Guided by the classical theory of "the liver being the general and the spleen being the defender"， this study explores the intrinsic relationship between the pathogenesis of hepatic fibrosis （HF） and immune-metabolic reprogramming. It is proposed that the pathogenesis of HF in traditional Chinese medicine demonstrates a high degree of biological correspondence to the modern medical concept of the immune-metabolic interaction network. Specifically， immune homeostasis imbalance is analogous to the failure of the spleen's defense and malnourishment of the liver collaterals； lipid metabolic disorder and inflammatory infiltration correspond to the wood constraint， earth congestion， and phlegm-dampness turbid accumulation； "heat-transformation brewing toxin" promotes glycolytic reprogramming and， together with "healthy qi deficiency and stasis binding" leads to microenvironment deterioration. Accordingly， a micro-level syndrome differentiation and treatment strategy is proposed， which emphasizes on enriching earth and nourishing wood， consolidating defense and moistening collaterals to restore immune homeostasis， soothing the liver and activating the spleen， dispelling dampness and eliminate turbidity to correct lipid metabolic disorder， clearing heat and removing toxins， reinforcing healthy qi and resolving stasis to intervene in glycolytic reprogramming and the inflammatory microenvironment， thereby ameliorating the progression of HF.

Objective: To quantify the spatiotemporal factors and built environment effects on daily blood collection volumes at fixed sites using multi-source spatiotemporal data, explore the influence radii of different point of interest(POI) categories, and develop a classification framework for sites, thereby providing data references for efficiency diagnosis and network optimization of blood collection sites. Methods: We collected daily blood donation records from 16 fixed whole blood collection sites in Guangzhou in 2023, constructing a balanced “site-day” panel dataset (16 sites × 365 days = 5 840 observations). Multi-source geospatial data, including Amap POI, OpenStreetMap (OSM) road network, and meteorological data were integrated to establish 300 m, 500 m, 800 m, and 1 000 m buffer zones around each site. Variables extracted included counts of surrounding commercial facilities, distance to the nearest subway station, rainfall, and temperature. A two-way fixed effects panel model was employed with a first-order lag term of the dependent variable to capture the inertial effect of blood donation behavior. Based on the significant regression coefficients, a "Structure-Function Index (SFI)" was constructed for each site to identify its optimal buffer radius. Combining inherent site capacity (fixed effects) with the optimal SFI, a two-dimensional quadrant diagram was created to classify the sites. Results: The optimized model showed an adjusted R of 0.89 and a Durbin-Watson statistic of 1.90, with the lag term coefficient stable at 0.36 (P<0.05). Temporal effects were significant: campaign days increased blood collection by 1 717.75 mL, holidays by 3 755.53 mL, and overlapping holidays with campaign days by 5 650.49 mL (P<0.05). Rainy days reduced collection by approximately 419 mL (P<0.05), and each 1℃ rise in daily average temperature decreased collection by approximately 31 mL (P<0.05). Distance to the nearest subway station was significantly positive (coefficient 0.95-1.39, P<0.05). POI effects showed scale-dependent differences: within 300 m, leisure and entertainment (+173.65 mL/unit) and shopping (+2.95 mL/unit) were significantly positive; within 500 m, tourist attractions (+72.55 mL/unit) and hotels (+40.09 mL/unit) were significantly positive; within 1 000 m, these effects diminished. Based on the two-dimensional classification of inherent collection capacity and optimal SFI, sites were categorized into four types: core, potential, adjustment, and resource-dependent. Conclusion: This study elucidates the multidimensional determinants of blood collection site efficiency, and provides quantitative evidence for performance diagnosis. It proposes a "concentric-zone planning" approach for site selection assessment alongside a" station-specific strategy" classification framework, offering data-driven references for network planning and resource allocation in blood collection and supply institutions. It should be noted that blood donation site selection also involves complex factors such as budgetary constraints, interdepartmental coordination, and venue conditions. This study provides a spatial econometric perspective for the quantitative optimization of blood collection networks.

ObjectiveBased on ultra performance liquid chromatography-quadrupole-electrostatic field orbital trap high-resolution mass spectrometry（UPLC-Q-Orbitrap-MS）， to identify the in vivo and in vitro chemical components of total phenolic acids in Gei Herba（TPAGH）， and to clarify the pharmacological effects and potential mechanisms of the effective part in promoting acute wound healing and inhibiting scar formation. MethodsUPLC-Q-Orbitrap-MS was used to identify the chemical components of TPAGH and ingredients absorbed in vivo after topical administration. A total of 120 ICR mice were randomly divided into the model group， recombinant human epidermal growth factor（rhEGF） group（4 mg·kg^-1）， and low， medium， and high dose groups of TPAGH（3.5， 7， 14 mg·kg^-1）， with 24 mice in each group. A full-thickness skin excision model was constructed， and each administration group was coated with the drug at the wound site， and the model group was treated with an equal volume of normal saline， the treatment was continued for 30 days， during which 8 mice from each group were sacrificed on days 6， 12， and 30. The healing of the wounds in the mice was observed， and histopathological changes in the skin tissues were dynamically observed by hematoxylin-eosin（HE）， Masson， and Sirius red staining， and enzyme-linked immunosorbent assay（ELISA） was used to dynamically measure the contents of interleukin-6（IL-6）， tumor necrosis factor-α（TNF-α）， vascular endothelial growth factor A（VEGFA）， matrix metalloproteinase（MMP）-3 and MMP-9 in skin tissues. Network pharmacology was used to predict the targets related to the promotion of acute wound healing and the inhibition of scar formation by TPAGH， and molecular docking of key components and targets was performed. Gene Ontology（GO） biological process analysis and Kyoto Encyclopedia of Genes and Genomes（KEGG） pathway enrichment analysis were carried out for the related targets， so as to construct a network diagram of herbal material-compound-target-pathway-pharmacological effect-disease for further exploring its potential mechanisms. ResultsA total of 146 compounds were identified in TPAGH， including 28 phenylpropanoids， 31 tannins， 23 triterpenes， 49 flavonoids， and 15 others， and 16 prototype components were found in the serum of mice. Pharmacodynamic results showed that， compared with the model group， the TPAGH groups showed a significant increase in relative wound healing rate and relative scar inhibition rate（P<0.05）， and the number of new capillaries， number of fibroblasts， number of new skin appendages， epidermal regeneration rate， collagen deposition ratio， and Ⅲ/Ⅰ collagen ratio in the tissue were significantly improved（P<0.05， 0.01）， the levels of IL-6， TNF-α， MMP-3 and MMP-9 in the skin tissues were reduced to different degrees， while the level of VEGFA was increased. Network pharmacology analysis screened 10 core targets， including tumor protein 53（TP53）， sarcoma receptor coactivator（SRC）， protein kinase B（Akt）1， signal transducer and activator of transcription 3（STAT3）， epidermal growth factor receptor（EGFR） and so on， participating in 75 signaling pathways such as advanced glycation end-products（AGE）-receptor for AGE（AGE/RAGE） signaling pathway， phosphatidylinositol 3-kinase（PI3K）/Akt signaling pathway， mitogen-activated protein kinase（MAPK） signaling pathway. Molecular docking confirmed that the key components genistein， geraniin， and casuariin had good binding ability to TP53， SRC， Akt1， STAT3 and EGFR. ConclusionThis study comprehensively reflects the chemical composition of TPAGH and the absorbed components after topical administration through UPLC-Q-Orbitrap-MS. TPAGH significantly regulates key indicators of skin healing and tissue reconstruction， thereby clarifying its role in promoting acute wound healing and inhibiting scar formation. By combining in vitro and in vivo component identification with network pharmacology， the study explores how key components may bind to targets such as TP53， Akt1 and EGFR， exerting therapeutic effects through related pathways such as immune inflammation and vascular regeneration.

Purpose To investigate the clinical,imaging,and pathological features of Kikuchi-Fujimoto disease(KFD).Methods A retrospective analysis was conducted on 123 pathologically confirmed KFD cases.Clinical and imaging data were collected,and histopathological features were evaluated using HE staining,immunohistochemistry,in situ hybridization for EBER,and molecular analyses(TCR/Ig gene rearrangements by PCR with capillary electro-phoresis).Results Among the 123 patients,the male-to-female ratio was 1∶2,with a median age of 30 years.All patients presented with lymphadenopathy.Among 30 hospitalized patients,63.3％(19/30)had fever,and 23.3％(7/30)had concurrent autoimmune diseases.Of the 12 patients who underwent PET-CT,91.7％(11/12)were sus-pected of malignancy,prompting biopsy recommendations.Among 47 consultation cases,27.7％(13/47)were ini-tially misdiagnosed as lymphoma.Histopathological examination revealed proliferative,necrotic,and xanthomatous phases,which coexisted or occurred independently.The proliferative phase was characterized by atypical lymphocytes and histiocytes,the necrotic phase by abundant eosinophilic fibrin deposits and nuclear debris,and the xanthomatous phase by clusters of foam-like histiocytes.Immunohistochemically analyses revealed that atypical lymphocytes were neg-ative for CD20,CD4,and CD56 but positive for CD3,CD8,TIA1,Granzyme B,and Perforin.Histiocytes expressed CD68,CD163,and MPO,while CD123-positive plasmacytoid dendritic cells were predominantly located around the le-sions and blood vessels.EBER was positive in individual cells in 4 cases.TCR gene rearrangement was positive in 2 cases and suspected positive in 3 cases,while Ig rearrangement was positive and suspected positive in 1 case each.Conclusion KFD exhibits clinical,imaging,and pathological features that can mimic lymphoma,highlighting the im-portance of accurate diagnosis to avoid misdiagnosis and inappropriate treatment.

Circular RNA(circRNA)is a single-stranded RNA with a covalently closed loop structure,which has a more stable structure and lower immunogenicity than linear RNA.Many studies have shown that circRNA has characteristics such as conservation,stability,and tissue specificity,and can act as a microRNA(miRNA)sponge to interact with proteins and translation templates,and regulate biological functions such as gene expression and signal transduction.Based on the characteristics and various bio-logical functions of circRNA,some endogenous circRNA plays an important regulatory role in the occur-rence and development of tumors and has the potential to be used as biomarkers and therapeutic targets.In addition,mRNA drugs have limitations such as instability,easy degradation,low translation efficien-cy,and immunogenicity in practical applications.Engineered translatable exogenous circRNA can solve some of the limitations of linear mRNA application and become a new type of potential efficient drug.In this paper,we introduce the circRNA biogenesis mechanisms,specific biological functions,and the cur-rent status of diagnosis and treatment applications in tumors.This includes the diagnostic application of endogenous circRNA in tumors,the design and synthesis strategies of exogenous circRNA,and the cur-rent progress in the design and application of engineered circRNA vaccines using their stable and efficient protein expression functions in the treatment of tumors.Finally,we discuss the current clinical diagnostic application problems of circRNA,the challenges of exogenous circRNA therapeutic applications,and the prospects of the field.

Purpose To investigate the clinical,imaging,and pathological features of Kikuchi-Fujimoto disease(KFD).Methods A retrospective analysis was conducted on 123 pathologically confirmed KFD cases.Clinical and imaging data were collected,and histopathological features were evaluated using HE staining,immunohistochemistry,in situ hybridization for EBER,and molecular analyses(TCR/Ig gene rearrangements by PCR with capillary electro-phoresis).Results Among the 123 patients,the male-to-female ratio was 1∶2,with a median age of 30 years.All patients presented with lymphadenopathy.Among 30 hospitalized patients,63.3％(19/30)had fever,and 23.3％(7/30)had concurrent autoimmune diseases.Of the 12 patients who underwent PET-CT,91.7％(11/12)were sus-pected of malignancy,prompting biopsy recommendations.Among 47 consultation cases,27.7％(13/47)were ini-tially misdiagnosed as lymphoma.Histopathological examination revealed proliferative,necrotic,and xanthomatous phases,which coexisted or occurred independently.The proliferative phase was characterized by atypical lymphocytes and histiocytes,the necrotic phase by abundant eosinophilic fibrin deposits and nuclear debris,and the xanthomatous phase by clusters of foam-like histiocytes.Immunohistochemically analyses revealed that atypical lymphocytes were neg-ative for CD20,CD4,and CD56 but positive for CD3,CD8,TIA1,Granzyme B,and Perforin.Histiocytes expressed CD68,CD163,and MPO,while CD123-positive plasmacytoid dendritic cells were predominantly located around the le-sions and blood vessels.EBER was positive in individual cells in 4 cases.TCR gene rearrangement was positive in 2 cases and suspected positive in 3 cases,while Ig rearrangement was positive and suspected positive in 1 case each.Conclusion KFD exhibits clinical,imaging,and pathological features that can mimic lymphoma,highlighting the im-portance of accurate diagnosis to avoid misdiagnosis and inappropriate treatment.

Circular RNA(circRNA)is a single-stranded RNA with a covalently closed loop structure,which has a more stable structure and lower immunogenicity than linear RNA.Many studies have shown that circRNA has characteristics such as conservation,stability,and tissue specificity,and can act as a microRNA(miRNA)sponge to interact with proteins and translation templates,and regulate biological functions such as gene expression and signal transduction.Based on the characteristics and various bio-logical functions of circRNA,some endogenous circRNA plays an important regulatory role in the occur-rence and development of tumors and has the potential to be used as biomarkers and therapeutic targets.In addition,mRNA drugs have limitations such as instability,easy degradation,low translation efficien-cy,and immunogenicity in practical applications.Engineered translatable exogenous circRNA can solve some of the limitations of linear mRNA application and become a new type of potential efficient drug.In this paper,we introduce the circRNA biogenesis mechanisms,specific biological functions,and the cur-rent status of diagnosis and treatment applications in tumors.This includes the diagnostic application of endogenous circRNA in tumors,the design and synthesis strategies of exogenous circRNA,and the cur-rent progress in the design and application of engineered circRNA vaccines using their stable and efficient protein expression functions in the treatment of tumors.Finally,we discuss the current clinical diagnostic application problems of circRNA,the challenges of exogenous circRNA therapeutic applications,and the prospects of the field.

Purpose To investigate the clinicopathological features and prognosis of adult large B-cell lymphoma with IRF4 rearrangement(LBCL-IRF4r).Methods Clinical data of 63 adult LBCL-IRF4r cases were collected.The EnVision two-step method was employed for immunohistochemical staining,and fluorescence in situ hybridization was used to detect rearrangements or deletions of the IRF4,BCL2,MYC,BCL6,and TP53 genes.The relationship be-tween clinicopathological features and prognosis was analyzed and compared with data from 132 adult non-specified dif-fuse large B-cell lymphoma(DLBCL)cases.Results Among the 63 adult LBCL-IRF4r patients,the male to female ratio was 1.1∶1,with a median age of 54.0 years(range 20-84 years),and 14 cases(22.2％)were＜40 years old,24 cases(38.1％)were between 40 and 60 years old,and 25 cases(39.7％)were＞60 years old.18 cases(28.6％)were involved in Waldeyer's ring,along with 8 cases(12.7％)in cervical lymph nodes,7 cases(11.1％)in other lymph nodes and lymphatic organs,13 cases(20.6％)in stomach,4 cases(6.4％)in intestine,and 13 cases(20.6％)in other extranodal sites.63 cases showed IRF4 rearrangements,with no BCL2 and MYC translocations(0/58),30.9％(17/55)had BCL6 translocations,and 16.3％(8/49)had TP53 deletions.59 pa-tients were followed up for a median of 28 months(range 1-65 months).48 patients(81.4％)achieved complete re-sponse,10 patients(16.9％)experienced disease progression or relapse,and 3 patients(5.1％)died.Univariate a-nalysis showed that lactate dehydrogenase level,Ann Arbor stage,international prognostic index(IPI)score,growth pattern,Hans classification,and double expression of BCL2 and C-MYC were significantly associated with progression-free survival.Age,Ann Arbor stage,and IPI score were significantly associated with overall survival.Multivariate Cox regression analysis showed that double expression of BCL2 and C-MYC was an independent prognostic factor for pro-gression-free survival.Adult LBCL-IRF4r had significantly higher complete response rate and progression-free survival than adult DLBCL.Conclusion LBCL-IRF4r occurs in adults of all age groups,commonly affecting Waldeyer's ring,cervical lymph nodes,and gastrointestinal tract,and has a favorable clinical prognosis.

Objective:To explore the development process of family resilience in children with congenital pseudarthrosis of the tibia (CPT) and to understand the long-term challenges and coping strategies that CPT imposes on the families of affected children.Methods:This study combined purposive sampling and theoretical sampling. It selected 15 caregivers of CPT children from Hunan Children's Hospital for semi-structured interviews. Grounded theory was used to analyze the interview results.Results:The development of family resilience in CPT children's families occurred in three stages: pre-formation stage, formation stage, and maintenance stage. In facing negative emotions and family challenges, caregivers first needed to rebuild their inner beliefs. They then adjusted the family organizational model, adopted open and inclusive communication, and actively sought external support to foster the development of family resilience. Ultimately, caregivers were able to self-regulate their emotions, accumulate caregiving experience, and begin to shift their life perspective.Conclusions:The development of family resilience in CPT children's families is a dynamic, multi-stage process with interactions of multiple factors. Healthcare providers should offer professional health guidance according to the different stages of family development. Moreover, the government and schools should increase their attention and support, working together with families and healthcare providers to enhance family resilience for children with CPT.

Objective To analyze the characteristics of MR amide proton transfer(APT)imaging and enhancement signals in benign and malignant muscular soft tissue tumors and to explore the value of MR APT imaging,contrast enhancement techniques,and their combined application in the differential diagnosis of benign and malignant muscular soft tissue tumors.Methods A retrospective analysis was conducted on 34 patients with muscular soft tissue tumors confirmed by pathology,including 13 malignant and 21 benign.All patients underwent both MR with contrast enhancement and APT imaging examinations before surgery.APT values were obtained through post-processing on an image workstation.The enhancement signal characteristics and APT values were compared between benign and malignant muscular soft tissue tumors.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of the two techniques alone and in combination for differentiating between benign and malignant muscular soft tissue tumors.Results There were significant differences in enhancement signal characteristics on MR and APT values between benign and malignant muscular soft tissue tumors(P<0.05).The enhancement signal of malignant tumors was more heterogeneous,with higher enhancement degree than benign tumors;the APT value of benign tumors was(2.20±0.93)%,and the APT value of malignant tumors was(3.52±0.83)%,the ROC curve analysis determined a cutoff APT value of 2.82%for malignant tumors,with a diagnostic specificity of 90.5%and sensitivity of 76.9%.The area under the curve(AUC)for MR with contrast enhancement,APT imaging,and the combination of the two techniques were 0.694,0.857 and 0.894,respectively.No significant differences were found in the diagnostic efficacy between MR with contrast enhancement and APT imaging(Z=1.587,P=0.112 6)or between APT imaging and the combination of the two tech-niques(Z=1.217,P=0.223 4),but there was significant difference between MR with contrast enhancement and the combination of the two techniques(Z=2.428,P=0.015 2).Moreover,the combination of the two techniques showed the overall highest diag-nostic efficacy.Conclusion The combined application of MR APT imaging and contrast enhancement techniques is more beneficial for the qualitative diagnosis of muscular soft tissue tumors.