Objective To explore the diagnostic value of hemodynamic and morphological characteristics based on four-dimensional flow magnetic resonance imaging(4D Flow MRI)for unstable saccular intracranial aneurysms(IAs).Methods Seventy-four patients with saccular unruptured intracranial aneurysms(UIAs)who underwent 4D Flow MRI examinations were selected.Morphological and hemodynamic data of the IAs were collected and followed up.According to the follow-up results,patients were divided into stable group and unstable group.Logistic regression analysis was used to identify factors associated with the unstable group,and the diag-nostic performance of the model was evaluated using the receiver operating characteristic(ROC)curves and the area under the curve(AUC).Results The aneurysm diameter,height,width,neck width,and aspect ratio(AR)value in the unstable group were greater than those in the stable group.The wall shear stress(WSS)at the aneurysm neck and the parent artery inflow,as well as the end diastolic velocity(EDV)at the parent artery inflow,were lower in the unstable group than those in the stable group(P＜0.05).Multivariate logistic regression analysis showed that the AR and WSS at the aneurysm neck were independent predictors of unstable IAs(P＜0.05).The combined model of WSS at the aneurysm neck and AR showed an AUC of 0.742[95％confidence interval(CI)0.608-0.875],repre-sented the highest diagnostic performance.Conclusion The hemodynamic characteristics quantified by 4D Flow MRI offer supple-mentary information for risk assessment of IAs.Combining hemodynamic and morphological characteristics is of significant value in identi-fying unstable saccular IAs.

Objective To explore the diagnostic value of hemodynamic and morphological characteristics based on four-dimensional flow magnetic resonance imaging(4D Flow MRI)for unstable saccular intracranial aneurysms(IAs).Methods Seventy-four patients with saccular unruptured intracranial aneurysms(UIAs)who underwent 4D Flow MRI examinations were selected.Morphological and hemodynamic data of the IAs were collected and followed up.According to the follow-up results,patients were divided into stable group and unstable group.Logistic regression analysis was used to identify factors associated with the unstable group,and the diag-nostic performance of the model was evaluated using the receiver operating characteristic(ROC)curves and the area under the curve(AUC).Results The aneurysm diameter,height,width,neck width,and aspect ratio(AR)value in the unstable group were greater than those in the stable group.The wall shear stress(WSS)at the aneurysm neck and the parent artery inflow,as well as the end diastolic velocity(EDV)at the parent artery inflow,were lower in the unstable group than those in the stable group(P＜0.05).Multivariate logistic regression analysis showed that the AR and WSS at the aneurysm neck were independent predictors of unstable IAs(P＜0.05).The combined model of WSS at the aneurysm neck and AR showed an AUC of 0.742[95％confidence interval(CI)0.608-0.875],repre-sented the highest diagnostic performance.Conclusion The hemodynamic characteristics quantified by 4D Flow MRI offer supple-mentary information for risk assessment of IAs.Combining hemodynamic and morphological characteristics is of significant value in identi-fying unstable saccular IAs.

Objective:To compare the clinical efficacies of gasless transoral vestibular robotic surgery and open surgery for the treatment of thyroglossal duct cysts.Methods:A retrospective analysis was conducted on patients with thyroglossal duct cysts who underwent surgical treatment in the Department of Otolaryngology at Sun Yat-sen Memorial Hospital, Sun Yat-sen University from August 2020 to October 2023. According to the differences in surgical methods, patients were divided into a robotic surgery group and an open surgery group. Statistical analysis was conducted on demographic data, surgical time, bleeding volumes, drainage volumes, postoperative complications, scar conditions, postoperative aesthetic scores, and recurrence rates of the two groups of patients. For normally distributed measurement data, inter-group comparison was done via independent-sample t-test. For non-normally distributed data, Mann-Whitney U test was applied. Comparisons of composition ratios or rates were performed using the χ2 test or Fisher′s exact probability method. Results:A total of 44 patients with thyroglossal duct cysts who met the inclusion and exclusion criteria were included, including 22 males and 22 females, aged from 3 to 73 years old. Both the robotic surgery group and the open surgery group had respectively 22 cases. The maximum diameter of tumors of the open surgery group was 3.45(2.50, 4.00) cm, while the robotic surgery group measured 2.50 (2.10, 3.20) cm, with the open group demonstrating significantly larger tumor dimensions compared to the robotic group ( Z=-2.329, P<0.05). Compared to the open surgery group, the robotic surgery group showed significantly more surgical time [105.00 (95.00, 135.00) min vs. 65.00(58.75, 76.25) min, Z=-5.377, P<0.05], postoperative hospitalization time [4.00 (3.75, 5.00) days vs. 3.00(2.00, 4.00) days, Z=-3.202, P<0.05] and bleeding volume [20.00 (10.00, 20.00) ml vs. 5.00 (5.00, 10.00) ml, Z=-4.769, P<0.05], but had less scar length [0 cm vs. 4.00 (2.00, 5.00) cm, Z=-6.097, P<0.05] and better postoperative cosmetic satisfaction [10.00 (10.00, 10.00) vs. 8.00 (6.75, 8.00), Z=-5.221, P<0.05]. With follow-up of 10.0-48.0 months, both the robotic surgery group and the open surgery group showed no recurrence. There was no significant difference in the follow-up time between the two groups ( Z=-0.224, P=0.823). Conclusion:Gasless transoral vestibular robotic surgery is safe and feasible for the treatment of thyroglossal duct cysts, with efficacy comparable to traditional surgery, which can provide a new option for the treatment of thyroglossal duct cysts.

Objective:To compare the efficacy of gasless robotic surgery via transaxillary approach and combined axillary-retroauricular approach for unilateral N1b PTC, and to explore the safety and effectiveness of gasless robotic surgery via transaxillary approach for unilateral N1b PTC. Methods:Unilateral N1b PTC patients who underwent surgery in the Department of Otolaryngology, Sun Yat Sen Memorial Hospital, Sun Yat sen University between July 2016 and December 2024 were included and analyzed. According to the inclusion and exclusion criteria and the differences of surgical approaches, the patients were divided into the transaxillary approach（TA） group and the combined axillary-retroauricular approach（TARA） group. The demographic data, operation time, intraoperative blood loss, postoperative drainage volume, postoperative complications, shoulder function evaluation, postoperative visual analogue scale（VAS） of neck aesthetics and recurrence of the two groups were statistically analyzed. Results:A total of 88 patients undergoing gasless robotic surgery were included in this study, including 23 cases in the TA group and 65 cases in the TARA group. The proportion of males in the TA group was significantly higher than that in the TARA group（56.5% vs 21.5%, χ²=9.776, P=0.002）. The total operation time in the TA group was significantly lower than that in the TARA Group（180.00[155.00, 220.00]min vs 220.00[177.50, 272.50]min, z=-2.775, P=0.006）, and the postoperative blood loss in the TA group was significantly lower than that in the TARA Group（30.00[20.00, 50.00]ml vs 50.00[30.00, 60.00]ml, Z=-2.127, P=0.033）. The proportion of area Ⅱ-Ⅴ in the TA group and the TARA group was 87.0% and 70.8%, respectively, and there was no significant difference between the two groups（P>0.05）. There was no significant difference in lateral cervical lymph node dissection and central lymph node dissection between the two groups（P>0.05）. During the follow-up period, no recurrence was found in the two groups, and there was no significant difference in the incidence of complications between the two groups（P>0.05）. According to the stratification of dynamic recurrence risk assessment, it can be seen that the proportion of curative effect satisfaction in the TA group was as high as 95.7%, and that in the TARA group was as high as 81.5%, with no significant difference between the two groups. There was no significant difference in VAS score of neck, Constant Shoulder Score and NDⅡ scale between the two groups（P>0.05）. Conclusion:Gasless robotic surgery via transaxillary approach for unilateral N1b PTC is safe and feasible, and the amount postoperative lymph node acquisition is equivalent to that of combined axillary-retroauricular approach, which can provide a new choice for the treatment of unilateral N1b PTC patients.
Humans ; Robotic Surgical Procedures/methods* ; Axilla/surgery* ; Male ; Female ; Operative Time ; Middle Aged ; Adult ; Treatment Outcome ; Postoperative Complications

Innovative drugs are defined as new chemical entities that play a vital role in the treatment and maintenance of human health. While single-target innovative drugs have achieved notable success, they face limitations in addressing the increasingly complex and precise spectra of diseases. The advent of multi-target innovative drugs offers new opportunities, supported by a growing body of pharmacological evidence. Herbal medicines are recognized as valuable sources of multi-target therapeutics due to their proven efficacy in treating complex diseases. However, the identification and validation of such drugs from herbal sources continue to pose significant challenges. This paper presents a comprehensive review of the literature on traditional Chinese medicine, integrated medicine, chemistry, and biology from 2015 to 2025. It summarizes the strategies employed in integrating traditional Chinese and Western medicine for innovative drug development, along with successful application cases. We believe these efforts will deepen understanding of the current landscape, accelerate the discovery of multi-target innovative drugs from herbal medicine, and contribute to addressing major human health challenges.

Objective:To compare the clinical efficacies of gasless transoral vestibular robotic surgery and open surgery for the treatment of thyroglossal duct cysts.Methods:A retrospective analysis was conducted on patients with thyroglossal duct cysts who underwent surgical treatment in the Department of Otolaryngology at Sun Yat-sen Memorial Hospital, Sun Yat-sen University from August 2020 to October 2023. According to the differences in surgical methods, patients were divided into a robotic surgery group and an open surgery group. Statistical analysis was conducted on demographic data, surgical time, bleeding volumes, drainage volumes, postoperative complications, scar conditions, postoperative aesthetic scores, and recurrence rates of the two groups of patients. For normally distributed measurement data, inter-group comparison was done via independent-sample t-test. For non-normally distributed data, Mann-Whitney U test was applied. Comparisons of composition ratios or rates were performed using the χ2 test or Fisher′s exact probability method. Results:A total of 44 patients with thyroglossal duct cysts who met the inclusion and exclusion criteria were included, including 22 males and 22 females, aged from 3 to 73 years old. Both the robotic surgery group and the open surgery group had respectively 22 cases. The maximum diameter of tumors of the open surgery group was 3.45(2.50, 4.00) cm, while the robotic surgery group measured 2.50 (2.10, 3.20) cm, with the open group demonstrating significantly larger tumor dimensions compared to the robotic group ( Z=-2.329, P<0.05). Compared to the open surgery group, the robotic surgery group showed significantly more surgical time [105.00 (95.00, 135.00) min vs. 65.00(58.75, 76.25) min, Z=-5.377, P<0.05], postoperative hospitalization time [4.00 (3.75, 5.00) days vs. 3.00(2.00, 4.00) days, Z=-3.202, P<0.05] and bleeding volume [20.00 (10.00, 20.00) ml vs. 5.00 (5.00, 10.00) ml, Z=-4.769, P<0.05], but had less scar length [0 cm vs. 4.00 (2.00, 5.00) cm, Z=-6.097, P<0.05] and better postoperative cosmetic satisfaction [10.00 (10.00, 10.00) vs. 8.00 (6.75, 8.00), Z=-5.221, P<0.05]. With follow-up of 10.0-48.0 months, both the robotic surgery group and the open surgery group showed no recurrence. There was no significant difference in the follow-up time between the two groups ( Z=-0.224, P=0.823). Conclusion:Gasless transoral vestibular robotic surgery is safe and feasible for the treatment of thyroglossal duct cysts, with efficacy comparable to traditional surgery, which can provide a new option for the treatment of thyroglossal duct cysts.

Purpose To evaluate the changes of carotid artery elasticity in children with type 1 diabetes mellitus (T1DM) via RF-data based quantitative analysis on vessel stiffness technique (R-VQS),and to detect its correlation with the duration of diabetes mellitus and blood sugar control. Materials and Methods A total of 75 children with T1DM from the Pediatrics Department of Henan Chest Hospital,the Pediatrics Department of Henan People's Hospital,and the Endocrinology,Genetics,and Metabolism Department of Henan Children's Hospital were prospectively collected from September 2019 to November 2021. According to the T1DM duration,all patients were divided into long course group (duration ≥5 years,n=30 cases) and short course group (duration<5 years,n=45 cases). And 30 age and sex matched controls were also collected. The systolic diameter (Diam),vascular displacement (Dist),pulse wave velocity (PWV),stiffness coefficient (HC) and intima-media thickness (IMT) of common carotid artery were measured by R-VQS. Fasting blood glucose (FBG),glycosylated hemoglobin (HbA1c),triglyceride (TG),serum total cholesterol (TC),high-density lipoprotein (HDL),low-density lipoprotein cholesterol (LDL) were collected to compared the differences of parameters among the three groups. Results The FBG,HbA1c and IMT of the long and short course groups were all significantly higher than those of control group (all P<0.05). There were statistically significant differences in PWV and HC among the three groups (F=22.854,P<0.001;F=16.811,P<0.001;H=33.214,P<0.001). The course of disease was moderately correlated with PWV and HC (r=0.621,0.517,respectively,P<0.001). HbA1c was moderately correlated with PWV (r=0.562,P<0.001). Conclusion Early onset of T1DM in children may lead to decreased carotid artery elasticity,and prolonged hyperglycemia can aggravate the degree of arterial elasticity damage. R-VQS is a simple,effective,and non-invasive method for assessing arterial elasticity,providing a basis for clinical diagnosis and treatment.

Objective:To evaluate the arousal effect of plantar reflex area and acupoint massage combined with music therapy in patients with brain trauma and coma.Methods:From March 2022 to March 2023, 90 patients with brain trauma and coma who were treated in the Neurosurgery Intensive Care Unit of Tangshan Gongren Hospital in Hebei Province were selected as the research subject. According to the random number table method, patients were divided into a control group, experimental group 1, and experimental group 2, with 30 cases in each group. The control group received routine nursing for brain trauma, while the experimental group 1 received music therapy with the natural voice on the basis of the control group. The experimental group 2 was treated with plantar reflex area and acupoint massage treatment on the basis of the experimental group 1. This study compared the Glasgow Coma Scale (GCS) scores and Coma Recovery Scale-Revised (CRS-R) scores of three groups of patients before and after intervention.Results:After 2, 4, and 6 weeks of intervention, the GCS scores and CRS-R scores of patients in experimental group 2 were higher than those in the control group and experimental group 1, with statistically significant differences ( P<0.05) . Conclusions:The combination of plantar reflex area and acupoint massage with music therapy has a certain arousal effect on patients with brain trauma and coma, and can be promoted and applied in clinical practice.

The nasal swab samples of swine influenza(SI)suspected pigs were collected and tested for H3 subtype swine influenza virus(SIV)positive by RT-qPCR.The positive samples were inoc-ulated into SPF chicken embryos for virus isolation.The full genome sequencing and sequence anal-ysis of the isolated H3N2 subtype SIV were conducted,and its pathogenicity was studied.The re-sults showed that a strain of SIV was successfully isolated and identified as H3N2 subtype by RT-PCR,named A/Swine/Yunnan/KM/06/2023(H3N2).The BLSAT results showed that the eight segments of SIV H3N2 KM had the highest homology with eight different strains of swine influ-enza or human influenza viruses,reaching 95.41％-97.49％.The HA and NA segments were de-rived from H3N2 subtype SIV,the NP segment was derived from H1N1 subtype human influenza virus,the M segment was derived from H1N2 subtype SIV,and all other segments were derived from H1N1 subtype SIV.The key receptor sites(190D,223V,226I,228S)of HA protein remained unchanged.The pathogenicity experiment results showed that infected piglets exhibited symptoms such as fever,sneezing,runny nose,the virus could be detoxified to the outside through the nasal cavity,and the lungs had different degrees of lesion.Immunohistochemistry(IHC)showed that the virus could replicate in the lungs.In conclusion,a strain of H3N2 subtype SIV was successfully iso-lated,and the genetic evolution,molecular characteristics and pathogenicity of the virus were stud-ied.It revealed that H3N2 subtype SIV is constantly evolving and had pathogenicity to piglets,pro-viding a reference for monitoring and preventing SIV epidemics in China,and provided a candidate strain for SI vaccine development.

Objective:To evaluate the efficacy of neoadjuvant chemoimmunotherapy (NACI) combined with transoral robotic surgery (TORS) in the treatment of locally advanced oropharyngeal squamous cell carcinoma (OPSCC).Methods:This was a retrospective study of 15 patients with locally advanced OPSCC who underwent TORS after neoadjuvant therapy (NAT) at the Department of Otolaryngology-Head and Neck Surgery of Sun Yat-sen Memorial Hospital of Sun Yat-sen University from April 2019 to February 2023. There were 12 males and 3 females, aged 31 to 74 years. Twelve cases were tonsil cancer, and 3 cases were tongue base cancer. There were 11 cases in stage Ⅲ and 4 cases in stage Ⅳ. Two patients received neoadjuvant chemotherapy and 13 patients received NACI, with 2 to 3 cycles, and all patients underwent TORS after multidisciplinary team consultation. The clinicopathological characteristics, surgical outcomes, and oncological results were summarized.Results:All surgeries were successfully completed with negative surgical margins, and no case was required conversion surgery. All patients were fed via nasogastric tubes postoperatively, with a median gastric tube stay of 7 days (range: 2-60 days). No tracheotomy was applied. There were no major complications such as postoperative bleeding. Pathological complete response (pCR) was found in 10 cases (76.9%) among the 13 patients with NACI. The follow-up time was 21 months (range: 10-47 months), and there was no death or distant metastasis. One patient with rT0N3M0 tonsil cancer had local recurrence 5 months after surgery. The 2-year overall survival and 2-year disease-free survival were respectively 100.0% and 93.3% in the 15 patients.Conclusion:NACI combined with TORS provides a safe, effective and minimally invasive treatment for patients with locally advanced oropharyngeal squamous cell carcinoma.