Objective To preliminarily investigate the safety and efficacy of donor pancreas needle biopsy in simultaneous pancreas-kidney transplantation. Methods Clinical data of 7 cases undergoing donor pancreas biopsy were collected retrospectively. All cases underwent donor pancreas biopsy before or during simultaneous pancreas-kidney transplantation. Frozen section or paraffin sectioning techniques were used for tissue preparation, and hematoxylin-eosin and Masson staining were performed to histologically evaluate the donor pancreas. The quality of donor pancreas was comprehensively assessed by combining histological findings with the donor's clinical data. Postoperative follow-up data of 5 simultaneous pancreas-kidney transplant recipients were collected to summarize the safety of donor pancreas biopsy and the prognosis of transplant recipients. Results The 7 pancreas donors were aged 28 to 62 years, with a body mass index ranging from 20.76 to 27.68 kg/m². Liver ultrasound indicated fatty liver in 3 cases, while pancreatic ultrasound did not reveal any significant abnormalities. Among them, biopsy was performed on 2 donors after completion of pancreatic procurement and processing, and the frozen section histology showed moderate acute pancreatitis changes (edema of acinar cells, necrosis and inflammatory cell infiltration). Combined with a serum amylase level elevated more than 3 times the upper limit of normal value, these two donor pancreases were finally discarded. The remaining 5 cases underwent biopsy immediately after pancreatic vascular anastomosis during simultaneous pancreas-kidney transplantation, and histological evaluation was performed on paraffin-embedded sections. No biopsy-related complications (such as bleeding, pancreatic fistula, etc.) occurred after transplantation. One recipient died of severe infection 2 months after transplantation, while the other 4 recipients were followed up for more than 5 years, with well-functioning transplant kidneys and pancreases. Conclusions Donor pancreas biopsy is relatively safe, and the risk of biopsy-related complications after transplantation is controllable. Comprehensive assessment of donor pancreas quality by combining histological evaluation with the donor's clinical indicators is conducive to improving the accuracy of donor pancreas selection and organ utilization.

Oral squamous cell carcinoma (OSCC) is a common head and neck malignancy. Approximately 50% to 60% of patients with OSCC are diagnosed at a locally advanced stage (clinical staging III-IVa). Even with comprehensive and sequential treatment primarily based on surgery, the 5-year overall survival rate remains below 50%, and patients often suffer from postoperative functional impairments such as difficulties with speaking and swallowing. Programmed death receptor-1 (PD-1) inhibitors are increasingly used in the neoadjuvant treatment of locally advanced OSCC and have shown encouraging efficacy. However, clinical practice still faces key challenges, including the definition of indications, optimization of combination regimens, and standards for efficacy evaluation. Based on the latest research advances worldwide and the clinical experience of the expert group, this expert consensus systematically evaluates the application of PD-1 inhibitors in the neoadjuvant treatment of locally advanced OSCC, covering combination strategies, treatment cycles and surgical timing, efficacy assessment, use of biomarkers, management of special populations and immune related adverse events, principles for immunotherapy rechallenge, and function preservation strategies. After multiple rounds of panel discussion and through anonymous voting using the Delphi method, the following consensus statements have been formulated: 1) Neoadjuvant therapy with PD-1 inhibitors can be used preoperatively in patients with locally advanced OSCC. The preferred regimen is a PD-1 inhibitor combined with platinum based chemotherapy, administered for 2-3 cycles. 2) During the efficacy evaluation of neoadjuvant therapy, radiographic assessment should follow the dual criteria of Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 and immune RECIST (iRECIST). After surgery, systematic pathological evaluation of both the primary lesion and regional lymph nodes is required. For combination chemotherapy regimens, PD-L1 expression and combined positive score need not be used as mandatory inclusion or exclusion criteria. 3) For special populations such as the elderly (≥ 70 years), individuals with stable HIV viral load, and carriers of chronic HBV/HCV, PD-1 inhibitors may be used cautiously under the guidance of a multidisciplinary team (MDT), with close monitoring for adverse events. 4) For patients with a poor response to neoadjuvant therapy, continuation of the original treatment regimen is not recommended; the subsequent treatment plan should be adjusted promptly after MDT assessment. Organ transplant recipients and patients with active autoimmune diseases are not recommended to receive neoadjuvant PD-1 inhibitor therapy due to the high risk of immune related activation. Rechallenge is generally not advised for patients who have experienced high risk immune related adverse events such as immune mediated myocarditis, neurotoxicity, or pneumonitis. 5) For patients with a good pathological response, individualized de escalation surgery and function preservation strategies can be explored. This consensus aims to promote the standardized, safe, and precise application of neoadjuvant PD-1 inhibitor strategies in the management of locally advanced OSCC patients.

AIM: To explore the application effect of eyelid margin incision combined with floating bridge technique in the treatment of ptosis patients, and to analyze its effects on the margin reflex distance 1(MRD1)and the aesthetic effect of the eyes. METHODS:Prospective study. This study enrolled patients with blepharoptosis treated at the Department of Ophthalmology of the hospital between January 2023 and July 2025, who were assigned to either an observation group or a control group. The patients in the control group received levator aponeurosis shortening surgery through conventional double-eyelid incision, while the patients in the observation group underwent levator aponeurosis shortening surgery using the eyelid margin incision combined with floating bridge technique. Subsequently, the surgical-related indicators,the correction effect of ptosis, the aesthetic effect, the ocular function indicators, the postoperative complication occurrence rate, and recurrence rate were compared and analyzed between two groups.RESULTS:A total of 100 patients(100 eyes)with blepharoptosis were enrolled in this study, with 50 patients(50 eyes)in the observation group and 50 patients(50 eyes)in the control group. The observation group had a mean age of 27.33±5.32 y, including 20 males and 30 females. The control group had a mean age of 27.64±4.66 y, including 24 males and 26 females. Compared with the control group, the operative time of the observation group was longer, the postoperative swelling resolution time and natural recovery time were shorter,and the correction rate was higher(P<0.05). Three months after the surgery, the VSS score and POSAS score of the observation group were lower than those of the control group, while the scores for eyelid curvature, symmetry of eyelid height, and the PFH, MRD1, palpebral fissure size, and upper eyelid levator muscle strength were all higher than those of the control group(all P<0.05). However, there was no significant difference in postoperative complication occurrence rate and recurrence rate between two groups(all P>0.05).CONCLUSION:The combined use of eyelid margin incision and floating bridge technique for treating ptosis results in slightly longer operation time, but it can shorten the postoperative recovery period, effectively ameliorate the MRD1 and ocular function of patients, and enhance the correction effect and aesthetic quality of the eyes. In addition, it has a low incidence of complications and guaranteed safety.

ObjectiveFor prepubertal and urgently treated malignant tumor patients, ovarian tissue cryopreservation and transplantation represent more appropriate fertility preservation methods. Current clinical practices often involve freezing ovarian tissue with high concentrations of cryoprotectants (CPAs) and thawing with water baths. These processes lead to varying degrees of toxicity and devitrification damage to ovarian tissue. Therefore, this paper proposes optimized methods for vitrification of ovarian tissues based on sodium alginate hydrogel encapsulation and magnetic induction nanowarming technology. MethodsFirstly, the study investigated the effects of sodium alginate concentration, the sequence of hydrogel encapsulation and CPAs loading on vitrification efficiency of encapsulated ovarian tissue. Additionally, the capability of sodium alginate hydrogel encapsulation to reduce the required concentration of CPAs was validated. Secondly, a platform combining water bath and magnetic induction nanowarming was established to rewarm ovarian tissue under various concentrations of magnetic nanoparticles and magnetic field strengths. The post-warming follicle survival rate, antioxidant capacity, and ovarian tissue integrity were evaluated to assess the efficacy of the method. ResultsThe study found that ovarian tissue encapsulated with 2% sodium alginate hydrogel exhibited the highest follicle survival rate after vitrification. The method of loading CPAs prior to encapsulation proved more suitable for ovarian tissue cryopreservation, effectively reducing the required concentration of CPAs by 50%. A combination of 8 g/L Fe₃O₄ nanoparticles and an alternating magnetic field of 300 Gs showed optimal warming effectiveness for ovarian tissue. Combining water bath rewarming with magnetic induction nanowarming yielded the highest follicle survival rate, enhanced antioxidant capacity, and preserved tissue morphology. ConclusionSodium alginate hydrogel encapsulation of ovarian tissue reduces the concentration of CPAs required during the freezing process. The combination of magnetic induction nanowarming with water bath provides an efficient method ovarian tissue rewarming. This study offers novel approaches to optimize ovarian tissues vitrification.

Objective To explore the relationships of microRNA-125b(miR-125b),microR-NA-142-5p(miR-142-5p)and microRNA-140-3p(miR-140-3p)with sensitivity to programmed death receptor-1(PD-1)antibody therapy in patients with non-small cell lung cancer(NSCLC)and their clinical significance.Methods A total of 219 NSCLC patients were selected and divided into sensitive group(n=92)and non-sensitive group(n=127)based on their sensitivity to PD-1 anti-body therapy.Serum levels of miR-125b,miR-142-5p and miR-140-3p were compared between the two groups.A new combined predictor was constructed using miR-125b,miR-142-5p,and miR-140-3p through a Logistic regression model.The predictive performance was evaluated using the receiver operating characteristic(ROC)curve,and data were substituted into the equation forpredictive vali-dation.Results The serum level of miR-125b was higher in the non-sensitive group than that in the sensitive group,while the serum levels of miR-142-5pand miR-140-3p were lower in the non-sensitive group(P＜0.05).Logistic regression analysis showed that an increased level of miR-125b was an independent risk factor for sensitivity to PD-1 antibody therapy in NSCLC patients(P＜0.05),while increased levels of miR-142-5p and miR-140-3p were independent protective factors(P＜0.05).The optimal cut-off value for the combined predictor was 0.117,with a sensitivity of 90.22％,a specificity of 85.04％,and an accuracy of 87.21％.ROC curve analysis revealed that the area under the curve(AUC)for the combined predictor in predicting sensitivity to PD-1 antibod-y therapy was 0.928,which was significantly larger than the AUCs of 0.825,0.817 and 0.772 for miR-125b,miR-142-5p and miR-140-3p,respectively(P＜0.05).A new equation was obtained by transforming the original Logistic regression equation,and data from three randomly selected pa-tients were substituted into the equation for calculation,with predictive results being consistent with clinical reality.Conclusion The miR-125b,miR-142-5p and miR-140-3p are all associated with sensitivity to PD-1 antibody therapy in NSCLC patients and can serve as biomarkers for predicting sensitivity to PD-1 antibody therapy.The combined predictor based on these three microRNAs can further enhance predictive value and provide more reliable reference information for clinical treat-ment decisions.

Objective To explore the effects of lipoxygenase(LOX)on severe fever with thrombocytopenia syndrome virus(SFTSV)in human umbilical vein endothelial cells(HUVECs).Methods The CCK-8 assay was used to assess the cytotoxicity of LOX in HUVECs.Real-time quantitative PCR(qPCR)was adopted to detect the replication of viral RNA in cells.The infection rate of SFTSV to HUVECs was observed via indirect immunofluorescence assay(IFA).The expressions of intracellular viral NP protein and autophagy related proteins microtubule-associated protein 1 light chain 3(LC3)and adenosine 5'-monophosphate-activated protein kinase(AMPK)/mammalian target of rapamycin(mTOR)were detected via Western blotting.Lipid metabolomics was used to analyze the differences in expressions of intracellular metabolites in the SFTSV-infected Huh 7 with or without LOX treatment.Results The results of CCK-8 showed no obvious cytotoxicity to HUVECs with LOX≤8 mg/mL.With the increase of LOX concentrations,the viral RNA level,viral infection rate,and expressions of SFTSV nucleoprotein(NP)protein were gradually decreased,respectively.The autophagy reaction was activated in SFTSV-infected HUVECs,evidenced by the increased expression level of LC3 Ⅱ protein.Compared with the untreated group,LOX treatment resulted in decreased levels of LC3 Ⅱ and AMPK phosphorylation,and enhanced phosphorylation of mTOR in SFTSV-infected HUVEC.Conclusion LOX negatively regulates autophagy by inhibiting AMPK/mTOR signaling pathway,thereby inhibiting SFTSV replication.

Objective To explore the longitudinal associations of body roundness index(BRI),visceral adiposity index(VAI),and metabolic score for visceral fat(METS-VF)with the risk of new-onset atrial fibrillation(AF).Methods This study included participants from the UK Biobank who were free of AF or pregnancy at baseline and completed the first and second assessments of BRI,VAI,and METS-VF.The changes in BRI,VAI,and METS-VF were classified using K-means clustering analyses,and the cumulative adiposity indices were also calculated.The primary outcome was new-onset AF.Three Cox regression models were employed to investigate the longitudinal associations of the BRI,VAI,and METS-VF changes with the risk of incident new-onset AF.The results were presented as hazard ratios(HRs)and the corresponding 95%confidence intervals(CIs).Restricted cubic spline analyses were performed to explore potential non-linear associations between baseline or cumulative adiposity indices and the risk of new-onset AF.C-index analyses were conducted to evaluate the predictive value of BRI,VAI,and METS-VF for new-onset AF.Subgroup analyses were performed according to age,gender,race,smoking status,alcohol consumption,and physical activity.Polygenic risk scores were applied to account for genetic susceptibility and investigate potential interactions between adiposity indices and genetic risk.Univariate linear regression analyses were performed to evaluate the relationships of cumulative adiposity indices and magnetic resonance imaging and dual X-ray absorptiometry parameters,including visceral adipose tissue(VAT)volume,VAT mass,trunk fat volume,and trunk fat mass.We further applied the eXtreme Gradient Boosting(XGBoost)algorithm,with the feature importance being measured to evaluate the predictive value of each adiposity index for imaging parameters.Mendelian randomization analysis was further conducted to investigate the potential causal relationship between trunk fat mass and AF.Results A total of 12 776 participants were included.Over a median follow-up of 9.60 years,761(5.96%)new-onset AF events were recorded.Participants were divided into four classes based on the changes in adiposity indices.In the fully adjusted model,compared to participants in Class 1 of BRI,those in Class 3(HR=1.30,95%CI 1.04-1.63,P=0.023)and Class 4(HR=2.17,95%CI 1.61-2.93,P＜0.001)were associated with significantly higher risks of new-onset AF.Regarding METS-VF,participants in Class 4 of METS-VF also demonstrated a significantly higher risk of new-onset AF compared to those in Class 1(HR=1.66,95%CI 1.15-2.39,P=0.007).However,no significant association was observed between different classes of VAI and the risk of new-onset AF.For every 1 standard deviation increase in cumulative BRI,VAI,and METS-VF,the fully adjusted HRs of new-onset AF were 1.23(95%CI 1.13-1.35),1.02(95%CI 0.94-1.10),and 1.23(95%CI 1.12-1.35),respectively.Cumulative adiposity indices(BRI,VAI,and METS-VF)were divided into quartiles.Using the first quartile as reference,participants in the highest quartiles of BRI(HR=1.40,95%CI 1.10-1.79,P=0.007)and METS-VF(HR=1.44,95%CI 1.13-1.83,P=0.003)both exerted a significantly higher risk of new-onset AF.Regarding VAI,no significant association was observed(HR=1.00,95%CI 0.81-1.23,P=0.988).Restricted cubic spline analyses revealed non-linear relationships between cumulative BRI,baseline/cumulative VAI,and baseline/cumulative METS-VF with new-onset AF risk(all Poverall＜0.05,Pnon-linear＜0.05).In the C-index analysis,BRI demonstrated the highest predictive performance for new-onset AF,followed by METS-VF and VAI.Subgroup analysis indicated a stronger association between METS-VF and the risk of new-onset AF amongst participants younger than 60 years(Pinteraction=0.008).Polygenic risk score analysis stratified by genetic risk demonstrated a synergistic effect between BRI and genetic risk with new-onset AF,with the overall risk of new-onset AF increasing as both BRI and genetic risk increased.Linear regression analysis revealed a positive correlation between cumulative BRI with VAT volume,VAT mass,trunk fat volume,and trunk fat mass.The feature importance plot derived from the XGBoost algorithm indicated that cumulative BRI had the greatest predictive value on VAT volume,VAT mass,trunk fat volume,and trunk fat mass.Mendelian randomization analysis confirmed a significant causal relationship between trunk fat mass and AF.Conclusions There are significant non-linear associations between BRI,METS-VF,and VAI with new-onset AF.Higher BRI and METS-VF are significantly associated with a higher risk of new-onset AF,whereas no significant association is observed for the VAI.BRI exhibits a positive correlation with VAT and trunk fat,and demonstrates superior performance in predicting new-onset AF compared to VAI and METS-VF.Monitoring and managing BRI may be important in the early detection and intervention of AF.

Objective To discuss the method of constructing TCM word network and the subsequent optimization method;To solve the problems of natural language processing in the TCM-clinical decision support system using TCM terminology.Methods This study was based on several national standards and terminology dictionaries of TCM,such as Zhong Yi Lin Chuang Zhen Liao Shu Yu Ji Bing Part and Zhong Yi Yao Xue Zhu Ti Ci Biao,supplemented with related corpus on the Internet,and the framework of TCM word network was constructed with ontology as the guide.Word2Vec was used to load pre-trained models for similarity calculation,statistical and rule-based new word discovery,bibliometric analysis,and other methods to add or delete concept words and synonyms such as symptom terms and prescription terms.Results The TCM word network contained 55 semantic types and 13 semantic relationships,more than 110 000 concept words,and more than 300 000 synonyms.In addition to classifying concept words by semantic types,more detailed semantic classification was carried out in the upper and lower tree structures,in which more than 30 000 concept words had superordinate words,and nearly 2 600 concept words had subordinate words.At the same time,a process-based terminology supplementation mechanism,update review mechanism and cleaning mechanism were created.Conclusion TCM word network can not only be applied to the natural language processing process of TCM-clinical decision support system,but also can be applied to the normalization of data and the automatic construction of knowledge graph.

Objective:To explore the value of metanephrine, normetanephrine, and some steroid hormones in the assessment of adrenal venous sampling (AVS).Methods:This retrospective study enrolled 101 patients with primary aldosteronism who underwent AVS at Peking Union Medical College Hospital between June 1, 2021, and October 1, 2024. Multiple hormones, including aldosterone, cortisol, metanephrine, normetanephrine and steroid hormone profiles, were measured in samples from the inferior vena cava and bilateral adrenal veins during AVS. Selectivity index and lateralization index were calculated based on the levels of different hormones to determine successful AVS cannulation (selectivity index≥2) and aldosterone hypersecretion lateralization (lateralization index≥2). Patients who underwent unilateral adrenalectomy were followed for at least 6 months. Clinical and biochemical outcomes were assessed according to the Primary Aldosteronism Surgical Outcome (PASO) criteria, with biochemical remission defined as achieving complete or partial biochemical remission postoperatively. The efficacy of different hormones relative to cortisol for calculating selectivity index and lateralization index was evaluated for subtype classification.Results:The age at diagnosis of the enrolled patients was (50.5±9.6) years, including 77 males. Regarding the selectivity index, five hormones including metanephrine, normetanephrine, androstenedione, 17α-hydroxypregnenolone, and dehydroepiandrosterone demonstrated significantly higher selectivity index compared to cortisol (all P<0.05). Based on the cortisol-derived selectivity index, AVS cannulation was unsuccessful in 8 patients; using the five indices, unsuccessful cannulation occurred in 2, 2, 3, 4, and 5 patients, respectively. Based on postoperative follow-up, 55 patients were identified as having unilateral surgically relievable primary aldosteronism. In identifying these patients, the performance of metanephrine, normetanephrine, androstenedione, 17α-hydroxypregnenolone, and dehydroepiandrosterone was non-inferior to cortisol, correctly identifying 95% (52/55), 93% (51/55), 91% (50/55), 87% (48/55), and 89% (49/55) of cases, respectively. However, among these patients, there were no statistically significant differences in the success rate of intubation in AVS and the ability to identify patients with unilateral primary aldosteronism between the five indicators and cortisol (all P>0.05). Using cortisol-based lateralization as the reference standard, androstenedione and dehydroepiandrosterone both achieved an accuracy of 90% (84/93) for determining the lateralized side, while 17α-hydroxypregnenolone, normetanephrine, and metanephrine achieved accuracies of 89% (83/93), 81% (74/93), and 80% (73/93), respectively. Conclusion:Metanephrine, normetanephrine, androstenedione, 17α-hydroxypregnenolone and dehydroepiandrosterone could increase the success rate of intubation in AVS, with a high ability to identify patients with unilateral primary aldosteronism, and are expected to replace cortisol as new indicators of AVS.

Functional dyspepsia (FD), characterized by persistent or recurrent dyspeptic symptoms without identifiable organic, systemic or metabolic causes, is an increasingly recognized global health issue. The objective of this guideline is to equip clinicians and nursing professionals with evidence-based strategies for the management and treatment of adult patients with FD using traditional Chinese medicine (TCM). The Guideline Development Group consulted existing TCM consensus documents on FD and convened a panel of 35 clinicians to generate initial clinical queries. To address these queries, a systematic literature search was conducted across PubMed, EMBASE, the Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP Database, China Biology Medicine (SinoMed) Database, Wanfang Database, Traditional Medicine Research Data Expanded (TMRDE), and the Traditional Chinese Medical Literature Analysis and Retrieval System (TCMLARS). The evidence from the literature was critically appraised using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. The strength of the recommendations was ascertained through a consensus-building process involving TCM and allopathic medicine experts, methodologists, pharmacologists, nursing specialists, and health economists, leveraging their collective expertise and empirical knowledge. The guideline comprises a total of 43 evidence-informed recommendations that span a range of clinical aspects, including the pathogenesis according to TCM, diagnostic approaches, therapeutic interventions, efficacy assessments, and prognostic considerations. Please cite this article as: Zhang SS, Zhao LQ, Hou XH, Bian ZX, Zheng JH, Tian HH, Yang GH, Hong WS, He YY, Liu L, Shen H, Li YP, Xie S, Shu J, Zeng BF, Li JX, Liu Z, Xiao ZH, Xiao JD, Zheng PY, Huang SG, Chen SL, Fei GJ. International clinical practice guideline on the use of traditional Chinese medicine for functional dyspepsia (2025). J Integr Med. 2025; 23(5):502-518.
Dyspepsia/drug therapy* ; Humans ; Medicine, Chinese Traditional/methods* ; Practice Guidelines as Topic ; Drugs, Chinese Herbal/therapeutic use*