Traditional Chinese medicine （TCM）， through its multi-target and systematic regulatory effects， has demonstrated unique advantages in the treatment of gastric precancerous lesions （GPL）. At present， TCM theoretical research on GPL is mainly reflected in three aspects， the integration of macroscopic syndrome differentiation， the inflammation-carcinoma transformation mechanism， as well as the systematization and scientization of theoretical inheritance from famous TCM practitioners. High-quality evidence-based research findings serve as the foundation for clinical practice guidelines on GPL， and TCM has gained international academic recognition in the field of GPL prevention and treatment. Research on TCM mechanisms has yielded a series of important outcomes in the aspects of signaling pathways， gene expression regulation， cellular epigenetics， histone modification， and intestinal microecology. It is proposed that future research on GPL should focus on four key directions， establishing multi-omics data， exploring targeted intervention strategies on key regulatory nodes， advancing the standardization process of integrated traditional Chinese and western medicine prevention and treatment technologies， and constructing stratified screening and intervention platforms. The in-depth integration of TCM microcosmic mechanism of action with its macroscopic syndrome differentiation and treatment system， coupled with interdisciplinary research， will provide valuable references for the clinical treatment and scientific research of GPL.

The spine is the most common site of skeletal metastasis in lung cancer, which frequently leads to severe complications such as pathological fracture and neurological compromise and is associated with poor prognosis. The development and progression of spinal metastasis from lung cancer are linked to the unique local microenvironment and tumor microenvironment (TME) of the vertebral column. During metastatic evolution, the dense vascular network of the spine and a plethora of signaling molecules, together with the complex cellular constituents and their intricate interactions within the TME, all cooperate to facilitate the tumor invasion and colonization of the vertebral compartment. Mechanistic studies delineating the role of the TME in spinal metastasis from lung cancer have markedly expanded, fostering the emergence of innovative therapeutic strategies—including nanomedicines, sono-photodynamic therapy, gene therapy, and combination regimens. These strategies demonstrate remarkably potential for clinical translation and offer new directions for the precision management of spinal metastasis from lung cancer.

To interpret the evidence-to-decision （EtD） framework and to illustrate its application in traditional Chinese medicine （TCM） guideline development using the example of the Pharmacovigilance Guideline of Chinese Patent Medicine， thereby providing methodological references for TCM guideline standardization. Based on the core three stages of the EtD framework （formulating the question， making an assessment of the evidence， and drawing conclusions）， critical decision points and evaluation evidence within the evidence-translation process were systematically addressed， aligning with the purpose， scope， and key questions of the guideline. Qualitative research methods， such as the nominal group technique， were employed to formulate recommendations. The analysis was conducted based on the EtD framework. During question formulation， the specific characteristics and practical needs of pharmacovigilance for Chinese patent medicines were clarified， focusing on the core objective of safety assurance throughout the product lifecycle. In the evidence assessment， multi-source evidence was integrated， including policy documents， literature research， and expert consensus， completing the evidence evaluation. Finally， in recommendation-forming， dispersed research evidence and expert experience were synthesized into consensus， culminating in the guideline's completion through solicitation of opinions and peer review. The EtD framework provides a structured tool for evidence-to-decision translation in TCM guideline development， effectively enhancing the transparency and scientific rigor of the process. Therefore， it is recommended that TCM guideline development adopt the EtD framework to improve the evidence-to-decision process with TCM characteristics.

To interpret the evidence-to-decision （EtD） framework and to illustrate its application in traditional Chinese medicine （TCM） guideline development using the example of the Pharmacovigilance Guideline of Chinese Patent Medicine， thereby providing methodological references for TCM guideline standardization. Based on the core three stages of the EtD framework （formulating the question， making an assessment of the evidence， and drawing conclusions）， critical decision points and evaluation evidence within the evidence-translation process were systematically addressed， aligning with the purpose， scope， and key questions of the guideline. Qualitative research methods， such as the nominal group technique， were employed to formulate recommendations. The analysis was conducted based on the EtD framework. During question formulation， the specific characteristics and practical needs of pharmacovigilance for Chinese patent medicines were clarified， focusing on the core objective of safety assurance throughout the product lifecycle. In the evidence assessment， multi-source evidence was integrated， including policy documents， literature research， and expert consensus， completing the evidence evaluation. Finally， in recommendation-forming， dispersed research evidence and expert experience were synthesized into consensus， culminating in the guideline's completion through solicitation of opinions and peer review. The EtD framework provides a structured tool for evidence-to-decision translation in TCM guideline development， effectively enhancing the transparency and scientific rigor of the process. Therefore， it is recommended that TCM guideline development adopt the EtD framework to improve the evidence-to-decision process with TCM characteristics.

AIM:To investigate the expression levels of serum sirtuin 6(Sirt6)and nicotinamide adenine dinucleotide phosphate oxidase 2(NOX2)in patients with primary glaucoma and their correlation with the severity of the disease. METHODS:This study is a cross-sectional study. Patients diagnosed with primary glaucoma at the hospital from August 2022 to June 2025 were enrolled and divided into mild-to-moderate and severe groups based on the mean deviation of visual field defects, along with healthy individuals as a control group. Clinical data were collected, and serum levels of Sirt6 and NOX2 were measured using enzyme-linked immunosorbent assay(ELISA). Correlations between serum Sirt6 and NOX2 levels and clinical parameters were analyzed. Multivariate Logistic regression was used to identify factors influencing disease severity, and the diagnostic efficacy of serum Sirt6 and NOX2 levels was evaluated using receiver operating characteristic(ROC)curves. RESULTS:A total of 120 patients with primary glaucoma(58 males, 62 females, mean age 60.08±8.19 y)and 100 controls(46 males, 56 females, mean age 60.23±8.67 y)were enrolled in this study. There were no statistically significant differences in sex or age between the two groups(both P>0.05). The intraocular pressure and serum NOX2 expression level in the primary glaucoma group were significantly higher than those in the control group, while the Sirt6 level was significantly lower than in the control group(all P<0.001). The AUC values of serum Sirt6 and NOX2 in the diagnosis of primary glaucoma were 0.733 and 0.770, respectively, with optimal cutoff values of 2.35 and 4.25 ng/mL, respectively. The AUC of the combined diagnosis of the two was 0.901, and its efficacy was obviously better than that of a single indicator(Zcombination-Sirt6=5.317, Zcombination-NOX2=4.720, P<0.001).The severe group had lower serum Sirt6 expression levels(P<0.05), and higher NOX2 expression levels(P<0.05)than the mild-to-moderate group. Serum Sirt6 expression levels were prominently negatively correlated with mean intraocular pressure(r=-0.354, P<0.05); NOX2 expression levels were prominently positively correlated with mean intraocular pressure(r=0.240, P<0.05). Multivariate Logistic regression analysis showed that a decrease in serum Sirt6 expression levels(OR=0.229, 95%CI: 0.090-0.581), an increase in serum NOX2 expression levels(OR=2.649, 95%CI: 1.658-4.232), an increase in mean intraocular pressure(OR=1.278, 95%CI: 1.118-1.462)which were risk factors for the progression to severe glaucoma. The AUC values of serums Sirt6 and NOX2 expression levels in diagnosing severe primary glaucoma were 0.794 and 0.800, respectively, the AUC, sensitivity, and specificity of the combined diagnosis of the two were 0.916, 80.00%, and 89.33%, respectively, and the combined diagnostic efficacy was better than that of a single indicator(Zcombination-Sirt6=2.627, P=0.009, Zcombination-NOX2=2.762, P=0.006). CONCLUSION:The decreased serum Sirt6 and increased NOX2 expression levels in patients with primary glaucoma are significantly correlated with disease severity, and the combined detection demonstrates good diagnostic value for primary glaucoma and its severity.

AIM: To investigate the associations of aqueous humor miR-21 and miR-29b levels with the severity of optic nerve damage and GMPE in patients with primary open angle glaucoma(POAG).METHODS:POAG patients who presented to the hospital from May 2023 to May 2025 were prospectively enrolled as the disease group, and patients with cataract treated during the same period were included as the control group. Baseline characteristics and aqueous humor levels of miR-21 and miR-29b were compared between the two groups. POAG patients were categorized into mild and moderate-to-severe groups according to the mean deviation(MD)of visual field. Clinical characteristics and the expression levels of miR-21 and miR-29b in aqueous humor were compared between the two groups. Correlations and nonlinear associations between miR-21/miR-29b levels and RNFL thickness, visual field MD, and BMO-MRW were evaluated. Furthermore, factors influencing the progression of optic nerve damage were analyzed. Based on prognostic outcomes, patients were divided into good prognosis and poor prognosis groups, and the aqueous humor levels of miR-21 and miR-29b were compared. ROC curve analysis was performed to assess the predictive value of combined GMPE with miR-21 and miR-29b for prognosis in POAG patients.Internal validation and decision curve analysis(DCA)were also conducted.RESULTS:This study included 151 patients in the disease group(age 56.07±7.59 y, 84 males and 67 females)and 138 patients in the control group(age 56.84±8.25 y, 68 males and 70 females). There were 45 cases in the mild group(age 54.63±7.34 y, 27 males and 18 females)and 106 cases in the moderate-severe group(age 56.68±8.39 y, 57 males and 49 females). There were 118 cases in the good prognosis group(age 55.83±8.07 y, 67 males and 51 females)and 33 cases in the poor prognosis group(age 56.94±8.23 y, 17 males and 16 females). Compared with the control group, the disease group exhibited significantly higher miR-21 levels and lower miR-29b levels(all P<0.001). Compared with the mild group, intraocular pressure and miR-21 levels were significantly higher in the moderate-to-severe group, while RNFL thickness, visual field MD, BMO-MRW, and miR-29b levels were significantly lower(all P<0.01). The miR-21/miR-29b ratio was negatively correlated with RNFL thickness, visual field MD, and BMO-MRW(all P<0.05). Elevated intraocular pressure and miR-21 levels, reduced RNFL thickness, lower visual field MD, and decreased BMO-MRW and miR-29b levels were identified as risk factors for aggravated optic nerve damage in POAG patients(all P<0.05). Compared with the good prognosis group, the poor prognosis group showed significantly higher miR-21 levels and lower miR-29b, RNFL, and BMO-MRW levels(all P<0.001). The combined prediction model incorporating aqueous humor miR-21, miR-29b, RNFL, and BMO-MRW yielded significantly higher AUC and specificity for predicting POAG prognosis than individual parameters alone(both P<0.05). The ROC prediction model demonstrated good consistency, and the combined prediction model exhibited high clinical utility.CONCLUSION: Aqueous humor levels of miR-21 are significantly elevated while miR-29b levels are significantly decreased in POAG patients, and these alterations are closely correlated with the severity of optic nerve damage and GMPE parameters.

Liver cirrhosis is the terminal stage of various chronic liver diseases， with the main clinical manifestation of portal hypertension， which can lead to spontaneous portosystemic shunt （SPSS）. SPSS is very common in clinical practice and is closely associated with the prognosis of patients. This article summarizes the recent studies in the clinical significance of cirrhotic portal hypertension with SPSS， the controversies in studies， and the current status and future prospects and challenges of treatment， in order to provide a reference for the standardized diagnosis and treatment of portal hypertension.

The lacrimal gland organoids are innovative in vitro cultured tissue model that mimics the lacrimal gland, retaining its original histological and molecular biological properties. This model can more accurately reproduce the physiological environment of the lacrimal gland, including its ductal system and tear film protein secretion. It offers a new platform for studying the physiopathological basis of the lacrimal gland, establishing disease models, conducting regenerative medicine applications, and performing drug screening. Currently, organoids technology is continuously evolving, with ongoing updates to the methods for in vitro culturing of the lacrimal gland. These advancements gradually address challenges related to cultivation complexity, cost, and time, demonstrating a wide range of application potential. In this paper, we summarize the latest progress in lacrimal gland organoids research both domestically and internationally, exploring the development of lacrimal gland organoids, 3D construction technologies, and their potential for clinical applications, in order to provide new insights for clinical research on lacrimal gland-related diseases and to promote broader application of lacrimal gland organoids in drug development and personalized diagnosis and treatment.

The lacrimal gland organoids are innovative in vitro cultured tissue model that mimics the lacrimal gland, retaining its original histological and molecular biological properties. This model can more accurately reproduce the physiological environment of the lacrimal gland, including its ductal system and tear film protein secretion. It offers a new platform for studying the physiopathological basis of the lacrimal gland, establishing disease models, conducting regenerative medicine applications, and performing drug screening. Currently, organoids technology is continuously evolving, with ongoing updates to the methods for in vitro culturing of the lacrimal gland. These advancements gradually address challenges related to cultivation complexity, cost, and time, demonstrating a wide range of application potential. In this paper, we summarize the latest progress in lacrimal gland organoids research both domestically and internationally, exploring the development of lacrimal gland organoids, 3D construction technologies, and their potential for clinical applications, in order to provide new insights for clinical research on lacrimal gland-related diseases and to promote broader application of lacrimal gland organoids in drug development and personalized diagnosis and treatment.

Background Metals and metalloids in fine particulate matter (PM_2.5) may cause damage to the respiratory and circulatory systems of the human body, and long-term exposure is prone to causing chronic poisoning, cancer, and other adverse effects. Objective To assess the distribution characteristics of metals and metalloids in outdoor PM_2.5 in a southern city of China, conduct source apportionment, and evaluate the associated health risks, thereby providing theoretical support for further pollution control measures. Methods PM_2.5 samples were collected in districts A, B, and C of a southern China city, and the concentrations of 17 metals and metalloids were detected by inductively coupled plasma-mass spectrometry (ICP-MS). Pollution sources were assessed through enrichment factor and principal components analysis, and the main pollution sources were quantified using absolute principal component scores-multivariate linear regression (APCS-MLR). Health risks were evaluated based on the Technical guide for environmental health risk assessment of chemical exposure (WS/T777—2021). Results The ambient air PM_2.5 concentrations in the city were higher in winter and spring, and lower in summer and autumn. The annual average concentrations of ambient PM_2.5 in districts A, B, and C were 36.7, 31.9, and 24.4 μg·m⁻³, respectively. The ambient PM_2.5 levels in districts B and C were below the second-grade limit set by the Ambient air quality standards (GB 3095—2012). The enrichment factors of cadmium (Cd), aluminum (Al), and antimony (Sb) were greater than 10, those of copper (Cu), lead (Pb), arsenic (As), nickel (Ni), mercury (Hg), and molybdenum (Mo) fell between 1 and 10, and those of manganese (Mn), vanadium (V), chromium (Cr), cobalt (Co), barium (Ba), beryllium (Be), and uranium (U) were below or equal to 1. The comprehensive evaluation of source analysis showed that the main pollution sources in districts A and C and the whole city were coal-burning. In district B, the main pollution source was also coal combustion, followed by industrial process sources and dust sources. The carcinogenic risks of As and Cr were between 1×10⁻⁶ and 1×10⁻⁴. However, the hazard quotients for 15 metals and metalloids in terms of non-carcinogenic risk were below 1. Conclusion Cr and As in the atmospheric PM_2.5 of the city present a certain risk of cancer and should be paid attention to. In addition, preventive control measures should be taken against relevant pollution sources such as industrial emission, dust, and coal burning.