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.

Vascular endothelial growth factor (VEGF) inhibitors are drugs that target and inhibit tumor angiogenesis. By blocking the signaling pathway of VEGF and its receptor, they suppress tumor proliferation and play a crucial role in tumor treatment. However, their side effects, such as hypertension, proteinuria, hand-foot skin reactions, and myelosuppression, during treatment seriously affect patients' treatment compliance and quality of life. The development of intervention strategies for the side effects of VEGF inhibitors is of great importance for tumor treatment. This article reviews the clinical characteristics and toxic mechanisms of common side effects caused by VEGF inhibitors during tumor treatment and summarizes intervention strategies that combine traditional Chinese and Western medicines. Drug dosages were precisely monitored and adjusted to achieve antitumor treatment. Patients' discomfort symptoms are improved through prescriptions that act by tonifying qi and promoting blood circulation, strengthening the spleen, and tonifying the kidney. The combination of traditional Chinese and Western medicines is used to treat patients, thus providing a safe and effective treatment plan for patients with cancer.

[This corrects the article DOI: 10.1016/j.apsb.2021.10.012.].

Over the past few decades, tumor immunotherapy has revolutionized the landscape of cancer clinical treatment. There is a flourishing development of combination strategies to improve the anti-tumor efficacy of mono-immunotherapy. However, instead of a straightforward combination of multiple therapeutics, it is more preferable to pursue a synergistic effect by designing rational combinations as well as administration strategies, which are based on a comprehensive understanding of the physiological and pathological features. In this case, the timing and spatial distribution of the combination drugs become essential factors in achieving improved therapeutic outcomes. Therefore, the concept of Sequential Drug Delivery System (SDDS) is proposed to define the spatiotemporally programmed drug delivery/release through triggers of internal conditions and/or external interventions, thus complying with the dynamic disease evolution and the human immunity. This review summarizes the recent advancements in biomaterial-based SDDSs used for spatiotemporally-tuned combination tumor immunotherapy. Furthermore, the rationales behind various engineering strategies are discussed. Finally, an overview of potential synergistic mechanisms as well as their prospects for combination immunotherapy is presented.

Objective:To establish a risk prediction model by analyzing the influencing factors of delivery be-fore 34 weeks' gestatior with singleton pregnancies who underwent transcervical McDonald's cervical cerclage.Methods:Clinical data of 500 pregnant women with singleton pregnancies who underwent McDonald's cervical cerclage in the Department of Obstetrics and Gynecology,Heping Hospital,General Hospital of the People's Lib-eration Army Northern Theater of Operations from January 1,2019 to February 29,2024 were retrospectively ana-lyzed,and were randomly divided into a training set of 350 cases versus a validation set of 150 cases in accord-ance with a 7∶3 randomization.The data in the training set were screened for predictive variables affecting deliv-ery before 34 weeks' gestation after cervical cerclage using univariate combined multivariate Logistic regression,predictive modeling and assessment were established,and internal validation was performed in the validation set.Results:Preoperative cervical length(CL)＜20 mm,amniotic fluid deposits(AFS),absence of Lactobacillus vagi-nalis,and cervical dilatation＞3 cm were independent risk factors for adverse outcomes of labor and delivery be-fore 34 weeks' gestation after cervical cerclage(OR＞1,P＜0.05),and the Nomogram model constructed on the basis of this was found to have an AUC of 0.887,with a good agreement of the model(H-L test:P=0.905,Brier score of 0.095).The results of the clinical decision curve showed that the clinical decision value of the model was high when the threshold was between 0.10-0.92.The model was internally validated with an AUC of 0.812,and there was a high degree of agreement between the predictions and the actual situation(H-L test:P=0.859).Conclusions:The column-line diagram model constructed on this basis has a high clinical value,which can help us to screen out the high-risk pregnant women and give them individualized interventions in a timely manner.

Objective To explore the influencing factors of early neurological deterioration(END)in patients with acute anterior circulation large-vessel occlusive mild stroke who were treated with medications alone within 72 h after onset.Methods Retrospective consecutive data were collected of patients with acute large-vessel occlusive mild stroke who presented to the Advanced Stroke Center of Linyi People's Hospital within 24 h of onset from January 2021 to December 2022.END was defined as an increase of ≥ 4 points in the National Institutes of Health stroke scale(N1HSS)score within 72 h after onset compared to the admission score.Patients were divided into the neurological deterioration group and the stable condition group(NIHSS score did not increase or increased by 1-3 points within 72 h after onset compared to the admission score).Baseline and clinical data of all patients were collected,including sex,age,cerebrovascular disease risk factors(hypertension,diabetes mellitus,hyperlipidemia,coronary heart disease,atrial fibrillation,smoking,alcohol consumption,stroke history),NIHSS score at admission,time from onset to admission,systolic blood pressure at admission,diastolic blood pressure at admission,laboratory test indicators at admission(blood glucose,glycosylated hemoglobin,homocysteine,total cholesterol,triglyceride,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,neutrophils,lymphocytes and neutrophil-to-lymphocyte ratio),responsible occlusion artery(internal carotid artery,middle cerebral artery,anterior cerebral artery),affected cerebral hemisphere,collateral circulation score,and medications used within 72 h after admission(intravenous thrombolysis+dual antiplatelet therapy,tirofiban+dual antiplatelet therapy,argatroban+dual antiplatelet therapy,argatroban alone,dual antiplatelet therapy alone).Variables with statistically significant differences in univariate analysis were included in multivariate Logistic regression analysis to explore the independent influencing factors for END in patients with acute anterior circulation large-vessel occlusive mild stroke treated with medications alone.Results A total of 208 patients with acute anterior circulation large-vessel occlusive mild stroke were included,with 143 males and 65 females,aged 38-85 years,with an average age of(64±9)years.Among them,86 patients were in the neurological deterioration group and 122 in the stable condition group.(1)There were statistically significant differences between the neurological deterioration group and the stable condition group in terms of history of diabetes mellitus(39.5％[34/86]vs.17.2％[21/122]),smoking history(43.0％[37/86]vs.29.5％[36/122]),left cerebral hemisphere lesion(57.0％[49/86]vs.41.0％[50/122]),collateral circulation score(4[3,5]vs.5[4,5]),time from onset to admission(7.0[3.0,17.0]hvs.4.3[2.0,11.0]h),blood glucose at admission(7.4[5.8,10.0]mmol/L vs.6.7[5.8,7.7]mmol/L),neutrophil-to-lymphocyte ratio(3.8[2.4,5.1]vs.3.0[2.1,4.3]),dual antiplatelet therapy alone(19.8％[17/86]vs.6.6％[8/122]),and argatroban+dual antiplatelet therapy(8.1％[7/86]vs.29.5％[36/122];all P＜0.05).There were no statistically significant differences in the results of the remaining univariate analyses(all P＞0.05).(2)Multivariate Logistic regression analysis showed that diabetes mellitus(OR,2.674,95％CI 1.121-6.377,P=0.027)and left cerebral hemisphere vessel occlusion(OR,2.030,95％CI I.083-3.806,P=0.027)were independent risk factors for END in acute anterior circulation large-vessel occlusive mild stroke.Argatroban+dual antiplatelet therapy(OR,0.267,95％CI 0.116-0.613,P=0.002)and high collateral circulation score(OR,0.551,95％CI 0.368-0.824,P=0.004)were independent protective factors for END in acute anterior circulation large-vessel occlusive mild stroke.Conclusions Acute anterior circulation large-vessel occlusive mild stroke patients with diabetes mellitus or left cerebral hemisphere lesions are prone to END.The combination of argatroban and dual antiplatelet therapy and good collateral circulation can reduce the risk of END.

Objective:To investigate community residents' utilization preferences for "Internet + Nursing Service" and provide evidence for improving service uptake.Methods:Based on literature review, semi-structured interviews, and expert consultation, six service attributes and their levels were identified. Using a discrete choice experiment, 12 choice sets were generated through orthogonal design. Convenience sampling was employed to recruit 294 community residents in Nanjing from January to October 2024. A structured questionnaire was administered, and a conditional logit model was used to explore residents' preferences for "Internet + Nursing Service".Results:A total of 294 questionnaires were distributed, and all were validly returned, with an effective response rate of 100.0%. Preference analysis revealed that nurse type, service continuity, hospital classification, medical insurance coverage, and service price significantly influenced residents' preferences for "Internet + Nursing Service" ( P<0.05). Relative importance analysis indicated that the most valued attributes, in descending order, were medical insurance coverage (41.7%), nurse type (17.9%), service price (12.7%), hospital classification (12.1%), service continuity (11.7%), and waiting time (3.9%). When the proportion of medical insurance coverage reached 80%, residents' willingness to pay was the strongest. Conclusions:Medical insurance coverage is the key factor affecting community residents' choice of "Internet + Nursing Service". Residents prefer services provided by general hospitals and expert nurses. It is recommended to improve medical insurance and pricing policies, allocate resources precisely, and enhance service quality to promote the development of "Internet + Nursing Service".

Objective:To evaluate the long-term efficacy and safety of recombinant coagulation factor Ⅷ (Octocog alfa) in Chinese patients with hemophilia A (HA) enrolled in the International Antihemophilic Factor Hemophilia A Outcome Database (AHEAD) study (NCT02078427) .Methods:Enrollment of Chinese patients in the AHEAD study was completed by January 2021, and data were collected up to July 15, 2022. This study primarily assessed patients in terms of the Gilbert score, global gait score within the Hemophilia Joint Health Score (HJHS), annualized bleeding rate (ABR), annualized joint bleeding rate, and adverse events.Results:A total of 168 male patients were included in this study, of which 113 received prophylactic treatment and 53 received on-demand treatment. The average age of the patients was 21.4±13.37 years. Compared with baseline, the global gait score within HJHS significantly decreased during the 1-year follow-up in patients with moderately severe HA in the prophylactic treatment group ( P=0.01) and on-demand treatment group ( P=0.008). The mean reduction in Gilbert score was greater in the prophylactic treatment group than in the on-demand treatment group (28.6% vs 8.2%). The average ABR decreased significantly during the 1-year follow-up (3.70 vs 7.78, P=0.01) in the prophylactic treatment group, particularly in patients with severe HA (2.14 vs 8.98, P=0.006) and pediatric patients (2.1 vs 4.73, P=0.03). The ABR score also decreased significantly in the moderate-dose prophylactic treatment group ( P=0.015). During the 1-year follow-up, 25 patients (14.9%) reported 39 adverse events, with only one patient developing treatment-related F Ⅷ inhibitor. Conclusion:Joint mobility improved in patients receiving either prophylactic or on-demand Octocog alfa. Bleeding episodes significantly reduced in patients receiving prophylactic treatment, particularly in pediatric patients and those with severe HA.

Objective:To develop a treatment-related quality of life scale for Chinese patients with multiple myeloma (MM) and to test its reliability and validity.Methods:The initial scale was constructed through a literature search, Delphi expert correspondence, and cognitive testing. This study conducted a preliminary survey of 379 patients with MM and a formal survey of 865 patients from the hematology departments of 155 hospitals nationwide from February 2024 to March 2024. The final scale was obtained after conducting item analysis and reliability and validity tests on the initial scale.Results:The constructed scale contains 36 items covering six domains: physiological, psychological, social, treatment side effects, general health, and others. In the preliminary survey, the Cronbach’s alpha coefficient of each item ranged from 0.597 to 0.939, and the test-retest reliability was 0.747 ( P<0.001). Exploratory factor analysis extracted eight common factors with a cumulative variance contribution of 60.058%. In the formal survey, the Cronbach’s alpha coefficient of each item ranged from 0.484 to 0.930, and the test-retest reliability was 0.835 ( P<0.001). Confirmatory factor analysis revealed a comparative fit index of 0.750, a root-mean-square error of approximation of 0.090, and a root-mean-square residual of 0.067. Conclusion:The treatment-related quality of life scale for Chinese patients with MM designed in this study exhibited good reliability and validity, reflecting the impact of treatment on the quality of life of patients. This scale can provide a reference to clinicians for assessing the disease status of patients.

Objective To investigate the effects of Zhongfengting granule on plasma metabolites in acute cerebral ischemia MCAO model rats by non-targeted metabolomics techniques,and to elucidate the neuroprotective mechanism of Zhongfengting granule.Methods 24 male SD rats were randomly divided into blank group,model group and Chinese medicine group,with 8 rats in each group.Model group and Chinese medicine group were treated with middle cerebral artery thrombus method to establish the MCAO rat model,and the medicine was administered on the same day after the successful modeling.The Chinese medicine group was given(22.68 g·kg-1)Zhongfengting granule solution by gavage,and the blank group and model group were given equal volume normal saline for 7 days.After administration,blood was collected intravenously.Plasma samples from blank group,model group and Chinese medicine group were analyzed by ultra-high performance liquid chromatogre-quadrupole tandem time-of-flight mass spectrometer,and differential metabolites were screened by multivariate statistical analysis.The metabolic pathways of the differentiated metabolites were analyzed based on KEGG database.Results Multivariate statistical analysis showed that the content of 22 potential biomarkers in the rat model of acute cerebral ischemia had significant changes,and the above-mentioned 22 potential biomarkers were significantly reversed by Zhongfengting granule(P<0.05).The enrichment results of metabolic pathways showed that Zhongfengting granule mainly affected phenylalanine metabolism,tyrosine metabolism,ascorbic acid metabolism and arachidonic acid metabolism.Conclusion Metabolites and metabolic pathways in MCAO model rats with acute cerebral ischemia are changed,and the different metabolites and metabolic pathways can be reversed by Zhongfengting granule,which mainly involve phenylalanine metabolism and regulate energy metabolism.