Hepatocellular carcinoma (HCC) develops within a profoundly immunosuppressive tumor immune microenvironment (TIME), which limits the efficacy of immunotherapy. Polarization of tumor-associated macrophages (TAMs) toward a pro-tumorigenic M2 phenotype is a major driver of immune escape. Ferroptosis, an iron-dependent regulated cell death program, intersects with hepatic iron metabolism and immune regulation and thus offers promising points of therapeutic intervention. This review systematically elucidates the mechanistic role of TAM ferroptosis in HCC immune evasion and highlights a “bidirectional regulation” intervention strategy grounded in the Traditional Chinese medicine (TCM) principle of “fortifying healthy qi and eliminating pathogens” (Fuzheng Quxie). This strategy employs “eliminating pathogens” (Quxie) approaches to exploit the metabolic vulnerability of M2-like TAMs and precisely induce their ferroptosis. Moreover, it utilizes “fortifying healthy qi” (Fuzheng) approaches to protect M1-like TAMs and CD8⁺ T cells from oxidative damage. This parallel “induction-protection” paradigm demonstrates the unique advantages of TCM in systemically remodeling TIME through multitarget synergistic actions. Accordingly, precision regulation of TAM ferroptosis based on the Fuzheng Quxie theory represents a promising integrative Chinese-Western medicine strategy for overcoming current bottlenecks in HCC immunotherapy, although its clinical translational potential warrants further validation.

BackgroundIn recent years， the incidence of depression among adolescents has been increasing steadily， posing a serious threat to their physical and mental health and even leading to severe consequences such as self-harm and suicide. At the same time， the detection rate of subclinical depression symptoms among adolescents is even higher. Although these symptoms do not meet the clinical diagnostic criteria， they have significantly affected their quality of life， and their persistence over time may further develop into depression. Therefore， in-depth exploration of adolescent depression symptoms and the predictive factors holds significant practical significance and research value. However， up to now， no large-scale investigation and research on depression symptoms among children and adolescents has been conducted in Inner Mongolia Autonomous Region. ObjectiveTo understand the prevalence of depressive symptoms among children and adolescents in Inner Mongolia Autonomous Region， in order to provide references for formulating scientific and effective prevention strategies and intervention measures. MethodsBy using the cluster stratified random sampling method， 6 281 students from the third grade of primary school to the second grade of high school in 12 leagues and cities of Inner Mongolia Autonomous Region were selected in March 2024. A self-designed questionnaire and the Self-rating Depression Scale （SDS） were used for on-site investigation. ResultsA total of 6 058 （96.45%） children and adolescents completed the valid questionnaire survey， and 2 728 cases （45.03%） were found to have depressive symptoms. There were statistically significant differences in the detection rates of depressive symptoms among children and adolescents of different genders， ages， whether they were only children， different family types， family monthly income， parents' educational levels， and whether the mother was employed （χ²=33.769， 40.618， 48.593， 29.972， 142.648， 195.999， 168.190， 5.445， P<0.05 or 0.01）.The results of the Logistic regression analysis showed that for children and adolescents， being female， aged between 12 and 16， over 16 years old， not being an only child， living in a reconstituted family， having a monthly family income of less than 5 000 yuan， and having parents with an education level of primary school or below were predictors of depressive symptoms （OR=1.241， 1.427， 1.273， 1.177， 1.549， 1.278， 1.462， 1.417， 1.514， 1.929， 1.660， 1.528， P<0.05 or 0.01）. ConclusionThe detection rate of depressive symptoms among children and adolescents in Inner Mongolia Autonomous Region is relatively high. Factors that may predict depressive symptoms in children and adolescents include female gender， ages between 12 and 16， ages over 16 years old， non-only children， families with a restructured structure， monthly family income of less than 5 000 yuan， and parents with an education level of primary school or below. ［Funded by Science and Technology Planning Project of the Inner Mongolia Autonomous Region （number， 2022YFSH0119）］

Objective To analyze the related factors of retinopathy in elderly patients with type 2 diabetes mellitus (T2DM) and explore the discriminant efficiency. Methods A retrospective analysis was conducted on 314 elderly patients with T2DM who were treated in Beijing Aerospace General Hospital between April 2022 and April 2025. The related factors of retinopathy in elderly patients with T2DM were explored by logistic regression analysis. ROC curve was drawn to analyze the discriminant efficiency of related factors. Results Compared with the patients in the non-concurrent group, the patients in the concurrent group had a longer course of diabetes mellitus, a higher level of glycosylated hemoglobin (HbA1c), and higher proportions of diabetic peripheral neuropathy, hypertension history, high myopia history and smoking history (P<0.05). After logistic regression analysis, the course of diabetes mellitus, HbA1c, diabetic peripheral neuropathy, history of hypertension and history of high myopia were found to be related factors of retinopathy in elderly patients with T2DM (P<0.05). Based on the above related factors, a model was established for ROC curve analysis, and it was found that the area under the curve was 0.935, with sensitivity, specificity, and 95%CI being 0.867, 0.916, and 0.890-0.979, respectively. Conclusion Course of diabetes mellitus, HbA1c, diabetic peripheral neuropathy, history of hypertension, and history of high myopia are related factors of retinopathy in elderly patients with T2DM. These related factors demonstrate good discriminant efficiency on retinopathy in elderly patients with T2DM.

Uveal melanoma(UM)is the most common primary intraocular malignancy in adults, characterized by high invasiveness and unique metastatic biological features. Although local treatments(such as proton beam therapy and brachytherapy)can effectively control the primary lesion, approximately 50% of patients eventually develop distant metastasis, with the liver being the primary target organ(occurring in 90% of cases). This highlights a paradigm shift in treatment focus from mere local control to systemic prevention and management. For metastatic UM(mUM), current treatment strategies encompass biomarker-guided molecular targeted therapy, immunotherapy(including Tebentafusp, vaccines, and oncolytic virus therapy), and liver-directed therapy. Focusing on the synergy between local and systemic prevention and control, this article systematically elaborates on the precision local treatment for primary UM, the decision-making pathway for systemic treatment of metastatic UM based on molecular subtyping, the integration of local and systemic therapies for liver metastases, and the translational value of nanomedicine in addressing therapeutic bottlenecks. It provides insights for optimizing clinical management of mUM and developing novel therapeutic strategies.

[摘 要] 目的：探究外周血1型辅助性T细胞（Th1）/Th2/Th17细胞相关细胞因子IL-2、IL-4、IL-6、IL-10、IFN-γ、TNF-α、IL-17A对Ⅲ~Ⅳ期肺鳞状细胞癌（LSCC）患者一线免疫治疗联合化疗疗效和预后的预测价值及其动态变化的意义。方法：回顾性分析2020年1月至2023年12月在内蒙古医科大学附属医院接受一线免疫治疗联合化疗的58例Ⅲ~Ⅳ期LSCC患者的临床资料，采集基线及治疗2、4、6周期后和疾病进展时的外周血，用流式细胞术检测Th1/Th2/Th17细胞分泌的细胞因子水平，用受试者工作特性曲线（ROC）确定各细胞因子基线的最佳截断值，据此将患者分为高、低表达组；根据RECIST 1.1标准，将患者分为客观缓解（ORR）[完全缓解（CR） + 部分缓解（PR）]组、非ORR[（疾病稳定（SD） + 疾病进展（PD）]组、疾病控制（DCR）（CR + PR + SD）组和非DCR（即PD）组；根据PD-L1表达评分将患者分为PD-L1 ≥ 1%组和PD-L1 < 1%或未知组。比较组间疗效的差异；分析临床病理特征与疗效的相关性；用广义估计方程（GEE）评估细胞因子动态变化与疗效的关系；用Kaplan-Meier法绘制生存曲线，Log-Rank检验比较组间差异，COX比例风险回归模型进行单因素及多因素预后分析。结果：IL-2和IFN-γ高表达组患者的客观缓解率（ORR）显著高于低表达组患者（P < 0.001）。IL-2、IFN-γ高表达组和IL-10、TNF-α低表达组患者的疾病控制率（DCR）均显著高于对应低/高表达组（P < 0.001）。PD-L1 ≥ 1%组DCR显著高于PD-L1 < 1%或未知组（P < 0.001）。动态分析显示，在4周期及6周期时，有效组患者血清中IL-6表达水平显著低于无效组（P < 0.05），控制组IL-6表达水平显著低于未控制组（P < 0.001）；治疗前及6周期时有效组IFN-γ表达水平显著高于无效组（P < 0.05），治疗前控制组IFN-γ表达水平显著高于未控制组（P < 0.05）。生存分析显示，IL-2低表达组、IL-10高表达组、TNF-α高表达组和IFN-γ低表达组患者的中位PFS显著缩短（均P < 0.05）。COX多因素分析证实，治疗前IL-2 < 2.45 pg/mL和IL-10 ≥ 3.52 pg/mL 是PFS的独立危险因素。结论：外周血Th1/Th2/Th17细胞相关细胞因子的基线水平及动态变化对Ⅲ~Ⅳ期LSCC患者一线免疫治疗联合化疗的疗效和预后具有预测价值。

OBJECTIVE To improve the inventory turnover rate of traditional Chinese medicine （TCM） decoction pieces in hospitals and achieve refined inventory management for cost reduction and efficiency improvement. METHODS Inventory data of TCM decoction pieces in our hospital from 2022 to 2023 were collected. Based on the sale amount and demand coefficient of variation respectively， the ABC classification method and XYZ analysis method were adopted for classification. The two classification results were combined through a cross matrix to divide them into three-level management priorities： level Ⅰ （AX， AY， BX）， level Ⅱ （AZ， BY， CX）， and level Ⅲ （BZ， CY， CZ）. Differentiated inventory strategies were formulated for each level， and core indicators such as turnover rate and inventory cost before and after inventory management optimization were compared. RESULTS There were 58 types （14.22%） in level Ⅰ， 85 types （20.83%） in level Ⅱ， and 265 types （64.95%） in level Ⅲ. After inventory management optimization， the average inventory value of TCM decoction pieces decreased by 341 800 yuan， the average turnover rate increased by 73.03%， and the average turnover days decreased by 4.98 days. The differences in all indicators before and after optimization were statistically significant （ P ＜0.01）. CONCLUSIONS The ABC-XYZ analysis method can break through the single-dimensional limitation of the traditional ABC classification method， adapt to characteristics such as the strong seasonality of TCM decoction pieces， significantly optimize the inventory structure， improve turnover efficiency， and reduce operating costs. It provides a feasible plan for the refined and scientific management of hospital TCM warehouses.

In the challenging and specific military environment， medical activities are not only confined to traditional medical care but must also adapt to the special requirements of military operations. Meanwhile， when military operations employ medical interventions for treatment and research， they introduce complexities and ethical considerations inherent in the medical domain. Against this backdrop， the ethical conflicts and moral dilemmas confronted by the special identity of military doctors have become an inevitable and urgent issue requiring resolution. The identities of doctors and soldiers， typically distinct， overlap and intersect in the role of the military doctors on the battlefield， inevitably giving rise to intricate ethical predicaments that frequently place them in arduous moral choices. The special considerations in behavioral decision-making， contradictions in value judgments， and the reconciliation of moral injury among military doctors in battlefield scenarios should be comprehensively considered based on factors such as professional codes of conduct， values and emotions， international law， and humanitarian principles. Military doctors should regard respecting life as the supreme principle， while also taking into account the protection needs of special groups， and adhering to the core concept of fairness and reasonableness， all of which should serve as the fundamental guidance for their behavioral standards.

AIM:To investigate the prevalence of ocular fundus lesions among active-duty military personnel with high myopia and to analyze the associated influencing factors.

METHODS: A cross-sectional study. Subjects included military personnel with high myopia(≤-6.00 D)and elongated axial length(≥26 mm). A systematic evaluation protocol was implemented, consisting of standardized questionnaires, general physical health examinations, and comprehensive ophthalmic assessments. Optical coherence tomography(OCT)was used to screen for fundus lesions in highly myopic subjects, and the prevalence of related lesions was calculated. Axial length, refractive error, best-corrected visual acuity(BCVA), and macular ganglion cell complex(GCC)thickness were measured. Univariate analysis was performed to compare differences in the above parameters between highly myopic subjects with and without concomitant fundus lesions. Multivariate Logistic regression analysis was further applied to identify risk factors for fundus lesions.

RESULTS:A total of 134 male patients(268 eyes)were enrolled, with the mean age of 24.5±3.2 y. Of the 268 eyes, 123 eyes(45.9%)showed positive signs of fundus lesions. Among these, parapapillary blood flow density reduction was found in 84 eyes(31.3%), GCC thinning in 46 eyes(17.2%), drusen in 8 eyes(3.0%), optic disc edema in 7 eyes(2.6%), retinoschisis in 6 eyes(2.2%), and choroidal excavation in 3 eyes(1.1%). BCVA was significantly lower in highly myopic patients with retinoschisis than in those without retinoschisis(P<0.05).Univariate analysis showed that refractive error, axial length, and posterior scleral expansion were associated with the occurrence of fundus lesions(P<0.05). Multivariate Logistic regression analysis revealed that axial length(OR=2.52, 95%CI: 1.67-3.80, P<0.001)and posterior scleral expansion(OR=3.12, 95%CI: 1.65-5.92, P<0.01)were significant risk factors for fundus lesions in highly myopic military personnel.

CONCLUSION: The prevalence of fundus lesions is relatively high among active-duty military personnel with high myopia. Peripapillary flow density reduction and GCC thinning are the most common manifestations in this population. Increased axial length and posterior scleral ectasia are significant contributing factors. It is recommended that OCT be incorporated into routine ophthalmic examinations for these military personnel, thereby providing a basis for the early detection and intervention of fundus lesions.

ObjectiveTo design a "roly-poly" style interactive home-based hand function training device based on the principle of self-stabilization and recovery in light of the characteristics of post-stroke hand dysfunction and the current scarcity of home-based hand function training devices; and explore the feasibility and clinical value of this device in hand function rehabilitation training for stroke patients. MethodsThis study adopted a phased research design consisting of two stages: device development and clinical validation. At the first stage, focusing on the principle of the tumbler's automatic return to center, combined with the clinical needs of hand function rehabilitation training for stroke patients, the development of a home-based interactive hand function training device was completed, and the application and authorization of a utility model patent were obtained. At the second stage, 30 stroke patients with post-stroke hand dysfunction hospitalized at Beijing Bo'ai Hospital from May to October, 2025 were randomly divided into control group (n = 15) and experimental group (n = 15). Both groups received conventional rehabilitation therapy, the control group added routine hand function training every evening, and the experimental group added hand function training using the device developed in this study every evening, for four weeks. The grip strength, lateral pinch strength, finger pad pinch strength, three-finger pinch strength and wrist joint range of motion (dorsal-flexion, palm-flexion, radial deviation and ulnar deviation) were measured before and after intervention. The upper limb and hand motor function was assessed with Fugl-Meyer Assessment (FMA), and the modified Barthel Index (MBI) was used to evaluate activities of daily living (ADL). ResultsA self-stabilizing hemispherical hand functional rehabilitation device was developed and granted a utility model patent. After intervention, the grip strength, lateral pinch strength, finger pad pinch strength, three-finger pinch strength, wrist joint range of motion, and FMA and MBI scores significantly improved in both groups (|t| > 5.683, P < 0.05); except for the score of MBI (P > 0.05), all the other indicators were better in the experimental group than in the control group (t > 2.633, P < 0.05). ConclusionThe self-stabilizing, closed-loop home-based functional hand interaction training device designed in this study effectively improves hand grip, pinching function and wrist joint range of motion of stroke patients, significantly enhancing upper limb and hand motor function, and demonstrates feasibility for home-based hand rehabilitation training. However, the device does not provide notable additional improvements in patients' ADL, necessitating further optimization to enhance its clinical application value.

Diabetic macular edema(DME), a serious complication of diabetic retinopathy(DR), is a chronic condition caused by multiple factors. Throughout its progression, inflammatory factors and vascular endothelial growth factor(VEGF)play a critical role. Anti-VEGF drugs have shown significant effectiveness in the treatment of DME; however, some patients may experience persistent DME after injection or require frequent injections. Dexamethasone intravitreal implants(DEX implants)serve as a sustained-release implant characterized by a reasonable release profile and high bioavailability. They offer safe, effective, and prolonged anti-inflammatory effects, aiding in the repair of retinal barrier and reduction of exudation. To further enhance patients' visual quality, exploring the efficacy of DEX implants in combination with existing treatment regimens has great clinical significance. This review primarily discusses the research advancements in DEX implants, focusing on their pharmacological properties, indications for use, and their combination with existing drugs and treatment methods. It also evaluates the advantages and disadvantages of combination therapy or switching to DEX implants compared to current standard treatments, aiming to provide guidance for personalized treatment options for patients with DME.