Objective To explore the application of plasma 7 microRNA (miR7) testing in the differential diagnosis of very early-stage hepatocellular carcinoma (HCC). Methods This study is a multicenter real-world study. Patients with single hepatic lesion (maximum diameter≤2 cm) who underwent plasma miR7 testing at Zhongshan Hospital, Fudan University, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Anhui Provincial Hospital, and Peking University People’s Hospital between January 2019 and December 2024 were retrospectively enrolled. Patients were divided into very early-stage HCC group and non-HCC group, and the clinical pathological characteristics of the two groups were compared. The value of plasma miR7 levels, alpha-fetoprotein (AFP), and des-gamma-carboxy prothrombin (DCP) in the differential diagnosis of very early-stage HCC was evaluated using receiver operating characteristic (ROC) curves and area under the curve (AUC). In patients with both negative AFP and DCP (AFP＜20 ng/mL, DCP＜40 mAU/mL), the diagnostic value of plasma miR7 for very early-stage HCC was analyzed. Results A total of 64 528 patients from 4 hospitals underwent miR7 testing, and 1 682 were finally included, of which 1 073 were diagnosed with very early-stage HCC and 609 were diagnosed with non-HCC. The positive rate of miR7 in HCC patients was significantly higher than that in non-HCC patients (67.9% vs 24.3%, P＜0.001). ROC curves showed that the AUCs for miR7, AFP, and DCP in distinguishing HCC patients from the non-HCC individuals were 0.718, 0.682, and 0.642, respectively. The sensitivities were 67.85%, 43.71%, and 44.45%, and the specificities were 75.70%, 92.78%, and 83.91%, respectively. The pairwise comparison of AUCs showed that the diagnostic efficacy of plasma miR7 detection was significantly better than that of AFP or DCP (P＜0.05). Although its specificity was slightly lower than AFP and DCP, the sensitivity was significantly higher. Among patients negative for both AFP and DCP, miR7 maintained an AUC of 0.728 for diagnosing very early-stage HCC, with 67.82% sensitivity and 77.73% specificity. Conclusions Plasma miR7 testing is a potential molecular marker with high sensitivity and specificity for the differential diagnosis of small hepatic nodules. In patients with very early-stage HCC lacking effective molecular markers (negative for both AFP and DCP), miR7 can serve as a novel and effective molecular marker to assist diagnosis.

Drug repurposing offers a promising alternative to traditional drug development and significantly reduces costs and timelines by identifying new therapeutic uses for existing drugs. However, the current approaches often rely on limited data sources and simplistic hypotheses, which restrict their ability to capture the multi-faceted nature of biological systems. This study introduces adaptive multi-view learning (AMVL), a novel methodology that integrates chemical-induced transcriptional profiles (CTPs), knowledge graph (KG) embeddings, and large language model (LLM) representations, to enhance drug repurposing predictions. AMVL incorporates an innovative similarity matrix expansion strategy and leverages multi-view learning (MVL), matrix factorization, and ensemble optimization techniques to integrate heterogeneous multi-source data. Comprehensive evaluations on benchmark datasets (Fdataset, Cdataset, and Ydataset) and the large-scale iDrug dataset demonstrate that AMVL outperforms state-of-the-art (SOTA) methods, achieving superior accuracy in predicting drug-disease associations across multiple metrics. Literature-based validation further confirmed the model's predictive capabilities, with seven out of the top ten predictions corroborated by post-2011 evidence. To promote transparency and reproducibility, all data and codes used in this study were open-sourced, providing resources for processing CTPs, KG, and LLM-based similarity calculations, along with the complete AMVL algorithm and benchmarking procedures. By unifying diverse data modalities, AMVL offers a robust and scalable solution for accelerating drug discovery, fostering advancements in translational medicine and integrating multi-omics data. We aim to inspire further innovations in multi-source data integration and support the development of more precise and efficient strategies for advancing drug discovery and translational medicine.

Objective:To evaluate the early efficacy and safety of the exclusively transnasal endoscopic approach and the combined transconjunctival-endoscopic approach in the resection of benign orbital apex lesions.Methods:A retrospective analysis was conducted on 51 patients who underwent transnasal endoscopic resection of benign lesions in the orbital apex at Peking University Third Hospital from May 2021 to December 2024. The study population was composed of 17 males and 34 females, with the age of (39.4±12.4) years (range: 4 to 65 years). Pathology diagnoses were identified as orbital cavernous hemangioma (OCH, n=38), schwannoma ( n=8), solitary fibrous tumor ( n=1), mucocele ( n=1), optic nerve sheath meningioma ( n=1), pseudotumor ( n=1), and organized hematoma ( n=1). Two surgical approaches were compared as the exclusively transnasal endoscopic resection ( n=27) and the combined transconjunctival-endoscopic approach (combined approach, n=24). Preoperative and postoperative evaluations were conducted for the best corrected visual acuity (BCVA), visual field, intraocular pressure (IOP), and exophthalmos before and after surgery. Demographic characteristics, tumor features, and postoperative complications were analyzed between the two surgical groups. Differences in Orbital Resection by Intranasal Technique (ORBIT) stage between the two surgical approaches were analyzed. SPSS 27.0 software was used for statistical analysis. Results:Among the 51 patients, 3 schwannomas underwent intracapsular resection (1 via exclusively transnasal endoscopic approach, and 2 via combined approach), and the remaining 48 patients underwent complete tumor resection. Significant postoperative improvements were observed in BCVA, visual field, IOP and exophthalmos ( t value was 2.96, 4.34, 4.85, and 4.63, respectively, all P<0.05). The combined approach required longer operative time but showed comparable intraoperative blood loss. Tumors resected via the combined approach were larger in volume, though not statistically significant. Postoperative complications (e.g., diplopia, mydriasis) were more frequent in the combined approach group but resolved within a short-term period. There was no significant difference in ORBIT stage between the two groups ( P=0.178). Conclusions:Both exclusively transnasal and combined transconjunctival-endoscopic approaches prove safe and effective for benign orbital apex lesions resection. The combined approach ensures complete tumor removal.

International studies have established that electrons, X-rays, protons, and heavy ions can all be utilized in ultra-high dose-rate radiotherapy. Among these modalities, megavoltage X-ray ultra-high dose-rate radiotherapy holds particularly broad clinical promise. With its long-term expertise in high-intensity pulsed radiation sources, the Institute of Applied Electronics at the China Academy of Engineering Physics has pioneered global solutions for generating and measuring megavoltage X-rays ultra-high dose-rate radiotherapy, positioning China at the forefront of this field. Herein, we review the development history, current status, and future trends in ultra-high dose-rate X-ray generation, measurement, and protection. The insights provided aim to serve as a reliable reference for clinical and preclinical research, equipment development, and standardization, thereby enabling more precise and reliable megavoltage ultra-high dose-rate X-ray production and measurement. We hope this work will significantly support further research and clinical translation of ultra-high dose-rate radiotherapy technology.

Objective:To establish a rapid and precise dose measurement method with EBT4 film and ensure its measurement accuracy to be within the required range through strict operational procedures for the purpose of addressing the two essential issues of poor measurement accuracy and timeliness of EBT film under FLASH conditions.Methods:After storing under different humidity conditions for a certain period of time, the film was exposed to radiation for analyzing the influence of air humidity on the intrinsic performance of EBT film. By means of repeated scanning operations and the film angle rotation, the influences of repeated scanning and film placement angle were analuzed. Parabolic correction method was used to reduce the spatial position influence during the scanning process. By analying the relationship between net optical density (netOD) and absorbed dose through the comparison of three fitting method, the optimal fitting curve was selected. After irradiation of the same batch of films for 5 min and 24 h, the film doses were calibrated and then compared with ionization chamber-measured result. The rapid and precise film dosimetry method was used to measure both the percentage depth dose from X-rays at ultra-high dose rate and the dose distribution at a depth of 2 cm in water.Results:Air humidity had the greatest influence on the intrinsic performance of EBT film (approximately 20%). The average deviation of repeated scans is within 0.5%. The angle at which the film is placed significantly affected the readouts of the film with the maximum influence approximately 70%. The net optical density combined with polynomial fitting can control the fitting residuals of 1-16 Gy within 3%. The change rate of light channels at 5 min already mostly met the requirements of the rapid mode (< 0.5%). Compared with the measurement result obtained using the reference ionization chamber, the deviations of the 5 min or 24 h dose calibration curves were all within 2%.Conclusions:The EBT4 film can be employed as a precise dosimeter to quickly measure the FLASH radiation dose. Rapid and precise FLASH dose measurements can meet the stringent requirements of both preclinical and clinical FLASH research.

Objective:This study aims to explore the independent and interactive effects of childhood trauma (CT) and major depressive disorder (MDD) on amygdala subregion volumes and to examine whether volumetric changes in these subregions mediate the relationship between CT and depressive severity.Methods:A total of 129 MDD patients and 127 age- and sex-matched healthy controls were recruited from Nanjing Brain Hospital between October 2022 and November 2024. All participants underwent 3D-T 1 weighted MRI scans,and amygdala subregions were segmented using the FreeSurfer software. Depressive and anxiety symptoms were assessed with the 17-item Hamilton Depression Rating Scale (HAMD 17) and the Hamilton Anxiety Scale (HAMA),respectively. Childhood trauma exposure was evaluated via the Childhood Trauma Questionnaire (CTQ). Generalized linear models (GLM) were applied to analyze the main and interactive effects of MDD diagnosis (depression/healthy controls) and CT (presence/absence),adjusting for age,estimated intracranial volume,sex,medication history,and education years. Partial correlation and mediation analyses were conducted to explore associations between amygdala subregion volumes and clinical measures in MDD patients. Results:MDD diagnosis was independently associated with increased volumes in the right central nucleus ( Wald χ2=9.09, P=0.026) and medial nucleus ( Wald χ2=10.08, P=0.026). CT exposure was independently associated with reduced volumes in the right central nucleus ( Wald χ2=7.99, P=0.047) and medial nucleus ( Wald χ2=9.20, P=0.047). No significant interaction effects between MDD and CT were observed in any amygdala subregion. Mediation analysis revealed that reduced right medial nucleus volume partially mediated the relationship between total CTQ scores and depressive severity (proportion mediated: 26.69%,95% CI=0.002-0.060) and mediated the association between emotional neglect and depressive severity (proportion mediated: 26.75%,95% CI=0.006-0.150). Such mediating effects were not found for the right central nucleus. Conclusion:CT and MDD exhibit divergent patterns of influence on amygdala subregions. CT is linked to volumetric reductions,whereas MDD is associated with volumetric enlargement. Reduced volume of the right medial nucleus mediates the relationship between CT and depression severity.

Objective:To quickly identify the causes of morphological abnormalities of microcytic hypochromic erythrocytes that are detected during health checkups for recruitment of flying cadets, and to explore its role in medical selection.Methods:Students with hemoglobin (Hb)≥110 g/L and morphological abnormalities of microcytic hypochromic erythrocytes detected during the 2023 medical selection of flying cadets by Guangzhou Selection Center were selected. Their medical history was collected, and iron metabolism, Hb electrophoresis and hemoglobin H (HbH) inclusion bodies were examined to screen for thalassemia and iron deficiency. The diagnosis of thalassemia was confirmed by thalassemia gene testing. Those with iron deficiency received iron supplementation therapy and the recovery of Hb was observed.Results:Ninety-one students were diagnosed with Hb≥110 g/L and morphological abnormalities of microcytic hypochromic erythrocytes, accounting for 4.35% of the total. Among these cases, 85 with abnormal Hb electrophoresis and/or positive HbH inclusion body detection were confirmed as thalassemia minor via thalassemia genetic testing, and 3 cases with normal iron metabolism, Hb electrophoresis, and negative HbH inclusion body detection. A total of 88 cases of thalassemia minor were diagnosed, accounting for 96.70% of the total. Among them, 2 cases were complicated with iron deficiency while 3 were diagnosed with iron deficiency erythropoiesis. Out of the 91 students with Hb≥110 g/L and morphological abnormalities of microcytic hypochromic erythrocytes, 9 were recruited, including 7 cases with thalassemia minor (Hb≥130 g/L), 1 case with thalassemia minor combined with iron deficiency erythropoiesis (Hb≥130 g/L after iron supplementation), and 1 case with iron deficiency erythropoiesis (Hb≥130 g/L after iron supplementation). Among the 9 recruits, 8 were followed up for over one year and the results of their military physical fitness tests all reached or exceeded the standards, but the remaining one dropped out and lost contact.Conclusions:Among physical examinees during medical selection of flying cadets in South China, thalassemia is the leading cause of morphological abnormalities of microcytic hypochromic erythrocytes. Results of iron metabolism, Hb electrophoresis, and HbH inclusion body detection can help identify thalassemia and iron deficiency quickly. Cases of morphological abnormalities of microcytic hypochromic erythrocytes caused by iron deficiency can be considered eligible for selection after Hb levels return to normal following iron supplementation therapy. Students who are diagnosed with thalassemia with Hb<130 g/L can be determined as ineligible. Such rapid identification can facilitate the medical selection of the above 2 types of students.

Objective To investigate the clinical characteristics of lower respiratory tract infections oc-currence and respiratory system prognosis in infantile stage of children patients with bronchopulmonary dys-plasia(BPD).Methods Fifty premature infants with lower respiratory tract infection and BPD treated in this hospital from March 2017 to December 2020 were selected as the BPD group and 50 preterm infants with low-er respiratory tract infection without BPD during the same period were selected as the non-BPD group.The clinical data and occurrence situation of respiratory system diseases within 3 years after birth in the two groups were collected and analyzed.Results Compared with the non-BPD group,the incidence rates of tachy-pnoea(48.0%vs.12.0%),wheeze(44.0%vs.10.0%),wheezing rale(44.0%vs.10.0%),three concave sign(28.0%vs.8.0%),cyanosis(20.0%vs.4.0%),severe pneumonia(48.0%vs.12.0%)and respirato-ry failure(20.0%vs.4.0%)in the BPD group were higher,the hospitalization duration[7.5(7.0,10.0)d vs.7.0(6.0,7.0)d]was longer,the reaching peak time ratio[18.20%(14.65%,22.25%)vs.24.85%(19.55%,32.78%)],the reaching peak volume ratio[22.15%(19.43%,23.83%)vs.25.65%(22.40%,34.90%)]and the inspiratory/expiratory ratio(0.70±0.12 vs.0.76±0.11)were lower,the 3-year total lower respiratory tract infection times[5.0(4.0,10.0)times vs.3.0(2.0,5.0)times],wheeze times[2.0(1.0,4.0)times vs.0.5(0,1.0)times],the hospitalization times[3.00(2.00,5.00)times vs.2.00(1.00,2.00)times],severe pneumonia times[2.0(1.0,2.0)times vs.1.0(0,1.0)times]and wheeze times in differ-ent ages were more,total hospitalization duration[29.50(19.50,38.25)d vs.13.00(7.00,17.75)d]was lon-ger,the differences were statistically significant(P<0.05).Conclusion The children patients with BPD are prone to lower respiratory tract infections,especially 0-<1 years old,the proportion of severe pneumonia af-ter infection is higher and wheezing is easily to develop.

Aptamers are a class of short DNA/RNA single strand oligonucleotides that can bind to target molecules with high affinity specificity. They have the advantages of high affinity specificity, low molecular weight and low immunogenicity, and have been widely used in biomedical research, clinical diagnosis and therapy, and biosensor development. Systematic evolution of ligand by exponential enrichment (SELEX) is an in vitro screening technique, which enriches the aptamers with high affinity and specific binding to the target through multiple cycles of screening, and has a wide range of applications in tumor therapy.

Objective To systematically evaluate the risk factors for new-onset atrial fibrillation (NOAF) after off-pump coronary bypass grafting (OPCABG). Methods PubMed, EMbase, Web of Science, The Cochrane Library, Wanfang data, CBM, VIP, and CNKI databases were systematically searched by computer to collect studies related to the risk factors for NOAF after OPCABG from the establishment of the database to July 2023. Literature screening and quality evaluation were conducted independently by two researchers. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the literature. RevMan 5.3 and Stata15.0 were used for meta-analysis. Results Finally, 19 case-control studies related to the risk factors for NOAF after OPCABG were included, all of which were high-quality literature with NOS score≥6 points, with a total of 7019 subjects. The results of meta-analysis showed that the following factors were associated with NOAF after OPCABG: (1) the patient’s own factors: age (MD=3.51, 95%CI 2.39 to 4.63, P<0.01); (2) preoperative factors: history of hypertension (OR=1.17, 95%CI 1.04 to 1.32, P=0.01), history of myocardial infarction (OR=1.21, 95%CI 1.06 to 1.38, P<0.01), history of percutaneous coronary intervention (OR=2.22, 95%CI 1.03 to 4.77, P=0.04), EuroSCOREⅡ score (MD=0.59, 95%CI 0.25 to 0.94, P<0.01), low-density lipoprotein (MD=0.11, 95%CI 0.02 to 0.20, P=0.02), left atrial diameter (MD=1.64, 95%CI 0.24 to 3.04, P=0.02); (3) postoperative and treatment factors: left ventricular end-diastolic diameter (MD=1.16, 95%CI 0.33 to 1.99, P<0.01), left ventricular ejection fraction (MD=0.90, 95%CI 0.07 to 1.73, P=0.03), mechanical ventilation time (MD=2.78, 95%CI 1.65 to 3.90, P<0.01), B-type natriuretic peptide (MD=219.67, 95%CI 27.46 to 411.88, P=0.03), ICU retention time (MD=7.07, 95%CI 5.64 to 8.50, P<0.01). Conclusion The existing evidence shows that age, history of hypertension, history of myocardial infarction, history of percutaneous coronary intervention, preoperative EuroSCOREⅡscore, preoperative low-density lipoprotein, preoperative left atrial diameter, postoperative left ventricular end-diastolic diameter, postoperative left ventricular ejection fraction, postoperative mechanical ventilation time, postoperative B-type natriuretic peptide, and postoperative ICU retention time are risk factors for NOAF after OPCABG. Clinical attention should be paid to the above factors to achieve early identification, thereby reducing the incidence of NOAF after OPCABG and improving the clinical prognosis of patients.