Objective: To investigate the impact of current laboratory testing models and screening strategies on blood safety by analyzing repeat nucleic acid testing (NAT) results obtained from blood donors who had dual-reactive enzyme-linked immunosorbent assay (ELISA) results but were initially nonreactive by NAT. Methods: Samples from blood donors with dual-reactive ELISA results and initially nonreactive NAT results collected at Dalian Blood Center from 2017 to 2025 were included. Repeated testing was performed using two NAT systems: transcription-mediated amplification (TMA) and polymerase chain reaction (PCR). The results were analyzed in terms of the frequency of reactive NAT results and the testing strategies, including minipool and individual donation testing. Results: A total of 199 samples with dual-reactive ELISA results and initially nonreactive NAT results were included，comprising 66 HBsAg-reactive samples，130 anti-HCV-reactive samples，and 3 HIV Ag/Ab-reactive samples. Among the HBsAg-reactive samples，57（57/66，86.4%）showed at least one reactive NAT result upon repeated testing，and 49 showed two or more repeat reactive results. Anti-HBc was reactive in 64 samples（64/66，97.0%）and nonreactive in 2 samples（2/66，3.0%）；both anti-HBc-nonreactive samples remained nonreactive in repeated NAT. No stable repeat nucleic acid reactivity was observed in anti-HCV- or HIV Ag/Abreactive samples. The TMA system detected 50 reactive samples（50/66，75.8%）through three combined assays plus one discriminatory assay, whereas the PCR system detected 51 reactive samples (51/66, 77.3%) through four rounds of individual-donation testing. Fortyfour samples were reactive on both systems, 6 were reactive only on the TMA system, and 7 were reactive only on the PCR system. Conclusion: Among blood donors with dual-reactive ELISA results and initially non-reactive NAT results, HBsAg-reactive samples contain a high proportion of low viral load HBV-related cases, with intermittent and probabilistic nucleic acid detectability. Both testing frequency and detection strategy significantly affect the detection of low viral load samples. These findings highlight the importance of recognizing the detection characteristics of low viral load HBV-related samples in order to optimize blood screening strategies and improve blood safety.

Multidrug-resistant (MDR) bacterial infections have emerged as a serious challenge of global public health crisis. The overuse and misuse of conventional antibiotics have dramatically accelerated the emergence, evolution and worldwide spread of drug-resistant bacterial strains, necessitating urgent exploration of novel antibacterial strategies. Bacteriophages serve as natural bacterial predators offering distinct advantages including high host specificity, autonomous self-replication capabilities and cost-effective large-scale production. However, wild-type phages present significant clinical limitations due to their narrow host ranges, susceptibility to rapid immune clearance and poor penetration of bacterial biofilms, which severely restrict their therapeutic applications. The convergence of synthetic biology, nanotechnology and advanced gene editing technologies has accelerated the development of engineered bacteriophage platforms, providing programmable, scalable and clinically translatable pathways to overcome these inherent biological constraints. Here, we systematically delineate four fundamental strategies for engineered bacteriophage development. Chemical modification utilizes reactive functional groups such as amino, carboxyl and thiol moieties on capsid proteins through esterification, amidation or click chemistry reactions to achieve precise drug conjugation and surface functionalization. In vivo editing encompasses ultraviolet or chemical mutagenesis for random mutation induction, homologous recombination for targeted genetic alterations, recombineering methodologies including electroporation-mediated bacteriophage recombination engineering, and CRISPR-Cas systems for precise genome editing to enable exact genetic reconstruction and host range reprogramming. In vitro synthesis leverages genome engineering platforms where intact phage genomes are transferred into yeast or host bacteria to facilitate highly efficient homologous recombination, enabling large DNA fragment assembly and cross-gene host range expansion without bacterial toxicity constraints. Directed evolution combines artificial selection through mutation library screening with rational design approaches involving chimeric receptor binding protein construction or site-specific mutagenesis, effectively balancing the discovery of unknown adaptive pathways with targeted host specificity modification. Moreover, we comprehensively discuss therapeutic applications across diverse clinical scenarios. Engineered bacteriophage effectively disrupt bacterial biofilms through sophisticated functionalized delivery platforms including nanozyme-conjugated phages, phage-liposome nanoconjugates and bio-responsive hydrogels, demonstrating significantly enhanced bactericidal efficiency compared to unmodified free phages. These bioengineered vectors attenuate bacterial virulence and resensitize pathogens to antibiotics by delivering CRISPR-Cas systems or base editors to disrupt critical virulence factors such as pili, capsule synthesis machineries and quorum sensing systems, or by inactivating antibiotic resistance determinants including beta-lactamase genes. As an intelligent nanomedicine delivery platform, engineered bacteriophage enable precise pathogen elimination an through photocatalytic reactive oxygen species generation, immunomodulatory interventions, or controlled release of antibacterial drugs. Furthermore, oral administration of engineered bacteriophage facilitates microbiota modulation, which selectively eliminate intestinal pathogens while preserve beneficial commensal microbiota, thereby restoring microbial community balance and preventing complications associated with dysbiosis. Finally, we critically analyze persistent challenges including host strain matching complexity, evolution of bacterial resistance mechanisms, pharmacokinetic optimization requirements, optimal administration route selection, large-scale production quality control standards and clinical dosing determination protocols. Through multidisciplinary integration of synthetic biology, infectious disease medicine and immunology, future translational medicine studies of bacteriophage should establish comprehensive technical platforms encompassing rapid phage screening, intelligent rational design, rigorous in vivo evaluation and standardized clinical validation processes, ultimately advancing engineered bacteriophage from laboratory innovations to clinically approved therapeutics for effectively combating MDR bacterial infections.

ObjectiveTo investigate the molecular mechanisms related to angiogenesis during the development and progression of diabetic retinopathy （DR）. MethodsAngiogenesis-related genes were obtained from the Gencard website and intersected with differentially expressed genes from DR datasets （GSE60436 and GSE94019）. Functional enrichment and protein-protein interaction （PPI） networks were then used to screen candidate genes and evaluate their diagnostic value. Gene set enrichment analysis （GSEA） was used to explore potential pathways underlying candidate genes， and immune infiltration analysis revealed associations between candidate genes and immune cells. Cellular experiments were conducted to validate the role of fibronectin 1 （FN1） in human retinal microvascular endothelial cells （HRMECs） under high glucose （HG） conditions. ResultsA total of 237 differentially expressed genes related to angiogenesis were identified， enriched in pathways such as phosphoinositide 3-kinase/protein kinase B signaling pathway （PI3K-Akt）， tumor suppressor protein 53 （P53）， tumor necrosis factor （TNF）， and Janus kinase （JAK）/signal transducer and activator of transcription signaling pathway （STAT）. Among them， collagen type I alpha 1 chain （COL1A1）， COL1A2， FN1， TNF， and tumor protein p53 （TP53） were key genes with high diagnostic value. GSEA indicated that these genes were involved in multiple signaling pathways， including P53. CIBERSORTx analysis revealed significant associations with the infiltration of multiple immune cells. HG treatment led to the upregulation of FN1. In HG-induced HRMECs， compared with the si-NC control group， si-FN1 significantly reduced cell proliferation， migration， and tube formation， while P53 protein expression was increased. ConclusionThis study reveals the important role of FN1 in angiogenesis in DR and suggests that it may be a potential diagnostic and therapeutic target.

Objective To examine the potential causal associations between different dietary taste preferences and the risk of prostatitis, so as to provide reference for the primary prevention of this disease. Methods Summary-level genome-wide association study(GWAS)data on five taste preferences-sweet, sour, salty, bitter and spicy—were obtained from the GWAS, and GWAS data for prostatitis were sourced from the FinnGen database. The potential causal associations between the dietary taste preferences and risk of prostatitis were analyzed with MR. The inverse variance weighted(IVW)method served as the primary analytical approach. Heterogeneity was assessed using Cochran's Q test. Horizontal pleiotropy was evaluated via the MR-Egger intercept and Mendelian randomization pleiotropy residual sum and outlier(MR-PRESSO)tests. Leave-one-out analysis was performed to evaluate the influence of individual single nucleotide polymorphisms(SNPs)on the causal estimates. Results Preferences for sweet(OR=1.338, 95%CI:1.024-1.748, P=0.033)and salty(OR=1.356, 95%CI:1.092-1.684, P=0.006)tastes showed positive causal associations with the risk of prostatitis, whereas a preference for bitter taste was negatively associated(OR=0.638, 95%CI:0.416-0.978, P=0.039). No significant causal links were observed for sour or spicy taste preferences(P＞0.05). Sensitivity analyses and reverse MR analyses further supported the robustness of the findings.Conclusion Sweet and salty taste preferences may be potential dietary risk factors for prostatitis, while bitter taste preference could play a protective role. Further research is needed to elucidate these causal relationships, which may contribute to developing tailored dietary intervention strategies for prostatitis prevention.

Objective To establish a risk prediction model for cerebral edema after mechanical thrombectomy in acute cerebral infarction (ACI) based on multimodal computed tomography (CT) parameters. Methods A total of 220 ACI patients who underwent mechanical thrombectomy at The People’s Hospital of Bozhou between January 2022 and June 2025 were enrolled. All patients underwent preoperative conventional non-contrast CT, CT perfusion imaging, and multiphase CT angiography. Based on the presence or absence of cerebral edema at 72 hours postoperatively, patients were divided into cerebral edema and non-cerebral edema groups. General data and multimodal CT parameters were compared between the two groups. Multivariable logistic regression model was used to analyze the influencing factors of postoperative cerebral edema. A nomogram prediction model was constructed based on the multivariable analysis results, and the efficacy of the model was validated. Results The incidence of postoperative cerebral edema was 23.64% (52/220). Multivariable logistic regression analysis showed that time from onset to recanalization (OR=1.081, 95%CI=1.017-1.149), cerebral blood flow (OR=0.903, 95%CI=0.828-0.984), time to peak (OR=1.171, 95%CI=1.041-1.317), mean transit time (OR=2.815, 95%CI=1.823-6.178), and collateral circulation score (OR=0.960, 95%CI=0.930-0.990) were influencing factors for cerebral edema after mechanical thrombectomy in ACI patients (P<0.05). A nomogram model was constructed based on these factors. The calibration curve indicated good model fit, and the decision curve demonstrated net benefit. The area under the receiver operating characteristic curve for predicting cerebral edema after mechanical thrombectomy in patients with ACI was 0.961, with a sensitivity of 88.46% and a specificity of 91.07%. The Hosmer–Lemeshow goodness-of-fit test showed good model fit (χ²=1.766, P=0.962). Conclusion A risk prediction model for cerebral edema after mechanical thrombectomy in ACI patients was constructed using multimodal CT parameters. The model demonstrated high sensitivity and specificity.

Objective To establish a risk prediction model for cerebral edema after mechanical thrombectomy in acute cerebral infarction (ACI) based on multimodal computed tomography (CT) parameters. Methods A total of 220 ACI patients who underwent mechanical thrombectomy at The People’s Hospital of Bozhou between January 2022 and June 2025 were enrolled. All patients underwent preoperative conventional non-contrast CT, CT perfusion imaging, and multiphase CT angiography. Based on the presence or absence of cerebral edema at 72 hours postoperatively, patients were divided into cerebral edema and non-cerebral edema groups. General data and multimodal CT parameters were compared between the two groups. Multivariable logistic regression model was used to analyze the influencing factors of postoperative cerebral edema. A nomogram prediction model was constructed based on the multivariable analysis results, and the efficacy of the model was validated. Results The incidence of postoperative cerebral edema was 23.64% (52/220). Multivariable logistic regression analysis showed that time from onset to recanalization (OR=1.081, 95%CI=1.017-1.149), cerebral blood flow (OR=0.903, 95%CI=0.828-0.984), time to peak (OR=1.171, 95%CI=1.041-1.317), mean transit time (OR=2.815, 95%CI=1.823-6.178), and collateral circulation score (OR=0.960, 95%CI=0.930-0.990) were influencing factors for cerebral edema after mechanical thrombectomy in ACI patients (P<0.05). A nomogram model was constructed based on these factors. The calibration curve indicated good model fit, and the decision curve demonstrated net benefit. The area under the receiver operating characteristic curve for predicting cerebral edema after mechanical thrombectomy in patients with ACI was 0.961, with a sensitivity of 88.46% and a specificity of 91.07%. The Hosmer–Lemeshow goodness-of-fit test showed good model fit (χ²=1.766, P=0.962). Conclusion A risk prediction model for cerebral edema after mechanical thrombectomy in ACI patients was constructed using multimodal CT parameters. The model demonstrated high sensitivity and specificity.

Objective To establish a risk prediction model for cerebral edema after mechanical thrombectomy in acute cerebral infarction (ACI) based on multimodal computed tomography (CT) parameters. Methods A total of 220 ACI patients who underwent mechanical thrombectomy at The People’s Hospital of Bozhou between January 2022 and June 2025 were enrolled. All patients underwent preoperative conventional non-contrast CT, CT perfusion imaging, and multiphase CT angiography. Based on the presence or absence of cerebral edema at 72 hours postoperatively, patients were divided into cerebral edema and non-cerebral edema groups. General data and multimodal CT parameters were compared between the two groups. Multivariable logistic regression model was used to analyze the influencing factors of postoperative cerebral edema. A nomogram prediction model was constructed based on the multivariable analysis results, and the efficacy of the model was validated. Results The incidence of postoperative cerebral edema was 23.64% (52/220). Multivariable logistic regression analysis showed that time from onset to recanalization (OR=1.081, 95%CI=1.017-1.149), cerebral blood flow (OR=0.903, 95%CI=0.828-0.984), time to peak (OR=1.171, 95%CI=1.041-1.317), mean transit time (OR=2.815, 95%CI=1.823-6.178), and collateral circulation score (OR=0.960, 95%CI=0.930-0.990) were influencing factors for cerebral edema after mechanical thrombectomy in ACI patients (P<0.05). A nomogram model was constructed based on these factors. The calibration curve indicated good model fit, and the decision curve demonstrated net benefit. The area under the receiver operating characteristic curve for predicting cerebral edema after mechanical thrombectomy in patients with ACI was 0.961, with a sensitivity of 88.46% and a specificity of 91.07%. The Hosmer–Lemeshow goodness-of-fit test showed good model fit (χ²=1.766, P=0.962). Conclusion A risk prediction model for cerebral edema after mechanical thrombectomy in ACI patients was constructed using multimodal CT parameters. The model demonstrated high sensitivity and specificity.

Gastric cancer remains a highly prevalent malignancy worldwide, with surgical resection currently constituting the cornerstone of treatment aimed at improving long-term patient survival. Owing to their notable advantages, including reduced surgical trauma and accelerated postoperative recovery, minimally invasive procedures are progressively supplanting conventional open surgery and have become the mainstream approach in gastric cancer management. Concurrently, the rapid advancement of artificial intelligence (AI) technologies has enabled real-time intraoperative monitoring of surgical scenes, thereby furnishing novel technical support for adjunctive decision-making, surgical navigation, and skill assessment during gastrectomy. This article provides a systematic review of the current status of AI applications in minimally invasive gastric cancer surgery, with a particular focus on research progress pertaining to instrument recognition, surgical phase identification, delineation of normal anatomical structures, detection of metastatic foci, and early warning of intraoperative adverse events. Furthermore, we discuss the potential value of AI in enhancing surgical efficiency, ensuring patient safety, and optimizing surgical education. On this basis, we further analyze the principal challenges and inherent risks confronting current AI systems, with the aim of informing future technological innovation and facilitating clinical translation.

ObjectiveThis paper aims to investigate the distribution patterns of traditional Chinese medicine syndromes in patients with chronic hepatitis B （CHB） comorbid with metabolically associated fatty liver disease （MAFLD） and analyze their correlation with clinical characteristics and the progression of liver fibrosis. MethodsA cross-sectional study method was employed， and 506 patients with CHB comorbid with MAFLD who attended the Hepatology Outpatient Department of Public Health Clinical Center of Chengdu from June 2024 to December 2024 were enrolled. General information， traditional Chinese medicine syndromes information， laboratory indicators， and imaging examination results were collected using case report forms （CRF）. Tongue images of patients were acquired using a tongue diagnosis instrument， and tongue feature parameters were extracted using computer image processing technology. Frequency analysis， factor analysis， and cluster analysis， and other methods were used to explore syndrome categories and distribution patterns. Non-parametric tests were used to compare the differences in clinical characteristics among different syndromes. Univariate and multivariate logistic regression analyses were performed to investigate the correlation between traditional Chinese medicine syndromes and the progression of liver fibrosis. ResultsThe main traditional Chinese medicine syndromes in patients with CHB comorbid with MAFLD were mainly dominated by damp-heat accumulation syndrome， liver stagnation and spleen deficiency syndrome， and phlegm-blood stasis syndrome， with damp-heat accumulation syndrome accounting for the highest proportion （41.89%）. Compared with those without damp-heat accumulation syndrome， patients with damp-heat accumulation syndrome had significantly lower tongue proper H value， tongue coating H value， and tongue coating a^* value （P<0.05）， significantly higher tongue coating b^* value （P<0.05）， significantly increased levels of white blood cell （WBC）， red blood cell （RBC）， hemoglobin （HGB）， and glucose （GLU）， increased CAP values （P<0.05）， a higher proportion of males （P<0.05）， and a younger age （P<0.05）. Univariate and multivariate logistic regression analyses show that age， hepatitis B surface antigen （HBsAg）， diabetes， and damp-heat accumulation syndrome are independent risk factors for liver fibrosis （P<0.05）， and that damp-heat accumulation syndrome is predominantly distributed in liver fibrosis stage F0-F1. ConclusionDamp-heat accumulation syndrome is a typical syndrome in patients with CHB comorbid with MAFLD， which is significantly associated with enhanced inflammatory response， metabolic disorders， and early liver fibrosis， and is a key link in disease progression. Clinical attention and early intervention are needed.

With the accelerating aging of the population, the proportion of elderly patients with lung cancer continues to rise, presenting multiple challenges to perioperative management. This paper systematically reviews the clinical characteristics of elderly lung cancer patients. Based on the comprehensive geriatric assessment, it proposes incorporating seven major geriatric syndromes—frailty, delirium, sarcopenia, cognitive impairment, malnutrition, dysphagia, and mood disorders—into the core evaluation system. By integrating multimorbidity management with complication prevention and control, an integrated "geriatric syndrome-multimorbidity-complication" perioperative management model is constructed. Furthermore, this paper outlines stratified intervention strategies for geriatric syndromes, a "five-step" workflow for comorbidity management, and a comprehensive intervention pathway for complications across the preoperative, intraoperative, and postoperative phases. Multidisciplinary team (MDT) collaboration serves as the core mechanism to achieve individualized comprehensive treatment. This paper aims to provide a novel perioperative comprehensive treatment model for elderly lung cancer patients, which is centered on geriatrics, supported by multidisciplinary collaboration, and guided by precision medicine.