Cancer has become a significant global public health issue， severely impacting public health and societal development. Despite advances in tumor treatment methods in recent years and a gradual decline in cancer mortality rates， drug-related adverse reactions and drug resistance remain substantial challenges. Traditional Chinese medicine （TCM） has demonstrated significant clinical efficacy in cancer treatment and small side effects， making it widely applied in the field of oncology. Xuefu Zhuyutang， derived from Yilin Gaicuo， is known for its abilities to invigorate blood circulation， dispel blood stasis， promote Qi flow， and alleviate pain. It was specifically formulated by the esteemed WANG Qingren of the Qing dynasty for the "blood stasis syndrome in the blood mansion" and is commonly used to treat Qi stagnation and blood stasis syndrome. Clinical studies have shown that Xuefu Zhuyutang， when combined with conventional Western medications， produces significant effects in the treatment of malignant tumors such as liver cancer， lung cancer， and cervical cancer. It substantially reduces the incidence of adverse reactions following Western treatments， including radiation esophagitis， radiation encephalopathy， radiation-induced oral mucositis， and edema. Additionally， it alleviates cancer-related pain and fever， blood hypercoagulability， and associated complications such as depression and anxiety， and also mitigates chemotherapy-induced side effects like hand-foot syndrome. Basic research has demonstrated its potential anti-tumor mechanisms， including the inhibition of Wnt/β-catenin signaling pathway activation， suppression of mitogen-activated protein kinase （MAPK） pathway activation， and anti-tumor angiogenesis. Pharmacological studies have revealed that its active components inhibit tumor cell proliferation and migration， induce tumor cell apoptosis， suppress tumor angiogenesis， enhance the cytotoxicity of natural killer cells against tumors， improve the tumor microenvironment， and regulate immune function. This paper reviewed the latest research progress on Xuefu Zhuyutang in the treatment of malignant tumors from four aspects： theoretical exploration， clinical studies， mechanisms of action， and pharmacological basis， aiming to provide insights and methods for the clinical diagnosis and treatment of malignant tumors.

Cancer has become a significant global public health issue， severely impacting public health and societal development. Despite advances in tumor treatment methods in recent years and a gradual decline in cancer mortality rates， drug-related adverse reactions and drug resistance remain substantial challenges. Traditional Chinese medicine （TCM） has demonstrated significant clinical efficacy in cancer treatment and small side effects， making it widely applied in the field of oncology. Xuefu Zhuyutang， derived from Yilin Gaicuo， is known for its abilities to invigorate blood circulation， dispel blood stasis， promote Qi flow， and alleviate pain. It was specifically formulated by the esteemed WANG Qingren of the Qing dynasty for the "blood stasis syndrome in the blood mansion" and is commonly used to treat Qi stagnation and blood stasis syndrome. Clinical studies have shown that Xuefu Zhuyutang， when combined with conventional Western medications， produces significant effects in the treatment of malignant tumors such as liver cancer， lung cancer， and cervical cancer. It substantially reduces the incidence of adverse reactions following Western treatments， including radiation esophagitis， radiation encephalopathy， radiation-induced oral mucositis， and edema. Additionally， it alleviates cancer-related pain and fever， blood hypercoagulability， and associated complications such as depression and anxiety， and also mitigates chemotherapy-induced side effects like hand-foot syndrome. Basic research has demonstrated its potential anti-tumor mechanisms， including the inhibition of Wnt/β-catenin signaling pathway activation， suppression of mitogen-activated protein kinase （MAPK） pathway activation， and anti-tumor angiogenesis. Pharmacological studies have revealed that its active components inhibit tumor cell proliferation and migration， induce tumor cell apoptosis， suppress tumor angiogenesis， enhance the cytotoxicity of natural killer cells against tumors， improve the tumor microenvironment， and regulate immune function. This paper reviewed the latest research progress on Xuefu Zhuyutang in the treatment of malignant tumors from four aspects： theoretical exploration， clinical studies， mechanisms of action， and pharmacological basis， aiming to provide insights and methods for the clinical diagnosis and treatment of malignant tumors.

Objective To explore the predictive value of maximum standardized uptake value(SUVmax)and mean standardized uptake value(SUVmean)parameters in 18F-prostate specific membrane antigen-1007 positron emission tomography/computed tomography(18F-PSMA-1007 PET/CT)for the diagnosis and disease progression of prostate cancer(PCa).Methods Eighty patients with suspected PCa who underwent 18F-PSMA-1007 PET/CT examination in the hospital were selected and divided into the PCa group(49 cases)and the non-PCa group(31 cases)according to the biopsy pathological results.The 18F-PSMA-1007 PET/CT parameters were collected in the two groups of patients at admission,including SUVmax and SUVmean.The prostate specific antigen(PSA)and prostate cancer histological grade(GLEASON)score were also collected in patients of the PCa group at admission and 3 months after admission.The diagnostic efficiency of 18F-PSMA-1007 PET/CT parameters on PCa was analyzed by receiver operating characteristic(ROC)curve.The correlation between 18F-PSMA-1007 PET/CT parameters of patients in the PCa group at admission and PSA,GLEASON score was analyzed by Pearson method.Results The SUVmax and SUVmean in the PCa group were higher than those in the non-PCa group(P＜0.05).ROC curve analysis showed that the areas under the curves(AUCs)of SUVmax and SUVmean were 0.887 and 0.843 respectively,the sensitivities were 80.65%and 83.87%,and the specificities were 87.76%and 73.47%respectively.The PSA and GLEASON score were lower 3 months after admission than those at admission in the PCa group(P＜0.05).Pearson correlation analysis showed that the SUVmax and SUVmean of patients in the PCa group at admission were positively correlated with PSA and GLEASON score at admission and 3 months after admission(P＜0.05).Conclusion SUVmax and SUVmean parameters of 18F-PSMA-1007 PET/CT have high predictive value for the diagnosis and disease progression of PCa.

For differentiated thyroid cancer(DTC),which accounts for over 90%of cases and usually has a good prognosis,bone metastasis is not only the main threat to patients'survival and quality of life,but also a difficult problem that needs to be solved urgently in clinical diagnosis and treatment at this stage.Currently,existing clinical guidelines at home and abroad have not yet provided comprehensive management recommendations and precise diagnostic and treatment strategies for bone metastasis in thyroid cancer,making it imperative to promote the implementation of systematic and personalized diagnostic and treatment plans.Therefore,understanding epidemiological characteristics,clarifying the pathogenesis,mastering commonly used diagnostic techniques,exploring the latest treatment progress and evaluating treatment efficacy are crucial for the management of bone metastasis in thyroid cancer.In terms of pathogenesis,bone metastasis in thyroid cancer is mostly osteolytic,regulating the interaction between the bone microenvironment and cancer cells through the release of various cytokines,thus forming a vicious cycle of bone metastasis.Early identification of bone metastasis in DTC is crucial for improving patient prognosis.Its diagnosis can be based on clinical manifestations(such as bone pain,pathological fractures,spinal cord compression and hypercalcemia),laboratory tests(such as red blood cell and platelet counts,serum calcium/phosphorus and bone turnover markers),and imaging examination results[such as X-ray,computed tomography(CT),magnetic resonance imaging(MRI),single photon emission computed tomography(SPECT)/CT,and positron emission tomography(PET)/CT].The treatment of DTC bone metastasis involves multiple modalities,such as surgical treatment,interventional radiological treatment and external beam radiation therapy for local lesions,or the use of radionuclides(131I,89Sr and 153Sm),tyrosine kinase inhibitors(lenvatinib,sorafenib,etc.),or bone-targeting agents(including zoledronic acid,denosumab and 99Tc-methylene diphosphonate)to control the development of systemic bone metastasis.After the treatment of DTC bone metastasis,an efficacy evaluation should be conducted to guide subsequent treatment decisions and predict prognosis.With the increasingly mature multidisciplinary collaborative diagnosis and treatment model today,the diagnosis and treatment of bone metastatic DTC should include surgery,nuclear medicine,radiation and interventional therapy,external beam radiation therapy,medical oncology and clinical laboratory testing to ensure a comprehensive assessment of the patient's condition,make objective decisions on individualized treatment plans,and achieve the goal of preventing disease progression and alleviating symptoms.This article mainly reviewed the epidemiology,pathogenesis,diagnostic methods,treatment strategies and efficacy evaluation of bone metastasis,aiming to clarify the diagnostic and treatment thinking of bone metastasis in thyroid cancer,assist in clinical management,and provide useful references for clinicians to make rapid and accurate diagnosis and precise treatment decisions when facing patients with bone metastatic DTC.

BACKGROUND:Multiple myeloma is one of the most common hematological malignancies,which is difficult to treat,prone to relapse,and resistant to drugs.The endogenous transport system of exosomes plays a communication role by affecting the exchange of functional components between cells.Among them,miRNA is more easily packaged in exosomes due to its small size,so it affects cell function in many ways and over a wide range.OBJECTIVE:To summarize the mechanism of exosomal miRNA in multiple myeloma and to propose potential targets.METHODS:The terms"multiple myeloma,bone marrow mesenchyml stem cell,fibroblasts,peripheral blood,complication,progression,drug resistance,exosomal miRNA"were used as English search terms in the PubMed database.The time frame of the search was from the inception to June 2024.After reading the titles and abstracts,we excluded irrelevant or repetitive literature,and finally included 81 papers for review.RESULTS AND CONCLUSION:(1)Multiple myeloma cells participate in multiple myeloma bone lesions by regulating the balance of osteogenic and osteoclast functions through various miRNA mediated exosomes,regulating erythrocyte calcium ion efflux channels to participate in the occurrence of hypercalcemia,promoting renal epithelial mesenchymal transition leading to renal fibrosis and renal dysfunction,and upregulating bone marrow-derived mononuclear suppressor cells to promote suppression of the immune microenvironment.In addition,miRNAs in the exosomes of multiple myeloma cells are also involved in the occurrence and development of immunotherapy resistance,as well as pathological processes such as angiogenesis,cell proliferation,and cell aging.(2)Both bone marrow mesenchymal stem cells and tumor-associated fibroblasts can affect the proliferation,metastasis,and apoptosis of multiple myeloma cells through exosomal miRNA,interfere with angiogenesis,and regulate the resistance of chemotherapy drugs.(3)Peripheral blood circulating exosomal miRNAs,as cutting-edge noninvasive biomarkers,can play a key role in judging the stage and progression of multiple myeloma disease,predicting patient formation and prognosis,and evaluating drug sensitivity and drug resistance.(4)Multiple myeloma exosomes long non-coding RNA,circular RNA,miRNA,mRNA and target gene can form different combinations,and the flexible construction of new biological axes and biomolecular networks is in line with the development concept of holistic medicine.(5)Exosome miRNA has great development potential as a therapeutic target for predictive biomarkers and new drug research and development.How to maximize the use of exosome miRNA and how to accelerate the clinical transformation of related scientific research results deserve further investigation.

Objective To explore the predictive value of maximum standardized uptake value(SUVmax)and mean standardized uptake value(SUVmean)parameters in 18F-prostate specific membrane antigen-1007 positron emission tomography/computed tomography(18F-PSMA-1007 PET/CT)for the diagnosis and disease progression of prostate cancer(PCa).Methods Eighty patients with suspected PCa who underwent 18F-PSMA-1007 PET/CT examination in the hospital were selected and divided into the PCa group(49 cases)and the non-PCa group(31 cases)according to the biopsy pathological results.The 18F-PSMA-1007 PET/CT parameters were collected in the two groups of patients at admission,including SUVmax and SUVmean.The prostate specific antigen(PSA)and prostate cancer histological grade(GLEASON)score were also collected in patients of the PCa group at admission and 3 months after admission.The diagnostic efficiency of 18F-PSMA-1007 PET/CT parameters on PCa was analyzed by receiver operating characteristic(ROC)curve.The correlation between 18F-PSMA-1007 PET/CT parameters of patients in the PCa group at admission and PSA,GLEASON score was analyzed by Pearson method.Results The SUVmax and SUVmean in the PCa group were higher than those in the non-PCa group(P＜0.05).ROC curve analysis showed that the areas under the curves(AUCs)of SUVmax and SUVmean were 0.887 and 0.843 respectively,the sensitivities were 80.65%and 83.87%,and the specificities were 87.76%and 73.47%respectively.The PSA and GLEASON score were lower 3 months after admission than those at admission in the PCa group(P＜0.05).Pearson correlation analysis showed that the SUVmax and SUVmean of patients in the PCa group at admission were positively correlated with PSA and GLEASON score at admission and 3 months after admission(P＜0.05).Conclusion SUVmax and SUVmean parameters of 18F-PSMA-1007 PET/CT have high predictive value for the diagnosis and disease progression of PCa.

The"2025 American Thyroid Association Management Guidelines for Adult Patients with Differentiated Thyroid Cancer"released by the American Thyroid Association(ATA)in 2025 include several important updates regarding nuclear medicine diagnosis and treatment for post-operative differentiated thyroid cancer(DTC).This article systematically reviewed advances in the nuclear medicine aspects of post-operative DTC assessment,decision-making for radioactive iodine therapy(RAIT),dynamic response evaluation,and follow-up strategies,guided by the 2025 ATA guidelines'DATA clinical management framework—Diagnosis,risk/benefit Assessment,Treatment decisions,and response Assessment.Building on the 2015 ATA guidelines and recent research evidence,the 2025 ATA guidelines emphasize the critical importance of post-operative response assessment(including serological and imaging evaluations)for the real-time refinement of risk stratification.It further subcategorizes recurrence risk from the original three categories(low,intermediate,high)to four categories(low,low-intermediate,intermediate-high and high)to more accurately predict the risk of structural recurrence.Regarding RAIT strategy,the 2025 ATA guidelines clearly state that remnant ablation is no longer routinely recommended for low-risk patients to avoid unnecessary radiation exposure,and highlight the preferred use of recombinant human thyroid stimulating hormone(rhTSH)for RAIT preparation in low-and intermediate-risk patients.The 2025 ATA guidelines further clarify the appropriate clinical application scenarios for nuclear medicine molecular imaging methods such as diagnostic whole-body scan(DxWBS)and 18F-FDG positron emission tomography and computed tomography(PET/CT).At the same time,concerning post-RAIT follow-up strategies,indications for repeated RAIT,as well as the diagnostic criteria and management principles for radioactive iodine-refractory DTC(RAIR-DTC),this article highlighted the key updated points in the 2025 ATA guideline.

AIM:The aim of this study was to explore the effects of Yiqi-Yangyin-Quyu prescription(YP)on skeletal muscle injury and related metabolic disorders in mice with Sj?gren syndrome(SS),and to clarify the role of hy-droxyacyl-CoA dehydrogenase trifunctional multienzyme complex subunit beta(Hadhb)in mediating the effect of YP on skeletal muscle in SS.METHODS:The SS mice underwent YP treatment for 8 weeks.The morphological changes of the submandibular gland and muscle tissue were examined using hematoxylin-eosin staining.The mitochondrial status in mus-cle tissue was assessed through transmission electron microscopy.Additionally,combined transcriptome and proteome se-quencing was conducted on skeletal muscle samples.The omics sequencing results were validated by RT-qPCR.Immuno-fluorescence was used to confirm the levels of key proteins involved in the P53/peroxisome proliferator-activated receptor gamma(PPARG)signaling pathway.Immunohistochemistry and Western blot were employed to determine the levels of Hadhb key targets.RESULTS:Combined transcriptome and proteome analysis identified 1 523 differentially expressed genes(DEGs)and 182 differentially expressed proteins(DEPs)between the muscle tissue of SS mice(model group)and that of control animals(ICR group),12 of which showed co-differential expression at both transcriptomic and proteomic levels.Compared with model group,1 232 genes and 432 proteins were found to be differentially expressed in the muscle tissue of the mice in YP group.Among these,23 exhibited co-differential expression at both mRNA and protein levels.Gene Ontology(GO)analysis showed that the DEGs and DEPs between ICR and model groups were mainly involved in ener-gy metabolism and fatty acid oxidation,while the DEGs and DEPs between YP and model groups were primarily associated with sarcomere tissue and actin structure.Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis indi-cated that the DEGs and DEPs between ICR and model groups and between model and YP groups were enriched in the com-plement and coagulation cascade and lipid and pyruvate metabolism.The RT-qPCR validation results were consistent with those of the transcriptome analysis.Furthermore,the protein expression of the tumor suppressor P53 was significantly de-creased in YP group compared with model group,whereas that of PPARG was significantly increased.Western blot analy-sis showed that compared with ICR group,Hadhb protein expression was significantly decreased in model group,whereas the opposite trend was detected in YP group.CONCLUSION:The SS-related skeletal muscle damage is closely related to amino acid metabolism disorder and fatty acid degradation.Treatment with YP modulates innate immune defenses,lipid metabolism and energy metabolism in SS,and Hadhb is the key target of YP in SS-related skeletal muscle.

The"2025 American Thyroid Association Management Guidelines for Adult Patients with Differentiated Thyroid Cancer"released by the American Thyroid Association(ATA)in 2025 include several important updates regarding nuclear medicine diagnosis and treatment for post-operative differentiated thyroid cancer(DTC).This article systematically reviewed advances in the nuclear medicine aspects of post-operative DTC assessment,decision-making for radioactive iodine therapy(RAIT),dynamic response evaluation,and follow-up strategies,guided by the 2025 ATA guidelines'DATA clinical management framework—Diagnosis,risk/benefit Assessment,Treatment decisions,and response Assessment.Building on the 2015 ATA guidelines and recent research evidence,the 2025 ATA guidelines emphasize the critical importance of post-operative response assessment(including serological and imaging evaluations)for the real-time refinement of risk stratification.It further subcategorizes recurrence risk from the original three categories(low,intermediate,high)to four categories(low,low-intermediate,intermediate-high and high)to more accurately predict the risk of structural recurrence.Regarding RAIT strategy,the 2025 ATA guidelines clearly state that remnant ablation is no longer routinely recommended for low-risk patients to avoid unnecessary radiation exposure,and highlight the preferred use of recombinant human thyroid stimulating hormone(rhTSH)for RAIT preparation in low-and intermediate-risk patients.The 2025 ATA guidelines further clarify the appropriate clinical application scenarios for nuclear medicine molecular imaging methods such as diagnostic whole-body scan(DxWBS)and 18F-FDG positron emission tomography and computed tomography(PET/CT).At the same time,concerning post-RAIT follow-up strategies,indications for repeated RAIT,as well as the diagnostic criteria and management principles for radioactive iodine-refractory DTC(RAIR-DTC),this article highlighted the key updated points in the 2025 ATA guideline.

This article systematically analyzes the historical evolution of the name， origin， quality evaluation， harvesting， processing and other aspects of Picrorhizae Rhizoma by referring to the medical books， prescription books， and other documents of the past dynasties， combined with relevant modern research materials， in order to provide a basis for the development and utilization of famous classical formulas containing this medicinal herb. The research results indicate that Picrorhizae Rhizoma was first recorded in New Revised Materia Medica from the Tang dynasty. Throughout history， Huhuanglian has been used as its official name， and there are also aliases such as Gehu Luze， Jiahuanglian and Hulian. The main source of past dynasties is the the rhizomes of Picrorhiza kurrooa and P. scrophulariiflora. In ancient times， Picrorhizae Rhizoma was mainly imported by foreign traders via Guangzhou and other regions， and also produced in China， mainly in Xizang. In ancient times， it was harvested and dried in early August of the lunar calendar， while in modern times， it is mostly harvested from July to September， with the best quality being those with thick and crispy rhizomes without impurities， and bitter taste. Throughout history， Picrorhizae Rhizoma was collected， washed， sliced， and dried before being used as a raw material for medicine， it has a bitter and cold taste， mainly used to treat bone steaming， hot flashes， infantile chancre fever， and dysentery. There is no significant difference in taste and efficacy between ancient and modern times. Based on the research results， it is recommended that the rhizomes of P. scrophulariiflora in the 2020 edition of Chinese Pharmacopoeia， or the rhizomes of P. kurrooa， can be used in famous classical formulas containing this medicinal herb， which can be processed according to the processing requirements marked by the original formula. For those without clear processing requirements， the dried raw products are used as medicine.