Triple-negative breast cancer (TNBC) is aggressive, with high recurrence rates and poor prognosis. Paclitaxel (PTX) remains a key chemotherapeutic agent for TNBC, but its efficacy diminishes due to the emergence of drug resistance, largely driven by cancer stem-like cells (CSCs), vasculogenic mimicry (VM) formation and tumor immunosuppressive microenvironment (TIME). Pyruvate kinase M2 (PKM2) is highly expressed in TNBC, and is a potential target for TNBC treatment. In this study, we developed a biomimetic codelivery system using albumin nanoparticles (termed S/P NP) to co-encapsulate PTX and shikonin (SHK), a natural inhibitor of PKM2. By inhibiting PKM2, SHK suppressed β-Catenin signaling, thereby reversing CSC stemness and preventing VM formation. The S/P NP system exhibited tumor-targeting delivery effect and significantly inhibited TNBC growth and lung metastasis. Mechanistically, the treatment reversed epithelial-mesenchymal transition (EMT) and stem-like properties of TNBC cells, suppressed VM formation, and remodeled the TIME. It reduced immunosuppressive cells (M2 macrophages, MDSCs) while promoting anti-tumor immunity (M1 macrophages, dendritic cells, cytotoxic T cells, and memory T cells). This dual-action strategy holds promise for improving TNBC therapy by targeting CSCs, VM, and the immune microenvironment, and for overcoming PTX resistance and reducing metastasis.

OBJECTIVES: To explore the efficacy of DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy for management of cancer pain and provide reference for its standardized clinical application. Methods and. RESULTS: Recommendations were formulated based on literature review and expert group discussion, and consensus was reached following expert consultation. The consensus recommendations are comprehensive, covering the entire treatment procedures from preoperative assessment and preparation, surgical operation process, postoperative management and traditional Chinese medicine treatment to individualized treatment planning. The study results showed that the treatment plans combining traditional Chinese with Western medicine effectively alleviated cancer pain, reduced the use of opioid drugs, and significantly improved the quality of life and enhanced immune function of the patients. Postoperative follow-up suggested good treatment tolerance among the patients without serious complications. CONCLUSIONS The formulated consensus is comprehensive and can provide reference for clinicians to use DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy. The combined treatment has a high clinical value with a good safety profile for management of cancer pain.
Humans ; Medicine, Chinese Traditional ; Cancer Pain/therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Drug Delivery Systems ; Pain Management/methods* ; China

The rapid development of artificial intelligence (AI), especially generative AI (GenAI), has already brought, and will continue to bring, revolutionary changes to our daily production and life, as well as create new opportunities and challenges for diagnostic and therapeutic practices in the medical field. Haihe Hospital of Tianjin University collaborates with the National Supercomputer Center in Tianjin, Tianjin University, and other institutions to carry out research in areas such as smart healthcare, smart services, and smart management. We have conducted research and development of a full-process disease diagnosis and treatment assistance system based on GenAI in the field of smart healthcare. The development of this project is of great significance. The first goal is to upgrade and transform the hospital's information center, organically integrate it with existing information systems, and provide the necessary computing power storage support for intelligent services within the hospital. We have implemented the localized deployment of three models: Tianhe "Tianyuan", WiNGPT, and DeepSeek. The second is to create a digital avatar of the chief physician/chief physician's voice and image by integrating multimodal intelligent interaction technology. With generative intelligence as the core, this solution provides patients with a visual medical interaction solution. The third is to achieve deep adaptation between generative intelligence and the entire process of patient medical treatment. In this project, we have developed assistant tools such as intelligent inquiry, intelligent diagnosis and recognition, intelligent treatment plan generation, and intelligent assisted medical record generation to improve the safety, quality, and efficiency of the diagnosis and treatment process. This study introduces the content of a full-process disease diagnosis and treatment assistance system, aiming to provide references and insights for the digital transformation of the healthcare industry.
Artificial Intelligence ; Humans ; Delivery of Health Care ; Generative Artificial Intelligence

Objective To explore the efficacy of DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy for management of cancer pain and provide reference for its standardized clinical application.Methods and Results Recommendations were formulated based on literature review and expert group discussion,and consensus was reached following expert consultation.The consensus recommendations are comprehensive,covering the entire treatment procedures from preoperative assessment and preparation,surgical operation process,postoperative management and traditional Chinese medicine treatment to individualized treatment planning.The study results showed that the treatment plans combining traditional Chinese with Western medicine effectively alleviated cancer pain,reduced the use of opioid drugs,and significantly improved the quality of life and enhanced immune function of the patients.Postoperative follow-up suggested good treatment tolerance among the patients without serious complications.Conclusion The formulated consensus is comprehensive and can provide reference for clinicians to use DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy.The combined treatment has a high clinical value with a good safety profile for management of cancer pain.

Objective To investigate the efficacy and safety of blank microspheres combined with microcoils in treating hemopty-sis due to arteriae bronchiales(BA)malformation during bronchial arterial embolization(BAE).Methods A retrospective analysis was conducted on the preoperative data,embolization materials,technical success rate,clinical success rate,postoperative recurrence rate,and complications of 87 patients who underwent BAE using blank microspheres for hemoptysis due to BA malformation.Results There were 87 patients in this study,and BA computed tomography angiography(CTA)classification was as follows:32 cases(36.78％)of type Ⅰ,23 cases(26.44％)of type Ⅱ,19 cases(21.84％)of type Ⅲ,and 13 cases(14.94％)of other types(Ⅳ-Ⅸ).A total of 171 blood vessels were embolized in 87 patients,including 16 ectopic BA,and 130 embolized microspheres,including 104 microspheres of 500-700 μm and 26 of 700-900 μm.There were 265 microcoils,with a technical success rate of 100％,a 24 h clinical success rate of 100％,and a 30 d clinical success rate of 98.85％.The recurrence rate was 3.45％ at 6 months,5.75％ at 12 months,and 8.05％ at 24 months.Postopera-tive complications(Clavien-Dindo classification):complications of grade Ⅰ,embolic syndrome recurrence rate was 8.05％,chest pain incidence was 3.45％,dysphagia incidence was 2.30％,BA injury incidence was 3.45％;complications of grade Ⅳ,paraplegia inci-dence was 1.15％.Conclusion The use of blank microspheres combined with microcoils in the treatment of hemoptysis caused by BA malformation has high safety and clear efficacy.

With the development of medical technology towards precision and individualization, the protection of gastric function and the postoperative quality of life of patients are increasingly receiving the attention and emphasis of surgeons. In the context of the booming development of function-preserving gastrectomy, the combined approach using both laparoscopy and endoscopy also presents a trend of diversity and innovation. The laparoscopic and endoscopic cooperative surgery not only addresses for the limitations of each method, but also plays a role in locating the tumor precisely, narrowing the scope of gastrectomy, preserving the anatomical structure and function of the stomach, maintaining the continuity of the gastric wall, precise lymphadenectomy, and preserving the vagus nerve in function-preserving gastrectomy. In this paper, the author expounds on the above advantages and scope of application of dual-scope cooperative surgery and recognizes the significance of dual-scope cooperative surgery in future development.

Objective To investigate the efficacy and safety of blank microspheres combined with microcoils in treating hemopty-sis due to arteriae bronchiales(BA)malformation during bronchial arterial embolization(BAE).Methods A retrospective analysis was conducted on the preoperative data,embolization materials,technical success rate,clinical success rate,postoperative recurrence rate,and complications of 87 patients who underwent BAE using blank microspheres for hemoptysis due to BA malformation.Results There were 87 patients in this study,and BA computed tomography angiography(CTA)classification was as follows:32 cases(36.78％)of type Ⅰ,23 cases(26.44％)of type Ⅱ,19 cases(21.84％)of type Ⅲ,and 13 cases(14.94％)of other types(Ⅳ-Ⅸ).A total of 171 blood vessels were embolized in 87 patients,including 16 ectopic BA,and 130 embolized microspheres,including 104 microspheres of 500-700 μm and 26 of 700-900 μm.There were 265 microcoils,with a technical success rate of 100％,a 24 h clinical success rate of 100％,and a 30 d clinical success rate of 98.85％.The recurrence rate was 3.45％ at 6 months,5.75％ at 12 months,and 8.05％ at 24 months.Postopera-tive complications(Clavien-Dindo classification):complications of grade Ⅰ,embolic syndrome recurrence rate was 8.05％,chest pain incidence was 3.45％,dysphagia incidence was 2.30％,BA injury incidence was 3.45％;complications of grade Ⅳ,paraplegia inci-dence was 1.15％.Conclusion The use of blank microspheres combined with microcoils in the treatment of hemoptysis caused by BA malformation has high safety and clear efficacy.

With the development of medical technology towards precision and individualization, the protection of gastric function and the postoperative quality of life of patients are increasingly receiving the attention and emphasis of surgeons. In the context of the booming development of function-preserving gastrectomy, the combined approach using both laparoscopy and endoscopy also presents a trend of diversity and innovation. The laparoscopic and endoscopic cooperative surgery not only addresses for the limitations of each method, but also plays a role in locating the tumor precisely, narrowing the scope of gastrectomy, preserving the anatomical structure and function of the stomach, maintaining the continuity of the gastric wall, precise lymphadenectomy, and preserving the vagus nerve in function-preserving gastrectomy. In this paper, the author expounds on the above advantages and scope of application of dual-scope cooperative surgery and recognizes the significance of dual-scope cooperative surgery in future development.

Objective To search,evaluate,and summarize the best evidence of insertion and maintenance of mini-midline in adult patients,in order to provide a solid evidence-based foundation for establishing clinical standardized and safe utilization of mini-midline.Methods We systematically searched UpToDate,BMJ Best Practice,Guideline International Network,National Guideline Clearinghouse,Joanna Briggs Institute,National Institute for Health and Care Excellence,Centers for Disease Control and Prevention,Scottish Intercollegiate Guidelines Network,Canadian Medical Association:Clinical Practice Guideline,Registered Nurses'Association of Ontario,Intravenous Nurses Society,Cochrane Library,PubMed,CINAHL,Embase,Web of Science,Yimaitong,China National Knowledge Infrastructure,Wanfang Database,and China Biomedical Literature Database.It includes clinical practice guidelines,expert consensuses,evidence summaries,systematic reviews,meta-analyses,and best practice on mini-midline insertion and maintenance.The search period covered January 2013 to May 2023.2 researchers independently evaluated the literature quality and extracted the literature that met the standards.The evidence was graded using the JBI evidence pre-grading system(2014),and the extracted evidence was classified and summarized by themes.Results A total of 10 pieces of the literature were involved,including 6 guidelines,2 expert consensuses,and 2 systematic reviews.This study summarized 20 pieces of best evidence in relation to the following 4 themes:indications and contraindications for mini-midline,catheter insertion,catheter maintenance and catheter removal.Conclusion The study comprehensively and scientifically summarizes the best evidence regarding the insertion and maintenance of mini-midline.We recommend that clinical practitioners integrate this evidence into their practice,while considering individual patient preferences and medical contexts.This approach,in line with the principle of individualization,will contribute to enhancing the standardization and safety of mini-midline use in clinical settings.

Objective To explore the clinical value of methylation at promoter sites of urine protein kinase Y-linked(PRKY)gene in the early diagnosis of prostate cancer(PCa).Methods Urine samples were collected from 50 suspected PCa patients.After extracting DNA,the methylation levels of the PRKY gene promoter sites cg05163709,cg08045599,and cg05618150 were detected using quantitative methylation-specific PCR(qMSP).Simultaneously,the patients were divided into the benign prostatic hyperplasia(BPH)group and the PCa group.The differences in clinical indicators between the two groups were analyzed,as well as the methylation status of the PRKY gene promoter sites in the urine of the two groups of patients.The receiver operating charac-teristic(ROC)curve of PRKY promoter sites methylation was established,and the area under the curve(AUC)was calculated to analyze the diagnostic value of PRKY promoter sites methylation in PCa,and to perform com-bined diagnosis with clinical indicators.Results The methylation rates of cg05163709 and cg05618150 in urine specimens of PCa patients were significantly higher than those of BPH patients.The AUC for cg05163709 methyla-tion in diagnosing PCa was 0.762,with a sensitivity of 86.70%.It showed better performance in early screening for PCa compared to total prostate specific antigen(tPSA),percentage free prostate specific antigen(f/tPSA)and prostate specific antigen density(PSAD)index.We found that the AUC for cg05618150 methylation in conjunc-tion with PSAD in diagnosing PCa was 0.787,with a sensitivity of 86.70%.The AUC of cg05163709 methylation and PSAD in the joint diagnosis of PCa was 0.855,and the specificity could reach 95.00%.Conclusion The methylation of urine PRKY gene promoter sites cg05163709 and cg05618150 shows high sensitivity and specificity in diagnosing PCa,making them promising biomarkers for early detection of PCa.