Adverse drug reactions (ADRs) significantly impact clinical medication safety. The timely identification and prediction of ADRs rely on the efficient analysis of real-world data, such as electronic health records, social media, and spontaneous reporting databases. In recent years, the rapid advancement of artificial intelligence, particularly large language models, in natural language processing, causal reasoning, and complex data mining has provided new technological means for real-time ADRs monitoring and individualized prediction. This paper summarizes the latest research achievements in AI-driven ADRs monitoring. Focusing on diverse data sources, including structured databases and electronic health records, it elaborates on the advantages andchallenges of AI in ADRs event extraction, relationship identification, causal analysis, and risk prediction. The aim is to provide a theoretical reference for constructing more intelligent and efficient ADRs monitoring systems.

In the process of tumor chemotherapy， the emergence of multi-drug resistance （MDR） has always been a thorny problem， which is a result of the joint action of the host， tumor cells， and the immune microenvironment. Tumor cells can escape the toxicity of chemotherapeutic drugs through multiple pathways， being easy to produce drug resistance. MDR greatly restricts the effect of chemotherapeutic drugs on tumor cells and affects their therapeutic effects. Traditional Chinese medicine （TCM） has the unique advantages of multi-target， multi-pathway and individualized treatment. The TCM treatment of tumors emphasizes regulating Yin and Yang， as well as reinforcing healthy Qi and dispelling pathogen. In recent years， TCM has demonstrated remarkable efficacy in the treatment of tumors and the amelioration of multi-drug resistance. TCM not only can target the phenomenon of MDR but also greatly weakens the side effects of the patients after the chemotherapy， thus improving the survival quality and rate of the patients. Accordingly， many patients adopt TCM as an adjuvant therapy during or after chemotherapy. The binding of TCM to targets can reverse the drug resistance of various tumors， which has become an emerging research highlight. From the regulatory mechanism of TCM on MDR of tumors， this paper introduces the mechanisms by which tumor cells continue to grow， proliferate， and metastasize by adjusting the intracellular drug concentration， altering or utilizing the tumor microenvironment， and affecting the cell death mode to achieve the resistance to chemotherapeutic drugs. In this regard， the active ingredients and compound prescriptions of TCM can increase the sensitivity of chemotherapeutic drugs by down-regulating drug transporters， improving the tumor microenvironment， and modulating the drug resistance pathways associated with apoptosis， autophagy， ferroptosis， or pyroptosis. The aim of this paper is to explore more clinical practical value of TCM in the treatment of tumors and provide exploratory ideas and a theoretical basis for the future research on tumors and MDR.

In 2025,the American Thyroid Association(ATA)divided the management of thyroid nodules and differentiated thyroid cancer(DTC)into two separate guidelines for the first time.This review highlighted the imaging-related updates and compared them with the 2015 ATA guidelines.The 2025 ATA guidelines introduce the following key updates:① Clarifying recommendations for screening of familial non-medullary thyroid cancer,and proposing that thyroid ultrasound screening is not recommended before treatment for patients who will receive glucagon-like peptide-1 receptor agonist(GLP-1 RA)therapy;② Refined the sonographic malignancy risk stratification system,enabling classification of all nodule types;③ Increasing size thresholds for fine-needle aspiration(FNA)and emphasized individualized decisions based on age,comorbidities and other factors;④ Follow-up intervals for nodules not meeting FNA criteria or with benign cytology have been adjusted,and clear ultrasound surveillance endpoints have been proposed;⑤ A standardized ultrasound protocol is established for active surveillance of cT1aN0M0 papillary thyroid cancer;⑥ Additional suspicious features,including abnormal blood flow in cervical lymph nodes,are introduced with quantitative evidence;⑦ Proposing dynamic risk stratification,adjusting follow-up intervals based on the patient's risk of residual lesion or disease recurrence and their response to treatment,and adding new endpoints for postoperative follow-up for low-risk DTC patients with sustained excellent response;⑧ Stressing the preoperative use of computed tomography(CT)or magnetic resonance imaging(MRI)to evaluate distant metastasis,while no longer recommending them as routine imaging tools during follow-up;⑨ Defining indications for thermal ablation:benign nodules,low-risk microcarcinomas and recurrent or metastatic lesions.Guided by evidence-based medicine,the 2025 ATA guidelines promote the transformation of thyroid ultrasound towards"precision,minimal invasiveness,individualization",providing a new paradigm for the whole-process clinical management of thyroid diseases.

In 2025,the American Thyroid Association(ATA)divided the management of thyroid nodules and differentiated thyroid cancer(DTC)into two separate guidelines for the first time.This review highlighted the imaging-related updates and compared them with the 2015 ATA guidelines.The 2025 ATA guidelines introduce the following key updates:① Clarifying recommendations for screening of familial non-medullary thyroid cancer,and proposing that thyroid ultrasound screening is not recommended before treatment for patients who will receive glucagon-like peptide-1 receptor agonist(GLP-1 RA)therapy;② Refined the sonographic malignancy risk stratification system,enabling classification of all nodule types;③ Increasing size thresholds for fine-needle aspiration(FNA)and emphasized individualized decisions based on age,comorbidities and other factors;④ Follow-up intervals for nodules not meeting FNA criteria or with benign cytology have been adjusted,and clear ultrasound surveillance endpoints have been proposed;⑤ A standardized ultrasound protocol is established for active surveillance of cT1aN0M0 papillary thyroid cancer;⑥ Additional suspicious features,including abnormal blood flow in cervical lymph nodes,are introduced with quantitative evidence;⑦ Proposing dynamic risk stratification,adjusting follow-up intervals based on the patient's risk of residual lesion or disease recurrence and their response to treatment,and adding new endpoints for postoperative follow-up for low-risk DTC patients with sustained excellent response;⑧ Stressing the preoperative use of computed tomography(CT)or magnetic resonance imaging(MRI)to evaluate distant metastasis,while no longer recommending them as routine imaging tools during follow-up;⑨ Defining indications for thermal ablation:benign nodules,low-risk microcarcinomas and recurrent or metastatic lesions.Guided by evidence-based medicine,the 2025 ATA guidelines promote the transformation of thyroid ultrasound towards"precision,minimal invasiveness,individualization",providing a new paradigm for the whole-process clinical management of thyroid diseases.

Objective This study aims to observe the clinical effect of bone plate reduction in combination with a re-sorbable plate on large mandibular cysts.Methods Between October 2017 and September 2022,patients with large mandibular cysts in the presence of labial and buccal cortical bone were involved in the study.Intraoral approach was performed for bone plate reduction.Cone beam computed tomography(CBCT)scan was reviewed at 3,6,and 9 months postoperatively to observe postoperative complications.Osteogenic results were assessed at these times to determine the clinical outcomes of this procedure.Results Eleven cases with large mandibular cysts in the presence of cortical bone were evaluated.The average thickness of the cortical bone on the labial and buccal sides was measured to be about(1.98±0.37)mm before surgery,with a mean value of(0.73±0.17)mm at the thinnest part of the plate and up to 0.51 mm at the thinnest part of the plate.The cystic cavities were well re-vealed during the surgeries,which were completed suc-cessfully.Postoperatively,the wounds healed in one stage without infection.The percentages of cyst shrinkage were 20.01%,41.76%,and 73.41%at 3,6,and 9 months after surgery,respectively.Quantitative measurement of bone mineral density in the jaws by CBCT with MIMICS software.The bone mineral densities of the adult bone were 313.78,555.85,and 657.45 HU at the 3,6,and 9 month time intervals,respectively.No significant change in the patient's maxillofacial appearance were observed from the preoperative period as assessed by the patient's and observer's visual analog scale.Conclusion Bone plate reduction is an effective treatment for large mandibular cysts of the oral and maxillofacial re-gion with the presence of cortical bone.

Objective To evaluate the molecular mechanisms by which dendritic cells(DCs)detect variations in the extracellular mechanical microenvironment and dynamically adjust their migration behavior.Methods Hydrogel substrates with varied stiffness were constructed to investigate the influence of the mechanical microenvironment on the DC migration behavior.A fibrotic rat liver model was established in combination with immunohistochemistry experiments to investigate the effect of liver fibrosis on the DC migration capability.Furthermore,potential key molecules involved in the mechanical sensing cascade during DC migration were analyzed using single-cell sequencing data from human/mouse fibrotic livers.Moreover,RT-qPCR was used to examine the expression levels of these key molecules in mouse DCs on substrates of different stiffness.Results The migration capability of DCs on stiff substrates was significantly lower than that on soft substrates.The DC infiltration in fibrotic rat livers increased,and 682 differentially expressed genes(DEGs)were observed between liver-infiltrating DCs from cirrhosis patients and normal individuals.Furthermore,focusing on genes relevant to cytoskeleton regulation and migration based on KEGG and GO pathway enrichment analysis,12 potential key molecules mediating stiffness detection during DC migration were identified.Among these,the expression levels of AIF1,GPR65,MYL12B,RAC1,and RHOG were upregulated in patients with liver cirrhosis,whereas those of ACTB,ACTG1,ARF6,CDC42,COTL1,PFN1,and TMSB10 were downregulated.Subsequently,the expression levels of ACTB and CDC42 were downregulated in mouse DCs grown on stiff substrates.This was consistent with the circumstance of liver-infiltrating DC in human cirrhotic patients.Conclusions Liver fibrosis potentially impairs DC migration and thereby,results in increased DC infiltration.ACTB and CDC42 are potential regulators of DC stiffness during migration.This study has provided a theoretical basis and an inspiring novel strategy for optimizing DC-mediated antitumor immune functions.

Objective:To investigate the efficacy and safety of tirofiban versus argatroban in the treatment of acute ischemic stroke. Methods:This study was a retrospective cohort study. Sixty-eight patients with acute ischemic stroke who were continuously admitted to Department of Neurology of The Third People's Hospital of Hubei Province from August 2022 to September 2023 were divided into tirofiban group ( n = 33) and argatroban group ( n = 35) according to the treatment regimen. Both groups were treated according to their respective treatment protocols for 7 days. Clinical outcomes were assessed based on the modified Rankin Scale (mRS) scores. The excellent clinical outcome (mRS score 0-1 points), good clinical outcome (mRS score 0-2 points), symptomatic intracranial hemorrhage, and mortality rates were compared between the two groups at 90 days post-treatment. Results:In the tirofiban group, the proportion of excellent clinical outcomes was 30.3% (10/33), which was significantly lower than the 65.7% (23/35) in the argatroban group (χ2 = 8.53, P = 0.003). However, the difference in the proportion of good clinical outcomes between the two groups was not statistically significant [54.5% (18/33) vs. 74.3% (26/35), χ2 = 2.90, P = 0.089]. There were no statistically significant differences between the two groups regarding symptomatic intracranial hemorrhage and mortality rates (both P > 0.05). Conclusion:For patients with acute ischemic stroke, the use of tirofiban or argatroban is effective and safe. Patients treated with argatroban are more likely to achieve excellent clinical outcomes; however, larger randomized controlled trials are needed for further confirmation.

Objective To evaluate the molecular mechanisms by which dendritic cells(DCs)detect variations in the extracellular mechanical microenvironment and dynamically adjust their migration behavior.Methods Hydrogel substrates with varied stiffness were constructed to investigate the influence of the mechanical microenvironment on the DC migration behavior.A fibrotic rat liver model was established in combination with immunohistochemistry experiments to investigate the effect of liver fibrosis on the DC migration capability.Furthermore,potential key molecules involved in the mechanical sensing cascade during DC migration were analyzed using single-cell sequencing data from human/mouse fibrotic livers.Moreover,RT-qPCR was used to examine the expression levels of these key molecules in mouse DCs on substrates of different stiffness.Results The migration capability of DCs on stiff substrates was significantly lower than that on soft substrates.The DC infiltration in fibrotic rat livers increased,and 682 differentially expressed genes(DEGs)were observed between liver-infiltrating DCs from cirrhosis patients and normal individuals.Furthermore,focusing on genes relevant to cytoskeleton regulation and migration based on KEGG and GO pathway enrichment analysis,12 potential key molecules mediating stiffness detection during DC migration were identified.Among these,the expression levels of AIF1,GPR65,MYL12B,RAC1,and RHOG were upregulated in patients with liver cirrhosis,whereas those of ACTB,ACTG1,ARF6,CDC42,COTL1,PFN1,and TMSB10 were downregulated.Subsequently,the expression levels of ACTB and CDC42 were downregulated in mouse DCs grown on stiff substrates.This was consistent with the circumstance of liver-infiltrating DC in human cirrhotic patients.Conclusions Liver fibrosis potentially impairs DC migration and thereby,results in increased DC infiltration.ACTB and CDC42 are potential regulators of DC stiffness during migration.This study has provided a theoretical basis and an inspiring novel strategy for optimizing DC-mediated antitumor immune functions.

Objective:To understand the regular leisure-time physical activity status of residents aged ≥60 years in China and to explore the potential influencing factors.Methods:National Chronic Disease and Risk Factor Surveillance were conducted in 298 counties (districts) in China in 2018, which covered 31 provinces (autonomous regions, municipalities), using a multi-stage stratified cluster random sampling method to select 194 779 permanent residents aged ≥18 years, using a questionnaire containing the Global Physical Activity Questionnaire. A face-to-face survey to obtain demographic information about the survey respondents, the frequency of moderate and vigorous-intensity leisure-time physical activity in their spare time and time, and other information related to chronic diseases and risk factors. Daily temperatures of 298 monitored counties (districts) in 2018 were obtained by inversion of satellite remote sensing data information such as MODIS, OMI, and AIRS, and the number of parks in 2017 was obtained by me. In this study, 68 379 residents aged ≥60 years who completed the survey and had complete information on leisure-time physical activity-related variables, temperature, and parks were used as survey respondents, and the prevalence of regular leisure-time physical activity and average weekly exercise time was calculated by gender in groups of age, urban and rural areas, education level, and geography. Multi-factor logistic regression models were used to analyze the individual and environmental influences on the regular exercise rate. All the results were weighted according to a complex sampling scheme.Results:The prevalence of regular leisure-time physical activity of residents aged ≥60 years in China in 2018 was 13.1% (95% CI: 12.1%-14.0%). The figures were slightly higher for men [13.6% (95% CI: 12.6%-14.7%)] than for women [12.5% (95% CI: 11.5%-13.5%)]; urban [17.5% (95% CI: 15.9%-19.1%)] were significantly higher than those in rural areas [9.6% (95% CI: 8.8%-10.4%)]; the prevalence of regular leisure-time physical activity in East China [15.1% (95% CI: 13.3%-16.9%)] was higher than those in other regions; older residents in counties (districts) with ≥28 parks [17.3% (95% CI: 15.3%-19.2%)] the highest. The average weekly exercise time of elderly residents in China was 68.3 (95% CI: 63.5-73.2) minutes; among them, men [74.3 (95% CI: 68.1-80.5) minutes] was higher than women [62.5 (95% CI: 57.8-67.2) minutes]; urban [89.8 (95% CI: 82.0-97.7) minutes] were higher than rural [51.4 (95% CI: 46.8-56.1) minutes]. The results of the multi-factorial logistic analysis showed that factors such as: living in rural areas, lower annual household income for literacy, poorer self-rated health status, and lack of parks in the area of residence were associated with a lower prevalence of regular leisure-time physical activity among elderly residents. Conclusions:The prevalence of regular leisure-time physical activity among elderly residents in China is still at a low level, and exercise time needs to be improved. We should increase the publicity of "national fitness", pay attention to the disadvantaged elderly groups and provide more suitable activity places to encourage more elderly residents to participate in leisure-time physical activity.

Cardio-cerebrovascular diseases (CVDs) are major public health concerns affecting the health of Chinese residents, and the insufficient intake of vegetables and fruit is an essential risk factor for the occurrence and development of major chronic diseases, including CVDs. A reasonable intake of vegetables fruit and different varieties have a positive significance for preventing and treating CVDs. This paper reviews the progress of recent research at home and abroad on the relationship between vegetables and fruit intake, types and methods of processing with CVDs occurrence, development, and mortality, as well as their possible mechanisms. It provides further support for promoting a proper diet, facilitating the formation of nutritionally balanced diet habits, and improving the strategies and measures for CVDs prevention and management of CVDs patients in general and high-risk populations in China.