Volume 105 · Issue 38 · 2025

The diagnosis and treatment of inner ear diseases are complex and challenging due to various factors, including unclear pathogenesis, diverse and intricate etiologies and symptoms, and a lack of precise detection techniques for early and minor lesions, as well as effective treatment methods. The article proposes the establishment of a systematic thinking framework for diagnosing and treating inner ear diseases. It emphasizes the importance of critical thinking and evidence-based treatment models during the diagnostic and therapeutic process. The article also highlights the need for interdisciplinary collaboration and staying informed about current research trends. By fostering an open-minded thinking framework, new perspectives in both basic and clinical research can be developed, promoting the integration and innovation of interdisciplinary technologies. This approach aims to promote the improvement of the diagnosis and treatment level of inner ear diseases.

The endolymphatic barrier, composed of tight junctions and ion transporters, regulates the ionic gradient between endolymph and perilymph and plays a pivotal role in maintaining inner ear function. Disruption of this biological barrier can result in ionic imbalance, causing both auditory and vestibular dysfunction. Medication needs to enter the perilymph instead of the endolymph by passing through the perilymphatic barrier to reach the hair cells. Targeted drug delivery has emerged as a promising therapeutic strategy for inner ear diseases, including intratympanic injection, intracochlear infusion, and molecularly targeted delivery systems. Intratympanic injection increases drug concentration in the perilymph while minimizing systemic side effects. Molecularly targeted approaches enable precise drug delivery to hair cells, spiral ganglion neurons, etc., thereby enhancing therapeutic efficacy. Future research should focus on improving targeting specificity to facilitate clinical translation for inner ear disease treatment. The current article systematically elucidates the key anatomical and physiological characteristics of the inner ear, the mechanisms of its biological barriers, and pathological damage under disease conditions, with a primary focus on discussing the strategies and prospects for targeted inner ear drug delivery.

Digital diagnosis and treatment, which is driven by intelligent mobile software, emerges as a novel model of telemedicine intervention that provides patients with evidence-based medical evidence. This article reviews the current application status, advantages and limitations of digital technique in the diagnosis and treatment of dizziness/vertigo diseases, and explores the prospects of digital technique in innovating the diagnosis and treatment model of dizziness/vertigo, aiming to provide references for the remote diagnosis and treatment management of patients with dizziness/vertigo in the future.

Hereditary hearing loss is one of the most common birth defects, and its prevention and control hold significant value for China′s three-tier birth defect prevention system. The "Expert consensus on clinical practice for pre-pregnancy and prenatal prevention of hereditary hearing loss", published in 2025, provides crucial guidance for the standardized clinical implementation of hereditary deafness prevention. This article interprets the consensus across six dimensions: disease characteristics of hereditary deafness, key target populations and screening strategies, advancements in molecular diagnostic techniques, construction of the three-tier prevention system, clinical implementation protocols and quality management, and ethical considerations. The consensus defines the criteria for identifying high-risk families, recommends technical approaches such as preconception carrier screening, preimplantation genetic testing, and prenatal diagnosis, and emphasizes ethical principles guiding technology selection. The mentioned three-tier deafness prevention system covers the preconception, prenatal, and neonatal stages, aiming to achieve whole-life-cycle management. Furthermore, the consensus proposes future directions for technological development and recommendations for building a multidisciplinary social support system. This article aims to provide practical references for clinicians and genetic counselors through in-depth interpretation, thereby contributing to reducing the disease burden of hereditary deafness.

The current strategy for managing chronic hepatitis B (CHB) in China focuses on expanding the coverage of antiviral therapy, actively pursuing functional cure, and eliminating hepatitis B as a public health threat. Laboratory diagnostics play a critical role in this process. This review systematically summarizes recent advances and novel discoveries in virological and immunological biomarkers related to HBV infection. We have summarized the roles of these biomarkers in assessing cccDNA transcriptional activity, evaluating the risk of treatment cessation, predicting disease progression, and reflecting host immune function, with an emphasis on their diagnostic value in achieving functional cure and their potential applications in precision diagnosis and treatment of CHB. Additionally, this review highlights the challenges faced by these emerging biomarkers in assay standardization and clinical translation, and provides perspectives on future development. As the pursuit of functional cure advanced and the concept of precision medicine deepened, novel virological and immunological biomarkers assume an increasingly pivotal role within the precision diagnosis-and-treatment framework for CHB. The systematic construction of a multidimensional biomarker system is expected to support the realization of precision-driven goals in CHB management.

Transparent reporting of a multivariable model for individual prognosis or diagnosis-large language models (TRIPOD-LLM) is a reporting guideline specifically developed for studies involving LLM in the healthcare domain. It aims to enhance the transparency, reproducibility, and methodological rigor of LLM-related research reporting. However, there is still a lack of systematic research regarding its applicable scope, current implementation status, and strategies for effective application. This study provides an in-depth analysis and discussion from three perspectives: the intended scope of TRIPOD-LLM, an investigation into its current application status, and how to better apply it, with the goal of assisting researchers in improving the standardization of the implementation and reporting of LLM-based studies. These findings suggest that the dissemination and application of TRIPOD-LLM are still at an early stage. Common challenges include limited understanding of specific checklist items and insufficient reporting of key methodological details. Strengthening awareness of the TRIPOD-LLM framework and promoting its adaptive use across diverse LLM research scenarios will help improve reporting quality and credibility, thereby advancing the responsible and standardized application of LLM in healthcare research.

Patients with obstructive sleep apnea (OSA) show marked individual differences in upper airway collapse patterns. Conventional static examinations are inadequate for fully assessing their dynamic pathophysiological mechanisms. Drug-induced sleep endoscopy (DISE) is an upper airway visualization assessment technique that simulates natural sleep using sedative medication. It enables direct and dynamic endoscopic observation of the site, severity, pattern, and configuration of upper airway collapse in patients, providing a crucial means for elucidating the pathophysiology of OSA and guiding precise diagnosis and treatment. However, standardized protocols are currently lacking for DISE clinical application. To address this, the Sleep Respiratory Diseases Working Committee of the Respiratory Physician Branch of the Chinese Medical Doctor Association organized experts in relevant fields to develop this consensus. Its core content includes: clarifying DISE indications and contraindications; standardizing sedative medication application during DISE procedures; establishing intraoperative scoring systems; and defining operational workflows for polysomnography-assisted drug-induced sleep endoscopy positive airway pressure titration multimodal real-time titration technology. This consensus systematically establishes China′s DISE technical standards for the first time. It will provide evidence-based support for OSA surgical decision-making, ventilator parameter optimization, and treatment efficacy prediction, thereby assisting in advancing personalized OSA diagnosis and treatment.

With the advent of immune checkpoint inhibitors (ICI), immunotherapy for tumors has achieved breakthrough progress. ICI can activate the host′s immune system and utilize the body's own immune function to kill tumor cells. In recent years, ICI have achieved remarkable efficacy in a variety of solid tumors, including breast cancer, as well as hematological malignancies. Among them, in the treatment of triple negative breast cancer (TNBC), multiple clinical trials have confirmed the efficacy and safety of ICI. In order to guide the better clinical application of ICI in the treatment of TNBC, the Expert Committee on Clinical Research of Oncology Drugs of the Chinese Medicine Education Association and the Breast Cancer Professional Committee of the China Primary Health Care Foundation have referred to relevant domestic and foreign guidelines, expert consensuses, and important references published in recent years. Combined with the data and clinical experience of some breast centers and cancer centers in China, and through discussions by the expert group, this consensus has been formulated to guide clinicians in the rational use of drugs and further standardize the diagnosis and treatment behaviors.

To examine the effects of two complete habituation training programs onsubjective and objective indicators in college students with motion sickness (MSD) and visually induced motion sickness (VIMSD).

A randomized controlled trial was conducted. A total of 92 college students diagnosed with MSD/VIMSD, recruited from December 2023 to June 2024, were randomized into an electric rotating chair group and an optokinetic drum rotating chair group. Both groups underwent a 28-day comprehensive habituation training program (7 days of electric/optokinetic drum rotating chair training, 14 days of four-pole swing training, and 7 days of "sky-earth rotation" balance exercises). Graybiel scores, sympathetic nervous system indicators [skin conductance response (SCR), etc.], autonomic nervous function indicators [root mean square of successive RR interval differences (rMSSD), etc], heart rate (HR), and other objective/subjective parameters (9 indicators) were recorded and analyzed before training, and one day, eight weeks and 12 weeks post-training. General demographic data were recorded for both groups. Within-and between-group differences were analyzed using parametric (paired/independent t-tests) or nonparametric tests (Wilcoxon/K-S tests), respectively. Intergroup differences across different follow-up time points were assessed by generalized estimating equations.

A total of 92 college students with MSD/VIMSD were enrolled, including 40 males and 52 females with a median age of 22 years (IQR: 20-23). Forty-six participants were assigned to the electric rotating chair group and 46 to the optokinetic drum rotating chair group. On day one post-training, Graybiel scores significantly decreased in both groups (all P<0.001), with a greater reduction observed in the electric rotating chair group [14 (8, 18) points vs 8 (0, 16) points, P=0.028]. Physiological results showed that the electric rotating chair group demonstrated superior improvements in sympathetic nervous system indicators (all P<0.05). The optokinetic drum rotating chair group exhibited better regulation of autonomic nervous function indicators (all P<0.05). With a follow-up of 12-weeks, the electric rotating chair group maintained sustained improvements in sympathetic indicators (β-range: 0.11 to 2.35, all P<0.01). The optokinetic drum group showed long-term stabilization of autonomic function parameters (β-range:-52.84 to -0.17, all P<0.01).

Both comprehensive interventions significantly alleviate MSD/VIMSD symptoms, with effects sustained for 12 weeks. The electric rotating chair group is more effective in reducing sympathetic nerve activation, while the optokinetic drum rotating chair group demonstrates superior regulation of autonomic nervous balance, providing evidence for personalized therapeutic strategies.

To investigate the short-term effects and influencing factors of short-term personalized vestibular rehabilitation (ST-PVR) on acute peripheral vestibular syndrome (APVS).

A randomized controlled study was conducted. APVS patients who visited the Department of Otolaryngology of Henan Provincial People′s Hospital from April 2024 to February 2025 were enrolled and divided into vestibular rehabilitation group and control group using the random number table method. The two groups completed clinical evaluation at 2 and 6 weeks after treatment, including spontaneous nystagmus (NYS), Romberg test (ROM), head shake test (HTT), unilateral weakness (UW) and directional preponderance (DP) in temperature test, video head impulse test (vHIT), and dizziness handicap inventory scale (DHI), visual analogue scale for vertigo (VAS), and activities-specific balance confidence (ABC) scale. The clinical indicators and vestibular rehabilitation grading scores of the two groups at different treatment time points were compared, and a multiple linear regression model was established to analyze the relationship between the baseline variables of the vestibular rehabilitation group and the vestibular rehabilitation grading score at 6 weeks after rehabilitation.

A total of 33 patients aged 53 (45, 60) years were included in the vestibular rehabilitation group, including 18 males and 15 females. There were 32 cases aged 52 (47, 57) years in the control group, including 17 males and 15 females. No statistically significant differences of the baseline data between the two groups were detected (all P>0.05). At 2 weeks after treatment, the positive rate of NYS, ROM and HTT, and DP value, DHI and VAS were lower than those in the control group, and the mean gain values of abnormal semicircular canals for vHIT and ABC were higher than those in the control group (all P<0.001). The number of abnormal semicircular canals in the vestibular rehabilitation group was smaller than that in the control group at 6 weeks after treatment (P=0.002), and DHI, ABC and VAS were improved compared with the control group (all P<0.001). The rehabilitation grading score of the vestibular rehabilitation group was higher than that of the control group at 6 weeks after rehabilitation [22 (21, 24) vs 16 (15, 18), P<0.001], and the total proportion of complete recovery and basic rehabilitation was higher than that of the control group [100% (33/33) vs 59.4% (19/32), P<0.001]. Multiple linear regression analysis showed that the vHIT grading score (β=0.996, 95%CI: 0.138-1.853, P=0.024), the average gain value of the affected semicircular canals (β=6.221, 95%CI: 0.870-11.572, P=0.024) and the number of affected semicircular canals (β=-1.172, 95%CI:-1.967--0.377, P=0.005) were the influencing factors of vestibular rehabilitation grading score after 6 weeks of rehabilitation.

ST-PVR can quickly improve vertigo symptoms and balance function in APVS patients, and basic recovery can be achieved within 6 weeks. The pre-rehabilitation vHIT result is a weighting factor affecting the vestibular rehabilitation effect, and its dynamic change can be used as a sensitive monitoring index for efficacy.

To investigate prognostic factors of bilateral sudden sensorineural hearing loss (BSSHL) and develop a prognostic prediction model.

The clinical data of BSSHL patients who were admitted to the Department of Otology, Chinese PLA General Hospital between January 2008 and December 2022 were retrospectively collected. The training set and validation set were randomly split by computer in a 7.5∶2.5 ratio. Based on hearing recovery outcomes, they were classified into effective and ineffective groups. Multivariable logistic regression analysis was used to identify prognostic factors, and a prognostic prediction model was constructed along with a nomogram. The model′s performance was evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA).

A total of 204 (118 males and 86 females) BSSHL patients were included, with a median age of 52 (IQR: 35-61) years. The overall treatment effectiveness rate was 26% (53/204). The training and validation sets consisted of 153 and 51 patients, respectively. Multivariable logistic regression analysis revealed that time from onset to treatment (OR=0.96, 95%CI: 0.94-0.99, P=0.020), fibrinogen (OR=0.45, 95%CI: 0.26-0.77, P=0.004), direct bilirubin (OR=0.56, 95%CI: 0.35-0.90, P=0.017), and creatine kinase (OR=0.99, 95%CI: 0.97-0.99, P=0.039) were factors associated with ineffective treatment, while height (OR=1.09, 95%CI: 1.02-1.16, P=0.009) was a factor associated with effective treatment. The prediction model demonstrated area under the curve (AUC) values of 0.87 (95%CI: 0.82-0.93) and 0.80 (95%CI: 0.66-0.93) in the training and validation sets, respectively.

Time from onset to treatment, height, fibrinogen, direct bilirubin and creatine kinase are prognostic factors for BSSHL. The predictive model developed using these factors demonstrated good performance.

To explore the differences in the distribution of vaginal microbiota in perimenopausal women before and after Femoston treatment and compared with healthy women.

A total of 29 perimenopausal patients (study group) who visited the Menopausal Endocrinology Joint Outpatient Clinic of the Second Hospital of Shandong University from January 2022 to December 2023 were selected; all received Femoston treatment and were further divided into the pre-treatment group (FMT1 group, n=29) and the post-treatment group (FMT2 group, n=29). During the same period, using convenience sampling and individual matching methods, 32 healthy women were individually matched from the physical examination population of the Health Management Center of the Second Hospital of Shandong University according to age (±2 years) and a ratio of 1∶1 to 1∶1.1 as the healthy control group. Secretions from the fornix were collected from the FMT1 group, FMT2 group, and control group, and sequenced using 16S rDNA amplicon sequencing technology to analyze microbial Alpha diversity, Beta diversity, intergroup species differences, and biomarkers.

The age of the study group was (46.1±6.0) years, and that of the healthy control group was (44.3±3.2) years, with no significant difference (P>0.05). Alpha diversity analysis showed that the Chao1 index [M (Q₁, Q₃)] [267.72 (139.27, 318.07) vs 109.67 (31.50, 223.55)] and the Observed-OTUs index [255.00 (131.00, 301.50) vs 109.00 (31.00, 208.00)] of the FMT1 group were both higher than those of the FMT2 group (all P<0.05). There were no significant differences in the Shannon index [2.09 (1.71, 3.49) vs 1.98 (1.09, 2.49)] or Simpson index [0.57 (0.39, 0.80) vs 0.53 (0.38, 0.72)] between the FMT1 group and the FMT2 group (all P>0.05). Beta diversity analysis showed that the microbial community structures were significantly separated between the FMT1 group and the FMT2 group, and between the FMT1 group and the healthy control group, with significant differences (R²=0.025, P=0.003 and R²=0.043, P=0.001, respectively), while no significant separation was observed between the FMT2 group and the healthy control group. Analysis of species differences between groups revealed that at the phylum and genus levels, significant differences in abundance between the FMT1 and FMT2 groups were observed in Firmicutes, Bacteroidota, Atopobium, and Prevotella (all P<0.05). Significant differences in abundance between the FMT2 group and the healthy control group were observed in Proteobacteria, Fusobacteriota, Pseudomonas, Ureaplasma, and Megasphaera (all P<0.05). Analysis of microbial biomarkers showed that the characteristic microorganisms in the FMT1 group were Proteobacteria and Bacteroidota, etc., while those in the FMT2 group were Firmicutes and Lactobacillus, etc.

Femoston treatment can improve the distribution of vaginal microbiota in perimenopausal women, reduce the diversity of vaginal microbiota and the abundance of various opportunistic pathogenic bacteria genera, and increase the abundance of Lactobacillus.

To investigate the antimicrobial resistance trends of Vibrioparahaemolyticus isolates in China from 2002 to 2022, and to describe their overall profile and spatiotemporal dynamics.

Two investigators independently searched research articles published between 2002 and 2022 on the antimicrobial resistance phenotypes of Vibrio parahaemolyticus isolates in China, from the China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, VIP Journal Service Platform, Web of Science, and PubMed medical literature databases. The pooled resistance rates for the 9 antimicrobial drugs were calculated using a random-effects model, and subgroup analyses were conducted stratified by isolation time, geographical location, and source.

A total of 98 studies were included altogether, involving 21 542 strains of Vibrio parahaemolyticus isolated in China. The pooled resistance rates (95%CI) for ampicillin, gentamicin, ciprofloxacin, Trimethoprim-Sulfamethoxazole, chloramphenicol, tetracycline, ceftazidime, imipenem, and amikacin were respectively 71.09% (64.49%-77.28%), 1.55% (0.85%-2.40%), 0.61% (0.18%-1.20%), 3.51% (2.16%-5.12%), 0.84% (0.33%-1.52%), 2.15% (1.28%-3.18%), 0.54% (0.21%-0.96%), 0.27% (0-0.94%), and 3.95% (1.66%-7.02%), respectively. In thetime-stratified subgroup analysis, the gentamicin resistance rate peaked during 2002-2006 (P<0.001), while resistance rates for both chloramphenicol (P=0.031) and ceftazidime (P=0.005) reached their highest levels in 2017-2022. Geographical subgroup analysis revealed that Northeast China had the highest resistance to amikacin (P<0.001), tetracycline (P=0.006), and ciprofloxacin (P=0.012) but the lowest ampicillin resistance (P<0.001); North China exhibited the highest ciprofloxacin resistance (P=0.044). In the strain source analysis, environmental strains had higher resistance rates to ciprofloxacin than aquatic product-derived strains (P<0.001), to chloramphenicol than clinical source strains (P<0.001) and aquatic product-derived strains (P<0.001), and to ceftazidime than both clinical source strains (P<0.001) and aquatic product-derived strains (P<0.001).

Overall, Vibrio parahaemolyticus strains isolated in China show high resistance rates to ampicillin, while demonstrating low resistance rates to other antimicrobial drugs. Significant variations in resistance were observed according to isolation time, geographical region, and source. Targeted surveillance and control strategies should be implemented based on these variations.

The data of 14 patients with hearing loss and subjected to whole exome sequencing in Department of Otorhinolaryngology, Eye ENT Hospital, Fudan University between March 2024 and March 2025 were retrospectively analyzed. The patients were categorized into two groups: the pathogenic (P)/likely pathogenic (LP) group and the variant of uncertain significance (VUS) group. The P/LP group consisted of eight cases (three males and five females), while the VUS group included six cases (four males and two females). The median (Q₁, Q₃) age of onset in the P/LP group was significantly younger than that in the VUS group [9.0 (5.8, 12.0) years vs 27.5 (17.0, 33.3) years, P=0.014]. Hearing loss in the P/LP group was more severe than in the VUS group at specific frequencies, including 250 Hz (P=0.015), 500 Hz (P=0.023), and low frequencies (125-500 Hz, P=0.029). Hearing loss in the P/LP group was mainly sloping (9/16 ears), while in the VUS group it was either sloping (4/12 ears) or U-shaped (4/12 ears). The results suggest that early-onset, low-frequency sloping hearing loss is more likely associated with P/LP variants.

Seven patients with radiographically confirmed lateral semicircular canal malformations who visited the Department of Otorhinolaryngology Head and Neck Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology between April 2013 and July 2019 were retrospectively reviewed. Among them, five cases had bilateral malformations and two were unilateral, involving a total of 12 ears, of which five ears were sensorineural hearing loss and two ears were mixed hearing loss. Glycerol test was performed in three cases (five affected ears), with positive results in three ears. Electrocochleography was performed in three cases (five affected ears), and only one affected ear was abnormal. Episodic vertigo occurred in six cases (including one case of positional vertigo), and chronic dizziness occurred in one case. Spontaneous nystagmus and abnormal caloric test results were observed in two cases. Vestibular evoked myogenic potential test was performed in four cases, with abnormalities in three cases. Video head impulse test results were normal in all three cases examined. All patients received symptomatic treatment and had good clinical control. The current study indicates that the clinical presentation and audio-vestibular function test results of patients with LSCC malformations are heterogeneous, and thus imaging studies are recommended to confirm the diagnosis. Further investigations are warranted to determine the pathogenesis of this malformation and the underlying mechanisms of inner ear functional impairment.

The clinical data and diagnostic process of a cerebellar hemangioblastoma (HB) patient presenting with positional vertigo and nystagmus as initial symptomwere retrospectively analyzed. To identify studies involving patients with positional vertigo secondary to cerebellar tumors misdiagnosed as benign paroxysmal positional vertigo (BPPV), a comprehensive literature search was systematically performed in databases such as PubMed, Wanfang, CNKI, and etc., covering the period from January 2004 to December 2024. The patient presented with positional vertigo as the primary symptom.An initial diagnosis of anterior semicircular canal BPPV was made, but attempts at canalith repositioning therapy proved ineffective. Furtherbrain MRI revealed a cystic mass in the right cerebellum. Histopathological examination of the resected specimen confirmed HB. Twenty-eight patients were included in the literature review, nine of whom were ultimately diagnosed with HB, and lesions predominantly involved midline cerebellar structures, including the nodulus and uvula. Literature analysis revealed that misdiagnosis was most often attributable to isolated positional vertigo, in the absence of specific central nervous system symptoms. And the key differential diagnostic features distinguishing CPPV from BPPV and other disorders included the therapeutic efficacy of canalith repositioning maneuvers and characteristics of positional nystagmus. Clinicians should synthesizea comprehensive evaluation, incorporating medical history, physical examination, auditory-vestibular function tests, and neuroimaging, to identify differential diagnostic features andthereby establish an accurate diagnosis.

This retrospective study summarized the clinical management of cancer pain patients who experienced inadequate analgesia following the implantation of a semi-implantable intrathecal drug delivery system (IDDS) at the Affiliated Cancer Hospital of Zhengzhou University between January 2020 and December 2022. The causes of inadequate analgesia and management strategies were analyzed. A total of 8 patients were included, comprising 4 males and 4 females, with a median age M(Q₁, Q₃) of 56.0 (42.8, 62.0) years. The time to onset of poor analgesic efficacy after IDDS implantation was 0.33 (0.25, 0.34) months. After individualized adjustment of treatment strategies, the total duration of IDDS analgesia was 5.10 (4.00, 7.42) months. The main reasons for inadequate analgesia included high-dose opioid tolerance, mixed types of pain with hyperalgesia, central toxicity of intrathecal analgesics, and rapid tumor progression. Strategies such as appropriately increasing the intrathecal drug dosage, opioid rotation, combination with adjuvant analgesics, multimodal analgesia, efforts to control tumor progression, and early application of intrathecal analgesia contributed to achieving more optimal analgesic outcomes.

Chikungunya fever is an acute infectious disease caused by the transmission of Chikungunya virus via Aedes mosquitoes, mainly manifested as fever, rash and joint pain. In recent years, it has shown a spreading trend in several regions due to global climate change and increased cross-border population movements. This paper systematically reviews the global and Chinese epidemic trends and disease burden, etiological characteristics, biological similarities and differences with other mosquito-borne viruses, pathogenesis, clinical characteristics, diagnostic methods, treatment options and preventive measures of the disease, covering the whole chain of information from virus molecular characteristics to epidemiological patterns, from clinical manifestations to public health interventions. The purpose of this paper is to provide scientific basis for monitoring, early warning, clinical diagnosis and treatment, and formulation of prevention and control strategies of chikungunya fever.

Inhalation-respiration ratio is one of the important parameters of mechanical ventilation, which can have certain influence on ventilation, ventilation and prognosis of patients. Based on the basic principle of respiratory ratio and respiratory physiology, the setting strategies of three respiratory ratios, constant-ratio ventilation, equal-ratio ventilation and inverse-ratio ventilation, and the clinical research progress of respiratory ratio setting strategies in the course of disease treatment are introduced in detail, in order to provide strong basis and new ideas for clinical application of pulmonary protective ventilation strategies and respiratory physiology research.

There were 7.7% ~28.0% of ascending aortic dissections that could not be repaired by open surgery, and the mortality rate of unoperated patients was as high as 49.7% ~58.0%. Endovascular repair of the ascending aorta became the only viable intervention option for such patients. However, the unique anatomical morphological structure and biomechanical characteristics of ascending aorta make the development of endovascular devices and the endovascular treatment of ascending aortic dissection face severe challenges. The purpose of this review is to systematically explain the current anatomical morphology, biomechanical related difficulties and research progress of endovascular treatment of ascending aortic dissection, in order to provide certain reference value for the technical development and device research and development of endovascular ascending aortic dissection.

Professor Wang Yingde's team from the Department of Gastroenterology, the First Affiliated Hospital of Dalian Medical University recently completed a basic study focusing on how FMS-like tyrosine kinase 3 ligand (FLT3L) promotes the mechanism of regulatory dendritic cells (DCreg) -induced regulatory T cells (Treg) expansion. Intestinal immune homeostasis is essential for health, and DCreg is a subset of dendritic cells in gut-associated lymphoid tissue (GALT) with a unique ability to induce immune tolerance, whose dysfunction is closely related to inflammatory bowel diseases (IBD) such as ulcerative colitis (UC). Clarifying how FLT3L regulates DCreg function and Treg amplification is of great significance for understanding the mechanism of intestinal immune tolerance and developing DCREG-based cell therapies.

Stroke is one of the leading causes of death and disability among residents worldwide, among which ischemic stroke (i.e. cerebral infarction) is the most common type. Effectively reducing the disability rate and mortality rate of cerebral infarction is the core goal of stroke prevention and treatment. Patients with cerebral infarction can present with severe neurological deficit. Severe cerebral infarction is difficult to treat and has poor prognosis. Previous studies often exclude it, and related studies are obviously lagging behind, and baseline data are lacking.

Vascular disease is one of the leading causes of death among Chinese residents, accounting for more than 40% of the total death toll, and exploring adjustable dietary factors is crucial for its prevention. Previous related studies were mostly based on European populations or small domestic samples, and the conclusions were difficult to directly apply to Chinese populations. This study filled this gap.

Article "Guidelines for the Diagnosis and Treatment of Insomnia (2025 Edition), Volume 105, Issue 34, September 9, 2025, page 2975, top left corner" 2. Medication: Recommended as a first-line treatment option for insomnia in children and used only when behavioral therapy is ineffective or sleep problems are persistent and severe. "It should read" 2. Medication: Not recommended as a first-line treatment option for insomnia in children and used only when behavioral therapy is ineffective or sleep problems are persistent and severe. "It is hereby corrected.