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 explore the risk factors for the development of plastic bronchitis (PB) in children with severe Mycoplasma pneumoniae pneumonia (SMPP), and to construct a predictive model for the risk of PB onset.

A total of 96 children with SMPP hospitalized at Jining No.1 People′s Hospital from July 1, 2023, to December 31, 2024, who underwent electronic bronchoscopy and treatment were enrolled. A retrospective analysis was conducted, the subjects were divided into PB group (n=29, complicated with PB) and non-PB group (n=67, not complicated with PB) based on whether PB was found through bronchoscopy. Multivariate unconditional logistic regression analysis was used to determine the independent risk factors for children with SMPP complicated with PB, and a Nomogram risk prediction model for children with SMPP complicated with PB was constructed based on these risk factors. This study was approved by the Medical Ethics Committee of Jining No.1 People′s Hospital (Approval No. 2025-IIT-quick 076). Written informed consents were obtained from all children′s guardians.

① The results of multivariate unconditional logistic regression analysis showed that SMPP children′s elevated serum LDH levels (OR=1.005, 95%CI: 1.001-1.009, P=0.010), elevated serum D-dimer levels (OR=1.000, 95%CI: 1.000-1.001, P=0.039), the occurrence of pleural effusion (OR=3.367, 95%CI: 1.049-10.805, P=0.041), and occurrence of pulmonary consolidation ≥2/3 of a single lobe (OR=4.872, 95%CI: 1.369-17.332, P=0.014) were all independent risk factors for children with SMPP complicated with PB. ② The area under the curve (AUC) of receiver operating characteristic (ROC) curve of the predictive model for children with SMPP complicated with PB based on the above independent risk factors was 0.866 (95%CI: 0.785-0.947), and the sensitivity, specificity and accuracy of the predictive model for predicting children with SMPP complicated with PB were 75.9%, 86.6% and 80.2%, respectively. The Hosmer-Lemeshow goodness-of-fit test indicated that the predictive model fitted well with the actual situation (χ²=13.92, P>0.05). The calibration and decision curve analysis of the Nomogram indicated that the predictive model possessed high predictive efficacy and clinical applicability. ③ Comparison of treatment outcomes between the two groups of children with SMPP showed that the PB group exhibited significantly higher proportions of children underwent bronchoscopic examinations and treatment at least 2 times, receiving glucocorticoid therapy, and treated with doxycycline or levofloxacin compared to the non-PB group (93.1% vs 4.5%, 72.4% vs 22.4%, 48.3% vs 22.4%), and the differences were statistically significant (χ²=74.00, P<0.001; χ²=21.61, P<0.001; χ²=6.43, P=0.011).

The predictive model incorporating serum D-dimer levels, serum LDH levels, pleural effusion, and pulmonary consolidation ≥2/3 of a single lobe of SMPP children demonstrates high clinical value for predicting the risk of children with SMPP complicated with PB.

To explore the improvement effect of " medical-education-rehabilitation-childcare" service management model on the self-care and social adaptation abilities of children with intellectual disabilities and the quality of life (QoL) of their parents.

A total of 80 children with intellectual disabilities admitted to Pingshan County " Qingmiao Rescue" Rehabilitation and Care Center for Disabled Children and the Department of Rehabilitation Medicine, People′s Hospital of Pingshan County from June 2022 to December 2024 were included as study subjects by quota sampling method. They were divided into study group (n=40, who received intervention using " medical-education-rehabilitation-childcare" service management model) and control group (n=40, who received intervention using a combination of routine comprehensive rehabilitation training and family rehabilitation training) by random number table method. Before and after intervention, the Barthel index scale was used to assess the activity of daily living (ADL) of the two groups of children with intellectual disabilities, the social maturity scale was used to assess their social adaptability, and the World Health Organization quality of life scale-brief (WHOQOL-BREF) was used to assess the QoL of the children′s parents. Statistical comparisons were performed using independent or paired samples t test, Mann-Whitney U test, or Wilcoxon signed-rank test. The procedures followed in this study complied with the regulations of the Ethics Committee of People′s Hospital of Pingshan County and were approved by the ethics committee (Approval No. 20244142).

①There were no significant differences in gender, age, intelligence quotient (IQ), and degree of intellectual disability between the two groups of children with intellectual disabilities (all P>0.05). ②Before intervention, there were no differences in each dimension score and total score of ADL ability, S-M, as well as the total QoL scores of the parents of two groups of children (all P>0.05). After intervention, the total score of ADL ability in study group was (70.5±13.3) points, which was significantly higher than (62.3±16.2) points in control group (t=-3.04, P=0.002). Meanwhile, after intervention, both the total score and each dimension score of ADL ability and S-M in study group of children were significantly improved compared to before intervention within the group (all P<0.05). After intervention, the total S-M score and scores for interpersonal communication, participation in group activities, and self-management ability in the study group were significantly higher than those in control group (P=0.035, 0.007, 0.005, 0.001). After the intervention, the total QoL score of the parents of children in study group was (72.4±9.9) points, which was significantly higher than that of control group (58.0±10.2) points, and the difference was statistically significant (t=-7.58, P<0.001). After intervention, the total QoL scores of the parents of children in both the study group and the control group were significantly higher than those before the intervention within each group, and the differences were statistically significant (P<0.05).

Compared with the conventional comprehensive rehabilitation training and family rehabilitation training model, the " medical-education-rehabilitation-childcare" service management model has greater advantages and can significantly improve the self-care ability, social adaptation behavior of children with intellectual disabilities and the QoL of their parents.

To investigate the clinical characteristics, management strategies, and prognosis of intracranial hypertension (IH) in children with systemic lupus erythematosus (cSLE).

A retrospective analysis was conducted on 7 children with cSLE complicated by IH who were admitted to Capital Center for Children′s Health, Capital Medical University, from January 2015 to September 2025. Clinical data including demographic characteristics, clinical manifestations, laboratory findings, imaging features, treatment, and follow-up outcomes were collected and analyzed. In addition, a literature review was performed by searching Wanfang Data, China National Knowledge Infrastructure (CNKI), VIP database, PubMed, and Web of Science using the keywords " systemic lupus erythematosus" " intracranial hypertension" and " child". The search covered the period from database inception to November 30, 2025. This study was approved by the institutional ethics committee (Approval No. SHERLLM2025008).

① All 7 patients were female with a median age of 13 years (range: 9-15 years), and all were in a high disease activity state [Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2000): 21 points (range: 17-33 points)]. Headache was present in all patients, with some accompanied by dizziness, vomiting, or visual disturbances. Three patients were overweight or obese. Laboratory findings showed anti-dsDNA antibody positivity in 6 patients, anti-ribosomal P protein antibody positivity in 4 patients, and antiphospholipid antibody positivity in 3 patients, with generally decreased complement levels. No specific abnormalities were observed on multimodal imaging. All patients received methylprednisolone pulse therapy (MPPT) combined with immunosuppressive therapy, and 6 patients additionally received biologic agents. Mannitol and other measures were administered to reduce intracranial pressure. The median follow-up duration was 19 months (range: 12-62 months), and all patients achieved remission without recurrence. ② A total of 22 cases (7 cases from this study and 15 cases from the literature) were included in the pooled analysis. Among them, 21 cases (95.5%) were female, with a median age of 13 years. Overweight or obesity was present in 10 cases (45.5%). In 6 patients (27.3%), IH occurred prior to the diagnosis of cSLE. Papilledema was observed in 11 cases (50.0%). Among 15 patients with available disease activity scores, all were in a highly active disease state, with a median SLEDAI-2000 score of 31 points (range: 17-50 points). Antiphospholipid antibodies and anti-ribosomal P protein antibodies were positive in 40.9% and 36.4% of cases, respectively.

cSLE complicated by IH predominantly occurs in adolescent females and is often associated with overweight or obesity and high disease activity. Some patients may present with positive anti-ribosomal P protein and/or antiphospholipid antibodies. IH may precede the diagnosis of cSLE and may occur without papilledema, increasing the risk of missed diagnosis. The presence of marked papilledema should raise concern for potential brain herniation.

To investigate the clinical manifestations, renal pathological characteristics, and potential mechanisms of Imerslund-Gräsbeck syndrome (IGS) caused by AMN gene mutations, and to analyze the characteristics of renal involvement through a literature review.

A male child (patient 1), aged 11 years and 7 months, diagnosed with AMN mutation-related IGS at the Department of Pediatric Nephrology, West China Second University Hospital (Tianfu), Sichuan University on August 19, 2025, was selected as the research subject. A retrospective analysis was conducted on clinical manifestations, laboratory examinations, renal biopsy findings, and genetic testing results. Additionally, a literature search was performed regarding AMN gene mutation-related IGS and the renal pathological findings associated with IGS. The procedures followed in this study were in line with the requirements of the newly revised World Medical Association Declaration of Helsinki in 2013.

①The primary clinical features of patient 1 included recurrent megaloblastic anemia, vitamin B₁₂ deficiency, and persistent proteinuria. Urinary protein component analysis indicated predominantly tubular proteinuria accompanied by elevated albuminuria. Light microscopy of the renal biopsy revealed mild mesangial proliferation. Electron microscopy showed diffuse thinning of the glomerular basement membrane (GBM) in approximately 70% of the capillary loops, along with segmental fusion of podocyte foot processes. Whole exome sequencing (WES) identified a novel homozygous frameshift mutation in the AMN gene: c. 624del (p.Ser209ArgfsTer51). Sanger sequencing confirmed that both parents were heterozygous carriers of this variant. This variant was not recorded in the gnomAD, ClinVar, or HGMD databases, and no relevant published reports were identified in the literature search. According to the American College of Medical Genetics and Genomics (ACMG)/Association for Molecular Pathology (AMP) guidelines, the variant was classified as pathogenic. ② The literature review identified 22 publications on pediatric patients with AMN mutation-related IGS. Including patient 1 from the present study, a total of 33 patients were included in the analysis, among whom anemia was reported in 32 cases (97.0%), decreased serum vitamin B₁₂ levels in 31 cases (93.9%), and proteinuria in 29 cases (87.9%). AMN mutation-related IGS is mainly characterized by megaloblastic anemia, vitamin B₁₂ deficiency, and proteinuria, with onset occurring predominantly from infancy to the preschool years. Following vitamin B₁₂ replacement therapy, anemia and vitamin B₁₂ deficiency were generally improved, whereas proteinuria often persisted. In addition, 12 publications reporting renal biopsy findings in patients with IGS were included; together with patient 1 from the present study, a total of 22 patients underwent renal biopsy. Renal pathological changes in patients with IGS were generally mild; among cases with a defined genotype, patients with AMN mutations usually exhibited only mild pathological alterations, whereas those with CUBN variants could also present with proximal tubular abnormalities.

Patients with IGS associated with the novel homozygous frameshift mutation of the AMN gene may exhibit ultrastructural glomerular abnormalities: specifically GBM thinning and podocyte alterations, in addition to impaired proximal renal tubular reabsorption. The clinical significance of these findings warrants further investigation.

To characterize the clinical phenotype and genetic features of infantile-onset atypical hemolytic uremic syndrome (aHUS) caused by DGKE gene variants.

One infant with aHUS (patient 1, the proband), admitted to Xi′an Children′s Hospital in June 2021, was investigated. Whole-exome sequencing (WES) was performed to identify candidate pathogenic variants, followed by validation using Sanger sequencing. Bioinformatics tools, including the Human Gene Mutation Database (HGMD, https: //www.hgmd.cf.ac.uk/), were used to determine whether the DGKE variant had been previously reported. The pathogenicity of the detected variant was classified according to the standards and guidelines for the interpretation of sequence variants issued by the American College of Medical Genetics and Genomics (ACMG). Amino acid conservation analysis and protein structural modeling were performed to evaluate the potential effect of the variant on protein structure and function, as well as its possible relevance to the clinical phenotype. A literature search was conducted using the keywords " DGKE" and " atypical hemolytic uremic syndrome" across CNKI, Wanfang Data, VIP, and PubMed databases, covering publications from January 1, 2021, to May 31, 2025. This study was approved by the Ethics Committee of Xi′an Children′s Hospital (Approval No. 20250040), and informed consent was obtained from the guardian of patient 1.

①Patient 1, an 8-month-old female, presented with a 4-day history of diarrhea and gross hematuria. Initial laboratory evaluations revealed hematuria, nephrotic-range proteinuria, decreased hemoglobin (Hb), thrombocytopenia, and elevated levels of lactate dehydrogenase (LDH), urea, and creatinine, with serum complement C3 and C4 levels within the normal range. The patient was treated with plasma infusion (PI) and plasma exchange (PE), and has been followed up for over 4 years. During this period, she experienced two relapses, with persistent proteinuria but preserved renal function. ② WES identified a homozygous variant in exon 5 of the DGKE gene [NM_003647.3: c.839A>T(p.D280V)], which has not been previously reported in HGMD. According to the rating criteria of the ACMG Guidelines, the variant was classified as a variant of uncertain significance. Both parents, who were asymptomatic, were confirmed to be heterozygous carriers, consistent with autosomal recessive inheritance. In silico analyses predicted this variant to be pathogenic. Three-dimensional modeling of the DGKE protein indicated that the mutation induces structural abnormalities, potentially disrupting downstream signaling pathways. ③ Literature review: According to the literature search strategy designed in this study, 7 relevant articles on DGKE gene variant-associated aHUS in children were retrieved from domestic and international sources, involving a total of 19 aHUS cases. Together with patient 1, a total of 20 aHUS children were included in the analysis of clinical phenotypes and genetic characteristics of aHUS children with DGKE gene variants. Among these, 16 were male and 4 female; 19 cases had disease onset before 2 years of age. Fourteen patients presented with nephrotic-range proteinuria, 16 developed hypertension, 8 exhibited varying degrees of complement depletion, and 11 experienced one or two relapses during follow-up. Five patients died during the initial episode or relapse.

This study identified that the homozygous variant c. 839A>T (p.D280V) in the DGKE gene is a previously unreported variant, which may cause infantile-onset aHUS, typically characterized by persistent proteinuria and a high risk of relapse. These findings expand the mutational spectrum of the DGKE gene and may enhance clinicians′ understanding, diagnosis, and management of DGKE-associated aHUS.

To explore the genetic causes of abnormal pregnancy caused by pericentric inverted insertion of chromosome 9 and provide guidance for reproduction.

The pregnant woman, her husband and the induced fetal tissues, who underwent induced abortion due to fetal growth restriction and fetal cardiac abnormalities in Chengdu Women′s and Children′s Central Hospital in February 2023, were enrolled in this study. Genetic methods such as chromosome microarray analysis (CMA), peripheral blood G-banding chromosome karyotyping, optical genome mapping (OGM), and fluorescence in situ hybridization (FISH) were used to sequential detect, analyze, and verify the abnormality of chromosome 9 in this family. This study was approved by the Ethics Committee of Chengdu Women′s and Children′s Central Hospital [Approval No. KYLS2023(23)]. Informed consent was obtained from all individuals and guardians of fetal included in this study.

① A 15.459 Mb duplication in the fetal chromosome 9q33.2q34.3 region were detected by CMA in the induced fetal tissues. ② There was no abnormality in the pregnant woman′s chromosome karyotype result, but her husband′s karyotype may be 46, XY, ? ins(9)(p24.3q34.3q33.2) or 46, XY, inv(9)(p24.3q33.2). ③ The husband′s OGM test results showed 9q34.3q33.2 was inversely inserted into chromosome 9p24.3 of the same chromosome, which was further verified by mid-stage FISH analysis. The husband′s accurate karyotype was 46, XY, ins(9)(p24.3q34.3q33.2). ④ The couple chose assisted reproductive technology (ART) for pregnancy assistance, and the results of preimplantation genetic testing (PGT) showed that among their 11 embryos, 2 were normal embryos and could be implanted preferentially.

The 9q33.2q34.3 duplication of fetal tissue comes from the recombinant gametes produced by pericentric inverted insertion of the father′s chromosome 9. The combination of multiple genetic technologies is conducive to the accurate diagnosis of rare chromosomal balanced structural variations, and provides an accurate laboratory data for the assessment risk of recurrence and the selection of fertility mode in offspring.

White matter injury (WMI) is a major cause of severe neurological complications in preterm infants, especially extremely preterm infants. With advances in neonatal care, the predominant pathological pattern of preterm WMI has shifted from focal necrotic lesions to diffuse injury. The core pathological features of preterm WMI include the significant vulnerability of late oligodendrocyte progenitor (preOL), dysmyelination, axonal injury, and abnormal neural network connectivity, which in turn affect nervous system development and function. This review summarizes the definition, high-risk population, clinical imaging manifestations, and pathological features of preterm WMI, and further discusses recent progress in its pathogenesis and therapeutic strategies, with the aim of providing a reference for understanding its pathophysiological mechanisms and exploring effective interventions.

To analyze the application effect of multimodal warming in the perioperative period of liver transplantation and its impact on early postoperative complications.

Patients who underwent liver transplantation at Affiliated Jinling Hospital, Medical School of Nanjing University from September 1, 2019 to January 31, 2025 were selected as observation subjects. They were divided into the conventional warming group and the multimodal warming group, using the implementation time of multimodal insulation regulations as the demarcation point. A total of 150 pairs of recipients were matched using a 1 ∶1 propensity score matching method. Perioperative temperature data and prognosis-related data of liver transplant recipients were collected, and the duration of intraoperative hypothermia, severity of hypothermia, and postoperative complications between the two groups were compared. Normally distributed measurement data were expressed as mean±standard deviation (±s), and comparisons between groups were performed using independent-samples t-test. Non-normally distributed measurement data were presented as median (interquartile range) [M(P₂₅, P₇₅)], and Mann-Whitney U test was used for inter-group comparison. Count data were expressed as number (percentage), and comparisons between groups were conducted using the χ² test or Fisher′s exact probability test. A P value <0.05 was considered statistically significant.

The incidence of hypothermia in the multimodal warming group was 42.7% (64/150), with a cumulative time of (22.3±8.4) min and a cumulative area of (4.5±2.3) ℃·min, all of which were lower than those in the conventional warming group [65.3% (98/150), (29.6±10.0) min, (5.8 ± 2.7) ℃·min] (χ²=15.152, t=6.844 and 4.771, all P<0.05). The body temperature of the multimodal warming group during hepatic portal occlusion was (36.2±0.3) ℃, and (35.6±0.6) ℃ at 5 min after inferior vena cava recanalization, both higher than those in the conventional warming group [(36.1±0.3) ℃ and (35.2±0.6) ℃, t=-2.459 and -4.955, all P<0.05]. The multimodal warming group also showed significantly lower intraoperative bleeding [1 600 (1 250, 2 190) vs 1 870 (1 300, 2 600) mL, Z=-2.508, P< 0.05], plasma transfusion [900 (700, 1 300) vs 1 000 (800, 1 600) mL, Z=-2.303, P<0.05], incidence of reperfusion syndrome [22.7% vs 35.3%, χ²=5.844, P<0.05], and a shorter postoperative time to extubation of tracheal tube [3(2, 9) vs 7(3, 13) h, Z=-4.110, P<0.05].

Multimodal warming technology can reduce the incidence and duration of intraoperative hypothermia in liver transplantation, decrease intraoperative bleeding and blood product requirements, lower the incidence of postoperative complications, and shorten the time of postoperative extubation, which promotes the rapid recovery of liver transplant recipients.

To investigate the psychological states, including depression, anxiety, loneliness, and post-traumatic stress symptoms, and the current situation of social support among parents who have lost their only child after organ donation in Zhejiang Province, and to analyze the influencing factors.

The questionnaire consisted of a general information questionnaire, the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder-7(GAD-7), the 6-items University of California Los Angeles loneliness scale (ULS-6), the Impact of Event Scale-Revised (IES-R), and the Social Support Rating Scale (SSRS). The t-test and Fisher′s exact test were applied to analyze the effects of various factors on mental status for normally distributed measurement data and count data, respectively. A value of P<0.05 was considered statistically significant.

A total of 90 questionnaires were distributed, and 36 valid questionnaires were retrieved, with an effective recovery rate of 40%. Among the 36 respondents, 21 individuals (58.3%) exhibited varying degrees of depressive symptoms, with a mean PHQ-9 score of 13.6±7.3. In terms of anxiety, 11 participants (30.6%) showed moderate to severe symptoms, with a mean GAD-7 score of 15.3±4.0. 21 respondents(58.3%) reported moderate to severe loneliness, with a mean ULS-6 score of 17.5±3.8. 27 individuals (75.0%) exhibited symptoms of post-traumatic stress, with a mean IES-R score of 47.9±27.5. Only 11.1% of the respondents received a high level of social support.

Parents who have lost their only child after organ donation in Zhejiang Province have high levels of depression, anxiety, loneliness, and post-traumatic stress. The occurrence of these mental issues is associated with economic burden, life difficulties, age, and the presence of chronic diseases.

Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver, and it is also one of the leading causes of tumor-related death worldwide. Due to hidden early symptoms, most patients are diagnosed in the intermediate-advanced HCC upon admission. For them, surgical resection, local ablation and liver transplantation are potential therapeutic options, whereas most patients have lost the opportunity of surgery. Along with recent in-depth exploration of the molecular mechanism of HCC and successful development of multiple targeted drugs, systemic therapy has become increasingly prominent in the treatment of HCC. Among them, targeted therapy combined with immunotherapy showcases significant therapeutic advantages. At present, multiple regimens of targeted therapy combined with immunotherapy have completed phase Ⅲ clinical trials and verified their efficacy and safety, which have been widely applied in clinical practice. Therefore, the combination of targeted therapy and immunotherapy will applied more through the whole process of treatment for intermediate-advanced HCC, which is expected to significantly improve the survival and prognosis of patients. In this article, the latest research progress in the field of first-line treatment for intermediate-advanced HCC was reviewed, providing theoretical basis and clinical guidance for targeted therapy combined with immunotherapy for HCC.

Liver transplantation has become the most effective therapeutic option for end-stage liver disease. Graft rejection is the main obstacle to the long-term survival of organ transplantation recipients. Although widespread use of immunosuppressants can significantly improve the short-term prognosis and survival of patients, long-term use of immunosuppressants will increase the risk of adverse events, such as drug poisoning, systemic infection and tumor recurrence, and exerts limited effect on improving the overall survival rate of grafts. Therefore, how to induce the immune tolerance of liver transplantation and maintain the long-term survival of grafts without use of immunosuppressants remains an urgent scientific challenge in the field of organ transplantation. In recent years, the mechanism research and clinical trials of tolerogenic dendritic cell (tolDC) in immune tolerance after liver transplantation have achieved initial outcomes. In this article, biological characteristics, immunomodulation and application of tolDC in clinical liver transplantation were reviewed, and the application value of tolDC in inducing immune tolerance in liver transplantation was evaluated.

Echinococcosis is a zoonotic parasitic disease that is distributed widely around the world, with hidden onset and long incubation period, which seriously threatens human health. The interaction between immune escape and host immune system is complex, and especially the helper T(Th) cell subsets and their secreted cytokines play a key role in disease progression. In this article, the role of IL-23/IL-17 axis in echinococcosis was reviewed. IL-23 is secreted by activated dendritic cells and macrophages, which can promote the differentiation of Th17 cells and secrete IL-17. Studies have shown that the changes of IL-23 and IL-17 levels in cystic echinococcosis are closely associated with the infection stage and immune response, and affected by drug intervention. In alveolar echinococcosis, IL-23 and IL-17 levels are increased in the early stage of infection, and are associated with disease activity in the late stage. IL-23/IL-17 axis can regulate inflammatory response and immune cell function through the JAK/STAT signaling pathway, which plays an important role in immune regulation of echinococcosis. Further study of the mechanism underlying IL-23/IL-17 axis in echinococcosis will contribute to developing novel therapeutic targets and biomarkers, providing new ideas for early diagnosis, prognostic evaluation and immunotherapy of echinococcosis.