Since the concept of artificial intelligence (AI) was proposed in 1956, medicine has been one of its core application fields. At present, AI technology has run through the whole diagnosis and treatment process, and has been extended to innovative scenarios such as drug research and development, surgical robots, and clinical trial optimization. Scenario application is the backbone of the technical system. Multimodal data fusion integrates heterogeneous data such as images, medical records, and genes, and federated learning realizes cross-institutional privacy protection and sharing. Deep learning achieved more than 90% sensitivity in imaging diagnosis for lung nodule detection, while generative AI accelerates drug molecule design. The core applications cover four major areas field: AI is more accurate than professional doctors in breast cancer and diabetic retinopathy screening; robotics shortens hospital stays and improves spinal screw placement accuracy; AI shortens the discovery cycle of drug targets; machine learning improves the efficiency of subject screening and enables real-time data monitoring. The application of AI in the medical field is first constrained by data quality and algorithm bias, and the "black box" characteristics of AI models and the ambiguity of responsibility attribution are the core obstacles to clinical implementation. This paper analyzes key technological breakthroughs and typical cases, discusses the application scenarios and challenges of AI in medicine, and aims to provide a reference for the future development of medical intelligence.

Objective: To analyze the global literature related to functional cure of hepatitis B from 2019 to 2023 by using bibliometric analysis methods, so as to help researchers understand the research hotspots and trends in this field. Methods: The literature related to the topic of functional cure of hepatitis B included in the Science Citation Index Expanded (SCI-Expanded) of the Web of Science Core Collection from 2019 to 2023 was searched. By using VOSviewer and CiteSpace visual analysis tools, analyses were conducted from the perspectives of publication trends, international research cooperation networks, and keyword emergence, and were elaborated with the specific contents of the related literature to elucidate research hotspots and trends. Results: A total of 600 eligible papers in this field were included. Keyword co-occurrence and thematic clustering suggested that the main research directions of functional cure were: serum biomarkers for prediction and monitoring of functional cure, functional cure and immunity, nucleoside analog discontinuation, interferon therapy, and long-term prognosis of functional cure. The research contents of the ESI highly cited original research papers were similar to the clustering of the above, but showed more attention on the novel agents for functional cure. The content of the keyword emergence map showed that hotspots of interest changed from virologic mechanisms and serum markers, to nucleoside analog discontinuation and interferon therapy, and finally to immunologic mechanisms and new drug. Conclusion: The research hotspots and trends of functional cure of hepatitis B were focused on virological mechanism, serum markers, immunological mechanism, nucleoside analog discontinuation, interferon therapy, and long-term prognosis after cure.

Objective: To investigate the epidemiological and demographic characteristics of Mycoplasma pneumoniae (Mp), respiratory syncytial virus (RSV), influenza A (FluA), and influenza B (FluB) in a single center in Minhang District, Shanghai after the end of the COVID-19 pandemic. Methods: A retrospective analysis of data from Apr 2023 to Jul 2024 of patients who underwent testing for Mp, RSV, FluA, and FluB due to respiratory tract infections in Minhang Hospital, Fudan University was conducted. Differences in pathogen infections were analyzed among different seasons and age groups. Results: A total of 39 103 individuals of respiratory tract infections with simultaneous testing for all four pathogens were included in this analysis, with a total detection rate of 44.7% (17 490/39 103). The detection rates were as follows: Mp 25.2%, FluA 13.1%, FluB 10.9%, and RSV 1.5%. Co-infections accounted for 5.9%, predominantly with Mp and FluA. The detection rate of Mp was > 38% in children under 14 years old, gradually decreasing with age. In the child group (≤14 years), both FluA and FluB had the highest detection rates in the 7-14 years age group (FluA, 16.5%; FluB, 10.4%). In the adult group (≥15 years), the highest detection rates for FluA and FluB were found in the 15-24 years age group (12.5%) and the 35-44 years age group (15.9%), respectively. The detection rates of pathogens varied significantly across different months (P < 0.001), with an increasing trend in the total number and overall detection rate of the four pathogens after Sept 2023 (P < 0.001). Conclusion: After the end of the COVID-19 pandemic, there was an abnormal increase in Mp in a single center in Minhang District, Shanghai. Mp, along with influenza viruses, became the main pathogens causing respiratory tract infections. Targeted prevention and control measures based on the epidemiological characteristics of infections should be implemented to guide clinical diagnosis and treatment.

Mendelian randomization (MR) is an epidemiological method that uses genetic variants as instrumental variables (Ⅳs). This article begins by elucidating the basic principles of IVs through causal diagrams, directed acyclic graph (DAG), and then systematically reviews the key assumptions, common challenges, and practical considerations in MR studies by comparing them with randomized controlled trials (RCTs). As an observational study, MR can theoretically help avoid confounding, but its validity in practice critically depends on confirming (ⅰ) a strong association between the genetic instrument and the exposure, (ⅱ) independence of the instrument from confounders, and (ⅲ) exclusion of alternative pathways from the instrument to the outcome; over-interpretation of findings should therefore be avoided. The paper also highlights the value of MR in drug target discovery and in exploring disease mechanisms, while reminding investigators that common issues in observational studies, such as the temporal order of exposure and outcome, still require rigorous attention.

Objective: To observe the efficacy and safety of Baduanjin combined with acupuncture in treating neck-type cervical spondylopathy (NTCS) patients. Methods: Eighty patients were randomly divided into an intervention group and a control group in a 1∶1 ratio. The intervention group was treated with a combination of Baduanjin and acupuncture. Patients underwent Baduanjin exercise daily and acupuncture treatment twice a week for a total of 8 consecutive weeks. The control group received routine acupuncture twice a week for a total of 8 consecutive weeks. After the end of the treatment course, the effective rates of the two groups, as well as the visual analogue scale (VAS), neck disability index (NDI), self-rating anxiety scale (SAS), self-rating depression scale (SDS), and general comfort questionnaire (GCQ) assessment before and after treatment were compared, then safety evaluations was assessed. Results: After intervention, the total effective rates of the intervention group and the control group were 91.4% and 76.31%, respectively, with a statistically significant difference (P < 0.05); Compared within the group, the VAS, NDI, SAS, SDS scores of both groups were significantly lower than before treatment (all P < 0.01), and the GCQ scores were higher than before treatment(both P < 0.01); After intervention, inter-group comparison showed that the improvement of VAS, NDI, SAS, SDS, and GCQ scores in the intervention group was more significant than that in the control group (all P < 0.05). Conclusion: The combination of Baduanjin and acupuncture treatment can improve the clinical efficacy of NTCS patients and has good safety, which is worthy of clinical promotion and application.

With the important trend of body shape in whole lifecycle management of breast cancer patients and the emergence of new evidence-based medical and nursing data, it is necessary to sort out and update the body shape management of breast cancer patients. Experts of Breast Cancer Integrated Nursing Professional Committee of Chinese Anti-Cancer Association, Breast Cancer Case Manager Branch of Chinese Medical Education Association and Breast Cancer Professional Committee of Chinese Anti-Cancer Association convened domestic experts in the field of breast cancer nursing, including breast surgery, medical oncology, radiotherapy, nursing management and other nursing fields, who jointly discussed and formulated the "expert consensus on body shape management of breast cancer patients". The consensus has elaborated on the management of surgery-related body, comprehensive treatment-related body and other related body management, hoping to provide homogenized suggestions for personnel in various breast specialties to carry out body shape management of patients, and improve the standardization of care.

Objective: To compare the pain relief and long-term clinical success rate of vital pulp therapy and root canal treatment in mature permanent teeth with carious irreversible pulpitis. Methods: A total of 90 patients diagnosed with carious irreversible pulpitis in mature permanent teeth were collected at Shanghai Stomatological Hospital from Jan 2021 to Jun 2022. They were randomly divided into two groups: test group (n=45) undergoing vital pulp therapy (VPT) and control group (n=45) undergoing root canal treatment (RCT). Pain scores were recorded before treatment, 24 hours after operation and 7 days after operation. We conducted clinical evaluation and imaging analysis at 1, 6, and 12 months after the surgery, then compared the pain scores and treatment success rates between the two groups. Results: Eighty-one patients, including 39 patients in group VPT aged (31.00±1.43) years old and 42 patients in group RCT aged (30.60±1.54) years old, received follow-up for more than 1 year, and the success rate of the test group and control was 97.44% and 95.24%. The pain degree of the two groups was reduced at 24 hours and 7 days after operation (P < 0.05), and the pain score of the test group was reduced compared with that in the control group 7 days after operation (P < 0.01). Conclusion: Compared with root canal treatment, vital pulp therapy for mature permanent teeth with carious irreversible pulpitis can achieve good results in short-term pain evolution and long-term clinical success.

Ovarian clear cell carcinoma (OCCC) typically exhibited high-grade atypia and aggressive chemotherapy resistance, leading to poor prognosis, necessitating continuous exploration of novel therapeutic approaches to enhance patient survival and quality of life. In recent years, with the in-depth study of the biological behavior and molecular characteristics of OCCC, unique molecular features of OCCC were discovered, making it a potential molecular target for personalized biotherapy, with the prospect of improving treatment efficacy and patient prognosis. An increasing number of clinical trials focused on exploring the driver mutations and molecular characteristics of recurrent OCCC in the hope of finding more precise and effective treatment modalities. This article provided a comprehensive review of the molecular characteristics of OCCC and advances in drug therapy.

Objective: To investigate the correlation between serum uric acid (SUA) levels and incident chronic kidney disease (CKD) in middle-aged and elderly Chinese population and gender differences. Methods: Based on the longitudinal survey data of China Health and Retirement Longitudinal Study from 2011 to 2015, the CKD-Epidemiology Collaboration cystatin C formula was used to estimate the glomerular filtration rate (eGFR), and 4 119 participants with normal renal function (eGFR≥60 mL·min^-1·1.72 m^-2) at baseline were included. Incident CKD was defined as eGFR<60 mL·min^-1·1.72 m^-2 at the follow-up in 2015. Logistic regression analysis was used to analysis the association of SUA levels at baseline and incident CKD among different genders. Restricted cubic spline analysis was used to analyze the dose-response relationship. Results: After 4-year follow-up, 127 participants developed incident CKD, including 57 males and 70 females. Multivariate Logistic regression analysis showed that elevated SUA levels were independently associated with the risk of incident CKD (OR=1.532, P<0.001). For each 1 mg/dL increase in SUA, the risk of incident CKD increased by 33.6% in males (OR=1.336, P=0.012) and 77.5% in females (OR=1.755, P<0.001). Restricted cubic spline analysis showed a linear positive correlation between SUA levels and incident CKD in both males and females. Participants were divided into four groups according to SUA quartiles (Q1-Q4). Multivariate Logistic regression analysis indicated a significant increase in the risk of incident CKD in Q3 group (3.75 mg/dL<SUA≤4.43 mg/dL) and Q4 group (SUA>4.43 mg/dL) compared with Q1 group in females (Q3 group: OR=2.571, P=0.045;Q4 group: OR=3.666, P=0.005). Conclusion: SUA is an independent risk factor for incident CKD in the middle-aged and elderly population. In females, serum uric acid levels exceeding 3.75 mg/dL are associated with an increased risk of incident CKD.

In elderly patients with malignant tumor, sarcopenia frequently co-occurs, which is largely attributed to the cachexia state observed in cancer patients. Although both sarcopenia and cachexia involve muscle loss, there are significant distinctions between the two conditions. Current research indicates that sarcopenia is a multifactorial condition, influenced by factors such as aging, endocrine dysfunction, motor neuron loss, cachexia, inflammation, and malnutrition. With the increasing depth of research into the correlation between sarcopenia and the nervous and immune systems, this article reviews the research progress on sarcopenia in patients with malignant tumors, with a focus on neuroimmunological aspects. It systematically analyzes the mechanisms underlying its onset and progression, as well as the influencing factors and potential intervention strategies for sarcopenia in this patient population.

胡懋廉（1899—1971），字洁民，天津人。医学教育家，国家一级教授，中国现代耳鼻喉科学奠基人之一。1921年毕业于国立北京医学专门学校，1931年赴美国哈佛大学医学院耳鼻喉科深造并获得博士学位。历任上海公济医院院长、上海第一医学院附属眼耳鼻喉科医院首任院长、上海第一医学院副院长。曾当选为第三届全国政协委员、第三届全国人民代表大会代表、第一至第五届上海市人民代表大会代表、上海市人民委员会委员。他从事医疗和教育工作近50年，为我国耳鼻喉科学创建和发展作出了巨大贡献。

Objective: To develop a precise and efficient single-disease management model to reduce the intensity of antibiotic use. Methods: Data was collected from surgical inpatient admissions at the Shanghai Pulmonary Hospital between Jan 2022 and Mar 2024. The study focused on the six most prevalent types of malignant tumors within single-disease management. Surgical patients who did not receive single-disease quality management from Jan 2022 to Jun 2023 were designated as the control group, while surgical patients who received single-disease quality management from Jul 2023 to Mar 2024 served as the management group. By formulating and implementing standardized policies and guidelines for antibiotic use, supervision and effect evaluation were conducted across departments. Results: A total of 21 746 individuals were included in the control group and 15 635 in the management group. Following the introduction of the single-disease management model, the proportion of non-restricted antibiotics used in various single diseases increased from 73.2%-77.0% before management to 78.3%-84.4% after management, while the usage of restricted antibiotics significantly decreased (P < 0.001). The intensity of antibiotic use, measured in defined daily doses (DDDs), fell significantly from 113.0-159.9 before management to 36.0-44.0 after management (P < 0.001). Moreover, compared with the control group, the average length of stay in the intervention group did not change considerably, although the length of stay increased for some diseases, possibly due to more precise medication adjustments. Conclusion: The single-disease management model optimizes antibiotic use, reduces the intensity of antibiotic use, and enhances overall medical quality and patient safety.

Observational studies are important approaches for obtaining real-world evidence. However, due to the lack of randomized allocation, differences in baseline characteristics between groups often introduce confounding bias, which may distort the results. Traditional stratified analyses and multivariable regression models have limited ability to control confounding when multiple covariates are involved. Propensity score matching estimates the probability of receiving an intervention based on observed covariates, then matches individuals with similar propensity scores between treatment and control groups, thereby balancing covariate distributions and reducing confounding. In recent years, propensity score matching has been widely applied in various fields, including chronic disease management and drug effectiveness evaluation, public health policy and health service assessment, vaccine effectiveness studies focusing on population disparities, and evaluations of telemedicine interventions. This review summarizes common matching methods and application scenarios of propensity score matching in observational studies.

Tumor microenvironment (TME) is the foundation for tumor survival, which is composed of various types of cells, tumor blood vessels, secretory factors, and extracellular matrix (ECM) within the tumor. The unique regulatory mechanism triggered by the vigorous metabolic demand of tumor plays an important role in its tumorigenesis, metastasis, invasion, and treatment resistance. A deeper understanding of the metabolic transformation and tumor-immune cell interactions in the TME will enable the development of therapeutic technologies that precisely target TME metabolism, facilitate the development of combination treatment strategies, and improve the clinical response rate of existing immunotherapies. This paper reviews the composition, metabolism and regulatory mechanisms of TME, summarizes the research progress of immunotherapy strategies targeting the physiological characteristics of TME, and discusses the prospects for clinical application of precision immunotherapy strategies targeting TME, which are expected to enhance immunotherapy drugs response and infiltration degree.

Abnormal lipid metabolism and renal ectopic lipid accumulation have been associated with the occurrence and development of kidney diseases, particularly in diabetic nephropathy. However, the drugs commonly used in clinic to treat hypercholesterolemia, such as statins, ezetimibe and proprotein convertase subtilisin/Kexin type 9 (PCSK9) inhibitors, can effectively reduce the blood lipid level, but fail to delay the progress of kidney disease. In recent years, an increasing number of research studies have focused on the impact of free fat acids (FFA) metabolism on kidney function. The profiles and metabolism of fatty acids are altered in chronic kidney disease (CKD), and deregulated fatty acid metabolism contributes to further kidney damage. Furthermore, the role of FFA transporter in the progression of kidney diseases is gradually recognized. Therefore, this review summarizes the recent preclinical researches of fatty acid transporter fatty acid transport protein 2 (FATP2) expressed in proximal renal tubular epithelial cells.

Mitochondria are one of the most important organelles in cellular metabolism, and their genomes are prone to mutations and lack damage repair mechanisms. Mitochondrial DNA (mtDNA) mutations and copy number variations play important roles in the occurrence and development of tumors. In recent years, research has found that mtDNA mutations and copy number variations exist in various tumor diseases, and the detection of mtDNA in tumor tissues, especially cell-free mitochondrial DNA in patient fluids, may also serve as important means to indicate tumor diseases. This article aims to summarize and to review the correlation between mitochondrial genome mutations and copy number variations with tumor diseases and their diagnosis, as well as the research progress as tumor biomarkers, in order to provide reference for the clinical diagnosis of tumor diseases.

Objective: To conduct a bibliometric analysis of relevant literature on liver failure caused by viral hepatitis from the past five years, and to help researchers understand the current status and hotspots in this field, and to provide insights into future research trends. Methods: Based on the Science Citation Index Expanded (SCI-Expanded) data from Web of Science Core Collection, visualization analysis and mapping were conducted through VOSviewer and CiteSpace software to generate visual representations of international research collaboration networks, keyword co-occurrence clustering, and keyword bursts. Results: From 2019 to 2023, a total of 873 relevant literature were included, with a total citation frequency of 7 364 and an average citation frequency of 8.44. Among them, China had the highest number of publications (458 articles, 52.46%) and had the most cooperation with the United States. The research hotspots of viral hepatitis induced liver failure were mainly divided into three categories: basic and clinical research on liver failure caused by non-hepatitis B virus (HBV), the pathogenesis of HBV related liver failure, and treatment and prediction models of liver failure. The keyword time overlay map and burst map showed that the research hotspots had gradually shifted from the prevention and control of new infections to the treatment and prognosis assessment of patients with chronic infection. Conclusion: China is a major international research entity in liver failure caused by viral hepatitis and actively participates in international scientific collaborations. The research hotspots on liver failure caused by viral hepatitis have gradually shifted from preventing viral hepatitis infections and expanding treatment options to the treatment of chronic infection patients and prognostic prediction.

During sudden outbreaks of major infectious diseases, traditional vaccine clinical trials often fail to deliver timely and meaningful outcomes. To address this, innovative trial designs are essential to accelerate or restructure the traditional three-phase clinical trial process while maintaining adherence to scientific principles of drug candidate safety and efficacy. This paper presents various innovative vaccine clinical trial designs and concepts, along with critical considerations for their application, to serve as a methodological reference for related research. Adaptive designs provide flexibility by dynamically adjusting trial parameters—such as dose selection, population stratification, and sample size reestimation—based on interim analysis results. Bayesian designs incorporate historical data and prior information, reducing sample size requirements. Master protocol designs enable the evaluation of multiple treatments or target populations within a unified framework, significantly improving efficiency. Additionally, real-world data (RWD), including electronic health records vaccination records and insurance claims, supports the creation of virtual control groups, addressing ethical concerns while enhancing trial feasibility. A hybrid design combining randomized controlled trials (RCTs) with RWD is also proposed to leverage the strengths of both methodologies. These innovative designs optimize the research process, accelerating vaccine development and regulatory approval. By integrating these approaches, robust evidence-based insights can be generated, advancing precision medicine goals and strengthening public health responses to emerging infectious diseases.

Objective: To preliminarily explore the safety of collecting colostrum in the third trimester, and to evaluate postpartum breastfeeding in pregnant women with hyperglycemia during pregnancy. Methods: Pregnant women with hyperglycemia during pregnancy who had prenatal examinations in Obstetrics and Gynecology Hospital, Fudan University from Jul to Nov 2022 were prospectively divided into the colostrum collection group (n=52) in the third trimester and the control group (n=55) by randomized controlled grouping method. The t-test, χ² test, Fisher's exact probability method and rank sum test were used for statistical analysis of the data to compare the delivery outcomes, neonatal outcomes and postpartum breastfeeding status between the two groups. Results: There were no significant differences in the gestational weeks at delivery, delivery methods, breastfeeding rates at 42 days postpartum and 4 months postpartum between the two groups of pregnant women with hyperglycemia during pregnancy. There were also no significant differences in the Apgar scores at 1 minute and 5 minutes after birth and the neonatal hospitalization rate. The proportion of formula milk as the first supplementary feeding after delivery and the delayed lactation rate at 3 days postpartum in the colostrum collection group were significantly lower than those in the control group (P < 0.05). The exclusive breastfeeding rates at 24 hours postpartum and 3 days postpartum in the colostrum collection group were significantly higher than those in the control group (P < 0.05). Conclusion: Collecting colostrum in the third trimester among pregnant women with hyperglycemia during pregnancy is safe, and it can reduce the rate of supplementary feeding with formula milk after delivery, and increase the exclusive breastfeeding rates at 24 hours postpartum and 3 days postpartum.

Objective: To investigate the peripheral blood cytokine levels in patients with acute myocardial infarction (AMI), and to analyze its correlation with Killip classification, N-terminal brain natriuretic peptide precursor (NT-proBNP), cardiac troponin I (cTnI), creatine kinase isoenzymes (CK-MB), and to provide a theoretical basis for assessing the severity and prognosis of the disease. Methods: A total of 312 patients with AMI admitted to Minhang Hospital, Fudan University from Jul 2021 to Oct 2023 were enrolled as the case group, and 201 patients with unstable angina pectoris were selected as the control group. General clinical data of the subjects were collected, and the concentrations of cytokines (IL-5, IFN-α, IFN-γ, IL-10, IL-12p70, IL-17, IL-1β, IL-2, IL-4, IL-6, IL-8, and TNF-α) in peripheral blood were detected by multiplex bead-based flow cytometry. NT-proBNP, cTnI and CK-MB were measured by chemiluminescence methods. The levels of cytokines between the two groups were compared, and their correlations with Killip classification, NT-proBNP, cTnI and CK-MB were analyzed. The predictive efficacy of cytokines for AMI was evaluated by receiver operating characteristic (ROC) curves. Results: There were no significant differences in baseline data between the AMI group and the control group (P > 0.05), with the exception of age. The levels of IL-6, IL-8 and TNF-α in the AMI group were higher than those in the control group (all P < 0.01). The correlation analyses showed that IL-6 was positively correlated with Killip classification, NT-proBNP, cTnI and CK-MB (all P < 0.01). ROC analyses showed that IL-6 levels had good predictive efficacy for AMI (AUC=0.882 9, P < 0.01). Conclusion: The expression of IL-6 was significantly increased in patients with AMI, and it was positively correlated with Killip classification, NT-proBNP, cTnI and CK-MB, suggesting that IL-6 may serve as a potential biomarker for assessing the severity of AMI.

Microphthalmos is a congenital ocular developmental anomaly that manifests as a significant reduction in the size of eyes, and is often combined with various ocular disorders such as cataract. Due to its special intraocular anatomical features, the risk of intraoperative and postoperative complications of cataract surgery in microphthalmos is usually high. Combined with subscleral sclerectomy, peripheral iridectomy, and anterior segment vitrectomy, the incidence of the pre-existing complications in cataract surgery has decreased, meanwhile, the additional procedures may also bring new complications. In-depth understanding of the research progress of cataract surgery in microphthalmos and the prevention of complications is of great guiding significance to improve surgical outcomes, and can reduce the incidence of postoperative complications such as uveal effusion syndrome, secondary glaucoma and corneal edema, and promote personalized treatments for microphthalmos patients who suffered from cataract.

Objective: To explore the effects of dodecanoylcarnitine (DA) and myristoleic acid (MA) on the function of mouse alveolar epithelial cell line MLE-12 and their underlying mechanisms. Methods: An inflammatory model was established by stimulating MLE-12 cells with IL-4. The expression levels of DA, MA, and sphingosine-1-phosphate (S1P) in the cell supernatant were detected by ELISA. MLE-12 cells were separately intervened with DA and MA. RT-PCR and flow cytometry were used to detect the expression changes of inflammatory factors IL-6 and tumor necrosis factor-α (TNF-α) and the level of intracellular reactive oxygen species (ROS). Additionally, Western blot was performed to detect the expression of key proteins such as p38 mitogen-activated protein kinase (p-38 MAPK) and src homology 2 domain-containing phosphatase 1 (SHP-1). To explore the role of S1PR2 in the effects of DA and MA, MLE-12 cells were pretreated with the S1PR2 inhibitor JTE-013, and the above experiments were repeated. Results: IL-4 stimulation significantly upregulated the levels of DA, MA, and S1P in MLE-12 cells (P<0.05). DA/MA treatment groups exhibited significantly increased expression of IL-6 and TNF-α compared with the control group (P<0.05), along with elevated ROS levels (P<0.05). Western blot analysis revealed that DA/MA promoted SHP-1 dephosphorylation and phosphorylated p38 MAPK activation in MLE-12 cells. Notably, JTE-013 pre-treatment completely reversed these effects (P<0.05). Conclusion: Asthma-related metabolites DA and MA exacerbate the inflammatory and oxidative stress responses of MLE-12 cells by activating the S1PR2 receptor, promoting the dephosphorylation of SHP-1 and the activation of the p-p38 MAPK pathway. This study reveals the core regulatory role of S1PR2 in this pathway as well.

Objective: To develop a simple method for producing mice adipose stem cells with highly efficient adipogenic differentiation capability. Methods: Subcutaneous adipose tissue was extracted from wild-type mice. By strictly controlling the digestion time of collagenase, we compared the number of adipose stem cells and their adipogenic differentiation ability obtained for different digestion times. Further, flow cytometry was used to clarify the differences in mesenchymal cells and vascular components at different digestion times. Results: The adipose stem cells obtained after 40 minutes of digestion by collagenase exhibited over 90% adipogenic differentiation ability in vitro, while those obtained after 60 minutes of digestion only showed 20% adipogenic differentiation ability. The main reason for this discrepancy was the presence of a portion of vascular-related cells in the latter. Conclusion: By controlling the digestion time of collagenase in adipose tissue, we have established an efficient method for preparing adipose stem cells with high adipogenic differentiation potential. The obtained adipose stem cells exhibit over 90% adipogenic differentiation ability in vitro.

With the continuous development of perinatal medicine and neonatology, although the survival rate of infants with low gestational age and low birth weight has improved, the incidence of neurodevelopmental morbidities remains high. Breast milk is the preferred source of enteral nutrition for preterm infants, playing an important role in growth, development, immunity, metabolism, and other functions. Of particular note is its effect on the nervous system, not only promoting brain development and maturation in preterm infants, but also effectively reducing the incidence and severity of brain injury, thereby improving long-term neurological outcomes. This review aims to explore the effects of breast milk on brain injury and repair, brain structural maturation, and neurodevelopmental outcomes in preterm infants, in order to further enhance the understanding of the importance of breast milk for the neurodevelopment of preterm infants.

The data from outpatient prescriptions of small-size aspirin enteric-coated tablets (25 mg/tablet) in a community hospital were analyzed to provide reference for rational clinical drug use. Patients' medication information of 1 325 prescriptions was collected and analyzed by defined daily dose system (DDDs) and drug utilization index (DUI), and the rationality of drug use was analyzed according to drug instructions and literature. The mean age of males and females were (73.70±8.33) years old and (72.95±8.34) years old, respectively. The top 3 DDDs age groups were women aged 60-79 years, men aged 60-79 years and women aged 80-99 years. The proportion of prescriptions in female patients was 59.62%. DUI ranges from 0.75 to 0.85. Irrational drug use was found in 123 prescriptions, including 89 prescriptions (72.35%) of inappropriate drug selection, 19 prescriptions (15.45%) with low dose, 6 prescriptions (4.88%) with contraindication, 5 prescriptions (4.06%) with inconsistent frequency of administration, 2 prescriptions (1.63%) of out-of-indication drug use, and 2 prescriptions (1.63%) of high dose. For the phenomenon of irrational drug use, it is necessary to conduct real-time intervention to ensure the safety and effectiveness of drug use.

Objective: To explore the effects of Rutin on multiple organ damage in septic mice and to investigate its mechanism from the perspective of inflammation. Methods: Male C57BL/6 mice were divided into the normal control (sham) group, cecal ligation and puncture (CLP) group, low-dose Rutin group (25 mg/kg), medium-dose Rutin group (50 mg/kg), and high-dose Rutin group (100 mg/kg), there are 20 mouse in each group. All mice were given gavage daily for 7 days starting at 8 weeks of age (the Rutin groups were administered the corresponding doses of the drug, while the sham and CLP groups were given the same volume of saline). Subsequently, sepsis was induced in mice by CLP. The survival rate of mice was analyzed; pathological damage of the lungs, liver, and kidneys in mice was assessed by HE staining; the lung coefficient and wet/dry (W/D) ratio of the lungs were measured; the levels of alanine transaminase (ALT), aspartate aminotransferase (AST), creatinine (CRE), and urea nitrogen (BUN) in mouse serum were detected; the content of urinary protein in mice was measured; the mRNA levels of tumor necrosis factor-α (TNF-α) and IL-6 in mouse tissues were detected by RT-qPCR; and the activation of the JAK2-STAT3 signaling pathway was analyzed by Western blot. Results: Rutin reduced the mortality rate of septic mice, alleviated liver, lung, and kidney damage, improved liver, lung, and kidney functions, inhibited the activation of the JAK2-STAT3 signaling pathway in tissues, and reduced the mRNA expression of pro-inflammatory factors. Conclusion: Rutin may alleviate inflammation by inhibiting the activation of the JAK2-STAT3 signaling pathway, and has a protective effect on liver, lung, and kidney damage in septic mice.

p120-catenin (p120ctn) is one of the crucial members of armadillo family, which is well known as a core stabilizing factor for vascular endothelial cadherin (VE-cadherin). Throughout the entire process of vascular development, p120ctn plays multiple roles. From neovascularization to endothelial barrier, the presence of p120ctn is indispensable. It participates in regulating the normal development of vertebrate embryo vasculature and promoting endothelial cell proliferation. Additionally, p120ctn contributes to the maintenance and remodeling of adherens junctions and can modulate adhesion strength by altering cell morphology. This review summarized the latest research progress on p120ctn from neovascular development and endothelial barrier function.

Objective: To explore the association between psychological resilience and internet addiction among senior primary school students, so as to provide a scientific basis for formulating strategies for preventing internet addiction and enhancing psychological resilience in this group. Methods: A stratified cluster sampling method was employed. In May 2021, a total of 1 618 fourth- and fifth- grade students from 5 primary schools in Jiading District, Shanghai were surveyed on psychological resilience and internet addiction through questionnaires. Independent sample t-tests, chi-square tests, and Logistic regression models were used for data analysis. Results: Among the 1 618 students, the prevalence rate of internet addiction was 8.8%(142 students). The total score of psychological resilience (t=6.215, P < 0.001) and the scores of three dimensions, namely family support (t=3.509, P < 0.001), goal focus (t=6.965, P < 0.001), and positive perception (t=5.887, P < 0.001), of those reported with internet addiction were all significantly lower than those without internet addiction. Multivariate logistic regression analysis showed that compared with individuals with low psychological resilience, those with moderate (aOR=0.395, 95%CI: 0.267-0.584, P < 0.001) and high psychological resilience (aOR=0.167, 95%CI: 0.077-0.365, P < 0.001) had a lower probability of internet addiction. The three sub-dimensions of psychological resilience, namely goal focus, positive perception and family support, also showed a statistically significant negative association with internet addiction in these students. Conclusion: Nearly one-tenth senior primary school students in Jiading District self-reported internet addiction. Higher levels of psychological resilience were associated with a lower probability of internet addiction among senior primary school students. Focusing on enhancing the goal focus, positive perception and family support dimensions in psychological resilience may be of great significance for preventing internet addiction among senior primary school students.

Objective: To investigate the ameliorative effects and mechanisms of six types of tea (green tea, cyan tea, red tea, white tea, black tea and yellow tea) on metabolic disorders in obesity mice induced by high-fat diet (HFD). Methods: Four-week-old male C57BL/6J mice were randomly divided into 8 groups with 7 mice per group. An HFD-induced obese mouse model was established, and the mice in control group maintained on standard diet followed by intragastric administration of different teas for 5 weeks. The body weight, liver weight ratio, fasting blood glucose, and lipid profile of the mice were measured to assess glucose and lipid metabolism. Serum inflammatory factors including IL-6, tumor necrosis factor-alpha (TNF-α) and oxidative stress markers [malondialdehyde (MDA) and superoxide dismutase (SOD) were measured. Additionally, liver histopathology and the expression of key glycolipid metabolism-related genes, adenosine monophosphate-activated protein kinase (AMPK) and carnitine palmitoyltransferase 1 (CPT-1), were analyzed to explore underlying mechanisms. Results: Cyan tea significantly suppressed weight gain, demonstrating superior weight control. White tea markedly reduced fasting blood glucose levels and decreased the area under the curve of oral glucose tolerance test (OGTT) and insulin tolerance test (ITT), indicating synergistic improvements in glucose metabolism and insulin sensitivity. Yellow tea exhibited exceptional anti-inflammatory and antioxidant effects, reducing hepatic IL-6 and MDA while enhancing SOD activity. Green tea activated the lipid oxidation pathway by upregulating AMPK/CPT-1 expression. All kinds of tea significantly attenuated hepatic lipid droplet accumulation. Conclusion: All six types of tea alleviated metabolic disorders by reducing hepatic fat content in obesity mice. However, different types of tea exert their unique effects on improving metabolic disorders through differential mechanisms such as glucose metabolism regulation, lipid oxidation, and anti-inflammatory and antioxidant actions.

The impact of hypertensive disorders of pregnancy (HDP) on maternal and fetal outcomes is well-established. However, the relationship between high-normal blood pressure (BP) and HDP, as well as its association with adverse maternal-fetal outcomes, remains unclear. This retrospective study analyzed singleton pregnancies delivered at Obstetrics and Gynecology Hospital, Fudan University from Jan 2021 to Dec 2021. Participants were categorized into a normal BP group (BP < 130/80 mmHg before delivery admission) and two high-normal BP groups (BP: 130-139/80-89 mmHg) with subgroup analysis based on gestational week of BP elevation before and after 20 weeks. Maternal characteristics, HDP incidence and adverse outcomes were compared across groups. The results demonstrated that compared with the normal BP group, both high-normal BP groups showed significantly increased HDP incidence, with more pronounced risk in the high-normal BP (after 20 weeks) group. The high-normal BP (before 20 weeks) group was associated with elevated risks of iatrogenic preterm birth and small for gestational age (SGA). This study provides a theoretical basis for implementing stricter BP monitoring strategies to reduce adverse maternal and neonatal outcomes.

To explore the mediating effect of resilience between sleep quality index and quality of life in lung cancer patients, we used General data questionnaire, Pittsburgh Sleep Quality Index, Connor-Davidson Resilience Scale, Chinese version Memorial Symptom Assessment Scale and functional Assessment of Cancer Therapy-Lung to investigate 218 lung cancer patients in the Department of Respiratory and Critical Care Medicine, Zhongshan Hospital, Fudan University during Nov 2023 to Feb 2024. A structural equation model was constructed to analyze the mediating effect of resilience between sleep quality index and quality of life. The sleep quality of lung cancer patients was in mild sleep disturbance. There was a negative correlation between sleep quality index and quality of life. Resilience of the patients partly mediated the relationship between sleep quality index and quality of life with an effect of 0.826, accounting for 28.47% of the total effect. Doctors and nurses should pay attention to enhancing the resilience level of lung cancer patients and improving their impact of sleep disturbance on the quality of life.

The lung is a vital organ that is in direct contact with the external environment. It is extremely susceptible to a variety of exogenous factors, which can trigger a series of inflammatory responses and lead to varying degrees of tissue damage. With the development of genetic engineering technology, silencing specific target genes through RNA interference has become a new strategy for the treatment of lung injury. Small interfering RNA (siRNA) is a crucial role in RNA interference that can bind to the target gene through base complementary pairing to inhibit its expression, thereby producing a corresponding regulatory effect. Due to its specific targeting and low biological toxicity, siRNA is gradually becoming an ideal tool for the treatment of lung injury and other lung diseases. This article reviews the mechanism of action of siRNA and its application progress and research status in the treatment of lung injury.

Objective: To investigate the effect of rapid maxillary expansion (RME) on sagittal soft and hard maxillofacial tissue in growing children. Methods: In this retrospective study, children aged 6-12 years treated in Shanghai Stomatology Hospital from Jan 2018 to Dec 2020 were employed as subjects. Of the subjects, 40 patients treated with RME were as the experimental group, 27 patients presenting individualized malocclusion were as the control group. Lateral cephalogram was taken before (T0) and 2 years after treatment (T1). The images were imported into Dolphin Imaging's cephalometric measurement software, and the results were statistically analyzed using SPSS 22.0 software. Results: Statistically significant differences were observed in all measurements before and after treatment in both two groups. A comparative analysis revealed that SNB value increased and ANB value decreased in the experimental group after treatment, while the changes in the control group were significantly smaller than those in the experimental group (P<0.05), indicating that RME is beneficial to the growth and development of mandibular in sagittal direction. Among the dentoalveolar measurements, statistically significant differences (P<0.01) were observed in U1-SN (upper incisor to sella-nasion angle), U1-NA (upper incisor to nasion-A point angle), U1-APog (upper incisor to A point-pogonion line distance), and overjet between the two groups. These findings indicate that RME significantly reduces the inclination of the maxillary central incisors, while having no significant effect on the mandibular central incisors. Compared with the control group, RME significantly reduced upper lip prominence, lip space and upper central incisor exposure (P<0.05), but had no effect on nose, chin and their correlation. Conclusion: RME not only improved the prominence of the upper teeth and upper lip, but also facilitate the sagittal growth of mandibular in growing children.

Objective: To analyze the current status of malaria vaccine research from 2019 to 2024 by using bibliometric methods. Methods: Based on the Web of Science core collection database, we used VOSviewer to conduct a visual analysis of the publishing trends, publishing journals, international cooperation status, institutions and research hotspots of malaria vaccine research. Results: A total of 2 467 relevant articles were retrieved, and the annual number of publications showed a stable trend. The number of articles published by different countries/regions varied greatly, and the top effect was obvious. The United States published the most papers (1 032 articles, 41.83%).The international cooperation network reflected the regional collaborative relationships in malaria vaccine research, predominantly involving the United States, the United Kingdom, Australia, India and China. Through keyword co-occurrence clustering, the current research hotspots in the field of malaria vaccines were basic research on key sites and mechanisms of potential vaccines, clinical research on new vaccines, epidemiological studies on the impact of malaria vaccines on malaria transmission, etc. Conclusion: In recent years, malaria vaccine research has received sustained attention. The translation of clinical research on malaria vaccine was currently accelerating, and children and women were still the key groups of concern.

Objective: To retrospectively analyze the association between metabolic factors and high-risk colorectal adenoma (CRA). Methods: The medical records of patients aged 18-75 years who underwent their initial colonoscopy at Karamay Central Hospital of Xinjiang Uygur Autonomous Region from Jul 2000 to Mar 2017 were collected. The comparison between normal colonoscopy (NC) and high-risk CRA patients was conducted using an unpaired t-test, while chi-square test was used for categorical variables. Least absolute shrinkage and selection operator (LASSO) regression and Logistic regression were utilized to analyze the association between metabolic factors and high-risk CRA. Results: A total of 1 798 patients meeting the inclusion and exclusion criteria were enrolled and divided into normal colonoscopy (NC) findings group (n=972) and high-risk CRA group (n=826). The high-risk CRA group exhibited significantly lower levels of high-density lipoprotein cholesterol (HDL-C) in comparison to the NC group, while uric acid and fibrosis 4 (FIB-4) index levels were significantly higher than those observed in the NC group (all P < 0.05). Based on LASSO regression analysis, we identified 12 variables that potentially influence the occurrence of high-risk CRA, including age, gender, smoking history, alcohol consumption history, non-alcoholic fatty liver disease (NAFLD), hypertension, coronary artery disease, hyperglycemia, hypercholesterolemia, low levels of HDL-C, elevated alanine aminotransferase, and elevated gamma-glutamyl transferase. Multivariate analysis revealed that individuals aged over 50 years, male gender, cigarette and alcohol consumption, low HDL-C levels, history of NAFLD and hypertension were identified as independent risk factors associated with high-risk CRA (P < 0.05). In addition, without or with adjusting for age, sex, smoking, and drinking history, patients with a high TG/HDL-C ratio (the ratio≥2.68) had a significantly higher risk of high-risk CRA than those with a low TG/HDL-C ratio (the ratio < 2.68) [odds ratios (ORs) were1.430 and 1.235 respectively, all P < 0.05)]. Without or with adjusting variables, the ORs for NAFLD patients with FIB-4 index > 2.67 were 1.849 (P=0.466) and 1.435 (P=0.707), respectively. Conclusion: A significant association exists between metabolic factors and high-risk CRA. Independent risk factors for high-risk CRA include older age (≥50 years), male, smoking history, alcohol consumption history, low levels of HDL-C, and a history of NAFLD and hypertension. Individuals exhibiting a TG/HDL-C ratio exceeding 2.68 manifest a significantly heightened susceptibility to the development of high-risk CRA. Therefore, elderly males with one or more aforementioned metabolic abnormalities should be considered a priority population for colorectal screening.

Transthoracic echocardiography (TTE) is the preferred noninvasive modality for screening and diagnosing pulmonary hypertension (PH). By measuring parameters such as tricuspid regurgitation velocity (TRV), TTE can estimate pulmonary artery systolic pressure (PASP) and evaluate right heart function. TTE plays a critical role in the early screening, risk stratification, and prognostic assessment of PH, particularly in large-scale epidemiological studies. Furthermore, in percutaneous valvular interventions (e.g., transcatheter aortic valve replacement, mitral valve edge-to-edge repair), TTE provides essential hemodynamic data for patient selection, intraoperative decision-making, and postoperative follow-up. This review summarizes recent advances in TTE for PH evaluation and its application in valvular interventions in order to support clinical practice.

Objective: To investigate the differences in demographic characteristics, reproductive health status, and the distribution of pregnancy-related diseases between couples conceived via assisted reproductive technology (ART) and naturally conceived couples, and to analyze the impact of ART treatment on the incidence of preterm birth (PTB) in singleton and twin and multiple pregnancies. Methods: We conducted a retrospective analysis of the maternal and infant cohort data of Jing'an District from 2013 to 2020. Based on the conception method, the subjects were categorized into two groups: the ART group and the natural conception group. Chi-square test was applied to compare baseline characteristics and disease distributions differences between the two groups, and logistic regression models were used to evaluate the association between ART and the PTB risks. A causal mediation model was used to evaluate the mediating effect of twin and multiple pregnancy in the relationship between ART and PTB. Results: A total of 117 717 parturients were included, 6 265 in the ART group and 111 452 in the natural conception group.Compared with the natural conception group, couples in the ART group were significantly older and had a higher prevalence of reproductive system diseases. The incidences of diabetes and hypertensive disorders during pregnancy in ART parturient were 13.76% and 9.99%, respectively, which were significantly higher than 7.88% and 4.75% in the natural conception group (both P < 0.001). The overall PTB rate in the ART group was 14.81%, higher than 5.35% in the natural conceptions group (P < 0.001). The PTB rate in ART for singleton pregnancies in the ART group was 6.40%, higher than 4.83% in the natural conception group (P < 0.001), while the PTB rate in ART for twin and multiple pregnancies in the ART group was 53.97%, lower than 60.42% in the natural conception group (P < 0.05). Mediation analysis showed that 97.99% of the effect of ART on PTB was mediated by twin and multiple pregnancy, with ART increasing the PTB risk by 3.44 times through multiple pregnancy. Conclusion: The overall PTB rate of ART recipients is higher than that of natural recipients, but ART does not increase the PTB risk in singleton and twin and multiple pregnancies. Twin and multiple pregnancy is the key mediating factor contributing to PTB in ART-conceived recipients. Compared with naturally conceived couples, ART conception couples own more advanced maternal age, and have higher risks of suffering gestational diabetes, gestational hypertension, and PTB.

Objective: To organize and summarize the medication rules of GU Nai-fang in treating skin diseases through real-world data. Methods: We collected traditional Chinese medicine prescriptions for GU Nai-fang's treatment of skin diseases from the outpatient medical record system of Shanghai Traditional Chinese Medicine Hospital to establish a database. Statistical analysis of disease types, performance, and efficacy was conducted, and association rules and systematic clustering analysis were performed using SPSS Modeler 18.0 and SPSS 26.0 software, respectively. Results: A total of 5 020 patients were included, and 5 020 prescriptions were collected, involving 241 traditional Chinese medicines with a total frequency of 85 758 uses. The frequency of using heat clearing drugs, deficiency tonifying drugs, blood activating and stasis removing drugs, surface clearing drugs, and wind and dampness dispelling drugs was relatively high; most drugs tended to be cold and warm, mainly targeting the heart, lungs, and colon meridians. The top 15 Chinese medicines with the highest frequency of use were Smilacis Glabrae Rhixoma, Cortex Moutan, Radix Paeoniae Rubra, Rehmanniae Radix, Scutellariae Radix, Cynanchi Paniculati Radix et Rhizoma, Schisandrae Chinensis Fructus, Violsse Herba, Mume Fructus, Herba Pyrolae, Hedyotis Diffusae Herba, Lonicerae Japonicae Flos, Cicadae Periostracum, Bombyx Batryticatus, Radix Salviae. Association rule analysis obtained 15 high-frequency combinations of 2 traditional Chinese medicines and 3 traditional Chinese medicines. Cluster analysis resulted in 7 clustered prescriptions. Conclusion: GU Nai-fang commonly used heat clearing drugs, deficiency tonifying drugs, blood activating and stasis removing drugs, surface resolving drugs, and wind and dampness dispelling drugs in the treatment of skin diseases, and Smilacis Glabrae Rhixoma, Cortex Moutan, Radix Paeoniae Rubra, Rehmanniae Radix, and Scutellariae Radix were the most frequently used drugs.

With the widespread application of electronic health record (EHR) in medical researches, the problem of multi-source heterogeneity has increasingly become a key challenge affecting the validity of observational studies. Differences in data sources, formats, coding standards, and population coverage in different healthcare systems can easily lead to selection bias, information bias, confounding bias, and immortal time bias, thereby weakening the reliability of causal inference. This paper systematically analyzed the sources and characteristics of EHR heterogeneity, including data structure differences, coding inconsistencies, and population heterogeneity, discussed the mechanism of its role in various biases, and its impact on the research results based on empirical cases. Then integrated data standardization, multiple imputation, sample weighting, propensity score matching (especially high-dimensional propensity score hd-PSM), instrumental variable analysis and DAG-assisted adjustment, and finally constructed a systematic framework for bias control and validation. A comprehensive framework that integrates standardized data processing processes, rigorous study design, advanced analytical control strategies, and objective validation methods is essential for deriving robust and credible scientific conclusions from EHR data.

Objective: To analyze the global research literature on monkeypox from 2014 to 2024 through bibliometric analysis, and provide reference for monkeypox research in China. Methods: Based on data from the Web of Science Core Collection database and utilizing the visualization analysis capabilities of VOSviewer software, we employed keyword co-occurrence analysis and national cooperative network analysis methods and examined the trends in monkeypox research publications, popular journals, high-yield institutions, international collaborations, and keywords. Results: A total of 2 396 papers were published from 2014 to 2024, with a significant increase in publications after 2022. The United States had the highest number of publications (808 papers, accounting for 33.72%). The network of international scientific collaborations showed close cooperation between the United States and countries like the United Kingdom and Canada, frequent collaborations among developing countries such as China and India, and extensive cooperation among European countries like Italy and Spain, which also established partnerships with Brazil, Mexico, and others. Keywords co-occurrence clustering and essential science indicators (ESI) highly cited papers revealed that the monkeypox research hotspots after 2022 including the analysis of the virology, clinical, epidemiological characteristics of the global outbreak in 2022, uncovering the causes of the global outbreak and the differences from previous outbreaks. Studies on vaccines and antiviral drugs also gradually became focal points. Conclusion: Since the outbreak of monkeypox in 2022, monkeypox research has developed rapidly. Papers focus on specific populations, and gradually shifting from virological, clinical and epidemiological characterization to the development of new drugs, vaccines, and clinical validation studies.