Liver fibrosis is caused by various factors such as viral infection， alcohol intake， and metabolism-related damage， leading to the replacement of normal tissue by fibrous scars. As a regulatory factor for cell proliferation， insulin-like growth factor 1 （IGF-1） participates in the regulation of cell cycle， the promotion of cell proliferation and differentiation， and the inhibition of cell apoptosis by binding to its receptor insulin-like growth factor-1 receptor （IGF-1R）. Studies have shown that the IGF-1/IGF-1R signaling pathway can regulate the process of liver fibrosis by affecting the senescence and apoptosis of hepatocytes， the activation and proliferation of hepatic stellate cells， and the dysfunction of endothelial cells. In addition， the IGF-1/IGF-1R signaling system can also regulate multiple mechanisms such as DNA damage repair， cell proliferation， lipid metabolism， cell senescence， and oxidative stress， thereby providing new strategies and potential targets for the prevention and treatment of liver fibrosis. This article summarizes the mechanism of action of IGF-1/IGF-1R and its signal transduction system in mediating liver fibrosis by regulating DNA damage repair in different cells， in order to provide a theoretical basis for the treatment of liver fibrosis.

Objective To investigate the species of sandflies and the prevalence of Leishmania infections in sandflies from selected areas of northern and northwestern China, so as to provide insights into identification of leishmaniasis vectors and assessment of epidemiological trends of leishmaniasis in China. Methods Sandfly samples were collected from Mentougou District of Beijing Municipality, Xiangning County in Linfen City of Shanxi Province, Ejin Banner in Alxa League of Inner Mongolia Autonomous Region, and Payzawat County of Karamay District of Karamay City, Gaochang District of Turpan City in Xinjiang Uygur Autonomous Region from July 2023 to July 2024. Approximately 100 intact female sandfly samples were randomly selected from each site and the species of sandflies was identified according to morphological characteristics and molecular assays. Female sandflies originating from the same habitat were grouped into pools of 10 individuals. Leishmania infection was detected using polymerase chain reaction (PCR) assay targeting the internal transcribed spacer 1 (ITS-1) gene, and the prevalence of Leishmania infection was calculated in sandflies from different sampling sites using the minimum infection rate (MIR) method. In addition, positive amplicons were sequenced and subjected to phylogenetic analysis. Results A total of 6 155 sandflies were collected from different environments at sampling sites across the six aforementioned regions from July 2023 to July 2024. Phlebotomus chinensis (96.00%) was the dominant sandfly species in Mentougou District, Beijing Municipality, with a small proportion of Ph. sergenti (4.00%), and only Ph. chinensis was found in Xiangning County, Linfen City, Shanxi Province. Ph. wui was the only sandfly species detected in Ejin Banner, Alxa League, Inner Mongolia Autonomous Region, and Payzawat County, Kashgar City, Xinjiang Uygur Autonomous Region, and Ph. caucasicus (97.70%) was the dominant sandfly species in Karamay District, Karamay City, Xinjiang Uygur Autonomous Region, with a small proportion of Ph. wui (2.30%), while Ph. alexandri was the only species in Gaochang District, Turpan City, Xinjiang Uygur Autonomous Region. A total of 40, 60, 34, 18, 18, and 22 pools of sandfly samples were tested from Mentougou District in Beijing Municipality, Xiangning County in Linfen City of Shanxi Province, Ejin Banner in Alxa League of Inner Mongolia Autonomous Region, Payzawat County in Kashgar City, Karamay District in Karamay City, and Gaochang District in Turpan City of Xinjiang Uygur Autonomous Region, respectively. L. infantum was detected in Ph. chinensis samples from Mentougou District in Beijing Municipality, and Xiangning County of Linfen City in Shanxi Province, with MIR of 0.25% to 1.00%, and L. donovani was detected in Ph. wui from Ejin Banner in Alxa League of Inner Mongolia Autonomous Region, and Payzawat County in Kashgar City of Xinjiang Uygur Autonomous Region, with MIR of 0.56% to 0.88%; however, no Leishmania infection was detected in Ph. caucasicus from Karamay District in Karamay City or Ph. alexandri from Gaochang District in Turpan City of Xinjiang Uygur Autonomous Region. Phylogenetic analysis showed that the Leishmania ITS-1 gene sequences obtained from Mentougou District in Beijing Municipality and Xiangning County in Linfen City of Shanxi Province were clustered into the same clade with the reference sequences of L. infantum ITS-1 gene, while the Leishmania ITS-1 gene sequences obtained from Ejin Banner in Alxa League of Inner Mongolia Autonomous Region and Payzawat County in Kashgar City of Xinjiang Uygur Autonomous Region were clustered into the same clade with the reference sequences of L. donovani ITS-1 gene. Conclusions There are variations in sandfly species in selected areas of northern and northwestern China, and variations in the species of Leishmania infecting sandflies. Improved surveillance of sandfly vectors and targeted control strategies with adaptations to geographical features and leishmaniasis vectors are recommended.

Radiotherapy is a crucial treatment modality for head and neck tumors. However, while effectively killing tumor cells, it significantly disrupts the homeostasis of the oral microecology, which is closely associated with various complications such as radiation-induced oral mucositis. Literature review indicates that as radiotherapy doses accumulate and treatment durations extend, the richness and diversity of the oral microbiota show a declining trend, with the genus Streptococcus decreasing most markedly. In contrast, radiotherapy selectively promotes the proliferation of bacterial phyla such as Proteobacteria and Bacteroidetes, which are rich in opportunistic pathogens. Mechanistically, radiotherapy activates the nuclear factor-kappa B pathway, triggering chronic inflammation and oxidative stress, damaging the epithelial barrier, suppressing local immunity, and causing damage to organs such as the salivary glands. It can also induce systemic diseases via the oral-gut axis, forming a multi-level, interconnected pathogenic network. In terms of interventions, treatment strategies including probiotics and prebiotics have shown promising efficacy against side effects such as radiation-induced oral mucositis. Saliva-based oral microbiota transplantation is an emerging strategy that is expected to become widely utilized for restoring oral microecological balance. Existing interventions provide preliminary pathways for clinical practice, but this field still faces several key scientific questions. The association between oral microecology and systemic diseases remains largely correlative, lacking causal evidence. Furthermore, critical parameters for oral microbiota transplantation, such as donor screening criteria, transplantation protocols, and long-term safety, are not yet well-defined. Therefore, future research should focus on conducting large-scale clinical trials to establish standardized protocols and safety evaluation systems for oral microecological interventions, and explore combined treatment therapies such as probiotics, prebiotics, and microbiota transplantation to advance the development of personalized precision modulation. These will enable more effective management of radiotherapy-induced oral microecological dysbiosis and improve treatment outcomes and quality of life for patients with head and neck tumors.

With advances in imaging and the growing emphasis on nephron preservation, partial nephrectomy has become central in the management of T1 renal tumors and has gradually been extended to complex renal masses, where surgical challenges are greater.This article reviews the current status, key technical advances, and clinical application strategies of minimally invasive partial nephrectomy for complex renal tumors.It compares the suitability and advantages of laparoscopic and robot-assisted approaches across different levels of tumor complexity, and summarizes the value of three-dimensional reconstruction, precise selective vascular control, and intraoperative navigation in improving surgical safety and controllability. It elaborates on the management pathways and technical strategies for typical scenarios such as renal hilar lesions, completely intrarenal tumors, cystic tumors, and multifocal tumors, and summarizes operative techniques and perioperative risk-control considerations for high-risk cases, including solitary kidneys, T2 or higher stage tumors, tumors with local invasion of the renal pelvis, and those complicated with vascular tumor thrombus.The article also briefly discusses controversies regarding indication boundaries and the balance between functional preservation and oncologic safety, and highlights the trend toward a standardized, reproducible precision surgery paradigm supported by intelligent planning and quality-control systems.

Objective To explore the research hotspots and developmental trends in urological education through a bibliometric analysis. Methods Relevant literature on urological education was retrieved from the Web of Science Core Collection and the China National Knowledge Infrastructure (CNKI) databases, covering all records up to Sep.16, 2025.A comprehensive bibliometric analysis was performed on the retrieved publications. Results A total of 303 Chinese and 290 English articles were collected.The annual number of publications demonstrated an overall upward trend.Harvard University in the United States was the most productive institution in this field. Conclusion Urological clinical education has attracted increasing attention from clinicians and medical trainees.Highly cited studies consistently highlight three actionable priorities for urological education:firstly, improving long-term knowledge retention through structured, spaced, and feedback-rich learning designs; secondly, standardizing simulation-based skills training with validated assessment and staged credentialing; thirdly, strengthening training system resilience while expanding non-technical skills training.These directions provide implementable pathways for optimizing urological teaching practices and the standardized residency training programs.

Objective:To summarize and analyze the clinical characteristics of patients with sudden sensorineural hearing loss（SSHL） accompanying diabetes mellitus, to explore whether diabetes affects the treatment outcomes during hospitalization, and to identify the factors influencing the efficacy of SSHL patients with diabetes. Methods:A retrospective analysis was conducted on clinical data from 939 patients with SSHL. The baseline characteristics, and onset conditions of the diabetes group（79 cases） and the non-diabetes group（860 cases） were compared. Propensity score matching（PSM） was applied in a 1︰ 2 ratio to match initial hearing levels with baseline characteristics such as age, sex, and BMI, resulting in 73 diabetes cases and 144 non-diabetes cases for treatment efficacy comparison. For the analysis of prognostic factors, a logistic regression model was established based on the treatment outcomes of 217 patients with SSHL. Results:The proportion of SSHL patients accompanying diabetes was 8.40%（79/939）. Compared to non-diabetic patients, those with diabetes were older（median age of 53 years in the diabetes group and 39 years in the non-diabetes group） and had a higher proportion of hypertension（43.04% vs 12.67%）, with significant difference observed（P<0.05）. After PSM, the treatment efficacy during hospitalization was better in the diabetes group than in the non-diabetes group（58.90% vs 47.92%）, although the difference was not statistically significant（P>0.05）. The prognosis of patients with SSNHL accompanied by diabetes was analyzed using a multivariate logistic regression model that included age, HDL-C, and INR as variables; however, no statistically significant differences were found（P>0.05）. Conclusion:Patients with SSHL accompanying diabetes are generally older with a higher incidence of hypertension. The presence of diabetes does not affect the treatment outcomes during hospitalization.
Humans ; Propensity Score ; Retrospective Studies ; Hearing Loss, Sensorineural/therapy* ; Hearing Loss, Sudden/therapy* ; Middle Aged ; Diabetes Mellitus ; Male ; Female ; Prognosis ; Adult ; Logistic Models ; Diabetes Complications ; Aged ; Treatment Outcome

Bombesin receptor subtype-3 (BRS3) is an orphan G protein-coupled receptor (GPCR) that plays critical roles in energy homeostasis, glucose metabolism, and insulin secretion. Recent structural studies have elucidated BRS3 signaling mechanisms using synthetic ligands, including BA1 and MK-5046. However, the molecular basis of BRS3 activation by bioactive natural compounds and their derivatives, particularly those derived from traditional Chinese medicine, remains unclear. Here, we present high-resolution cryogenic electron microscopy (cryo-EM) structures of the human BRS3-G_q complex in both unliganded and active states bound by two herb-derived compounds (DSO-5a and oridonin), at resolutions of 2.9, 2.8, and 2.9 Å, respectively. These structures display distinct ligand recognition patterns between DSO-5a and oridonin. Although both compounds bind to the orthosteric pocket, they differentially engage the interaction network of BRS3, as demonstrated by mutagenesis studies assessing calcium mobilization and inositol phosphate 1 (IP1) accumulation. These findings enhance our understanding of BRS3 activation and provide valuable insights into the development of small-molecule BRS3 modulators with therapeutic potential.

Dysfunction of the interoceptive system is recognized as an important component of clinical symptoms, including anxiety, depression, psychosis, and other mental disorders. Non-invasive neuromodulation is an emerging clinical intervention approach, and over the past decade, research on non-invasive neuromodulation aimed at regulating interoception has rapidly developed. This review first outlines the pathways of interoceptive signals and assessment methods, then summarizes the interoceptive abnormalities in psychiatric disorders and current studies for non-invasive neuromodulation targeting interoception, including intervention modes, target sites, interoceptive measures, and potential neurobiological mechanisms. Finally, we discuss significant research challenges and future directions.
Humans ; Interoception/physiology* ; Mental Disorders/therapy*

The prevalence of Class III malocclusion varies among different countries and regions. The populations from Southeast Asian countries (Chinese and Malaysian) showed the highest prevalence rate of 15.8%, which can seriously affect oral function, facial appearance, and mental health. As anterior crossbite tends to worsen with growth, early orthodontic treatment can harness growth potential to normalize maxillofacial development or reduce skeletal malformation severity, thereby reducing the difficulty and shortening the treatment cycle of later-stage treatment. This is beneficial for the physical and mental growth of children. Therefore, early orthodontic treatment for Class III malocclusion is particularly important. Determining the optimal timing for early orthodontic treatment requires a comprehensive assessment of clinical manifestations, dental age, and skeletal age, and can lead to better results with less effort. Currently, standardized treatment guidelines for early orthodontic treatment of Class III malocclusion are lacking. This review provides a comprehensive summary of the etiology, clinical manifestations, classification, and early orthodontic techniques for Class III malocclusion, along with systematic discussions on selecting early treatment plans. The purpose of this expert consensus is to standardize clinical practices and improve the treatment outcomes of Class III malocclusion through early orthodontic treatment.
Humans ; Malocclusion, Angle Class III/classification* ; Orthodontics, Corrective/methods* ; Consensus ; Child

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*