Liver fibrosis is a chronic liver injury resulting from factors like viral hepatitis, autoimmune hepatitis, non-alcoholic steatohepatitis, fatty liver disease, and cholestatic liver disease. Liver transplantation is currently the gold standard for treating severe liver diseases. However, it is limited by a shortage of donor organs and the necessity for lifelong immunosuppressive therapy. Mesenchymal stem cells (MSCs) can differentiate into various liver cells and enhance liver function when transplanted into patients due to their differentiation and proliferation capabilities. Therefore, it can be used as an alternative therapy for treating liver diseases, especially for liver cirrhosis, liver failure, and liver transplant complications. However, due to the potential tumorigenic effects of MSCs, researchers are exploring a new approach to treating liver fibrosis using extracellular vesicles (exosomes) secreted by stem cells. Many studies show that exosomes released by stem cells can promote liver injury repair through various pathways, contributing to the treatment of liver fibrosis. In this review, we focus on the molecular mechanisms by which stem cell exosomes affect liver fibrosis through different pathways and their potential therapeutic targets. Additionally, we discuss the advantages of exosome therapy over stem cell therapy and the possible future directions of exosome research, including the prospects for clinical applications and the challenges to be overcome.

Objective To measure the range of cervical spine mobility in flight trainees and analyze its correlation with flight task performance.Methods A total of 55 participants were enrolled(30 in the experimental group,25 in the control group).An independently developed AI-based digital cervical spine function assessment system was used to measure rotational ranges in yaw,pitch,and roll directions,with comparative analysis performed against contralateral rotation.A subjective scoring scale was designed,and flight instructors of the experimental group were invited to provide performance ratings to explore the relationship between cervical mobility and flight task performance.Results Significant differences were observed between the experimental and control groups in left rotation(P<0.01),right rotation(P<0.05),and flexion(P<0.05).Within the experimental group,significant differences were found between left and right rotation(P<0.01)and between flexion and extension(P<0.01).Correlation analysis between flight performance scores and cervical mobility revealed a significant association between situational awareness and yaw range(r=-0.415,P<0.05).Conclusion The experimental group exhibited significant differences in certain cervical mobility parameters compared to the control group,suggesting that occupational characteristics may influence cervical mobility.The correlation between yaw range and situational awareness implies a potential link between head-neck yaw capability and vestibular-visual system functions,though further validation is required.

Renal interstitial fibrosis （RIF） is a common pathological change process from the development of various chronic nephropathies to the end stage， and it is an important histological manifestation of renal function decline. At present， no effective anti-fibrosis drugs have been found in clinical practice. In recent years， with the continuous development of traditional Chinese medicine （TCM） pharmacology， molecular biology， system biology， and network pharmacology， the research on regulating RIF with TCM monomer， single TCM， TCM compound， Chinese patent medicine， and TCM injection is deepening. Among them， Jianpi Yishen recipe， Shendi Bushen capsules， Jianzhong Bushen Xiaozheng decoction， Liuwei Dihuangtang， and Lycium barbarum polysaccharides can regulate transforming growth factor-β/small mother against decapentaplegic （TGF-β₁/Smads）， Wnt/β-catenin， and neurogenic locus notch homolog protein （Notch） signaling pathways. Wulingsan， Zhenwutang， pachymic acid ZA， pachymic acid ZC， and pachymic acid ZD， which mainly induce diuresis， can regulate the Wnt/β-catenin signaling pathway. Hirudin， curcumin， and Fuzheng Huayu recipe， which mainly promote blood circulation， can inhibit inflammation-related pathways such as p-nuclear transcription factor-κB （NF-κB）， Toll-like receptor 4/p-nuclear transcription factor-κB （TLR4/NF-κB）， and Janus kinase 2/signal transducer and activator of transcription 3 （JAK/STAT）， so as to achieve anti-inflammatory and anti-oxidation effects and alleviate the progression of RIF. Shenshuai Xiezhuo decoction， Shenkang injection， and Shenshuai recipe， which are mainly used for invigorating Qi， removing blood stasis， and removing turbidity， can inhibit transdifferentiation of pericytes-myofibroblasts through vascular endothelial growth factor receptor （VEGFR） signaling pathway. At present， there are many studies on the regulation of the RIF signaling pathway by TCM， but there is a lack of a systematic summary. In this study， by combing the signaling pathway of TCM in the treatment of RIF， the effective target of TCM treatment is screened， and its possible mechanism is found， which provides new ideas for clinical treatment and new drug research and development.

Objective:To compare the dose-response effects of single-fraction ultra-high dose rate (FLASH) and conventional dose rate (CONV) whole abdominal irradiation (WAI) with X-rays on acute radiation-induced intestinal injury in mice, in order to identify optimal dose parameters and potential mechanisms.Methods:A total of 186 male C57BL/6J mice were randomly assigned to a non-irradiation group ( n=6), FLASH irradiation groups ( n=90), and CONV irradiation groups ( n=90). Acute radiation-induced intestinal injury models were established using single-fraction WAI with 11, 12, 13, 14, and 15 Gy X-rays (200 Gy/s for FLASH and 4 Gy/min for CONV). Changes in body weight, stool characteristics, and disease activity index (DAI) scores were assessed at 9 d post-irradiation. At 7 d post-irradiation at 11, 12, and 13 Gy, the intestines were collected for macroscopic examination and length measurement. The small intestine was selected for HE staining and quantitative analysis of intestinal crypt number and mucosal epithelial thickness. The survival of mice was assessed at 15 d post-WAI across all dose groups. Results:After single-fraction WAI at 11, 12, and 13 Gy, the body weight was higher in the FLASH group than that in the CONV group ( t=10.17, 12.65, 10.16, P<0.05). The DAI scores for the FLASH group were 1.00±1.10, 3.17±0.75, and 2.83±1.17, respectively, which were lower than those of the CONV group (4.33±0.52, 7.00±0.00, 8.60±0.55; t=8.70, 11.71, 14.99, P<0.05). However, after WAI at 14 Gy and 15 Gy, there were no significant differences in body weight and DAI between the FLASH group and the CONV group ( P>0.05). At 7 d after single-fraction WAI at 11, 12, and 13 Gy, mice in the FLASH group exhibited less intestinal congestion, edema, and shortening compared with the CONV group. The difference between the FLASH and CONV groups were statistically significant in small intestine length at 11 and 13 Gy ( t=4.42, 3.78, P<0.05), and in colorectal length at 11 and 12 Gy ( t=3.97, 3.12, P<0.05). Small intestine HE staining revealed superior preservation of intestinal architecture in the FLASH group compared with the CONV group, characterized by longer villi, increased crypt numbers, thicker mucosal epithelium, and enhanced structural integrity. The differences in crypt number and mucosal epithelial thickness were statistically significant ( tcrypt=13.10, 23.80, 11.90; tmucosal=5.75, 2.64, 7.74; P<0.05). At 15 d post-irradiation, the survival rate in the 15 Gy FLASH group was higher than that in the CONV group (50% vs. 10%, χ2=5.39, P<0.05), with a median survival extension of 6 d ( HR=0.340, 95% CI: 0.115 4-0.999 9). No significant survival differences were observed between the FLASH group and the CONV group at 11, 12, 13, and 14 Gy ( P>0.05). Conclusions:FLASH irradiation significantly alleviated acute radiation-induced intestinal injury from medium single-fraction WAI with 11, 12, and 13 Gy X-rays compared with CONV irradiation, and showed potential to improve mouse survival after single-fraction WAI at 15 Gy. This effect is likely associated with the preservation of intestinal crypts and exhibits a dose-dependent relationship.

Liver fibrosis is a chronic liver injury resulting from factors like viral hepatitis, autoimmune hepatitis, non-alcoholic steatohepatitis, fatty liver disease, and cholestatic liver disease. Liver transplantation is currently the gold standard for treating severe liver diseases. However, it is limited by a shortage of donor organs and the necessity for lifelong immunosuppressive therapy. Mesenchymal stem cells (MSCs) can differentiate into various liver cells and enhance liver function when transplanted into patients due to their differentiation and proliferation capabilities. Therefore, it can be used as an alternative therapy for treating liver diseases, especially for liver cirrhosis, liver failure, and liver transplant complications. However, due to the potential tumorigenic effects of MSCs, researchers are exploring a new approach to treating liver fibrosis using extracellular vesicles (exosomes) secreted by stem cells. Many studies show that exosomes released by stem cells can promote liver injury repair through various pathways, contributing to the treatment of liver fibrosis. In this review, we focus on the molecular mechanisms by which stem cell exosomes affect liver fibrosis through different pathways and their potential therapeutic targets. Additionally, we discuss the advantages of exosome therapy over stem cell therapy and the possible future directions of exosome research, including the prospects for clinical applications and the challenges to be overcome.

This paper focuses on the application of health big data in cancer screening. Firstly, the sources and characteristics of health big data are introduced, then the commonly used epidemiological designs and analytical techniques in hospital-based cancer screening studies are summarized and the application scenarios of such studies are described. Finally, the challenges and future development in the application of health big data are analyzed to provide reference for the future studies.

Malignant tumors(commonly referred to as cancer)represent a major global public health challenge and contribute significantly to the worldwide disease burden.Early screening plays a critical role in improving detection rates,enabling timely intervention,and enhancing pa-tient survival rates.However,current cancer screening guidelines primarily focus on site-specific screening,which may not fully address the need for comprehensive early detection.A scientifical-ly rational,multi-cancer screening approach offers several advantages:it optimizes the use of bio-logical samples,reduces time costs for participants,enhances the efficiency and comprehensive-ness of screening,and minimizes overall expenses.Such an approach also facilitates the rational allocation of healthcare resources,ultimately helping to reduce the societal burden of cancer.To address this need,the Cancer Epidemiology Committee of the Chinese Anti-Cancer Association has developed the Expert Consensus on Combined Screening for Common Cancers in China.This consensus integrates multidisciplinary expertise and synthesizes the latest domestic and interna-tional researches on cancer screening,early detection,and treatment for prevalent malignancies.Drawing upon China's unique demographic and healthcare context,as well as practical screening experiences,the consensus provides evidence-based recommendations on target populations,screening technologies,and procedural workflows for multi-cancer screening.These guidelines align with the principles and methodologies established by the World Health Organization(WHO),aiming to:enhance the effectiveness of combined cancer screening in China,improve early detec-tion rates,and provide a scientific foundation for national cancer prevention and control strategies.

Objective:To observe the impact of Yi Jin Jing(Sinew-transforming Exercise)plus individualized exercise prescription combining treadmill training and strength training on geriatric female patients with primary osteoporosis(POP).Methods:Seventy-five geriatric female POP patients were recruited and randomized into a control group,an exercise therapy group,or a combined group,with 25 cases in each group.The control group received regular treatment,including health education and oral administration of calcium carbonate and vitamin D3 granules and alendronate sodium.The exercise therapy group received treadmill-based exercise and strength training 3 times weekly in addition to the intervention given to the control group.The combined group underwent treadmill-based exercise,strength training,and Yi Jin Jing training 3 times weekly in addition to the intervention given to the control group.The intervention lasted 24 weeks in each group.Before and after treatment,the visual analog scale(VAS)score,grip strength,bone density of L1-L4 and femoral neck,and serum levels of parathyroid hormone(PTH),25-hydroxyvitamin D3[25(OH)D3],osteocalcin(OC),procollagen Ⅰ N-terminal propeptide(PINP),and beta C-telopeptide of type Ⅰ collagen(β-CTX)were compared.Results:After treatment,the combined group and exercise therapy group showed a significant decrease in the VAS score and an increase in the grip strength(P<0.05).The bone density of L1-L4 and femoral head rose in all three groups after the intervention(P<0.05),together with markedly decreased serum PTH,OC,PINP,and β-CTX levels(P<0.05)and a notably increased 25(OH)D3 level(P<0.05).After treatment,the combined and exercise therapy groups had a significantly lower VAS score and higher grip strength(P<0.05)compared to the control group;the former two groups also had a higher bone density of L1-L4 and femoral head(P<0.05),lower serum PTH,PINP,and β-CTX levels(P<0.05)and a higher 25(OH)D3 level(P<0.05).Compared to the exercise therapy group,the combined group had a lower VAS score,higher L1-L4 and femoral head bone density,and lower serum PINP and β-CTX levels.Conclusion:Based on regular treatment,personalized exercise prescriptions centered on Yi Jin Jing can alleviate pain,enhance grip strength and bone density,and correct abnormal expression of bone metabolism markers in geriatric females with POP.

Objective:To compare the efficacy of posteromedial combined with lateral Frosch approach versus anterior medial and lateral dual incision approach in open reduction and internal fixation for Schatzker type VI tibial plateau fractures.Methods:A retrospective cohort study was conducted to analyze the clinical data of 41 patients with Schatzker type VI tibial plateau fractures, who were admitted to the 940th Hospital of the Joint Logistics Support Force of the PLA from January 2018 to May 2024, including 23 males and 18 females, aged 34-79 years [(50.7±7.7)years]. Twenty-three patients underwent open reduction and internal fixation via the posteromedial combined with lateral Frosch approach (posterior approach group), while 18 patients underwent the same procedure via the anterior medial and lateral dual incision approach (anterior approach group). The following parameters were compared between the two groups: operation duration, intraoperative blood loss, postoperative drainage volume, depth of articular surface depression and tibial plateau width measured preoperatively, at 7 days, 3 months postoperatively, and at the last follow-up, medial proximal tibial angle (MPTA) and posterior proximal tibial angle (PPTA) measured at 7 days, 3 months postoperatively, and at the last follow-up, visual analogue scale (VAS) scores assessed preoperatively, at 7 days postoperatively, and at the last follow-up, American Knee Society (KSS) score and knee flexion range of motion assessed at 7 days, 3 months postoperatively, and at the last follow-up, fracture healing status at the last follow-up, and incidence of postoperative complications.Results:All the patients were followed up for 12-16 months [(14.3±2.1)months]. The operation duration was (119.6±11.8)minutes in the posterior approach group, which was significantly shorter than (140.3±10.6)minutes in the anterior approach group ( P<0.05). There were no statistically significant differences in intraoperative blood loss or postoperative drainage volume between the two groups ( P>0.05). No significant differences were found in the preoperative depth of articular surface depression or tibial plateau width between the two groups ( P>0.05). At 7 days, 3 months postoperatively, and at the last follow-up, the depth of articular surface depression was 0.8(0.6, 1.0)mm, 0.6(0.5, 0.8)mm, and 0.6(0.5, 0.7)mm in the posterior approach group, which were significantly shorter than 1.1(0.9, 1.3)mm, 0.8(0.7, 1.0)mm, and 0.8(0.7, 1.0)mm in the anterior approach group ( P<0.05). The tibial plateau width at the same time points was 71.0(69.1, 73.5)mm, 70.5(69.2, 72.9)mm, and 70.5(69.3, 72.5)mm in the posterior approach group, which were significantly shorter than 73.0(72.3, 74.2)mm, 71.5(71.0, 73.0)mm, and 71.5(71.1, 72.6)mm in the anterior approach group ( P<0.05). At 7 days, 3 months postoperatively, and at the last follow-up, the MPTA values were (87.4±0.7)°, (87.7±0.6)°, and (87.9±0.5)° in the posterior approach group, which were significantly larger than (85.2±2.5)°, (86.0±2.2)°, and (86.3±2.0)° in the anterior approach group ( P<0.01). The PPTA values at the same time points were (9.5±0.7)°, (9.0±0.5)°, and (8.6±0.4)° in the posterior approach group, which were significantly smaller than (11.2±1.0)°, (10.3±0.8)°, and (9.8±0.7)° in the anterior approach group ( P<0.01). There was no significant difference in the preoperative VAS score between the two groups ( P>0.05). At 7 days postoperatively and at the last follow-up, the VAS scores were 4.0(3.0, 5.0)points and 0.5(0.0, 2.0)points in the posterior approach group, which were significantly lower than 5.0(4.0, 5.0)points and 1.0(1.0, 3.0)points in the anterior approach group ( P<0.05). At 7 days, 3 months postoperatively, and at the last follow-up, the KSS scores were 62.5(57.0, 67.5)points, 75.5(72.0, 82.5)points, and 87.0(82.5, 93.5)points in the posterior approach group, which were significantly higher than 61.5(54.5, 63.0)points, 74.0(68.0, 79.0)points, and 85.5(78.0, 88.5)points in the anterior approach group ( P<0.05). The knee flexion range of motion was 90.0(85.0, 95.0)°, 115.0(109.0, 122.0)°, and 126.0(120.0, 130.0)° in the posterior approach group, which were significantly greater than 80.5(75.2, 85.8)°, 110.0(104.0, 115.0)°, and 119.0(113.0, 122.0)° in the anterior approach group ( P<0.05). At the last follow-up, all the fractures were healed in both groups. No statistically significant difference was found in the incidence of postoperative complications between the two groups ( P>0.05). Conclusion:Compared to the anterior medial and lateral dual incision approach, the posteromedial combined with lateral Frosch approach demonstrates superior advantages in operation duration, reduction quality, pain relief, functional recovery in the treatment of Schatzker type VI tibial plateau fractures, while the incidence of complications is comparable.