VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome is an adult-onset, X-linked clonal autoinflammatory disease caused by somatic mutations in the UBA1 gene, characterized by systemic inflammation accompanied by hematologic clonal abnormalities. Somatic UBA1 mutations result in impaired ubiquitination, disruption of protein homeostasis, and sustained activation of inflammatory signaling pathways, including nuclear factor-κB and Janus kinase-signal transducer and activator of transcription (JAK-STAT), which together constitute the core pathogenic mechanism. The disease involves multiple systems and tissues including the hematologic system, skin, cartilage and respiratory system, showing remarkable clinical heterogeneity. Diagnosis depends primarily on the combination of characteristic clinical manifestations and molecular confirmation of UBA1 mutations. Current therapeutic strategies lack a unified standard: glucocorticoids can rapidly control inflammation but are associated with high relapse rates, whereas targeted therapies such as JAK inhibitors, interleukin inhibitors, and hypomethylating agents show variable efficacy, and allogeneic hematopoietic stem cell transplantation offers curative potential in patients with concomitant myelodysplastic syndrome. This review systematically summarizes the genetic background, molecular mechanisms, clinical spectrum, diagnostic criteria, and therapeutic advances of VEXAS syndrome.

Purpose: Due to the preservation of the entire stomach after endoscopic resection, the occurrence of metachronous gastric cancer (MGC) remains a possibility. In this study, we investigated the incidence and risk factors for MGC in patients with early gastric cancer who underwent endoscopic submucosal dissection (ESD) and successfully eradicatedHelicobacter pylori. Materials and Methods: A retrospective analysis was conducted of 1,191 patients who underwent ESD and successfully eradicated H. pylori at the Affiliated Drum Tower Hospital of Nanjing University. Endoscopic surveillance was performed at 3, 6, and 12 months post-resection, and annually thereafter. MGC was defined as the development of a new cancer at a site other than the primary gastric cancer site, at least 1 year after the initial endoscopic resection. Results: A total of 77 patients were diagnosed with MGC during a median follow-up of 41.5 months. Kaplan-Meier analysis showed a 5-year cumulative incidence of MGC of 9.4% after successful H. pylori eradication. Multivariate analysis of the training set using Cox proportional hazards models identified male sex, severe atrophic gastritis, multiple gastric cancers before H. pylori eradication, and smoking history as independent risk factors for MGC.The nomogram exhibited favorable discrimination, with area under the curves of 0.767 and 0.822 in the training set and 0.724 and 0.745 in the testing set at 3 and 5 years, respectively. Conclusions Patients with gastric cancer who undergo endoscopic resection, even after successful H. pylori eradication, should undergo annual and continuous endoscopic surveillance for MGC.

Objective To investigate the herpes zoster vaccination willingness in middle-aged population in Zibo City, and analyze its influencing factors. Methods A questionnaire survey was conducted among population aged 40-59 years in 24 streets of 8 districts and counties in Zibo City using stratified sampling method, and the willingness to vaccinate herpes zoster vaccine was statistically analyzed. The influencing factors of herpes zoster vaccination willingness in middle-aged population in Zibo City were analyzed. Results Among the 692 survey subjects, 654 cases (94.51%) were not vaccinated with herpes zoster vaccine, among which 170 cases (25.99%) were willing to be vaccinated. Multivariate logistic regression analysis showed that gender, age, education level, knowledge of herpes zoster, presence or absence of people with herpes zoster around them, knowledge of symptoms and sequelae of herpes zoster, knowledge of herpes zoster vaccine, knowledge of preventive effect of herpes zoster vaccine on herpes zoster, possible adverse reactions after vaccination, and acceptable effective rate of vaccine were the influencing factors of herpes zoster vaccination willingness in middle-aged population in Zibo City (P<0.05). Conclusion The willingness of herpes zoster vaccination is low in middle-aged population in Zibo City, and its influencing factors include gender, age, education level, herpes zoster cognition and vaccine cognition. It is necessary to strengthen the education of herpes zoster and vaccine among middle-aged population in Zibo City, and formulate promotion strategies based on individualized needs to enhance the vaccination willingness of people.

Biohybrid robots are hybrid systems that deeply integrate living biological components （such as cells, tissues, organs, or microorganisms） with artificial synthetic components （including sensors, actuators, control systems, and structural materials）. Focusing on key advancements in cellular/microbial-level and tissue-level biohybrid robots, the applications in two major scenarios: targeted drug delivery in vivo and drug evaluation in vitro were reviewed. International research progress demonstrated that biohybrid robots offered novel solutions for overcoming deep tissue delivery barriers, enhancing biocompatibility, and enabling real-time monitoring. However, their clinical translation still faced critical challenges, including reproducibility, in vivo/in vitro nutrient supply, encapsulation technologies, and safety regulatory frameworks.

Objective: To analyze the characteristics and key risk factors of abnormal blood disposal throughout the 2024-2025 blood collection and supply process based on nationwide multi-site monitoring data, develop a comprehensive prevention and control strategy across the entire chain, reduce preventable blood waste, and ensure clinical blood safety. Methods: According to the Guidelines for Haemovigilance (T/CSBT 001-2026), we extracted 74 cases of abnormal blood disposal events reported by the China Blood Transfusion Association′s Blood Safety Monitoring System from January 1 2024, to December 31 2025, and conducted descriptive statistical analysis on the distribution of events, types of deviations, root causes, and classifications of disposal manifestations. Results: A total of 664 adverse events related to blood collection and supply were reported over two years, with 74 cases involving discarded abnormal blood units, accounting for 11.1% of the total. Among these, blood component preparation (40.5%) and blood collection (37.8%) remained traditional high-risk stages. The proportion of blood waste occurring during storage, distribution, and transportation increased from 7.7% in 2024 to 34.3% in 2025. Deviations from standard operating procedures (SOP) by personnel were the primary cause, accounting for 74.3% of cases. Discarded blood units were categorized into four types: compromised closed blood bag systems (40 cases), mainly due to inadequate heat sealing, physical damage, or dropped bags; blood out of the cold chain (12 cases), primarily resulting from blood being left at work sites; imbalanced proportion of preservation solution (10 cases), mostly caused by blood collection volumes exceeding the standard capacity of blood bags; and other causes (12 cases). Conclusion: Human operational errors are the core cause of abnormal blood waste. The collection and preparation stages have long been at high-risk, and the risks in the storage and transportation stages have been increasing year by year. We should focus on standardizing personnel management, improving specialized operation norms such as heat sealing, transportation, and storage, establishing a full-process intelligent cold chain monitoring and multi-node visual verification mechanism, and systematically reducing the occurrence rate of abnormal blood waste through a closed-loop quality intervention system, thereby improving the utilization efficiency of voluntary blood donation resources.

BACKGROUND:In orthodontic treatment,full-mouth treatment is usually used to treat single-root severely twisted teeth,and single-tooth treatment is less common.OBJECTIVE:To design a personalized orthodontic device based on biomechanical principles to address the rotation of teeth 11,12,13,21,22,and 23,and evaluate the device's impact on tooth movement using three-dimensional finite element method.METHODS:Based on the biomechanical principle of tooth rotation and movement,a personalized orthodontic device was made by digital design combined with three-dimensional printing,so that the personalized orthodontic device and the tooth formed an anchorage system.The absolute anchorage of the micro-implant was used to precisely control the single-root twisted tooth in the three-dimensional direction.The CBCT data of the maxillary alveolar bone and tooth tissue of a female volunteer were collected.The three-dimensional finite element models of the twisted tooth-periodontal ligament-maxillary bone-personalized orthodontic device were established using Mimics,Geomagic Wrap,SolidWorks,3-matic Research 15.0,and Ansys Workbench software.The equivalent stress distribution characteristics of the personalized orthodontic device,the movement trend of the tooth,and the equivalent stress distribution characteristics of the periodontal ligament were calculated under a thrust of 60 g.RESULTS AND CONCLUSION:(1)The maximum equivalent stress observed on the personalized orthodontic device was 47.71 MPa.(2)The initial tooth displacement under the device demonstrated a rotational trend.The peak equivalent stress in the periodontal ligament was concentrated at the neck,while lower stress was observed in the apex region.(3)The safety and feasibility of the personalized orthodontic device designed in this study for severely rotated single-rooted teeth were preliminarily verified through finite element analysis.

Objective To explore the clinical efficacy of endoscopic electrocoagulation resection and cold resection techniques in the treatment of elderly patients with complex colonic polyps.Methods A retrospective selection was made of 100 elderly patients with colonic polyps who underwent endoscopic electrocoagulation resection and cold resection of colonic polyps in the Department of Gastroenterology of Yiwu Central Hospital from August 2021 to August 2023.According to the different surgical methods,the patients were divided into the electrocoagulation group(50 cases)and the cold resection group(50 cases).The polyp resection status,intraoperative and postoperative treatment conditions,postoperative pain degree,gastrointestinal quality of life index(GIQLI)score,length of hospital stay,total treatment cost,and recurrence situation after 1-year follow-up of the elderly patients with colonic polyps in the two groups were statistically analyzed.Results 108 polyps were resected in the electrocoagulation group and 113 in the cold resection group.The complete resection rate of polyps in the cold resection group was higher than that in the electrocoagulation group,the specimen damage rate was lower than that in the electrocoagulation group,the differences were statistically significant(P<0.05).There were no statistically significant difference in the average number of polyps removed and the recovery rate of polyp specimens between the two groups(P>0.05).The operation time and hospital stay of the cold resection group were shorter than those of the electrocoagulation group,the total treatment cost was less than that of the electrocoagulation group,and the usage rate of titanium clips during the operation was lower than that of the electrocoagulation group.The differences were all statistically significant(P<0.05).The incidences of intraoperative bleeding,delayed bleeding,perforation and abdominal pain in the electrocoagulation group were 6.00%,2.00%,2.00%and 6.00%respectively,which were higher than those in the cold resection group(2.00%,0.00%,0.00%and 2.00%),and there was statistically significant difference in the total incidence of complications between the two groups of patients(P<0.05).The visual analogue scale(VAS)scores of the cold resection group at 24 and 48 h after surgery were lower than those of the electrocoagulation group,and the differences were statistically significant(P<0.05).The GIQLI score of the cold resection group 3 months after the operation was higher than that of the electrocoagulation group,and the difference was statistically significant(P<0.05).The recurrence rate of the cold resection group at 1 year was lower than that of the electrocoagulation group,but the difference was not statistically significant(P>0.05).Conclusion The clinical efficacy of endoscopic cold resection technique in the treatment of elderly complex colonic polyps patients is better than that of electrocoagulation resection,and it has high safety and low treatment cost.It is worthy of clinical promotion and application.

Objective:To summarize the clinical characteristics of elderly patients with stage Ⅰ diffuse large B-cell lymphoma (DLBCL) and analyze the factors associated with prognosis.Methods:A case series study was conducted by retrospectively collecting clinical data from patients aged over 60 years with newly diagnosed stage Ⅰ DLBCL across 20 medical centers in Jiangsu Province, China, between June 2010 and April 2023. The involved site, classification and treatment plan were summarized. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Statistical analyses were performed using the Kaplan-Meier method, and Cox regression model.Results:The study included 255 patients with a median age of 69 years, of whom 130 (51.0%) were male, 66 (25.9%) were aged ≥75 years and 26 (10.1%) had a high Charlson Comorbidity Index (CCI) score of ≥2. Extranodal involvement was observed in 163 (63.9%) patients, with the stomach (37.4%, 61/163), intestine (19.0%, 31/163), testes (11.0%, 18/163), and breast (7.4%, 12/163) being the most frequently affected sites. The non-germinal center B-cell (non-GCB) subtype was prevalent in 63.7% of patients (142/223), with no significant difference between the nodal and extranodal groups ( P=0.681). Furthermore, 73.9% (184/249) and 11.7% (29/249) of patients received the R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) and R-miniCHOP regimen, respectively. The overall 3-year PFS rate was 81.5%, and the 3-year OS rate was 85.6%. Patients aged ≥75 years ( HR=2.910, 95% CI 1.565-5.408, P=0.001) and/or with a CCI score ≥2 ( HR=2.324, 95% CI 1.141-4.732, P=0.020) had a significantly poorer PFS. Incorporating age ≥75 years and CCI score ≥2 into the stage-modified international prognostic index (sm-IPI) can better stratify the prognosis of elderly patients with stage Ⅰ DLBCL. The 3-year PFS rate was 48.7% in the high-risk group versus 85.7% in the low-risk group ( P<0.001). Conclusions:Our findings show that the elderly patients with stage Ⅰ DLBCL were predominantly characterized by extranodal involvement (particularly in the stomach and intestinal tract) and non-GCB subtype. Age ≥75 years and CCI ≥2 were identified as independent prognostic factors. The newly established sm-IPI-75-CCI incorporating these factors demonstrated superior prognostic discrimination compared to conventional risk assessment systems.

BACKGROUND:In orthodontic treatment,full-mouth treatment is usually used to treat single-root severely twisted teeth,and single-tooth treatment is less common.OBJECTIVE:To design a personalized orthodontic device based on biomechanical principles to address the rotation of teeth 11,12,13,21,22,and 23,and evaluate the device's impact on tooth movement using three-dimensional finite element method.METHODS:Based on the biomechanical principle of tooth rotation and movement,a personalized orthodontic device was made by digital design combined with three-dimensional printing,so that the personalized orthodontic device and the tooth formed an anchorage system.The absolute anchorage of the micro-implant was used to precisely control the single-root twisted tooth in the three-dimensional direction.The CBCT data of the maxillary alveolar bone and tooth tissue of a female volunteer were collected.The three-dimensional finite element models of the twisted tooth-periodontal ligament-maxillary bone-personalized orthodontic device were established using Mimics,Geomagic Wrap,SolidWorks,3-matic Research 15.0,and Ansys Workbench software.The equivalent stress distribution characteristics of the personalized orthodontic device,the movement trend of the tooth,and the equivalent stress distribution characteristics of the periodontal ligament were calculated under a thrust of 60 g.RESULTS AND CONCLUSION:(1)The maximum equivalent stress observed on the personalized orthodontic device was 47.71 MPa.(2)The initial tooth displacement under the device demonstrated a rotational trend.The peak equivalent stress in the periodontal ligament was concentrated at the neck,while lower stress was observed in the apex region.(3)The safety and feasibility of the personalized orthodontic device designed in this study for severely rotated single-rooted teeth were preliminarily verified through finite element analysis.

Objective To explore the clinical efficacy of endoscopic electrocoagulation resection and cold resection techniques in the treatment of elderly patients with complex colonic polyps.Methods A retrospective selection was made of 100 elderly patients with colonic polyps who underwent endoscopic electrocoagulation resection and cold resection of colonic polyps in the Department of Gastroenterology of Yiwu Central Hospital from August 2021 to August 2023.According to the different surgical methods,the patients were divided into the electrocoagulation group(50 cases)and the cold resection group(50 cases).The polyp resection status,intraoperative and postoperative treatment conditions,postoperative pain degree,gastrointestinal quality of life index(GIQLI)score,length of hospital stay,total treatment cost,and recurrence situation after 1-year follow-up of the elderly patients with colonic polyps in the two groups were statistically analyzed.Results 108 polyps were resected in the electrocoagulation group and 113 in the cold resection group.The complete resection rate of polyps in the cold resection group was higher than that in the electrocoagulation group,the specimen damage rate was lower than that in the electrocoagulation group,the differences were statistically significant(P<0.05).There were no statistically significant difference in the average number of polyps removed and the recovery rate of polyp specimens between the two groups(P>0.05).The operation time and hospital stay of the cold resection group were shorter than those of the electrocoagulation group,the total treatment cost was less than that of the electrocoagulation group,and the usage rate of titanium clips during the operation was lower than that of the electrocoagulation group.The differences were all statistically significant(P<0.05).The incidences of intraoperative bleeding,delayed bleeding,perforation and abdominal pain in the electrocoagulation group were 6.00%,2.00%,2.00%and 6.00%respectively,which were higher than those in the cold resection group(2.00%,0.00%,0.00%and 2.00%),and there was statistically significant difference in the total incidence of complications between the two groups of patients(P<0.05).The visual analogue scale(VAS)scores of the cold resection group at 24 and 48 h after surgery were lower than those of the electrocoagulation group,and the differences were statistically significant(P<0.05).The GIQLI score of the cold resection group 3 months after the operation was higher than that of the electrocoagulation group,and the difference was statistically significant(P<0.05).The recurrence rate of the cold resection group at 1 year was lower than that of the electrocoagulation group,but the difference was not statistically significant(P>0.05).Conclusion The clinical efficacy of endoscopic cold resection technique in the treatment of elderly complex colonic polyps patients is better than that of electrocoagulation resection,and it has high safety and low treatment cost.It is worthy of clinical promotion and application.