsive personality.

The application of immunosuppressants has significantly reduced the incidence rate of rejection reaction after liver transplantation， but the clinical efficacy of immunosuppressants is greatly affected by individual differences between patients. This article systematically reviews the recent research advances in the interaction between immunosuppressants and gut microbiota， with a focus on the regulatory role and mechanism of intestinal microflora communities on the efficacy of immunosuppressants. Studies have shown that intestinal microbiome is one of the key factors influencing the efficacy of immunosuppressive therapy after liver transplantation. This review aims to provide a theoretical basis for in-depth research in this field and provide new insights for developing individualized immunosuppressive treatment regimens based on the regulation of intestinal microflora.

Objective: To explore the association between the triglyceride-glucose-frailty index and the risk of diabetes mellitus among middle-aged and elderly population, so as to provide the evidence for diabetes mellitus risk screening and management among middle-aged and elderly population. Methods: Based on data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018, middle-aged and elderly individuals aged ≥45 years without diabetes mellitus at baseline were selected as study participants. Demographic characteristics, lifestyles, and laboratory test data were collected. The triglyceride-glucose index was calculated using triglyceride and fasting blood glucose levels, and the frailty index was derived from a 29-item health deficit accumulation model. The triglyceride-glucose-frailty index was obtained by multiplying the two indices, and participants were divided into four groups according to quartiles. Association between the triglyceride-glucose-frailty index and diabetes mellitus incidence risk was analyzed using a multivariable Cox proportional hazards regression model, and the dose-response relationship was assessed using a restricted cubic spline model. Results: A total of 5 246 participants were included, including 2 364 males (45.06%) and 2 882 females (54.94%). The mean age was (58.38±8.78) years. The median of the triglyceride-glucose-frailty index was 0.78 (interquartile range, 1.13). By 2018, 452 diabetes mellitus cases were identified, with a cumulative incidence of 8.62%. Multivariable Cox proportional hazards regression analysis showed that, after adjusting for demographic characteristics, lifestyle factors, and biochemical indicators, each one-standard-deviation increase of the triglyceride-glucose-frailty index was associated with a 37.5% higher risk of diabetes mellitus incidence (HR=1.375, 95%CI: 1.278-1.479). Compared with the Q1 group, the risk increased by 50.8% (HR=1.508, 95%CI: 1.072-2.123), 91.3% (HR=1.913, 95%CI: 1.380-2.651) and 241.6% (HR=3.416, 95%CI: 2.499-4.671) in the Q2, Q3 and Q4 groups, respectively, presenting an upward trend (Pfor trend <0.05). Restricted cubic spline analysis showed a non-linear relationship between the triglyceride-glucose-frailty index and diabetes mellitus incidence risk (P<0.05). Conclusion The triglyceride-glucose-frailty index was positively associated with diabetes mellitus risk among middle-aged and elderly population, and a nonlinear dose-response relationship was observed between the two.

It was a retrospective study. The propensity score matching was applied to divide the type 2 diabetes mellitus (T2DM) patients who have underwent percutaneous coronary intervention (PCI) into two groups: short-term (<4 weeks) sodium-glucose cotransporter 2 inhibitor (SGLT2i) group (213 patients) and control group (213 patients). The occurrence of contrast-induced acute kidney injury (CIAKI) after PCI was compared between the two groups. The results showed that the incidence of CIAKI in the SGLT2i group was not significantly different from the control group [10.8% (23/213) vs. 7.5% (16/213), χ2=1.383, P=0.313]. The incidence of CIAKI in patients with SGLT2i application time <1 week was higher than that in control patients, but the difference was not statistically significant [13.00% (16/123) vs. 7.5% (16/213), χ2=2.734, P=0.122]. Multivariate logistic regression analysis showed that short-term (<4 weeks) use of SGLT2i would not increase the risk of CIAKI after PCI in T2DM patients ( OR=0.507, 95% CI 0.238-1.077, P=0.077). Short-term application of SGLT2i before PCI may not increase the risk of CIAKI, but it is advisable to avoid initiating the application of SGLT2i before PCI as much as possible.

Objective:To explore the efficacy and safety of the Da Vinci robotic single-port-plus-one technique in common urological surgeries in children.Methods:The data of 59 children who underwent robot-assisted single-port-plus-one laparoscopic surgery from May 2022 to November 2023 in Fuzhou University Affiliated Provincial Hospital were retrospectively analyzed. There were 44 males and 15 females, aged 36 (6, 108)months. Among them, 27 cases had ureteropelvic junction obstruction, with a preoperative anterior-posterior diameter of the renal pelvis of (31.83±6.59) mm. The American Society of Fetal Urology (SFU) grading system revealed grade Ⅲ in 8 sides and grade Ⅳ in 19 sides. Bilateral renal function showed a difference of 13.50% (7.18%, 31.06%). Additionally, 17 cases presented with vesicoureteral reflux. Preoperative voiding cystourethrogram (VCUG) indicated reflux grades Ⅲ, Ⅳ, and Ⅴ in 8, 14, and 4 sides, respectively, with a difference in bilateral renal function of 18.58% (6.04%, 28.30%). Ten cases had obstructive megaureter, with a preoperative renal pelvis diameter of (22.17±7.64)mm and a maximum ureteral diameter of (19.51±3.71)mm. The preoperative bilateral renal function difference was 18.02% (5.23%, 49.42%).Five cases involved duplicated kidney and ureter. Magnetic resonance urography (MRU) confirmed unilateral duplicated kidneys with associated dilatation of the upper renal pelvis and calyces, hydroureter, thin renal cortex in all 5 patients. Among them, 2 cases had ectopic ureteral opening and 1 case had terminal ureteral cyst. Patients with ureteropelvic junction stenosis underwent pyeloplasty, those with vesicoureteral reflux and obstructive megaureter underwent ureteral reimplantation, and patients with duplicated ureters underwent nephrectomy. The Da Vinci robotic surgical system was employed for all procedures. The port placement technique involved a 2-3 cm incision around the navel to insert a single-port four-channel device, followed by the placement of an additional 8 mm operating channel in the left or right abdomen under direct visualization based on the surgical site. Preoperative and postoperative parameters were compared.Results:All operations were successfully completed without conversion to open or laparoscopic surgery. The operation time of the ureteropelvic junction obstruction children was (141.52±22.93) min. The postoperative renal pelvis diameter and bilateral renal function difference were (12.54±4.05) mm and 5.60%(2.14%, 14.48%), respectively, both of which showed significant improvement compared to preoperative levels ( P<0.01). Postoperative hydronephrosis grades were as follows: 13 sides with grade Ⅰ, 13 sides with grade Ⅱ, and 1 side with grade Ⅲ. The operation time of vesicoureteral reflux children was (125.00±11.75) min in the unilateral group and (153.22±14.39) min in the bilateral group. Postoperatively, 2 sides demonstrated reflux grade Ⅰ, 1 side grade Ⅱ, and 1 side grade Ⅲ, indicating improvement compared to preoperative levels. Bilateral renal function difference post-surgery was 13.34% (1.85%, 20.54%), which was more balanced than preoperatively ( P=0.011). Postoperative renal pelvis anterior-posterior diameter and maximum ureteral diameter were reduced to (10.31±3.86) mm and (6.62±2.44) mm, respectively, which were significantly smaller than preoperative measurements ( P<0.01). The bilateral renal function difference post-surgery was 12.04% (4.85%, 47.53%), showing improvement, though not statistically significant ( P=0.508). The operation time of the repeated nephrectomy children was (140.00±12.75) min. No recurrence of preoperative symptoms was noted, and renal cortical function remained generally normal during follow-up. In this study, only 3 cases of obstructive megaureter developed febrile urinary tract infection within 1 month after surgery, and no complications were observed in the remaining cases. Conclusions:This study preliminarily confirmed that the Da Vinci robotic single-port-plus one-port technology can be used in the treatment of common diseases of the urinary system in children. The patients' symptoms were significantly relieved after surgery, and the indicators of hydronephrosis improved compared with those before surgery. The incidence of postoperative complications was low, and aesthetic outcomes of postoperative scars were enhanced. Further studies are needed to assess its long-term efficacy.

Objective:To observe the clinical efficacy of snake-like moxibustion combined with aconitum ointment based on routine Western medication in the treatment of ankylosing spondylitis(AS)of cold-dampness blockage pattern,and to evaluate its effects on traditional Chinese medicine(TCM)symptoms,serum Dickkopf-1 protein(DKK-1)level,and disease activity.Methods:A total of 120 AS patients were selected as research subjects and randomly divided into an observation group and a control group according to the random number table method,with 60 cases in each group.The control group was treated with oral sulfasalazine enteric-coated tablets as conventional therapy;the observation group was additionally treated with snake-like moxibustion combined with external application of aconitum ointment based on the intervention in the control group.After 4 weeks of consecutive treatment in both groups,the total effective rate was compared.Changes in TCM symptom scores,spinal pain visual analog scale(VAS)score,overall evaluation VAS score,Bath ankylosing spondylitis disease activity index(BASDAI)score,Bath ankylosing spondylitis functional index(BASFI)score,erythrocyte sedimentation rate(ESR),and serum levels of C-reactive protein(CRP),tumor necrosis factor(TNF)-α,and DKK-1 were observed.Results:The total effective rate in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the scores of TCM symptoms,spinal pain VAS,overall evaluation VAS,BASDAI,and BASFI,as well as ESR,serum levels of CRP,TNF-α,and DKK-1 in both groups were lower than those before treatment,with statistically significant differences within groups(P<0.05);all indicators in the observation group were lower than those in the control group,with statistically significant differences between groups(P<0.05).Conclusion:Based on routine Western medication treatment,the addition of snake-like moxibustion combined with external application of aconitum ointment yields better therapeutic efficacy than Western medication alone in the treatment of AS.It can significantly improve clinical symptoms,control inflammation,and down-regulate the serum DKK-1 level.

Objective:This study investigated the expression of C-X-C motif chemokine receptor 3 (CXCR3) on CD45RO? T cells in the peripheral blood of patients with Alzheimer′s disease (AD) and its association with clinical features.Methods:A total of 41 AD patients and 30 age-and sex-matched healthy controls (HCs) were recruited from the Department of Neurology at the Medical Division of PLA General Hospital between September 2022 and March 2024. Flow cytometry was used to quantify CXCR3 expression on CD45RO? T cell subsets in peripheral blood. Dementia severity in AD patients was assessed using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Spearman correlation analysis examined the relationship between CD45RO?CXCR3? T cell levels and cognitive function in the AD group. Receiver operating characteristic (ROC) curve analysis determined the predictive utility of CD45RO?CXCR3? T cells for AD, quantified by the area under the curve (AUC).Results:Compared to healthy controls, AD patients exhibited significantly elevated levels of CD8?CD45RO?CXCR3? T cells [17.8% (7.2%, 40.3%) vs. 8.2% (5.1%, 12.3%), Z=-2.59, P<0.05]. However, no significant differences were observed for CD4?CD45RO?CXCR3? T cells, CD4?CD45RO?CXCR3? T cells, or CD8?CD45RO?CXCR3? T cells ( P>0.05). Spearman correlation analysis revealed a negative correlation between CD8?CD45RO?CXCR3? T cell levels and cognitive scores (MMSE: r=-0.72, P<0.05; MoCA: r=-0.70, P<0.05). ROC analysis demonstrated an AUC of 0.81 for CD8?CD45RO?CXCR3? T cells in predicting AD, with a sensitivity of 59.0% and specificity of 93.3%. Conclusions:CXCR3 expression is significantly upregulated on CD8?CD45RO? T cells in AD patients, and its levels correlate with cognitive impairment severity. These findings suggest that CD8?CD45RO?CXCR3? T cells may serve as a potential biomarker for AD diagnosis and progression monitoring.

Objective To explore the protective effect and possible mechanism of modified Shenqi Dihuang Decoction on podocytes in db/db mice based on ROS/NLRP3/GSDMD signaling pathway.Methods Fifty 8-week-old male db/db mice(SPF grade)were randomly divided into the model group,losartan group and TCM low-,medium-and high-dosage groups,with 10 mice in each group.Ten heterozygous db/m mice served as the blank group.Interventions were administered respectively for 12 weeks.The body mass,random blood glucose,serum creatinine,blood urea nitrogen and 24 h urinary protein content were detected,HE,PAS,PASM,Masson and Sirius red staining was used to observe the morphology of renal tissue,transmission electron microscopy was used to observe the ultrastructure of renal tissue,fluorescent probes were used to observe the release of ROS in renal tissue,immunofluorescence staining was used to detect the expression of Nephrin,NLRP3,Cleaved Caspase-1 and GSDMD-N in renal tissue,and Western blot was used to detect the expression of NLRP3,Cleaved Caspase-1,GSDMD-N,IL-1β,IL-18,Nephrin,Podocin,PODXL,WT-1 and Desmin proteins.Results Compared with the blank group,the body mass and random blood glucose of the model group mice significantly increased(P<0.05),and the contents of serum creatinine,blood urea nitrogen and 24 h urinary protein were significantly increased(P<0.05);glomerular hypertrophy,dilation of renal glomeruli and tubules,thickening of basement membrane,matrix proliferation in mesangial area,abnormal deposition of collagen fibers in renal interstitium,accompanied by damage to renal tubular epithelial structure and focal glomerulosclerosis,significant increase in type Ⅰ collagen deposition,extensive fusion of podocyte processes,and scattered electron dense material in the basement membrane or subepithelial layer;the ROS content in renal tissue significantly increased(P<0.05),and the protein expression of NLRP3,Cleaved Caspase-1,GSDMD-N,IL-1β,IL-18 and Desmin significantly increased(P<0.05),the protein expression of Nephrin,Podocin,PODXL and WT1 significantly decreased(P<0.05).Compared with the model group,the body mass and random blood glucose of mice in each dosage of TCM group were relatively stable,the contents of serum creatinine,blood urea nitrogen and 24 h urinary protein decreased;the pathological damage to renal tissue was reduced,the ultrastructure of podocytes was improved,and the density of podocytes increased;the ROS content decreased,and the protein expression of NLRP3,Cleaved Caspase-1,GSDMD-N,IL-1β,IL-18 and Desmin decreased,while the protein expression of Nephrin,Podocin,WT1 and PODXL increased.With the dosage of modified Shenqi Dihuang Decoction increased,the improvement effect gradually strengthened,and the differences in TCM high-dose group was statistically significant(P<0.05).Conclusion Modified Shenqi Dihuang Decoction can protects podocytes in db/db mice,potentially by modulating the ROS/NLRP3/GSDMD signaling pathway.

Objective To retrieve,analyze and synthesize evidence on post-transplant diabetes mellitus(PTDM)in lung transplant patients,providing reference for clinical healthcare professionals in preventing and managing PTDM in lung transplant patients.Methods Based on the"6S"evidence model,systematic searches were conducted across guideline websites,professional associations,and Chinese/English databases regarding post-transplant diabetes mellitus(PTDM)in lung transplant patients.The search period spanned from data-base inception to January 2025.Two researchers independently completed literature screening,quality assess-ment,and evidence extraction.Results A total of 14 articles were included,comprising 1 clinical decision,2 guidelines,5 expert consensuses,2 specifications,1 evidence summary,and 3 systematic reviews.Twenty-four pieces of best evidence were synthesized from seven aspects:risk factors,diagnosis,screening,prevention,treatment,glycemic control targets,and health education.Conclusion The best evidence for preventing and managing post-transplant diabetes mellitus in lung transplant patients provides an evidence-based foundation for clinical practice among healthcare professionals.Evidence should be selected and applied according to spe-cific clinical situations and patient needs.