Hepatitis D virus （HDV）， as a defective virus， relies on the envelope protein of hepatitis B virus （HBV） to complete replication and transmission. Chronic hepatitis B （CHB） patients comorbid with HDV infection may experience significant acceleration of liver disease progression and a significantly higher risk of serious complications such as liver cirrhosis and hepatocellular carcinoma （HCC） compared with the patients with CHB alone， which poses a serious threat to the life and health of patients. At present， the coverage rate of HDV screening needs to be improved， and some patients with HBV/HDV co-infection have not been found in time. Therefore， strengthening the understanding of HDV among clinicians， expanding the scope of HDV screening， identifying patients with infection in a timely manner， and performing standardized antiviral therapy and long-term follow-up management are of great significance for improving the prognosis of patients， reducing disease burden， improving the quality of life of patients， and achieving the global goal of “eliminating viral hepatitis as a public health threat by 2030”.

Organ transplantation is regarded as the pinnacle of medical achievement in the 21st century, with innovation serving as the core engine driving the advancement of transplant surgery. Taking the decades of practical exploration in organ transplantation (especially liver transplantation) in China as its main thread, this article systematically analyzes the core logic of transplant surgical innovation. This logic adheres to a three-pronged developmental pathway characterized by being clinically problem-solving oriented, patient-need centered, and critical-technology-conquering driven. By reviewing major milestones such as living donor liver transplantation, auxiliary partial orthotopic liver transplantation, combined multi-organ transplantation, and xenotransplantation, the study elucidates how surgical innovation should be grounded in resolving clinical pain points, return to medical humanism, and leverage technological iteration to foster revolutionary progress. Furthermore, the article explores the empowering role of cutting-edge technologies-including artificial intelligence, machine perfusion, and gene editing-in driving the next surgical revolution. It aims to construct a theoretical framework and provide practical insights for the future development of transplant surgery in China.

Organ transplantation is regarded as the pinnacle of medical achievement in the 21st century, with innovation serving as the core engine driving the advancement of transplant surgery. Taking the decades of practical exploration in organ transplantation (especially liver transplantation) in China as its main thread, this article systematically analyzes the core logic of transplant surgical innovation. This logic adheres to a three-pronged developmental pathway characterized by being clinically problem-solving oriented, patient-need centered, and critical-technology-conquering driven. By reviewing major milestones such as living donor liver transplantation, auxiliary partial orthotopic liver transplantation, combined multi-organ transplantation, and xenotransplantation, the study elucidates how surgical innovation should be grounded in resolving clinical pain points, return to medical humanism, and leverage technological iteration to foster revolutionary progress. Furthermore, the article explores the empowering role of cutting-edge technologies-including artificial intelligence, machine perfusion, and gene editing-in driving the next surgical revolution. It aims to construct a theoretical framework and provide practical insights for the future development of transplant surgery in China.

Septic shock, a prevalent critical condition in intensive care units (ICU) and a major cause of patient mortality, is fundamentally attributed to microcirculatory dysfunction. Traditional macrocirculatory parameters are often insufficiently sensitive to reflect microcirculatory status. Consequently monitoring peripheral microcirculatory function holds crucial significance for assessing disease progression and evaluating therapeutic efficacy in septic shock. The peripheral perfusion index (PPI), obtained from a standard pulse oximeter, is based on photoplethysmography (PPG). It calculates the differential absorption of red and infrared light emitted by the sensor between pulsatile arterial blood and non-pulsatile tissue, enabling real-time reflection of peripheral perfusion and thus providing non-invasive, continuous monitoring of microcirculatory function. Although often overlooked compared to other ICU monitoring parameters, PPI has demonstrated notable clinical advances in septic shock management. Specifically, in early identification, PPI combined with sequential organ failure assessment (SOFA) predicts disease progression, with its dynamic changes further aiding prognosis assessment. During fluid resuscitation, it guides fluid responsiveness evaluation and serves as a therapeutic target to optimize strategies. In circulatory support, it assists in determining vasoactive drug initiation timing and dosage titration. Additionally, PPI aids mechanical ventilation weaning and organ dysfunction evaluation. This article reviews the principles, influencing factors, and clinical application advances of PPI in septic shock, aiming to provide clinicians with a basis for individualized intervention, improved patient outcomes, and the advancement of precision medicine in septic shock management.
Humans ; Shock, Septic/therapy* ; Microcirculation ; Perfusion Index ; Prognosis ; Photoplethysmography

Objective:To investigate the contributing factors to elevated blood pressure in borderline cases during medical selection for recruitment of Air Force flying cadets in order to enhance the accuracy of selection.Methods:Blood pressure was measured among 2 350 male high school graduates in the 2022 re-selection phase of medical selection of Air Force flying cadets. None of the participants had a family history of hypertension according to previous health checkups. Identified through blood pressure measurement, subjects with borderline hypertension were assigned to an intervention group (self-intervention with personalized correction plans) and a control group (self-intervention alone) using a random number table. Standardized blood pressure measurements and comprehensive medical history reviews were performed to compare pre- and post-intervention outcomes across the 2 groups, followed by an investigation into the causative mechanisms of elevated blood pressure.Results:Among the 102 cases of borderline hypertension (51 per group) identified, primary contributing factors included the white-coat phenomenon (41.2%), pre-examination physical activity (17.6%), pre-examination medications (3.9%) and poor sleep quality (35.3%). No significant differences in systolic blood pressure (SBP) or diastolic blood pressure (DBP) were observed between the 2 groups at baseline (both P>0.05). After interventions, the intervention group showed significantly lower SBP ( t=3.13, P=0.002) and DBP ( t=7.68, P<0.001) than the control group. Both groups exhibited reductions in SBP and DBP from baseline ( t=6.63, 8.97, 4.13, 2.03, P<0.001, <0.001, <0.001, =0.043). The percentage of students with normal blood pressure was 96.1% (49/51) in the intervention group and 78.4% (40/51) in the control group. Conclusions:Transient blood pressure elevation in selection settings primarily stems from the white-coat phenomenon, physical exertion, medications and sleep disturbances. Standardizing blood pressure measurement protocols and addressing transient factors can help avoid unwarranted disqualifications and ensure the accuracy of selection.

Objective:To investigate the prevalence status and the clinical characteristics of hepatitis D virus (HDV) among patients chronically infected with hepatitis B virus (HBV) in the Xinjiang region.Methods:A cross-sectional study was conducted. Serum samples from 1 830 patients with chronic HBV infection who visited the Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region from December 2022 to October 2023 were collected. All sera were tested for anti-HDV IgG and IgM. Sera positive for anti-HDV IgG or IgM were selected for HDV RNA detection. HDV RNA-positive sera were sequenced to determine the HDV genotype. Age, gender, HBV course, and anti-HBV treatment status were used as scoring items based on the propensity score matching (PSM) method. Chronic HBV patients with negative anti-HDV were matched in a ratio of 1∶1. The clinical characteristics of anti-HDV -positive-patients were analyzed. The t-test was used for comparison between groups of normally distributed continuous data. The Wilcoxon signed-rank test was used for comparison between groups of skewness distribution. The χ2 test was used for comparison between groups of enumeration data. Results:The positive detection rates of anti-HDV IgG, anti-HDV IgM, and HDV RNA in 1 830 cases with chronic HBV infection were 2.24% (41/1 830), 1.09% (20/1 830), and 1.69% (31/1 830), respectively. All HDV RNA-positive patients had HDV genotype 1. Two anti-HDV-positive patients had negative hepatitis B surface antigen (HBsAg). Gender, age, HBV course, and anti-HBV treatment status had no significant difference. The quantification of HBsAg, liver biochemical indexes (alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and total bile acids), the proportion of patients with liver cirrhosis, and alpha-fetoprotein were significantly higher in the anti-HDV-positive group than in those in the anti-HDV-negative group ( P<0.05). Conclusion:The prevalence rate of HDV in chronic HBV-infected patients at a single center in the Xinjiang region was 2.24%, with the primary genotype being 1. Furthermore, overlap infection should be paid attention to because it might aggravate liver damage.

Diabetic retinopathy (DR) is a common complication of diabetes that can lead to visual impairment or even blindness. Current treatments mainly rely on invasive methods, which carry the risk of complications, making early intervention crucial. In recent years, research has revealed that the mechanical microenvironment of the retina plays a key role in the development and progression of DR, involving cell migration, functional disorders, and changes in the extracellular matrix. Mechanobiological mechanisms, such as mechanical signal transduction and the Hippo/Yes-associated protein pathway, are gradually being uncovered. Mechanical diagnostic and therapeutic strategies, including optical coherence elastography, tissue engineering, and intelligent diagnostic systems, offer new directions for DR management. In the future, further integration of biomechanics and mechanobiology research is needed to build multi-scale mechanical models and explore the synergistic regulation mechanisms between mechanical and biochemical factors, aiming to achieve precise and personalized diagnosis and treatment of DR and ultimately improve patients' visual outcomes.

Gliomas, with their infiltrative growth and malignant potential, present considerable therapeutic challenges. Maximal safe resection is essential for optimizing patient survival and quality of life. Despite this, existing intraoperative visualization techniques suffer from limited sensitivity and accuracy. Label-free Raman spectroscopy has emerged as a non-invasive, rapidly diagnostic, and highly accurate technique. It accurately diagnoses tumors, identifies infiltration margins, and classifies molecular subtypes, enhancing the precision of glioma surgery. This review summarizes the latest advances and applications of label-free Raman spectroscopy in glioma surgery.

The primary role of transfer RNA(tRNA)is to connect a specific amino acid to its 3' end, use its anticodon to match the codon on messenger RNA(mRNA), and deliver the corresponding amino acid to the ribosome for protein synthesis.tRNA exists in two forms: precursor tRNA and mature tRNA.When acted upon by enzymes like Dicer, elaC ribonuclease Z 2(ELAC2), angiopoietin(ANG), and other ribonucleases, tRNA is broken down into tRNA-derived stress-induced RNA(tiRNA)and tRNA-derived fragments(tRF).Recent advancements in RNA sequencing technology have led to increased interest in tiRNA and tRF, shedding light on their roles in various physiological and pathological processes.tRNA-derived small molecules(tsRNA)function similarly to microRNA(miRNA), influencing gene expression and protein synthesis.They show promise as diagnostic markers and potential therapeutic targets for age-related diseases.This review offers a comprehensive analysis of tsRNA classification, biological functions, research advancements, and clinical applications in age-related conditions.

Objective To analyze the main epidemiological characteristics of fungal infection in this hospital in the past 7 years,and to provide reference for clinical treatment and prevention and control strategies of fun-gal infection.Methods The fungal data and clinical data of related patients isolated from clinical samples in Peking Union Medical College Hospital from early January 2018 to the end of May 2024 were selected,and the main epidemiological characteristics of fungal infection in this hospital were identified and described through multi-angle statistical analysis.Results A total of 4 479 patients with filamentous fungal infection were en-rolled.The proportion of male patients[57.5％(2 576/4 479)]was higher than that of female patients[42.5％(1 903/4 143)],mainly distributed in internal medicine,Intensive Care Unit(ICU)and emergency de-partment,among which internal medicine accounted for the highest proportion[50.0％(2 241/4 479)].About 90.0％of the specimens were from the lower respiratory tract,in addition to specimens from skin and soft tis-sue,tissue,ear and blood culture.In terms of seasonal distribution,there are more patients in winter.The fun-gi were mainly composed of Aspergillus,Mucor,Cerdosporium,Fusarium and Penicillium,among which As-pergillus was the most abundant,accounting for 74.6％of the total.Aspergillus fumigatus was the most a-bundant Aspergillus,accounting for 42.5％of the total Aspergillus(1 418/3 340).Among the related infec-tions caused by mold,Aspergillus was the most common in the lower respiratory tract,accounting for 76.8％.Among them,Aspergillus fumigatus accounted for the highest proportion(33.6％).98.6％of the molds infected the ear were Aspergillus,of which Aspergillus niger and Aspergillus terreus were the most common.Skin infections are mainly caused by Sporothrix schenckii,Trichophyton rubrum,Microsporum ca-nis.The results of in vitro drug sensitivity test showed that the four common Aspergillus isolated in this hos-pital were sensitive to voriconazole,and amphotericin B had better antifungal activity against Mucorales in vitro.Conclusion Based on the main epidemiological characteristics of fungal infections in this hospital,it is recommended that special attention be paid to the admission of patients in the respiratory department during the peak infection period in autumn and winter.In the treatment of fungal infections in different regions and on different body parts,attention should be paid to the differences in the distribution of bacterial species.