To evaluate the features of carotid web (CW) by ultrasonography.

A total of 66 patients with CW were retrospectively enrolled from January 2018 to June 2019 at Xuanwu Hospital, Capital Medical University. All patients were examined by both ultrasonography and CTA, and were divided into either a<50% stenosis group (54 cases) or a ≥50% stenosis group (12 cases). The ultrasonographic characteristics of CW, including the length, thickness, direction (forward or backward to the flow), acute angle between the web and carotid wall, and thrombus between the web and carotid wall were compared between the two groups. The stenosis degrees of carotid artery were compared between patients with and without ischemic stroke.

Forty-two (42/66, 63.6%) patients were diagnosed with CW by initial CDFI examination, of whom 21 (21/66, 31.8%) were diagnosed with ulcerative plaque and 3 (3/66, 4.5%) were diagnosed with carotid dissection at first but confirmed by second examination. There were no differences in the web length, thickness, direction, or thrombus detected between the two groups (P>0.05). The angle between the web and carotid wall in the<50% stenosis group was significantly smaller than that of the ≥50% stenosis group (median angel 39o vs 73o, P=0.002), and the percentage of patients with an angle≤ 60o in the<50% stenosis group was significantly higher than that of the ≥50% stenosis group (74.1% vs 41.7%, P=0.042). The diameter of the residual carotid artery at CW location in the<50% stenosis group was significantly larger and peak systolic velocity was significantly higher in the<50% stenosis group than in the≥50% stenosis group (P<0.001). The stenosis degrees of carotid artery were not statistically different between patients with and without ischemic stroke (P=0.321).

Ultrasonography can be used to evaluate the characteristics of carotid web in 2D and color mode. When the angle between the CW and carotid wall is large, the carotid artery stenosis ≥ 50% is more likely to happen, but carotid artery stenosis is not the main cause of ischemic stroke.

The aim of the present study was to evaluate the efficiency of sling exercise, therapeuticultrasound, therapeuticultrasound and sling exercise in patients to alleviate pain and improve lumbar function with lumbar disc herniation.

Individuals were selected from a list of patients being followed at the department of Rehabilitation in the third hospital of Hebei Medical University. 30 patients who were diagnosed with lumbar disc herniation were collected, the diagnoses were established upon medical history, physical examination, and results of imaging studies. The patients were randomly divided into three groups: therapeuticultrasound group received 14 sessions of ultrasonic therapy to the lumbar region, Sling exercise group received 14 sessions of sling exercise, and therapeuticultrasound and sling exercise group received therapeuticultrasound and sling exercise therapy 14 sessions of therapeuticultrasound to the lumbar region,7 sessions per week, 2 weeks. The VAS and ODI were compared with the assessment of the patients before and at the end of the therapy.

At the end of treatment, three groups VAS scores (F=3.069, P=0.043) and ODI scores (t=12.676, P<0.001) was lower than that at the beginning of treatment (P<0.05), at the end of treatment the VAS scores (F=59.400, P<0.001) and of the ODI scores (t=12.737, P<0.001) of ultrasonic and sling exercise therapy group was lower than the other group, the difference is significantly.

All three groups could reduce pain and improve lumbar function, and the ultrasonic and sling exercise therapy was most effective for lumbar disc herniation treatment in the three groups.

To analyze the treatment of different types of traumatic cerebral infarction in children, and explore its pathogenesis in combination with literature so as to improve the cure rate and reduce disability rate.

The clinical data of 42 cases of traumatic cerebral infarction in children were retrospectively analyzed in The Hospital of 81^st Group Army PLA from January 2015 to December 2019. The diagnosis of traumatic cerebral infarction in children was made by CT scan and MRI scan. According to different conditions, children with traumatic cerebral infarction were classified, and different treatment strategies were selected. Children with lacunar infarction were treated with calcium antagonists and neurotrophic drugs, supplemented by hyperbaric oxygen and exercise rehabilitation. The children of focal cerebral infarction and complex cerebral infarction treated by junior dehydrant and hormone also included the calcium antagonist and nutritional nerve drugs. The therapeutic regimen perhaps adjusted by the evolution of the disease. The children of extensive cerebral infarction underwent emergency cranial decompression, and was treated by reducing intracranial pressure and preventing complications after operation. The treatment results and recovery were observed.

In 42 cases of traumatic cerebral infarction in children, 35 cases (83.3%) were good recovery, 4 cases (9.5%) were moderate disability, 2 cases (4.8%) were severe disability, 1 case (2.4%) died, and no vegetative state. The good recovery rate of lacunar infarction was 100%, that of focal cerebral infarction was 62.5%, that of mixed cerebral infarction was 60%, and that of extensive cerebral infarction was 50%.

It is of great significance to improve the therapeutic effect and prognosis of children with traumatic cerebral infarction to adopt different treatment schemes for different types of cerebral infarction.

To characterize the patients with supratentorial hypertensive intracerebral hemorrhage (ICH) in the Tibetan Plateau over an altitude of 4000 meters.

A total of 68 cases with supratentorial hypertensive ICH were retrospectively included in Ali Regional People’s Hospital from January 2017 to September 2018. The clinical and laboratory data were collected. A simple linear correlation analysis was applied to analyze the correlation between the amount of bleeding and sex, age, nationality, time from onset , systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), serum triglyceride (TG), and cholesterol. According to computed tomography (CT) findings, 68 cases were divided into the basal ganglia ICH group (33 cases) and the lobar ICH group (35 cases). The characteristics between two groups were analyzed using t-test or χ² test.

The data of sex, age, nationality, time from onset, SBP, DBP, Hb, TG, and cholesterol of 68 cases on admission did not show any definitive correlation with the hematoma volumes (P＞0.05). The SBP and DBP of patients in the basal ganglia ICH group were significantly higher than that in the lobar ICH group, respectively [(184.9±28.5) mmHg vs (164.6±24.4) mmHg; (113.0±18.1) mmHg vs (103.0±18.4) mmHg] (t=0.499, 0.486; P=0.002, 0.033).

The relevant factors of hematoma volumes in patients with ICH in plateau area were not yet clear. Diastolic and systolic blood pressure of patients in the basal ganglia ICH group was higher than that in those in lobar ICH group.

To compare the efficacy evaluation of electrospun composite biomaterials and a porcine small intestine submucosa mesh for hernia repair.

A randomized, single-blind, controlled multicenter trial was performed in 3 hospitals in Shanghai. Eligible adult patients with primary unilateral reducible groin hernias were randomly assigned (1∶1) to electrospun composite biomaterials (experimental group) or porcine small intestine submucosa (control group) mesh groups. Patients were treated with the tARB technique and assessed at 1,3 and 6 months after the surgery. The primary endpoint was hernia recurrence. The secondary endpoints were postoperative complications including groin pain and operative site infections.

172 patients were assigned to experimental (n=86) and control (n=86) groups. At 6 months follow-up, postoperative complications occurred in 5 patients (5/86, 5.95%) and 2 (2/86, 2.35%) patients in the control and experimental groups, respectively (P>0.05). There was no significant difference in VAS or SVS score between the two groups.

We demonstrate that electrospun composite biomaterial mesh can be used as a ideal choice for inguinal hernia repair. Electrospun composite biomaterial has the characteristics of low recurrence rate, absorbability and long-term comfort.It can be further applied in clinical practice in the future.

Pancreaticoduodenectomy(PD)remains one of the most complicated hepatobiliary operations. The development of minimally invasive surgery for PD has always been an hot spot. Laparoscopic pancreaticoduodenectomy(LPD) has not been widespread carried out due to its difficulty and long learning curve. LPD accounts for 9% of all PD, according to the National Cancer Data base. Compared with laparoscopic surgery, robotic surgery system has significant advantages in the field of minimally invasive PD, including stereotactic amplified vision, filtering hand tremor and simulating the wrist. The article would review the surgical techniques and notes, which could provide clinical reference for other surgeons.

To compare the short-term efficacy and long-term prognosis of robot-assisted hepatectomy versus laparoscopic hepatectomy in the treatment of hepatocellular carcinoma (HCC).

This retrospective study analyzed patients with hepatocellular carcinoma who underwent robot-assisted hepatectomy or laparoscopic hepatectomy in the Department of Hepatobiliary and Liver Transplantation Surgery, Gulou Hospital affiliated to Nanjing Medical University between 2021 and 2023. After applying the inclusion and exclusion criteria, a total of 221 patients were included, including 51 patients in the robotic group and 170 patients in the laparoscopic group. Propensity score matching (PSM) was performed at a 1∶1 ratio between the two groups. Perioperative outcomes, including hepatic inflow occlusion time, operative time, intraoperative blood loss, intraoperative transfusion volume, conversion to open surgery, 30-day readmission, postoperative complications, and length of hospital stay, were compared between the groups. Kaplan-Meier analysis was used to estimate and compare progression-free survival (PFS) between the two groups.

Before PSM, the robotic liver resection group exhibited shorter PT duration (P=0.022) and a lower incidence of cirrhosis (P=0.009). Patients in the robotic hepatectomy group had significantly larger tumor diameters in the resected specimens compared with those in the laparoscopic group (P=0.007). The robotic approach demonstrated a more pronounced advantage in conventional major hepatectomy (P<0.001) and showed stronger selectivity in surgeries with high Iwate difficulty scores (P<0.001). Perioperative outcomes before matching indicated that the robotic group had a significantly longer operative time than the laparoscopic group (200 min vs. 180 min, P=0.006) and a higher rate of Clavien-Dindo complications (Grade Ⅰ+ Ⅱ+ Ⅲ: 21.6% vs. 7.6%, P=0.020). After PSM, no significant differences were observed between the two groups in perioperative outcomes, including operative time, hepatic inflow occlusion time, intraoperative blood loss, intraoperative transfusion, postoperative hospital stay, conversion to open surgery, 30-day readmission, or Clavien-Dindo complication grade (all P>0.05). Long-term prognosis before and after PSM also showed no statistically significant difference in PFS between the robotic and laparoscopic groups (P>0.05).

Robot-assisted hepatectomy is an acceptable alternative to laparoscopic hepatectomy for the treatment of HCC, with no statistically significant difference in overall safety between the two approaches. Notably, the robotic approach may offer potential advantages in complex hepatectomy procedures and long-term prognosis (PFS).

To evaluate the feasibility and perioperative safety of three-dimensional computed tomography bronchography and angiography (3D-CTBA)-guided thoracoscopic split segmentectomy for deep pulmonary nodules.

Clinical data of consecutive patients screened for thoracoscopic split segmentectomy at a single center between Jan. 2020 and Dec. 2024 were retrospectively reviewed. A deep pulmonary nodule was defined as a nodule with a depth ratio >1/3. Preoperative thin-section computed tomography and three-dimensional reconstruction were used to assess the spatial relationships between the lesion and the segmental or subsegmental bronchi and vessels. A virtual 2-cm margin sphere was used to plan the individualized extent of resection. Intraoperatively, the lung parenchyma was split to establish an anatomical access route, followed by single segmentectomy or subsegmentectomy, or combined segmental and subsegmental resection. Outcomes included completion of the planned procedure, surgical margin distance, and perioperative outcomes.

Thirty patients were screened, of whom 6 with peripheral pulmonary nodules were excluded, leaving 24 patients for analysis. The mean lesion diameter was 0.99±0.27 cm, and the mean depth ratio was 0.40±0.06. Thirteen individualized resection combinations were performed. All 24 procedures were completed as planned, without extended resection or conversion to lobectomy. The mean surgical margin distance was 2.14±0.37 cm, operative time was 143.0±46.2 min, intraoperative blood loss was 44.2±17.5 mL, and postoperative hospital stay was 3.33±0.84 days. Prolonged air leak lasting >5 days occurred in 2 patients (8.3%). No reoperation, readmission, or 30-day mortality was observed.

With strict patient selection and three-dimensional reconstruction-based planning, split segmentectomy is safe and feasible for deep pulmonary nodules and can achieve adequate surgical margins.

Local pancreatic duct stricture (LPDS) is defined as focal narrowing, cutoff or irregular tapering of the main pancreatic duct or branch pancreatic ducts, which may be accompanied by upstream pancreatic duct dilatation, parenchymal atrophy, impaired pancreatic juice drainage, calculi, pancreatic fistula or recurrent pancreatitis. LPDS can result from benign conditions including chronic pancreatitis, pancreatic duct stones, postoperative anastomotic stricture, trauma and autoimmune pancreatitis; it may also serve as an early indicator of pancreatic ductal adenocarcinoma, high-grade pancreatic intraepithelial neoplasia (PanIN), intraductal papillary mucinous neoplasm (IPMN) or other neoplasms. In recent years, advances in endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasonography (EUS), peroral pancreatoscopy (POPS), EUS-guided pancreatic duct drainage (EUS-PD), sequential pancreatic juice cytology, EUS-guided fine-needle aspiration/biopsy (EUS-FNA/FNB) and pancreatic duct stenting have transformed the diagnosis of LPDS from simple morphological assessment to an integrated "imaging-endoscopy-histology-molecular" evaluation. Correspondingly, treatment has evolved from straightforward dilation and stent placement to individualized strategies stratified by etiology, anatomical features and risk profiles. This review summarizes the definition, etiologies, endoscopic diagnostic algorithms, management of benign and malignant strictures, interventions for refractory strictures, prevention and treatment of complications, and cutting-edge advances of LPDS, aiming to provide evidence for establishing standardized and practical endoscopic diagnosis and treatment workflows in clinical practice.

Adenomyosis is a common benign gynecological disease in women of reproductive age, characterized by the invasion of endometrial glands and stroma into the myometrium, accompanied by hyperplasia and hypertrophy of the surrounding myocytes. Its clinical manifestations mainly include progressively worsening dysmenorrhea, menorrhagia, chronic pelvic pain, and infertility, severely affecting patients' quality of life. Treatment strategies primarily include medical therapy and surgical treatment. For patients with severe symptoms who do not respond to medical therapy or have fertility requirements, surgical treatment is an important option. Radical surgery, i. e., hysterectomy, can cure the disease but deprives patients of fertility and brings about a series of physiological and psychological impacts. Therefore, uterus-preserving conservative surgical approaches are receiving increasing attention. This article aims to systematically review the latest advances in conservative surgical treatment of adenomyosis and provide an outlook on future directions.

Laparoendoscopic single-site surgery (LESS) has become an increasingly adopted method in minimally invasive gynecologic surgery, its advantages include reduced abdominal wall trauma, improved cosmetic satisfaction, less postoperative pain, and shorter recovery. Enhanced Recovery After Surgery (ERAS) is built on evidence-based perioperative medicine, its core components involve preoperative patient education, intraoperative fluid and temperature management, multimodal analgesia, and early postoperative feeding and mobilization. In gynecologic surgeries, combining ERAS with LESS has shown obvious clinical benefits including reductions in length of stay, lower analgesic requirements, and complication rates below 10% in selected patient cohorts. This review mainly introduces the combining application of LESS and ERAS to optimize the results of patients with gynecologic surgeries in authors′ center.

To investigate the expression characteristics, prognostic significance, and the association of hephaestin (HEPH) with cell migration, invasion, and epithelial-mesenchymal transition (EMT) in pancreatic cancer.

Expression differences of HEPH in pan-cancer and pancreatic cancer tissues were analyzed through public databases, with validation of HEPH expression levels in clinical samples. Survival analysis and receiver operating characteristic (ROC) curves were used to evaluate the prognostic value of HEPH. Gene set enrichment analysis (GSEA) was performed by grouping samples based on HEPH expression levels and using gene expression fold change as the ranking metric to identify significantly enriched biological pathways. Stable HEPH knockdown pancreatic cancer cell lines, PANC-1 and SW1990, were established. Cells infected with pLKO.1-Puro empty vector lentivirus were designated as the scramble group (negative control), and cells infected with shHEPH lentivirus were designated as shHEPH-1, shHEPH-2, and shHEPH-3 knockdown groups. Knockdown efficiency was verified by RT-qPCR and Western blot. The effects of HEPH on cell migration and invasion were assessed using scratch and Transwell assays. Expression changes of EMT-related markers (E-cadherin, N-cadherin, and Vimentin) were measured. Comparisons between two groups were performed using independent samples t-test. Comparisons among multiple groups were analyzed by one-way ANOVA followed by Dunnett's t-test for pairwise comparisons. Survival analysis was conducted using univariate Cox regression to calculate hazard ratios and 95% confidence intervals, and Kaplan-Meier survival curves were plotted.

HEPH was highly expressed in pancreatic cancer tissues, and high expression was associated with shorter overall survival in patients (HR = 1.55, P = 0.038). ROC analysis showed that the AUCs of HEPH for 3-year and 5-year overall survival of pancreatic cancer patients were 0.638 and 0.678, respectively. Immunohistochemical and paired tissue analyses further confirmed the high expression of HEPH in pancreatic cancer tissues. GSEA revealed that the EMT pathway was significantly enriched in the high HEPH expression group (NES = 3.000, P < 0.001). Compared with the scramble group, knockdown of HEPH reduced the migration (PANC-1: 148.70 ± 19.30 vs 314.30 ± 55.97; SW1990: 175.00 ± 24.58 vs 425.00 ± 26.51) and invasion (PANC-1: 97.67 ± 15.57 vs 227.70 ± 21.73; SW1990: 90.67 ± 11.93 vs 321.30 ± 34.70) abilities of PANC-1 and SW1990 cells (all P < 0.01). Compared to the control group, the HEPH knockdown group showed increased E-cadherin expression (PANC-1: 3.07 ± 0.48 vs 1.00 ± 0.05; SW1990: 2.58 ± 0.41 vs 1.00 ± 0.02; all P < 0.000 1) and decreased N-cadherin (PANC-1: 0.33 ± 0.06 vs 1.01 ± 0.05; SW1990: 0.44 ± 0.08 vs 1.00 ± 0.05; all P < 0.01) and Vimentin (PANC-1: 0.36 ± 0.06 vs 1.00 ± 0.02; SW1990: 0.39 ± 0.06 vs 0.99 ± 0.02; all P < 0.01) expression.

HEPH is highly expressed in pancreatic cancer and is associated with poor prognosis. Knockdown of HEPH suppresses migration and invasion of pancreatic cancer cells, accompanied by altered expression of EMT markers, suggesting that high HEPH expression is correlated with EMT activation and enhanced migratory/invasive capabilities. This suggests that HEPH may serve as a potential biomarker for prognosis and therapeutic intervention in pancreatic cancer.

To explore the effects and duration of adipose-derived mesenchymal stem cells (ADSCs) on cartilage injury and inflammatory response in knee osteoarthritis (KOA) rats.

Forty-five male SD rats were divided into the blank group, model group and treatment group randomly. Fourteen days after the KOA model establishment, the rats in the treatment group were injected with 1×10⁶ ADSCs/50 μL into the articular cavity while rats in the blank group and the KOA model group were injected with the same volume of normal saline once a week for four consecutive injections. The rats were observed at 4 weeks, 8 weeks and 12 weeks (n = 5) after the first injection. Independent blank group, model group and treatment group were set up at each observation time point. The mechanical pain threshold and thermal pain threshold of rats in each group were monitored and recorded. The degree of cartilage degeneration was observed by micro CT, HE-staining, Safranine O-fast green staining and Alcian blue staining. The protein expressions of collagen Ⅱ (COL2A1) and aggrecan (ACAN) were detected by immunohistochemistry. The expression levels of inflammatory factors IL-1β and TNF-α in articular cavity lavage fluid were detected by ELISA. Two-way factorial design ANOVA was used to analyze the main effect of group and observation time for all measurement data, and Bonferroni post-test was used for pairwise comparison.

The main effects of group in mechanical pain threshold, bone volume fraction, trabecular bone separation, Mankin score, OARSI score, COL2A1 and IL-1β in each group were statistically significant (all P < 0.05), while there was no significant difference in the main effects of time (all P > 0.05); The main effects of group and time were significant in terms of thermal pain threshold, trabecular thickness, trabecular number, ACAN and TNF-α (all P < 0.05). Compared with the blank group, the mechanical pain threshold, the thermal pain threshold, bone volume fraction, trabecular thickness and trabecular number [4 weeks: (0.92 ± 0.02) vs (1.17 ± 0.05) mm^-1, 8 weeks: (0.81 ± 0.07) vs (1.17 ± 0.04) mm^-1, 12 weeks: (0.75 ± 0.03) vs (1.16 ± 0.05) mm^-1] as well as positive cell expression rate of COL2A1 and ACAN protein were significantly decreased in the model group, while the bone trabecular separation, Mankin score, OARSI score and the expression levels of IL-1β [4 weeks: (53.87 ± 2.32) vs (29.71 ± 3.26) pg/mL, 8 weeks: (56.31 ± 5.85) vs (27.70 ± 2.69) pg/mL, (58.59 ± 3.36) vs (25.34 ± 3.23) pg/mL] and TNF-α [4 weeks: (142.52 ± 14.33) vs (71.52 ± 6.68) pg/mL, 8 weeks: (153.94 ± 7.36) vs (75.45 ± 2.78) pg/mL, (160.60 ± 10.93) vs (75.67 ± 3.20) pg/mL] were significantly increased (all P < 0.05). Compared with the model group, the mechanical pain threshold, the thermal pain threshold, the bone volume fraction, trabecular thickness, and trabecular number [4 weeks: (1.09 ± 0.04) vs (0.92 ± 0.02) mm^-1, 8 weeks: (1.02 ± 0.15) vs (0.81 ± 0.07) mm^-1, 12 weeks: (1.00 ± 0.05) vs (0.75 ± 0.03) mm^-1] and positive cell expression rate in the COL2A1 and ACAN protein was significantly increased in the treatment group, while the bone trabecular separation, Mankin score, OARSI score and the expression level of IL-1β [4 weeks: (37.15 ± 7.16) vs (53.87 ± 2.32) pg/mL, 8 weeks: (41.56 ± 7.24) vs (56.31 ± 5.85) pg/mL, 12 weeks: (42.39 ± 3.41) vs (58.59 ± 3.36) pg/mL] and TNF-α [4 weeks: (84.49 ± 7.12) vs (142.52 ± 14.33) pg/mL, 8 weeks: (88.22 ± 3.25) vs (153.94 ± 7.36) pg/mL, 12 weeks: (90.31 ± 5.29) vs (160.60 ± 10.93) pg/mL] were significantly decreased (all P < 0.05). Compared with the 4-week model group, the trabecular thickness and the expression level of TNF-α in the 12-week model group were significantly increased, while the number of trabeculae and the positive cell expression rate of ACAN protein were significantly decreased (all P < 0.05).

ADSCs can relieve the pain symptoms of KOA, reduce joint inflammation, and may repair cartilage damage by promoting chondrogenesis, which has a certain timeliness, providing experimental basis for certain timeliness characteristics of clinical stem cell therapy for KOA.

Mesenchymal stem cells (MSCs) have shown great promise in the treatment of diabetic foot ulcers due to their multipotent differentiation potential, self-renewal capacity, and biological characteristics such as pro-angiogenesis, immunomodulation, and anti-inflammation. Numerous clinical studies and systematic reviews have demonstrated that MSC transplantation is generally safe, with a low incidence of serious adverse events and mild, reversible major side effects. MSCs can exert therapeutic effects by improving local ischemia, promoting angiogenesis, and accelerating wound healing. Some randomized controlled trials and meta-analyses have shown that they are superior to conventional treatments in terms of ulcer healing rate, limb perfusion indicators, and quality of life improvement. MSCs from different tissue sources each have their own advantages in terms of proliferation capacity, immunomodulatory effects, and clinical efficacy. However, the clinical translation of MSCs still faces challenges such as variations in cell quality, lack of standardization in preparation procedures, limitations in large-scale production, and unclear long-term safety and efficacy. Larger sample sizes and more rigorously designed clinical studies are still needed to further clarify the efficacy evaluation system and optimal application strategies, and promote the standardized and sustainable clinical application of MSCs in diabetic foot ulcers.

Hair follicle stem cells (HFSCs), a kind of adult stem cells located in the bulge region of hair follicles, participate in cyclical hair follicle renewal and skin wound repair. Current evidence indicates that Wnt/β-catenin, bone morphogenetic protein (BMP), and sonic hedgehog (Shh) signaling pathways, together with neural, metabolic, mechanical, and injury-related microenvironments, regulate the transition between quiescence and activation in HFSCs. Three-dimensional culture, organoids, gene editing, high-content imaging, and single-cell analysis have also played a promoting role in its functional studies and translational evaluation. HFSCs show potential for hair regeneration, wound repair, and tissue engineering; however, maintenance of stemness, cellular heterogeneity, delivery and integration efficiency, and long-term safety require further investigation. This review summarizes the morphology and distribution, proliferation and differentiation, phenotypic markers, regulatory signals, and research techniques of HFSCs, as well as evidence for their use in hair regeneration, wound repair, tissue engineering, and neural regeneration, providing a reference for mechanistic studies and translational evaluation of HFSC-related strategies.

Myelodysplastic syndromes (MDS) are a group of clonal myeloid disorders originating from hematopoietic stem cells, which are characterized by high heterogeneity and potentially aggressive behavior. Treatment selection is primarily determined by the patient's risk category and therapeutic urgency. Currently, hematopoietic stem cell transplantation (HSCT) remains the only potentially curative treatment for MDS. This article systematically reviews the pathogenesis of MDS and its association with transplant prognosis, clinical treatment strategies, and research progress in HSCT for MDS. Specifically, it focuses on the controversy and advantages of hypomethylating agents combined with venetoclax (HMA+VEN) as pre-transplant bridging therapy, the innovation of post-transplant cyclophosphamide (PTCy) in graft-versus-host disease (GVHD) prophylaxis strategies, precision selection of novel conditioning regimens, and the latest strategies for post-transplant relapse prevention and minimal residual disease (MRD) monitoring and management. The aim is to provide a reference for individualized treatment of MDS patients.

Dysregulated adaptive remodeling of the hematopoietic system under high-altitude hypoxic conditions constitutes the core cause of high-altitude polycythemia (HAPC), and the classic hypoxia-inducible factor-erythropoietin axis theory fails to fully elucidate the mechanisms underlying its pathological transition. Recent studies have revealed that hypoxia drives the expansion of a multipotent progenitor subset with high expression of transcription factor FOS, shifts lineage differentiation toward erythroid cells and establishes hypoxic hematopoietic memory. At the same time, ferroptosis in splenic macrophages impairs erythrocyte clearance and upregulated CD47 enables red blood cells to evade phagocytosis, with all these processes collectively contributing to HAPC pathogenesis. Genetic and inflammatory factors exacerbate individual variability. Based on the above pathological mechanisms, mesenchymal stem cell therapy delivers therapeutic benefits by stabilizing the hematopoietic microenvironment, relieving inflammation and oxidative stress, repairing multi-organ injuries and improving systemic oxygen supply to target both pathogenic origins and secondary lesions, yet its clinical application is currently restricted by bottlenecks such as severe cellular heterogeneity and inadequate targeted homing capacity. Therefore, future work should combine susceptibility gene screening with optimized stem cell technologies to advance the prevention and treatment of HAPC from symptomatic intervention toward precise regulation at the source of lesions.

A key objective in regenerative medicine is the development of "off-the-shelf" cell therapies that combine reparative potential with a strong safety profile. Multilineage-differentiating stress-enduring (Muse) cells are an endogenous subpopulation of mesenchymal stem cells, primarily characterized by stage-specific embryonic antigen-3 (SSEA-3) positivity, non-tumorigenicity, and the potential for tri-lineage differentiation. Their reparative mechanisms involve homing to damaged tissues mediated by the sphingosine-1-phosphate and its receptor 2 (S1P-S1PR2) axis, rapid in situ differentiation via the phagocytosis of apoptotic cell fragments, and immune tolerance conferred by the expression of human leukocyte antigen-G. The safety profile of Muse cells is predicated on a unique molecular regulatory network that maintains pluripotency through the tumor suppressor let-7, rather than through oncogenes. Preclinical studies have corroborated their reparative efficacy in various injury models, including those of the neurological, cardiovascular, and hepatic systems, while early clinical trials have demonstrated their favorable safety profile across multiple diseases. Although the clinical translation of Muse cells continues to face challenges such as the rarity of cell sources, scalable manufacturing, and discrepancies between preclinical and clinical outcomes, "cell-free" therapies and strategies aimed at activating endogenous Muse cells serve as noteworthy directions for future development.