Hepatitis B virus （HBV） infection is the primary cause of viral hepatitis and represents a substantial disease burden in China. However， effective and safe agents capable of completely eliminating HBV DNA are still lacking. In modern medicine， anti-HBV strategies mainly target covalently closed circular DNA （cccDNA）， among other mechanisms， and multiple novel drugs are currently under clinical investigation. Traditional medicine has been shown to exert anti-HBV effects through direct pathways， such as blocking viral entry， as well as indirect pathways， including the regulation of programmed cell death. Studies have confirmed that the integration of traditional Chinese medicine （TCM） and Western medicine in treating HBV infection and its related complications offers complementary advantages， particularly in enhancing HBV clearance rates， improving liver function， preventing various complications， and delaying the progression from hepatic fibrosis to hepatocellular carcinoma. This review focuses on advances in anti-HBV research involving TCM， Western medicine， and their integrated application， aiming to provide a basis for integrated HBV therapy and new drug development.

Age-related macular degeneration(ARMD)is a progressive visual impairment fundus disease that frequently occurs in individuals aged >55 years. The main risk factors are aging, long-term smoking, genetics, and racial differences. Pathogenesis includes abnormal function of the retinal pigment epithelium, damaged blood-retinal barrier, and abnormal immune function. Currently, intravitreal injection(IVI)of anti-vascular endothelial growth factor(VEGF)drugs is the preferred treatment option for ARMD in clinical practice. However, it also faces challenges such as repeated treatments, high medical costs, and poor patient compliance. The predicament in the treatment of ARMD has given rise to several new treatment options. This article aims to review the treatment methods and progress of dry ARMD and wet ARMD, providing new ideas for addressing the limitations of the current clinical anti-VEGF treatment.

OBJECTIVE To investigate the apoptosis-inducing effect of esculetin （Esc） on acute myeloid leukemia （AML） HL-60 cells by regulating the protein kinase B （AKT）/S-phase kinase-associated protein 2 （SKP2）/MutT homolog 1 （MTH1） pathway. METHODS AML HL-60 cells were randomly divided into control group （routine culture）， Esc low-concentration group （L-Esc group， 25 μmol/L Esc）， Esc medium-concentration group （M-Esc group， 50 μmol/L Esc）， Esc high-concentration group （H-Esc group， 100 μmol/L Esc）， and high-concentration of Esc+ SC79 （AKT agonist） group （100 μmol/L Esc+5 μmol/L SC79）. Cell proliferation in each group was detected by MTT assay and colony formation assay. The level of reactive oxygen species （ROS） in cells was measured by using the CM-H2DCFDA fluorescent probe. Cell apoptosis was analyzed by flow cytometry. Western blot assay was performed to detect the expression levels of apoptosis-related proteins [B-cell lymphoma 2 （Bcl-2）， Bcl-2-associated X protein （Bax）， cleaved caspase-3]， AKT/SKP2/MTH1 pathway-related proteins （p-AKT， AKT， SKP2， MTH1）， along with the upstream and downstream proteins of AKT phosphatidylinositol 3-kinase （PI3K）， cyclin-dependent kinase inhibitor 1 （P21） and cyclin-dependent kinase inhibitor 1B （P27）. RESULTS Compared with control group， the cell viability， colony number， and the phosphorylation levels of AKT and PI3K proteins as well as protein expressions of SKP2， MTH1 and Bcl-2 were significantly decreased （P＜0.05）， while ROS level， apoptosis rate， and the expression levels of Bax， cleaved caspase-3， P21 and P27 proteins were significantly increased （P＜0.05）. Moreover， the effects of Esc exhibited concentration-dependence （P＜0.05）. Compared with H-Esc group， above indexes of high-concentration of Esc+ SC79 group were reversed significantly （P＜0.05）. CONCLUSIONS Esc may promote massive ROS production and induce activation of apoptosis in HL-60 cells by inhibiting the AKT/SKP2/MTH1 pathway， thus inhibiting the proliferation of HL-60 cells.

Metabolic associated fatty liver disease （MAFLD） is a common chronic liver disease worldwide， and timely and precise intervention can delay disease progression and significantly reduce the risk of serious complications such as liver fibrosis， liver cirrhosis， and liver cancer. Although traditional liver biopsy combined with metabolic markers is the gold standard， it may cause complications such as pain and bleeding as an invasive examination， which has promoted scientific research to shift its focus to the construction of noninvasive assessment systems. In recent years， noninvasive diagnostic technologies based on multi-dimensional detection strategies have been continuously updated， including serological models， imaging techniques， and clinical algorithms. This article systematically reviews the screening methods for MAFLD during the fibrotic stages F1—F3， especially deep learning models based on artificial intelligence， in order to provide ideas for the early screening of MAFLD， as well as a scientific reference for optimizing disease management strategies.

ObjectiveTo investigate the demand and the application outcomes of case-based learning (CBL) combined with teaching case library in continuing education courses for rehabilitation therapists. MethodsA convergent mixed-methods research design was adopted, involving 51 rehabilitation therapists and 31 instructors who participated in the advanced training program at the Department of Rehabilitation Medicine, Peking University Third Hospital between October, 2022 and October, 2024. Self-developed questionnaires were used to collect data on the perceived needs of teachers and students regarding CBL and teaching case library. Differences between CBL + teaching case library and traditional lecturing in student evaluations, classroom participation and interaction were compared using Student Evaluation of Teaching in Medical Lectures, Classroom Participation Scale and Flanders Interaction Analysis System. Semi-structured interviews were conducted to obtain evaluations and attitudes towards this method from both instructors and students' perspectives. ResultsThe survey showed that 91.4% of participating teachers and students supported the use of CBL in the courses, and 82.7% advocated that the teaching case library should include typical cases. Significant differences were observed in teaching preference between teachers and students (χ² = 17.597, P < 0.01). Application effects demonstrated that CBL+teaching library significantly outperformed traditional teaching methods in student previewing behaviors, classroom interaction and learning outcomes (|Z| ≥ 2.646, P < 0.01). Flanders Interaction Analysis indicated that CBL+teaching library was superior to traditional teaching in terms of students' motivation to speak and autonomous learning. Qualitative Research generated four positive themes including cultivating clinical reasoning, being close to clinical practice, deepening knowledge understanding and improving teaching quality; and three negative themes including increasing teaching burden, high software and hardware requirements and posing great challenges to students were generated. ConclusionCompared with traditional teaching methods, CBL combined with teaching case library is closely linked to clinical practice, facilitating students' clinical reasoning, enhancing teaching effectiveness and satisfaction, and therefore aligning with the goals and needs of continuing education for rehabilitation therapists, which is highly recognized by both instructors and students.

ObjectiveTo explore the complex network relationships among pain, kinesiophobia, social participation and knee function in patients after total knee arthroplasty (TKA), and to analyze the moderating effects of different socio-structural factors on the rehabilitation network from an ethical equity perspective. MethodsA convenience sampling method was used to select 291 patients who underwent TKA in Qilu Hospital of Shandong University from May to July, 2023. Pain was assessed using Numerical Rating Scale, kinesiophobia with Chinese short version of the Tampa Scale for Kinesiophobia, social participation with Impact on Participation and Autonomy Questionnaire, and knee function with Hospital for Special Surgery Knee Score. A partial correlation network among pain, kinesiophobia, social participation and knee function was constructed using Graphical Least Absolute Shrinkage and Selection Operator. Key variables were identified through node centrality and bridge centrality analysis. Network Comparison Tests (NCT) were used to analyze network differences among subgroups based on different socio-structural characteristics. ResultsIn the network model, the nodes with the highest strength centrality were indoor participation, activity behavior and activity pain. Bridge centrality analysis indicated that activity pain, knee function, indoor participation and activity cognition were key bridge nodes. NCT revealed no significant differences in overall network structure or global strength among subgroups based on residence, education level or payment method (P > 0.05). However, significant differences in edge weights were found for specific edges such as activity cognition-activity behavior and knee function-indoor participation (P < 0.05). ConclusionThere is a network of interactions among pain, kinesiophobia, social participation and knee function in patients after TKA, with nodes such as indoor participation and activity pain playing key roles in the rehabilitation process. Although the overall rehabilitation network is similar across different socio-structural groups, variations exist in specific relational pathways among patients from rural areas, those with lower education levels, and those with out-of-pocket payment. This suggests that clinical rehabilitation interventions should focus on these core nodes and implement targeted support strategies for socio-structurally disadvantaged groups to promote rehabilitation equity.

ObjectiveTo systematically evaluate the effectiveness of music therapy in reducing children’s dental anxiety by summarizing relevant literature， and to provide application references for the clinical practice of pediatric dentistry in China. MethodsA systematic literature search was conducted using the Cochrane Library and Medline databases. Clinical trials， systematic reviews， and cohort studies on the effectiveness of music in children’s dental anxiety both domestically and internationally were included. A detailed retrospective analysis of the included literature was conducted to extract relevant evidence and conclusions. ResultsThrough extensive literature screening and quality assessment， multiple studies showed that music therapy could positively influence emotions through biological and psychological mechanisms. In clinical practice， music was confirmed to be an effective auxiliary means that significantly reduced children’s dental anxiety levels. ConclusionMusic therapy can not only effectively alleviate children’s anxiety during medical visits but also improve the effectiveness of diagnosis and treatment， promoting harmonious doctor-patient relationships. Therefore， hospitals should actively explore and implement specific pathways to music therapy， including multiple specific suggestions such as music selection， optimization of playback environment， and interaction strategies with children， with a view to achieving the goals of being people-oriented and pursuing goodness and beauty in medical humanities， and thus achieving the ultimate goal of health humanities.

Disease computable phenotype is a data model designed to identify specific clinical conditions or characteristics, which automatically extracts information from clinical databases such as electronic health records through algorithms. Phenotypic data for rare diseases often reside in unstructured text. Due to the scarcity of rare disease cases, atypical symptoms, and insufficient physician experience, misdiagnosis and underdiagnosis rates remain high. In this context, the application of computable phenotype technology holds promise for improving the accuracy and efficiency of rare disease diagnosis. This article reviews the current research status, challenges, and opportunities of computable phenotype technology in biomedicine, particularly in the field of rare diseases, and proposes a development and validation framework for rare disease computable phenotypes, aiming to provide research and development insights for computable phenotypes to empower the diagnosis and treatment of rare diseases.

Rheumatoid arthritis （RA） is a common autoimmune disease characterised clinically by symmetrical joint pain， swelling， and stiffness. Long-term chronic synovial inflammation can lead to severe joint damage and even disability， thereby affecting quality of life for patients. Current clinical treatment of RA emphasises an integrated approach combining traditional Chinese and Western medicine， with traditional Chinese medicine offering certain advantages in reducing disease activity of RA， preventing relapses， and other aspects. Modern clinical evidence confirms that Guizhi Shaoyao Zhimutang （GSZT） is effective in improving symptoms such as immune metabolism， joint stiffness， and joint pain in RA patients. Pharmacological studies have revealed that GSZT primarily contains components such as cinnamaldehyde， total glucosides of paeony， total alkaloids of Aconiti Lateralis Radix Praeparata， glycyrrhetinic acid， zingiberone， isoimperatorin， ephedra polysaccharides， and cedrol. It improves RA symptoms via multiple mechanisms and targets， including enhancing immune responses， exerting anti-inflammatory and analgesic effects， regulating relevant signalling pathways， inhibiting cell apoptosis， and suppressing bone destruction. This paper reviewed the syndrome patterns and pharmacological basis of GSZT in the treatment of RA， as well as its clinical applications and related mechanisms， thereby providing a theoretical basis and reference for the further development and utilisation of GSZT in the treatment of RA.

Primary pigment dispersion syndrome(PDS)is characterized by pigment granules released from the pigment epithelium of iris, and their deposition in anterior segment of eye, particularly in the trabecular meshwork(TM). This condition may lead to elevated intraocular pressure(IOP),which further causes optic nerve damage, and progresses to pigmentary glaucoma(PG). PDS predominantly affects young myopic individuals and shows heterogeneous clinical manifestations. It may occur sporadically or in familial inheritance. It has been reported that the pathogenic genes include those involved in melanogenesis and melanosome homeostasis(e.g., PMEL, MC1R, SLC45A2, and TYR), and genes related to ocular development and anterior segment formation(e.g., CPAMD8, GSAP, and GRM5).The pathogenesis of PDS is closely associated with posterior iris concavity and reverse pupillary block, which may change the dynamics of aqueous humor, along with persistent liberation of pigmented granules by friction of iris and zonules. Pigmented granules accumulating in the TM may cause mechanical obstruction of TM, and increase the phagocytic burden of the cells, and result in cellular dysfunction and structural damage of TM. All these changes contribute to sustained elevation of IOP and optic neuropathy. Primary management of PDS involves regular follow-up and assessment of the risk of IOP elevation. Laser peripheral iridotomy may be considered to reduce posterior iris concavity in PDS. Treatment of PG focuses on IOP control for long term, which include topical medications, laser trabeculoplasty, and filtering or drainage surgery. Development of experimental animal models harboring human pathogenic genes and exhibiting PDS phenotypes is needed to facilitate in-depth research into the pathogenesis of PDS.