Chronic mucocutaneous candidiasis (CMC) is an infectious phenotype characterized by recurrent or persistent infections caused by Candida species that affect the skin, nails, oral, and genital mucosae for a duration exceeding six months. Current research suggests that CMC is an immunodeficiency disease with a complex pathogenesis. Patients with CMC have various defects in nonspecific and/or specific immunity against Candida infection, resulting in the inability of patients to defend themselves against Candida infection. CMC can be stratified into primary CMC and secondary CMC based on etiology. Primary CMC is often associated with genetic mutations leading to immunodeficiencies in T helper cell 17 and interleukin-17, whereas secondary CMC is frequently linked to factors such as human immunodeficiency virus infection, diabetes mellitus, and immunosuppressive therapy. Primary CMC typically manifests as Candida infections, with distinct genetic mutations often correlating to varied concomitant symptoms. Secondary CMC may present with not only superficial mucosal Candida infections and manifestations of the underlying primary disease but also with invasive fungal infections. Diagnosing CMC requires an integration of medical history and clinical presentation, supplemented by the outcomes of auxiliary diagnostic procedures, including microscopic examination of fungal smear, fungal culture, immunological testing, and genetic sequencing and analysis. Furthermore, confirming primary CMC requires exclusion of the aforementioned secondary factors. At present, antifungal drugs such as triazoles, echinocandins, and polyenes are the main treatment for CMC. Moreover, immunotherapy with biologics such as Janus kinase (JAK) inhibitors provides more options for the clinical treatment of patients with CMC. Gene therapy also has potential clinical application value. In this review, we discuss the etiologies, pathogenesis, clinical manifestations, diagnosis, and treatments of CMC, aiming to provide a reference for the clinical diagnosis and treatment of CMC.

Chronic eczema has a high prevalence in China， significantly impacting patients’ quality of life. Leveraging the unique advantages of pattern identification/syndrome differentiation and treatment， along with a holistic approach， traditional Chinese medicine （TCM）， which integrates internal and external therapies， has been widely applied in the management of chronic eczema. It has demonstrated significant efficacy and distinctive strengths in alleviating symptoms， reducing recurrence rates， maintaining disease stability， and enhancing patients’ quality of life. Oral administration of TCM（e.g. modified Longdan xiegan decoction） can improve patients’ clinical symptoms through systemic regulation. External use of TCM can directly act on the skin lesion with the help of steaming and washing， hydropathic compress， ointment and other forms. At the same time， it can effectively relieve the clinical symptoms of chronic eczema by combining with non-drug therapies such as acupuncture， moxibustion， acupoint catgut embedding， blood-letting puncture and cupping. In addition， characteristic therapies such as oral administration of TCM combined with external treatment， a combination of various external treatments and a combination of Chinese and Western medicine have also demonstrated certain advantages in regulating immune function， alleviating skin lesions， and relieving itching symptoms. These therapies cooperate with each other， creating a synergistic effect that treats both the symptoms and the root cause simultaneously. It is suggested that more high-quality， large-scale clinical research should be conducted in the future to systematically confirm the therapeutic advantages of TCM and further explore the specific molecular mechanism of action.

Based on the "regulating the pivot and unblocking the stomach" theory， this article proposes that the core pathogenesis of bile reflux gastritis （BRG） is disharmony of the three pivots and imbalance between the gallbladder and the stomach. Specifically， the pivot of zang-fu （脏腑） organs （spleen and stomach） exhibits abnormal ascending and descending functions， while the pivot of opening and closing （shaoyang） shows impaired flow， and the pivot of mind （heart and brain） has disordered regulation. These three pivots interact， ultimately leading to bile reflux attacking the stomach， injuring the gastric mucosa， and causing symptoms such as epigastric distension， pain， acid regurgitation， and heartburn. Clinically， the treatment principle is unblocking and regulating the three pivots， harmonizing the gallbladder and descending stomach qi， which closely follows the different pathomechanisms of three-pivot dysregulation， applying treatment according to syndrome differentiation. The regulation of the pivot of zang-fu organs focuses on fortifying the spleen and harmonzing stomach， raising the clear and directing the turbid downward. The regulation of the opening-and-closing pivot emphasizes harmonizing shaoyang， promoting gallbladder function and bowel movement. The regulation of the mind pivot centers on calming the heart and the mind， and harmonizing the stomach to ensure smooth qi flow. "Unblocking and regulating three pivots" method aims to restore the physiological functions of the gallbladder and stomach， providing a conceptual framework for the clinical management of BRG.

ObjectiveTo construct and evaluate a mouse model that simulates the pathological progression of immune checkpoint inhibitor-associated pneumonitis (CIP), in order to address the critical issue of the lack of standardized animal models in this research field. MethodsThirty-five SPF-grade 6-week-old male C57BL/6J mice were randomly assigned to a control group (n=5), a bleomycin (BLM) group (n=15), and a BLM+programmed death-1 (PD-1) monoclonal antibody (BLM+PD-1) group (n=15). Corresponding drugs were administered via intraperitoneal injection for intervention. The general condition, body weight changes, survival rate, and pulmonary histopathological alterations were systematically monitored. ResultsCompared with the BLM group, the BLM+PD-1 group exhibited significantly more severe pulmonary fibrosis, characterized by progressive body weight loss and more severe deterioration of general conditions. Histopathological examination showed that pulmonary inflammation was alleviated 4 weeks post-modeling in the BLM group. In contrast, pulmonary lesions continued to worsen in the BLM+PD-1 group, with no evidence of resolution of inflammation 28 days post-modeling. Quantitative immunohistochemical analysis revealed that the positive expression rate of interleukin-17A (IL-17A) in lung tissues reached 34.28% in the BLM+PD-1 group 14 days post-modeling, which was markedly higher than that in the BLM group (24.02%, P < 0.000 1). The positive expression rate of α-smooth muscle actin (α-SMA) was 12.40% in the BLM+PD-1 group 14 days post-modeling, nearly twice the level in the BLM group (5.87%). 28 days post-modeling, the positive expression rate of α-SMA remained at 7.72% in the BLM+PD-1 group, while it declined to 3.38% in the BLM group. ConclusionThe addition of a PD-1 inhibitor to bleomycin treatment accelerates the progression of pulmonary interstitial fibrosis and effectively recapitulates the pathological process of lung injury and fibrosis driven by aberrant immune activation during clinical immunotherapy. Accordingly, this study successfully establishes a dynamic CIP animal model recapitulating the progression from early inflammatory response to pulmonary fibrosis. This model addresses the critical shortage of animal models for this condition and offers an experimental platform for further mechanistic studies and the development of therapeutic strategies.

ObjectiveTo investigate the differential expression of LEFTY1 in peritoneal dialysis （PD）-associated peritoneal fibrosis （PF） and its clinical value. MethodsLevels of LEFTY1， transforming growth factor-β （TGF-β）， and fibronectin （FN） in peritoneal dialysis effluent were measured in 72 PD patients， and clinical data were collected. Differences in these indicators were compared among groups with different dialysis durations， and the correlation between LEFTY1 and clinical parameters was analyzed to evaluate its predictive value for ultrafiltration insufficiency. ResultsLEFTY1 levels decreased progressively with longer dialysis duration： short-term group ［（2 262.49±270.47） ng/mL］ > mid-term group ［（1 853.52±226.06） ng/mL］ > long-term group ［（1 767.24±264.57） ng/mL］， with significant differences among groups （P<0.001）. TGF-β and FN levels increased with prolonged dialysis duration （P<0.05）. Correlation analysis revealed that LEFTY1 was significantly negatively correlated with FN （r=-0.327， P=0.004）， dialysis duration （r=-0.496，P<0.001）， peritoneal Kt/V （r=-0.333， P=0.004）， peritoneal creatinine clearance （r=-0.239， P=0.043）， and serum calcium （r=-0.410， P<0.001）， while positively correlated with total creatinine clearance （r=0.283， P=0.016）. The area under the ROC curve for LEFTY1 combined with peritoneal Kt/V and peritoneal Ccr in predicting ultrafiltration insufficiency was 0.739. Multivariate regression analysis identified dialysis duration as an independent influencing factor for LEFTY1 expression （P=0.001）. ConclusionThe expression of LEFTY1 in the peritoneal dialysis effluent of PD patients decreases with prolonged dialysis duration and is negatively correlated with pro-fibrotic indicators， suggesting that it may play a potential anti-fibrotic role in the progression of PF. The combined detection of LEFTY1 and solute removal indicators holds value for the early identification of ultrafiltration dysfunction.

Objective To investigate the prevalence and related factors of sarcopenia among non–bedridden older adults in the community of Baoshan District using the China mini sarcopenia risk assessment 7 (C-MSRA-7) combined with Ishii scoring system. Methods The older individuals consulting at 20 community health stations in Baoshan District between April 2025 and June 2025 were enrolled. Data were collected using a general information questionnaire, a dietary and lifestyle habits survey, the C-MSRA-7, and the mini nutritional assessment-short form (MNA-SF). Handgrip strength and anthropometric measurements were also obtained. Individuals with both Ishii score and C-MSRA-7 results positive were classified into the sarcopenia risk group, while the remaining participants were assigned to the non–sarcopenia risk group. Differences in lifestyle habits, dietary patterns, and nutritional status between the two groups were compared. Results A total of 2 611 valid questionnaires were retrieved. Univariate analysis showed statistically significant differences in alcohol consumption, physical activity frequency, body mass index (BMI), nutritional status, activities of daily living, and regularity of three meals in sarcopenia risk group (n＝486) and non–sarcopenia risk group (n＝2 125, P<0.05). Logistic regression analysis showed that advanced age (75–84 years: OR＝2.55, 95%CI 2.03–3.21; ≥85 years: OR＝3.98, 95%CI 2.24–7.07), underweight status (OR＝2.19, 95%CI 1.50–3.19), weight loss＞2 kg (OR＝4.52, 95%CI 2.68–7.64) past 3 months, lack of regular physical activity (OR＝1.77, 95%CI 1.24–2.52) , and alcohol consumption (OR＝1.48, 95%CI 1.07–2.05) were independent risk factors for sarcopenia (P<0.05). Behaviors related to healthy diet, including daily milk consumption (OR＝0.40, 95%CI 0.30–0.52), regular three meals (OR＝0.56, 95%CI 0.41–0.78), and high-quality protein intake (OR＝0.70, 95%CI 0.52–0.94), were protective factors (P<0.05). Conclusions Sarcopenia among community–dwelling, non–bedridden older adults is closely associated with physical activity levels, dietary habits, and nutritional status. Early identification of individuals at risk, enhanced nutritional education, and timely implementation of nutritional interventions and exercise programs are recommended for this population.

ObjectiveTo explore the predictive value of serum cystatin C （CysC） and trabecular bone score （TBS） for postoperative fracture recurrence in elderly patients with osteoporotic vertebral fractures. MethodsA total of 100 elderly patients with osteoporotic vertebral fractures who were treated surgically at Fuling Hospital Affiliated to Chongqing University from June 2022 to June 2023 were followed up for 2 years. They were divided into the poor group （31 cases） and the good group （69 cases） based on the postoperative fracture recurrence. Pearson analysis was used to analyze the correlation between serum CysC and TBS， Cox analysis was used to analyze the influencing factors of postoperative fracture recurrence in elderly patients with osteoporotic vertebral fractures， and ROC analysis was used to analyze the predictive value of serum CysC and TBS for postoperative fracture recurrence in patients. ResultsThe proportion of bone cement penetration and serum CysC in the poor group were significantly higher than those in the good group （χ² = 4.977， P = 0.026； t = 4.749， P = 0.000）， while the proportion of postoperative anti-osteoporosis treatment， bone mineral density T value， and TBS were significantly lower than those in the good group （χ² = 4.229， P = 0.040； t = 2.065， P = 0.042； t = 5.163， P = 0.000）. Serum CysC was negatively correlated with TBS （r = -0.318， P = 0.001）. Elevated serum CysC was a risk factor for postoperative fracture recurrence in elderly patients with osteoporotic vertebral fractures （P < 0.05）， while elevated TBS was a protective factor （P < 0.05）. The AUC of serum CysC for predicting postoperative fracture recurrence in patients was 0.786 （95%CI = 0.679-0.894）， with a sensitivity of 77.42% and a specificity of 71.01%. The AUC of TBS for predicting postoperative fracture recurrence in patients was 0.795 （95%CI = 0.698-0.892）， with a sensitivity of 74.19% and a specificity of 79.71%. The AUC of the combination of serum CysC and TBS for predicting postoperative fracture recurrence in patients was 0.858 （95%CI = 0.773-0.943）， with a sensitivity of 74.19% and a specificity of 82.61%. The combination of the two had a higher predictive value for postoperative fracture recurrence in patients. ConclusionsElderly patients with osteoporotic vertebral fractures who experience postoperative fracture recurrence have elevated serum CysC and decreased TBS. The combination of serum CysC and TBS has a certain predictive value for postoperative fracture recurrence in elderly patients with osteoporotic vertebral fractures.

Objective:To investigate influence of different phantoms on the results of quality control for the images of cone beam computed tomography(CBCT)for breast on the basis of quality control for breast CBCT.Methods:Five different manufacturers'phantoms were selected,and they were placed at the position of testing breast in clinical examination to conduct position for phantom according to the method of the national health industry standard WS 818-2023.The analysis focused on the differences of evaluation results of using different phantoms for image quality on the basis of a series of parameters included uniformity,resolution of high contrast,resolution of low contrast,and CT value of water in scanning images of different phantoms.Data collection and image reconstruction were performed respectively by using commonly clinical procedures.Corresponding module images were selected from the reconstructed images of standard breast phantom.The common layer thickness and projection method of the system were set to record and analyze data.Results:The image uniformity of measured results of the five phantoms were respectively 42.37±2.01,-5.83±0.15,3.76±0.15,2.16±0.06,3.60±0.10.The differences of the image uniformities among the five phantoms were statistically significant(F=1310.02,P<0.001),and the differences of the CT values of the measured water among the five phantoms were statistically significant(F=9 846.46,P<0.001).The differences in the resolution of low contrast among them were also statistically significant(F=27.50,P<0.001).However,the results of the resolution of high contrast were stability,and there was no significant difference in that among the five phantoms.Conclusion:The measured results of quality control of different phantoms are different.

In recent years, with the rapid development of artificial intelligence technology, the application of deep learning in the field of pathology has been continuously expanding. Particularly, the rise of multimodal data fusion methods has opened up new technical paths for the precise diagnosis, prognosis assessment, and individualized treatment of tumors. By integrating multi-level and multi-source data such as clinical information, pathological omics, molecular omics, and imaging omics, deep learning models can identify potential associated features and key biological mechanisms that are difficult to reveal by a single modality, thereby significantly improving the accuracy of disease classification and the scientific nature of risk stratification. This article systematically reviews the research progress of multimodal data fusion methods based on deep learning in the field of pathology in recent years, focuses on sorting out different types of fusion strategies, evaluates their advantages and challenges in practical clinical applications, and looks forward to future development trends.

Objective:To evaluate the effect of applying function-related grouping model of Changsha medical insurance for patients convalescing from a cerebral infarction using the International Classification of Functioning, Disability and Health′s rehabilitation set (ICF-RS).Methods:Ninety cerebral infarction patients in convalescence were treated according to their functional status, including clinical treatment, rehabilitation, traditional Chinese medicine treatment, and rehabilitation nursing. Within 3 days after admission and at the time of discharge, they were evaluated using a comprehensive assessment system for cerebral infarction based on the ICF-RS. The modified Ashworth scale (MAS), Fugl-Meyer assessment (FMA), the mini-mental state examination (MMSE) and the Boston diagnostic aphasia examination (BDAE) were also employed.Results:With the exception of ICF-RS item b280 (pain perception) and item x005 of the MAS, all of the remaining assessments indicated significant enhancements compared to the pre-treatment levels. Functional severity grading also improved significantly after the treatment. Thirteen of the ICF-RS categories indicated more favorable therapeutic outcomes after the treatment. That was accompanied by improvements in the FMA upper limb, lower limb and total scores, and in the MMSE scores. However, no significant disparity was detected in the MAS scores or the BDAE grades before and after treatment.Conclusions:The comprehensive evaluation system based on the ICF-RS effectively evaluates the effectiveness of rehabilitation after cerebral infarction in a way suitable for medical insurance purposes.