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.

The “Enhanced perceptual functioning model” and the “Veridical mapping model” have been proposed to explain the presence and nature of special abilities in autism. Here， we propose an important update to these two models， by combining them with autistic idiosyncratic language development. The “special abilities” of individuals with autism are achieved by redirecting language analyzers toward structured， yet socially unbiased material， which explains how these special skills extend language processing to materials beyond language. Calendar calculation serves as a test of this theory， in which language analyzers are redirected to calendars， a possible consequence of non-social learning. Non-social learning itself results from the bifurcation caused by the absence of social bias in overall information processing. The longitudinal and operational properties of calendar calculation are analogous to the language learning and processing characteristics of neurotypical populations. Combining the “hijacking” of human language analyzer and directing it towards non-communicative， language-like material provides a concise explanation for the common features of most autistic special abilities and integrates and enriches the “Veridical mapping model”.

Objective To evaluate the effect of acceptance and commitment therapy （ACT） on the psychological intervention of Asperger syndrome children aged 7-10 years. Methods A total of 60 Asperger syndrome children admitted to the Third Hospital of Fuzhou from January 1， 2023 to December 31， 2023 were enrolled and divided into the ACT （n = 30） and control groups （n = 30） using the random number table method. Children in the control group were given with health psychological education， and those in the ACT group received ACT on the basis of health psychological education. All children were investigated by using Aberrant Behavior Checklist （ABC）， Screen for Child Anxiety Related Emotional Disorders （SCARED）， Self-Rating Scale Depressive Disorder in Childhood （DSRSC）， Acceptance and Action Questionnaire-2nd Edition （AAQ-Ⅱ）， Cognitive Fusion Questionnaire-Fusion （CFQ-F）， General Self-Efficacy Scale （GSES） before and after corresponding interventions and on-the-spot assessment. Results After interventions， the scores of ABC， DSRSC， SCARED， AAQ-Ⅱ and CFQ-F in the ACT group were lower than those before interventions and those in the control group after intervention， while the GSES score in the ACT group was higher than that before interventions and that in the control group after interventions， and the differences were statistically significant （all P < 0.05）. In the control group， no statistical significance was found in the scores of ABC， DSRSC， SCARED， GSES， AAQ-Ⅱ and CFQ-F before and after interventions （all P > 0.05）. The social interaction， verbal ability and total scores after intervention were lower than those before intervention in the ACT group （all P < 0.05）. In the ACT group， there was a negative correlation between self-efficiency score of GSES with DSRSC and SCARED scores （both P < 0.05）， and the experiential avoidance and cognitive fusion scores of AAQ-Ⅱ were positively correlated with the ABC scores （both P < 0.05）. Conclusions ACT can improve the psychological resilience of Asperger syndrome children aged 7-10 years， enhance their ability to deal with various stresses in life， alleviate the degree of experiential avoidance and cognitive integration and improve their social skills， which yields better overall effect than routine psychological health education.

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.

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.

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.

Autism research is evolving from a medical paradigm， which emphasizes deficits and interventions， to a neurodiversity paradigm that values autism as an integral part of human diversity. Historically， the medical paradigm’s focus on “rescue” efforts has distanced researchers from the autistic community， often failing to address the community’s real needs. In contrast， the neurodiversity paradigm advocates a comprehensive understanding of autism and the adoption of participatory research practices. This shift encourages active collaboration between researchers and autistic individuals， fostering inclusive knowledge production that is both meaningful and impactful for the autistic community. However， achieving this collaborative approach requires dismantling social barriers， such as power imbalances， that hinders effective partnership. This article explores the principles and practice of a neurodiversity-aligned participatory research approach and proposes a co-production framework designed to support researchers and the autistic community in advancing autism research that is relevant， respectful， and responsive.

Objective To explore the intervention dilemma of autistic children and their parents’ upbringing and growth experience， aiming to provide evidence for family support measures. Methods Through a descriptive phenomenological study， semi-structured interviews were conducted with 20 parents of children with autism from January to April 2023 at Child Development and Behavior Center of the Third Affiliated Hospital of Sun Yat-sen University. And data were analyzed using Colaizzi’s 7-step method. Results The intervention dilemmas of children with autism were distilled into two themes： lack of knowledge and resources， and intra-family conflict and disagreement. The parenting and growth experiences of parents were distilled into three themes： inclusive and tenacious mentality， multi-dimensional improvement of ability， and family members’ reconstruction of self and life value. Conclusions Parents of children with autism face intervention dilemmas while having positive caring growth experiences. Supporting children with autism and helping parents positively cope with challenges is crucial.

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.

This review provides an overview of the evolution and perceptions of the concept of autism within Western and Chinese contexts， as well as the perceptions of various groups toward official and related terminology. It emphasize the importance of language in constructing social cognition and values of autism， offering a guide to the translation， interpretation and usage of autism-related languages in Chinese. The discourse in the West surrounding “person-first language” and “identity-first language” reflects divergent perspectives on identity within the autistic community. In the Chinese context， the discourse on autism is largely led by professionals， with societal understanding of autism often shaped by medical and charity perspectives. Different Chinese users construct and perceive autism-related terms in diverse ways. The medical terms “孤独症” （gūdú zhèng） and “自闭症” （zìbì zhèng） carry stigmatizing connotations， especially “zìbì zhèng，” which， due to its negative association with self-imposed isolation， is often linked with negative labels such as “dangers” or “burdens.” Terms like “星星的孩子” （xīngxīng de háizi） and “闭娃” （bì wá）， despite their popularity， are criticized by the autistic community for their romanticized and demeaning connotations， and for overlooking adult autistic individuals. The term “孤独症谱系障碍” （gūdú zhèng pǔxì zhàng’ài） is preferred for its lesser stigmatizing implications. Autistic individuals prefer neutral and non-pathologizing expressions. This review calls for discussions of autism in the Chinese context to focus on individual experiences， respect their subjectivity， reflect on potential ableist tendencies， and promote the concept of neurodiversity， to foster a more comprehensive and inclusive societal understanding and acceptance of autistic people.

Persons with prototypical autism often present unique strengths that traditional intelligence assessments overlook， together with absence of oral language at the preschool age. Here， we propose a strengths-based approach in understanding and engaging with non-verbal autistic children. It emphasizes recognizing unique intellectual abilities often masked by communication challenges and conventional understanding of repetitive behaviors. By observing these children’s interests in structured objects， patterns， and screens， caregivers and clinicians can gain insights into their cognitive potential. We then present methods to leverage autistic strengths to support wellbeing of the families， including using “lateral tutorship” —a non-intrusive， side-by-side engagement method—as a way to connect with autistic children， respecting and utilizing their intrinsic learning style.

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.

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.

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.

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.

Objective To evaluate the performance of two categories of generative artificial intelligence （AI） in generating abdominal radiology reports， and compare with the performance of radiologists. Methods The radiology reports of 300 patients who underwent abdominal CT scan and MRI in the Third Affiliated Hospital of Sun Yat-sen University from June 2023 to May 2024 were retrospectively studied. The generative AI models of ERNIE 4.0 and Claude 3.5 Sonnet were utilized to re-generate radiology reports of 300 patients. Five radiologists evaluated the comprehensiveness， accuracy， expressiveness， hallucinations， and acceptance without revision of the impressions using a five-point Likert scale. Friedman test and Nemenyi test were used to compare the performance between two models and radiologists. Results CT and MRI reports from 300 patients were evaluated. For comprehensiveness，Claude 3.5 Sonnet was on a par with human physicians， and both were superior to ERNIE 4.0 （scores of 4.86±0.37 vs. 4.76±0.46 vs. 4.40±0.64； comparison between the first two， P = 0.200， comparison between the first two and the third， both P < 0.01）. For accuracy， Radiologists outperformed both ERNIE 4.0 and Claude 3.5 Sonnet （scores of 4.96±0.22 vs. 4.66±0.57 vs. 4.69±0.57； comparison between the first and the latter two， both P < 0.01）. For acceptance without revision， Claude 3.5 Sonnet was on a par with human physicians， and both were superior to ERNIE 4.0 （scores of 4.64±0.53 vs. 4.69±0.54 vs. 4.30±0.59； comparison between the first two， P = 0.595， comparison between the first two and the third， both P < 0.01）. Expressiveness and hallucinations metrics showed minimal variations among the three （all P > 0.05）. Conclusions Claude 3.5 Sonnet yields comparable performance to radiologists in generating radiology reports， indicating that advanced generative AI has the potential to assist radiologists， improve the work efficiency and reduce cognitive burden.

Bronchial asthma is a chronic inflammatory disease of the airway involving multiple inflammatory cells and cytokines. Severe asthma is characterized by recurrent attacks and persistent symptoms such as coughing， chest tightness， shortness of breath， and wheezing， etc.， which are difficult to be alleviated and have a significant impact on the quality of life of patients. At present， the standard therapy of combining high-dose inhaled corticosteroids and long-acting bronchodilators is recommended， but asthma symptoms of certain patients cannot be fully controlled， which is primarily related to persistent type 2 inflammation. For severe asthma patients with persistent type 2 inflammation， biological targeted drugs can be chosen. Biological targeted therapy can significantly mitigate symptoms， reduce the frequency of acute exacerbations and oral use of corticosteroids， bringing new hope to asthma patients with severe type 2 inflammation. This article reviews the research progress in biological targeted therapy for type 2 inflammation in patients with bronchial asthma.

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 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 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.

Allergen specific immunotherapy （AIT） is the only etiological treatment method that alters the course of allergic diseases by inducing allergen-specific immune tolerance. Subcutaneous specific immunotherapy （SCIT）， due to its standardized process and high-quality control， has become the most predominant desensitization method in major allergy centers across the country. However， there are limitations in the initial phase of conventional treatment plans， requiring patients to return to the hospital weekly for injections， which involves a high number of needle sticks and a lengthy duration. Consequently， clinical practitioners have been continuously exploring optimized treatment strategies for SCIT. Dust mites are the most common inhalant allergens causing sensitization in children， this article reviews the different optimization strategies and clinical application progress of dust mite allergen SCIT in children， aiming to provide a more comprehensive clinical basis for the implementation of SCIT.After reviewing the literature， it was found that compared with the conventional treatment regimen， the accelerated escalation regimen was helpful to improve treatment compliance. However， at present， the sample size of studies such as rush immunotherapy and single accelerated concentration escalation schemes is generally small， so large-scale studies with larger sample size and more complete research are still needed to provide reliable data support.

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.

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.

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.

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.

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 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.

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.

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.

Objective To explore the effect of Rhinitis Formula No. 1 combined with Seretide on the treatment of allergic rhinitis complicated with asthma， aiming to provide a new clinical basis for the application of Lingnan Traditional Chinese Medicine in the integrated treatment of nasal and lung diseases. Methods One hundred and forty patients who met the combined diagnosis of allergic rhinitis and asthma were randomly divided into the Western Medicine group and the Traditional Chinese medicine（TCM） combined with Western Medicine group， with 70 cases in each group. The Western Medicine group received routine treatment with Seretide. The TCM and Western Medicine group， in addition to Seretide， was administered Rhinitis Formula No. 1 （consisting of 15 g Codonopsis pilosula， 6 g Glycyrrhiza uralensis Fisch， 10 g Terminalia chebula Retz， 10 g Platycodon grandiflorus， 3 g Asarum sieboldii， 10 g Schizonepeta tenuifolia， 15 g Radix Rehmanniae Praeparata， 10 g Poria cocos， 3 g Ramulus Cinnamomi， 6 g dried tangerine peel， 6 g Morinda officinalis， and 10 g smoked plum） once daily， divided into two doses. Both groups were continuously observed for two weeks. The two groups were compared based on the self-developed TCM Symptom Scale Score， Total Nasal Symptom Score （TNSS）， Total Nasal and Non-Nasal Symptom Score （TNNSS）， Asthma Control Test Scores（ACT） ， indicators of immune function and inflammation，and adverse reactions before and after treatment. Results In the Western Medicine group， 7 patients dropped out， and in the TCM combined with Western Medicine group， 5 patients dropped out. The patients who dropped out were included in the safety analysis but were not included in the statistical analysis of efficacy. The general data of the two groups was comparable， and there were no significant differences in the TCM Symptom Scale Scores， TNSS， TNNSS and ACT before treatment between the two groups （all P > 0.05）. After treatment， the TCM Symptom Scale Scores （P < 0.001）， TNSS （P < 0.001）， and TNNSS （P = 0.001） in the TCM combined with Western Medicine group were lower than those in the Western Medicine group， while the ACT in the TCM combined with Western Medicine group was higher than those in the Western Medicine group （all P < 0.05）.The improvements in TCM Symptom Scale Scores， TNSS， TNNSS， and ACT in the TCM combined with Western Medicine group were superior to those in the Western Medicine group （all P < 0.05）. After treatment， the levels of IgA and IgG in both groups were higher than pretherapy， while the level of IgE was lower than pretherapy； the levels of IgA and IgG in the TCM combined with Western Medicine group were higher than those in the Western Medicine group， and the level of IgE was lower than that in the Western Medicine group （all P < 0.05）. After treatment， the levels of IL-10 in both groups were higher than pretherapy， and the levels of IL-6 and IL-17 were lower than pretherapy； the level of IL-10 in the TCM combined with Western Medicine group was higher than that in the Western Medicine group， and the levels of IL-6 and IL-17 were lower than those in the Western Medicine group（all P < 0.05）.There was no statistically significant difference in the incidence of adverse reactions between two groups （P = 0.753）. Conclusions Compared to the use of seretide alone， the combination of Rhinitis Formula No. 1 with Seretide demonstrates superior efficacy in the treatment of allergic rhinitis complicated with asthma.

Objective To develop two versions of dietary KAP（knowledge， attitude and practice）questionnaires among patients with type 2 diabetes mellitus （T2DM） and their family members， and to assess the reliability and validity， aiming to provide reference for medical staff regarding dietary education and management. Methods Based on KAP theory， the initial edition was compiled by literature reviews， semi-structured interviews， and two rounds of expert consultation. A total of 236 patients with T2DM admitted to Department of Endocrinology of the Third Affiliated Hospital of Sun Yat-sen University from June to December 2023 and their family members were selected by convenience sampling method， and the questionnaire was analyzed and tested for reliability and validity. Results Two versions of questionnaires on dietary KAP among patients with T2DM and their family members were developed. The questionnaire included three dimensions： knowledge， attitude and practice， with a total of 39 items. The item analysis and the validity of the questionnaire content reached the standard. Total Cronbach’s alpha for the questionnaire was 0.926 （patient version） and 0.946 （family version）. The Cronbach’s alpha for the three dimensions of knowledge， attitude and behavior were 0.944， 0.884， 0.825 （patient version） and 0.941， 0.928， 0.932 （family version）. Three common factors were extracted by exploratory factor analysis， and the cumulative variance contribution rates were 44.5% （patient version） and 53.4% （family member version）. The confirmatory factor analysis showed that the Chi-square degree of freedom ratio was calculated as 2.36 （patient version） and 2.58 （family member version）， the comparative fit index was 0.84 （patient version） and 0.81 （family member version）， the Tucker Lewis index was 0.83 （patient version） and 0.80 （family member version）， and the approximate root mean square error was 0.07 （patient version） and 0.08 （family member version）， respectively. Content validity analysis showed that the item-level content validity index was 0.938-1.000， and the average scale-level content validity index was 0.977 （patient version） and 0.968 （family member version）. Conclusion The dietary KAP questionnaires among T2DM patients and their family members developed in this study yield high reliability and validity， which could be an effective dietary assessment tool for patients with diabetes mellitus.

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.

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.

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.

Objective To evaluate the efficacy and safety of remimazolam besylate combined with esketamine in outpatient colonoscopy in patients with hypertension. Methods A total of 48 hypertensive patients undergoing outpatient colonoscopy at the Ordos Central Hospital in 2023 were enrolled. The patients sequentially received 2% lidocaine 0.5 mg/kg and esketamine 0.15 mg/kg，followed by either remimazolam besylate 0.15-0.25 mg/kg（R group）or propofol 1-2 mg/kg（P group）for induction. Continuous infusion of remimazolam besylate at 1-2 mg/（kg·h）（R group）or propofol at 2-4 mg/（kg·h）（P group）was administered to maintain sedation. Differences between the two groups were observed and compared in terms of mean arterial pressure（MAP），heart rate（HR），respiratory rate（RR），and pulse oxygen saturation（SpO₂），perioperative time indicators（induction time，operation time，resuscitation time and discharge time），and sedation indicators [bispectral index（BIS），the Modified Observer’s Assessment of Alertness/Sedation（MOAA/S）score，and the Ramsay sedation score]. Adverse events were also recorded. Results At 5 minutes after colonoscopy（T6），the MAP in the R group was higher than that in the P group [（95.7±2.8）mmHg vs.（92.5±3.0）mmHg，P < 0.05]. From the beginning to the end of the procedure（T3-T5），HR，RR，myocardial oxygen consumption，and BIS values were also higher in the R group（all P < 0.05）and all the above indicators remain within the normal range. Moreover，the R group perioperative minimum SpO₂ is significantly higher than that of P group [（96.1±2.0）% vs.（94.0±2.4）%，P < 0.05]，and postoperative recovery quality score is higher than P group[（144.0±3.5）vs.（140.9±3.8），P < 0.05]，the rate of injection pain in R group is lower than P group（0% vs. 23.1 %，P < 0.05）. However，the induction [（4.4±1.2）s vs.（3.7±1.1）s] and resuscitation times [（4.4±1.2）s vs.（3.7±1.1）s] were prolonged in the R group（both P < 0.05）. There was no significant difference in the success rate of induction between the two groups（90.9% vs. 96.2%，P > 0.05）. Conclusions In outpatient colonoscopy for patients with hypertension，remimazolam besylate and propofol，when combined with esketamine，provide comparable sedative efficacy. However，remimazolam besylate is associated with less injection pain and more stable hemodynamics，suggesting it may serve as a preferable option in this population.

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.

For well-differentiated and early-stage thyroid cancer， conventional treatment options such as surgery， thyroid-stimulating hormone suppression therapy， and radioactive iodine therapy can usually significantly extend patients’ overall survival and progression-free survival， with prognosis approaching that of the general population. In contrast， for advanced or undifferentiated thyroid cancer that cannot be surgically resected or is unresponsive to radioactive iodine treatment， systemic therapy is typically required. Traditional cytotoxic chemotherapy or external radiation therapy has limited efficacy in these patients. Over the past decade， targeted therapies for thyroid cancer have undergone rapid development. Despite these treatments yielding promising results， many patients with advanced thyroid cancer ultimately experience disease progression due to acquired resistance. In this paper， we summarize the mechanisms of resistance to targeted drugs in thyroid cancer and explore strategies to overcome resistance， aiming to provide reference for future clinical practice in targeted therapy and guide directions for subsequent research.

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.

Objective To investigate the incidence and influencing factors of nutritional deficits during the immediate postoperative period following radical resection surgery for oral cancer and to analyze its impact on the short-term recovery of surgical patients. Methods Nutritional support data of 87 oral cancer patients early after radical resection surgery （1 to 10 d after surgery） in Guangzhou First People’s Hospital between January 2018 and March 2024 were collected. Patients were divided into the nutritional adequacy and nutritional inadequacy groups according to the average daily nutritional intake. Relevant factors were statistically compared between two groups. Logistic regression analysis was performed to identify influencing factors of nutritional deficits. The length of stay and incidence of postoperative complications， such as partial or total flap loss and surgical site infection， were also compared between two groups. Results Only 23.0% （20/87） of oral cancer patients achieved nutritional adequacy during the follow-up period. Multivariate logistic analysis revealed that nutritional inadequacy was associated with ideal body weight （OR=5.308， 95%CI： 1.103-25.551， P = 0.037） and the actual nutritional intake （OR=0.897， 95%CI： 0.809-0.994， P = 0.038）. The length of stay in the nutritional adequacy group was significantly shorter compared to that in the nutritional inadequacy group （21 d vs. 24 d， P = 0.030）. The difference in the incidence of complications between the two groups was not statistically significant（15.0% vs. 35.8%，P =0.077）. Conclusions Inadequate nutritional intake is common in oral cancer patients early after radical resection surgery. Patients with higher ideal body weight and less actual nutritional intake are prone to nutritional deficits. Adequate nutrition contributes to promoting recovery and significantly shortening the length of hospital stay. Medical staff should consider individual energy needs when planning nutritional care， and effectively improve the actual nutritional intake of patients.

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.

Objective To fabricate 3D biomimetic design of tissue engineering scaffolds（Shell-Core scaffolds）incorporating mesenchymal stem cells（MSCs）and human umbilical vein endothelial cells（HUVECs）by using advanced coaxial 3D bioprinting technology，and to validate the biomimetic vascularization capacity of the scaffolds by experiments. Methods The Shell-Core scaffolds were successfully fabricated via coaxial 3D bioprinting technology. The biomimetic structural features were characterized using optical microscopy and histological staining assay. The in vitro pro-angiogenic capacity was evaluated through inter-group comparative observations and cell scratch assays. Furthermore，qRT-PCR was employed to quantify RNA expression levels of angiogenesis-related markers in cells cultured on the Shell-Core scaffolds. Results Shell-Core scaffolds were successfully fabricated. The scaffolds possessed high structural fidelity，which could be maintained at 7 d after scaffold fabrication. Cell proliferation assay showed that the cell proliferation rate in the scaffolds at 7 d was higher than that in the mixed culture on the 2D plane. Cell scratch assay showed that the shortening scratch distance of HUVECs treated by Shell-Core-CM was significantly greater than those treated by 3D-Mix-CM and blank groups [（431.6±33.6）μm vs.（378.7±22.5）μm vs.（302.3±20.1）μm，both P < 0.01]. At 7 d after in vitro cultured of engineered biomimetic tissues，under fluorescence microscope，HUVECs expressing green fluorescent protein remained in the designed core channel，and self-assembled endothelial buds in all directions. Furthermore，the results of qRT-PCR show that quantified RNA expression levels of angiogenesis-related markers（MMP-9）in cells cultured on the Shell-Core scaffolds was significantly higher（1.55±0.06，P < 0.01）than that in 3D-Mix scaffolds. Conclusions The Shell-Core scaffolds integrating MSCs and HUVECs demonstrates high structural fidelity and pro-angiogenic capacity，offering a novel strategy for addressing tissue defect repair and fabricating vascularized engineered organs. This platform further provides a physiologically relevant tissue model for drug testing and mechanistic investigation of angiogenesis.

This paper reviews the role of innate lymphoid cells （ILC2s） in the pathogenesis of bronchial asthma and explores the evidence for acupuncture’s regulatory effects on ILC2s in asthma treatment. Preliminary findings suggest that acupuncture may mitigate airway inflammation， curb airway hyperresponsiveness， and enhance airway remodeling in asthma patients by modulating ILC2 secretion and migration. Despite these insights， several challenges remain， including the unclear pathways through which ILC2s are regulated by acupuncture in asthma， a scarcity of animal experiments and clinical studies， and a lack of understanding regarding how acupuncture might improve the mechanisms underlying hormone-resistant asthma via the ILC2 pathway.

Objective To investigate the presentations and related clinical characteristics of catatonic symptoms in children with autism spectrum disorder （ASD） by using the Attenuated Behavior Questionnaire （ABQ） and related functional and emotional behavior questionnaires. Methods Children who were diagnosed with ASD in the Third Affiliated Hospital of Sun Yat-sen University or other tertiary hospitals from November 2021 to December 2023 were selected. Reports from parents or long-term caregivers of children with ASD were collected through an online questionnaire. Children with ASD were divided into the ABQ screening positive and negative groups using ABQ questionnaire. Sheehan Disability Scale， Repetitive Behavior Scale-Revised， Children’s Simplified Emotion Scale and Spence children’s Anxiety Scale were used to assess children’s functional impairment and related emotional behavior. Results Four hundred and forty-one valid questionnaires were collected. 166 children with ASD were screened positive by using the ABQ. The total scores of the first six core symptoms， motor symptoms， emotional changes and behavior changes in the ABQ questionnaire of ASD children in the positive group were significantly higher than those in the negative group （all P < 0.001）. All six core motor symptoms were commonly reported in the positive group， with “requiring prompts to complete actions” being the most reported， followed by “immobility， getting stuck， slowness in movement， and problems stopping actions once started”. Over 50% of the children in the positive screening group exhibited these symptoms. The days of functional loss and inefficiency in study/work， social life， family life/family responsibilities， and the proportion of “moderate” or above degree of disability of ASD children in the ABQ-positive group were higher than those in the negative group， and the differences were statistically significant （all P < 0.001）. The scores of stereotypical behaviors， self-injurious behavior， compulsive behavior， sameness/ritual behavior （all P < 0.001）， simplified emotion scale （P < 0.001） and anxiety scale （both P < 0.01） in the ABQ-positive group were significantly higher than those in the ABQ-negative group， and the differences were statistically significant. Conclusions Catatonic symptoms are not uncommon in children with ASD. ASD children complicated with such symptoms tend to exhibit more emotional and behavioral problems， as well as more severe functional impairment， underscoring the need for early identification and intervention.

Objective To explore the mediating role of behavioral regulation index （BRI） and metacognition index （MI）， two dimensions of executive function， in the relationship between attention deficit hyperactivity disorder （ADHD） symptoms and children’s emotional behavioral problems. Methods A total of 102 children with ADHD aged 6-12 years old who met the Diagnostic and Statistical Manual of Mental Disorders 5th edition （DSM-5） criteria were selected as the study subjects. They were investigated with the self-made general situation questionnaire， the Chinese version of the Swanson Nolan and Pelham， version Ⅳ for ADHD （SNAP-Ⅳ）-parent form， Behavior Rating Inventory of Executive Function （BRIEF） -parent form， and parent edition of Strengths and Difficulties Questionnaire （SDQ）. Parallel mediating effect was analyzed. Results Positive correlations were found among attention deficit， hyperactivity-impulsivity， BRI， MI， and emotional behavioral problems， respectively （r = 0.409-0.934， all P < 0.001）. Attention deficit positively predicted BRI， MI and emotional behavioral problems （β = 1.459， 1.114， 0.294， all P < 0.01）. BRI and MI positively predicted emotional behavioral problems （β = 0.224， β = 0.080， both P < 0.05）， suggesting that behavioral regulation index and metacognition index played a partial mediating role between attention deficit and emotional behavioral problems， and the mediating effect accounted for 58.73% of the total effect. Hyperactive-impulsivity positively predicted BRI， MI and emotional behavioral problems （β = 1.071， 2.057， 0.223， all P < 0.05）， BRI positively predicted emotional behavioral problems （β = 0.333， P < 0.001）， but MI did not predict emotional behavioral problems （β = 0.026， P > 0.05）， indicating that only behavioral management played a partial mediating role between hyperactive-impulsivity and emotional behavioral problems. The mediating effect accounted for 64.72% of the total effect. Conclusion BRI and MI play a mediating role between emotional behavioral problems and symptoms in ADHD children.