Objective To analyze the effect of releasing the lower pulmonary ligament on right residual lung expansion after right upper lobe resection under different body mass index (BMI) levels. Methods The clinical data of patients who underwent thoracoscopic right upper lobe resection in the First Affiliated Hospital with Nanjing Medical University from 2021 to 2022 were retrospectively analyzed. Patients were divided into a group A (17 kg/m2＜BMI≤23 kg/m2), a group B (23 kg/m2＜BMI≤29 kg/m2) and a group C (BMI＞29 kg/m2) according to BMI. The presence of residual cavity was judged by chest X-ray at 7-10 days after operation, the degree of compensation change of the right main bronchus angle was measured, and the changes in lung volume were determined by CT three-dimensional reconstruction. Results A total of 157 patients who underwent thoracoscopic right upper lobe resection were included, including 71 males and 86 females, with an average age of (59.7±11.2) years. There were 50 patients in the group A, 75 patients in the group B, and 32 patients in the group C. In the group A, compared with those without releasing the lower pulmonary ligament, patients with releasing had a lower incidence of postoperative residual cavity (P=0.016), greater changes in bronchus angle (P<0.001), and smaller changes in lung volume (P<0.001). In the group B and C, there was no significant effect of releasing the lower pulmonary ligament on postoperative residual cavity, bronchus angle, and lung volume changes (P>0.05). Conclusion For patients with thin and long body shape and low BMI, releasing the lower pulmonary ligament is helpful to promote the expansion of the residual lung after right upper lobe resection and reduce the occurrence of postoperative residual cavity in patients.

Objective To investigate the imaging features and diagnostic value of mammography and magnetic resonance imaging (MRI) in different molecular subtypes of breast cancer. Methods A total of 126 breast cancer patients treated between January 2023 and January 2025 were enrolled, including 36 cases of Luminal A, 30 cases of Luminal B, 32 cases of HER-2 overexpression, and 28 cases of triple-negative breast cancer. The mammographic and MRI features, as well as the detection rates of mammography and MRI, were compared among the different molecular subtypes. Results The proportion of triple-negative breast cancers presenting as masses on mammography was higher than those of other subtypes (P<0.05), while the proportion of calcification was lower than other subtypes (P<0.05). Luminal A tumors showed a lower proportion of masses with indistinct margins on mammography compared with other subtypes (P<0.05), but a higher proportion of spiculated margins compared with HER-2 overexpression and triple-negative subtypes (P<0.05). On MRI, the proportion of triple-negative breast cancers presenting as masses was higher than those of other subtypes (P<0.05). The apparent diffusion coefficients of Luminal A and Luminal B breast cancers were higher than those of other subtypes (P<0.05). The detection rate of Luminal B breast cancer was higher on MRI than that on mammography (P<0.05). Conclusion Mammographic and MRI features differed significantly among molecular subtypes of breast cancer. Both mammography and MRI showed high detection rates across subtypes, with MRI demonstrating a higher detection rate than mammography in Luminal B breast cancer.

Objective To investigate the imaging features and diagnostic value of mammography and magnetic resonance imaging (MRI) in different molecular subtypes of breast cancer. Methods A total of 126 breast cancer patients treated between January 2023 and January 2025 were enrolled, including 36 cases of Luminal A, 30 cases of Luminal B, 32 cases of HER-2 overexpression, and 28 cases of triple-negative breast cancer. The mammographic and MRI features, as well as the detection rates of mammography and MRI, were compared among the different molecular subtypes. Results The proportion of triple-negative breast cancers presenting as masses on mammography was higher than those of other subtypes (P<0.05), while the proportion of calcification was lower than other subtypes (P<0.05). Luminal A tumors showed a lower proportion of masses with indistinct margins on mammography compared with other subtypes (P<0.05), but a higher proportion of spiculated margins compared with HER-2 overexpression and triple-negative subtypes (P<0.05). On MRI, the proportion of triple-negative breast cancers presenting as masses was higher than those of other subtypes (P<0.05). The apparent diffusion coefficients of Luminal A and Luminal B breast cancers were higher than those of other subtypes (P<0.05). The detection rate of Luminal B breast cancer was higher on MRI than that on mammography (P<0.05). Conclusion Mammographic and MRI features differed significantly among molecular subtypes of breast cancer. Both mammography and MRI showed high detection rates across subtypes, with MRI demonstrating a higher detection rate than mammography in Luminal B breast cancer.

Objective To investigate the imaging features and diagnostic value of mammography and magnetic resonance imaging (MRI) in different molecular subtypes of breast cancer. Methods A total of 126 breast cancer patients treated between January 2023 and January 2025 were enrolled, including 36 cases of Luminal A, 30 cases of Luminal B, 32 cases of HER-2 overexpression, and 28 cases of triple-negative breast cancer. The mammographic and MRI features, as well as the detection rates of mammography and MRI, were compared among the different molecular subtypes. Results The proportion of triple-negative breast cancers presenting as masses on mammography was higher than those of other subtypes (P<0.05), while the proportion of calcification was lower than other subtypes (P<0.05). Luminal A tumors showed a lower proportion of masses with indistinct margins on mammography compared with other subtypes (P<0.05), but a higher proportion of spiculated margins compared with HER-2 overexpression and triple-negative subtypes (P<0.05). On MRI, the proportion of triple-negative breast cancers presenting as masses was higher than those of other subtypes (P<0.05). The apparent diffusion coefficients of Luminal A and Luminal B breast cancers were higher than those of other subtypes (P<0.05). The detection rate of Luminal B breast cancer was higher on MRI than that on mammography (P<0.05). Conclusion Mammographic and MRI features differed significantly among molecular subtypes of breast cancer. Both mammography and MRI showed high detection rates across subtypes, with MRI demonstrating a higher detection rate than mammography in Luminal B breast cancer.

Senile insomnia is a common clinical disorder. Traditional Chinese medicine （TCM） primarily attributes the pathogenesis of insomnia to Yang failing to enter Yin aspect and disharmony between Yin and Yang. However， the discussion on insomnia caused by Yang Qi deficiency in elderly patients remains insufficient. According to the theory of extreme Yang in the Huang Di Nei Jing， this paper systematically elucidates the central role of Yang Qi in maintaining mental tranquility and regulating the sleep-wake cycle. It posits that the natural decline of Yang Qi with aging leads to Yang failing to enter Yin aspect or deficient Yang floating upward， which constitutes a key pathogenesis of senile insomnia. From a modern medical perspective， mitochondrial energy metabolism dysfunction is identified as a crucial biological basis. Mitochondrial functional declines result in insufficient adenosine triphosphate （ATP） production and reactive oxygen species （ROS） accumulation， which disrupts the synthesis of sleep-related neurotransmitters and the expression of circadian clock genes， ultimately leading to sleep disturbances. Furthermore， this sutdy explores the intrinsic connection between Yang Qi deficiency and mitochondrial dysfunction， arguing for a high degree of correspondence in their functional and pathological manifestations. Accordingly， the therapeutic principle of warming and tonifying Yang Qi， nourishing the heart and tranquilizing the mild is proposed. This approach employs Yang-warming formulas and acupuncture to regulate the mitochondrial function through multiple targets. Specific mechanisms include enhancing the activity of respiratory chain complexes， activating the mitochondrial autophagy， and mitigating oxidative stress， thereby restoring energy metabolic homeostasis and improving sleep in the elderly. This study provides a new theoretical foundation and a therapeutic strategy for integrating TCM and Western medicine in preventing and treating senile insomnia.

In modern society， the comorbidity of insomnia with amnesia has shown a significantly increasing incidence and become increasingly severe， emerging as a public health issue that endangers people's physical and mental health and quality of life. Anmei Dan （AMD）， originally recorded in the Shishi Milu by CHEN Shiduo in the Qing Dynasty， possesses profound theoretical foundations and distinct clinical advantages in ameliorating insomnia with amnesia. Basic research has unequivocally confirmed its definite therapeutic effects on insomnia with amnesia and revealed partial mechanisms. AMD is therefore a veritable classic prescription embodying the principle of treating different diseases with the same method for insomnia and amnesia. However， few researchers have reviewed the related research progress. This article systematically summarized the theoretical connotations of traditional Chinese medicine in treating insomnia with amnesia， delineated the multi-component material basis of AMD in ameliorating insomnia with amnesia （including various chemical components such as ginsenosides， jujubosides， and salvianolic acids）， and evaluate its multi-dimensional clinical efficacy （e.g.， prolonging total sleep time， improving sleep efficiency， and enhancing memory）. Moreover， it systematically summarizes the multi-pathway mechanisms of action. The results indicate that AMD has a clear material basis， definite clinical efficacy， and a favorable safety profile in ameliorating insomnia and amnesia. AMD may exert the therapeutic effect by regulating sleep-wake rhythms， enhancing synaptic plasticity， inhibiting neuroimmune inflammation， and modulating autophagy， oxidative stress， and energy metabolism. In conclusion， AMD exerts synergistic effects through multi-component， multi-dimensional， and multi-pathway approaches， serving as an important prescription for enriching and developing the theory of treating different diseases with the same method for insomnia with amnesia.

Objective: To systematically evaluate the performance of machine learning (ML) models in predicting non suicidal self injury (NSSI) behavior among adolescents, providing an evidence based foundation for the development of clinically applicable risk assessment tools. Methods: A comprehensive search was conducted in PubMed, Embase, Web of Science, CNKI, and Wanfang databases for relevant studies from their inception to July 21, 2025. The Prediction Model Risk of Bias Assessment Tool (PROBAST) was used to evaluate the methodological quality of the included studies. Stata 18 software was used to calculate the area under the receiver operating characteristic curve (AUC) of the models, and publication bias assessment, sensitivity analysis, and Egger s test were performed. Results: The total of 12 studies (42 prediction models) involving 58 070 adolescents were included. There were 15 machine learning algorithms in total, among which Random Forest, Logistic Regression, XGBoost, and Support Vector Machines were the most frequently utilized. The most common predictors were gender (female), family function, depression, emotion regulation, and age. All 12 included studies exhibited a high risk of bias. The pooled AUC was 0.80 (95% CI =0.78-0.82), although heterogeneity was substantial ( I 2=95.8%, P <0.01). Sensitivity analysis confirmed the robustness of these findings (no overlap in 95% CI ), while Egger s test indicated the presence of publication bias ( P <0.05). Conclusions Machine learning demonstrates potential in the risk prediction of adolescent NSSI, but existing models have a high risk of bias. Future research should focus on improving methodological quality and optimizing model reliability through rigorous external validation.

Objective: To analyze the structural changes in whole blood and apheresis platelet donations in Chinese Society of Blood Transfusion (CSBT) sentinel units from 2021 to 2025, and to provide evidence for donor recruitment and blood service management. Methods: Aggregated data reported by sentinel sites were collected and stratified according to six indicators: age, sex, donation history, donation volume, donation site, and organization mode. Pearson χ test, Cramer′V coefficient, Cochran-Armitage trend test and simple linear regression were adopted for analysis. Results: A total of 16 256 973 whole blood donations and 1 576 546 apheresis platelet donations were included. Among whole-blood donations, the proportion of donors aged 18-22 years decreased from 27.30% to 10.60%. The proportion of male donors increased from 58.81% to 63.13%; the proportion of people aged 30 and above increased from 58.40% to 75.30%; the proportion of fixed locations rose from 28.37% to 36.57%; the proportion of social groups increased from 21.69% to 39.69%. The 400-mL donations decreased from 62.12% to 53.46%, while individually initiated voluntary donations remained above 50%. Apheresis platelet donations were predominantly from males, individuals aged 30-39 years, and repeat donors; 2-treatment-unit apheresis platelet donations increased from 67.19% to 74.93%, and individually initiated donations accounted for 92.97%-96.02%. Statistically significant overall annual compositional differences were observed for all six indicators (all P<0.001), whereas linear trends for some sub-categories were not statistically significant. Conclusion: In the participating CSBT sentinel units, among whole blood donations, the proportions of donors aged 18-22 years, university-organized group donations, and donations at blood mobiles decreased, whereas the proportions of organizational group donations and donations at fixed venues increased. The apheresis platelet donation cohort is relatively mature and is evolving toward a high-efficiency donation model. Individual voluntary donation remains the primary organization mode for both donation types. Strategies such as youth donor recruitment, optimized layout of fixed donation sites, and retention of repeat donors should be strengthened to improve the resilience of blood supply.

With the rapid advancement of medical technology and the increasing complexity of clinical environments, competence in clinical ethical decision-making has become an indispensable core competency for exemplary physicians. However, traditional medical ethics education has long been confronted with the persistent challenges of theory-practice dissociation and the disconnect between pedagogical settings and clinical realities. Thus, how to construct a "Clinical Ethics" curriculum that aligns with the objectives of training high-caliber medical professionals has emerged as a critical and challenging issue in current medical education reform. To effectively address this challenge, the Office of Education at Peking University Third Hospital, since 2021, has assembled a multidisciplinary "Clinical Ethics" teaching and management team comprising faculty from Peking University School of Humanities and key clinical specialists from the hospital. In 2022, the "Clinical Ethics" elective course was formally launched for fourth-year students in the eight-year MD program who had completed coursework in "Medical Ethics" and organ-system-based curricula, with the aim of exploring and operationalizing a pre-clinical ethics education model tailored for senior medical students. The course employs a modular instructional design encompassing "theoretical review-case-based deliberation-clinical workshop", which effectively facilitates the deep integration of medical humanities with clinical practice.Following four years of iterative refinement through the "plan-act-observe-reflect" cycle, the course has demonstrated positive outcomes in enhancing students' ethical awareness and decision-making capabilities, and has preliminarily established a sustainable collaborative mechanism among the multidisciplinary faculty team. This article systematically delineates the course development background, pedagogical model and methodological innovations, and the multidisciplinary collaborative framework, alongside reflections and summaries based on implementation outcomes, with the intent of providing references for the future development of "Clinical Ethics" curricula.

Corneal transparency depends on an avascular microenvironment, regularly organized stromal collagen, and regulated inflammatory repair response.CD34+ cells should not be regarded as a single functional population; rather, they comprise cornea-resident mesenchymal stem cell-like cells, peripheral blood-derived endothelial progenitor cells(EPCs), and fibrocytes with distinct origins, phenotypes, and pathological effects. Resident CD34+ cells are mainly associated with limbal stem cell niche maintenance and stromal homeostasis, whereas recruited EPCs and fibrocytes may contribute to corneal neovascularization and scarring under hypoxic, inflammatory, or TGF-β-driven conditions. This review summarizes the biological characteristics, corneal distribution, and key signaling pathways of CD34+ cells, including VEGF/VEGFR-2, SDF-1/CXCR4, NF-κB, and TGF-β/Smad signaling. And further discuss their roles in infectious keratitis, limbal stem cell deficiency, keratoconus, and post-traumatic corneal fibrosis. By integrating controversial findings with clinical evidence and translational limitations, this review suggests that future CD34-related therapies should shift from non-selective CD34 modulation toward spatiotemporally precise strategies that preserve resident reparative subpopulations while inhibiting recruited proangiogenic and profibrotic cells.