Volume 105 · Issue 18 · 2025

Entrusted by the National Health Commission, the national clinical practice guideline on obesity management aims to standardize the clinical diagnosis and treatment of obesity and prescribe scientific and effective treatment plans to patients, in order to continuously improve the homogenization across healthcare organizations, enhance the effectiveness of obesity treatment and improve long-term health benefits. This guideline is applicable to professionals engaging in the clinical practice on obesity, including clinical physicians, nutritionists, fitness and rehabilitation therapists, nurses, case managers, medical administrators, public health practitioners, as well as medical social workers. The purpose is to guide the clinical diagnosis, interventional treatment, health education, and construction of multi-disciplinary models of obesity management. This article aims to interpret the guidelines on key aspects such as the etiology of obesity, epidemiology, diagnostic assessment, classification and staging, risks of obesity related diseases and benefits of weight loss, principles of treatment, multidisciplinary treatment pathways, multidisciplinary treatment methods, and multidisciplinary collaborative treatment models.

To compare the diagnostic value of rest ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET) myocardial ischemic memory imaging and rest ⁹⁹Tc^m-methoxyisobutylisonitrile (MIBI) single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) for obstructive coronary artery disease (CAD) in patients with suspected unstable angina (UA).

This prospective study included low-and medium-risk patients who presented with chest pain or discomfort at the Chest Pain Center or Cardiovascular Department of the Third Affiliated Hospital of Soochow University from September 2020 to June 2024. These patients, whose initial clinical assessments were negative but still suspected of UA, all underwent rest ⁹⁹Tc^m-MIBI SPECT MPI, rest ¹⁸F-FDG PET myocardial ischemic memory imaging, and invasive coronary angiography (ICA). Using ICA as the diagnostic gold standard, the diagnostic value of rest ⁹⁹Tc^m-MIBI SPECT MPI and rest ¹⁸F-FDG PET myocardial ischemic memory imaging were compared for obstructive CAD in suspected UA patients. The diagnostic performance was assessed using receiver operating characteristic curves.

A total of 274 patients with suspected UA were included, of whom 158 (57.7%) had ICA confirmed obstructive CAD [112 males(70.9%), aged (64.3±10.3) years], and 116 (42.3%) had no obstructive CAD [61 males(52.6%), aged (65.4±8.4) years].Rest ¹⁸F-FDG PET myocardial ischemic memory imaging demonstrated significantly higher sensitivity (67.7% vs 52.5%), specificity (90.5% vs 78.4%), positive predictive value (90.7% vs 76.9%), negative predictive value (67.3% vs 54.8%), accuracy (77.4% vs 63.5%), and the area under the curve [0.79 (95%CI: 0.74-0.84) vs 0.66 (95%CI: 0.60-0.71)] compared to rest ⁹⁹Tc^m-MIBI SPECT MPI (all P<0.05). The net reclassification improvement (NRI) index for the diagnosis of obstructive CAD using rest ¹⁸F-FDG PET myocardial ischemic memory imaging over ⁹⁹Tc^m-MIBI SPECT MPI was 0.27 (95%CI: 0.14-0.41), and the difference was statistically significant (P<0.05).

Rest ¹⁸F-FDG PET myocardial ischemic memory imaging demonstrates superior diagnostic performance compared to ⁹⁹Tc^m-MIBI SPECT MPI for obstructive CAD in patients with suspected UA.

To investigate the risk factors of postoperative delirium in Sun′s procedure for acute type A aortic dissection and its influence on patients′ prognosis.

The clinical data of patients with acute type A aortic dissection who were admitted to Beijing Anzhen Hospital and treated by Sun′s procedure from August 2020 to August 2022 were retrospectively collected and analyzed. Patients were divided into delirium group and non-delirium group according to whether postoperative delirium occurred. The mortality rate within 90 days after surgery and the incidences of postoperative complications were compared between the two groups. Multivariate logistic regression was used to analyze the risk factors related to postoperative delirium.

A total of 336 patients aged (48.5±10.6) years were enrolled, including 277 males and 59 females. There were 67 patients (19.9%) in the delirium group, of which 18 patients (26.9%) died within 90 days after surgery, which was significantly higher than that in the non-delirium group [26.9% (18/67) vs 7.4% (20/269), P<0.001]. Postoperative length of intensive care unit stay [178 (108, 271) h vs 56 (32, 88) h] and time of mechanical ventilation [105 (36, 197) h vs 17 (12, 41) h] in the delirium group were significantly longer than those in the non-delirium group (both P<0.001). Moreover, the incidences of pneumonia, cardiac shock, respiratory failure, tracheotomy and continuous renal replacement therapy were higher in the delirium group (all P<0.05). Multivariate logistic analysis showed that history of stroke (OR=8.21, 95%CI: 1.86-36.16, P=0.005), preoperative cardiogenic shock (OR=2.61, 95%CI: 1.08-6.33, P=0.033), concomitant left common carotid artery cannulation (OR=2.51, 95%CI: 1.25-5.03, P=0.010) and cardiopulmonary bypss (CPB) time (OR=1.01, 95%CI: 1.01-1.02, P=0.003) were independent risk factors for postoperative delirium.

The incidence of postoperative delirium after surgery for type A aortic dissection is high, and the early prognosis of patients with postoperative delirium is poor. History of stroke, preoperative cardiogenic shock, long duration of intraoperative CPB, and intraoperative cerebral perfusion combined with left common carotid artery cannulation are independent risk factors for postoperative delirium.

To investigate altered effective connectivity patterns between thalamic subregions and the whole brain in obsessive-compulsive disorder (OCD) through Granger causality analysis (GCA).

This retrospective study included 69 OCD patients hospitalized at the Second Affiliated Hospital of Xinxiang Medical University between January 2020 and June 2024 (OCD group) and 69 age, gender, and education-matched healthy volunteers (control group). Resting-state functional magnetic resonance imaging (rs-fMRI) data were acquired for all participants, and OCD symptom severity was assessed using the Yale-Brown obsessive-compulsive scale (Y-BOCS). Sixteen thalamic subregions were selected as seed regions based on the brainnetome atlas, and degree centrality (DC) analysis was used to assess the suitability of these subregions as seed regions. GCA was used to explore the effective connectivity between the seed points and the whole brain. Subsequently, the differences in DC and effective connectivity between the OCD group and the control group were compared, and the correlation between the effective connectivity values and Y-BOCS score were analyzed.

The OCD group consisted of 31 males and 38 females, aged (28.9±8.5) years; the control group comprised 32 males and 37 females, aged (30.3±8.2) years. There were no statistically significant differences in gender, age, or years of education between the two groups (all P>0.05). The OCD group exhibited lower DC in the bilateral thalamus compared to the control group (all P<0.001, false discovery rate correction). Compared to the control group, the OCD group showed stronger effective connectivity from the thalamus to the bilateral cuneus, left superior/inferior parietal lobule, and right precuneus [all P<0.05, Gaussian random field (GRF) corrected], whereas weaker effective connectivity was observed from the thalamus to the right superior occipital gyrus and inferior parietal lobule, as well as from the left inferior parietal lobule to the thalamus (all P<0.05, GRF corrected). Additionally, the OCD group demonstrated stronger effective connectivity from the left middle temporal visual area, cuneus/lingual gyrus, inferior parietal lobule, and postcentral gyrus to the thalamus, as well as from the right precuneus, parieto-occipital sulcus, and superior occipital gyrus to the thalamus (all P<0.05, GRF-corrected). In particular, the effective connectivity values for thalamic enhancement to area 40 of the caudal part of the left inferior parietal lobule (r=0.355, P=0.003) and to area 5 of the medial precuneus on the right (r=0.339, P=0.004) were positively correlated with the Y-BOCS total score.

Abnormal effective connectivity of the thalamus to several brain regions within the parietal and occipital lobes in patients with OCD; enhanced effective connectivity of the thalamus to the left inferior parietal lobule and the right precuneus was associated with the severity of obsessive-compulsive symptoms.

To explore the effect and mechanism of biochanin A (BCA) on the inflammatory response and cardiac remodeling following myocardial infarction (MI) in mice.

Using the simple random sampling method, 8-week-old male C57BL/6J mice were categorized into the sham operation control group (5 mice), sham operation experimental group (5 mice), BCA-MI control group (15 mice), BCA-MI experimental group (15 mice), azithromycin-MI control group (4 mice), and azithromycin-MI experimental group (4 mice). The mouse MI model was constructed by ligating the left anterior descending coronary artery. The BCA-MI experimental group was administered 200 mg/kg BCA by gavage, while the BCA-MI control group was given an equal volume of solvent once a day for 3 consecutive days. Mice in the azithromycin-MI experimental group were administered 160 mg/kg azithromycin by gavage, and those in the azithromycin-MI control group were given an equal volume of solvent once a day for 3 consecutive days. The azithromycin-MI experimental group served as a positive control for the influence of BCA on neutrophil infiltration. At 21 days after MI, cardiac MRI and ultrasound examinations were conducted on the sham operation control group, sham operation experimental group, BCA-MI control group, and BCA-MI experimental group, and the left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were recorded; The hearts of MI mice were extracted, and Masson staining was utilized to assess the MI area and collagen deposition. At 3 days after MI, the hearts of the BCA-MI control group, BCA-MI experimental group, azithromycin-MI control group, and azithromycin-MI experimental group were extracted for flow cytometry to evaluate the infiltration of neutrophils in the heart. At 3 days after MI, the peripheral blood of the BCA-MI control group and BCA-MI experimental group was collected, centrifuged to obtain serum, and the levels of inflammatory factors were evaluated using the enzyme-linked immunosorbent assay (ELISA); The hearts of the mice were extracted, and the infiltration of neutrophils and the level of apoptotic myocardial cells in the MI area were evaluated by immunofluorescence staining. Circulating neutrophils from one healthy mouse were stimulated with phorbol myristate acetate (PMA) (in vitro control group) or PMA+BCA (in vitro experimental group) for 4 hours to induce the inflammatory state of neutrophils, and the culture medium was obtained through centrifugation. The culture medium from the in vitro control group and in vitro experimental group was used to cultivate H9C2 cardiomyocytes to induce their injury. The inhibitory effect of BCA on the injury of cardiomyocytes by neutrophils was evaluated by Western blotting for apoptosis-related proteins BCL2-associated X protein (Bax) and Cleaved caspase 3.

Compared with the BCA-MI control group, the BCA-MI experimental group exhibited a smaller infarct area (19.56%±3.48% vs 31.45%±2.27%, P=0.003), an increased LVEF (52.79%±0.36% vs 48.42%±1.04%, P=0.005), a decreased LVFS (24.31%±0.32% vs 26.41%±0.16%, P=0.001), and a lower proportion of neutrophils (79.52%±1.92% vs 87.20%±2.01%, P<0.001). There was no statistically significant difference in the proportion of neutrophils between the BCA-MI experimental group and the azithromycin-MI experimental group (P=0.517). The number of apoptotic myocardial cells in the heart and the levels of inflammatory factors, such as interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α, in the peripheral blood of mice in the BCA-MI experimental group were all lower than those in the BCA-MI control group at 3 days after MI (all P<0.05). In the in vitro experiment, the gray levels of Bax protein (65.63%±28.81% vs 100.80%±43.01%, P=0.023) and Cleaved caspase3 protein (77.59%±34.67% vs 108.40%±46.45%, P=0.047) in the experimental group were both lower than those in the control group.

BCA improves cardiac function after MI in mice by inhibiting neutrophil-mediated inflammatory responses and reducing myocardial cell apoptosis.

To investigate the safety and efficacy of the visual flexible laryngeal mask in rhinology and otology surgery under general anesthesia. Patients who underwent elective rhinology and otology under general anesthesia from March to July 2024 in Beijing Tongren Hospital, Capital Medical University, were prospectively enrolled. Patients were inserted with visual flexible laryngeal mask after induction of general anesthesia. The success ratio of insertion and final ventilation of visual flexible laryngeal masks, ventilation effect and laryngeal mask alignment grade after induction, at the beginning and end of surgery, postoperative sore throat and other adverse events related to laryngeal mask use were observed. A total of 210 patients were included, including 102 males and 108 females, aged (48.7±13.6) years. Among them, 205 patients (97.6%) were successfully inserted with laryngeal masks, and the success ratio of ventilation was 100% (205/205). There were statistically significant differences in oropharyngeal leakage pressure at different time points in patients with successful laryngeal mask placement (P<0.05). The oropharyngeal leakage pressure at the beginning [(22.2±3.3) cmH₂O (1 cmH₂O=0.098 kPa)] and end of the operation [(22.4±3.1) cmH₂O] was higher than that after induction [(21.8±3.1) cmH₂O] (all P<0.05). There were no significant differences in the actual tidal volume, the difference between the actual tidal volume and the set value, and laryngeal mask alignment grade at different time points (all P>0.05). There were no airway adverse events during the operation. None of the patients had severe sore throat or other adverse events related to laryngeal mask use. The visual flexible laryngeal mask is safe and effective for rhinology and otology surgery, and can ensure ventilation during the operation.

This study aimed to investigate the characteristics of balance function during the interictal period in patients with Ménière′s disease (MD) and analyze related influencing factors. A retrospective analysis was conducted on the clinical data of 183 MD patients admitted to the Vertigo Department of Shandong ENT Hospital between July 2021 and December 2023. Balance function was assessed using the sensory organization test (SOT), along with evaluations of mean hearing threshold, semicircular canal function, otolith organ function, and endolymphatic hydrops status. The cohort comprised 89 male and 94 female patients, aged (46.3±9.1) years. SOT results revealed balance dysfunction in 87 cases (47.5%), categorized into vestibular dysfunction type (58 cases), visual dependence type (13 cases), and visual-vestibular dysfunction type (16 cases). Multivariate logistic regression analysis identified abnormal ocular vestibular evoked myogenic potentials (OR=1.977, 95%CI: 1.023-3.819) and abnormal caloric test results (OR=2.310, 95%CI: 1.153-4.630) as significant influencing factors for balance dysfunction. This study suggests a high prevalence of balance dysfunction during the interictal period in MD patients, with utricular function and low-frequency horizontal semicircular canal function being key determinants of balance performance.

To investigate the MRI features of liver metastases from clear cell renal cell carcinoma (ccRCC) and evaluate the impact of postoperative adjuvant therapy on MRI findings. This study retrospectively analyzed clinical, pathological data, and MRI findings of 20 ccRCC patients [mean age (62.1±11.9) years, 14 males (70%)] with liver metastases (71 lesions in total) treated at the First Medical Center of Chinese PLA General Hospital from January 2015 to April 2024. Patients were stratified into adjuvant therapy (39 lesions) and non-adjuvant therapy groups (32 lesions). Two abdominal radiologists jointly evaluated MRI features of liver metastases from ccRCC, including lesion location, size, margins, signal characteristics of plain scan and enhancement patterns. Intergroup comparisons were performed using χ² tests or independent sample t tests. On unenhanced MRI, liver metastases from ccRCC predominantly exhibited moderate hypointensity on T₁-weighted imaging (64/71, 90.1%) and moderate hyperintensity on T₂-weighted imaging (59/71, 83.1%). On diffusion-weighted imaging (DWI), lesions showed mild hyperintensity (42/71, 59.2%) or marked hyperintensity (29/71, 40.8%). Signal drop was observed in 45.1% (32/71) of lesions on out-of-phase images. On contrast-enhanced MRI, liver metastases from ccRCC predominantly demonstrated arterial-phase peripheral rim hyperenhancement (50/70, 71.4%) with persistent rim enhancement maintained in portal venous and delayed phases (37/70, 52.9%). The adjuvant therapy group demonstrated significantly higher rates of ill-defined margins, but lower proportions of marked DWI hyperintensity and arterial-phase rim enhancement compared to the non-adjuvant therapy group (all P<0.05). Liver metastases from ccRCC typically present as multiple round hepatic lesions with hyperintensity on DWI, signal drop on out-of-phase images, and persistent rim enhancement across arterial, portal venous, and delayed phases. Postoperative adjuvant therapy may lead to ill-defined margins, reduced diffusion restriction, and non-rim arterial enhancement patterns in liver metastases from ccRCC.

The current study aimed to analyze the genotype and phenotype characteristics of families with hearing loss caused by LHFPL5 gene variants. The clinical and molecular genetic data of two Han Chinese families with heredity hearing loss who visited Tianjin Medical University General Hospital and Chinese PLA General Hospital from May to November 2023 were retrospectively analyzed. The probands from two families are a 35-year-old female deaf-mute patient and a 5-year-old boy with hearing loss. Whole exome sequencing was used to identified candidate pathogenic genes in probands, and variant loci were verified by Sanger sequencing among family members. Additionally, the phenotypic characteristics were analyzed by hearing and vestibular assessment. The clinical phenotypes of patients from two families were bilateral congenital total deafness and rare progressive severe to profound sensorineural hearing loss. Homozygous variant LHFPL5 (p.Tyr67Cys) and compound heterozygous variants LHFPL5 (p.Tyr67Cys, p.Ser88del) were identified. This study extends the LHFPL5 variant spectrum and enriches the knowledge of auditory phenotypes, providing an important basis for accurate diagnosis and intervention of hearing loss caused by LHFPL5 variants.

This article reports an adolescent male patient with prolonged and recurrent nephritic syndrome and nephrotic syndrome as clinical manifestations. Three renal puncture biopsies showed membranoproliferative glomerulonephritis, but the screening of common secondary causes was negative. After a comprehensive medical history review and meticulous imaging examination, the patient finally found a rare congenital portosystemic shunt. Portosystemic shunt can lead to renal involvement, and the main pathological manifestation is membranoproliferative glomerulonephritis mediated by immune complex. Glucocorticoids and immunosuppressants are partially effective, and surgical occlusion of shunt can improve the manifestation of nephropathy. The patient was treated with long-term immunosuppressive therapy, and the dose of glucocorticoids and immunosuppressants was reduced after the etiology was clarified. After 6 months follow-up, the urine protein did not increase significantly, and the renal function was stable.

A case of primary Sjogren's syndrome complicated with cutaneous lymphoma with cold agglutinin disease is reported. An 84-year-old female was admitted to hospital due to "purple lines on the skin for 1 month and yellowing skin for half a month". The direct anti-human globulin test was positive, the titer of cold agglutinin test was significantly increased, the antinuclear antibody (ANA) was 1:3 200 (spot type), the anti-Sjogren's syndrome antigen A (SSA) antibody, anti-Sjogren's syndrome antigen B (SSB) antibody and anti-centromerin B antibody were all positive, and the labial gland biopsy showed focal lymphocyte infiltration 2 foci/4 mm²Primary Sjogren's syndrome with cold agglutinin disease was diagnosed, and glucocorticoids combined with low-dose rituximab were given to treat the condition in remission. After six months of follow-up, a skin mass appeared, and the biopsy pathology showed diffuse large B-cell lymphoma. Radiotherapy combined with rituximab was given, and the skin mass gradually shrank. The patient's condition was stable after follow-up until January 2025.

This paper reports a case of metastatic metachronous double renal carcinoma and precise treatment based on second-generation sequencing. A 59-year-old male patient went to the Second Hospital of Tianjin Medical University on February 3, 2017 due to "space-occupying lesions of the right kidney for more than 5 years", and underwent partial right nephrectomy. Postoperative pathology (T1) diagnosed "clear cell carcinoma". In July 2018, local recurrence and metastasis of right kidney carcinoma were found after operation, and targeted and immune combined targeted therapy was performed. In March 2020, drug resistance developed. Right nephrectomy (T2) was performed on November 25, 2020, and pulmonary nodules and left kidney space-occupying were found on July 12, 2022. Left kidney puncture biopsy pathology (T3) suggested clear cell carcinoma. The genetic test results of double renal carcinoma (T1~ T3) showed that they shared PBRM1 and TET2 mutations, and the final diagnosis was "metastatic metachronous renal carcinoma". He was treated with immune combined targeted therapy. He died due to tumor progression on December 13, 2023. Since February 2017, the overall survival was 6 years and 10 months. The experience of auxiliary diagnosis and precision treatment based on second-generation sequencing can provide clinical reference for handling similar cases.

The treatment-related peripheral neuropathy of multiple myeloma is mainly manifested as sensory neuropathy, and motor nervous system damage and autonomic neuropathy may occur. It has important implications for patients' quality of life and healthcare resource use, but there is a lack of randomized clinical trials exploring prevention and treatment strategies. This article summarizes the mechanism of action, clinical manifestations, risk factors, prevention and treatment of peripheral neuropathy associated with treatment of multiple myeloma. The role of gene polymorphisms and epigenetics in the pathogenesis of multiple myeloma remains to be further investigated. In terms of treatment, although cryocompression therapy is effective, it is poorly tolerated; At present, there is no drug that has a clear role in preventing multiple myeloma treatment-related peripheral neuropathy; Neuromodulation and mesenchymal stem cells and hyperbaric oxygen may have encouraging effects in the prevention and treatment of this disease, but further exploration is still needed.

The clinical application of metagenomic high-throughput sequencing (mNGS) of pathogenic microorganisms has laid the foundation for the extensive detection of pathogenic microorganisms, etiological diagnosis, treatment and prevention of infectious diseases, but it is also accompanied by a series of problems, among which a very important link is the lack of unified or basic standards in the detection process of mNGS. The testing steps of mNGS are cumbersome, and the errors introduced in each step of the testing process will affect the accuracy of the testing results. The challenges of methodology and standardization still need to be overcome in the process of clinical application. In this paper, the present situation and countermeasures of standardization and standardization of mNGS detection process including wet experiment, dry experiment, platform hardware and personnel configuration are introduced in detail, so as to provide more reference for mNGS in clinical application of infectious diseases.

Vitamin K (VK) is one of the essential nutrients for human body. VK deficiency is prevalent in patients with chronic kidney disease (CKD). This paper focuses on the renal protection mechanism of VK in patients with CKD, such as improving oxidative stress, inhibiting inflammation, preventing renal calcification and delaying renal interstitial fibrosis, and elaborates the delaying effect of VK on CKD complications such as osteoporosis and cardiovascular diseases.

Vascular calcification is a common and serious complication in patients with chronic kidney disease (CKD), and its pathogenesis is very complex. To date, there is still a lack of comprehensive therapeutic approaches that can cure or reverse vascular calcification in CKD. In recent years, with the increasing results of related clinical trials, the effectiveness and safety of many drugs in the treatment of vascular calcification have made great progress. This article reviews the progress of clinical treatment of vascular calcification in CKD from five aspects: correcting calcium and phosphorus metabolism disorders, supplementing magnesium, supplementing vitamin K, applying sodium thiosulfate and inhibiting the formation of hydroxyapatite, and summarizes the potential strategies that may be used to prevent and treat vascular calcification in CKD in the future, in order to provide reference for future research directions and clinical decisions.

Ferroptosis, as a pattern of cell death distinct from apoptosis, has attracted much attention in anti-tumor therapy because of its unique iron-dependent mechanism. This mechanism relies on iron, which catalyzes lipid peroxidation of phospholipids through ferrous ions or ester oxygenase, thus inducing cellular ferroptosis. Ferroptosis not only enhances the efficacy of traditional therapies, but also provides new strategies for cancer treatment. Triple negative breast cancer (TNBC) lacks specific receptor expression, has poor prognosis, high recurrence rate and chemotherapy resistance. Given that TNBC cells are rich in iron and lipids, induction of ferroptosis may overcome their chemoresistance problems. The application of nanotechnology in cancer treatment exhibits unique advantages. By developing novel nanoparticles, it can effectively respond to cancer challenges and reduce the risk of multiple drug resistance. Combining nanotechnology and traditional treatment methods, TNBC treatment strategies are more diversified and the efficacy is significantly improved. In this paper, the latest research achievements of ferroptosis and nanotechnology in the treatment of TNBC are integrated, and its mechanism of action, signaling pathway, clinical translation prospect and shortcomings are deeply discussed, and the characteristics of different nanocarriers are compared and analyzed, in order to provide new ideas and methods for the treatment of TNBC.

The patient, a 39-year-old female, was admitted on 14-Nov-2023 with "cough for 2 months". At the time of admission, there were no obvious abnormalities in the specialist physical examination, and the nucleic acid tests of tumor markers and common respiratory pathogens were negative. Chest plain scan + enhanced CT showed a round-like nodular shadow in the upper lobe of the left lung, with clear boundary, about 27 mm ×21 mm in size, and adjacent vascular signs around it. The enhanced scan showed a relatively uniform moderate enhancement (CT value 64~80 HU), and punctate calcification was visible (arrows in Figures 1 and 2). Thoracoscopic partial resection of the upper lobe of the left lung was performed to confirm the diagnosis. Pathology showed a benign tumor in the upper lobe of the left lung, which was a mixture of solid, papillary, sclerosing and angiomatous tissue structures (FIG. 3, hematoxylin-eosin staining ×100). Immunohistochemistry showed that the expression of thyroid transcription factor (TTF-1) was positive in alveolar epithelial cells and interstitial cells, vimentin interstitial cells of tumor cells and cytokeratin alveolar epithelium; The expression of smooth muscle actin, anaplastic lymphoma kinase and desmin were negative. Sclerosing alveolar cell tumor (PSP) was diagnosed. PSP is a rare benign lung tumor in clinic, which is more common in women. The incidence rate accounts for about 0.2% ~1.0% of primary lung tumors. It grows slowly, has less metastasis, and has a good prognosis. Complete surgical resection is the first choice of treatment. PSP includes surface cubic epithelial cells and mesenchymal circular cells, and its internal components mainly include papillary area, solid area, sclerosis area and hemangioma-like area. PSP consists of at least 2 or more (mostly 3 or more) ingredients. Typical CT images show round or quasi-round nodules, and larger ones can show solitary masses, with most lesions with clear boundaries and may be accompanied by calcifications; It may also be manifested as enhancement, the degree and manner of enhancement depending on tissue composition and lesion size. Small lesions were mainly hemangioma-like and papillary areas, with dense vascular distribution and obvious and uniform early enhancement; With the enlargement of the lesion, the proportion of solid and sclerotic areas increased, and the distribution was uneven, the vascular distribution was sparse, and the degree of enhancement was low. The special signs were welt vascular sign and halo sign.

In biomedical research, traditional animal models are difficult to fully reflect human physiological characteristics due to species differences and experimental limitations, resulting in high failure rate of clinical trials. As a new three-dimensional cell model, organoid technology can partially simulate the cellular heterogeneity, tissue structure and functional characteristics of organs. However, organoids still face problems such as uneven self-assembly, lack of vascularization, and immune system support, limiting their application in long-term culture and mature disease modeling.

Oncolytic virus (OV) therapy is a promising treatment for tumors. OV can lyse tumor cells by replication and also stimulate long-term anti-tumor immune responses. Due to its broad cell affinity and strong exogenous gene expression ability, vaccine virus (VV) has become one of the main candidates for OV, and oncolytic vaccine virus (OVV) has entered the clinical trial stage. This review provides an overview of the main development strategies and clinical trials of OVV, and explores the issues to be addressed during the development of OVV, as well as future development strategies.