Co-infection of hepatitis D virus （HDV） and hepatitis B virus （HBV） is the most severe form of viral hepatitis and is associated with accelerated progression of liver disease and a significant increase in the risk of liver cirrhosis and hepatocellular carcinoma. Nucleo（s）tide analogues for HBV treatment are ineffective against HDV infection， necessitating the urgent need for developing specific and effective antiviral therapies for HDV. In recent years， significant advances have been made in the research and development of specific antiviral drugs against HDV， including entry inhibitors targeting viral entry （Bulevirtide） and monoclonal antibody drugs （Libevitug）， which bring ground-breaking advances in the treatment of HDV infection. This article briefly reviews the latest research advances in therapeutic drugs for HDV， introduces the mechanism of action and clinical research data of new drugs recently approved for the treatment of HDV， and discusses the challenges that need to be solved in the field of HDV treatment， in order to provide a reference for understanding the current status of hepatitis D treatment.

Gorham-Stout disease(GSD) is a rare osteolytic disorder characterized by spontaneous and progressive osteolysis, along with abnormal angiogenesis and lymphangiogenesis, with no new bone formation. We present a case of a 15-year-old female admitted due to " recurrent right leg pain for 5 years, 11 months after undergoing right femoral fracture surgery". Through comprehensive integration of the patient's clinical phenotype, laboratory tests, imaging findings, pathological examinations, and molecular biological test results, GSD was considered highly likely. A multidisciplinary treatment approach was conducted, including a combination of zoledronic acid and sirolimus to inhibit osteolysis, along with rehabilitation training and orthopedic intervention, providing a personalized and comprehensive treatment strategy.

Hepatitis B virus （HBV） exclusively infects liver parenchymal cells and forms covalently closed circular DNA （cccDNA） within their nuclei. HBV cccDNA serves as the essential template for viral gene transcription， the sole source of progeny virus production， and the key driver of viral antigen expression， and it is the molecular basis for the persistence of HBV infection. Therefore， elimination and/or functional silencing of cccDNA is the key to eradicate chronic HBV infection. This article discusses the critical scientific issues that need to be solved during elimination of the harm of HBV infection from the perspectives of the synthesis， transcription， and clearance of cccDNA， as well as the impact of nonparenchymal cells on cccDNA， in order to provide a reference for eradicating HBV infection in the future.

ObjectiveTo investigate the role of interleukin （IL）-17A in acute inhalational pneumonia induced by the highly drug-resistant and hypervirulent Staphylococcus aureus strain USA300-R in mice. MethodsAn acute inhalational pneumonia model was established in mice using an aerosolized pulmonary delivery technique. RNA sequencing （RNA-seq） and enzyme-linked immunosorbent assay （ELISA） were employed to examine the expression dynamics of Il17a mRNA and IL-17A protein， respectively， in the lungs of infected mice. Il17a knockout （Il17a^-/-） mice were generated using CRISPR/Cas9 gene editing technology. The survival rate， body weight， bacterial load in lung tissue， and histopathological changes were compared between Il17a^-/- and wild-type （WT） mice following inhalational infection with USA300-R. Results12 hours after USA300-R infection， compared to pre-infection， the expression level of Il17a mRNA in lung tissue and the level of IL-17A protein in bronchoalveolar lavage fluid （BALF） increased by approximately 50-fold （P<0.01） and 6-fold （P<0.001）， respectively. Compared to WT mice， Il17a^-/- mice exhibited approximately 10-fold higher bacterial loads in lung tissue at both 12 and 24 hours post-infection （P<0.001， P<0.05）. However， they showed significantly attenuated lung histopathological injury， reduced alveolar wall thickening， markedly decreased neutrophil infiltration， and an approximately 50% improvement in survival rate （P<0.05）. ConclusionIn acute Staphylococcus aureus USA300-R inhalational pneumonia， IL-17A contributes to bacterial clearance by recruiting neutrophils； however， excessive neutrophil infiltration exacerbates pulmonary inflammation and injury， reduces survival rates， and represents a potential therapeutic target.

Objective To explore the clinical efficacy of single-branch intraoperative stent combined with modified bilateral cerebral perfusion in type A aortic dissection. Methods A retrospective analysis was conducted on the clinical data of patients who underwent surgery for type A aortic dissection at the First Affiliated Hospital of Anhui Medical University from January 2021 to May 2024. Patients were divided into a test group (single branch stent+modified bilateral cerebral perfusion) and a control group (traditional surgical method, straight stent+unilateral cerebral perfusion) according to the surgical method. Propensity score matching analysis was used to match the two groups of patients with a ratio of 1:1, and the perioperative data and clinical efficacy after matching were compared. Results A total of 14 patients were included in the test group, including 13 males and 1 female, with an average age of (46.6±16.4) years. There were 56 patients in the control group, including 38 males and 18 females, with an average age of (52.1±11.7) years. After propensity score matching, 14 patients were included in each group. Compared with the control group, the ventilator support time [(27.4±24.3) h vs. (93.4±88.0) h, P=0.018], length of stay in the intensive care unit [(2.8±1.8) d vs. (8.7±6.5) d, P=0.009], and postoperative awakening time [(5.4±2.2) h vs. (8.8±4.8) h, P=0.047] in the test group were shorter than those in the control group, with statistically significant differences. There was no statistical difference in neurological complications between the two groups (P=1.000). Conclusion Single-branch intraoperative stent combined with modified bilateral cerebral perfusion can effectively shorten ventilator support time, length of stay in the intensive care unit, and postoperative awakening time, and is safe and effective for the treatment of type A aortic dissection, which is worth further promotion.

Sixteen compounds were isolated from the solid rice culture of the endophytic fungus Alternaria alstroemeriae WZ-419 derived from Pseudostellariae Radix, using silica gel, ODS, Sephadex LH-20 column chromatography, and preparative HPLC. Their structures were elucidated based on physicochemical properties and comprehensive spectroscopic analyses, and identified as alterpenoid A (1), tricycloalternarene A (2), altenusin (3), 4'-epialtenuene (4), altenuene (5), alternariol (6), altenuisol (7), 3-hydroxyalternariol-5-O-methylether (8), alternariol-9-methyl ether (9), alternariol 1′-hydroxy-9-methyl ether (10), stemphyperylenol (11), dihydroalterperylenol (12), alterinone A (13), 4-hydroxy-3-methoxy-5-(2E,6E-3,7,11-trimethyldodeca-2,6,10-trien-1-yl) benzoic acid (14), hexylitaconic acid (15), and altechromone A (16). Among them, compound 1 and 13 were new, and compounds 14 and 15 were isolated from the genus Alternaria for the first time. The antibacterial activities of compounds 1–16 were evaluated in vitro. Compounds 3, 6–8, 10, 11, 13, and 14 exhibited notable inhibitory effects against Gram-positive bacteria, with minimal inhibitory concentrations ranging from 8 to 64 µg/mL.This study isolated a series of antimicrobial metabolites from the endophytic fungi of Pseudostellariae Radix, providing new insights into their bioactive constituents and laying a foundation for further pharmacological investigations.

Objective To evaluate the effect of low-dose ¹⁸F-fluorodeoxyglucose (FDG) injection on image quality in pediatric patients, calculate the whole-body effective dose and absorbed doses to critical organs, and provide a reference for clinical protection in pediatric low-dose positron emission tomography/computed tomography (PET/CT) examination. Methods A total of 67 pediatric patients aged 4-14 years who underwent ¹⁸F-FDG whole-body PET/CT imaging in the Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University between January 2024 and December 2025 were enrolled in a retrospective study. According to the injected ¹⁸F-FDG dose, patients were divided into a full-dose group (37 cases, 2.96-3.7 MBq/kg, PET acquisition duration of 10 min) and a low-dose group (30 cases, 1.85-2.4 MBq/kg, PET acquisition duration of 15 min). All scans were performed using a uEXPLORER PET/CT scanner. The standardized uptake value, standard deviation, and signal-to-noise ratio were measured for the liver and mediastinal blood pool. Image quality was compared between the two groups. The PET effective dose was calculated based on body mass index, and the total effective dose was obtained by combining PET effective dose with CT effective dose. The doses to critical organs were calculated according to ICRP Publication 128. Statistical analysis was performed using SPSS 26.0 and Prism 9.0 software. Differences were compared between groups. Results There were no significant differences in age, sex, weight, height, or body mass index between the two groups (P>0.05), while the injected dose showed a significant difference (P<0.001). In terms of image quality, there were no significant differences in standardized uptake value, standard deviation, and signal-to-noise ratio between the two groups. In terms of radiation dose, compared with the full-dose group, the low-dose group showed a 35.13% reduction in PET effective dose and a 15.22% reduction in total effective dose (P<0.05), whereas the CT effective dose was reduced by 2.4% and the difference was not significant (P=0.0892). The doses to critical organs (gonads, breasts, thyroid, red bone marrow, lungs) in the low-dose group were significantly lower than those in the full-dose group (P<0.01). Conclusion Under the premise of meeting clinical diagnostic requirements, low-dose ¹⁸F-FDG whole-body PET/CT imaging in pediatric patients can reduce the overall radiation exposure by 15%, and decrease the doses to critical organs, including the gonads, by more than 20%.

Objective To evaluate the effect of low-dose ¹⁸F-fluorodeoxyglucose (FDG) injection on image quality in pediatric patients, calculate the whole-body effective dose and absorbed doses to critical organs, and provide a reference for clinical protection in pediatric low-dose positron emission tomography/computed tomography (PET/CT) examination. Methods A total of 67 pediatric patients aged 4-14 years who underwent ¹⁸F-FDG whole-body PET/CT imaging in the Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University between January 2024 and December 2025 were enrolled in a retrospective study. According to the injected ¹⁸F-FDG dose, patients were divided into a full-dose group (37 cases, 2.96-3.7 MBq/kg, PET acquisition duration of 10 min) and a low-dose group (30 cases, 1.85-2.4 MBq/kg, PET acquisition duration of 15 min). All scans were performed using a uEXPLORER PET/CT scanner. The standardized uptake value, standard deviation, and signal-to-noise ratio were measured for the liver and mediastinal blood pool. Image quality was compared between the two groups. The PET effective dose was calculated based on body mass index, and the total effective dose was obtained by combining PET effective dose with CT effective dose. The doses to critical organs were calculated according to ICRP Publication 128. Statistical analysis was performed using SPSS 26.0 and Prism 9.0 software. Differences were compared between groups. Results There were no significant differences in age, sex, weight, height, or body mass index between the two groups (P>0.05), while the injected dose showed a significant difference (P<0.001). In terms of image quality, there were no significant differences in standardized uptake value, standard deviation, and signal-to-noise ratio between the two groups. In terms of radiation dose, compared with the full-dose group, the low-dose group showed a 35.13% reduction in PET effective dose and a 15.22% reduction in total effective dose (P<0.05), whereas the CT effective dose was reduced by 2.4% and the difference was not significant (P=0.0892). The doses to critical organs (gonads, breasts, thyroid, red bone marrow, lungs) in the low-dose group were significantly lower than those in the full-dose group (P<0.01). Conclusion Under the premise of meeting clinical diagnostic requirements, low-dose ¹⁸F-FDG whole-body PET/CT imaging in pediatric patients can reduce the overall radiation exposure by 15%, and decrease the doses to critical organs, including the gonads, by more than 20%.

Objective To evaluate the effect of low-dose ¹⁸F-fluorodeoxyglucose (FDG) injection on image quality in pediatric patients, calculate the whole-body effective dose and absorbed doses to critical organs, and provide a reference for clinical protection in pediatric low-dose positron emission tomography/computed tomography (PET/CT) examination. Methods A total of 67 pediatric patients aged 4-14 years who underwent ¹⁸F-FDG whole-body PET/CT imaging in the Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University between January 2024 and December 2025 were enrolled in a retrospective study. According to the injected ¹⁸F-FDG dose, patients were divided into a full-dose group (37 cases, 2.96-3.7 MBq/kg, PET acquisition duration of 10 min) and a low-dose group (30 cases, 1.85-2.4 MBq/kg, PET acquisition duration of 15 min). All scans were performed using a uEXPLORER PET/CT scanner. The standardized uptake value, standard deviation, and signal-to-noise ratio were measured for the liver and mediastinal blood pool. Image quality was compared between the two groups. The PET effective dose was calculated based on body mass index, and the total effective dose was obtained by combining PET effective dose with CT effective dose. The doses to critical organs were calculated according to ICRP Publication 128. Statistical analysis was performed using SPSS 26.0 and Prism 9.0 software. Differences were compared between groups. Results There were no significant differences in age, sex, weight, height, or body mass index between the two groups (P>0.05), while the injected dose showed a significant difference (P<0.001). In terms of image quality, there were no significant differences in standardized uptake value, standard deviation, and signal-to-noise ratio between the two groups. In terms of radiation dose, compared with the full-dose group, the low-dose group showed a 35.13% reduction in PET effective dose and a 15.22% reduction in total effective dose (P<0.05), whereas the CT effective dose was reduced by 2.4% and the difference was not significant (P=0.0892). The doses to critical organs (gonads, breasts, thyroid, red bone marrow, lungs) in the low-dose group were significantly lower than those in the full-dose group (P<0.01). Conclusion Under the premise of meeting clinical diagnostic requirements, low-dose ¹⁸F-FDG whole-body PET/CT imaging in pediatric patients can reduce the overall radiation exposure by 15%, and decrease the doses to critical organs, including the gonads, by more than 20%.

Objective: To evaluate the clinical efficacy and safety of injectable platelet-rich fibrin (i-PRF) in the treatment of mild to moderate female pattern hair loss (FPHL), and to analyze the related clinical factors affecting the therapeutic efficacy of i-PRF. Methods: This was a secondary analysis of a prospective, randomized controlled trial. A total of 29 FPHL patients with Sinclair grade Ⅱ-Ⅲ, who attended the outpatient clinics of Beijing Friendship Hospital, Capital Medical University and Peking University Third Hospital from March 2024 to April 2025, were enrolled. All patients received i-PRF treatment once every 4 weeks for a total of 4 sessions, with follow-up up to 24 weeks. Standardized clinical photographs were taken at baseline, week 12 and week 24. Trichoscopic examination was performed to measure the non-vellus target area hair count (TAHC) and hair diameter (HD) in the target area, and all adverse events were recorded. The Mann-Whitney U test was used to compare the intergroup differences in efficacy for categorical influencing factors; Spearman rank correlation analysis was employed to assess the correlation between continuous influencing factors and efficacy; and multiple linear regression (enter method) was performed to identify independent influencing factors of efficacy. Results: A total of 27 patients completed the trial. At week 12, TAHC significantly increased from 112 (105, 120) hairs/cm at baseline to 128 (110, 150) hairs/cm , with a median increase of 12 (5, 28) hairs/cm and a median growth rate of 10.5 (4.2, 24.5)% (P=0.045); hair diameter significantly increased from 42.5 (39.8, 45.2) μm to 52.0 (47.0, 58.0) μm, with a median increase of 7.5 (3.0, 12.5) μm and a median growth rate of 18.0 (7.5, 29.0)% (P<0.001). At week 24, TAHC further significantly increased to 141 (125, 158) hairs/cm (P<0.001), with a median growth rate of 24.8 (18.5, 32.0)%; hair diameter continued to improve to 55.0 (50.0, 61.0) μm (P=0.008), with a median growth rate of 21.5 (16.0, 27.0)%. The overall incidence of adverse events was 10.34% (3/29), mainly presenting as mild scalp pruritus and transient headache, without severe adverse effects. Multiple linear regression analysis revealed that baseline TAHC was an independent influencing factor for i-PRF efficacy (P<0.05), while age, BMI, disease duration, Sinclair grade, family history of AGA, and baseline HD showed no significant independent effect on efficacy in this model (P>0.05). Conclusion: This preliminary study indicates that i-PRF can improve hair density and hair shaft diameter in patients with FPHL with a favorable safety profile. Patients with FPHL and lower baseline TAHC may achieve greater clinical improvement.