Breast cancer prevention and treatment have become major issues that urgently need to be addressed in the field of global public health. As a key pathological transitional stage in the progression of breast cancer， preneoplastic breast cancer （PBC） carries a significant risk of clinical transformation. Effective intervention in the progression of PBC is of great clinical significance in preventing the occurrence of breast cancer. Pathological studies have shown that abnormal angiogenesis is a key mechanism driving the transformation of PBC into breast cancer. Vascular endothelial growth factor （VEGF）， as a core regulatory molecule that promotes angiogenesis， plays a pivotal role in this process. The malignant transformation of PBC is closely associated with the abnormal activation of the VEGF-mediated pro-angiogenic network. Although modern medicine has achieved certain therapeutic effects through surgery and endocrine therapy， clinical limitations such as invasiveness， drug resistance， and adverse reactions still exist. Recent studies have demonstrated that the VEGF signaling system mediates the phosphatidylinositol 3-kinase-protein kinase B （PI3K/Akt） signaling pathway and the mitogen-activated protein kinase （MAPK） pathway. In addition， the hypoxia-inducible factor-1α （HIF-1α）/VEGF signaling pathway and the delta-like ligand 4 （DLL4）/Notch receptor 1 （Notch1） signaling pathway， together with other pathways， form a complex regulatory network that plays a central role in angiogenesis during PBC. Traditional Chinese medicine （TCM）， characterized by multi-component synergy， multi-pathway regulation， and high safety， demonstrates significant advantages in inhibiting pathological angiogenesis and blocking PBC progression by targeting the VEGF signaling pathway. From the perspective of VEGF pathway regulation， this paper systematically reviews the latest research progress on TCM in inhibiting angiogenesis and intervening in PBC， and discusses its mechanisms and application value in the early prevention and treatment of PBC， with the aim of providing references for optimizing clinical intervention strategies for PBC.

Objective: To investigate the factors influencing intraoperative blood transfusion in patients with hip fractures and to develop a machine learning (ML) model for predicting this risk. Methods: A total of 424 patients with hip fractures who underwent surgical treatment between November 2022 and March 2025 in our hospital were selected. Key feature variables of intraoperative blood transfusion risk were identified using the Boruta algorithm. Four different ML algorithms—support vector machine (SVM), linear discriminant analysis (LDA), mixed discriminant analysis (MDA), and extreme gradient boosting (XGBoost)—were used to develop predictive models for intraoperative blood transfusion risk. The predictive performance of the four ML models were evaluated using accuracy, precision, receiver operating characteristic (ROC) curves, precision-recall curves (PRC), precision-recall gain curves (PRGC), and F1 scores. Shapley additive interpretation (SHAP) was used to interpret the final model. Results: Among the 424 patients, 77(18.2%) received intraoperative blood transfusion. The Boruta algorithm identified albumin (ALB), activated partial thromboplastin time (APTT), types of anesthesia, types of fracture, and hemoglobin (Hb) as key feature variables for predicting intraoperative blood transfusion risk. In model evaluation, the SVM model outperforms the other three models across multiple metrics, including the area under the receiver operating characteristic curve (AUC), recall, recall gain, accuracy, precision, F1 score, and the area under the precision-recall curve (PRC-AUC). The SVM model, interpreted and visualized based on SHAP values, effectively predicted intraoperative blood transfusion risk in patients with hip fracture. A visual online application was developed based on the SVM model (https://pbo-nomogram.shinyapps.io/blood/). Conclusion: Preoperative low ALB and Hb levels, prolonged APTT, general anesthesia, and intertrochanteric fractures are risk factors for intraoperative blood transfusion in hip fracture patients. The risk prediction model for intraoperative blood transfusion constructed based on the SVM algorithm has optimal performance, which provides new ideas and methods for the clinical early identification of hip fracture patients with high transfusion risk and the implementation of targeted interventions.

Allergen-associated proteases, pollutants, viral and fungal pathogens disrupted epithelial barrier integrity and promoted airway epithelial release of alarmins.Epithelial-derived Alarmins include thymic stromal lymphopoietin (TSLP), interleukin 33 (IL-33), and interleukin 25 (IL-25), which acted on a variety of effector cells such as dendritic cells (DCs), T-lymphocytes, innate lymphocyte cells (ILC2), B-lymphocytes, eosinophils, mast cells, basophils, and macrophages. T-lymphocytes, innate lymphocyte cell type 2 (ILC2), B-lymphocytes, eosinophils, mast cells, basophils and macrophages are the effector cells. By affecting the physiological and biochemical functions of target cells, such as proliferation and differentiation, survival and recruitment, and material metabolism, the alarmins had activated the intrinsic and adaptive immunity, and played a key role in allergic diseases such as bronchial asthma, atopic dermatitis, allergic rhinitis, and urticaria. A variety of monoclonal antibodies targeting epithelial-derived alarm factors have been developed for the above allergic diseases, and some of these products are already put into clinical use. As epidemiological studies showed that skin allergy closely related to airway allergy, allergic co-morbidities has imposed a heavy economic and psychological burden to patients. In-depth understanding the mechanism of alarmins will help to understand the developing and progression of allergic diseases, and develop more effective diagnostic and therapeutic strategies for allergic co-morbidities. This article reviews the mechanism and recent research advances of epithelial-derived alarmins in a variety of allergic diseases.

Allergen-associated proteases, pollutants, viral and fungal pathogens disrupted epithelial barrier integrity and promoted airway epithelial release of alarmins.Epithelial-derived Alarmins include thymic stromal lymphopoietin (TSLP), interleukin 33 (IL-33), and interleukin 25 (IL-25), which acted on a variety of effector cells such as dendritic cells (DCs), T-lymphocytes, innate lymphocyte cells (ILC2), B-lymphocytes, eosinophils, mast cells, basophils, and macrophages. T-lymphocytes, innate lymphocyte cell type 2 (ILC2), B-lymphocytes, eosinophils, mast cells, basophils and macrophages are the effector cells. By affecting the physiological and biochemical functions of target cells, such as proliferation and differentiation, survival and recruitment, and material metabolism, the alarmins had activated the intrinsic and adaptive immunity, and played a key role in allergic diseases such as bronchial asthma, atopic dermatitis, allergic rhinitis, and urticaria. A variety of monoclonal antibodies targeting epithelial-derived alarm factors have been developed for the above allergic diseases, and some of these products are already put into clinical use. As epidemiological studies showed that skin allergy closely related to airway allergy, allergic co-morbidities has imposed a heavy economic and psychological burden to patients. In-depth understanding the mechanism of alarmins will help to understand the developing and progression of allergic diseases, and develop more effective diagnostic and therapeutic strategies for allergic co-morbidities. This article reviews the mechanism and recent research advances of epithelial-derived alarmins in a variety of allergic diseases.

The advantages of few-shot learning in arrhythmia detection were introduced.The research progress of few-shot learning strategies,including metric learning,transfer learning and data augmentation,was reviewed when applied to arrhythmia detection.The limitations of few-shot learning in arrhythmia detection were analyzed.It was pointed out that the graph neural network and new incremental learning techniques would be involved in the future development of few-shot learning in arrhythmia detection.[Chinese Medical Equipment Journal,2025,46(8):104-112]

Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

Objective To investigate correlations of the ratio of specific brain region volume to total brain volume(ratio％),standard uptake value(SUV)of specific brain region based on 18F-FDG PET/MR examination in Alzheimer disease(AD)patients,as well as the relationship between changes of these two.Methods Fifty AD patients were retrospectively collected.Based on FDG PET/MR,the ratio％and the mean SUV(SUVmean)of 40 specific brain regions were obtained,and the correlation between ratio％and SUVmean for each region were evaluated.According to a database of normal brains,Z-scores for ratio％and SUVmean were calculated to represent structural and functional changes in AD patients,and the correlation between these 2 Z-scores was assessed.Results Correlations were found between ratio％and SUVmean,also between Z-scores of these two parameters in 29 brain regions(r=0.288 to 0.778,all P＜0.05).Among them 7 brain regions,i.e.bilateral middle temporal gyrus,right fusiform gyrus,right hippocampus,right precuneus,left lingual gyrus and right parahippocampal gyrus exhibited correlation coefficients greater than 0.6.Conclusion There were some relationships between brain structural and metabolic functions and their changes in AD patients showed on FDG PET/MR.

Objective:To compare the diagnostic efficacy of 18F-fibroblast activation protein inhibitor (FAPI) PET/MR and contrast-enhanced CT in detecting metachronous ovarian metastasis after gastric signet-ring cell carcinoma (GSRCC) surgery, and to evaluate its impact on clinical decision-making. Methods:This study employed a diagnostic test design. A retrospective analysis was conducted on 26 female patients with suspected metachronous ovarian metastasis following GSRCC resection between January 2023 and June 2025 in Renji Hospital, Shanghai Jiao Tong University School of Medicine. All patients underwent both 18F-FAPI PET/MR and contrast-enhanced CT within 2 weeks. Using histopathology or clinical imaging follow-up (≥6 months) as the reference standard, the diagnostic performance of both modalities was compared (McNemar test, Fisher exact test and Delong test), and changes in clinical management were analyzed. Results:Metachronous ovarian metastasis was confirmed in 12 patients (22 lesions). 18F-FAPI PET/MR showed significantly higher sensitivity (90.9%(20/22) vs 72.7%(16/22); χ2=4.10, P=0.043), specificity (100%(30/30) vs 50.0%(15/30); χ2=13.01, P<0.001), and accuracy (96.2%(50/52) vs 59.6%(31/52); χ2=15.43, P<0.001), compared to contrast-enhanced CT, with a significantly higher AUC (0.964 vs 0.815; Z=2.85, P=0.015). It also demonstrated superior detection of extraovarian metastases, including anastomotic recurrence, peritoneal spread, and lymph node involvement ( P values: 0.004-0.031), and identified 5 additional rare-site metastases in 3 patients that were missed by contrast-enhanced CT. Based on 18F-FAPI PET/MR findings, clinical management was adjusted in 6 patients with metastasis. Conclusion:18F-FAPI PET/MR outperforms contrast-enhanced CT in diagnosing metachronous ovarian metastasis and performing whole-body restaging in post-surgical GSRCC patients, therapy provides critical evidence for informing decision-making.

Reconstruction of low-dose CT image faced problems such as low resolution,blurred artifacts and strong noise.Deep learning reconstruction met the needs of reducing radiation dose and improving imaging quality,promoted reconstruction of CT image towards high efficiency,intelligence and integration of clinical diagnosis and treatment.The research progresses in deep learning low-dose CT imaging reconstruction were reviewed in this article.

Ubiquitination represents a critical post-translational modification of proteins,capable of indu-cing alterations in the stability,cellular localisation and activity of substrate proteins.Consequently,it plays a pivotal role in a multitude of essential cellular processes.The intracellular parasite Legionella pneumophila releases in excess of 300 effector proteins into its host cell via its distinctive type IVB secre-tion system.These effector proteins regulate the physiological activity of host cells,thereby facilitating the growth and reproduction of Legionella and ultimately resulting in Legionella infection in humans.In the context of host infection,a number of effector proteins have been identified as regulators of the host cell ubiquitination system.Together with SidJ,SdjA,DupA/DupB,LnaB,and MavL,SidEs precisely and dynamically modulate the ubiquitination pathway of host cells,thereby providing a suitable environment for L.pneumophila to survive.The clarification of the biological functions of LnaB and MavL has led to the elucidation of this complex non-canonical ubiquitination regulatory cycle in L.pneumophila.This re-view presents a summary of the structural and enzymatic basis of non-classical ubiquitination mediated by SidEs,along with an examination of its biological significance in regulating endoplasmic reticulum rear-rangement and promoting Legionella-containing vacuole formation in host cells;the mechanism by which SidJ/SdjA regulates the phosphoribosylation activity of SidEs;and DupA/DupB,LnaB and MavL reverse the ubiquitination of host substrate proteins by SidEs through a multi-step catalytic reaction.In conclu-sion,this study will provide a reference for further understanding the detailed mechanism and biological significance of this type of non-classical ubiquitination modification,as well as offering insights into the pathogenic mechanism of L.pneumophila.