Intravitreal anti-vascular endothelial growth factor(anti-VEGF)therapy has been widely used, but the variability in its therapeutic efficacy limits individualized treatment. In recent years, the application of artificial intelligence(AI)has opened up new avenues for personalized treatment response prediction, and its core branches include machine learning(ML)and deep learning(DL). This review systematically retrieved and analyzed 41 relevant studies published up to April 2025. Comprehensive analysis reveals that AI predictive models are evolving from forecasting single endpoints(such as visual acuity or central retinal thickness)to integrating multi-dimensional endpoints(encompassing anatomical, functional, and treatment demand parameters)and generating predictive imaging outputs. In terms of technical approaches, DL models(28 studies, accounting for 68.3%)dominate this field due to their robust image interpretation capabilities, while ML models(10 studies, 24.4%)retain significant value in the analysis of structured clinical data. Cross-disease comparisons indicate that research efforts are most concentrated on age-related macular degeneration(ARMD)and diabetic macular edema(DME), with shared conceptual frameworks for model construction, yet distinct anatomical and functional indicators are prioritized for each disease. Currently, the field confronts several key challenges, including insufficient prospective clinical validation, limited model interpretability(the “black box problem”), and a scarcity of high-quality multi-center datasets. Moving forward, it is imperative to advance real-world validation and develop explainable AI techniques to expedite the clinical translation of these predictive models.

Human keratinocyte growth factor-1 (hKGF-1), a member of the fibroblast growth factor (FGF) family, plays crucial roles in organ development, cell proliferation, wound healing, and tissue repair, representing one of the most effective and specific growth factors for skin repair. However, obtaining recombinant hKGF-1 remains challenging due to its universally low expression efficiency in vitro. This study employs the Bombyx mori baculovirus expression system to establish a technological platform that utilizes the economically important insect Bombyx mori as a bioreactor for high-efficiency and low-cost expression and production of recombinant human keratinocyte growth factor 1 (hKGF-1) protein, ultimately achieving high-level expression of hKGF-1 in Bombyx mori ovary cell line (BmN). In this study, we optimized the hKGF-1 sequence based on the codon preference of baculovirus. By fusing hKGF-1 with polyhedrin (highly expressed in this system) and adding extra promoters and enhancers, we significantly improved the expreesion level of hKGF-1 in Bombyx mori cells. The results demonstrated that the aforementioned strategies significantly enhanced the expression level of hKGF-1 in Bombyx mori cells. SDS-PAGE and Western blotting results revealed that the highest hKGF-1 expression (accounting for 8.7% of total cellular protein) was achieved when the Polh promoter was combined in tandem with the P6.9 promoter and hKGF-1 was fused with a 15-residue polyhedrin fragment for co-expression. The optimal harvest time was determined to be 120 h post transfection. This study achieved the efficient expression of hKGF-1 in Bombyx mori cells, establishing an ideal technological platform for the industrial utilization of recombinant hKGF-1. The developed methodology not only provides valuable technical references for the production of other growth factors and complex proteins, but also demonstrates significant implications for employing silkworms as bioreactors for recombinant human protein expression.
Bombyx/metabolism* ; Animals ; Baculoviridae/metabolism* ; Humans ; Fibroblast Growth Factor 7/biosynthesis* ; Recombinant Proteins/genetics* ; Cell Line ; Genetic Vectors/genetics*

Bombyx mori nucleopolyhedrovirus (BmNPV) is extremely harmful to the silk industry. The polyhedrin, which encodes the polyhedrin (Polh), can be expressed at ultra-high levels and form occlusion bodies in the nucleus, embedding the progeny virus within it. However, the detailed mechanism by which polyhedrin is transported into the host cell nucleus remains unknown. Clarifying the nuclear import mechanisms of viral proteins can help us develop better prevention and treatment measures against baculoviruses. This study employed molecular cloning, co-immunoprecipitation, and immunofluorescence to analyze in detail the expression pattern of the highly expressed polyhedrin in the very late stage of the virus, and further revealed that the host protein importin α participates in the nuclear import of polyhedrin through protein interactions. This study provides a reference for further elucidating the nuclear import mechanisms of the baculovirus proteins including polyhedrin that can enter the nucleus.
Nucleopolyhedroviruses/metabolism* ; Active Transport, Cell Nucleus ; Animals ; Bombyx/virology* ; alpha Karyopherins/metabolism* ; Cell Nucleus/metabolism* ; Viral Structural Proteins/metabolism* ; Occlusion Body Matrix Proteins

Objective To investigate the effect of triglyceride-glucose index(TyG)on the short-term prognosis of patients with initial acute ischemic stroke.Methods A total of 391 patients with initial acute ischemic stroke who were hospitalized in Kunshan Second People's Hospital and The Affiliated Suzhou Hospital of Nanjing Medical University from Jun.2020 to Jun.2023 were retrospectively included.According to the modified Rankin scale(mRS)scores at 90 d follow-up,they were assigned to good prognosis group(286 cases)or poor prognosis group(105 cases).Logistic regression and receiver operating characteristic(ROC)curve were used to evaluate the effect of TyG on the short-term prognosis of patients with initial acute ischemic stroke.Results Compared with the good prognosis group,the patients of poor prognosis group had older age,higher proportion of atrial fibrillation,higher levels of homocysteine,triglyceride,total cholesterol,low-density lipoprotein,and TyG,and higher National Institutes of Health stroke scale(NIHSS)score(all P＜0.05).Multivariate logistic regression analysis showed that age,homocysteine,TyG and NIHSS score were independent risk factors for poor prognosis in patients with initial acute ischemic stroke(all P＜0.05).ROC curve analysis showed that TyG combined with NIHSS score had good predictive value for poor prognosis of patients with initial acute ischemic stroke,and the area under curve value was 0.795.Conclusion The combination of TyG and NIHSS score is an independent influencing factor for poor short-term prognosis in patients with initial acute ischemic stroke.

Objective To summarize the operation experience of 1 case of ultra-long-distance single-port robotic-assisted laparoscopic renal cyst decortication using a domestic robotic system,and provide references for the development of long-distance telesurgery.Methods The procedure was performed using a domestically produced single-port robotic system.The distance between the main control end and the patient end was 2 400 km.The operation was conducted remotely via a 5G network and a 100 Mbps dedicated line provided by China Telecom.The surgeon controlled the robotic arm remotely.Results The surgery was completed smoothly within a duration of 32 min.The real-time latency was(90±20)ms.Blood loss during the operation was 10 mL,and no drainage tube was placed.The patient recovered smoothly and returned to the ward without any complications.Conclusion It is safe and feasible for the domestically produced single-port robotic system to implement ultra-long-distance telesurgery.This approach facilitates the decentralization of advanced medical resources and helps mitigate disparities in healthcare access.

OBJECTIVE To establish a nomogram model based on clinical and biochemical parameters in elderly patients with p16-negative nasopharyngeal carcinoma and to identify patients who may benefit from concurrent chemoradiotherapy(CCRT)combined with induction chemotherapy(IC).METHODS A total of 142 nasopharyngeal carcinoma patients who received CCRT in Huanggang Central Hospital between June 2021 and May 2024 were retrospectively included for analysis,and the patients were divided into a training set(n=99)and a validation set(n=43)in a ratio of 7:3.Before treatment,all patients underwent a complete physical examination,fiberoptic nasopharyngeal endoscopy,laboratory tests,and plasma Epstein-Barr virus deoxyribonucleic acid(EBV-DNA)level detection.The study endpoint was disease-specific survival(DSS),defined as the time from initial treatment to cancer-related death or the last follow-up date.RESULTS EBV-DNA level,T stage,N stage,albumin(ALB),and lactate dehydrogenase(LDH)were screened by COX and LASSO regression analysis to establish a nomogram model for predicting DSS in nasopharyngeal carcinoma patients.The nomogram model had good discrimination ability[C-index value:0.947(95%CI:0.905-0.990)vs.0.930(95%CI:0.862-0.998)]and accuracy in both the training set and the validation set.The nomogram model was divided into low-risk group,medium-risk group and high-risk group according to risk.There were statistical differences in DSS among the three groups in the training set and validation set(χ2=7.153,9.266,P=0.028,0.010).In the training set and validation set,only the patients in the high-risk group who received IC+CCRT had a longer DSS than those who received CCRT.CONCLUSION The nomogram model of pre-treatment EBV-DNA level,T stage,N stage,ALB,and LDH was used to distinguish high-risk elderly p16-negative nasopharyngeal carcinoma patients,suggesting that this population may be the beneficiary of IC+CCRT in clinical practice.

Chest low-dose computed tomography (LDCT) is a widely utilized modality for lung cancer screening and follow-up in high-risk populations, owing to its low radiation dose. However, the diagnostic accuracy of LDCT is significantly constrained by inherent limitations, including elevated image noise and reduced contrast resolution. The potential for deep learning technologies to address these challenges through data-driven LDCT image denoising approaches has been demonstrated. In this review, the advantages and limitations of deep learning models were introduced, including supervised, unsupervised, and self-supervised learning. The potential and challenges of these models in clinical applications were analyzed, thereby providing a reference for subsequent research and clinical practice.

Objective To evaluate the clinical efficacy of electroacupuncture at acupoints distributed on conception vessel(CV)and governor vessel(GV)in treating ischemic stroke(AIS)complicated with dysphagia and explore its potential mechanism.Methods A total of 120 patients diagnosed with AIS complicated with dysphagia at Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University from December 2020 to December 2023 were enrolled and randomly divided into an observation group and a control group,with 60 patients per group.The control group received conventional swallowing training,while the observation group received additional electroacupuncture at acupoints distributed on CV and GV.The treatment lasted for 4 weeks.After 1 month of treatment,clinical efficacy was assessed,and the changes in Standardized Swallowing Assessment(SSA)scores,National Institutes of Health Stroke Scale(NIHSS)scores,hyolaryngeal mobility(thyroid cartilage anterior/superior displacement,hyoid bone anterior/superior displacement),and KubotaWater Swallowing Test scores were observed.Cerebral microcirculation parameters and the Chinese version of the Eating/Drinking Quality of Life(EDQoL)questionnaire were also compared.Safety and adverse events were evaluated.Results(1)The total effective rate in the observation group was 95.00%(57/60),compared to 76.67%(46/60)in the control group,demonstrating statistically superior therapeutic efficacy in the observation group(P＜0.05).(2)After treatment,both groups showed significant improvements in SSA scores and NIHSS scores(P＜0.05),with the observation group exhibiting markedly better enhancement in both SSA and NIHSS scores compared to the control group,showing statistically significant differences(P＜0.05).(3)After intervention,significant improvements were observed in anterior displacement of thyroid cartilage,superior displacement of thyroid cartilage,anterior displacement of hyoid bone,and superior displacement of hyoid bone in both groups(P＜0.05).The observation group outperformed the control group in all these laryngeal kinematic parameters with statistically significant differences(P＜0.05).(4)Both groups demonstrated significant improvement in Kubota Water Swallowing Test scores after treatment(P＜0.05),with the observation group displaying statistically greater improvement than the control group(P＜0.05).(5)Cerebral arterial parameters including peak systolic velocity(Vs),mean velocity(Vm),and resistance index(RI)were significantly improved in both groups after treatment(P＜0.05).The observation group showed superior enhancement in these cerebrovascular hemodynamic indices compared to the control group(P＜0.05).(6)Significant improvements in EDQoL scores were observed in both groups after treatment(P＜0.05),with the observation group achieving statistically greater improvement than the control group(P＜0.05).(7)The total incidence of adverse reactions was 1.67%(1/60)in the observation group versus 11.67%(7/60)in the control group,indicating a statistically significant lower adverse event rate in the observation group(P＜0.05).Conclusion Electroacupuncture at acupoints distributed on CV and GV effectively alleviates dysphagia and neurological impairment,improves hyolaryngeal mobility and cerebral microcirculation,enhances quality of life,and reduces adverse events such as aspiration pneumonia in AIS patients complicated with dysphagia.

Objective To observe the characteristics of gut microbiota in patients with type 2 diabetes mellitus(T2DM)with different traditional Chinese medicine(TCM)syndrome types,and to further explore the key microbial communities and functional differences affecting syndrome differentiation.Methods A total of 45 patients who visited the Department of Geriatrics,Hunan Provincial Hospital of Integrated Traditional Chinese and Western Medicine in 2023 were enrolled.These included 15 T2DM patients with qi-yin deficiency and blood stasis syndrome(Group A),15 T2DM patients with qi-yin deficiency syndrome(Group B),and 15 non-diabetic patients from the same period(Group C).Fecal samples were collected,and 16S rRNA sequencing and analysis were performed.Results 1)A total of 1 564 operational taxonomic units(OTUs)were obtained from the three groups of patients,with 224,127,and 351 unique OTUs identified in Groups A,B and C,respectively.2)Both α-and β-diversity analyses indicated differences among the gut microbiota of the three groups.For instance,in the α-diversity analysis,the Sobs index showed significant inter-group differences(P＜0.01).Group A(264.00±88.84)was significantly higher than Group B(145.90±87.0)(P＜0.01),while Group B was significantly lower than Group C(229.7±112.4)(P＜0.05).In the β-diversity analysis,the principal coordinate analysis(PCoA)indicated a clear separation among groups(R=0.1610,P＜0.01).The R values in the Anosim/Adonis analysis ranged from 0.144 to 0.196,and the R2 values ranged from 0.067 to 0.083,all indicating differences in inter-group comparisons(P＜0.01).3)At the phylum level,Firmicutes,Actinobacteriota,and Bacteroidota were predominant in all groups.Among them,Bacteroidota exhibited significant inter-group differences(P＜0.05),with its abundance in Group A being significantly higher than that in Group B(P＜0.01).4)Analysis of differences in microbiota composition,combined with linear discriminant analysis effect size(LEfSe)and Random Forest analysis,revealed that,at the genus level,the microbiota biomarkers between Group A and Group B were Parabacteroides,Bacteroides,g_unclassified_f_Lachnospiraceae,Roseburia,and Aspergillus,those between Group B and Group C were Erysipelotrichaceae_UCG-003 and Ruminococcus,and those between Group A and Group C were Parabacteroides,Anaerotruncus,and Oscillibacter.The results were validated by receiver operating characteristic(ROC)curve analysis,which suggested that the microbiota biomarkers between Group A and Group B(AUC=0.91;95％CI,0.80-1.00),Group B and Group C(AUC=0.84;95％CI,0.69-0.99),Group A and Group C(AUC=0.87;95％CI,0.75-0.99)had good diagnostic efficacy.5)The study identified 116 major pathways with inter-group differences through Kyoto Encyclopedia of Genes and Genomes(KEGG)analysis.For example,the enrichment degree of ABC transporter pathway in Group A(2.58±0.36)was significantly lower than those in Group B(2.90±0.48)and Group C(3.11±0.66)(P＜0.05).These pathways were associated with metabolism and environmental information processing.g.Conclusion The differences in the gut microbiota characteristics and functions among patients with specific TCM syndromes of T2DM may provide references for TCM syndrome differentiation and therapeutic mechanisms.

The cultivation of top innovative nursing talents with Chinese characteristics in the new era lends critical support to the accomplishment of the strategic goal of the Healthy China Initiative.Herein,we reviewed the historical development of nursing science in China,clarified the conceptual framework of nursing science with Chinese characteristics in the new era,and identified the essential qualities and competencies required for top innovative nursing talents.Furthermore,we analyzed the mission and challenges in cultivating these nursing talents,and put forward new approaches,including formulating new ethics and political education theories specific to nursing science with Chinese characteristics,establishing a cross-disciplinary educational model of Nursing+X,and creating a new nursing talent cultivation ecosystem adapted to the era of human-machine symbiosis.This study provides theoretical insights into the cultivation of top innovative nursing talents who align their development well with national strategic needs,embody patriotism,and possess a strong sense of contemporary responsibility.