Onco-critical care has emerged as an important subspecialty at the intersection of critical care medicine and oncology, attracting increasing attention in recent years. With continuous innovations in cancer therapies, patient survival has improved significantly; however, the incidence of associated critical complications has also increased. The reasons for cancer patients requiring intensive care unit admission are diverse and can be broadly categorized into three groups: progression of the underlying malignancy, treatment-related complications, and coexisting classical critical illnesses. Traditional critical care concepts and practices face limitations in addressing the multidimensional and heterogeneous challenges of onco-critical care. Based on the core mechanism of critical illness development—host/organ unregulated response (HOUR)—this article systematically elaborates on how this framework advances understanding and clinical practice into onco-critical care, with emphasis on its manifestations in neuroendocrine, immune-inflammatory, and coagulation-metabolic pathways. The review summarizes recent advances in clinical assessment and phenotyping systems for onco-critical illness and discusses a multidisciplinary, integrated management strategy centered on the "Disease Control, Host Response Modulation, Organ Support" triad. Finally, major challenges and future directions in this field are outlined. By integrating existing evidence and theoretical insights, this review aims to provide new perspectives and a theoretical foundation for the clinical management of onco-critical illness, thereby promoting its evolution toward precision and standardization.

To thoroughly implement the strategic deployment outlined in the Opinions of the Central Committee of the Communist Party of China and the State Council on Promoting the Inheritance and Innovative Development of Traditional Chinese Medicine regarding research on dominant diseases of traditional Chinese medicine and to uphold the development philosophy of equal emphasis on traditional Chinese medicine and western medicine，the China Association of Chinese Medicine has fully played a leading academic role by systematically organizing and conducting a series of academic youth salons on clinical dominant diseases of traditional Chinese medicine. On September 13，2024，the 36^th Youth Salon on Clinical Dominant Diseases was successfully held in Nanjing，focusing on the advantages of traditional Chinese medicine and the integrative traditional Chinese medicine and western medicine in the diagnosis and treatment of erectile dysfunction （ED）. The conference brought together leading experts from traditional Chinese medicine，western medicine，and interdisciplinary fields，facilitating in-depth multidisciplinary discussions that led to key consensus on optimizing traditional Chinese medicine treatment protocols for ED，researching and developing new drugs of traditional Chinese medicine，and advancing interdisciplinary development in traditional Chinese medicine. This salon systematically sorted out the clinical strengths and distinctive features of traditional Chinese medicine in the diagnosis and treatment of ED. Based on current research foundations and clinical needs，it identified key directions for future scientific layout and scientific research tackling： （1） Standardization of syndrome differentiation system of traditional Chinese medicine for ED. （2） Optimization and standardization of intervention methods of integrated traditional Chinese medicine and western medicine. （3） High-quality clinical research guided by evidence-based medicine. （4） In-depth analysis of the pharmacological mechanisms of traditional Chinese medicine in the treatment of ED. （5） Clinical translation and application promotion of new drugs of traditional Chinese medicine. （6） Interdisciplinary integration and innovation in traditional Chinese medicine. For each research direction，key focus areas，expected objectives，and clinical value were further refined，along with the establishment of a scientifically sound priority funding level evaluation system. Therefore，building on the series of salons on the ED-focused dominant diseases of traditional Chinese medicine，this paper provides standardized guidance for clinical practice of traditional Chinese medicine in ED management，effectively contributing to the high-quality development of traditional Chinese medicine. It serves as a valuable reference for national scientific and technological strategic layout， research and development decision-making in new drugs of traditional Chinese medicine，research topic planning，and clinical guideline formulation.

To evaluate the clinical value of nebulized indocyanine green(ICG) combined with near-infrared fluorescence imaging for intraoperative detection of air leaks during pulmonary resection.

ObjectiveTo evaluate the clinical efficacy of Huayu Tongluo Formula （化瘀通络方， HTF） in patients with mid-stage diabetic kidney disease of blood stasis syndrome and explore its potential mechanisms. MethodsA multi-center， randomized， double-blind， placebo-controlled clinical trial was conducted. Ninety patients of mid-stage diabetic kidney disease of blood stasis syndrome were divided into a control group of 46 cases and a treatment group of 44 cases. Both groups received conventional western medicine treatment， the treatment group additionally taking HTF， while the control group taking a placebo of the formula. The treatment was administered once daily for 24 weeks. The primary outcomes included 24-hour urine total protein （24 h-UTP）， serum albumin （Alb）， glycated hemoglobin （HbA1c）， and serum creatinine （Scr）.The secondary outcomes included changes in levels of endothelin-1 （ET-1）， nitric oxide （NO）， vascular endothelial growth factor （VEGF）， and traditional Chinese medicine （TCM） syndrome scores before and after treatment. Clinical efficacy was evaluated based on TCM syndrome scores and overall disease outcomes. Adverse reactions and endpoint events were recorded. ResultsIn the treatment group after treatment， 24 h-UTP， ET-1， and VEGF levels significantly decreased （P＜0.05）， Alb and NO levels significantly increased （P＜0.05）； while the TCM syndrome scores for edema， lumbar pain， numbness of limbs， dark purple lips， dark purple tongue or purpura， and thin， rough pulse all significantly decreased （P＜0.05）. In the control group， no significant changes were observed in any of the indicators after treatment （P＞0.05）.Compared with the control group， the treatment group showed significant reductions in 24 h-UTP， ET-1， and VEGF levels， and increases in Alb and NO levels （P＜0.05）. The TCM syndrome scores for edema， lumbar pain， dark purple tongue or purpura， and thin， rough pulse were all lower in the treatment group than in the control group （P＜0.05）. The total effective rate of TCM syndrome in the treatment group was 59.09% （26/44）， and the overall clinical effective rate was 45.45% （20/44）. In the control group， these rates were 15.22% （7/46） and 8.7% （4/46）， respectively， with the treatment group showing significantly better outcomes （P＜0.05）. A total of 7 adverse events occurred across both groups， with no significant difference （P＞0.05）. No endpoint events occurred during the study. ConclusionOn the basis of conventional treatment of Western medicine， HTF can further reduce urinary protein levels and improve clinical symptoms in patients with mid-stage diabetic kidney disease of blood stasis syndrome. The mechanism may be related to its effects on endothelial function.

Objective:To investigate the application value of photon-counting detector CT (PCD-CT) in preoperative identification of critical anatomical structures and surgical assessment in pancreatic cancer, and to compare its performance with conventional energy-integrating detector CT (EID-CT) in delineating tumor margins, vascular structures, and neural anatomy.Methods:This single-center retrospective matched case-control study included 25 patients with pathologically confirmed pancreatic ductal adenocarcinoma who underwent PCD-CT enhanced scanning and curative surgery at Peking Union Medical College Hospital between February and June 2025 (PCD-CT group). These patients were matched in a 1∶2 ratio to 50 patients who underwent EID-CT between January 2016 and December 2024 and subsequently received curative surgery (EID-CT group). Tumor boundary clarity, vascular visualization scores, and neural structure visibility were subjectively evaluated using the Likert scoring system. The assessed vessels included the celiac artery, common hepatic artery, superior mesenteric artery, splenic artery, portal vein, superior mesenteric vein, splenic vein, and pancreaticoduodenal arterial arcade. Imaging-based assessment of structural involvement was compared with intraoperative findings and pathological results to calculate diagnostic accuracy. Surgeons rated the usefulness of PCD-CT images for identifying key structures and determining resectability using a 5-point Likert scale. The Mann-Whitney U test was used for group comparisons of subjective scores, and categorical data were analyzed using the χ2 test or Fisher exact test. Results:The PCD-CT group showed significantly higher scores for tumor boundary clarity, vascular visualization, and neural structure detectability than those of the EID-CT group (all P<0.05). The accuracy of assessing superior mesenteric vein involvement was 96.0% (24/25) in the PCD-CT group and 72.0% (36/50) in the EID-CT group, with a significant difference ( χ2=6.00, P=0.014). Postoperative surgeon evaluations indicated that PCD-CT provided substantial assistance for both key structure identification [5 (5, 5)] and resectability assessment [5 (4, 5)]. Conclusion:PCD-CT demonstrates superior performance over EID-CT in preoperative delineation of tumor margins, vascular structures, and neural anatomy and in the assessment of structural involvement in pancreatic cancer. It provides valuable anatomical information to support preoperative evaluation and surgical decision-making.

Objective To screen and analyze key genes in rabbit corneal alkali burns based on transcriptomics se-quencing technology and bioinformatics techniques.Methods Thirty healthy male New Zealand rabbits were randomly di-vided into 2 groups(n=15 per group):The control group received no intervention,while the alkali burn group underwent corneal alkali burn modeling.Histological evaluation of corneal tissues was performed via hematoxylin-eosin(HE)stai-ning.Transcriptome sequencing was conducted for library construction and sequencing.Differentially expressed genes(DEGs)were identified using DESeq2,followed by Gene Ontology(GO)functional enrichment analysis and Kyoto Ency-clopedia of Genes and Genomes(KEGG)pathway analysis.A protein-protein interaction(PPI)network was constructed to screen hub genes,and RT-PCR was employed to validate mRNA expression levels of key genes.Results HE staining revealed orderly arranged corneal stromal layers and scattered stromal cells in the control group,whereas the alkali burn group exhibited stromal edema,thickened collagen fibers with loose/disorganized alignment,and increased fibroblast and inflammatory cell infiltration.Compared to the control group,1 827 significant DEGs were identified in the alkali burn group,including 1 495 upregulated and 332 downregulated genes.GO analysis showed biological processes such as immune response,plasma membrane,and identical protein binding.KEGG analysis indicated that DEGs were enriched in pathways related to cancer,lipid and atherosclerosis,and neuroactive ligand-receptor interaction.The PPI network screened 11 key genes:neutrophil cytosolic factor 1(NCF1),neutrophil cytosolic factor 2(NCF2),matrix metallopeptidase 2(MMP2),ma-trix metallopeptidase 9(MMP9),interleukin-1α(IL-1α),interleukin-1β(IL-1β),interleukin-6(IL-6),interleukin-8(CXCL8),cluster of differentiation 4(CD4),C-C motif ligand 2(CCL2)and tumor necrosis factor(TNF).RT-PCR valida-tion revealed that the mRNA expression levels of key genes in the corneal tissues of the alkali burn group were significantly higher than those in the control group(all P＜0.05),consistent with the transcriptomic sequencing results.Conclusion Based on the rabbit corneal alkali burn model,this study identified 11 key genes(NCF1,NCF2,MMP2,MMP9,IL-1α,IL-1β,IL-6,CXCL8,CD4,CCL2 and TNF)through transcriptomics and bioinformatics analysis.

Objective To explore the current situation of caring behavior among hospice nurses,and to analyze its latent profiles and population characteristics,so as to provide ideas for targeted interventions.Methods From August to November 2023,convenience sampling was used to select hospice nurses from 22 secondary and above hospitals in Jiangsu Province,Zhejiang Province,Shanghai City,Shandong Province,Anhui Province,Beijing City,Guangdong Province,and Sichuan Province.The demographic characteristics questionnaire,the Caring Behaviors Inventory,the Empathy Ability Scale for Hospice Nurses,and the Practice Environment Scale were used for investigation.Latent profile analysis was conducted based on 24 items of the Caring Behaviors Inventory as explicit indicators,and the influencing factors of different profiles were analyzed through multivariate logistic regression model.Results A total of 420 questionnaires were collected,of which 393 were valid,with a valid questionnaire response rate of 93.57％.The caring behavior of hospice nurses could be divided into 3 latent profiles,namely high level of care-low respect and connection group(49.62％),high to low caring behavior-overall fluctuation group(30.79％),and medium level of care-high knowledge and skills group(19.59％).The results of multivariate logistic regression showed that age,the dimensions of cognitive and emotional empathy in the Empathy Ability Scale for Hospice Nurses and the dimension of nursing foundations for quality of care in the Practice Environment Scale were the influencing factors of the latent profile of hospice nurses'caring behavior(P＜0.05).Conclusion There is significant heterogeneity in the caring behavior of hospice nurses.Nursing managers should develop individualized interventions for hospice nurses according to the influencing factors of different latent profiles to improve their level of caring behavior.

Objective To analyze the implementation of MPOWER tobacco control policies in different regions and populations in China,as well as the impact of perceptions of tobacco control policies on individual smoking behavior and quit intentions,to promote the fairness of policy implementation and protection for vulnerable groups.Methods A multivariable regression model was constructed utilizing raw data from the China Adult Tobacco Survey to analyze disparities in perceived MPOWER policy implementation among various social demographics and its impact on smoking behavior and quitting intentions.Results Regarding protection from tobacco smoke(P),local economic level,urban-rural divide were significantly correlated with awareness of comprehensive smoking bans.For offering help to quit smoking(O),local tobacco industry revenue and individual age were associated with the doctor's advice for quitting.As to the warning about the harm of tobacco(W),economic level,geography and urban-rural disparity were correlated with the visibility of health warnings.About the tobacco advertising,promotion and sponsorship(E),geography was related to the exposure to tobacco advertisements,local tobacco industry revenue was associated with the tobacco promotion.For tobacco taxes(R),education level and age were significantly correlated with tobacco affordability.People who perceived comprehensive smoking bans(OR=0.69,95%CI:0.59-0.81)was associated with less smoking behavior,while people perceiving tobacco promotional activities(OR=2.51,95%CI:2.00-3.17)were more likely to smoke.Additionally,people who perceived comprehensive smoking bans(OR=1.70,95%CI:1.25-2.31)and health warning(OR=2.09,95%CI:1.48-3.01)had higher intention to quit smoking.Conclusion In economically disadvantaged regions and among specific socially vulnerable groups(such as low-income individuals,rural residents,and the elderly)in China,the perception of tobacco control policy implementation is relatively low,the perception of tobacco control policies can influence smoking behavior and quitting intentions.Legislative and enforcement efforts should be increased targeting these groups with lower perceptions of the policies to enhance the fairness of tobacco control measures.

Acute respiratory distress syndrome(ARDS)is a common respiratory emergency,but current clinical treatment remains at the level of symptomatic support and there is a lack of effective targeted treatment measures.Our previous study confirmed that inhalation of hydrogen gas can reduce the acute lung injury of ARDS,but the application of hydrogen has flammable and explosive safety concerns.Drinking hydrogen-rich liquid or inhaling hydrogen gas has been shown to play an important role in scavenging reactive oxygen species and maintaining mitochondrial quality control balance,thus improving ARDS in patients and animal models.Coral calcium hydrogenation(CCH)is a new solid molecular hydrogen carrier prepared from coral calcium(CC).Whether and how CCH affects acute lung injury in ARDS re-mains unstudied.In this study,we observed the therapeutic effect of CCH on lipopolysaccharide(LPS)induced acute lung injury in ARDS mice.The survival rate of mice treated with CCH and hydrogen inhalation was found to be comparable,demonstrating a significant improvement compared to the untreated ARDS model group.CCH treatment significantly reduced pulmonary hemorrhage and edema,and improved pulmonary function and local microcirculation in ARDS mice.CCH promoted mitochon-drial peripheral division in the early course of ARDS by activating mitochondrial thioredoxin 2(Trx2),improved lung mitochondrial dysfunction induced by LPS,and reduced oxidative stress damage.The results indicate that CCH is a highly efficient hydrogen-rich agent that can attenuate acute lung injury of ARDS by improving the mitochondrial function through Trx2 activation.

Objective To explore the efficacy of DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy for management of cancer pain and provide reference for its standardized clinical application.Methods and Results Recommendations were formulated based on literature review and expert group discussion,and consensus was reached following expert consultation.The consensus recommendations are comprehensive,covering the entire treatment procedures from preoperative assessment and preparation,surgical operation process,postoperative management and traditional Chinese medicine treatment to individualized treatment planning.The study results showed that the treatment plans combining traditional Chinese with Western medicine effectively alleviated cancer pain,reduced the use of opioid drugs,and significantly improved the quality of life and enhanced immune function of the patients.Postoperative follow-up suggested good treatment tolerance among the patients without serious complications.Conclusion The formulated consensus is comprehensive and can provide reference for clinicians to use DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy.The combined treatment has a high clinical value with a good safety profile for management of cancer pain.