Background/Aims: Liver transplantation (LT) following total hepatectomy is a life-saving treatment for hepatocellular carcinoma (HCC). The HCC recurrence after LT hinders the effectiveness of the procedure. The objective of this study is to develop a pre-operative risk stratification model based on a liquid biopsy. Methods: We conducted a comprehensive multi-omics study of 260 HCC patients from three centers, including clinical data, low-coverage whole-genome sequencing of cell-free DNA (cfDNA) from plasma, as well as whole-exome, single-nucleus RNA, and spatial transcriptomics from matched tumor and non-tumor tissues. Results: We identified cfDNA-derived copy number alteration (CNA) signatures associated with post-transplant recurrence. By integrating cfDNA-derived CNA profiles with single-cell transcriptomic data, we traced recurrence-associated cfDNA to a distinct subpopulation of malignant cells within the primary tumor. These cells were embedded in a pro-metastatic microenvironment of specialized endothelial subtypes and cancer-associated fibroblasts. Notably, most recurrence-associated lesions were detectable in cfDNA prior to liver transplantation (LT). Building on these insights, we developed the ZJU Criteria based on CNA fragments and tumor markers, a pre-LT risk prediction tool that integrates conventional clinical factors with cfDNA-derived CNA signatures, and validated it using internal and independent external cohorts. Conclusion Our findings suggest that post-transplant recurrence commonly originates from advanced subclones that emerge late during tumor evolution. The ZJU Criteria provides an accurate, non-invasive strategy that significantly improves pre-LT risk stratification and clinical decision-making for patients with HCC.

Objective To construct prostate cancer(PCa)prediction models based on machine learning algorithms, so as to improve the accuracy of early diagnosis of PCa. Methods A retrospective analysis was performed on the clinical data of 504 patients who underwent prostate biopsy at our hospital during Jan. 2020 and Nov. 2024. Patients' age, body mass index(BMI), history of hypertension, diabetes and smoking, total prostate-specific antigen(tPSA), free prostate-specific antigen(fPSA), f/tPSA, prostate volume(PV), neutrophil count, lymphocyte count, neutrophil-to-lymphocyte ratio(NLR), Prostate Imaging Reporting and Data System(PI-RADS)score, digital rectal examination(DRE)results, and pathological findings were collected. The patients were divided into the training and testing sets at a ratio of 7:3. Ten early diagnosis prediction models of PCa were constructed using 10 supervised machine learning algorithms. Model performance was evaluated and validated using metrics including area under the receiver operating characteristic curve(AUC), accuracy, sensitivity, specificity, calibration curves, and decision curve analysis(DCA). SHAP analysis was used to interpret the models, and to clarify the importance of each feature and the basis for model decisions. Results All models showed good predictive value, with the gradient boosting machine(GBM)model performing the best(AUC=0.905, accuracy=84.1%, sensitivity=90.2%, specificity=80.0%). Calibration curves indicated good calibration and fitting of the GBM model, while DCA demonstrated favorable clinical net benefits. SHAP analysis identified the most significant features affecting PCa occurrence in descending order:tPSA, f/tPSA, PIRADS score, PV, age, and DRE. Conclusion The GBM model exhibits the optimal performance among the 10 models. The importance of features for predicting the occurrence of PCa, from the highest to the lowest, is as follows:tPSA, f/tPSA, PIRADS score, PV, age, and DRE.

Objective To prepare a mouse model of asthenozoospermia(AZS)with high sperm DNA fragmentation(SDF)using corticosterone(CORT)and sodium benzoate(NaB).Methods Fifty 3-week-old male ICR mice were divided randomly into CORT-treated(n=30)and NaB-treated(n=20)groups.The CORT group was further divided into the following six groups(n=5 per group):high CORT(500 μg/mL),medium CORT(200 μg/mL),and low CORT(10 μg/mL)drinking water group,drinking water control group,CORT injection(40 mg/kg)group,and injection control group(normal saline).The animals were modeled continuously for 50 d.Mice in the NaB group were further divided into four groups(n=5 per group):high NaB(500 mg/kg),medium NaB(300 mg/kg),and low NaB(100 mg/kg)gavage groups,and control group(normal saline).The animals were modeled continuously for 50 d.The physiological state of the mice in each group was observed and mass changes were recorded continuously.The sperm motility capacity and DNA fragmentation index(DFI)of the sperm were observed from the tail of the epididymis after the end of the modeling.Results The rate of mass change in the CORT-injection moding group showed a downward trend.There was no significant difference(P＞0.05)in the high NaB gavage group,and the rate of body mass change in the high NaB gavage group was significantly decreased compared with the control group(P＜0.05).The percentages of forward motility sperm were significantly decreased in the CORT injection group(P＞0.05)and the percentage in the high NaB gavage group(P＜0.05),compared with the control group.The DFI was increased in the CORT injection group compared with the control group,but the difference was not significant(P＞0.05),and the DFI in the high NaB gavage group was significantly increased compared with the control group(P＜0.05).Conclusions Intragastric gavage with NaB 500 mg/(kg·d)for 50 d is an ideal method for constructing an animal model of AZS with high SDF.

Objective To investigate the spectrum-efficacy relationship between the fingerprint of green tea extract and its pharmacological effects in intervention of neovascular age-related macular degeneration(nAMD),explore the phar-macodynamic material basis,and identify key active components.Methods The fingerprint of green tea extract was es-tablished using UPLC-Q-Exactive Orbitrap MS.Hierarchical cluster analysis and orthogonal partial least squares discrimi-nant analysis were used to explore differences in chemical composition among green tea samples from different origins.A zebrafish nAMD model induced by cobalt chloride was established to evaluate the pharmacological activity of green tea ex-tract in nAMD intervention.Partial least squares regression analysis(PLSR)and grey relational analysis(GRA)were em-ployed to study the spectrum-efficacy correlation,comprehensively analyze the pharmacodynamic material basis of green tea in AMD intervention,and screen for key active components.Results A fingerprint detection method for green tea ex-tract was successfully established,and 31 chemical components were qualitatively and quantitatively characterized.Hierar-chical cluster analysis and orthogonal partial least squares discriminant analysis classified 50 batches of green tea samples into two major categories,identifying 15 key differential components.Pharmacological experiments demonstrated that green tea extract inhibited abnormal vascular growth in the zebrafish retina caused by cobalt chloride.Through PLSR and GRA,six components of green tea extract were found to be significantly correlated with pharmacological activity and showed high variable importance in projection:quinic acid,epicatechin,gallocatechin,epigallocatechin,gallocatechin gal-late,and epigallocatechin gallate.Conclusion This study comprehensively characterized 31 chemical components in green tea.Based on the nAMD zebrafish model and spectrum-effect correlation theory,PLSR and GRA analyses were ap-plied to accurately identify quinic acid,epicatechin,gallocatechin,epigallocatechin,gallocatechin gallate,and epigallocate-chin gallate as the key effective substances in green tea for intervening in nAMD.This provides a foundation for the devel-opment of new drugs with therapeutic potential against nAMD,and offers data support for establishing a comprehensive quality evaluation system for green tea.

Objective:To explore patterns of traditional Chinese medicine (TCM) use among patients with inflammatory bowel disease (IBD) in Jiangsu Province, China from 2019 to 2023.Methods:Using data from the IBD health data platform of the National Healthcare Big Data (Eastern) Center, a retrospective cohort study was conducted. We performed descriptive analyses on hospitalised patients diagnosed with IBD between 2019 and 2023, who received TCM treatment.Results:The study included 11 095 case records from 4 760 patients, with TCM diagnoses primarily indicating diarrhoea and abdominal pain. Ulcerative colitis (UC) accounted for 4 782 hospitalizations (3 103 patients), while Crohn's disease (CD) accounted for 6 313 hospitalizations (1 657 patients). Patient demographics showed a trend towards younger age and a higher proportion of males. Treatment utilisation was highest in southern Jiangsu compared with the central and northern regions. In terms of disease burden, all treatment costs showed a downward trend. In terms of external TCM therapies, UC patients tend to prefer plasters and enemas, while CD patients are more inclined to use acupuncture. Regarding herbal medicine, licorice, white atractylodes, and white peony root are commonly used single herbs for IBD patients.Conclusions:The number of IBD patients treated with TCM in Jiangsu Province has steadily increased from 2019 to 2023. It is important to identify effective TCM treatment methods to reduce the burden of patients.

The incidence of chronic venous disease(CVD)is significantly higher in the elderly population compared to non-elderly individuals,with more severe disease manifestations.Additionally,elderly CVD patients often have comorbid conditions such as cardiovascular diseases,making the evaluation process more complex and increasing treatment difficulty.Currently,there are no established recommendations in China for the diagnosis and treatment of CVD in individuals aged 60 and above.Against this backdrop,the Peripheral Vascular Disease Management Branch of the Chinese Geriatric Society has developed the Chinese Expert Consensus on the Diagnosis and Treatment of Chronic Venous Disease in the Elderly based on domestic and international guidelines,relevant evidence-based medical research,and the physiological and clinical characteristics of the elderly population in China.This consensus aims to provide an important reference for improving the diagnosis and treatment of CVD in elderly patients in China.

Heat stress(HS)is a critical factor contributing to male infertility,primarily by disrupting the testicular spermatogenic microenvironment,leading to oligospermia,asthenospermia,teratospermia and other male healthcare con-cerns.Sertoli cells are the major components of spermatogenic microenvironment and the blood-testis barrier(BTB),provi-ding structural and nutritional support for spermatogenesis.HS impairs the structure and function of Sertoli cells and the BTB,disrupts the spermatogenesis,and damages other testicular cells and extracellular matrix components.Current re-search predominantly employs surgical or environmental simulation models.A large number of studies have found that natu-ral compounds and traditional Chinese medicines exhibit therapeutic potential through antioxidant,anti-apoptotic,and hor-mone synthesis-regulating mechanisms.Patent and market translation efforts focus on optimizing formulars and developing novel antioxidant molecules.This review systematically summarizes the mechanisms of HS-induced reproductive damage,advances in basic research,and translational progress,aiming to provide a theoretical foundation for clinical diagnosis,treatment,and product development,while enhancing awareness of male reproductive health protection.

Objective To prepare a mouse model of asthenozoospermia(AZS)with high sperm DNA fragmentation(SDF)using corticosterone(CORT)and sodium benzoate(NaB).Methods Fifty 3-week-old male ICR mice were divided randomly into CORT-treated(n=30)and NaB-treated(n=20)groups.The CORT group was further divided into the following six groups(n=5 per group):high CORT(500 μg/mL),medium CORT(200 μg/mL),and low CORT(10 μg/mL)drinking water group,drinking water control group,CORT injection(40 mg/kg)group,and injection control group(normal saline).The animals were modeled continuously for 50 d.Mice in the NaB group were further divided into four groups(n=5 per group):high NaB(500 mg/kg),medium NaB(300 mg/kg),and low NaB(100 mg/kg)gavage groups,and control group(normal saline).The animals were modeled continuously for 50 d.The physiological state of the mice in each group was observed and mass changes were recorded continuously.The sperm motility capacity and DNA fragmentation index(DFI)of the sperm were observed from the tail of the epididymis after the end of the modeling.Results The rate of mass change in the CORT-injection moding group showed a downward trend.There was no significant difference(P＞0.05)in the high NaB gavage group,and the rate of body mass change in the high NaB gavage group was significantly decreased compared with the control group(P＜0.05).The percentages of forward motility sperm were significantly decreased in the CORT injection group(P＞0.05)and the percentage in the high NaB gavage group(P＜0.05),compared with the control group.The DFI was increased in the CORT injection group compared with the control group,but the difference was not significant(P＞0.05),and the DFI in the high NaB gavage group was significantly increased compared with the control group(P＜0.05).Conclusions Intragastric gavage with NaB 500 mg/(kg·d)for 50 d is an ideal method for constructing an animal model of AZS with high SDF.

The incidence of chronic venous disease(CVD)is significantly higher in the elderly population compared to non-elderly individuals,with more severe disease manifestations.Additionally,elderly CVD patients often have comorbid conditions such as cardiovascular diseases,making the evaluation process more complex and increasing treatment difficulty.Currently,there are no established recommendations in China for the diagnosis and treatment of CVD in individuals aged 60 and above.Against this backdrop,the Peripheral Vascular Disease Management Branch of the Chinese Geriatric Society has developed the Chinese Expert Consensus on the Diagnosis and Treatment of Chronic Venous Disease in the Elderly based on domestic and international guidelines,relevant evidence-based medical research,and the physiological and clinical characteristics of the elderly population in China.This consensus aims to provide an important reference for improving the diagnosis and treatment of CVD in elderly patients in China.

Objective:To explore the effect of self-made static progressive braces in the stepwise treatment of hand flexion dysfunction caused by scar contracture after burn injury.Methods:This study was a retrospective observational study. From January 2022 to March 2024, the First Affiliated Hospital of Air Force Medical University admitted twenty-nine patients who met the inclusion criteria and used the self-made static progressive braces for stepwise treatment of hand flexion dysfunction caused by scar contracture, including 23 males and 6 females, aged 16 to 55 years. The depth of burn on the back of the hand was deep partial-thickness to full-thickness. The self-made static progressive brace referred to the self-made static progressive joint distractor and the self-made static progressive hand flexion distractor. The stepwise treatment was adopted. In the first stage, in-hospital treatment for 2 to 4 weeks was selected. The treatment contents included conventional rehabilitation training and training on the application of the self-made joint distractors. When the active flexion range of motion of the metacarpophalangeal joint was ≥60°, the second stage of treatment was carried out, that is, two weeks of home remote rehabilitation treatment. The treatment contents included individualized exercise training such as training with self-made static progressive joint distractors and training with self-made static progressive hand flexion distractors. Adverse events such as blister, brace compression, and tissue strain during the stepwise treatment were recorded. After the end of the stepwise treatment, the active flexion of the affected hand was observed. During follow-up, the total active range of motion of the affected hand was measured, and the extensibility of the scar and skin and soft tissue on the back of the affected hand and the patient's satisfaction with the therapeutic effect were evaluated. At the last follow-up, the function of the affected hand was evaluated according to the trial standards for evaluation of partial function of upper extremity by the Hand Surgery Society of Chinese Medical Association.Results:During the stepwise treatment, a small amount of blisters developed on the skin at the wrist joint in 2 patients, which was cured after symptomatic treatment; the other patients had no adverse events such as brace compression and tissue strain. After the end of the stepwise treatment, the active flexion function of the hand was better, and the fist could be basically clenched. After 1-3 months of follow-up, the total active range of motion of the affected hand was 200-245°; the scar on the back of the hand was soft and light-colored, and the skin and soft tissue was malleable. Twenty-two patients were very satisfied with the curative effect, 6 patients were satisfied, and 1 patient was dissatisfied. At the last follow-up, there were 20 cases with excellent hand function and 9 cases with good hand function.Conclusions:The stepwise treatment of hand flexion dysfunction caused by scar contracture after burn injury with self-made static progressive braces has a good effect and few complications. Moreover, the two self-made static progressive distractors are convenient in material acquisition, simple to make, cost-effective, and highly practical, which is worthy of clinical promotion.