Hepatic alveolar echinococcosis is a highly invasive zoonotic parasitic disease with poor prognosis. Surgical intervention serves as the pivotal approach to achieve radical cure and improve the prognosis of hepatic alveolar echinococcosis patients. In recent years, with the popularization of the concept of precision surgery and the development of the multidisciplinary diagnosis and treatment model, the surgical treatment strategies for hepatic alveolar echinococcosis have been continuously enriched, and the selection of surgical procedures has become increasingly diversified. Although key surgical techniques such as radical hepatectomy, autologous liver transplantation and allogeneic liver transplantation have achieved remarkable progress in clinical application, many insurmountable challenges still remain. Therefore, by sorting out the latest evidence-based advances in the field of surgical treatment for hepatic alveolar echinococcosis, this article focuses on discussing the application status and bottlenecks of radical hepatectomy, autologous liver transplantation and allogeneic liver transplantation in hepatic alveolar echinococcosis, aiming to provide a reference for the clinical treatment of hepatic alveolar echinococcosis.

ObjectiveTo evaluate the quality of clinical practice guidelines and expert consensus statements on knee osteoarthritis （KOA） based on the Appraisal of Guidelines for Research & Evaluation Ⅱ （AGREE Ⅱ）， thus providing a new perspective for clinical selection as well as guideline development and updating. MethodsA systematic search was conducted for KOA-related guidelines and consensus statements published from November 1， 2019 to December 31， 2025. The databases and platforms searched included CNKI， VIP， Wanfang Data， PubMed， Web of Science， the National Institute for Health and Care Excellence （NICE）， SinoMed， Yimaitong， and relevant official websites. Two researchers independently screened the literature， and four researchers used AGREE Ⅱ to score the included documents and completed the quality appraisal after reaching a unified understanding. Subgroup analyses were further performed according to developing organization， document type， medical approach， funding status， and region of development， and longitudinal comparisons were conducted by year of publication. ResultsA total of 23 guidelines and consensus statements were included. The standardized scores of the six AGREE Ⅱ domains， from the highest to the lowest， were clarity of presentation ［（70.36±8.13）%］， scope and purpose ［（67.46 ± 11.44）%］， editorial independence ［（64.50±20.01）%］， rigor of development ［（62.24±15.26）%］， stakeholder involvement ［（55.73±10.29）%］， and applicability ［（53.89±13.17）%］. In terms of overall recommendation， 6 documents were rated as grade A and 17 as grade B. Stratified analyses showed that professional organizations scored higher than comprehensive organizations. The overall scores of traditional Chinese medicine/integrative medicine and Western medicine guidelines （or consensus statements） were similar. Guidelines scored higher than consensus statements. The overall scores were similar between documents with reported funding and those without reported funding. International guidelines scored higher than domestic guidelines. Longitudinal comparisons showed that the largest number of documents was published in 2021. The overall scores were higher in 2021—2022， and some domain scores declined in 2023—2024. Overall， the quality of recent guidelines and consensus statements for KOA showed slight fluctuations， without a clear linear trend. ConclusionThe included guidelines and consensus statements for KOA can generally serve as references for clinical practice. However， the quality across domains remains uneven， and stakeholder involvement and applicability are still weak domains. Future guideline development and updating should further improve methodological standardization and transparency in reporting.

ObjectiveTo observe the intervention effect of Fufang Kangjiaolv capsules on anxiety-like behaviors in the rat model of chronic restraint stress （CRS） and explore the mechanism underlying the anti-anxiety effect via the microbiota-gut-brain axis. MethodsRats were assigned into blank， model， positive drug （diazepam， 1 mg·kg^-1）， and low-， medium-， and high-dose （0.75， 1.5， 3 g·kg^-1， respectively） Fufang Kangjiaolv capsules groups. After 14 days of administration， the elevated plus maze test， open field test， light and dark box test， and marble burying test were performed. Hematoxylin-eosin staining was employed to observe the pathological changes in the hippocampus and colon of rats， and Nissl staining was conducted to observe the damage of hippocampal neurons. The gut microbiota was analyzed by 16S rRNA gene sequencing. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was employed to determine the mRNA levels of zonula occludens-1 （ZO-1） and occludin in the colon of rats. The levels of tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）， and interleukin-1β （IL-1β） in the colon， serum， and hippocampus were determined by enzyme-linked immunosorbent assay. Western blot was employed to determine the protein levels of ZO-1， occludin， nuclear factor-κB p65 （NF-κB p65） in the colon tissue and NF-κB p65 and brain-derived neurotrophic factor （BDNF） in the hippocampal tissue. ResultsCompared with the blank group， the model group showed reductions in the time and frequency ratio of rats entering the elevated plus maze， the time and frequency of rats entering the central area of the open field， the time of entering the open box， the times of passing through the light and dark box， and the number of unburied beads （P<0.05， P<0.01）. Compared with the model group， Fufang Kangjiaolv capsules ameliorated the anxiety of the model rats to varying degrees， and the high-dose group had the best effect， with increases in the proportions of time and frequency of rats entering the open arm in the elevated plus maze （P<0.05）， the number of rats entering the central area in the open field （P<0.05）， the time of entering the open box， the times of passing through the light and dark boxes， and the number of unburied beads （P<0.01）. Moreover， the high-dose group showed alleviated pathological damage of hippocampal neurons and colon. The results of 16S rRNA gene sequencing showed that the model group had increased relative abundance of Firmicutes， Deferribacterota， Romboutsia， and Phascolarctobacterium， while it had decreased relative abundance of Bavcteroidota and Lactobacillus. The drug administration groups showed increased relative abundance of Bavcteroidota， Bacteroides， norank f norank o Clostridia UCG-014， and Blautia and decreased relative abundance of Firmicutes and Deferribacterota. Compared with the blank group， the model group showed down-regulated protein and mRNA levels of ZO-1 and occludin in the colon （P<0.01）， elevated levels of TNF-α， IL-6， and IL-β in the colon， serum， and hippocampus （P<0.01）， up-regulated protein level of NF-κB p65 in the colon and hippocampus （P<0.01）， and down-regulated protein level of BDNF in the hippocampus （P<0.05）. Compared with the model group， high-dose Fufang Kangjiaolv capsules up-regulated the mRNA levels of ZO-1 and occludin in the colon （P<0.01）， lowered the levels of TNF-α， IL-6， and IL-β in the colon， serum， and hippocampus （P<0.01）， up-regulated the protein levels of ZO-1 （P<0.01） and occludin （P<0.05） in the colon， down-regulated the protein level of NF-κB p65 in the colon and hippocampus （P<0.05）， and up-regulated the protein level of BDNF in the hippocampus. ConclusionFufang Kangjiaolv capsules can reduce the anxiety-like behaviors in the rat model of CRS by regulating the gut microbiota disturbance， up-regulating the expression of tight junction proteins in the colon， repairing intestinal mucosal mechanical barrier， and down-regulating NF-κB/BDNF signaling pathway， thereby reducing peripheral and central inflammation. This study proves the hypothesis that Fufang Kangjiaolv capsules play an anti-anxiety role via the microbiota-gut-brain axis， providing a new idea for further research.

Terahertz(THz)technology,as an emerging tool for characterizing biomacromolecules,has rapidly developed over the past few decades,demonstrating significant application potential in multiple fields.Defensive qi is a vital energy in the human body,responsible for defense functions by warming the skin,regulating the opening and closing of the striae and interstices,and resisting the invasion of external pathogens.Defensive qi is one of the core concepts for disease prevention and health maintenance in traditional Chinese medicine(TCM).However,due to the high abstraction and complexity of TCM theory,the scientific connotation and mechanism of action of defensive qi remained incompletely elucidated.THz waves have the unique physical properties of molecular vibration sensitivity,penetrability,and thermal radiation effects,and are highly sensitive to biological tissues,which make THz technology a promising tool for defensive qi research.By analyzing the characteristics of THz waves,this paper explores the feasibility of applying THz technology to investigate the circulation patterns of defensive qi,the prevention and treatment of disorders related defensive qi,the pathological essence of defensive qi diseases,the material basis of defensive qi,the screening of defensive qi disorders,and the development of novel drugs targeting defensive qi disorders.This approach provides a new perspective and methodology for the research of TCM fundamental theory.

Objective To explore the effects of nail-tail transverse connection in the treatment of atlantoaxial dislocation(AAD)and its impacts on bone metabolism,serum vascular endothelial growth factor(VEGF),and fibroblast growth factor-2(FGF-2)levels.Methods A total of 150 pa-tients with AAD were selected as the research subjects and divided into two groups using the random number table method,with 75 cases in each group.The observation group was treated with nail-tail transverse connection combined with posterior atlantoaxial pedicle screw internal fixation(C1-C2 PSR),while the control group was treated with C1-C2 PSR alone.Serum bone metabolism indicators[osteocalcin(BGP),type Ⅰ collagen N-terminal peptide(NTX),bone alkaline phosphatase(BALP),tartrate-resistant acid phosphatase(TRAP),type Ⅰ collagen carboxy-terminal peptide(CTX)],VEGF and FGF-2 levels were compared between the two groups at different time points.The Japanese Orthopaedic Association(JOA)score was used to evaluate the patients' neurological function before surgery and 3 years after surgery.Bone graft fusion was evaluated at 6 months,1 year,2 years,and 3 years after surgery.Results At 1,3 and 6 months after surgery,the serum VEGF and FGF-2 levels in the observation group were higher than those in the control group,and the differences were statistically significant(P＜0.05).After treatment,the BALP,BGP,NTX,TRAP and CTX levels in both groups were lower than those before treatment,and their levels in the observation group were lower than those in the control group,with statistically significant differences(P＜0.05).Before surgery,there was no statistically significant difference in the JOA scores be-tween the two groups(P＞0.05).At 3 years after surgery,the JOA scores in both groups were higher than those before surgery,and the JOA score and the score improvement rate in the observa-tion group were higher than those in the control group,with statistically significant differences(P＜0.05).At 6 months,1 year,2 years and 3 years after surgery,the success rate of bone graft fusion in the observation group was higher than that in the control group,with statistically significant differ-ences(P＜0.05).Conclusion Nail-tail transverse connection has significant effects in the treat-ment of AAD,which can effectively improve patients' bone metabolism and increase the serum VEGF and FGF-2 levels.

Objective:To compare the clinical efficacy and safety of bronchial artery chemoembolization (BACE) combined with anlotinib (BACE+A) versus BACE alone in patients with stage III-IV non-small cell lung cancer (NSCLC).Methods:A total of 94 patients with advanced NSCLC treated at six interventional centers between November 2020 and November 2021 were retrospectively enrolled. Patients were divided into the BACE+A group ( n=46) and the BACE alone group ( n=48) based on treatment regimen. Baseline and perioperative clinical data were collected and compared between the two groups. Treatment response was evaluated using the modified Response Evaluation Criteria in Solid Tumors (mRECIST) at 1, 6, and 12 months after the first BACE procedure. Objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and treatment-related adverse events (AEs) were recorded. Kaplan-Meier survival curves were plotted to compare median OS and PFS between groups. Cox proportional hazards regression analysis was used to identify factors influencing OS and PFS. Results:The Kaplan-Meier analysis showed that the median OS was significantly longer in the BACE+A group (18.8 months, 95% CI 16.3-21.3) than in the BACE group (13.4 months, 95% CI 11.6-15.2) ( P=0.001). The median PFS was also significantly longer in the BACE+A group (9.0 months, 95% CI 7.3-10.7) compared to the BACE group (6.1 months, 95% CI 4.9-7.3) ( P=0.001). At 6 and 12 months post-first BACE, the ORR (43.5%, 40.0%) and DCR (89.1%, 83.3%) were significantly higher in the BACE+A group than in the BACE group (ORR: 20.8%, 14.8%; DCR: 66.7%, 59.3%) (all P<0.05). Multivariate Cox regression identified treatment with BACE+A ( HR=0.42, 95% CI 0.27-0.72, P=0.002), tumor stage ( HR=1.80, 95% CI 1.05-3.07, P=0.031), presence of pre-existing complications requiring intervention ( HR=2.72, 95% CI 1.65-4.50, P<0.001), and >2 BACE procedures ( HR=0.32, 95% CI 0.15-0.68, P=0.003) as independent factors influencing OS. Treatment with BACE+A ( HR=0.49, 95% CI 0.32-0.76, P=0.001), tumor stage ( HR=1.72, 95% CI 1.07-2.77, P=0.025), multi-arterial tumor blood supply ( HR=2.76, 95% CI 1.76-4.31, P<0.001), and>2 BACE procedures ( HR=0.40, 95% CI 0.22-0.71, P=0.002) were independent factors influencing PFS. There was no significant difference in BACE-related adverse events between the two groups (all P>0.05). Hypertension, fatigue, hand-foot syndrome, and anorexia were common anlotinib-specific adverse reactions in the combination group, but no grade 4 or higher adverse reactions were observed. Conclusions:BACE combined with anlotinib demonstrates superior efficacy compared to BACE alone in treating advanced NSCLC, significantly prolonging OS and PFS. The safety profile is manageable, with adverse events remaining within tolerable limits.

Objective:To investigate the clinical features, diagnostic and therapeutic methods, and prognosis of patients with acute myeloid leukemia (AML) who are positive for multiple genes.Methods:The clinical data of a 35-year-old male AML patient, who was admitted to The 940 th Hospital of the PLA Joint Logistics Support Force on October 10, 2021, were analyzed based on related literature. Results:The patient was admitted due to rhinorrhea for 1 month and sore throat with cervical lymph node enlargement for 3 days. Based on laboratory test results, the patient was diagnosed with acute myelomonocytic leukemia with eosinophilia and mutations in the core-binding factor β subunit gene ( CBFβ-MYH11), located on the long arm of chromosome 16, as well as mutations in the Wilms' tumor 1 gene ( WT1), the stem cell factor receptor gene ( KIT), and the neuroblastoma RAS viral oncogene homolog ( NRAS). The patient was treated multiple times with a regimen of idarubicin combined with cytarabine (Ara-C), achieving complete remission with negative minimal residual disease detection. The patient tolerated the treatment well. However, after the fourth cycle of chemotherapy with Ara-C, the patient developed grade Ⅳ bone marrow suppression. Following treatment to increase white blood cells and platelets, as well as blood component transfusions, the patient's condition improved. Subsequently, after receiving intensified Ara-C treatment, the patient's condition stabilized. Conclusions:AML with a positive CBFβ- MYH11 fusion gene has a favorable prognosis. However, the presence of a concomitant KIT mutation and a high proportion of primitive white blood cells in the peripheral blood at initial diagnosis may affect the prognosis of this type of AML. Additionally, WT1 is an independent prognostic factor for AML. RAS gene mutations do not impact overall survival, disease-free survival, complete remission, or relapse rates.

Objective:To evaluate the efficacy of eradication therapy based on potassium-competitive acid blocker (P-CAB) for Helicobacter pylori( HP) infection in re-eradication therapy (the second-line therapy treatment after initial eradication failure of HP infection) and determine whether it can achieve the ideal eradication rate (90%). Methods:From January 2022 to December 2023, the clinical data of patients who received vonoprazan-based HP re-eradication therapy were collected in Department of Gastroenterology, the First Affiliated Hospital of Soochow University. The patients were divided into 4 groups according to their different HP treatment regimens, including VAMB group (vonoprazan 20 mg, quaque die( qd)+ amoxicillin 1 g, bis in die( bid)+ minocycline 100 mg, bid+ potassium bismuth citrate 220 mg, bid; 156 cases), VA group (vonoprazan 20 mg, bid+ amoxicillin 1 g, ter in die( tid); 44 cases), VMFB group (vonoprazan 20 mg qd+ minocycline 100 mg, bid+ furazolidone 100 mg, bid+ potassium bismuth citrate 220 mg, bid; 42 cases), and VAFB group (vonoprazan 20 mg, qd+ amoxicillin 1 g, bid+ furazolidone 100 mg, bid + potassium bismuth citrate 220 mg, bid; 13 cases). All the 4 groups of patients took the medication for 14 days. The 13C or 14C urea breath test would be conducted 4 weeks after the treatment. The overall eradication rate to evaluate the treatment efficacy. The eradication rate and adverse reaction rate were calculated for each group, and the eradication rates and adverse reaction rates between groups were compared using the chi-square test or Fisher′s exact test. Results:The total eradication rate of HP infection based on P-CAB therapy was 91.8% (234/255), and the total adverse reaction rate was 5.1% (13/255). The eradication rate and adverse reaction rate were 92.9% (145/156) and 3.2% (5/156) in the VAMB group, 84.1% (37/44) and 0 in the VA group 95.2% (40/42) and 11.9% (5/42) in the VMFB group, 12/13 and 3/13 in the VAFB group, respectively. Additionally, there was no statistical difference in the eradication rate among the 4 groups (Fisher′s exact test, P=0.227), but there was a statistical difference in the adverse reaction rates (Fisher′s exact test, P=0.002), and the adverse reaction rate of the VAFB group was higher than that of VAMB and VA groups and the differences were statistically significant (both Fisher′s excact test, P=0.016 and 0.010). Conclusions:The total HP re-eradication rate based on P-CAB therapies can reach 91.8%, achieving the ideal eradication rate of HP infection. The VA therapeutic regimen has the lowest incidence of adverse reactions, representing a novel therapeutic option for HP re-eradication.

Objective:To observe the changes of small airway parameters in patients with coal workers' pneumoconiosis in different disease stages by high resolution computed tomography (HRCT) , and analyze the correlation between them and the severity of the disease.Methods:From June 2016 to June 2023, 25 healthy volunteers and 71 untreated patients with coal worker's pneumoconiosis in the Fifth People's Hospital of Ningxia were selected as the research objects. The clinical and imaging data of the patients were collected, and the disease stages were performed according to the dust exposure history and high-kilovolt chest X-ray. The patients were divided into 4 groups: control group (25 cases) , coal workers' pneumoconiosis stage Ⅰ group (17 cases) , coal workers' pneumoconiosis stage Ⅱ group (32 cases) and coal workers' pneumoconiosis stage Ⅲ group (22 cases) . Quantitative chest HRCT parameters of each group were collected, including the square root of wall area at 10 mm inner perimeter (AWT-Pi10, Pi10) , airway wall thickness, airway wall volume, airway wall area percentage of the whole lung and the 5th, 6th, 7th and 8th level airways, and low attenuation area percentage (LAA%) of the whole lung. Pulmonary function indicators were collected, including forced expiratory volume in 1 second (FEV 1) and the percentage of its projected value [FEV 1 (%pred) ], the ratio of FEV 1 to forced vital capacity (FEV 1/FVC) and the percentage of its projected value[FEV 1/FVC (%pred) ]. One-way ANOVA or Kruskal-Wallis H test and Spearman rank correlation were used to analyze the difference and correlation. Results:Compared with control group, FEV 1, FEV 1 (%pred) , FEV 1/FVC and FEV 1/FVC (%pred) in stage Ⅱ and Ⅲ coal workers' pneumoconiosis groups were lower ( P<0.05) . In addition, the FEV 1 and FEV 1 (%pred) of the stage Ⅲgroup were lower than those of the stageⅡ group ( P<0.05) , and the FEV 1/FVC and FEV 1/FVC (%pred) of the stage Ⅲgroup were lower than those of the stage Ⅰgroup ( P<0.05) . Compared with stage Ⅰ group, Pi10 in stage Ⅲ group were increased ( P < 0.05) at the 6th and 8th level airways, and airway wall thickness and airway wall volume in the 6th, 7th and 8th level airways of stage Ⅲgroup increased ( P<0.05) . Correlation analysis showed that all pulmonary function indexes were negatively correlated with Pi10 of whole lung and the 6th, 7th and 8th level airways ( P<0.05) , all pulmonary function indexes were negatively correlated with airway wall thickness of the 7th and 8th level airways ( P<0.05) , and FEV 1/FVC (%pred) was negatively correlated with airway wall volume of the 7th and 8th level airways ( P<0.05) . FEV 1, FEV 1 (%pred) , FEV 1/FVC (%pred) were negatively correlated with percentage of airway wall area of whole lung and the 6th, 7th and 8th level airways ( P<0.05) . Conclusion:The quantitative airway parameters of coal workers' pneumoconiosis based on HRCT are correlated with pulmonary function indexes, which can reflect the severity of coal workers' pneumoconiosis.

[Objective]To study the academic characteristics of ZHANG's fever theory of Shanghai-style traditional Chinese medicine(TCM)of Sojae Semen Praeparatum herb pairs,and briefly analyze its clinical application in pulmonary epidemics.[Methods]Based on school-specific medical records,classical Chinese medical texts including Treatise on Cold Damage Diseases and Discussion of Warm Diseases,and modern pharmacological research,this study systematically summarizes the application features of Sojae Semen Praeparatum herb pairs in ZHANG's internal medicine for treating pulmonary epidemics.A representative case study was presented to exemplify ZHANG's clinical strategy of"pathogen elimination through dispersion".[Results]The ZHANG's internal medicine school has accumulated rich theories on and developed a profound and unique understanding of febrile diseases.By analyzing Sojae Semen Praeparatum's properties,efficacy and pairing principles,along with its commonly used herb combinations,an application system centered on"providing pathogens an exit route"was established.The proved case was of febrile disease in winter,and was treated with a modified decoction of Sojae Semen Praeparatum and achieved good results.[Conclusion]ZHANG's school employs Sojae Semen Praeparatum herb pairs with remarkable flexibility,addressing both pathological complexity and herbal synergism.The approach achieves significant therapeutic effects through pathogen dispersion,representing one of ZHANG's academic essences in treating pulmonary epidemics and providing valuable insights for modern TCM clinical practice.