Hepatitis B virus （HBV） infection is one of the major global health problems， and it can lead to the development of liver cirrhosis and hepatocellular carcinoma. Due to the strict species specificity of HBV infection， no animal model has yet been established to fully support the complete life cycle of HBV infection and accurately reflect host immune responses and pathogenesis. Current animal models used for HBV research include various hosts such as chimpanzees， tree shrews， and mice， as well as surrogate models based on related hepatotropic viruses. Although these models have contributed significantly to the research on HBV replication， immune response， and antiviral drug evaluation， they still have certain limitations such as ethical concerns， low infection efficiency， high costs， and a lack of persistent infection. In recent years， the development of novel strategies， such as humanized mouse models with reconstituted human liver and immune systems， transgenic models， and viral vector-mediated infection systems， has greatly promoted the research on HBV biology. In the future， with the integration of emerging technologies including gene editing， tissue engineering， and multi-system reconstruction， it is possible to establish HBV infection models that can more closely mimic human pathophysiology， thereby laying a robust foundation for understanding virus-host interactions， exploring the pathways for viral clearance， and developing radical treatment strategies.

With the accelerating trend of population aging, the number of elderly patients with lung cancer continues to rise, and the disease burden is becoming increasingly heavy. The clinical management of these patients faces severe challenges due to their decreased physiological reserve, complex comorbidities, and significant individual heterogeneity. Consequently, under traditional diagnosis and treatment models, doctors often struggle to identify the individualized risks of elderly patients in a timely and comprehensive manner, which can easily lead to decision biases such as undertreatment or overtreatment. In view of this, this study advocates for the establishment of an umbrella decision-making model specifically tailored for elderly lung cancer patients. Grounded in a multidisciplinary team (MDT) platform, this model deeply integrates oncological indicators with the comprehensive geriatric assessment (CGA) system. By holistically considering multidimensional variables including tumor burden, organ function, frailty index, cognitive status, and social support, the model establishes an operational mechanism characterized by "single entry, precise stratification, and targeted selection". Accordingly, patients can be scientifically triaged into distinct intervention tiers, such as active surveillance, minimally invasive surgery, drug therapy, radiotherapy, and best supportive care, thereby achieving real-time alignment between treatment intensity and patient fitness. This article elaborates on the construction logic and key operational procedures of this novel decision-making framework, aiming to guide clinical practice beyond the limitations of a tumor-centric perspective toward a holistic, dynamic, whole-course management strategy. This transition seeks to ensure optimal quality of life and clinical net benefit for elderly patients alongside survival prolongation.

Objective To explore the preliminary experience and clinical outcomes of domestic(Jingfeng)robot-assisted laparoscopic radical cystectomy and detubularized sigmoid neobladder construction, and to evaluate the technical feasibility, safety, and postoperative functional recovery. Methods A retrospective analysis was conducted on 12 patients undergoing surgery in our department during Jun. and Dec.2024. The operation time, intraoperative blood loss, postoperative complications, and hospital stay were recorded to assess the surgical efficacy and safety.Results All 12 procedures were successfully completed. The average operation time was 460(390-540)minutes, including 213(170-250)minutes for radical cystectomy with lymph node dissection and 247(200-300)minutes for neobladder reconstruction and anastomosis. Intraoperative blood transfusion was required in 2 cases, and postoperative hemoglobin levels decreased by 22(7-46)g/L in 10 patients. All surgical margins were negative. No major complications of Clavien-Dindo Ⅲ or above occurred postoperatively. The average hospital stay was 9(7-14)days, and bowel function recovered within 2.58(2-3)days. During the follow-up of 2 to 6 months, 11 patients achieved daytime urinary continence, and 6 had normal continence. All patients had no obvious obstruction or hydronephrosis in the upper urinary tract. Conclusion Domestic robot-assisted laparoscopic radical cystectomy and detubularized sigmoid neobladder reconstruction is technically feasible, with advantages in precision, minimal invasiveness, and favorable postoperative recovery. Initial results demonstrate its potential in lymph node dissection, nerve preservation, and urinary continence restoration, suggesting it can become a valuable option for bladder cancer treatment.

Objective On the basis of the theory of the tumor metastatic state, this work aims to explore the metastasis trajectories and peripheral immune response patterns in patients with non-small cell lung cancer (NSCLC) receiving vital qi-strengthening and toxin-eliminating therapy (Fuzheng Juandu) and reveal the value of peripheral immunity in assessing vital qi deficiency during metastasis. Methods A retrospective study design was adopted. Patients with NSCLC admitted from January 1, 2018, to October 31, 2025 were enrolled. Data on metastasis status and peripheral immune indices were collected at the follow-up time points of one, two, three, and five years. Group-based trajectory modeling was used to fit metastasis trajectories, and the independent predictors of trajectory grouping were analyzed through multifactor and multiclassification logistic regression. Results A total of 184 patients with NSCLC were included, and three different groups of metastasis trajectories were identified, namely, the low-risk stable (46.74%, n=86), low-risk rising (13.59%, n=25), and high-risk stable (39.67%, n=73) groups. Univariate analysis revealed substantial differences in peripheral immune indices among the three trajectory groups. Multivariate analysis showed that TNM stage, absolute neutrophil count, lymphocyte count, absolute monocyte count, platelet volume, SAA:CRP ratio, and NLR were independent predictors of the low-risk rising group, whereas TNM stage, absolute monocyte count, basophil count, SII, and NLR were independent predictors of the high-risk stable group. Conclusion Under Fuzheng Juandu therapy, patients with NSCLC exhibit three distinct metastasis trajectories, each corresponding to a specific peripheral immune response pattern. Elucidating these peripheral immune response patterns may facilitate the objective quantification of the degree of vital qi deficiency, prediction of future metastasis risk, and providing an important reference for the individualized clinical implementation of Fuzheng Juandu therapy.

ObjectiveTo investigate the possible mechanism of Shenfuhuang Formula （参附黄配方） in prevention and treatment of epsis-associated encephalopathy from the perspective of brain genomics. MethodsC57BL/6 mice were randomly divided into sham surgery group， sepsis group， and Shenfuhuang group， with 20 mice in each group. The sepsis group and Shenfuhuang group were induced to develop sepsis by cecal ligation and puncture （CLP） procedure. At 4 hours after modelling， Shenfuhuang group were gavaged with 2.5 g/（kg·d） of Shenfuhuang Formula， 0.5 ml each time， at 12 hours intervals， for a total of 4 times after modelling. Sepsis group and sham surgery group were given 0.5 ml of purified water orally. At 48 hours after modeling， the transcriptome sequencing was used to explore the differential gene expression in the effects of Shenfuhuang Formula on the brain regions of septic mice， and real-time PCR and ELISA were later used to further validate the differential gene and proteins expression. ResultsA total of 4605 genes were differentially expressed in Shenfuhuang group compared with sepsis group， of which 2353 genes were up-regulated and 2252 genes were down-regulated. According to the results of previous publications， six key genes were screened， including serine/threonine-protein kinase （Nek1）， myelin-associated glycoprotein （Mag）， endothelial cell-specific tyrosine kinase receptor （Tek）， a disintegrin and metalloproteinase with thrombospondin motifs 20 （Adamts20）， lymphocyte antigen 86 （Ly86）， and E3 ubiquitin-protein ligase （Traip）. Further genetic and protein validation revealed that， compared to the sham surgery group， the mRNA levels and corresponding protein levels of Nek1， Mag， Tek， Adamts20， Ly86， and Traip in the brain tissue of septic mice significantly reduced （P＜0.05）. In comparison to the sepsis group， Shenfuhuang group showed significantly increased mRNA levels and corresponding protein levels of Nek1， Mag， Tek， Adamts20， Ly86， and Traip （P＜0.05）. ConclusionThe potential therapeutic targets of Shenfuhuang Formula for treating sepsis-associated encephalopathy may be related to the Nek1， Mag， Tek， Adamts20， Ly86， and Traip genes and their encoded proteins.

Central nerve injuries, most commonly caused by traffic accidents or falls, frequently result in irreversible deficits such as paralysis, cognitive impairment and respiratory failure, profoundly impairing patients′ life quality and even proving to be fatal. Current therapeutic strategies including early surgical decompression, corticosteroid administration and neurotrophic pharmacotherapy fail to restore the neuro-homeostatic balance and systemic function. In recent years, biomaterial-based interventions have emerged as a promising alternative for central nerve injuries. Among them, the human amniotic membrane (HAM), a placental basement-membrane scaffold rich in collagen, hyaluronic acid and a cocktail of growth factors, perfectly combines angiogenic, anti-fibrotic and neurotropic properties that meet the complex demands of central nerve repair. Nevertheless, HAM-based therapies for central nerve injuries remain at an early stage of pre-clinical investigation. In the meantime, most studies have simply translated protocols validated for peripheral nerve injuries without addressing the pathological microenvironment specific to central nerve injuries. To this end, the authors reviewed recent advances in the modes of HAM application for central nerve injuries, aiming to provide novel insights and reference for future research on central nerve injuries.

Spinal cord injury is a highly disabling central nervous system disorder whose pathological progression is closely associated with blood-spinal cord barrier (BSCB) disruption. Physical trauma to the spine or spinal cord may compromise BSCB integrity, triggering secondary damage including spinal edema, hemorrhage, oxidative stress, and excessive inflammatory responses. For the pivotal role of protecting the spinal cord microenvironment, the repair of BSCB is crucial in the treatment of spinal cord injury. Although present studies have explored BSCB repair strategies such as biological factor regulation, biomaterial applications, and traditional Chinese medicine interventions, most studies focus on improving the overall barrier function and fail to systematically elucidate how these strategies target the core functional units of BSCB, namely the endothelial cells and their junction structures, to achieve functional and structural restoration of the barrier. Therefore, the authors reviewed the composition and key repair targets of BSCB, along with research advances in BSCB repair strategies based on endothelial cells and junction structures, aiming to provide insights for basic research and clinical treatment of spinal cord injury.

Objective:To explore the clinical characteristics and healthcare burden in patients with McCune-Albright syndrome (MAS).Methods:A cross-sectional study was conducted at the Children′s Hospital, Zhejiang University School of Medicine. Clinical and healthcare burden data were systematically collected through structured questionnaires in 164 children with MAS from February 2022 to May 2023. According to the clinical characteristics, patients were categorized into 3 groups: monosymptomatic, bisymptomatic and trisymptomatic groups. Patients were also divided into 3 groups according to the age of <7, 7-<10 and 10-18 years. Comparative analyses of clinical characteristics and healthcare burden were conducted across age, sex, and symptom categories.Results:The cohort comprised 59 males (36.0%) and 105 females (64.0%) with an age of 4.6 (2.0, 7.4) years. Age stratification revealed 117 cases (71.3%) aged 0-<7 years, 29 cases (17.7%) aged 7-<10 years, and 18 cases (11.0%) aged 10-<18 years. Among monosymptomatic (67 cases, 40.9%), the cohort comprised 32 females (47.8%) and 35 males (52.2%), predominantly presenting with fibrous dysplasia (57 cases, 85.1%). This subgroup showed peak prevalence in the 0-<7 years age range (29 cases (50.9%)). The bisymptomatic cohort (56 cases, 34.1%) consisted of 39 females (69.6%) and 17 males (30.4%), predominantly manifesting fibrous dysplasia with skin hyperpigmentation (25 cases, 44.6%). Peak prevalence occurred in the 0-<7 years subgroup(16 cases (64.0%)). The trisymptomatic cohort (41 cases, 25.0%) consisted of 34 females (82.9%) and 7 males (17.1%), with peak prevalence occurring in the 0-<7 years subgroup (36 cases (87.8%)). The diagnostic journey analysis revealed 94 cases (57.3%) required 1-3 referrals, and 34 cases (20.7%) necessitated >3 referrals from symptom onset to definitive diagnosis. Healthcare expenditure analysis revealed 69 families (42.1%) incurred direct medical costs of 10 000-100 000 CNY, with 11 families (6.7%) exceeding >100 000 CNY. Direct non-medical costs reached of 10 000-100 000 CNY for 62 families (37.8%) and >100 000 CNY for 4 families (2.4%). Productivity loss affected 58 families (35.4%) at 10 000-100 000 CNY and 8 families (4.9%) above 100 000 CNY during the study period.Conclusion:MAS requires increased attention to skeletal manifestations, especially in children aged 0-<7 years. Moreover, the significant financial burden on families necessitates a society-wide support system.

Objective To discuss the causes and the therapeutic strategy of acute cardiac tamponade(ACT)occurring as a complication of transcatheter aortic valve replacement(TAVR)so as to improve the success rate of the surgery and to make a further understanding of this complication.Methods The general clinical data,surgical procedures,and postoperative follow-up results of five patients,who received TAVR at the Affiliated Northern Jiangsu People's Hospital of Yangzhou University of China and developed ACT from March 2018 to September 2024,were retrospectively analyzed.Results After developing ACT,all the 5 patients received pericardiocentesis together with other adjuvant therapies including blood volume expansion with infusion,vasopressors,heparin neutralization,and blood transfusion.However,due to no obvious reduction in drainage volume and unstable hemodynamics all the 5 patients had eventually to receive open-chest surgery to identify the source of bleeding and to make hemostasis.Surgical exploration revealed that the perforation or rupture of cardiac structures caused by the temporary pacemaker lead or a super-stiff guide wire during the procedure was the main cause of ACT.Finally,after active treatment four patients recovered and discharged,and one patient died.The discharged patients were followed up for 3-12 months,and no procedure-related complications such as acute coronary artery occlusion,severe arrhythmia,exacerbation of heart failure symptoms,valve displacement,or stroke occurred.Conclusion As a severe complication occurring during the TAVR procedure,ACT requires to get a rapid diagnosis and management.Improvement of surgical techniques and operative methods,comprehensive preoperative assessment,and close intraoperative monitoring are crucial points for the prevention of ACT.

The application of mechanics in clinical wound healing has a long history;however,the systematic underlying mechanisms remain unclear.With recent advancements in biomechanics and mechanobiology,the principles regarding how mechanical factors influence the formation,progression,and healing of wounds have gradually been elucidated.Herein,based on progress in theories,technologies,and clinical practices concerning the interplay between mechanics and wound healing,this study introduces the concept of wound-repairing mechanomedicine.Relevant research is systematically reviewed from the perspectives of biomechanics,mechanobiology,and mechanotherapy.Additionally,potential future development directions are prospectively analyzed to provide novel insights into wound care and strategies for preventing scar formation.