In January 2026， the European Reference Network on Hepatological Diseases released a position statement on polycystic liver disease （PLD）. Compared with existing diagnosis and treatment recommendations， this statement provides the latest practical guidance on somatostatin analogues as the sole available pharmacological intervention for severe PLD， including clear criteria for eligibility， the criteria for initiation and discontinuation of treatment， and the gaps requiring further research. This statement also defines the criteria for patient selection， treatment goals， and monitoring strategies， and these updates fully reflect the latest clinical evidence and practical needs in the management of PLD. This article gives an excerpt of the key practical recommendations from the statement.

Background: The tight junction protein claudin18.2 (CLDN18.2) has been implicated in poor prognosis and suboptimal immunotherapy response in gastric cancer (GC). This study investigates the clinicopathological relevance of CLDN18.2 expression and its association with molecular subtypes in GC patients from a high-incidence region, combining transcriptomic and proteomic approaches to explore how CLDN18.2 contributes to progression and metastasis. Methods: A retrospective cohort of 494 GC patients (2019–2024) underwent immunohistochemical analysis for CLDN18.2, Epstein-Barr virus (Epstein–Barr virus–encoded RNA), p53, human epidermal growth factor receptor 2 (HER2), and mismatch repair proteins (MLH1, MSH2, PMS2, and MSH6). CLDN18.2 positivity was defined as moderate to strong (2+/3+) membranous staining in ≥75% of tumor cells. Clinicopathological correlations, biomarker associations, and survival outcomes were evaluated. Transcriptomic and proteomic sequencing was performed to explore molecular mechanisms. Results: CLDN18.2 positivity was observed in 26.9% (133/494) of gastric adenocarcinomas. CLDN18.2-positive tumors correlated with TNM stage (p = .003) and shorter overall survival (p = .018). No associations were identified with age, sex, HER2 status, microsatellite instability, or Epstein-Barr virus infection. Transcriptomic profiling revealed CLDN18.2-high tumors enriched in pathways involving cell junction disruption, signaling regulation, and immune modulation. Proteomic profiling showed that tumors with high CLDN18.2 were enriched in multiple mechanism-related pathways such as integrated metabolic reprogramming, cytoskeletal recombination, immune microenvironment dysregulation, and pro-survival signaling. These mechanisms may collectively contribute to tumor progression and metastasis. Conclusions CLDN18.2 overexpression is associated with poor prognosis in GC patients. Transcriptomic and proteomic analyses demonstrate that CLDN18.2 promotes tumor progression and metastasis, underscoring its potential as an independent prognostic factor in regions with a high incidence of GC.

Puerariae Lobatae Radix and Puerariae Thomsonii Radix are the dried roots of Pueraria lobata and Pueraria thomsonii of the Leguminosae family， respectively. Since their separate inclusion in the 2005 edition of Pharmacopoeia of the People's Republic of China， the two herbs have been individually recorded. Although they share the same functions and indications， the required content of puerarin differs by a factor of up to eightfold between them. The current quality standard relies solely on a single indicator， puerarin， which fails to reflect the correlation between chemical constituents and core therapeutic effects. This has resulted in prominent issues of mixed use in clinical practice and production， thereby constraining the high-quality development of the industry. Modern research has demonstrated that Puerariae Lobatae Radix contains a comprehensive range and higher content of isoflavonoid constituents， while Puerariae Thomsonii Radix is rich in starch and polysaccharides. Puerariae Lobatae Radix exhibits stronger effects in antipyresis， cardiovascular and cerebrovascular protection， and central analgesia， while Puerariae Thomsonii Radix demonstrates greater advantages in anti-inflammation， hypoglycemia， and peripheral analgesia. Based on this， the chemical material bases of Puerariae Lobatae Radix and Puerariae Thomsonii Radix at both the macromolecule and micromolecule levels were systematically reviewed and compared. The pharmacodynamic material bases and mechanisms of action underlying their three core therapeutic effects， namely "relieving exterior syndrome and clearing heat"， "promoting fluid production to quench thirst"， and "dredging channels and activating collaterals"， were summarized. The most highly correlated common metabolic pathway shared by both herbs for these three therapeutic effects is the arachidonic acid metabolic pathway， and their common core target is prostaglandin-endoperoxide synthase 2 （PTGS2）. This review provided clinical application recommendations based on the therapeutic differences between the two herbs， elucidated the scientific connotation of their "same origin but different effects"， and， grounded in the quality marker （Q-Marker）， proposed the concept of efficacy-related Q-Marker based on "substance-efficacy-syndrome" association， as well as a novel strategy for efficacy-oriented quality evaluation. Preliminary screening of quality markers associated with different therapeutic effects was also conducted. This study aims to provide critical scientific evidence for the precise clinical application of Puerariae Lobatae Radix and Puerariae Thomsonii Radix， the improvement of quality standards， and the high-quality development of the industry.

Objective:To investigate the factors influencing the prognosis of critically ill patients and the predictive value of the C-reactive protein-albumin-lymphocyte (CALLY) index.Methods:A retrospective analysis was conducted on the clinical data of 122 critically ill patients admitted to Guoyao Dongfeng General Hospital affiliated with Hubei University of Medicine from June 2022 to December 2023. Patients were divided into a death group and a survival group based on their 28-day prognosis. Clinical data were compared between the two groups to analyze the factors influencing prognosis and assess the predictive value of various indicators. Normally distributed measurement data were expressed as Mean±SD, and intergroup comparisons were performed by independent samples t-test; non-normally distributed measurement data were expressed as M( Q1,Q3), and intergroup comparisons were performed by the Mann-Whitney U test. Counting data were expressed as case (%), and intergroup comparisons were performed by the χ2 test. Multivariate logistic regression was used to analyze factors influencing patient prognosis, and receiver operating characteristic (ROC) curves were plotted to analyze the predictive value of each indicator. Results:The Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score, blood lactate, CRP, and B-type natriuretic peptide levels in the death group were higher than those in the survival group [22 (17, 30) points vs. 17 (14, 22) points, (4.8±1.4) mmol/L vs. (3.3±1.0) mmol/L, 134 (83, 2 381) mg/L vs. 13 (10, 27) mg/L, 259 (111, 592) ng/L vs. 108 (40, 247) ng/L; Z=3.04, P=0.002; t=5.79, P<0.001; Z=8.57, P<0.001; Z=3.28, P=0.001, respectively]. Albumin, neutrophil count, lymphocyte count (LYC), and the CALLY index were lower in the death group than in the survival group [(31±5) g/L vs. (37±6) g/L, (58±9)×10 9/L vs. (63±10)×10 9/L, 0.6 (0.4, 0.8)×10 9/L vs. 1.3 (0.8, 1.7)×10 9/L, 0.03 (0.02, 0.11) vs. 0.26 (0.13, 0.49); t=6.05, P<0.001; t=3.04, P=0.003; Z=5.82, P<0.001; Z=6.52, P<0.001, respectively]. Multivariate logistic regression analysis indicated that the APACHE Ⅱ score and CRP were risk factors for poor prognosis in critically ill patients ( OR=1.349, 95% CI: 1.004-1.821, P=0.048; OR=1.006, 95% CI: 1.003-1.010, P=0.001, respectively), while LYC and the CALLY index were protective factors ( OR=0.297, 95% CI: 0.111-0.795, P=0.016; OR=0.989, 95% CI: 0.955-0.999, P=0.001, respectively). The area under the ROC curve for the CALLY index predicting 28-day mortality in critically ill patients was 0.872 (95% CI: 0.800-0.926), which was higher than that of the APACHE Ⅱ score, LYC, and CRP [0.673 (95% CI: 0.582-0.756), 0.664 (95% CI: 0.573-0.748), 0.576 (95% CI: 0.482-0.665), respectively]. The cut-off values were 0.06, 20 points, 0.8×10 9/L, and 50 mg/L, respectively. When the CALLY index was 0.06, the specificity was 97.65%, the sensitivity was 72.97%, and the Youden index was 0.706. Conclusions:The APACHE Ⅱ score, CRP, LYC, and CALLY index are all factors influencing the prognosis of critically ill patients. The CALLY index has certain predictive value, but its false negative rate is relatively high. Further combination with other indicators is needed to improve its predictive value.

This paper summarizes the current status of research on the prevention and treatment of malignant tumors with traditional Chinese medicine(TCM),and points out that TCM has the advantages of being based on the holistic view and advocating the preven-tive treatment of diseases.The strategies of TCM in preventing and treating malignant tumors are proposed:first,it is necessary to clar-ify the leading or auxiliary treatment role in different stages of tumors and give full play to its strengths and advantages;second,find the characteristics of the superior and inferior populations and microscopic markers of tumor diagnosis and treatment to promote accurate di-agnosis and treatment;third,improve the overall diagnosis and treatment level of tumors by grasping the core pathogenesis and ensure clinical efficacy;fourth,incorporate modern medical therapy factors into the TCM tumor diagnosis and treatment system in order to in-tercept the disease;fifth,add TCM psychological intervention on the basis of the four-in-one holistic syndrome differentiation view to achieve harmony between body and spirit;sixth,improve the rehabilitation and health care system of tumors combined with traditional Chinese and Western medicine through the use of multiple methods to promote the recovery of diseases.In this way,the clinical effica-cy of TCM in preventing and treating tumors can be continuously improved,and the great goal of TCM in preventing and treating tumors and benefiting all mankind can be truly realized.

This paper summarizes the ideas and methods of Professor Wu Mianhua's diagnosis and treatment of prostate cancer based on the theory of"solidifying the root and clearing the filth",and believes that prostate cancer is a combination of deficiency in the root and excess in the manifestation,with deficiency and excess mixed.Spleen and kidney deficiency and cancer toxicity accumula-tion are the basis of prostate cancer,and the mutual entanglement of dampness,phlegm,heat and stasis is the key to the pathogenesis of prostate cancer.Clinically,prostate cancer is diagnosed and treated from the perspective of"solidifying the root and clearing the filth",warming the kidney and nourishing the kidney to consolidate the innate root,strengthening the spleen and activating the spleen to cultivate the acquired root,clearing heat and dampness,resolving phlegm and removing stasis to clear filth and detoxify.Strengthen the root to promote clearing the filth,and clear the fifth to help strengthen the root,achieve dynamic balance,and synergistically con-trol the progression of tumors.

Objective To explore the correlations between interleukin-6(IL-6),interleukin-8(IL-8),antimicrobial peptide LL-37 and the microbial abundance and the degree of mucosal injury in patients with trichomonal vaginitis(TV).Methods A total of 120 TV patients admitted from January 2022 to December 2024 were selected and divided into the occurrence group(n=63)and the non-occurrence group(n=57)according to presence and absence of mucosal injury.The general data,IL-6,IL-8,LL-37 and microbial abundance were compared between the two groups.According to the degree of mucosal injury,the occurrence group was divided into the mild subgroup(n=34),the moderate subgroup(n=20),and the severe subgroup(n=9).Pearson correlation analysis was applied to investigate the correlations between IL-6,IL-10,antimicrobial peptide LL-37,microbial abundance and the degree of mucosal injury.Multivariate logistic regression was used to analyze the influencing factors of mucosal injury in TV patients.The receiver operating characteristic curve(ROC)was used to evaluate the predictive value of relevant indicators for mucosal injury in TV patients.Result The levels of IL-6,IL-8,antimicrobial peptide LL-37,and the abundance of Actinobacteria and Gardnerella in the occurrence group were higher than those in the non-occurrence group,while the abundance of Firmicutes and Lactobacillus was lower than that in the non-occurrence group(P<0.05,P<0.01).Pearson correlation analysis showed that IL-6,IL-8,antimicrobial peptide LL-37,and abundance of Actinobacteria and Gardnerella were positively correlated with the degree of mucosal injury(r=0.543,0.713,0.352,0.409,0.659,P<0.01),while the abundance of Firmicutes and Lactobacillus was negatively correlated with the degree of mucosal injury(r=-0.540,-0.504,P<0.01).Multivariate logistic regression analysis showed that IL-6,IL-8,antimicrobial peptide LL-37,and abundance of Actinobacteria were risk factors for mucosal injury in TV patients,while the abundance of Firmicutes and the abundance of Lactobacillus were protective factors(P<0.05).The ROC curve showed that the area under the ROC curve(AUC)of the combined detection of IL-6,IL-8,antibacterial peptide 37,and the abundance of Actinobacteria,Firmicutes,and Lactobacillus in evaluating mucosal injury in TV patients was higher than that of the single detection(P<0.01).Conclusion IL-6,IL-8,antimicrobial peptide LL-37 and microbial abundance are closely related to the degree of mucosal injury in TV patients.The combined detection has a high value in evaluating the occurrence of mucosal injury in TV patients.

The development of malignant tumors is influenced by multiple factors,including genetics,environment,lifestyle,and pathogen infection.Viral infection plays a significant role in tumor development and progression.This article integrates the common pathways of seven oncogenic viruses(HPV,EBV,HBV,HCV,KSHV,HTLV-1,and HIV)based on the theory of cancer toxin pathomechanism.The findings reveal that cancer toxin formation is influenced by both internal factors(healthy qi deficiency,viscus dysfunction,and qi,blood,and body fluid stagnation)and external factors(viral infection,environmental factors,and the six exogenous pathogens),driving tumor development,metastasis,and recurrence.Viral infection not only provides the material foundation for cancer toxin but also accelerates its maturation and spread through chronic inflammation and immune imbalance,forming a complex pathogen-esis of"viral toxicity-endogenous cancer toxin",which translates into a three-stage strategy of"prevention,treatment,and post-recovery prevention".This article systematically discusses the pathogenesis of major cancer toxins and their associated tumors.Inte-grating the cancer toxin theory,the article explores preventive and therapeutic strategies for virus-associated malignancies,providing a theoretical basis and practical reference for the integrated prevention and treatment of tumors using traditional Chinese and Western medicine.

[Objective]To summarize Associate Professor WANG Xiaorong's experience in treating children with exogenous disease from the perspective of"three Yin diseases".[Methods]Through learning from teacher,sorting out outpatient medical records,combining relevant traditional Chinese medicine classic literature and modern research data,it summarized Teacher WANG's understanding of the etiology,pathogenesis and treatment method of"evil into three Yin"in children,and attached three experimental cases to prove it.[Results]Teacher WANG believes that because of the physiological characteristics of"delicate organs,not full of Qi"and"not full of young Yang",children are more likely to have"evil into three Yin"than adults when they are exogenous,and takes warming Yang to dispel cold,supporting the healthy energy,and harmonizing Yin and Yang as the basic treatment principles.If having a combination of diseases,"look at its pulse syndrome,know what the offense is,and treat it with the syndrome".Three medical records were attached for verification.In the case 1 of Taiyin disease syndrome in children,revised Guizhi Renshen Decoction was used to relieve the exterior and strengthen the spleen,warm the middle and remove dampness;in case 2 of Shaoyin disease syndrome,the prescription of Mahuang Xixin Fuzi Decoction or Sini Decoction was used to warm Yang and disperse cold,relieve the superficial signs;in case 3 of Jueyin disease syndrome,the prescription of Chaihu Guizhi Ganjiang Decoction was used to change Yin and Yang and relieve the exogenous signs.Three cases all got good curative effects.[Conclusion]Teacher WANG's syndrome differentiation combined with children's physiology,treats children's exogenous disease from the"three Yin disease",the clinical effect is remarkable,worthy of learning and promotion.

Objective:To analyze the prevalence and clinical characteristics of pertussis in children with different cough durations.Methods:From January 2021 to October 2022, information on children aged 0-18 years who visited eight hospitals in Shandong Province due to cough was enrolled. Pertussis serological antibody testing and/or nucleic acid testing were performed. The prevalence and clinical characteristics of pertussis were compared among the acute cough group, protracted cough group, and chronic cough group using the χ2 test or Fisher′s exact test. Results:A total of 1 565 children with cough were included in the study, of which 348 (22.24%) were laboratory-confirmed pertussis. There was a significant difference in the laboratory-confirmed rate of pertussis among different cough groups ( χ2=83.424, P<0.001). The confirmation rate of pertussis in the protracted cough group (42.21%) was significantly higher than that in the acute cough group (16.49%, P<0.05) and chronic cough group (19.50%, P<0.05). In each cough group, the age of children was significantly associated with the confirmed rate of pertussis, and the confirmed rate was relatively high in children aged 3 months to <2 years. Pertussis vaccination was significantly associated with the confirmed rate in all groups, and the confirmed rate was higher in unvaccinated children. Among laboratory-confirmed pertussis cases, the incidence of typical symptoms such as paroxysmal cough, whoop, and post-tussive emesis or sleep disturbance was significantly higher than that in the non-confirmed cases. In the protracted and chronic cough groups, the proportion of non-confirmed cases complicated with asthma/cough variant asthma (CVA) was significantly higher than that in pertussis-confirmed cases. Conclusion:There are differences in the confirmation rate of pertussis among children with different cough durations. The confirmation rate is significantly associated with age, vaccination status, and clinical symptoms. Enhancing clinical vigilance against pertussis, conducting early diagnosis, and getting timely and standardized vaccination are crucial for effectively controlling pertussis and preventing outbreaks.