Objective To explore a method for rapid and differential diagnosis of rejection after kidney transplantation through urine hyperspectral imaging technology. Methods Hyperspectral data information from urine samples of 118 recipients after kidney transplantation was collected, and a deep learning model was constructed to diagnose and classify the types of rejection. Results A deep learning diagnostic model based on the 34-layer residual network (ResNet-34) was constructed, and 118 patients were included and divided into the training set and the test set. Based on the pathological results of the transplanted kidney puncture, the urine samples of the patients were classified into five groups: the non-rejection group, the T-cell-mediated rejection group, the antibody-mediated rejection group, the mixed rejection group and the nephropathy recurrence group. The results showed that the diagnostic sensitivities of the model for the above five groups were 0.960, 0.980, 0.930, 0.940 and 0.943 respectively, and the diagnostic specificities were 0.983, 0.993, 0.997, 0.989 and 0.989 respectively. The overall diagnostic accuracy rate reached 95.7%. Conclusions The study provides a non-invasive, rapid and accurate auxiliary diagnostic method for the differential diagnosis of rejection after kidney transplantation.

Machine learning （ML） is increasingly being integrated into clinical decision-making in dermatology， penetrating multiple critical stages including lesion identification， multimodal differential diagnosis， personalized treatment recommendation， efficacy prediction， and prognosis evaluation. By synthesizing multi-source data such as medical imaging， genomics， and clinical characteristics， ML models not only assist clinicians in improving diagnostic accuracy but also optimize therapeutic selection， enabling dynamic disease management and individualized intervention， thereby demonstrating substantial clinical application potential. For instance， convolutional neural network-based image analysis systems have exhibited performance comparable to or exceeding that of dermatology experts in the recognition of cutaneous neoplasms. Regarding treatment optimization， ML can recommend personalized medication regimens， predict treatment responses and adverse event risks by analyzing multidimensional patient data， thereby providing robust support for precision medicine. In the realm of prognosis assessment and long-term management， ML models incorporating patient-reported outcomes and time-series data facilitate dynamic monitoring of disease progression and individualized prediction of recurrence risk. However， despite rapid technological advances， the practical translation of ML into dermatological clinical decision-making still confronts multiple bottlenecks， including data bias， insufficient algorithmic generalization， lack of robust clinical validation， difficulties in system integration， and incomplete ethical supervision. This review systematically outlines the current applications and research progress of ML across various stages of dermatological clinical decision-making， thoroughly analyzes the key bottlenecks encountered， and comprehensively synthesizes advances in ML-assisted clinical decision support spanning image recognition， treatment optimization， prognosis evaluation， and ethical challenges， aiming to provide valuable insights for related research and clinical practice.

Objective:To analyze the mechanism of HOX transcript anti-sense RNA(HOTAIR)promoting invasion and metastasis of gastric cancer from the perspective of its structural domains.Methods:The clinical data of 60 patients with gastric cancer were collected at the Tianjin Medical University Cancer Institute&Hospital from December 2010 to December 2012.Mutants of HOTAIR 3'and 5'domains were constructed as HOT△P and HOT△L,respectively,and the invasion and metastasis of gastric cancer cells were detected using Transwell as-say.Western blot was used to detect epithelial-mesenchymal transition(EMT)-related protein expression;RNAseq was used to analyze the differential genes between the NC and the HOT△L group.RNA was extracted from the clinical tissues for analyzing the correlation between gene expression and clinical information.Results:HOT△L promoted the invasive and metastatic ability of gastric cancer cells more visibly than HOT△P.The mechanistic studies demonstrated that HOT△L more significantly promotes the EMT process in gastric cancer cells com-pared to HOT△P.HOT△L specifically up-regulated the expression of glycine amidinotransferase(GATM).Data analysis and clinical analysis suggested that the high expression of both HOTAIR and GATM group was associated with distal metastasis in gastric cancer patients(P=0.02),which further proved that the high expression of HOTAIR and GATM predicted the poor prognosis of gastric cancer.Molecular in-vestigations suggested that GATM could promote the invasion and metastasis of gastric cancer cells by advancing the progression of EMT.Regulation of EMT by GATM is the key mechanism by which HOT△L promotes the invasive and metastatic ability of gastric cancer,as de-termined by back-complementary experiments.Conclusions:HOTAIR 5'domain regulates the EMT process through specific up-regulation of GATM,thus,promoting the invasion and metastasis of gastric cancer.

Atherosclerosis is the most common cause of ischemic stroke. Antiplatelet aggregation is considered as the effective treatment for atherosclerotic ischemic stroke. Ticagrelor is a novel P2Y12 receptor antagonist, which has the advantages as rapid onset, strong effect, no need for liver metabolism activation and reversible platelet inhibition. Studies have confirmed that ticagrelor has a better therapeutic effect on ischemic stroke patients who are resistant to clopidogrel; especially in dual antiplatelet therapy, patients used ticagrelor have lower stroke risk and severe hemorrhage risk does not increase in these patients. This article reviews the recent advances in mechanism of ticagrelor and its application in acute ischemic stroke, with the aim of providing references for clinical application of ticagrelor.

Objective:To conduct a scoping review of financial toxicity assessment tools both domestically and internationally,and to summarize their scoring methods,evaluation content,development approaches,reliability/validity,and application status,aiming to provide references for selecting or developing such tools.Methods:Following scoping review methodology,databases including CNKI,VIP,Wanfang,PubMed,Web of Science,Embase,and CINAHL were searched for studies on financial toxicity assessment tools,with the search period spanning from database inception to Oct 8,2024.Results:A total of 34 eligible studies were included,covering 14 financial toxicity assessment tools.These tools primarily focused on economic status,psychosocial responses,or coping behaviors.Tools developed by domestic scholars exhibited strong specificity but lacked generalizability.Conclusions:Existing financial toxicity assessment tools are diverse,yet their reliability and validity in Chinese patient populations require further validation.Most scales lack comprehensive dimensions,and domestically developed tools are overly specific.A universal assessment tool suitable for China's cultural and policy environment needs to be developed.

Lung cancer patients frequently experience multiple co-occurring symptoms that manifest as symptom clusters during treatment,severely compromising patients'quality of life.Sentinel symptoms,coexisting with symptom clusters,serve as predictive indicators for the emergence of these clusters.This study focuses on sentinel symptoms within symptom clusters in lung cancer patients,reviewing the current research status,identification methods,related intervention measures,and exist-ing research shortcomings.It summarizes the problems in current studies,with the goal of providing clinical nursing staff to as-sess and manage symptom clusters,as well as to conduct related nursing research.

Objective:To conduct a scoping review of financial toxicity assessment tools both domestically and internationally,and to summarize their scoring methods,evaluation content,development approaches,reliability/validity,and application status,aiming to provide references for selecting or developing such tools.Methods:Following scoping review methodology,databases including CNKI,VIP,Wanfang,PubMed,Web of Science,Embase,and CINAHL were searched for studies on financial toxicity assessment tools,with the search period spanning from database inception to Oct 8,2024.Results:A total of 34 eligible studies were included,covering 14 financial toxicity assessment tools.These tools primarily focused on economic status,psychosocial responses,or coping behaviors.Tools developed by domestic scholars exhibited strong specificity but lacked generalizability.Conclusions:Existing financial toxicity assessment tools are diverse,yet their reliability and validity in Chinese patient populations require further validation.Most scales lack comprehensive dimensions,and domestically developed tools are overly specific.A universal assessment tool suitable for China's cultural and policy environment needs to be developed.

Lung cancer patients frequently experience multiple co-occurring symptoms that manifest as symptom clusters during treatment,severely compromising patients'quality of life.Sentinel symptoms,coexisting with symptom clusters,serve as predictive indicators for the emergence of these clusters.This study focuses on sentinel symptoms within symptom clusters in lung cancer patients,reviewing the current research status,identification methods,related intervention measures,and exist-ing research shortcomings.It summarizes the problems in current studies,with the goal of providing clinical nursing staff to as-sess and manage symptom clusters,as well as to conduct related nursing research.

Objective:To analyze the mechanism of HOX transcript anti-sense RNA(HOTAIR)promoting invasion and metastasis of gastric cancer from the perspective of its structural domains.Methods:The clinical data of 60 patients with gastric cancer were collected at the Tianjin Medical University Cancer Institute&Hospital from December 2010 to December 2012.Mutants of HOTAIR 3'and 5'domains were constructed as HOT△P and HOT△L,respectively,and the invasion and metastasis of gastric cancer cells were detected using Transwell as-say.Western blot was used to detect epithelial-mesenchymal transition(EMT)-related protein expression;RNAseq was used to analyze the differential genes between the NC and the HOT△L group.RNA was extracted from the clinical tissues for analyzing the correlation between gene expression and clinical information.Results:HOT△L promoted the invasive and metastatic ability of gastric cancer cells more visibly than HOT△P.The mechanistic studies demonstrated that HOT△L more significantly promotes the EMT process in gastric cancer cells com-pared to HOT△P.HOT△L specifically up-regulated the expression of glycine amidinotransferase(GATM).Data analysis and clinical analysis suggested that the high expression of both HOTAIR and GATM group was associated with distal metastasis in gastric cancer patients(P=0.02),which further proved that the high expression of HOTAIR and GATM predicted the poor prognosis of gastric cancer.Molecular in-vestigations suggested that GATM could promote the invasion and metastasis of gastric cancer cells by advancing the progression of EMT.Regulation of EMT by GATM is the key mechanism by which HOT△L promotes the invasive and metastatic ability of gastric cancer,as de-termined by back-complementary experiments.Conclusions:HOTAIR 5'domain regulates the EMT process through specific up-regulation of GATM,thus,promoting the invasion and metastasis of gastric cancer.

Atherosclerosis is the most common cause of ischemic stroke. Antiplatelet aggregation is considered as the effective treatment for atherosclerotic ischemic stroke. Ticagrelor is a novel P2Y12 receptor antagonist, which has the advantages as rapid onset, strong effect, no need for liver metabolism activation and reversible platelet inhibition. Studies have confirmed that ticagrelor has a better therapeutic effect on ischemic stroke patients who are resistant to clopidogrel; especially in dual antiplatelet therapy, patients used ticagrelor have lower stroke risk and severe hemorrhage risk does not increase in these patients. This article reviews the recent advances in mechanism of ticagrelor and its application in acute ischemic stroke, with the aim of providing references for clinical application of ticagrelor.