Pathological diagnosis is the gold standard for confirming breast cancer. Traditional manual pathological diagnosis methods for breast cancer are time-consuming, labor-intensive, highly subjective, and exhibit poor diagnostic consistency. In recent years, artificial intelligence (AI) technology has rapidly advanced and is progressively being applied clinically as a promising early diagnostic tool. However, many existing AI models lack interpretability, which limits the trustworthiness of their clinical application. Khater et al, by combining a high-precision machine learning model with an explainable AI model, achieved highly accurate breast tumor diagnosis and provided explanations for key biological and pathological features influencing the diagnostic results. This points the way for the future application and development of AI in medical diagnosis and treatment. The article interprets the main content of that study, and analyzes the advantages and limitations of AI in medical diagnosis and treatment, with the aim of promoting its better application in clinical practice.

Breast cancer is one of the most common malignant tumors in women, and its treatment and management strategies are crucial for improving patients’ prognosis and quality of life. Early breast cancer refers to lesions confined to the breast and regional lymph nodes (N1 stage) without distant metastasis. Thanks to the improvement of screening techniques, the detection rate of early breast cancer has increased. The “early diagnosis and early treatment” model has led to a decrease in breast cancer mortality, especially among young women. The 2024 European Society for Medical Oncology (ESMO) clinical practice guideline for the diagnosis, treatment, and follow-up of early breast cancer aims to provide comprehensive and standardized recommendations for the diagnosis and treatment of early breast cancer, helping clinicians make optimal decisions. This article interprets the main content of the guideline in order to provide references and assistance for the current clinical diagnosis and treatment of early breast cancer in China.

Objective To calculate the absorbed doses and conversion coefficients of various organs in humans after oral administration of urea-¹⁴C, and to provide a convenient method for evaluating the internal radiation dose caused by ingestion of urea-¹⁴C in Chinese population. Methods The Chinese reference human voxel model was imported into the FLUKA software to simulate the absorbed doses to organs under internal exposure to ¹⁴C, and to obtain the dose conversion coefficients for oral administration of urea-¹⁴C. Results The absorbed dose conversion coefficients for the stomach, colon, bladder, heart, and muscles were 0.029, 0.029, 0.32 (0.24), 0.028, and 0.029 mGy/MBq in negative cases, and 0.079, 0.078, 0.18 (0.15), 0.076, and 0.080 mGy/MBq in positive cases. The committed effective dose coefficients were 0.041 (0.037) mSv/MBq in negative cases and 0.082 (0.081) mSv/MBq in positive cases. Conclusion The dose conversion coefficients obtained in this study can provide important parameters for evaluating the absorbed dose to Chinese population after oral administration of urea-¹⁴C.

Methylthioadenosine phosphorylase (MTAP) is a rate-limiting enzyme in the methionine and purine salvage pathway, and is closely related to polyamine metabolism, adenine metabolism and methionine metabolism. MTAP is frequently deleted in malignant mesothelioma (MM) and plays an important role in the diagnosis and differential diagnosis of MM. At the same time, metabolic reprogramming caused by MTAP deletion creates new therapeutic strategies for MM. Besides, MTAP gene is also associated with the prognosis of MM, therefore MTAP is a significant biomarker for the diagnosis, treatment and prognosis of MM.

Objective To compare the clinical efficacy of abdominal ultrasound-guided endoscopic retrograde appendicitis therapy(ERAT)with laparoscopic appendectomy(LA)for acute uncomplicated appendicitis using propensity score matching.Methods The clinical data of 441 patients with acute uncomplicated appendicitis admitted to the Third People's Hospital of Yunnan Province from March 2020 to April 2023 were collected.The cases were classified based on the differences in surgical method and divided into the ERAT group(n = 30)and LA group(n = 411).The clinical efficacy of patients was compared between the two groups after reducing confounding bias by propensity score matching(PSM).Results After PSM,a total of 30 pairs of patients in the two groups were successfully matched,and the baseline data of the two groups met the requirements for comparability.At 24 hours after the operation,the ERAT group exhibited lower white blood cells,neutrophil counts,and C-reactive protein levels compared to the LA group,and these differences were statistically significant(P<0.05).There was no significant difference in the operation time and total effective rate between the ERAT group and the LA group(P>0.05).However,the ERAT group had lower intraoperative blood loss and shorter pain relief time compared to the LA group,and these differences were statistically significant(P<0.05).Conclusion Abdominal ultrasound-guided endoscopic retrograde appendicitis treatment is an effective,safe,and feasible technique with good prospects for the treatment of acute uncomplicated appendicitis.

Objective:To investigate the clinical effect of composite surgery in the treatment of chronic common carotid artery occlusion(CCAO).Methods:A retrospective descriptive study was conducted. The clinical data of 7 patients with CCAO admitted to Xuanwu Hospital, Capital Medical University from October 2020 to December 2023 were collected retrospectively. There were 6 males and 1 female. The age was (66.7±10.9) years, ranging from 52 to 83 years. Outpatient or telephone follow-up were conducted after surgery, carotid artery ultrasound or computed tomography angiography were performed at 3 months, 6 months, and 1 year postoperatively to determine vascular patency. The selection of surgical methods and clinical effect were analyzed. Normally distributed measurement data were expressed as mean±standard deviation ( ± s). The measurement data of skewed distribution were expressed by M ( Q1, Q3). Count data were expressed as frequency. Results:All 7 patients were diagnosed with chronic CCAO before operation, 6 on the left and 1 on the right. 3 cases affected the middle and distal segments of the common carotid artery, 1 case affected the proximal segment, and 1 case each affected the middle and distal segments, the remaining case involves the entire common carotid artery. All the procedures were successfully performed, among which 4 cases underwent carotid endarterectomy combined with stent placement, and 3 cases did not receive stent placement after carotid endarterectomy. 1 patient developed neck hematoma after surgery and the remaining patients recovered well after surgery without any complications or deaths. The follow-up time was 13.5(4.0, 20.5) months; 1 patient was lost to follow-up, and 6 patients received effective follow-up. the common carotid artery remained unobstructed in all 6 patients, and there were no transient ischemic attacks or strokes during the follow-up period.Conclusion:Composite surgery is a safe and feasible method that can be used to treat chronic CCAO lesions, and has satisfactory short-term results.

AIM:To investigate the role of phosphoenolpyruvate carboxykinase 1(PCK1)in the proliferation and migration of mouse vascular smooth muscle cells(VSMCs)and the underlying mechanism.METHODS:The prolif-eration and migration of mouse VSMCs were induced by platelet-derived growth factor(PDGF)-BB.The cells were divided into a vehicle group and a PDGF-BB group.The expression of PCK1 was detected by Western blot and immunofluores-cence staining.The mouse Pck1 siRNA(si Pck1)were transfected into mouse VSMCs to silence PCK1.The cells were di-vided into the vehicle,si Pck1+vehicle,PDGF-BB and si Pck1+PDGF-BB groups.The protein level of PCK1 was detected by Western blot.The proliferation was explored by Ki-67 immunofluorescence staining and the viability was detected by CCK-8 assay.The migration was determined by a scratch test.Mitochondrial dynamics were observed via transmission electron microscopy.A lentivirus carrying dynamin-related protein 1(Drp1)gene(lenti-Drp1)was transfected into VSMCs to induce them to overexpress DRP1.The cells were divided into the PDGF-BB,si Pck1+PDGF-BB,lenti-Drp1+PDGF-BB and lenti-Drp1+si Pck1+PDGF-BB groups.Proliferation,migration and mitochondrial dynamics were measured as described above.RESULTS:PDGF-BB increased the protein expression of PCK1 and DRP1,cell viability,the per-centage of Ki-67-positive cells,the wound healing rate and mitochondrial division in VSMCs.These effects were sup-pressed when PCK1 protein expression was silenced.After DRP1 was overexpressed,the inhibitory effects of PCK1 silenc-ing on cell viability,the percentage of Ki-67-positive cells,the wound healing rate and mitochondrial division were signifi-cantly reversed.CONCLUSION:PCK1 promotes the mitochondrial division,proliferation and migration of VSMCs in mice by upregulating the expression of DRP1.

Messenger RNA (mRNA) is the template for protein biosynthesis and is emerging as an essential active molecule to combat various diseases, including viral infection and cancer. Especially, mRNA-based vaccines, as a new type of vaccine, have played a leading role in fighting against the current global pandemic of COVID-19. However, the inherent drawbacks, including large size, negative charge, and instability, hinder its use as a therapeutic agent. Lipid carriers are distinguishable and promising vehicles for mRNA delivery, owning the capacity to encapsulate and deliver negatively charged drugs to the targeted tissues and release cargoes at the desired time. Here, we first summarized the structure and properties of different lipid carriers, such as liposomes, liposome-like nanoparticles, solid lipid nanoparticles, lipid-polymer hybrid nanoparticles, nanoemulsions, exosomes and lipoprotein particles, and their applications in delivering mRNA. Then, the development of lipid-based formulations as vaccine delivery systems was discussed and highlighted. Recent advancements in the mRNA vaccine of COVID-19 were emphasized. Finally, we described our future vision and perspectives in this field.

Owing to the inherent shortcomings of traditional therapeutic drugs in terms of inadequate therapeutic efficacy and toxicity in clinical treatment, nanomedicine designs have received widespread attention with significantly improved efficacy and reduced non-target side effects. Nanomedicines hold tremendous theranostic potential for treating, monitoring, diagnosing, and controlling various diseases and are attracting an unfathomable amount of input of research resources. Against the backdrop of an exponentially growing number of publications, it is imperative to help the audience get a panorama image of the research activities in the field of nanomedicines. Herein, this review elaborates on the development trends of nanomedicines, emerging nanocarriers, in vivo fate and safety of nanomedicines, and their extensive applications. Moreover, the potential challenges and the obstacles hindering the clinical translation of nanomedicines are also discussed. The elaboration on various aspects of the research trends of nanomedicines may help enlighten the readers and set the route for future endeavors.

Objective:To use the resting state functional network connectivity (FNC) method based on independent component analysis (ICA) to analyze the characteristics of FNC changes in patients with basal ganglia aphasia (BGA) after stroke, and to explore its occurrence and recovery mechanism under the intervention of acupuncture combined with language rehabilitation training.Methods:Using a prospective observational research method, 16 right-handed BGA patients who were treated at Beijing Hospital of Traditional Chinese Medicine, Capital Medical University from July 2021 to December 2022, as well as 14 healthy subjects matched in age, gender, education level, and handedness, were included. The resting state functional magnetic resonance imaging, demographic information, and Western Aphasia Examination data of healthy subjects and BGA patients before and after intervention were collected. The GIFT toolbox based on MATLAB platform was applied for ICA and resting state brain network FNC analysis. The FNC differences between BGA patients and healthy subjects were compared horizontally, and the FNC changes in BGA patients before and after intervention were compared vertically.Results:Compared with healthy subjects, post-stroke BGA patients showed decreased connectivity between the basal ganglia network, default network, and visual network before intervention, while increased connectivity between the auditory network, right frontoparietal network, and anterior cuneiform network; After the intervention of acupuncture combined with language rehabilitation training, the connectivity between the basal ganglia network, visual network, and anterior cuneiform network decreased, while the connectivity between the anterior convex network and bilateral frontoparietal network decreased, while the connectivity between the default network, auditory network, right frontoparietal network, and visual network increased. The BGA patient group showed enhanced connectivity between the basal ganglia network and the left frontoparietal network before and after intervention.Conclusions:The FNC changes between the basal ganglia network and other brain networks are key to reflecting the mechanism of BGA occurrence and language function recovery. Acupuncture combined with language rehabilitation training may improve language function by enhancing the connectivity between the basal ganglia network and the left frontoparietal network, and the redistribution of attention resources may also be one of the reasons for promoting language function recovery in BGA patients.