Diabetes mellitus, characterized by glucose metabolism disorders and marked by insulin deficiency or insulin resistance, has seen a continuous rise in prevalence. In recent years, islet transplantation has matured as a therapeutic approach for diabetes, becoming an important method for glycemic control and the reduction of diabetes-related complications. Donor selection directly influences transplant outcomes, and various research institutions worldwide have proposed multiple scoring systems to optimize donor assessment, such as the University of Alberta scoring system and the North American Islet Donor Score. This article explores the impact of key factors such as donor age, body mass index and ischemia time on islet transplantation. Combining practical experience in pancreatic donor selection from Shanghai Changzheng Hospital, it proposes screening criteria for pancreatic donors suitable for China, aiming to provide new evidence for improving the success rate of islet transplantation.

OBJECTIVE: To develop a user-friendly visualization application for the automatic annotation of Human Phenotype Ontology (HPO) terms based on large language models and retrieval-augmented generation (RAG) technology, and to validate its performance in an authoritative case dataset. METHODS: By integrating the domestic open-source large language model DeepSeek-V3 with RAG technology, an interactive web application was deployed on the Streamlit cloud platform. Using only the latest official HPO dataset as the data source, the lightweight sentence-embedding model BAAI/bge-small-en-v1.5 was employed to construct a FAISS vector index. During the online phase, a four-step closed-loop process is automatically completed: multilingual translation, phenotype phrase extraction, RAG candidate retrieval, term mapping, and official database validation. 121 English case reports publicly released by BMJ Case Reports and Oxford Medical Case Reports (with a gold-standard HPO set of 1 794 terms) were selected for application validation. Precision, recall, and F1 score were calculated and compared horizontally with traditional dictionary tools, standalone large language models, and the similar application "RAG-HPO". Finally, replace the model with the more advanced ChatGPT-5 and evaluate its performance on the newly extracted dataset. RESULTS: An HPO term automatic annotation visualization application named PhenoRAG, based on large language models and RAG technology, was successfully developed. Users can access it directly via a web link. Across the 112 cases, a total of 2 150 HPO terms were generated; 2,064 (96.0%) were fully validated by the official database, with a hallucination rate of 1.3% and an HPO ID-name mismatch rate of 2.7%. After deduplication, 1,906 terms remained for testing. The overall precision was 63.65%, recall was 67.34%, and F1 was 65.44%, significantly outperforming traditional annotation tools (F1: 0.45-0.49, P < 0.001). Although PhenoRAG's F1 was lower than that of RAG-HPO (F1 = 0.78, P < 0.001), which relies on a manually constructed synonym database of 54 000 entries plus the HPO dataset, it requires no additional dictionary maintenance and can be used without any background in computer programming. Moreover, after switching to the GPT-5 model, PhenoRAG exhibited no hallucination rate on the new dataset, and its F1 score significantly increased (P = 0.038). CONCLUSION Without constructing a synonym database, the PhenoRAG achieved high-accuracy automatic mapping from clinical text to standard HPO terms. It features a low usage threshold, free access, and a Chinese-language interface, and can directly serve rare disease diagnosis, genetic counseling, and research scenarios in China and worldwide, warranting further clinical promotion and multicenter validation.
Humans ; Phenotype ; Biological Ontologies ; Language ; Software ; Large Language Models

[摘 要] 目的：探讨蟾毒灵（BU）对肿瘤相关巨噬细胞（TAM）介导的结直肠癌（CRC）细胞程序性死亡蛋白-配体1（PD-L1）表达的调控作用及其分子机制。方法：采用HCT116细胞与THP-1来源巨噬细胞构建体外共培养体系。佛波酯（PMA）诱导THP-1细胞分化为M0型巨噬细胞，进一步以HCT116细胞条件培养基（CM）刺激形成TAM样细胞。流式细胞术检测CD11b、CD206表达，以评价巨噬细胞极化水平；RT-qPCR及WB法检测TGF-β、IL-10、STAT3/p-STAT3及PD-L1表达变化；慢病毒转染构建STAT3敲低细胞系HCT116sh-STAT3，结合BU干预验证STAT3/PD-L1信号通路作用。结果：HCT116细胞CM可诱导巨噬细胞向M2表型极化，表现为CD11b⁺CD206⁺细胞比例升高（P < 0.01）及TGF-β、IL-10表达增加（均P < 0.001）。TAM条件培养基可显著促进HCT116细胞STAT3磷酸化（P < 0.001）并上调PD-L1 mRNA及蛋白表达水平（P < 0.001或P < 0.01）。BU干预后，TAM介导的STAT3磷酸化水平明显下降，PD-L1表达同步下调（均P < 0.01）。STAT3敲低可降低PD-L1表达，其作用趋势与BU一致。结论：BU可通过抑制TAM介导的STAT3信号激活，下调CRC细胞PD-L1表达，提示其在肿瘤免疫微环境调控中具有潜在的应用价值。

ObjectiveTo investigate the expression level of mammalian sterile 20-like kinase 1 （MST1） in prostate cancer （PCa） tissues， its biological functions， and its regulatory effects on androgen receptor （AR） and vascular endothelial growth factor （VEGF） expression. MethodsImmunohistochemistry was performed to detect MST1 expression in 77 prostate cancer tissues and 34 benign prostatic hyperplasia （BPH） tissues， and the relationship between MST1 expression and clinicopathological parameters was analyzed. MST1-overexpressing C4-2 and LNCaP cell lines were constructed. CCK-8 assay， Transwell migration assay， and angiogenesis assay were conducted to evaluate the effects of MST1 on cell proliferation， migration， and angiogenesis. The expression changes of AR and VEGF were detected by qRT-PCR and Western blot. ResultsMST1 expression was significantly lower in PCa tissues compared with BPH tissues （P=0.012）. Low MST1 expression was significantly associated with tumor metastasis （P=0.033）. MST1 overexpression inhibited C4-2 cell proliferation and migration， with transmembrane migrated cells reduced by 53.6% （P<0.01）. MST1 overexpression decreased the mRNA and protein expression levels of AR and VEGF （P<0.05）. Angiogenesis assay demonstrated that the length of new vessel structure was significantly reduced （P<0.05）. ConclusionMST1 shows a low expression level in PCa tissues and is associated with tumor metastasis. MST1 exerts tumor-suppressive effects in prostate cancer by inhibiting cell proliferation， migration， and angiogenesis， as well as downregulating the expression of AR and VEGF， indicating its potential as a therapeutic target for prostate cancer.

Babesiosis is a zoonotic parasitic disease caused by tick-borne Babesia species. Currently, more than 100 species of Babesia have been characterized, including at least 4 species that may infect humans. Babesiosis is prevalent across the world, and humans are commonly susceptible to babesiosis. The incidence of babesiosis appears an obvious seasonal distribution, and peaks in summer and autumn. Recently, the number of reported babesiosis cases has increased year by year with the improvement of diagnostic and monitoring capabilities, and the range of animal hosts has continued to expand. However, effective prevention and control of babesiosis remain challenging because of the lack of highly effective specific drugs and available vaccines. This review summarizes the pathogenic characteristics, epidemiological characteristics, epidemic process of babesiosis, and influencing factors of its epidemic, with an emphasis on natural and social factors, so as to provide the scientific evidence for risk assessment of babesiosis and formulation of babesiosis control strategy.

Objective: To analyze the screening results and influencing factors of active pulmonary tuberculosis (PTB) and latent tuberculosis infection (LTBI) among close contacts of PTB patients in Sichuan Province, so as to provide the evidence for optimizing hierarchical management strategies and promoting preventive treatment. Methods: Data of newly registered active PTB patients in Sichuan Province in 2025 were extracted from the Tuberculosis Management Information System of China Disease Prevention and Control Information System. Information on close contacts of PTB patients was collected using the 2025 Individual Screening Registration Form for Close Contacts of Pulmonary Tuberculosis Patients. Active pulmonary tuberculosis was diagnosed according to WS 288—2017 Diagnosis of Pulmonary Tuberculosis. Individuals with positive Mycobacterium tuberculosis infection who were clinically evaluated to have excluded active pulmonary tuberculosis were classified as having LTBI. Multivariable logistic regression models were applied to identify influencing factors for active PTB and LTBI among close contacts. Results: A total of 25 451 newly registered PTB patients and 65 459 corresponding close contacts were recorded in Sichuan Province in 2025, with a contact-to-patient registration ratio of 2.57:1. Among all close contacts, 28 902 (44.15%) were males and 36 557 (55.85%) were females. The age group of 41-<61 years accounted for the largest proportion (22 856, 34.92%). Multivariable logistic regression revealed that close contacts aged 41-<61 years had a lower risk of developing active PTB (OR=0.721, 95%CI: 0.574-0.905). Higher risks of active PTB were observed among contacts with household exposure (OR=1.274, 95%CI: 1.012-1.604), suspicious TB symptoms (OR=12.979, 95%CI: 9.361-17.996), and contacts of patients with positive etiological test results (OR=1.385, 95%CI: 1.071-1.791). For LTBI risk, elevated odds were found in contacts aged ≥21 years (21-<41 years, OR=1.627, 95%CI: 1.471-1.800; 41-<61 years, OR=2.113, 95%CI: 1.933-2.310; ≥61 years, OR=1.731, 95%CI: 1.573-1.905), those with household exposure (OR=1.092, 95%CI: 1.012-1.178), individuals presenting suspicious TB symptoms (OR=4.170, 95%CI: 3.326-5.229), and contacts of etiologically positive PTB patients (OR=1.403, 95%CI: 1.283-1.534). Conclusion Active PTB and LTBI among close contacts of pulmonary tuberculosis patients in Sichuan Province were associated with factors including age, type of exposure, presence of presumptive tuberculosis symptoms, and etiological results of the index patients.

Objective To explore the identification method,pathogenesis,clinical characteristics and individualized pharmacotherapy of asymptomatic hyperuricemia after renal transplantation.Methods The pharmacist was on duty at the organ transplant outpatient clinic.During this time,they analyzed and sorted out the medications,identified and differentiated a case of asymptomatic hyperuricemia related to spironolactone in a patient who had undergone a renal transplant,and provided comprehensive care throughout the entire process.Results The asymptomatic hyperuricemia in this patient might be associated with spironolactone,and the adverse reactions of the patient were alleviated by pharmacists through optimizing clinical treatment.Up to now,no hyperuricemia occurred.Conclusions Pharmacists are required to collaborate closely with clinicians to establish medication profiles for patients under long-term follow-up and to closely monitor and evaluate drug-related adverse reactions.Additionally,they should assess the renal function and immune status of transplant recipients promptly and formulate individualized treatment plans in order to enhance the long-term survival of both the transplanted kidneys and the recipients.

Objective:To analyze the hotspots and trends in thyroid cancer nursing research from 2004 to 2023 at home and abroad through bibliometric methods, so as to provide references and ideas for future research in this field.Methods:A systematic search was conducted for core journal documents on thyroid cancer nursing research included in China National Knowledge Infrastructure, Wanfang Database, VIP Chinese Journal Network and Web of Science Core Collection from January 1, 2004 to December 31, 2023, using CiteSpace6. 3.R1 software performs visual analysis.Results:A total of 119 domestic documents and 417 international documents were included for analysis. From 2004 to 2023, the number of publications in the field of thyroid cancer nursing research at home and abroad showed an upward trend. Domestic research hotspots mainly include four directions: perioperative nursing, symptom nursing, care for radioactive iodine-131 treatment, and physical and mental health promotion. Foreign research hotspots mainly include three directions: nursing practice exploration and guideline formulation, care for radioactive iodine-131 treatment, and quality of life.Conclusions:The field of thyroid cancer nursing has received continuous attention from scholars at home and abroad. In future research, it is recommended that domestic scholars actively carry out cross-institutional and multi-center team cooperation in accordance with local needs, focus on the research of physical and mental care and health promotion of thyroid cancer patients at different survival stages, and the construction of clinical nursing guidelines. With the help of core research institutions and expert teams, actively promote the development of high-quality nursing research in this field.

Objective:To investigate biomarkers that are significantly associated with the immune checkpoint(ICs)genes of colorectal cancer(CRC)and have a key impact on the prognosis of patients,and to search for related sensitive drugs by using bioinformatics methods.Methods:Genes with up-regulated expression in TCGA database and associated with poor prognosis of patients were screened,and molecules with high correlation with immune checkpoint were extracted to verify their impact on the prognosis of patients with colorectal cancer.Finally,their im-pact on immune cell infiltration and correlation were detected,and sensitive drugs that act on target genes were ana-lyzed and searched.Results:Colorectal cancer patients with up-regulated expression of tissue inhibitor of metallo-proteinase 1(TIMP1)had poor prognosis.Different TIMP1 expression levels showed significant differences in the infil-tration levels of various immune cells.Further drug sensitivity analysis predicted that bleomycin and middotolin could be highly sensitive to samples with high TIMP1 expression.Conclusion:TIMP1 is expected to be a new predictive biomarker to identify the benefits of cancer immunotherapy,and bleomycin and middotolin may be potential individualized treatment options for patients with high expression of TIMP1.

OBJECTIVE:To systematically evaluate the correlation between phase angle and sarcopenia and its diagnostic indexes.METHODS:The PubMed,EMbase,Cochrane Library,Web of Science,CNKI,WanFang Data,VIP and SinoMed databases were electronically searched to collect studies on the correlation between phase angle and sarcopenia and its diagnostic indexes from database inception to May 8,2024. Two reviewers independently screened literature,extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.3 and Stata 14.0 software. RESULTS:A total of 50 eligible articles were included. Meta-analysis results showed that compared with the non-sarcopenic population,the phase angle was significantly reduced in sarcopenic patients[standardized mean difference (SMD)=-0.99,95％ confidence interval (CI) (-1.09,-0.90),P<0.00001]. The results of subgroup analysis indicated that the difference of phase angle was more significant in patients with severe sarcopenia and Asian sarcopenia. Moreover,reduction in the phase angle was more obvious in patients with malignant tumors and respiratory diseases with sarcopenia. And skeletal muscle mass index (Pearson's r=0.565,P<0.00001),grip strength (Pearson's r=0.446,P<0.00001),and gait speed (Pearson's r=0.405,P<0.00001) all showed a moderate positive correlation with phase angle. However,appendicular skeletal muscle mass index showed a very weak positive correlation with phase angle (Pearson's r=0.139,P=0.02). CONCLUSION:Phase angle has a significant difference between sarcopenia and non-sarcopenia population,and it is correlated with the diagnostic indexes of sarcopenia to different extents. It suggests that phase angle has some clinical values in the objective diagnosis of sarcopenia. However,the results may be influenced by some factors such as sarcopenia severity and detection instruments of phase angle. Due to the limited quality and quantity of the included studies,more high-quality studies are needed to verify the above conclusion.