The occurrence of diabetes mellitus （DM） is closely related to insulin resistance and islet β cell dysfunction. Modern studies have found that macrophages are widely present in the liver，fat，skeletal muscle，islets， and other tissues and organs. Macrophage M1/M2 polarization plays an important role in the occurrence and development of diabetes mellitus and its related complications by intervening in inflammatory response，improving insulin resistance，and promoting tissue repair. Most of the traditional Chinese medicines that regulate the activation and polarization of macrophages are Qi-replenishing and Yin-nourishing，heat-clearing， and detoxicating medicinal，which are consistent with the etiology and pathogenesis of diabetes and its related complications. Therefore，by summarizing the mechanisms between macrophage activation，polarization， and insulin resistance in various tissues，this paper reviewed traditional Chinese medicine and its effective components and compounds in improving diabetes mellitus and its related complications through multi-channel regulation of macrophage polarization and regulation of M1/M2 ratio，providing references for the future treatment of DM and its related complications with traditional Chinese medicine.

To summarise the clinical experience of Professor TONG Xiaolin in treating prediabetes combined with overweight or obesity using the method of relieving depression and reducing turbidity. It is believed that prediabetes belongs to the category of "spleen-heat syndrome" in traditional Chinese medicine， and its core pathogenesis is center fullness with internal heat， while obesity is the initiating factor for exacerbating center fullness and internal heat， therefore， it is of great significance to reduce the risk of diabetes by interrupting the transformation between overweight， obesity and glucose metabolism abnormality. It is proposed that the main pathogenesis of prediabetes combined with overweight or obesity is qi depression and turbidity obstruction in middle jiao， with qi depression as the root and turbidity obstruction as the cause， forming a treatment idea with the method of relieving depression and reducing turbidity as the core. In clinic， Dahuang Huanglian Xiexin Decoction （大黄黄连泻心汤） is used as the basic prescription， with a primary focus on directing the turbid downward， supplemented by regulating qi， which embodies the concept of "promoting movement through descent， then figuring out the root of spleen-heat syndrome. Furthermore， the treatment is flexibly modified based on the patient's deficiency-excess syndrome to ensure individualized therapy.

Objective:To observe the aging-related trends and age-sensitive changes in postural control reaction time(RT)and movement time(MT)during the adaptive balance after instability. Method:A total of 97 healthy adult subjects aged 20-79 were tested for posture control time using the DE-A somatosensory balance detection system.The test included postural adjustment RT and MT during the adaptive balance(e.g.forward,backward,left and right)tilts of the support surface under static and dynamic balance states.The subjects were sequentially divided into six age groups based on 10-year age intervals,with 16 in Group 1(20-29 years),10 in Group 2(30-39 years),17 in Group 3(40-49 years),18 in Group 4(50-59 years),31 in Group 5(60-69 years)and 5 in Group 6(70-79 years).The age-related trends and age-sensitive changes in postural control RT and MT were observed and analyzed. Result:The postural control RT and MT increased with age.In static balance,all RT and MT indicators were longer in group 6 than in groups 1 to 5,with significant differences compared with groups 1 to 4(P＜0.05)but no significant differences compared to group 5(P＞0.05).All RT and MT indicators were longer in group 5 than in groups 1 to 4,and there were significant differences(P＜0.05).All RT and MT indicators were lon-ger in group 4 than in groups 1 to 3,with a significant difference compared with group 1 in RT when the support surface was tilted to the right(P＜0.05),but no significant differences between groups for the remain-ing indicators(P＞0.05).All RT and MT indicators were longer in group 3 than in groups 1 to 2,with a sig-nificant difference compared with group 1 in MT when the support surface was tilted to the left(P＜0.05),but no significant differences between groups for the remaining indicators(P＞0.05).There was no significant difference(P＞0.05)between group 2 in all RT and in MT compared with group 1.In dynamic balance,all RT and MT indicators were longer in group 6 than in groups 1 to 5,with significant differences compared with groups 1 to 4(P＜0.05)but no significant differences compared with group 5(P＞0.05).All RT and MT indicators were longer in group 5 than in groups 1 to 4,but there were no significant differences(P＞0.05).All RT indicators were longer in group 4 than in groups 1 to 3,with no significant differences compared with group 1 in RT when the support surface was tilted to the left(P＞0.05),while there were significant dif-ferences between groups for the remaining RT indicators(P＜0.05).All MT indicators were longer in group 4 than in groups 1 to 3,with significant differences compared with group 2 in MT when the support surface was tilted to the back and left(P＜0.05),while there were no significant differences between groups for the remaining RT indicators(P＞0.05).All RT indicators were longer in group 3 than in groups 1 to 2,with no significant differences compared with group 1(P＞0.05).All MT indicators were longer in group 3 than in groups 1 to 2,with significant differences compared with group 1(P＜0.05).There was no significant differ-ence between group 2 in all RT and in MT compared with group 1(P＞0.05). Conclusion:The postural control RT and MT during the adaptive balance after instability gradually increase with aging.The deterioration of postural control response time and motion time in static balance may start to become evident around the age of 60,while in dynamic balance,these deteriorations may begin to appear around the ages of 50 and 40,respectively.

Objective To assess the efficacy of endoscopic ultrasound-guided enteroenterostomy(EUS-EE)in the management of malignant bowel obstruction(MBO).Methods Retrospective analysis was conducted on clinical data from 14 patients who underwent EUS-EE for MBO from June 2022 to December 2023.A modified intestinal preparation protocol was employed prior to the procedure,and the resolution of symptoms,improvement in nutritional status,and occurrence of complications were statistically analyzed post-EUS-EE.Results EUS-EE was successfully performed in all 14 cases.The Colorectal obstruction scoring system(CrOSS)was used to evaluate preoperative and postoperative symptom relief and alleviation of bowel obstruction.One week after the procedure,CrOSS scores increased from 1 to 2 before surgery to 2～4.The patient-generated subjective global assessment(PG-SGA)score for malignancy patients demonstrated a mean score of(9.64±3.13)one week after surgery among the study cohort of 14 patients.This score showed a significant decrease compared to their preoperative PG-SGA score(12.36±3.22),with a statistical difference(t=2.26,P=0.032).Postoperatively,five patients experienced elevated body temperature,three had pneumoperitoneum,and two developed short bowel syndrome;However,these complications were effectively managed through symptomatic treatment resulting in recovery or relief thereof.At one-year follow-up,the median survival time was recorded as 81(41,500)d with a one-year survival rate at 64.29％.Conclusion EUS-EE offers advantages such as high remission rates for symptoms,minimal trauma,and low reintervention rates.For patients with poor baseline conditions or limited life expectancy,EUS-EE can alleviate physical discomfort symptoms,improve quality of life,and prolong survival period.

Objective To investigate the effect of Piezo1 activated by mechanical stress on knee osteoarthritis synovial fibrosis via the extracellular signal-regulated kinase(ERK)1/2 signaling pathway.Methods Twenty-five Sprague Dawley rats were divided into blank,exercise,exercise+GsMTx4,exercise+PD98059,and exercise+GsMTx4+PD98059 groups(n=5 per group).After modeling,serum and synovial tissue were extracted and collagen deposition was evaluated by Sirius red and Masson staining.Expression levels of Piezo1,ERK1/2,phospho(p)-ERK1/2,α-smooth muscle actin(SMA),transforming growth factor(TGF)-β,Collagen Ⅰ,and tissue inhibitor of metalloproteinase(TIMP)-1 were detected by Western blot and reverse transcription-quantitative polymerase chain reaction(RT-qPCR),and the interleukin(IL)-1β,IL-6,and tumor necrosis factor(TNF)-α contents were detected by enzyme-linked immunosorbent assay.For cell experiments,synovial cells were divided into blank,pull,pull+GsMTx4,pull+PD98059,and pull+GsMTx4+PD98059 groups and the above indices were detected in the model cells by Western blot,RT-qPCR,and other techniques.Results Mechanical stress increased collagen deposition in synovial tissues in the rats,and increased the protein and mRNA expression levels of the pathway-related and fibrosis-specific indicators Piezo1,p-ERK/ERK,α-SMA,TGF-β,Collagen I,and TIMP-1(P＜0.05).Piezo1 expression was significantly down-regulated by both inhibitors(P＜0.05),but the ERK inhibitor(PD98059)had no significant effect on Piezo1 gene expression.Levels of serum inflammatory factors were significantly higher in the exercise group compared with the blank group(P＜0.05),and levels were significantly reduced by the inhibitors(P＜0.05).The in vitro experiments showed the same trends as the animal experiments.Conclusions The Piezo1 ion channel can sense mechanical stress and activate the ERK 1/2 pathway to mediate knee synovial fibrosis.