Digital biopsy for liver diseases is characterized by the deep integration of artificial intelligence （AI） technologies and large-scale liver disease data， through which intelligent analytics are applied to support clinical decision-making and full-cycle management. This article reviews the AI technical framework based on standardized data governance and centered on multimodal large medical models， covering the application of natural language processing， knowledge map， generative AI， and large language models in the establishment of databases for specialty diseases， diagnosis， prognosis prediction， treatment， and automated medical documentation. This article also discusses the application prospects of this framework in medical education， scientific research， and healthcare management. Although this technique shows broad application potential， it still faces challenges in areas such as multi-center data integration， model interpretability， ethics， and data security. In the future， a smart ecosystem with closed-loop optimization and human-AI collaboration should be established to promote the comprehensive implementation of digital biopsy in the whole process of medicine， education， research， and management， thereby providing help for the precise prevention and control and holistic health management of liver diseases.

Ischemia-reperfusion (I/R) injury following skin flap transplantation is a critical factor leading to flap necrosis and transplant failure. Antagonizing inflammatory responses and oxidative stress are regarded as crucial targets for mitigating reperfusion injury and enhancing flap survival. In this study, caffeic acid-vanadium metal polyphenol nanoparticles (CA-V NPs) were prepared for the treatment of skin flap ischemia and reperfusion. This study was conducted using a one-step method to prepare new types of CA-V NPs with uniform sizes and stable structures. In vitro, the CA-V NPs exhibited CAT-like and SOD-like activities and could effectively scavenge ROS, generate oxygen, and alleviate oxidative stress. In the H₂O₂-induced cellular oxidative stress model, CA-V NPs effectively reduced ROS levels and inhibited apoptosis through the XIAP/Caspase-3 pathway. In the cellular inflammation model induced by LPS combined with IFN-γ, CA-V NPs reprogrammed macrophage polarization toward the M2 phenotype and reduced inflammatory responses by reducing the expression of the chemokines CCL4 and CXCL2. In addition, animal experiments have shown that CA-V NPs can alleviate oxidative stress in skin flap tissues, inhibit apoptosis, promote angiogenesis, and ultimately improve the survival rate of skin flaps. CA-V NPs provide a new target and strategy for the treatment of flap I/R injury.

Extracorporeal membrane oxygenation(ECMO)provides blood circulation with assisted breathing for patients with severe cardiopulmonary failure,and buys valuable time for the rescue of critical patients.However,extracorporeal membrane oxygenation is often associated with serious complications.Small animal models have the advantages of low price,wide source,high flexibility and good reproducibility,and are an effective platform for evaluating strategies for prevention and treatment of ECMO complications.In recent years,more and more experimental studies have been conducted using small animal ECMO models.In this paper,the current status of the construction and application of small animal ECMO models at home and abroad is summarized,in order to optimize the related strategies of small animal ECMO model construction and promote the application and development of small animal ECMO models.

With the increasing difficulty of traditional chemical drug research and development,peptide drugs have gradually become a hot spot in drug research and development due to their advantages of high specificity,significant efficacy,easy metabolism and low toxicity.This review systematically expounds the physicochemical properties,main advantages and limitations of peptide drugs,and summarizes the currently common strategies for structural modification and delivery.It focuses on the application and target of approved peptide drugs in various diseases such as diabetes,cancer,bacterial and viral infections,multiple sclerosis,and osteoporosis.Furthermore,the research analyzes the challenges in the research and development of peptide drugs,including poor in vivo stability,low bioavailability,and limited routes of administration.It also discusses the prospects of new technologies based on molecular modification,nanodelivery systems,and computer-aided design.In summary,peptide drugs have shown unique advantages in multi-field therapy,but they still need to break through bottlenecks in preparation,delivery and drug resistance to provide new ideas and directions for future precision therapy.

Extracorporeal membrane oxygenation(ECMO)provides blood circulation with assisted breathing for patients with severe cardiopulmonary failure,and buys valuable time for the rescue of critical patients.However,extracorporeal membrane oxygenation is often associated with serious complications.Small animal models have the advantages of low price,wide source,high flexibility and good reproducibility,and are an effective platform for evaluating strategies for prevention and treatment of ECMO complications.In recent years,more and more experimental studies have been conducted using small animal ECMO models.In this paper,the current status of the construction and application of small animal ECMO models at home and abroad is summarized,in order to optimize the related strategies of small animal ECMO model construction and promote the application and development of small animal ECMO models.

Objective:To analyze the epidemiological and clinical characteristics of pertussis cases identified through active surveillance.Methods:Active surveillance for pertussis was conducted in three sentinel hospitals in Yiwu, Zhejiang Province, and Yongcheng, Henan Province. The study population included cases that met the surveillance case definition and sought medical care at outpatient/emergency departments or were hospitalized between June 1, 2021, and May 31, 2022. Samples were collected for bacterial culture and PCR detection. Case information and clinical data were collected. Differences in rates were assessed using the chi-square test or Fisher's exact probability test, and the differences in cough time were compared using the Mann-Whitney U test. Results:Among 1 423 cases of pertussis surveillance, the positive rate of pertussis was 28.11% (400/1 423), with a median age of 5 years (interquartile range: 2, 8). The positive rate in Yongcheng, Henan Province, and Yiwu, Zhejiang Province were 39.27% (216/550) and 21.08% (184/873), respectively; the positive rate of pertussis was highest in July 2021, and the highest positive rate of pertussis was among those aged 10-14. The positive rate of pertussis in hospitalized cases was higher than in outpatient/emergency cases (26.68%) ( χ2=4.16, P=0.041). Among the 400 laboratory test-positive cases, the highest proportion of atypical symptom cases was in adults aged 20-59 (43.33%, 13/30). The specificity rates of apnea and worsening nocturnal cough in monitored cases under 3 months of age were 100.00% and 73.81%, respectively. Among monitored cases aged 3 months to 9 years, the proportions of symptoms including worsening nighttime cough (63.00%) and night sweats (4.59%) in test-positive cases were significantly higher than those in the test-negative group (47.77% and 0.56%, respectively), with statistically significant differences (both P<0.05). The specificity rates of worsened nighttime coughing and night sweats were 52.23% and 99.44%, respectively. Conclusions:The active surveillance results for pertussis showed that the 10-14 age group exhibited the highest positivity rate. Active surveillance enhanced the detection rate of pertussis. Among laboratory-confirmed cases, the proportion of atypical symptoms was the highest in adults, suggesting that laboratory testing should be combined to diagnose programs of pertussis. For infants under 3 months, worsening nighttime cough and apnea increase the diagnostic specificity, while for individuals aged 3 to 9 years old, worsening nighttime cough and night sweats increase the diagnostic specificity.

Objective To establish an efficient and stable one-step real-time quantitative PCR(qRT-PCR)method for detecting mi-croRNA-like small RNAs(milRNAs)encoded by novel Bunyavirus and evaluate its clinical application value.Methods Three kinds of milRNAs encoded by novel Bunyavirus,including sRNA S-1480,sRNA M-692,and sRNA L-4706,were selected based on prelimi-nary screening.The specific qRT-PCR primers and reaction systems for them were designed and optimized.The sensitivity,specificity,and clinical applicability of the method were further evaluated by standard curve drawing,primer concentration/sequence optimization,fluorescent dye optimization,product sequencing verification,and serum specimen detection of 20 patients infected with novel Bunya-virus and 20 healthy controls.Results A one-step qRT-PCR detection system was successfully established.The standard curve con-structed with standard substance showed a good linear relationship in the range of 10 fmol/L to 100 nmol/L(R2>0.98).The detection limits for three kinds of milRNAs were 10 fmol/L.The analysis results of the receiver operating characteristics(ROC)curve showed that sRNA S-1480(AUCROC=0.972 5),sRNA M-692(AUCROC=0.757 5),sRNA L-4706(AUCROC=0.957 5),and their combina-tion(AUCROC=0.995 0)could effectively distinguish the patients infected with novel Bunyavirus from healthy controls.Conclusion The established one-step qRT-PCR detection system exhibits high sensitivity and provides an efficient and reliable alternative for the clinical diagnosis of novel Bunyavirus infection.

Objective:To analyze the epidemiological and clinical characteristics of pertussis cases identified through active surveillance.Methods:Active surveillance for pertussis was conducted in three sentinel hospitals in Yiwu, Zhejiang Province, and Yongcheng, Henan Province. The study population included cases that met the surveillance case definition and sought medical care at outpatient/emergency departments or were hospitalized between June 1, 2021, and May 31, 2022. Samples were collected for bacterial culture and PCR detection. Case information and clinical data were collected. Differences in rates were assessed using the chi-square test or Fisher's exact probability test, and the differences in cough time were compared using the Mann-Whitney U test. Results:Among 1 423 cases of pertussis surveillance, the positive rate of pertussis was 28.11% (400/1 423), with a median age of 5 years (interquartile range: 2, 8). The positive rate in Yongcheng, Henan Province, and Yiwu, Zhejiang Province were 39.27% (216/550) and 21.08% (184/873), respectively; the positive rate of pertussis was highest in July 2021, and the highest positive rate of pertussis was among those aged 10-14. The positive rate of pertussis in hospitalized cases was higher than in outpatient/emergency cases (26.68%) ( χ2=4.16, P=0.041). Among the 400 laboratory test-positive cases, the highest proportion of atypical symptom cases was in adults aged 20-59 (43.33%, 13/30). The specificity rates of apnea and worsening nocturnal cough in monitored cases under 3 months of age were 100.00% and 73.81%, respectively. Among monitored cases aged 3 months to 9 years, the proportions of symptoms including worsening nighttime cough (63.00%) and night sweats (4.59%) in test-positive cases were significantly higher than those in the test-negative group (47.77% and 0.56%, respectively), with statistically significant differences (both P<0.05). The specificity rates of worsened nighttime coughing and night sweats were 52.23% and 99.44%, respectively. Conclusions:The active surveillance results for pertussis showed that the 10-14 age group exhibited the highest positivity rate. Active surveillance enhanced the detection rate of pertussis. Among laboratory-confirmed cases, the proportion of atypical symptoms was the highest in adults, suggesting that laboratory testing should be combined to diagnose programs of pertussis. For infants under 3 months, worsening nighttime cough and apnea increase the diagnostic specificity, while for individuals aged 3 to 9 years old, worsening nighttime cough and night sweats increase the diagnostic specificity.

Objective To establish an efficient and stable one-step real-time quantitative PCR(qRT-PCR)method for detecting mi-croRNA-like small RNAs(milRNAs)encoded by novel Bunyavirus and evaluate its clinical application value.Methods Three kinds of milRNAs encoded by novel Bunyavirus,including sRNA S-1480,sRNA M-692,and sRNA L-4706,were selected based on prelimi-nary screening.The specific qRT-PCR primers and reaction systems for them were designed and optimized.The sensitivity,specificity,and clinical applicability of the method were further evaluated by standard curve drawing,primer concentration/sequence optimization,fluorescent dye optimization,product sequencing verification,and serum specimen detection of 20 patients infected with novel Bunya-virus and 20 healthy controls.Results A one-step qRT-PCR detection system was successfully established.The standard curve con-structed with standard substance showed a good linear relationship in the range of 10 fmol/L to 100 nmol/L(R2>0.98).The detection limits for three kinds of milRNAs were 10 fmol/L.The analysis results of the receiver operating characteristics(ROC)curve showed that sRNA S-1480(AUCROC=0.972 5),sRNA M-692(AUCROC=0.757 5),sRNA L-4706(AUCROC=0.957 5),and their combina-tion(AUCROC=0.995 0)could effectively distinguish the patients infected with novel Bunyavirus from healthy controls.Conclusion The established one-step qRT-PCR detection system exhibits high sensitivity and provides an efficient and reliable alternative for the clinical diagnosis of novel Bunyavirus infection.

Objective:To investigate the mechanism, treatment and prevention of brain edema after controlled ovarian hyperstimulation (COH) and transvaginal ovarian puncture and oocyte retrieval.Methods:A retrospective clinical study and literature review were performed to analyze one patient who was diagnosed as having brain edema after COH and transvaginal ovarian puncture and oocyte retrieval.Results:After long acting gonadotropin-releasing hormone analogue (GnRH-a) COH protocol, 30 oocytes were obtained. Hydroxyethyl starch 500 mL was given to treat ovarian hyperstimulation syndrome (OHSS) after oocyte retrieval. The patient had sudden irritability, blurred consciousness and vomiting at the 8th hour after oocyte retrieval. The examinations showed hyponatremia and brain edema. The patient relived after mannitol and hypertonic saline treatment. On the 5th day after oocyte retrieval, the patient performed paracentesis guided by ultrasound due to seroperitoneum. Low molecular weight heparin was applied to prevent thrombosis after the flare up of serum D-Dimer on the 7th day. The patient recovered and discharged after 2 weeks.Conclusion:The incidence of brain edema after COH and transvaginal ovarian puncture and oocyte retrieval was very low. However, the symptoms may be severe and may be life-threatening.