In recent years， the incidence of papillary thyroid carcinoma （PTC） in China has increased significantly. Thus， it is necessary to standardize the procedures of diagnosis， treatment and follow-up. Thyroid Center of the Third Affiliated Hospital of Sun Yat-sen University （consisted of Department of Ultrasound， Department of Thyroid and Breast Surgery， Department of Otolaryngology Head and Neck Surgery， Department of Endocrinology， Department of Nuclear Medicine， Department of Medical Oncology， Department of Pathology， and Department of Radiology） referred to the 2015 American Thyroid Society guidelines for the diagnosis and treatment of adult thyroid nodules and differentiated thyroid cancer， the 2021 Chinese society of clinical oncology thyroid guidelines， China Anti-Cancer Association guidelines for holistic integrative management of thyroid cancer （2022 version） combined with clinical front-line work experience， aimed at the pre-operative diagnosis process of papillary thyroid cancer， fine needle aspiration pathology reporting standards， the indications and complication of radical treatments such as open surgery， endoscopic surgery， thermal ablation treatment for newly diagnosed PTC， the standards and processes of ¹³¹I treatments with intents of thyroid clearance， adjuvant therapy， and focal cleaning treatment， postoperative dynamic evaluation， and TSH inhibition treatment， etc.， and finally built the integrated diagnosis and treatment path of PTC （initial treatment）. Hereby we released this guideline.

Objective To identify lactylation-related molecular subtypes， construct a prognostic model， and predict immunotherapy efficacy in ovarian cancer （OC）. Methods The prognostic significance of lactylation-related genes （LRGs） was analyzed using data from TCGA-OV， GSE63885， and GSE26193 datasets. Unsupervised clustering identified four distinct lactylation-related clusters （LRGClusters）. Differential expression and Gene Ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） enrichment analyses were performed for these clusters. Using univariate Cox regression analysis （P < 0.0001）， five prognostic-related genes （PRGs） were identified. The expression levels of these PRGs in normal ovarian tissues， as well as early and advanced-stage ovarian cancer tissues were validated via RT-qPCR. Based on the five PRGs， a second round of unsupervised clustering was conducted to identify two gene clusters （geneClusters）， and a prognostic scoring system， termed LactyScore， was developed. Immune cell infiltration， immunotherapy response， and drug sensitivity analyses were then performed based on LactyScore stratification. Results Four LRGClusters and two geneClusters were identified. Five differentially expressed genes including COL16A1， SPEN， AHDC1， LUZP1， and SDF2L1 were significantly associated with prognosis of OC patients. RT-qPCR indicated that SPEN， COL16A1， AHDC1， and LUZP1 were the potential risk factors for poor prognosis， whereas SDF2L1 might serve as a protective factor. Based on these PRGs， the LactyScore prognostic scoring system was established. Survival analysis revealed that patients in the high LactyScore group exhibited significantly better overall survival compared to those in the low LactyScore group. Moreover， patients with a high LactyScore showed increased immune evasion potential and lower response rates to immunotherapy. Conclusions Five prognostic genes including COL16A1， SPEN， AHDC1， LUZP1， and SDF2L1 are associated with OC and these genes demonstrate their potential as biomarkers for OC. Furthermore， the development of the robust LactyScore system offers an accurate tool for predicting OC prognosis and immunotherapy responsiveness， providing insights for personalized therapeutic strategies.

In 2024， significant progress has been made globally in the research of cerebral small vessel disease （cSVD）， particularly in genetic mechanisms， clinical typing， biomarkers and treatment strategies. However， challenges remain in terms of pathological complexity， insufficient specificity of biomarkers， and limited therapeutic means. Protein aggregates containing both wild-type and mutant NOTCH3 are key drivers of arterial pathology in CADASIL. Research on the staging of NOTCH3-related cSVD severity demonstrated that CADASIL can be clinically divided into 5 stages and 9 phases. For acute cerebral infarction thrombolysis in CADASIL， the risk of intravenous thrombolysis-related hemorrhage is relatively low due to the small volume of cerebral infarction. Progress has also been made in blood-based biomarkers for cSVD. Regarding the imaging biomarkers of cSVD， perivascular spaces in the basal ganglia， water diffusion fraction， and DTI-ALPS independently promote the burden of cSVD and cognitive decline. In the field of cerebral amyloid angiopathy （CAA）， studies have shown that anxiety can exacerbate neutrophil NETosis and promote the progression of CAA， opening new avenues for research on the role of neuroinflammation exacerbated by negative emotions in the pathogenesis of cSVD. In CAA combined with Alzheimer’s disease （AD）， 289 proteins showed different levels in CAA （+） vessels of AD patients， with associations to increased collagen-containing extracellular matrix， reduced ribonucleoprotein complexes， and decreased BBB proteins. SGLT2 and SGLT1 inhibition plays a protective role in the development of cSVD. This review introduces the progress in both the basic and clinical research of cSVD in 2024.

With the continuous development of science and technology， 3D printing technology has been widely used in the medical field. Especially in the field of dental prosthetics and implants， 3D printing technology provides patients with more accurate， minimally invasive， fast and personalized solutions. This review discussed the application of 3D printing technology in oral prosthesis implantation， including its principle， advantages， application scope and future development trend， aiming to provide a reference for the clinical use of 3D printing technology.

In the central nervous system， microglia account for about 10% of the total number of cells. They are the main immune cells in the nervous system， responsible for immune surveILlance， inflammatory response， and removal of harmful substances. When the nervous system is damaged， infected， or inflammatory， microglia are activated into macrophage-like cells and release inflammatory mediators and cytokines. These molecules can guide the migration of immune cells， regulate inflammatory responses， and participate in the repair and recovery process. In this review， we mainly focus on the activation and mechanism of microglia in the inflammatory response of the nervous system， further explain the inflammatory response process of the nervous system and the role of microglia in some specific neurological diseases.

Orthodontic tooth movement is a series of highly ordered dentin-periodontal membrane-alveolar bone remodeling processes mediated by orthodontic forces. The adaptive responses of the periodontal cellular microenvironment （including extracellular matrix， cell membrane， cytoskeleton， cellular nuclear proteins， and genome） involve the local synthesis and release of various key cytokines. In this study， we reviewed the recent relevant literature in recent years， and organized cytokines with potential clinical applications from various types of cells involved in the orthodontic process， focusing on the roles of various factors in the mechanical force of orthodontic tooth movement-cell signaling process， with the aim of assisting researchers to carry out preclinical studies.

Objective To explore the effects of Thymosin β4 （Tβ4） on the lipopolysaccharide （LPS）-induced polarization tendency of murine monocyte-macrophage RAW264.7 cells and its influence on inflammatory responses. Methods An inflammation model was established by LPS induction in RAW264.7 cells. Cell viability was assessed using the CCK-8 assay. The concentrations of cytokines [tumor necrosis factor-α （TNF-α） and interleukin-6 （IL-6）] were detected by enzyme-linked immunosorbent assay （ELISA）. Nitric oxide （NO） secretion in the cell culture supernatant was detected using the Griess method. Real-time quantitative polymerase chain reaction （RT-qPCR） was employed to detect mRNA expression levels of nuclear factor-κB （NF-κB）， cyclooxygenase-2 （COX-2）， TNF-α， and IL-6. Western blotting was used to analyze protein levels of inducible nitric oxide synthase （iNOS）， NF-κB， phosphorylated NF-κB （p-NF-κB）， NF-κB inhibitor α （IκB-α）， and phosphorylated IκBα （p-IκB-α）. The polarization status of macrophages was observed using double fluorescence staining. Immunofluorescence staining was performed to examine NF-κB localization and expression. Results After treatment with 1 000 μg/L Tβ4 for 24 hours， the cell viability of RAW 264.7 cells was 90.2%， showing a statistically significant difference compared to the blank control group （P < 0.05）. Tβ4 at various concentrations effectively inhibited NO production （all P < 0.000 1）. Tβ4 decreased the concentrations of pro-inflammatory cytokines（TNF-α and IL-6） and NO in the LPS-induced RAW264.7 inflammatory model. It also downregulated mRNA expression of NF-κB， COX-2， TNF-α， and IL-6， as well as protein expression of iNOS， p-NF-κB， and p-IκBα. Additionally， Tβ4 inhibited NF-κB nuclear translocation and decreased CD80 expression （all P < 0.05）. Conclusion Tβ4 exhibits anti-inflammatory effects， the mechanisms of which may be associated with the inhibition of the NF-κB signaling pathway and suppression of macrophage M1 polarization.

Objective To explore the social cognitive characteristics and social integration needs of youth with autism spectrum disorder （ASD） based on the double empathy theory， and to propose potential social support measures to facilitate their social integration. Methods From August to October 2024， four youth with ASD were recruited for a qualitative research using in-depth interviews. A semi-structured interview design was adopted， and the interviews were conducted by telephone. Results Youth with ASD demonstrated distinct social cognitive challenges and coping strategies. They faced difficulties in understanding nonverbal information， facial expressions in particular， during social interactions. Although they cope through conscious attention regulation or verbal inquiries， it is still insufficient to address the complexity and variability of emotions， leading them to seek support in social cognition and interaction skills. In terms of social integration， they tended to prefer interest-driven and low-social-pressure environments but encountered conflicts arising from the double empathy paradox and sensory overload. To cope with conflicts， they employed diversified strategies such as avoiding face-to-face communication， adopting a “cold” approach， or resorting to written communication. In addition， youth with ASD generally emphasizes the important role of sensory environmental needs in their social integration， expressing demand for sensory-friendly modifications in public places （e.g.， noise reduction spaces， appropriate lighting design） and technical support. Conclusions To construct social integration practices for the ASD population， it is necessary to implement the double empathy theory by providing social interventions that meet their skill-enhancement needs， by carrying out science popularization and public education to shape public awareness and reduce misunderstandings， and by enhancing sensory-friendly features in public spaces while establishing technology-assisted communication.

Objective To provide empirical evidence for the application of artificial intelligence model in the clinical diagnosis and treatment of osteoporosis. Methods The core chapters of the guidelines for the diagnosis and treatment of primary osteoporosis were selected，and 10 orthopedic surgeons compared the answers of ChatGPT and DeepSeek with the guidelines from the four dimensions of accuracy，comprehensiveness，interpretability，and clinical applicability. Combined with the results of clinical bone mineral density test，the accuracy and scientificity of the model decision-making were evaluated. Results The scores of 10 orthopedic surgeons were consistent. The accuracy score of DeepSeek was significantly higher than that of ChatGPT，and DeepSeek was more accurate in drug management and parameter analysis，which conformed to the key points of guideline update. Although there was no statistical difference in comprehensiveness and interpretability score，DeepSeek built a multidimensional evaluation framework by integrating drug leave management，FLS collaboration mode and OSTA screening tools，and used charts to improve the efficiency of information presentation. The clinical application score of DeepSeek was better than that of ChatGPT，and its decision-making path and full-cycle monitoring system effectively shortened the time consumption of clinical decision-making. Clinical bone mineral density analysis showed that ChatGPT only provided a basic diagnosis and treatment framework，while DeepSeek showed a more complete guideline compliance and clinical applicability. Conclusion AI can improve the efficiency and quality of clinical decision-making in osteoporosis，and the performance of DeepSeek interpretation is better than that of ChatGPT.

Sea cucumber polypeptides have garnered significant attention in the treatment of neurological diseases due to their unique structure and diverse biological activities. Recent studies have shown that sea cucumber polypeptides possess biological activities such as antioxidant， anti-inflammatory， and immune modulation， effectively reducing neural inflammation and oxidative stress on nerve cells， thereby protecting neurons. Specifically， the mechanisms by which sea cucumber polypeptides act in neurological diseases， including Alzheimer’s disease， Parkinson’s disease， and stroke， have become focal points of research in recent years. These polypeptides can positively impact neurodegenerative changes by suppressing inflammatory responses， modulating neurotransmitter levels， and promoting neuroregeneration. Despite promising findings， current studies are mainly focused on in vitro and animal experiments， with relatively limited clinical research evidence； thus， further exploration of their safety and efficacy is required. This paper reviews the primary biological activities of sea cucumber polypeptides and their recent advancements in applications to neurological diseases， providing references for future research and clinical application.

Benign Paroxysmal Positional Vertigo （BPPV） is a common external vestibular disease with a high recurrence rate. Currently， the main treatment for this disease is manual reduction， but some patients still have residual dizziness after successful reduction. Therefore， the exploration of more effective treatment methods has become an important direction of clinical research. This paper analyzes the relevant literature in recent years to describe the status quo of research on the treatment of residual dizziness after BPPV reduction at home and abroad from the perspectives of Western medicine manual reduction， drug treatment， vestibule rehabilitation training， traditional Chinese medicine， external Chinese medicine and combined traditional Chinese and Western medicine treatment. It aims to provide reference for more effective treatment methods of combined traditional Chinese and Western medicine， reduce the recurrence rate of patients and improve the quality of life of patients.

Adolescent depressive disorders are not only associated with the problematic use of mobile phones by adolescents themselves but also with the frequent use of mobile phones by their parents. The latter may indirectly increase the risk of depression in adolescents by affecting the satisfaction of their basic psychological needs and their self-esteem levels. This article focuses on exploring the ways in which adolescents use mobile phones and the impact of high-frequency mobile phone use by adolescent parents on adolescent depressive disorders. It also emphasizes the importance of interdisciplinary research and suggests a comprehensive prevention of adolescent depressive disorders due to problematic mobile phone use through technological interventions， as well as at the levels of schools， communities， and society. The aim is to provide new ideas for early detection and improving treatment outcomes.

Insomnia is a common sleep disorder that significantly impacts daily functioning and overall health. Traditional treatments， including Cognitive Behavioral Therapy for Insomnia （CBT-I） and pharmacotherapy， are widely used； however， anesthesiology， as an emerging treatment modality， has shown promising potential due to its precise drug management and unique technical advantages. Anesthesiologists can offer personalized treatments using sedative-hypnotic drugs and nerve block techniques， particularly for chronic and refractory insomnia. Innovations such as propofol， dexmedetomidine， and stellate ganglion block have been shown to regulate sleep architecture， improve sleep quality， and quickly reverse sleep deprivation， breaking the vicious cycle of insomnia. Despite these promising results， challenges remain， including technical complexity， the need for standardized protocols， and long-term efficacy evaluation. In the future， with the standardization of anesthetic techniques， multidisciplinary collaboration， and the integration of emerging technologies， anesthesiology is expected to play a greater role in insomnia treatment.

Diabetes mellitus has become a chronic metabolic disease that seriously threatens global public health. Its severe complications markedly increase mortality and disability， and insulin resistance is the core pathological mechanism. Thus， new therapeutic targets are needed. In recent years， activation of brown adipose tissue （BAT） and browning of white adipose tissue （WAT）， owing to their distinct thermogenic function and metabolic regulatory roles， have become focal areas in the research of diabetes treatment. Accordingly， this review systematically summarizes research advances concerning BAT activation and WAT browning in diabetes mellitus and the regulation of glucose metabolism， with emphasis on the mechanisms by which BAT activation and WAT browning improve insulin sensitivity， maintain glucose homeostasis， and enhance energy metabolism， aiming to provide more precise and effective clinical interventions for patients with diabetes mellitus.

Objective To evaluate the value of lacrimal gland herniation（LGH）in judging the activity of thyroid-associated ophthalmopathy（TAO）and predicting the efficacy of glucocorticoids. Methods A retrospective analysis was conducted on the clinical data of 238 patients with TAO who were hospitalized at the Department of Endocrinology and Metabolic Diseases，the Third Affiliated Hospital of Sun Yat-sen University，from January 2014 to November 2022. Magnetic resonance imaging（MRI）was used to measure LGH and its differences were compared among different activity groups. Spearman rank correlation analysis was used to assess the correlation between LGH and the clinical activity score（CAS）. The effectiveness of LGH in staging TAO activity was evaluated using the receiver operating characteristic（ROC）curve. Follow-up was performed on 92 patients receiving glucocorticoid therapy to analyze the differences in LGH between the different efficacy groups. The influencing factors of efficacy were analyzed by multivariate Logistic regression analysis. Results The LGH of patients in the active group was higher than that in the non-active group（P < 0.05）. Spearman rank correlation analysis results showed a positive correlation between LGH and CAS score（P < 0.05）. The ROC curve analysis showed that the staging efficacy of LGH for TAO activity was optimal when the cut-off value of LGH was 9.78 mm，with an area under the curve（AUC）of 0.703，sensitivity of 78.9%，and specificity of 54.8%. Combining external ocular muscle thickness（EOMT）with LGH further improved staging efficacy，with an AUC of 0.752，sensitivity of 62.7%，and specificity of 78.1%. The AUC for the combined EOMT and LGH was greater than that for LGH alone（Z = 2.052，P < 0.05）. In the glucocorticoid treatment efficacy group，LGH was lower than in the ineffective group（P < 0.05）. Multivariate Logistic regression analysis indicated that LGH was an independent predictor of efficacy（P < 0.05）. Conclusions The LGH of TAO patients is correlated with the CAS score and can be used as a good indicator to judge the activity of TAO. The combination of LGH and EOMT can effectively improve the staging efficacy of TAO，thus providing effective assistance for precise clinical diagnosis and treatment.

Objective To systematically evaluate the clinical efficacy of traditional Chinese medicine （TCM） based on liver regulation theory combined with anti-thyroid drugs in the treatment of hyperthyroidism， aiming to provide more sufficient evidence of evidence-based medicine for the application of TCM in hyperthyroidism. Methods Studies related to TCM treatment of hyperthyroidism based on liver regulation theory were retrieved from CNKI， Wanfang Database， Chongqing VIP Database， Chinese Biomedical Literature Database， Web of Science， PubMed， Cochrane Library and Embase until November 30， 2024. After screening the eligible studies， the quality of the studies was evaluated. Revman 5.4 software was used to systematically re-evaluate the efficacy. Results A total of 36 published studies were included， including 2 616 patients， 1 309 in the control group and 1 307 in the study group. Comparison of thyroid function improvement between two groups showed that TSH elevation in the study group was higher than that in the control group （I ²=93%，SMD=1.16，95% CI（0.81， 1.51）， P < 0.000 01）， and decreased FT₃ （I ²=95%，SMD=-1.56，95%CI （-1.98， -1.14）， P < 0.000 01） and FT₄ （I ²=96%，SMD=-1.78，95%CI （-2.25，-1.30）， P < 0.000 01） were better than those in the control group. In addition， the symptoms were more significantly mitigated in the study group （I ²=93%， SMD=-1.55， 95%CI （-1.95， 1.15）， P < 0.000 01）. The clinical response rate in the study group was higher than that in the control group （I ²=0%，RR=1.23， 95%CI （1.19， 1.27）， P < 0.000 01）. Conclusion TCM based on liver regulation theory combined with anti-thyroid drugs can better improve thyroid function， relieve clinical symptoms and improve clinical efficacy， which remains to be validated by large-scale， high-quality clinical research.

Vestibular migraine is a hereditary disease characterized by recurrent vestibular symptoms， with a higher incidence in females than in males， and is often associated with poor lifestyle and mood， most commonly stress， sleep disorders， and anxiety and depression. Since there is no preferred pharmacological treatment， and the changes in lifestyle and improvement of mood are proving to be effective in controlling vestibular migraine symptoms， non-pharmacological treatments are becoming more important. Avoidance of triggering factors， lifestyles changes， vestibular rehabilitation， cognitive-behavioral therapy， and acupuncture are the main approaches of non-pharmacological treatment. This article mainly analyses the effects of lifestyle and mood on vestibular migraine， and discusses the progress of non-pharmacological treatment of vestibular migraine.

In response to the clinical needs and patient expectations regarding adult enterostomy care in China， the Wound， Ostomy and Continence Nursing Committee of Chinese Nursing Association cooperated with Professional Committee of Integrated Nursing for Colorectal Cancer of China Anti-cancer Association and Evidence-based Nursing Center of Peking University Health Science Center to organize a panel of national experts in relevant field to form a guideline development team. Following the WHO Handbook for Guideline Development， the team systematically reviewed literature and conducted rigorous quality assessments addressing defined clinical issues. Through expert consensus meetings， recommendations were formulated， and the initial draft of the Guideline for Adult Enterostomy Care （hereinafter referred to as the Guideline） was prepared. The draft Guideline underwent review by 24 experts from various regions across China. Based on their feedback， the Guideline was revised， and a final expert meeting was convened to formulate the final version. The finalized Guideline covers four major aspects： preoperative care， postoperative care， rehabilitation care， and management of enterostomy and peristomal skin complications， comprising a total of 89 recommendations. Based on the best evidence available， current domestic clinical practices， and professional judgment， the Guideline is highly scientific and practical， which can be applied to guide clinical practice in adult enterostomy care.

The residual neurological dysfunction after traumatic spinal cord injury seriously affects the life status and quality of life of patients. With the rapid development of biomedical technology at home and abroad， there have been a variety of neuroregulatory techniques， including electrical stimulation， magnetic stimulation， ultrasonic stimulation and near-infrared laser stimulation， but the effect is different. This paper reviews the application and mechanism of various neuroregulatory techniques in the field of traumatic spinal cord injury，to provide guidance basis for future basic research and clinical application.

Objective To compare the efficacy and safety of multifocal rigid gas permeable （MFRGP） lenses versus single-vision rigid gas permeable （SVRGP） lenses in controlling myopia progression in adolescents aged 8 to 14 with high myopia. Methods A total of 120 adolescent patients with high myopia， who visited the Guangdong Provincial People’s Hospital between 2021 and 2023， were enrolled. Based on their myopia correction method， the patients were divided into the MFRGP group （58 cases） and the SVRGP group （62 cases）. Follow-up was conducted for 1 year， during which we assessed their spherical equivalent （SE）， annual increase of axial length （AL）， visual acuity with lenses， residual SE， and the incidence of corneal adverse reactions. Results Both groups showed an increasing trend in SE and AL. In the MFRGP group， the SE change was （-0.40±0.31） D and and the AL growth was （0.25±0.13） mm， while in the SVRGP group， the SE change was （-0.62±0.37） D and the AL growth was （0.38±0.27） mm. The differences in the SE and AL increment changes between and within the two groups were statistically significant （all P < 0.05）. At 12 months， the MFRGP group had better corrected visual acuity than the SVRGP group [LogMAR： +0.02±0.06 vs. +0.10±0.09， P < 0.001]， and the residual SE was significantly lower than that in the SVRGP group [（-0.29±0.31）D vs.（-0.78±0.71）D，P = 0.002]. No severe complications occurred in either group， and although the MFRGP group had a slightly higher probability of adverse reactions compared with the SVRGP group， the difference was not statistically significant and could be alleviated with intervention. Conclusions MFRGP is superior to SVRGP in controlling the progression of high myopia in adolescents， and its safety is controllable. MFRGP shows better clinical efficacy in myopia prevention and control.

Immunotherapy has achieved good efficacy in clinical anti-tumor therapy， especially chimeric antigen receptor T cell （CAR-T cell） therapy， as an emerging tumor immunotherapy， has achieved breakthrough efficacy in the clinical treatment of hematologic malignancies. However， CAR-T cell face the problem of gradual exhaustion during the treatment process， especially in the treatment of solid tumors， which will lead to poor anti-tumor efficacy and possible risks such as recurrence. This paper analyzed the possible mechanism of CAR-T cell exhaustion and describes the relevant research progress in inhibiting CAR-T cell exhaustion， with a view to designing reasonable therapeutic strategies to reduce CAR-T cell exhaustion and improve the efficacy of CAR-T cell.

Thyroid surgery has experienced more than a century of development. From conventional anterior neck incision to various types of endoscopic surgery， minimally invasive and beauty are increasingly valued by doctors and patients. However， there is no unified conclusion on whether all thyroid surgeries performed under endoscopy are minimally invasive surgery， how to define surgical trauma， how to evaluate postoperative physical and psychological trauma， and how scars affect patients. This article reviews the above issues.

Objective To construct a model using radiomics to predict the mutation status of isocitrate dehydrogenase （IDH） in gliomas. Methods A retrospective analysis was conducted on preoperative magnetic resonance imaging （MRI） images of 336 glioma patients， and imaging features were extracted to construct an radiomics model. Receiver operating characteristic curve was used to evaluate the effectiveness of the model in predicting IDH mutation status. Results The radiomics features of each sequence were compressed and selected， of which 26 radiomics features were obtained from T₁WI， 24 radiomics features were obtained from T₂WI， 12 radiomics features were obtained from enhanced T₁WI， and 27 radiomics features were obtained from the three sequences combined. In the single sequence model， the area under the curve （AUC） of T₁WI was 0.780 （95%CI 0.724-0.836） in the training set and 0.763 （95%CI 0.650-0.876） in the test set. The AUC of T₂WI was 0.790 （95%CI 0.736-0.845） in training group and 0.785 （95%CI 0.677-0.893） in test group. The AUC of enhanced T₁WI was 0.815 （95%CI 0.762-0.867） in the training group and 0.810 （95%CI 0.702-0.918） in the test group. The radiomics model based on three sequences （T₁WI， T₂WI and enhanced T₁WI） combined had the best prediction performance. The area under the curve of the training group was 0.877 （95%CI 0.837-0.917）， and the area under the curve of the test group was 0.862 （95%CI 0.773-0.952）. Conclusion The radiomics feature model based on conventional MRI can effectively predict the IDH genotype of gliomas， thereby further guiding clinical diagnosis and treatment， and evaluating patient prognosis.

Objective To summarize the research progress and hotspots of cognitive behavioral therapy for insomnia and predict future research directions in this field. Methods Literature related to cognitive behavioral therapy for insomnia was retrieved from the Web of Science Core Collection （WoSCC） database from 2003 to 2024. VOSviewer and CiteSpace software were used for bibliometric visual analysis. Results A total of 3，256 articles from 3，254 institutions in 77 countries were included， primarily from the USA and China. Since 2017， research in this field has entered a rapid development phase. The journal with the highest publication volume on cognitive behavioral therapy for insomnia is Sleep， which is also the most cited journal， with a total of 13，349 authors contributing to these papers； “sleep quality”“acupuncture treatment”“mental health”“novel coronavirus pneumonia”“pregnancy”“quality of life”are current research hotspots and trends in this field. Conclusion Over the past 21 years， cognitive behavioral therapy for insomnia has developed rapidly， and future trends and research hotspots in this field may focus on “acupuncture treatment” and “mental health”.

Objective To evaluate the effect of syndrome differentiation in traditional Chinese medicine on intestinal flora and metabolomics in elderly patients with community-acquired pneumonia（CAP）after discharge from the hospital. Methods Nineteen elderly patients with CAP（11 in the experimental group and 8 in the control group）who were discharged from from the First Affiliated Hospital of Henan University of Traditional Chinese Medicine between December 2022 and November 2023 and 16 healthy volunteers were randomly selected. Plasma and fecal samples were collected. The changes in gut microbiota were analyzed using 16S rDNA high-throughput sequencing technology. Plasma metabolomics research was conducted using ultra-high-performance liquid chromatography-mass spectrometry technology. Results Based on the intestinal flora assay，at the phylum level，the abundance of Campylobacter species and Desulfovibrio phylum was increased after treatment（both P < 0.05）；at the genus level，the genera of Fusiform streptococcus，Trichoderma sphaericornutum group NK4A136，Desulfovibrio unclassified，and Prevotella anomalies were significantly elevated（all P < 0.05）. Based on untargeted metabolomics assay，the treatment improved patients’ metabolite levels of L-tryptophan，malonate，and glycine，which are mainly involved in glycine，serine，and threonine metabolism，aminoacyl-tRNA biosynthesis，and purine metabolism pathways. In the joint analysis of intestinal flora and plasma differential metabolites，Patella species showed a significantly negative correlation with adenine after treatment（P = 0.006）；Fusobacterium spp. showed a significantly negative correlation with 4，6-dihydroxyquinoline（P = 0.003）；and Lactobacillus spp. showed a significantly positive correlation with adenosine phosphorothioate（P = 0.004）. Conclusions In post-discharge elderly CAP patients，syndrome differentiation in traditional Chinese medicine may exert therapeutic effects by improving the structure of intestinal microbial species，increasing the relative abundance of probiotics and decreasing the relative abundance of harmful bacteria，and influencing the pathways associated with the metabolism of amino acids，proteins and energy.

Currently， tumor and radiotherapy can result in physiological and functional damage to the salivary glands， significantly impacting the physiological and psychological well-being of patients. The repair of salivary gland injuries remains a challenging aspect of clinical treatment. Tissue regeneration engineering through cytokine-mediated stem cell directed differentiation offers a novel therapeutic approach for addressing salivary gland injuries. Embryonic stem cells （ESC） and induced pluripotent stem cells （iPSC）， with their potential for multidirectional differentiation and self-renewal， play a crucial role in regenerating and repairing salivary gland tissue. Building upon studies on classical tridermal differentiation of ESC/iPSC mediated by cytokines， this paper provides an extensive review on the research progress and future prospects of utilizing cytokine-mediated stem cell differentiation for salivary gland regeneration.

Objective To systematically evaluate the efficacy and safety of intravenous magnesium sulfate in improving postoperative sleep quality. Methods Clinical randomized controlled trials assessing the role of intravenous magnesium sulfate in improving postoperative sleep quality were searched from PubMed， Web of Science， Embase， Cochrane Library， CNKI， Wanfang， VIP Database， and Grey Literature Database. The retrieval time was from the date of database inception to March 2024. The included literatures were subject to meta-analysis using RevMan 5.4 software after quality evaluation. Results A total of 256 surgical patients from five studies were included. The results of meta-analysis showed that the Visual Analogue Scale （VAS） score （mean difference was -1.49， 95%CI -1.87~-1.12， P < 0.000 01） of sleep quality in the first night in patients receiving perioperative intravenous magnesium sulfate was better than that in the control group， and there were no significant differences in postoperative VAS pain scores under activity status， and the outcomes of nausea and vomiting， shivering and hypotension between two groups （all P > 0.05）. Conclusion Intravenous magnesium sulfate during perioperative period can improve postoperative sleep quality and bring clinical benefits to patients without severe adverse reactions.

Fat mass and obesity-associated protein （FTO）， the first identified obesity-susceptibility gene， exerts complex roles in tumors via its RNA demethylase function. Through modulation of N6-methyladenosine （m⁶A） modification levels on mRNA， FTO influences the stability of oncogenes and related signaling pathways， thereby promoting metabolic reprogramming， proliferation， invasion， and chemoresistance in tumor cells. In obesity-related tumors， FTO expression exhibits tissue-specific patterns： it is highly expressed in endometrial， colorectal， pancreatic and breast cancers， where it facilitates tumor progression by activating an immunosuppressive microenvironment and glycolysis. Conversely， FTO expression is downregulated in thyroid cancer， inhibiting malignancy through the regulation of ferroptosis. Additionally， FTO exerts dual oncogenic or tumor-suppressive roles in ovarian and liver cancers， depending on molecular contexts and subtypes. FTO expression correlates closely with tumor staging， metastasis， and prognosis， underscoring its potential as a novel prognostic biomarker. Small-molecule inhibitors targeting FTO have demonstrated promising antitumor effects in preclinical models， presenting a new therapeutic strategy for precision intervention in obesity-associated cancers. This review summarizes the molecular mechanisms and translational prospects of FTO in obesity-related tumors， providing theoretical support for precision medical strategies.

Free fatty acids are important substances for regulating energy metabolism in the body and mainly exert their functions by binding to G protein-coupled receptors（GPRs）on the cell membrane. GPR120 is the receptor for medium and long-chain free fatty acids in mammals. Studies have found that the activation of GPR120 on endothelial cells，vascular smooth muscle cells，and monocytes/macrophages can reduce monocyte adhesion，promote cholesterol efflux from foam cells，regulate the migration and differentiation of macrophages，and exert anti-inflammatory and antioxidant functions，potentially resisting atherosclerosis. This article reviews the molecular structure，tissue distribution，ligand types，signal transduction pathways of GPR120，and its research progress in anti-atherosclerotic diseases，aiming to reveal the molecular mechanism of GPR120 in resisting atherosclerosis and its potential value as a therapeutic target.

Objective To elucidate the role of C-type lectin domain family 7 member A （CLEC7A） in high-grade serous ovarian carcinoma （HGSOC） and its underlying mechanisms. Methods Using the Cancer Genome Atlas-Ovarian Cancer （CGA-OV） dataset， combined with transcriptional regulatory network analysis and master regulator analysis （MRA）， the impact of CLEC7A on immune-related genes in HGSOC was determined. Pathway enrichment analysis and validation identified the regulatory mechanism of CLEC7A on the Janus Kinase （JAK）/signal transducer and activator of transcription 3 （STAT3） pathway. The GSE184880 single-cell sequencing dataset was analyzed to reveal differences in immune cell proportions and cellular communication between CLEC7A low-expression and high-expression HGSOC tumors. Paraffin-embedded tumor tissues and corresponding adjacent tissues， along with clinicopathological data， were collected from 70 HGSOC and 70 ovarian clear cell carcinoma （OCCC） patients diagnosed and surgically treated at the First Affiliated Hospital of the University of Science and Technology of China/Anhui Provincial Hospital between January 2017 and December 2022. Differences in prognostic factors between HGSOC and OCCC were compared. Immunohistochemical staining was used to detect the expression levels of CLEC7A and PD-L1 in HGSOC， OCCC， and corresponding adjacent tissues. A short hairpin RNA （shRNA） vector targeting CLEC7A was constructed to assess changes in the proliferation and apoptosis of HGSOC cells both after CLEC7A inhibition. In a mouse tumor model with high CLEC7A expression， the proportion of myeloid-derived suppressor cells （MDSCs） and CD8⁺ T cells， as well as the functional changes of MDSCs， were observed. Results Transcriptional regulatory network analysis revealed that forkhead box protein P3 （FOXP3） and CLEC7A both regulate immune-related genes. CLEC7A was not only correlated with overall patient survival but also highly expressed in HGSOC tumor tissues（all P <0.05）. Knockdown of CLEC7A promoted apoptosis and inhibited the proliferation of HGSOC cell lines both in vitro and in vivo （all P < 0.05）. CLEC7A regulated the expression of programmed death ligand-1 （PD-L1） through the JAK/STAT3 signaling pathway. In CLEC7A high-expressing tumor tissues， the proportion of CD8⁺ T cells decreased， while the proportion of MDSCs increased， and the functionality of MDSCs was enhanced （all P < 0.05）. Conclusion CLEC7A induces PD-L1 expression in HGSOC， promotes HGSOC proliferation， and activates immunosuppressive signaling pathways， potentially leading to the malignant growth of HGSOC.

Inflammatory bowel disease （IBD） including Crohn’s disease and ulcerative colitiscan. It affects the perianal region and the rectum， often presenting as anal fistulas， perianal abscesses， and fecal incontinence， etc. Among these manifestations， fecal incontinence is frequently neglected in clinical practice， whereas it will cause significant impact on the quality of life and mental health of IBD patients. In this article， research progress in the current status of fecal incontinence in IBD， adverse effects， associated risk factors， assessment and management of anal function was reviewed， aiming to enhance awareness among healthcare professionals regarding the importance of fecal incontinence in the IBD population and to provide valuable insights for effective management of this condition in affected patients.

Sleep is a basic need for human life-sustaining activities， and sleep quality is closely related to human health. With the rapid changes in the global climate， an increasing number of studies have found that climate change has an important impact on sleep quality of human beings， and this impact is a complex process involving multiple interacting factors. Climate factors affect human physiology and the comfort of the sleep environment， which then affects the sleep quality of individuals. This article reviews domestic and international studies on the effects of climate factors such as temperature， humidity， air pressure， oxygen content and light on sleep quality， and analyse the mechanism of climate change on sleep quality， with the purpose of providing reference for the clinical treatment of sleep disorders.

Objective To investigate the status of shift work disorder （SWD） and influencing factors in medical staff， aiming to improve individual sleep cognition and sleep behavior of medical staffs and enhance the quality of shift work sleep， thereby optimizing medical service system and benefiting the patients. Methods Five hundred medical staff were selected by random sampling method to conduct a questionnaire survey of SWD in four dimensions including the situation of waking up early and unable to fall back to sleep， the perceived comfort of waking up during night shift， the possibility of dozing off during night shift， and the situation of dozing off or falling asleep while driving after at least 2 days rest during night shift. Influencing factors of SWD were analyzed from these four dimensions by using univariate and multivariate binary Logistic regression analyses. Results Among 500 respondents， 88.2% of them experienced the situation of waking up early and unable to fall back to sleep during night shift in the past month， 88.0% for those with decreased perceived comfort of waking up during night shift in the past month， 85.2% with the possibility of dozing off during night shift in the past month and 56.0% with the situation of dozing off or falling asleep while driving after at least 2 days rest during night shift in the past month， respectively. According to the risk of SWD in all respondents， 72% of them had high-risk SWD and the remaining 28% had low-risk SWD. Multivariate binary Logistic regression analysis showed that martial status （P = 0.011 for overall test； OR = 2.322，95%CI： 1.328-4.058，P = 0.003 for married versus single）， and intake of hypnotics during non-night shift （OR = 5.678， 95%CI： 1.350-23.872， P = 0.018） were both influencing factors of waking up early and unable to fall back to sleep during night shift. Stress （OR =3.732， 95%CI： 1.072-12.996， P = 0.039） and intake of hypnotics during non-night shift （OR = 5.731， 95%CI： 1.367-24.031， P = 0.017） were influencing factors of decreased perceived comfort of waking up during night shift. Exercise （OR = 0.540， 95%CI： 0.325-0.895， P = 0.017） and stress （OR = 5.246， 95%CI： 1.616-17.025， P = 0.006） were influencing factors of dozing off during night shift. Marital status （P = 0.043 for overall test； OR = 1.509， 95%CI： 1.024-2.224，P = 0.037 for married versus single）， duration of light exposure （P = 0.003 for overall test； OR = 0.410， 95%CI： 0.208-0.825， P = 0.012 for 3~<6 h versus <1 h light exposure） and nap during night shift （OR = 0.640， 95%CI： 0.422-0.972， P = 0.036） were protective factors of dozing off while driving after at least 2 days rest. Conclusions SWD is relatively common in medical staff， especially the married and those who take hypnotics during non-night shift are at a higher risk of SWD. Relieving stress， increasing appropriate exercise， increasing nap and light exposure for 3~<6 h during night shift may help improve the quality of sleep.

The incidence of type 1 diabetes mellitus （T1DM） is increasing globally， with environmental factors playing a significant role in its onset and progression. Studies have shown that gut microbiota dysbiosis may lead to T1DM through mechanisms such as altering intestinal permeability， modifying the abundance of microbial metabolites， and regulating immune responses. While insulin remains the primary therapeutic means， targeting the gut microbiota has emerged as a promising research focus for T1DM intervention. This article reviews the relationship between gut microbiota and T1DM， discusses the preventive and therapeutic effects of probiotics on T1DM and their underlying mechanisms， aiming to provide new insights for T1DM prevention and treatment research.

Objective To explore the prevalence of hyperuricemia and hypouricemia in patients with psoriasis and explore their potential impact on the occurrence of cardiovascular disease（CVD）. Methods Patients with psoriasis who were hospitalized in the Department of Dermatology at the First People’s Hospital of Kashi Prefecture from January 2022 to September 2023 were enrolled. Clinical data and laboratory test results were collected. The occurrence of hypouricemia，hyperuricemia，and cardiovascular disease（CVD）among these patients was analyzed. Clinical characteristics were compared between patients with and without CVD. Multivariate logistic regression analysis was performed to assess the associations between serum uric acid levels and the risk of CVD. Results A total of 206 psoriasis patients were included in the study. The mean age was（52.0±13.7）years and 130 patients（63.1%）were male. 33 patients（16.0%）had comorbid cardiovascular disease（CVD）. The prevalence of hyperuricemia and hypouricemia was 26.2% and 10.2%，respectively. Compared with patients with normal uric acid levels，those with hyperuricemia had a higher prevalence of CVD（27.8% vs. 9.2%，P = 0.011），and similarly，patients with hypouricemia also had an increased prevalence of CVD（28.6% vs. 9.2%，P = 0.001），even without higher traditional cardiovascular risk factors. Compared with psoriasis patients without CVD，those with CVD showed higher proportions of hyperuricemia（45.5% vs. 22.5%），hypouricemia（18.2% vs. 8.8%），hypertension（63.3% vs. 13.3%），diabetes（30.3% vs. 8.1%），total cholesterol ≥ 5.2 mmol/L（39.4% vs. 20.8%），and hsCRP> 5 mg/L（57.6% vs. 27.7%）（all P < 0.05）. Multivariate logistic regression analysis indicated that，compared with patients with normal uric acid levels，both hyperuricemia（OR=1.668，95%CI 1.022-2.722，P = 0.041）and hypouricemia（OR=4.520，95%CI 1.210-16.877，P = 0.025）were independent risk factors for CVD in patients with psoriasis. Conclusions Both hyperuricemia and hypouricemia may be potential risk factors of CVD in patients with psoriasis.

Dysphagia not only severely affects patients’ quality of life but also significantly increases the incidence of complications and mortality risk. In recent years， neuromodulation technologies have provided breakthrough therapeutic strategies for swallowing rehabilitation by targeting peripheral and central neural circuits. This article systematically reviews the key technologies and recent advances in this field： for peripheral stimulation， it highlights pharyngeal electrical stimulation and vagus nerve stimulation； for central modulation， it focuses on the applications of repetitive transcranial magnetic stimulation and transcranial direct current stimulation. These neuromodulation techniques exert their therapeutic effects through multiple mechanisms， including regulating neural plasticity and improving neuromuscular coordination. Future development should focus on the integration of multimodal technologies and optimization of personalized treatment strategies to promote the establishment of a precise rehabilitation system for dysphagia.

Based on the high target-to-background ratio（TBR），new imaging agents targeting fibroblast activation protein（FAP）have shown better imaging effects in a variety of tumors. In recent years，with in-depth research，FAP inhibitor（FAPI）has shown great application prospects in tumor imaging and treatment. It can be used as a supplement to the mainstream metabolic imaging agent ¹⁸F-labeled fluorodeoxyglucose（¹⁸F-FDG），which provides the possibility of more efficient combination of tumor metabolism and tumor stroma visualization in the future. It is helpful to guide clinical diagnosis and treatment more accurately. This article mainly reviews the application of new FAP imaging agents in various tumors，compares them with existing radiological diagnostic methods，and summarizes the clinical application progress and future potential of tracers specifically targeting FAPI in tumors and non-specific tissues.

Near-infrared spectroscopy is a brain functional neuroimaging technology， which is widely used in the research and clinical diagnosis of neurological diseases. Near-infrared technology can measure tissue oxygenation status and hemodynamic parameters non-invasively， providing a new tool for diagnosis， treatment and monitoring of neurological diseases. The purpose of this paper is to summarize the application progress of near-infrared technology in central nervous system diseases in recent years， and discuss its potential clinical significance， including the application in different neurological diseases and the application prospect in neurological rehabilitation， so as to provide new ideas for the diagnosis and treatment of diseases.

Lung cancer is not only one of the most common malignancies，but also has the highest mortality rate worldwide，among which non-small cell lung cancer（NSCLC）is the most common subtype. Radiation therapy is one of the main treatments for patients with advanced NSCLC，and the resistance generated during long-term treatment is the key to radiation therapy failure and poor prognosis. With the widespread application of whole genome and RNA sequencing technology and the in-depth exploration of the biological functions of non-coding RNA（ncRNA），there is growing evidence that ncRNA are key regulators in tumorigenesis and development，and different ncRNAs play a role in promoting or inhibiting tumor radioresistance，which are expected to become a useful markers for tumor diagnosis and new targets for tumor treatment. In this article，recent research progress in ncRNA such as microRNA（miRNA），long non-coding RNA（lncRNA），and circular RNA（circRNA）in the radioresistance of NSCLC was reviewed.

Objective To investigate the clinical characteristics and cognitive impairments in children with frontal lobe epilepsy （FLE） comorbid with attention deficit hyperactivity disorder （ADHD） who have normal intelligence. Methods A total of 167 children aged 6-14 years， diagnosed with FLE at Guangdong Provincial People’s Hospital from January 2018 to June 2024， were screened for comorbid ADHD. They were divided into the FLE group and the FLE+ADHD group. Additionally， 72 children with ADHD alone and 74 healthy children of the same age from the child health clinic were included as the ADHD group and the healthy control group， respectively. The assessment results of the Wechsler Intelligence Scale for Children-Fourth Edition （WISC-IV） and the Wisconsin Card Sorting Test （WCST） were compared among the four groups. Clinical characteristics were compared between the FLE group and the FLE+ADHD group. Results Among the 167 FLE children， 62 （37.1％） cases met the diagnostic criteria for ADHD， with the inattentive subtype being the most common （68.3%）. Compared with the healthy control group， the FLE+ADHD group， the FLE group， and the ADHD group exhibited decreased scores in verbal comprehension index （VCI）， perceptual reasoning index （PRI）， working memory index （WMI）， processing speed index （PSI） and full-scale intelligence quotient （FSIQ）， alongside a lower score of WCST categories completed， and higher scores of WCST responses errors， perseverative responses errors， and non-perseverative responses errors （all P < 0.05）. Compared with the FLE group， the FLE+ADHD group demonstrated significantly lower VCI， PRI， WMI， PSI， FSIQ scores， lower score of WCST categories completed， and higher scores of WCST responses errors and perseverative responses errors （all P < 0.05）. Compared with the ADHD group， the FLE+ADHD group had lower VCI， PRI， FSIQ scores， and higher scores of WCST responses errors and non-perseverative responses errors （all P < 0.05）. Early onset of epilepsy （<6 years）， incomplete seizure control， use of multiple antiepileptic drugs， and interictal discharges on the left or bilateral sides on EEG were correlated with ADHD comorbidity. Conclusions Compared with children with FLE or ADHD alone， those with FLE and comorbid ADHD exhibit similar domains of cognitive impairment but show greater severity in some of these domains.

Objective To investigate the relationship between sleep quality and nighttime sleep duration and sarcopenia in middle-aged and elderly men （≥ 45 years old）. Methods A cross-sectional study was conducted on 345 hospitalized patients inUrumqi. The Pittsburgh Sleep Quality Index was used to assess sleep quality， and L3 skeletal muscle index was used to diagnose sarcopenia. Univariate Logistic regression was used to analyze the relationship between sleep factors and sarcopenia， and multivariate Logistic regression models were used to explore the relationship between sleep quality and nighttime sleep duration and sarcopenia in middle-aged and elderly men. Results The prevalence of sarcopenia in the included patients was 35.1%. The prevalence of sarcopenia was different among those with different sleep quality and nighttime sleep duration （P < 0.05）. The prevalence of sarcopenia in patients with poor sleep quality and nighttime sleep duration ≤ 6 h was higher than that in the non-sarcopenia group （P < 0.05）. MultivariateLogistic regression analysis showed that， without adjusting for arguments， the prevalence of sarcopenia in men aged 45~<74 years with poor sleep quality was 1.992 times that of those with good sleep quality， and the prevalence of sarcopenia in men aged 45~<74 years with nighttime sleep duration ≤ 6 h was 2.770 times that of those with nighttime sleep duration > 6 h. After adjusting for body mass index， nutrition risk screening 2002， alcohol consumption， smoking， Generalized Anxiety Disorder-7， Patient Health Questionnaire-9， and C-reactive protein levels， the prevalence of sarcopenia in men aged 45~<74 years with poor sleep quality was 4.152 times that of those with good sleep quality， and the prevalence of sarcopenia in men aged 45~<74 years with nighttime sleep duration ≤ 6 h was 3.703times that of those with nighttime sleep duration > 6 h. However， in men aged ≥74 years， there was no statistically significant relationship between sleep quality and nighttime sleep duration and sarcopenia （P > 0.05）. Conclusion In men aged 45~<74 years， poor sleep quality and nighttime sleep duration ≤ 6 h increase the risk of sarcopenia.

This consensus was developed to standardize clinical nursing practice for adult patients with non-HIV-associated cryptococcal meningitis， with the goal of enhancing the quality of care and improving patient prognosis. The development process involved systematic evidence retrieval from major Chinese and English databases， supplemented by in-depth interviews with clinical specialists， leading to the formulation of a preliminary draft. Subsequent revisions through two rounds of Delphi expert consultations and one multidisciplinary panel meeting culminated in the finalized consensus. The framework encompasses six critical domains： comprehensive nursing assessment， intravenous therapy and pharmacotherapeutic management， nursing care for related symptoms， perioperative nursing care， prevention and management of common complications， and structured rehabilitation. Particular emphasis is placed on holistic patient evaluation， tailored therapeutic drug monitoring， early recognition of complications， and integrated rehabilitative continuity. This consensus seeks to deliver an evidence-based， standardized operational framework for specialized nursing practice， thereby safeguarding therapeutic efficacy and promoting excellence in patient care.

Objective To analyze the diagnostic value and safety of transbronchial lung cryobiopsy （TBLC） in interstitial lung disease （ILD） and malignant lung lesions. Methods This study is a non-randomized controlled trial. Using the method of non-random sampling， 55 patients with ILD and pulmonary space-occupying lesions who were hospitalized in the Department of Respiratory and Critical Care Medicine of Beijing Tsinghua Changgung Hospital affiliated with Tsinghua University from January 2015 to February 2022 were selected. All patients were divided into the ILD group （n = 31） and pulmonary space-occupying lesion group （n = 24）. Basic information and clinical data were collected in both groups. Transbronchial forceps biopsy （TBFB） and TBLC techniques were sequentially employed to obtain lung biopsy samples based on intraoperative conditions， with no pre-inserted balloon in the TBLC group. Biopsy samples in both groups were sent for pathological examination. Kappa test was used to compare the consistency of pathological diagnosis between TBFB and TBLC. The receiver operating characteristic （ROC） curve and Logistic regression analysis were used to analyze the diagnostic efficiency of TBLC and TBFB alone or these two combined for malignant pulmonary lesions. Results Among the 55 patients， 61.8% （34/55） were male and 40.0% （22/55） were smokers. 40 cases （72.7%） had mild bleeding， 14 cases （25.5%） had moderate bleeding， and 1 case （1.8%） had no bleeding. No severe bleeding events or pneumothorax events occurred. In the ILD group， 19 patients were male and 12 female， aged （58.65±14.47） years on average， ranged from 16 to 76 years. The diagnoses of 17 patients were confirmed and 14 unconfirmed cases in this group. Among the confirmed cases， idiopathic pulmonary interstitial fibrosis （n = 4） and organizing pneumonia （n = 4） accounted for the highest percentage. In the pulmonary space-occupying lesion group， 15 patients were male and 9 female， aged （63.17±10.77） years old on average， ranged from 40 to 79 years. The diagnoses of 21 patients were finally confirmed and 3 unconfirmed cases in this group. Among the confirmed cases， there were 16 cases of malignant lung lesions， primarily lung adenocarcinoma （n = 7）. In the ILD group， the diagnostic rate of TBFB was 19.4% and 51.6% for TBLC， and the diagnostic rate in the TBLC group was higher than that in the TBFB group （P = 0.008）. In the pulmonary space-occupying lesion group， the diagnostic rate of TBLC was also superior to that of TBFB （79.2% vs. 37.5%， P = 0.002）. The area under the ROC curve of TBFB and TBLC in the diagnosis of malignant lung lesions was 0.77 （95%CI： 0.57-0.98） and 0.83 （95%CI： 0.66-1.00）， respectively. Conclusion TBLC has significant advantages in the diagnosis of ILD and lung malignancies， with a low risk of bleeding and high safety in clinical practice.

Objective To explore the influence factors of visual impairment and recovery in patients with central retinal vein occlusion （CRVO） complicated with macular edema （ME）. Methods One hundred patients who were initially diagnosed with CRVO-ME and phlegm and blood stasis syndrome based on traditional Chinese medicine in Eye Hospital， China Academy of Chinese Medical Sciences were involved. They were treated with Quji Tongluo Decoction combinied with intravitreal ranibizumab injections. At baseline and 90 days after treatment， optical coherence tomography angiography （OCTA） was used to measure the vascular density （VD） of optic disc （VD in the whole optic disc scanning area， VD inside disc and peripapillary VD optic disc）， the thickness of the retinal nerve fiber layer （RNFL）， the vertical cup / disc ratio （C/D）， the area of the optic disc， the volume of the optic cup， VD of the superficial capillary plexus （SCP） and the deep capillary plexus in the macula， and central macular thickness （CMT）. Results After treatment， best corrected visual acuity（BCVA （LogMAR））， RNFL thickness， VD in the whole optic disc scanning area， VD inside disc， peripapillary VD， DCP-VD and CMT had significant differences before and after treatment （all P < 0.05）. At baseline， BCVA （LogMAR） was significantly correlated with VD in the whole optic disc scanning area （r_s = -0.294， P =0.003）， VD inside disc， optic disc （r_s = -0.401， P < 0.001）， peripapillary VD （r_s = -0.315， P = 0.001）， SCP-VD （r_s = -0.291， P = 0.003）， DCP-VD （r_s = -0.258， P = 0.009）， and CMT （r_s = 0.334， P = 0.001）. Multivariate linear regression analysis showed that VD within the optic disc （B = -0.045， P < 0.001） and CMT （B = 0.001， P = 0.018） had a significant impact on visual acuity. After treatment， the changes of BCVA （LogMAR） were correlated with the changes of VD in the whole optic disc scanning area （r_s =-0.226， P = 0.024）， VD within the optic disc （r_s = -0.284， P = 0.004） and CMT （r_s = 0.241， P = 0.016）. Multivariate linear regression analysis showed that the changes of VD within the optic disc （B = -0.028， P = 0.006） and CMT （B = 0.001， P = 0.023） had a significant impact on the improvement of visual acuity. Conclusion The blood flow perfusion of the main vessels in the optic disc is of significance for the occurrence and recovery of CRVO. VD within the optic disc could be used as a new biomarker evaluating visual impairment and prognosis.

Neuromyelitis optica spectrum disorder （NMOSD） is a group of autoimmune-mediated inflammatory demyelinating disorders of the central nervous system， mainly involving the optic nerve and spinal cord. Pain is a common clinical symptom in the course of NMOSD， which severely affects the quality of life of patients. At present， clinical use of glucocorticoids， immunosuppressants， analgesics and other drugs can partially alleviate NMOSD complicated with pain. However， recurrence， aggravation or persistence of the pain， and low efficacy remain the challenges. Consequently， progress in clinical characteristics， pathogenesis and treatment of NMOSD-related pain was reviewed， aiming to provide reference for the clinical treatment and management.

Objective To evaluate the impact of contrast-enhanced ultrasound （CEUS） on the diagnostic performance of ovarian-adnexal reporting and data system （O-RADS） 4-5 adnexal lesions. Methods A total of 224 patients with ovarian-adnexal lesions admitted to 10 hospitals between April 2021 and August 2023 were retrospectively enrolled. Sonographic characteristics and contrast-enhanced features were analyzed. The diagnostic performance of O-RADS， CEUS， and CEUS combined with O-RADS for O-RADS 4-5 lesions was evaluated using histopathology as the gold standard. Results A total of 232 lesions from 224 patients were included in this study， comprising 132 benign and 100 malignant lesions. O-RADS feature analysis revealed that lesion type， blood flow score， and presence of ascites were all significantly associated with malignancy in univariate analysis （all P < 0.001）. The CEUS manifestations of benign and malignant masses were distinct. The contrast-enhanced ultrasound features （enhancement morphology， time to initial enhancement， enhancement level， and washout pattern） and relative contrast parameters （arrival time，time to peak， peak intensity and area under the curve） showed statistically significant differences between the benign and malignant mass groups （all P < 0.001）. The AUC （95%CI） for differentiating benign from malignant adnexal masses in O-RADS categories 4-5 using O-RADS， CEUS， and the combination of CEUS and O-RADS was 0.716 （0.654， 0.773）， 0.793 （0.735， 0.843）， and 0.858 （0.806， 0.900）， respectively. The diagnostic accuracy of CEUS combined with O-RADS for O-RADS 4-5 lesions was significantly higher compared to either method alone （both P < 0.001）. Conclusion The combination of CEUS and O-RADS can improve diagnostic accuracy for O-RADS 4-5 lesions， providing additional valuable information to guide clinical management strategies in patients with such lesions.

Objective To investigate the effects of electroconvulsive therapy （ECT） on depressive behaviors and explore the mechanisms by which it regulates the composition and function of the gut microbiota via the microbiota-gut-brain axis. Methods A mouse model of depression was established using Chronic Unpredictable Mild Stress （CUMS）. The mice were divided into the control group， depression group and ECT group （n = 6 in each group）， and the depressive symptoms were assessed by behavioral experiments such as body weight change， open field test （OFT）， sucrose preference test， and forced swimming test （FST）. Meanwhile， histological and microcirculatory blood flow changes in the brain and intestines were assessed by HE staining， immunofluorescence （IF） and laser speckle contrast imaging （LSCI）. The levels of inflammatory factors such as TNF-α and IL-6 in intestinal tissues were detected by enzyme-linked immunosorbent assay （ELISA）， and changes in the diversity and abundance of gut microbiota in mice were analyzed by metagenomic sequencing. Results ECT significantly improved the behavioral performance of depressed mice， as reflected by weight gain， reduced immobility time in the FST and tail suspension test （TST） （all P < 0.05）. HE staining showed a significant reduction in intestinal inflammatory infiltration after ECT （P < 0.05）， and IF analysis demonstrated an increase in the expression of c-Fos in the hippocampal region （P < 0.05）. Inflammatory factor assay results showed that the TNF-α and IL-6 levels were significantly reduced in the ECT group （both P < 0.01）. In addition， the results of metagenomic sequencing showed that ECT significantly increased the diversity of gut microbiota， especially the abundance of Bacteroidota and Verrucomicrobiota was restored （both P < 0.05）. Conclusion ECT exerts antidepressant effects and improves sleep by regulating intestinal flora and improving gut-brain axis function.

Objective To evaluate the efficacy and safety of Chaihu Shugan Powder in the treatment of Hashimoto’s thyroiditis. Methods Randomized controlled trials of Chaihu Shugan Powder in the treatment of Hashimoto’s thyroiditis were searched from China Knowledge Network， VIP Database， Wanfang Database， China Biomedical Literature Database， PubMed， Embase and Cochrane Library from date of database inception until October， 2024. Meta-analysis was performed using RevMan 5.3. Results A total of 9 literatures were included， involving 671 patients with Hashimoto’s thyroiditis. Meta-analysis showed that Chaihu Shugan Powder could improve the clinical effectiveness rate of Hashimoto’s thyroiditis [RR （95%CI） =1.21 （1.13， 1.30）]， reduce the levels of thyroid peroxidase antibody [TPO-Ab， SMD （95%CI） =-1.61 （-2.28， -0.94）]， decrease the level of thyroglobulin antibody [TgAb， SMD （95%CI） =-1.28 （-1.70， -0.86）]， reduce traditional Chinese medicine syndrome score [MD （95%CI） =-6.15 （-6.69， -5.61）]， improve function of thyroid [TSH： MD （95%CI） =-0.83 （-1.57， -0.09）， FT₃： MD （95%CI） =0.64 （0.12， 1.16）， FT₄： MD （95%CI） =2.31 （0.70， 3.92）] and reduce the level of inflammatory factor interleukin-23 [IL-23， SMD （95%CI） =-1.92 （-2.29， -1.54）]. In addition， compared with the control group， Chaihu Shugan Powder did not increase the incidence of adverse reactions. Conclusion Chaihu Shugan Powder is an effective and safe treatment for Hashimoto’s thyroiditis， but further research and verification is needed.