Circular RNAs (circRNAs) represent a distinct group of RNA molecules produced through back-splicing of precursor mRNAs. Their covalently closed structure, which lacks both a 5′ cap and a poly(A) tail, renders them highly resistant to exonucleolytic degradation and contributes to their remarkable intracellular stability. Although circRNAs were historically viewed as noncoding transcripts, accumulating evidence indicates that certain circRNAs can undergo translation under appropriate molecular contexts. Two major modes of noncanonical translation have been described so far: initiation mediated by internal ribosome entry sites (IRESs) and translation triggered by N6-methyladenosine (m6A) modification. Recent studies have revealed that, beyond their canonical classification as non-coding RNAs, circRNAs can give rise to functional peptides through cap-independent translational mechanisms. Accumulating evidence indicates that circRNA-encoded peptides participate in key biological processes during tumor initiation and progression by modulating tumor-associated signaling pathways and protein-protein interaction networks. Functionally, these peptides may promote tumor cell proliferation, migration, invasion, and epithelial-mesenchymal transition, while others exert tumor-suppressive effects by inhibiting oncogenic signaling pathways or interfering with critical protein interactions. Their dual and context-dependent functions highlight the complexity of circRNA-mediated regulation and suggest that these translation products participate in multiple layers of tumor initiation and progression. In this review, we synthesize current knowledge regarding the molecular mechanisms that enable circRNAs to be translated, with particular attention to IRES-driven initiation, m6A-dependent regulation, ribosome accessibility, and the structural determinants required for translation competence. We further summarize well-characterized circRNA-encoded peptides and discuss how they influence tumor-associated signaling networks. In addition, we examine the potential translational applications of these peptides, including their value as diagnostic indicators, prognostic markers, or therapeutic entry points. Their inherent sequence stability, relative expression specificity, and detectability in clinical specimens make circRNA-derived peptides promising candidates for future biomarker and therapeutic development. Overall, circRNA translation research is reshaping our understanding of RNA function and offers new perspectives for studying tumor biology. We propose that expanding investigations into circRNA-encoded peptides will not only improve the mechanistic resolution of cancer research but may also pave the way for innovative strategies in precision oncology, including RNA-based therapeutics and peptide-targeting interventions.

Circular RNAs (circRNAs) represent a distinct group of RNA molecules produced through back-splicing of precursor mRNAs. Their covalently closed structure, which lacks both a 5′ cap and a poly(A) tail, renders them highly resistant to exonucleolytic degradation and contributes to their remarkable intracellular stability. Although circRNAs were historically viewed as noncoding transcripts, accumulating evidence indicates that certain circRNAs can undergo translation under appropriate molecular contexts. Two major modes of noncanonical translation have been described so far: initiation mediated by internal ribosome entry sites (IRESs) and translation triggered by N6-methyladenosine (m6A) modification. Recent studies have revealed that, beyond their canonical classification as non-coding RNAs, circRNAs can give rise to functional peptides through cap-independent translational mechanisms. Accumulating evidence indicates that circRNA-encoded peptides participate in key biological processes during tumor initiation and progression by modulating tumor-associated signaling pathways and protein-protein interaction networks. Functionally, these peptides may promote tumor cell proliferation, migration, invasion, and epithelial-mesenchymal transition, while others exert tumor-suppressive effects by inhibiting oncogenic signaling pathways or interfering with critical protein interactions. Their dual and context-dependent functions highlight the complexity of circRNA-mediated regulation and suggest that these translation products participate in multiple layers of tumor initiation and progression. In this review, we synthesize current knowledge regarding the molecular mechanisms that enable circRNAs to be translated, with particular attention to IRES-driven initiation, m6A-dependent regulation, ribosome accessibility, and the structural determinants required for translation competence. We further summarize well-characterized circRNA-encoded peptides and discuss how they influence tumor-associated signaling networks. In addition, we examine the potential translational applications of these peptides, including their value as diagnostic indicators, prognostic markers, or therapeutic entry points. Their inherent sequence stability, relative expression specificity, and detectability in clinical specimens make circRNA-derived peptides promising candidates for future biomarker and therapeutic development. Overall, circRNA translation research is reshaping our understanding of RNA function and offers new perspectives for studying tumor biology. We propose that expanding investigations into circRNA-encoded peptides will not only improve the mechanistic resolution of cancer research but may also pave the way for innovative strategies in precision oncology, including RNA-based therapeutics and peptide-targeting interventions.

Purpose: Due to the preservation of the entire stomach after endoscopic resection, the occurrence of metachronous gastric cancer (MGC) remains a possibility. In this study, we investigated the incidence and risk factors for MGC in patients with early gastric cancer who underwent endoscopic submucosal dissection (ESD) and successfully eradicatedHelicobacter pylori. Materials and Methods: A retrospective analysis was conducted of 1,191 patients who underwent ESD and successfully eradicated H. pylori at the Affiliated Drum Tower Hospital of Nanjing University. Endoscopic surveillance was performed at 3, 6, and 12 months post-resection, and annually thereafter. MGC was defined as the development of a new cancer at a site other than the primary gastric cancer site, at least 1 year after the initial endoscopic resection. Results: A total of 77 patients were diagnosed with MGC during a median follow-up of 41.5 months. Kaplan-Meier analysis showed a 5-year cumulative incidence of MGC of 9.4% after successful H. pylori eradication. Multivariate analysis of the training set using Cox proportional hazards models identified male sex, severe atrophic gastritis, multiple gastric cancers before H. pylori eradication, and smoking history as independent risk factors for MGC.The nomogram exhibited favorable discrimination, with area under the curves of 0.767 and 0.822 in the training set and 0.724 and 0.745 in the testing set at 3 and 5 years, respectively. Conclusions Patients with gastric cancer who undergo endoscopic resection, even after successful H. pylori eradication, should undergo annual and continuous endoscopic surveillance for MGC.

Objective To characterize the species composition and distribution patterns of ticks in 17 counties and cities of Yunnan Province, thereby furnishing fundamental data for the prediction, prevention, and control of local tick-borne diseases. Methods Tick specimens deposited in Yunnan Institute of Endemic Disease Control and Prevention (YIEDC) collected from 17 counties or cities during 1957-2024 were thoroughly trimmed and morphological identified based on diagnostic characters. Results A total of 2 923 tick specimens were taxonomically identified and classified into 18 species within 6 genera in the Ixodidae family. Specifically, the genus Haemaphysalis comprised 6 species with 154 specimens, the genus Rhipicephalus included 3 species with 2 444 specimens, the genus Ixodes consisted of 4 species with 236 specimens, the genus Amblyomma included 3 species with 49 specimens, the genus Dermacentor contained 1 species with 12 specimens, and the genus Hyalomma included 1 species with 28 specimens. A wide range of host animals were found, including livestock, wild avian species, wild mammalian species, reptiles (including pythons), and humans. Conclusions Ticks were found on a wide array of host animals within the 17 counties and cities of Yunnan Province, demonstrating high host species diversity. Our data suggest a need to strengthen the monitoring of tick-borne diseases and provide health education for the general population in Yunnan Province.

Objective To explore the recognition capabilities of electronic nose combined with machine learning in identifying the breath odor map of benign and malignant pulmonary nodules and Traditional Chinese Medicine (TCM) syndrome elements. Methods The study design was a single-center observational study. General data and four diagnostic information were collected from 108 patients with pulmonary nodules admitted to the Department of Cardiothoracic Surgery of Hospital of Chengdu University of TCM from April 2023 to March 2024. The patients' TCM disease location and nature distribution characteristics were analyzed using the syndrome differentiation method. The Cyranose 320 electronic nose was used to collect the odor profiles of oral exhalation, and five machine learning algorithms including random forest (RF), K-nearest neighbor (KNN), logistic regression (LR), support vector machine (SVM), and eXtreme gradient boosting (XGBoost) were employed to identify the exhaled breath profiles of benign and malignant pulmonary nodules and different TCM syndromes. Results (1) The common disease locations in pulmonary nodules were ranked in descending order as liver, lung, and kidney; the common disease natures were ranked in descending order as Yin deficiency, phlegm, dampness, Qi stagnation, and blood deficiency. (2) The electronic nose combined with the RF algorithm had the best efficacy in identifying the exhaled breath profiles of benign and malignant pulmonary nodules, with an AUC of 0.91, accuracy of 86.36%, specificity of 75.00%, and sensitivity of 92.85%. (3) The electronic nose combined with RF, LR, or XGBoost algorithms could effectively identify the different TCM disease locations and natures of pulmonary nodules, with classification accuracy, specificity, and sensitivity generally exceeding 80.00%.Conclusion Electronic nose combined with machine learning not only has the potential capabilities to differentiate the benign and malignant pulmonary nodules, but also provides new technologies and methods for the objective diagnosis of TCM syndromes in pulmonary nodules.

Objective To investigate the diagnostic value of 4 novel inflammatory markers related to routine blood tests,namely neutrophil-to-lymphocyte ratio(NLR),red blood cell distribution width(RDW),hemoglobin-to-RDW ratio(HRR)and systemic immune-inflammation index(SII),in elderly patients with chronic cardiovascular disease(CVD)complicated with frailty.Methods Retrospectively analyze 110 patients with chronic stable CVD who were hospitalized in the cadre ward of cardiovascular medicine at the Air Force Characteristic Medical Center from January 2022 to June 2023.According to the assessment results of the Fried scale,they were divided into three groups:non-frailty group(Fried score=0,n=30),the pre-frailty group(Fried score 1 or 2,n=40)and frailty group(Fried score≥3,n=40).The differences in general information,the impairment rate of daily living activities,miniature nutritional assessment-short form(MNA-SF)scores,mini-mental state examination(MMSE)scores,and the indicators such as NLR,RDW,HRR,and SII among the three groups were compared.Spearman rank correlation was used to analyze the correlation between NLR,RDW,HRR,SII and frailty scores as well as each frailty indicator.Multivariate logistic regression analysis was performed to identify the independent risk factors for frailty in elderly patients with chronic CVD,and the receiver operating characteristic(ROC)curve was used to assess the clinical diagnostic value of NLR and HRR in elderly patients with chronic CVD complicated with frailty.Results Compared with non-frailty group and pre-frailty group,patients in frailty group were older,with higher impaired rates of daily living activities,NLR,RDW,and SII,and lower MNA-SF scores,MMSE scores,and HRR,and differences were statistically significant(P<0.05).Spearman rank correlation analysis showed that the frailty score was positively correlated with NLR(rs=0.354,P<0.001),and RDW(rs=0.448,P<0.001),negatively correlated with HRR(rs=-0.232,P=0.024),and had no significant correlation with SII(rs=0.144,P=0.167).Further analysis of the correlation between the above novel inflammatory markers and the 5 components of frailty showed that NLR was positively correlated with fatigue(rs=0.228,P=0.017),slowed walking speed(rs=0.299,P<0.001),and low physical function(rs=0.319,P<0.001);RDW was positively correlated with decreased grip strength(rs=0.321,P<0.001),slowed walking speed(rs=0.422,P<0.001),and low physical function(rs=0.246,P=0.001);and HRR was negatively correlated with slowed walking speed(rs=-0.230,P=0.025),and low physical function(rs=-0.299,P=0.003).Multivariate logistic regression analysis showed that MNA-SF score(OR=0.577,95%CI 0.342-0.973)was an independent protective factor for pre-frailty in elderly patients with chronic CVD(P<0.05);NLR(OR=7.866,95%CI 1.101-56.185)was an independent risk factor for frailty,while HRR(OR=0.344,95%CI 0.120-0.983)and MNA-SF score(OR=0.292,95%CI 0.146-0.580)were independent protective factors for frailty in elderly CVD patients(P<0.05).The area under the ROC curve of NLR and HRR for diagnosing frailty in elderly patients with chronic CVD were 0.778 and 0.749,respectively.Conclusion NLR and HRR have high clinical diagnostic value for frailty in elderly patients with chronic CVD,and are expected to become effective inflammatory markers for screening elderly patients with chronic CVD complicated with frailty.

Objective To study the economic burden caused by healthcare-associated infection(HAI)in patients with severe acute pancreatitis(SAP),and provide theoretical basis for formulating HAI prevention and control measures.Methods Patients with SAP discharged from a tertiary first-class hospital in Jiangxi Province from July 1,2023 to June 30,2024 were selected as the study subjects.Information including demographic characteristics,clinical data,and hospitalization expense were collected.Patients were divided into a HAI group and a non-HAI group according to HAI occurrence.A propensity score matching(PSM)method was used to conduct a 1∶2 ma-tching,and differences in the length of hospital stay and hospitalization expense between the two groups of patients after PSM were compared.Results A total of 709 patients were included in the analysis,out of which 65 cases ex-perienced HAI,with a HAI incidence of 9.17％.After PSM,all 65 patients in the HAI group were successfully matched.The length of hospital stay,total hospitalization expense,expenses of medication and hygiene product of patients in the HAI group were all higher than those in the non-HAI group,and differences were all statistically sig-nificant(all P＜0.001).Patients who experienced≥2 episodes of HAI had a higher economic burden than those who experienced only once(P＜0.05).HAI of bloodstream,abdomen,digestive system,and respiratory system significantly increased the economic burden of patients(all P＜0.05).Conclusion HAI in SAP patients can extend the length of hospital stay and increase economic burden of patients.Targeted infection prevention and control mea-sures should be formulated to reduce the incidence of HAI and save medical resources.

Objective To compare the efficacy of Qwen2.5(model A)and GPT-4o model(model B)for converting free-text reports of thyroid ultrasound into structured reports.Methods Preoperative thyroid ultrasound data of 100 patients who then underwent thyroidectomy(236 thyroid nodules)were retrospectively collected.Free-text reports were written by an attending ultrasound physician in accordance with guidelines of American College of Radiology thyroid imaging reporting and data system(ACR TI-RADS)and input into both model A and B for 3 times to generate structured thyroid ultrasound reports.The quality of these structured reports output by 2 models were compared,including structured writing,ACR TI-RADS categories and management recommendations,while the consistency of 3 times structured reports output by the models were analyzed.Results Among 300 structured reports output by models,the total satisfaction rate of structured writing was 94.00％(282/300)for model A and 94.67％(284/300)for model B,and no significant difference was found(x2=0.045,P=0.832).Among 236 thyroid nodules,there were 36,47,33,39 and 81 in ACR TI-RADS categories 1,2,3,4 and 5,respectively.The total accuracy model A and B for 3 times categories of thyroid nodules was 88.28％(625/708)and 89.27％(632/708),respectively,with no significant difference(x2=0.582,P=0.505).Moderate consistencies of results of 3 times structured writing(ICC=0.531,0.673)and nodules categories(ICC=0.714,0.747)were noticed between 2 models.The coincidence rate of model A and B for providing management recommendations for thyroid nodules was 74.86％(530/708)and 67.51％(478/708),respectively,the former was higher than the latter(x2=4.567,P=0.033),and the consistencies of 3 times management recommendations provided by 2 models were both good(ICC=0.836,0.769).Conclusion The efficacy of structured writing and ACR TI-RADS categories of Qwen2.5 and GPT-4o models for converting thyroid ultrasound free-text reports into structured reports was comparable,while the former was more effective for providing management recommendations.

Objective:To establish a core competence evaluation index system for pediatric internal medicine nurses.Methods:On the basis of literature review, theoretical analysis, and clinical practice of the research group, the evaluation index system of the core competence of nurses in pediatric internal medicine was preliminarily formulated after the discussion of the research group. The Delphi method was employed for two rounds of expert consultation, involving a total of 18 experts. Finally, the evaluation index system of the core competence of nurses in pediatric internal medicine was established, and the weights of indicators at all levels were calculated.Results:The effective recovery rates of the first and second rounds of expert consultation were 100.00%. In the first and second rounds of expert consultation, the authority coefficients were 0.896 and 0.890, the judgment coefficients were 0.901 and 0.889, and the familiarity coefficients were 0.847 and 0.891, with authority coefficients >0.70 in both rounds. The coefficients of variation of the two rounds of expert correspondence were 0.041-0.227 and 0.002-0.126, respectively, and the coefficients of variation of indicators at all levels were <0.25. In the first round of expert consultation, Kendall's coordination coefficients of primary, secondary, and tertiary indicators were 0.305, 0.362, and 0.364, respectively, with P values <0.001. In the second round of expert consultation, Kendall's coordination coefficients of primary, secondary, and tertiary indicators were 0.371, 0.352, and 0.380, respectively, with P values <0.001. Finally, the core competence evaluation index system of pediatric internal medicine nurses was established, including 3 first-level indicators, 14 second-level indicators, and 57 third-level indicators. Conclusions:The evaluation index system of the core competence of pediatric internal medicine nurses has scientificity, reliability, specialty-specific characteristics, and reference value, which can provide a reference for the training and evaluation of pediatric internal medicine nurses in China.

Objective To investigate the relationship between the intraluminal characteristics of the occlusion segment and the degree of the primary collateral circulation(Circle of Willis)opening in patients with acute internal carotid artery occlusion(ICAO)and the occurrence of different subtypes of ipsilateral intracranial watershed infarction(WSI).Methods A total of 63 patients with unilateral acute ICAO accompanied by ipsilateral intracranial WSI were retrospectively included and divided into the internal watershed infarction(IWSI)group and the cortical watershed infarction(CWSI)group.The intraluminal characteristics of the occlusion segment and the degree of the Circle of Willis opening were analyzed using vessel wall magnetic resonance imaging(VW-MRI).Multivariate binary logistic regression analysis was employed to identify independent predictive indicators for the occurrence of CWSI.Results There was no significantly statistical difference in the occlusion range between the two groups.The range of intraluminal high signal involvement,the ratio of intraluminal relative highest signal,the incidence of high signal at the end of occlusion,and the degree of the Circle of Willis opening in the CWSI group were higher than those in the IWSI group(P<0.001).The range of intraluminal high signal involvement,high signal at the end of occlusion,and the degree of the Circle of Willis opening were identified as independent predictive factors for CWSI.Conclusion VW-MRI analysis of the intraluminal characteristics of the occlusion segment and the degree of the Circle of Willis opening can help to elucidate the mechanisms underlying the occurrence of IWSI/CWSI and can provide assistance in formulating etiology-based treatment strategies for clinical practice.