According to the Qi-blood-body fluid theory and the association between the spleen in visceral manifestation theory of traditional Chinese medicine （TCM） and mitochondria in modern cellular biology， it is proposed that the role of the spleen in generating and transforming Qi and blood is analogous to the energy-producing function of mitochondria—both serving as fundamental power sources for vital activities of the human body. The spleen governs transportation and transformation， playing a critical role in energy metabolism and the digestion and absorption of nutrients. Similarly， mitochondria are vital for maintaining physiological functions such as cellular energy supply， cell survival， and overall human metabolism. Furthermore， spleen deficiency is closely linked to mitochondrial dysfunction. Accordingly， mitochondrial energy conversion and substance metabolism are regarded as the microscopic essence of the spleen's function in transportation and transformation. Spleen deficiency and mitochondrial dysfunction contribute to the formation of pathological products such as phlegm-turbidity and blood stasis. This aligns with the pathogenesis of chronic obstructive pulmonary disease （COPD）， with Qi deficiency as the root cause and phlegm-turbidity and blood stasis as the manifestations. Therefore， the integrative treatment of COPD should follow the therapeutic principle of invigorating the spleen and reinforcing healthy Qi， while also resolving phlegm and removing blood stasis to address both root cause and manifestations. This approach can improve the mitochondrial function， regulate energy metabolism， and reduce oxidative stress levels to alleviate COPD symptoms， slow down disease progression， and improve prognosis. By integrating the holistic concept of TCM with molecular mechanisms of modern medicine， this paper explores the pathogenesis and therapeutic principles of COPD from the spleen-mitochondria correlation. It not only provides a new direction for the modern development of TCM and the integration of Chinese and Western medicine but also offers a theoretical foundation for the integrated treatment of chronic， complex age-related diseases.

According to the Qi-blood-body fluid theory and the association between the spleen in visceral manifestation theory of traditional Chinese medicine （TCM） and mitochondria in modern cellular biology， it is proposed that the role of the spleen in generating and transforming Qi and blood is analogous to the energy-producing function of mitochondria—both serving as fundamental power sources for vital activities of the human body. The spleen governs transportation and transformation， playing a critical role in energy metabolism and the digestion and absorption of nutrients. Similarly， mitochondria are vital for maintaining physiological functions such as cellular energy supply， cell survival， and overall human metabolism. Furthermore， spleen deficiency is closely linked to mitochondrial dysfunction. Accordingly， mitochondrial energy conversion and substance metabolism are regarded as the microscopic essence of the spleen's function in transportation and transformation. Spleen deficiency and mitochondrial dysfunction contribute to the formation of pathological products such as phlegm-turbidity and blood stasis. This aligns with the pathogenesis of chronic obstructive pulmonary disease （COPD）， with Qi deficiency as the root cause and phlegm-turbidity and blood stasis as the manifestations. Therefore， the integrative treatment of COPD should follow the therapeutic principle of invigorating the spleen and reinforcing healthy Qi， while also resolving phlegm and removing blood stasis to address both root cause and manifestations. This approach can improve the mitochondrial function， regulate energy metabolism， and reduce oxidative stress levels to alleviate COPD symptoms， slow down disease progression， and improve prognosis. By integrating the holistic concept of TCM with molecular mechanisms of modern medicine， this paper explores the pathogenesis and therapeutic principles of COPD from the spleen-mitochondria correlation. It not only provides a new direction for the modern development of TCM and the integration of Chinese and Western medicine but also offers a theoretical foundation for the integrated treatment of chronic， complex age-related diseases.

As a major challenge in the global field of critical care medicine, sepsis is associated with high morbidity and mortality, driving intensive research into the development of precise risk prediction models. Among these, machine learning and deep learning-based predictive models have garnered particular attention. This article systematically reviews the evolution of sepsis risk prediction models and the challenges associated with their clinical translation, with a focus on their clinical applicability in common septic complications, including acute kidney injury, encephalopathy, and coagulation disorders. Current evidence indicates that machine learning models, by integrating multidimensional dynamic data from electronic health records, significantly enhance early warning capabilities and individualized predictive performance. However, major bottlenecks limiting clinical translation include insufficient data standardization, lack of model interpretability, and inadequate external validation. Future research should prioritize multicenter collaboration, time-series modeling strategies, and explainable artificial intelligence frameworks to optimize clinical translation pathways and facilitate the paradigm shift from traditional empirical approaches to data-driven precision strategies in sepsis risk stratification.

Acute-on-chronic liver failure (ACLF) is a dynamic syndrome that develops on the basis of chronic liver disease. Its key characteristics include acute decompensation of chronic liver disease, severe systemic inflammatory response, and intrahepatic or extrahepatic organ failure, with an exceptionally high short-term (28-day) mortality rate. Currently, liver transplantation is the most effective treatment for ACLF. However, challenges such as liver shortages and organ allocation may lead to delays in transplantation, causing some critically ill ACLF patients to miss the optimal surgical window, thereby significantly worsening their prognosis. Conversely, some ACLF patients may achieve substantial recovery with medical management yet still undergo liver transplantation, leading to unnecessary utilization of scarce donor organs. To maximize patient survival benefits and optimize the use of valuable liver grafts, precise identification of the optimal timing for liver transplantation in ACLF is essential. This review explores the ideal timing for liver transplantation in ACLF patients by examining the definition of ACLF, commonly used scoring systems both nationally and internationally, and the latest research on transplantation indications.

Objective:To explore the risk factors for contralateral central lymph nodes (Cont-CLNs) metastasis of unilateral papillary thyroid carcinoma (PTC) and to guide the decision-making of clinical surgical scope.Methods:The data of 362 patients who underwent total thyroidectomy and bilateral central lymph node dissection at the Sichuan Cancer Hospital from September 2020 to April 2022 and were confirmed as unilateral PTC by postoperative pathology were retrospectively analyzed. Among them, 87 were male and 275 were female, aged from 11 to 76 years. According to whether presence of Cont-CLNs metastasis, they were divided into the metastasis group (115 cases) and the non-metastasis group (247 cases). The relationship between the demographic characteristics, clinicopathological characteristics and other indicators of the two groups of patients and their metastases of Cont-CLNs was analyzed. Univariate analysis, multivariate logistic regression analysis and receiver operating characteristic (ROC) curve analysis were used to screen the risk factors for Cont-CLNs metastasis. Postoperative follow up was performed in the patients.Results:Univariate analysis showed that age, gender, combined Hashimoto′s thyroiditis, extranodal invasion, pretracheal and prelaryngeal lymph node metastasis, ipsilateral central lymph nodes (Ipsi-CLNs) metastasis on the affected side, lateral cervical lymph node metastasis on the affected side, lesion location, and tumor diameter were associated with Cont-CLNs metastasis (all P values<0.05). Multivariate revealed that: each of male gender, Ipsi-CLNs metastasis, pretracheal and prelaryngeal lymph node metastasis, cancer focus location in the isthmus, and unilateral glandular lobe combined with isthmus was an independent risk factor for Cont-CLNs metastasis. For predicting the metastasis risk of Cont-CLNs, the optimal critical value of the number of metastasized Ipsi-CLNs was 2.5, and the area under the ROC curve (AUC) was 0.700; the optimal cut-off value of the number of metastasized pretracheal and prelaryngeal lymph nodes was 1, with an AUC of 0.681. The AUC of gender was 0.630, and the AUC of the cancer lesion location was 0.545. Multivariate ROC curve analysis for Cont-CLNs metastasis based on gender, the number of metastasized Ipsi-CLNs, the number of metastasized pretracheal and prelaryngeal lymph nodes, and the location of cancer foci showed an AUC of 0.794. The patients were followed up until January 2025. Excluding 3 cases with hoarseness caused by recurrent laryngeal nerve invasion before the operation and 3 cases with resection and reconstruction of invaded recurrent laryngeal nerves discovered during the operation, there were no patients with permanent recurrent laryngeal nerve palsy after the operation. There were 3 cases with postoperative permanent hypoparathyroidism. There no patients with postoperative recurrence. Conclusion:Risk factors for Cont-CLNs metastasis include male sex, Ipsi-CLNs metastasis, pretracheal and prelaryngeal lymph nodes metastasis, and tumor location in the isthmus or unilateral lobe plus isthmus. In unilateral PTC with the risk factors, Cont-CLNs dissection may be considered.

Objective:To investigate depressive symptoms and associated factors among precariously em-ployed individuals(PEI).Methods:A total of 11 031 residents were selected by a combination of stratified sam-pling and quota sampling from 120 cities nationwide according to the proportion of the seventh national population census in 2021,including 1 829 PEI.New general self-efficacy scale,short-form of family health scale,12-item short-form health literacy questionnaire,Patient Health Questionaire-9items used to evaluate self-efficacy,family health,health literacy and depressive symptoms.among people with precarious employment.Results:The prevalence of depressive symptoms in PEI was 21.0％.Male gender(OR=1.30)was risk factors for depressive symptoms in PEI.Age 46 to 55 years(OR=0.39),junior middle school graduate(OR=0.46),and high family health(OR=0.90)were protective factors for depressive symptoms in PEI.The structural equation model showed that the family health scores were negatively correlated with the depression scores(β=-0.13,P＜0.001),while family health scores were positively correlated with health literacy scores(β=0.10,P＜0.01)and self-efficacy scores(β=0.66,P＜0.001).The self-efficacy scores were negatively correlated with the depression scores(β=-0.11,P＜0.001).Conclusion:The prevalence of depressive symptoms in PEI is high.Young age,male gender,high educa-tional level and lower family health are the risk factors of depression,while health literacy and self-efficacy play protective roles.

Objective:To investigate the feasibility and safety of radical thyroidectomy through a small incision in the side neck of the sternocleidomastoid intermuscular approach.Methods:Clinical data of newly treated patients with papillary thyroid carcinoma admitted to the Department of Thyroid-Otolaryngology and Head and Neck Surgery,Sichuan Cancer Hospital from Feb. 2022 to Mar. 2024 were collected. They were divided into SMIA group and LACA group according to surgical methods. In the SMIA group, 52 cases were treated by the sternocleidomastoid intermuscular approach with a small incision on the side of the neck. In the LACA group, 100 cases were treated by the cervical white line approach with a low cut incision on the front of the neck. Clinical data of the two groups, such as perioperative related indicators,postoperative aesthetic effects and postoperative complications were collected. Independent sample t test or Mann-Whitney U test were compared between the measurement data groups. Chi-square test was used for comparison between data sets. Results:There was no significant difference in demographic and clinical characteristics of tumor between the two groups. Compared with the control group,the operation time of the observation group was longer (83.85±18.72minvs71.33±15.50min, t=4.39, P<0.001) , the total postoperative drainage volume was significantly reduced (61.29±41.80ml vs. 99±35.80ml, Z=-4.65, P<0.001) , and the extubation time was significantly shortened (2.81±0.82d vs. 3.19±0.66d, Z=-3.31, P<0.001) , and the difference was statistically significant. There was no difference in postoperative transient hoarseness between the two groups ( χ 2=0.01, P=0.932) . Patient’s self-feeling was followed up one month after surgery. The number of patients with swallowing discomfort in the SMIA group was significantly lower than that in the LACA group ( χ2=4.30, P=0.017) . There was no significant difference between the two groups in neck stiffness ( χ2=3.16, P=0.075) , scar hyperplasia ( χ2=0.04, P=0.840) , and incision aesthetic effect score ( Z=-0.73, P=0.468) . Conclusions:Radical thyroidectomy through a small incision in the side neck of the sternocleidomastoid muscle is a safe, feasible and aesthetic mode of operation. It’s worth promoting in clinical practice,especially for patients with unilateral tumor and early tomur T stage.

Ovarian follicle expansion is an important part of their growth and development into dominant follicles,and is regulated by a variety of molecules and signals,including follicular cavity formation,follicular fluid accumulation,and granulosa cell proliferation.Polycystic ovary syndrome(PCOS)is the most common reproductive endocrine disease in women,and patients mainly present with increased preantral follicles and polycystic ovarian lesions caused by inadequate ovarian follicle expansion.This review summarizes recent research developments concerning the physiological process of ovarian follicle expansion and the related regulatory factors and mechanisms.We also consider the possible factors restricting ovarian follicle expansion in patients with PCOS,to provide a theoretical basis for follicular dysplasia,ovulation disorders and other diseases caused by abnormal ovarian follicle expansion.

Hepatic osteodystrophy is a common complication in patients with chronic liver disease and is influenced by various risk factors， and it has become one of the important influencing factors for the prognosis of liver transplantation. By analyzing the influencing factors for bone health and bone metabolism during the perioperative period of liver transplantation， this article emphasizes the importance of a comprehensive assessment of bone health and necessary interventions at this stage， with an aim to reduce the risk of postoperative complications and improve the long-term prognosis of patients. A deeper exploration of the association between hepatic osteodystrophy and the prognosis of liver transplantation can help to reveal the key influencing factors for postoperative outcomes， thus providing a theoretical basis for optimizing postoperative management strategies. Furthermore， advances in this research field will offer new insights into the treatment of patients receiving liver transplantation， and it is expected to further improve quality of life and long-term survival rate.

In cases where a tracheal injury exceeds half the length of the adult trachea or one-third of the length of the child trachea, it becomes difficult to perform end-to-end anastomosis after tracheal resection due to excessive tension at the anastomosis site. In such cases, tracheal replacement therapy is required. Advances in tissue engineering technology have led to the development of tissue engineering tracheal substitutes, which have promising applications. Hydrogels, which are highly hydrated and possess a good three-dimensional network structure, biocompatibility, low immunogenicity, biodegradability, and modifiability, have had wide applications in the field of tissue engineering. This article provides a review of the characteristics, advantages, disadvantages, and effects of various hydrogels commonly used in tissue engineering trachea in recent years. Additionally, the article discusses and offers prospects for the future application of hydrogels in the field of tissue engineering trachea.