Volume 105 · Issue 47 · 2025

In China, stroke is characterized by high incidence, high disability rate, and high recurrence rate. Coupled with population decline and deep aging, it poses challenges to public health and the economy. The "Million Disability Reduction Project" has made progress in stroke prevention and treatment, yet shortcomings remain, such as inadequate hypertension management and disconnection between screening and prevention. Drawing on relevant experiences from the United States, Japan, and the United Kingdom, Haian City in Jiangsu Province has established a county-township-village three-level grid-based system, realizing full-process intervention covering prevention, screening, diagnosis, treatment, management, and rehabilitation. This study puts forward suggestions including strengthening top-level policy coordination, implementing prevention-oriented strategies, and improving long-term support mechanisms, which aims to build a new grid-based system for chronic disease prevention and treatment, and provide support for the Healthy China Initiative and Chinese modernization.

Central neck compartment metastases are most commonly found in papillary thyroid cancer(PTC) patients. Central neck dissection (CND), encompassing lymph node levels Ⅵ and Ⅶ, remains controversial when performed prophylactically CND (pCND) in clinically node-negative (cN0) PTC patients. Current guidelines, consensus statements, and literatures lack a unified, objective criterion for determining cN0 status. The reasons for the controversy surrounding pCND lie in the varying oncological benefits and complication rates of pCND reported in different studies for cN0 PTC patients, as well as the inconsistent research conclusions drawn by scholars from China and the West. Currently, there is insufficient evidence from large-sample, long-term follow-up randomized controlled trials to support the oncologic benefits of pCND. Therefore, the application of non-long-term follow-up study results regarding pCND in cN0 PTC should be interpreted and approached with caution. Furthermore, there is no established quality control indicators for CND. Anatomic landmark-guided standardized CND is crucial for ensuring the quality control of pCND.

Congenital hypothyroidism (CH) is one of the most common inherited metabolic disorders in children, and delayed diagnosis and treatment can adversely affect intellectual development and growth. In April 2025, the Chinese Society of Endocrinology and the Chinese Society of Pediatrics jointly released the "Guidelines for the diagnosis and treatment of congenital hypothyroidism". Based on the latest evidence-based medical data and clinical experience, these guidelines systematically established a comprehensive management framework covering screening, diagnosis, treatment, and follow-up, aiming to standardize CH screening, diagnosis, treatment, and long-term management. This article provides an interpretation of the main content of the guidelines. The guidelines emphasize that early diagnosis and treatment can improve the prognosis of CH and set a newborn screening cut-off value of≥8-10 mU/L as the standard for recall and examination. In terms of treatment, the guidelines stress the principle of "early and adequate" intervention, recommending levothyroxine (LT₄) as the first-line treatment with a starting dose of at least 10 μg/kg. Timely follow-up and avoidance of overtreatment are also highlighted. For transient CH, it is recommended to discontinue LT₄ treatment after the age of 3 and conduct further evaluations of thyroid function and imaging examinations. The guidelines also note that genetic testing to identify the molecular etiology of CH has significant guiding value for the treatment of specific types of CH. The guidelines achieve standardization of the diagnostic and therapeutic process, address the gap in lifelong management of CH in China from the neonatal period to adulthood, and provide healthcare professionals with an accurate, effective, and comprehensive normative document.

To explore the correlation between obesity and ultrasonic malignant features of papillary thyroid carcinoma (PTC).

A retrospective analysis was conducted on 8 483 patients who underwent thyroid surgery and were postoperatively diagnosed with PTC at China-Japan Union Hospital of Jilin University between January 2008 and December 2017. The cohort included 1 580 males and 6 903 females, with the age [M(Q₁,Q₃)] of 42.0(36.0,49.0) years. Patients were divided into the non-obese group and the obese group based on whether their body mass index was≥28 kg/m². Propensity score matching (PSM) was employed to conduct 1∶1 matching for variables such as gender and history of diabetes. Core ultrasound features and thyroid imaging reporting and data system (TIRADS) scores were compared between the two groups. Subgroup analyses were performed based on gender. A multivariate logistic regression model was employed to analyze the correlation between obesity and malignant ultrasonic features of PTC.

After PSM, each group consisted of 1 762 patients, and there were no statistically significant differences between the two groups in terms of gender, diabetes history, family history of thyroid cancer, the maximum tumor diameter was>1 cm, multifocality, extraglandular invasion, lymph node metastasis, and Hashimoto′s thyroiditis (all P>0.05). The proportion of punctate hyperechoic foci (microcalcifications) in the obese group was lower than that in the non-obese group [33.1% (584/1 762) vs 37.9% (668/1 762), P=0.009]. Subgroup analysis by gender revealed that among obese males, the proportions of markedly hypoechoic nodules [4.9% (34/692) vs 2.7% (19/694)] and coarse calcifications [25.0% (173/692) vs 19.3% (134/694)] were higher than those in the non-obese group, while the proportion of punctate hyperechoic foci was lower [35.6% (246/692) vs 42.4% (294/694)] (all P<0.05). Among females, there were no statistically significant differences in any ultrasound features between the obese and non-obese groups (all P>0.05). There was no statistically significant difference in the overall distribution of TIRADS risk categories in thyroid nodules between the obese and non-obese groups (P=0.054). The multivariate logistic regression analysis revealed that obesity was a significant factor associated with the presence of peripheral calcification or punctate hyperechoic foci in thyroid ultrasound findings (OR=0.80, 95%CI: 0.70-0.93).

Obesity is associated with a decreased display rate of a key malignant ultrasound feature in PTC —— punctate hyperechoic foci. The incidence of this feature is lower in obese males compared to non-obese males.

To analyze the surgical characteristics of da Vinci robotic and endoscopic-assisted thyroidectomy and compare the clinical outcomes of da Vinci robotic and endoscopic-assisted gasless unilateral transaxillary approach for thyroid surgery.

A retrospective analysis was conducted on patients who underwent da Vinci robotic or endoscopic-assisted thyroidectomyat the Head and Neck Surgery Department of Fudan University Shanghai Cancer Center between July 2020 and June 2024, with follow-up until December 2024. Data on clinicopathological characteristics, operative time, hospitalization costs, surgical complications, and postoperative incision satisfaction were collected and analyzed.

During the study period, a total of 618 da Vinci robot-assisted thyroid surgeries and 239 endoscope-assisted thyroid surgeries were performed. In terms of surgical approach, both the robot group and the endoscope group mainly used the unilateral axillary gasless approach: 598 cases (96.8%) in the robotic group and 161 cases (67.4%) in the endoscopic group. The proportion of patients undergoing extended surgical procedures, such as unilateral lobectomy plus ipsilateral central neck dissection (level Ⅵ) and lateral neck dissection, was higher in the robotic group than in the endoscopic group [8.9% (53/598) vs 0.6% (1/161), P<.001]. Regarding the scope of surgery, both groups mainly performed unilateral thyroid lobectomy with ipsilateral level Ⅵ lymph node dissection: 543 cases (87.9%) in the robotic group and 218 cases (91.2%) in the endoscopic group. For patients undergoing unilateral thyroid lobectomy with level Ⅵ lymph node dissection, there were 531 cases in the robotic group [average age (35.4±9.1) years, 92 male] and 154 cases in the endoscopic group [average age (34.5±9.0) years, 13 male]. The robotic group had higher proportions of males [17.3% (92/531) vs 8.4% (13/154)], higher BMI [(22.8±3.6) vs (21.8±3.0) kg/m²], larger tumor diameters [(7.2±3.6) vs (6.5±2.8) mm], higher total costs [(5.5±0.5) vs (2.5±0.7) ten thousand yuan], and more level Ⅵ lymph nodes removed [(3.1±2.3) vs (2.0±1.4)] than the endoscopic group (all P<0.05). The robotic group′s surgeries were shorter [(87.4±35.3) vs (127.1±40.2) min], and they had a lower incidence of temporary postoperative hoarseness [1.13% (6/531) vs 3.89% (6/154)] compared to the endoscopic group (both P<0.05). There was no significant difference in postoperative scar satisfaction between the two groups (P>0.05).

The gasless unilateral transaxillary approach and unilateral lobectomy plus ipsilateral central neck dissection (level Ⅵ) are the most common surgical approach and extent for da Vinci robotic and endoscopic-assisted thyroidectomy, respectively. Da Vinci robotic surgery is more frequently applied in male patients, higher BMI, larger tumors, and more extensive resections, and it offers superior recurrent laryngeal nerve protection compared to endoscopic systems. However, health economic factors must be considered in practical applications.

To compare the diagnostic and therapeutic preferences for Graves′ disease (GD) between Chinese and international endocrinologists.

A secondary analysis was conducted on the results of a global questionnaire survey on the management preferences for GD from May 1 to August 31, 2023. The questionnaire consisted of 31 items covering the diagnosis and treatment of GD, as well as the management of patients under different clinical scenarios, including those with pregnancy plans or concurrent pregnancy, and those with recurrent GD. Differences in responses between endocrinologists in China and those in other countries were compared.

A total of 991 questionnaire responses from interviewed endocrinologists were deemed valid data, including 380 males, 604 females, and 7 physicians who declined to answer. Among them, there were 108 Chinese endocrinologists and 883 foreign endocrinologists. The age of Chinese endocrinologists was mainly concentrated in the 36-45 age group (43.5%, 47/108), while foreign endocrinologists were mostly over 45 years old (56.9%, 502/883). For the diagnosis of GD, both Chinese and foreign endocrinologists selected thyrotropin receptor antibody (TRAb), thyroid peroxidase antibody (TPOAb), free triiodothyronine (FT3), and thyroid-stimulating hormone re-examination as diagnostic indicators. The proportion of Chinese endocrinologists choosing TRAb [98.1% (106/108) vs 75.4% (666/883)], TPOAb [84.3% (91/108) vs 40.8% (360/883)], thyroglobulin antibody (TgAb) [82.4% (89/108) vs 24.7% (218/883)], and FT3 [58.3% (63/108) vs 28.1% (248/883)] was higher than that of foreign endocrinologists (all P<0.001). For GD treatment, antithyroid drugs (ATD) were selected as the preferred treatment method by both Chinese and foreign endocrinologists [95.4% (103/108) vs 94.2% (832/883), P=0.637]. When treating GD patients with pregnancy plans or concurrent pregnancy, Chinese endocrinologists were more likely to choose ATD or radioactive iodine therapy compared to foreign endocrinologists (both P<0.05). For patients with recurrent GD, Chinese endocrinologists had a significantly higher proportion of selecting long-term (≥24 months) ATD treatment compared to foreign endocrinologists (P<0.001).

Chinese endocrinologists generally share similar core diagnostic and therapeutic strategy preferences (in terms of diagnostic items and first-choice medications) with their foreign counterparts for GD. However, they exhibit a higher selection rate for certain examination items and demonstrate differences from foreign endocrinologists in terms of treatment approaches and duration preferences for special GD patients.

To investigate the trends in the quality of reperfusion therapy for acute ischemic stroke in Beijing from 2018 to 2024.

Data of acute ischemic stroke patients who underwent reperfusion therapy between 2018 and 2024 was retrospectively collected using stroke emergency quality control data from the Beijing Center for Stroke Quality Control and Improvement. The Mann-Whitney U test was used to compare door-to-needle time (DNT) and door-to-puncture time (DPT) between hospital tiers and regions. Trends in DNT and DPT were assessed using Joinpoint Regression (version 4.8.0.1), and the average annual percentage change (AAPC) was calculated.

From 2018 to 2024, the number of institutions capable of performing intravenous thrombolysis increased from 76 to 86, and those capable of performing mechanical thrombectomy increased from 50 to 58. During this period, a total of 41 860 intravenous thrombolysis procedures were performed. The annual number of intravenous thrombolysis cases increased from 3 913 in 2018 to 8 702 in 2024. The median DNT [M(Q₁, Q₃)]decreased significantly from 51 (36, 72) minutes in 2018 to 37 (28, 49) minutes in 2024 (AAPC=-5.13%, P<0.001). A total of 10 383 mechanical thrombectomy procedures were performed from 2018 to 2024. The annual number of mechanical thrombectomy cases increased from 841 in 2018 to 2 614 in 2024. The median DPT showed a non-significant decrease from 119 (85, 169) minutes to 117 (80, 178) minutes (AAPC=-0.95%, P=0.504). In tertiary hospitals, DNT decreased from 51 (36, 73) minutes to 37 (29, 50) minutes (AAPC=-5.15%, P<0.001), while in secondary hospitals, it decreased from 50 (40, 66) minutes to 30 (25, 40) minutes (AAPC=-7.73%, P<0.001). The DPT trend showed no statistically significant difference both in tertiary hospitals (AAPC=-1.94%, P=0.154) and secondary hospitals (AAPC=2.64%, P=0.251). In urban areas of Beijing, DNT decreased from 47 (32, 66) minutes to 36 (27, 50) minutes (AAPC=-4.50%, P<0.001), while DPT showed a non-significant decrease from 115 (83, 165) minutes to 112 (76, 175) minutes (AAPC=-1.56%, P=0.410). In suburban areas of Beijing, DNT decreased significantly from 58 (45, 81) minutes to 37 (30, 48) minutes (AAPC=-6.05%, P=0.010), while DPT showed a non-significant decrease from 136 (95, 181) minutes to 128 (90, 183) minutes (AAPC=-0.76%, P=0.459).

From 2018 to 2024, the number of reperfusion therapy cases for acute ischemic stroke in Beijing increased, accompanied by a significant reduction in DNT.

To assess the impact of the Jilin Province Stroke Emergency Map (JSEM) initiative on the efficiency of emergency care for acute ischemic stroke.

This study utilized data from the Jilin Stroke Center Construction Management Information System to describe the contruction of the regional stroke emergency network in Jilin Province since the JSEM initiative launched. Comparisons were made regarding the number and proportion of acute ischemic stroke patients receiving intravenous thrombolysis (IVT) and mechanical thrombectomy (MT), as well as the Emergency Medical Services (EMS) response times, during the following periods: the 1-year pre-JSEM period (August 2016-July 2017), and the 1-year periods following the release of JSEM Version 1 (August 2017-July 2018), Version 2 (August 2018-July 2019), Version 4 (December 2021-November 2022), and Version 5 (August 2023-July 2024).

As JSEM evolved from Version 1 (August 2017) to Version 6 (September 2024), the number of hospitals in Jilin Province with IVT capability increased from 19 to 71, and those with MT capability increased from 10 to 30. With the increase in IVT-capable hospitals within the JSEM network, the number of acute ischemic stroke patients receiving IVT in Jilin Province has increased continuously, from 2 585 cases in the year pre-Version 1 to 9 464 cases within the year following Version 5 release. The IVT rate among the patients entering the"green channel"of stroke also increased from 3.3% (2 585/78 063)to 5.5%(9 464/172 951). The median door-to-needle time decreased from 62 (54, 71) minutes pre-Version 1 to 51 (43, 60) minutes post-Version 5. Meanwhile, the number of patients receiving emergency MT in Jilin Province rose from 457 cases pre-Version 1 to 1 337 cases post-Version 5; the MT rate among patients entering the"green channel"of stroke increased from 0.6% (457/78 063) to 0.8% (1 337/172 951). Treatment timeliness for MT also improved: the door-to-puncture time shortened from 136 (104, 157) minutes pre-Version 1 to 112 (94, 143) minutes post-Version 5.

The launch and promotion of JSEM effectively reduces stroke-induced death and disability rates by optimizing the provincial stroke emergency network, reducing pre-and post admission delays, and enhancing treatment efficiency, which contributes to achieving the goals of the national"One Million Disability Reduction Project".

Based on the registration data of stroke centers in Guangdong, to analyze the current status of stroke diagnosis and treatment medical quality in the province, and identify key issues,.

Registration data from 258 stroke centers in Guangdong province on the cerebrovascular disease big data platform from 2023 to 2024 were collected, covering core indicators such as the number of stroke centers, the timeliness, safety and efficacy of intravenous thrombolysis and mechanical thrombectomy, and the 3-month disability rate. Regional differences among the Pearl River Delta, northern Guangdong, eastern Guangdong and western Guangdong were compared.

By 2024, the number of stroke centers in tertiary and secondary hospitals in the province reached 97 and 161 respectively, with a coverage rate of 100% (21/21) in cities and 81.15%(99/122) in counties. Among the 122 administrative regions in Guangdong province, there are still 8 counties with a population greater than 300 000 that do not have qualified stroke centers. In 2024, there were 22 020 cases of intravenous thrombolysis in the province, an increase of 12.6% (2 468/19 552) compared to 2023. In 2024, there were 12 909 cases of mechanical thrombectomy in the province, an increase of 25.1% (2 591/10 318)compared to 2023. The median of door-to-needle time (DNT) [M(Q₁, Q₃)] of intravenous thrombolysis decreased from 39(29, 54) min in 2023 to 38 (28,53) min in 2024, and the median of onset-to-needle time (ONT) decreased from 146 (98,255) min to 145 (98,202) min.The intravenous thrombolysis rate of stroke centers in the province has increased from 7.84%(19 552/249 385) in 2023 to 8.00%(22 020/275 252) in 2024. The median of door-to-puncture time (DPT) for mechanical thrombectomy has increased from 110 (79,155)min in 2023 to 111 (81,154)min in 2024, both of which are longer than the national average of 108 (75,158)min and 109 (76,158)min; The severe disability rate of ischemic stroke within 3 months of onset in 2024 is 22.72%(3 458/15 220) , which is only slightly lower than 23.45%(3 157/13 463) in 2023. The distribution of stroke centers is uneven, with an average of 488 000 people having one stroke center in the province. In the Pearl River Delta region and northern Guangdong region, there is one stroke center for an average of 453 300 and 398 000 people, respectively, while in the eastern and western Guangdong regions, there is only one stroke center for an average of 711 100 and 801 000 people, respectively. The intravenous thrombolysis rate in the Pearl River Delta region is 8.55%(13 504/159 031), while in northern Guangdong it is 8.93%(3 766/42 157), in eastern Guangdong it is 7.05% (1 947/27 583), and in western Guangdong it is only 6.03% (2 803/46 481). There are significant differences in the corresponding intravenous thrombolysis DNT and ONT, mechanical thrombectomy DPT and onset to puncture time (OPT) in different regions. The incidence of complications such as intracranial hemorrhage, hospital mortality, and unplanned discharge rates in intravenous thrombolysis and mechanical thrombectomy also exhibit regional variations within the province, with the Pearl River Delta region showing lower rates compared to other areas. The severe disability rate within 3 months after ischemic stroke onset in the Pearl River Delta region is 20.83%(1 967/9 442), lower than that in northern, eastern, and western Guangdong.

The number of stroke centers has grown rapidly and the total number of treatments has increased significantly, yet challenges remain, including low intravenous thrombolysis rates, obvious time delays, and unbalanced regional development. These issues ultimately result in the disability rate failing to meet the expected improvement target and further efforts are needed.

To determinate the effective axial compression yield loads of different types of femoral fracture fixed by bridge system with mixed-rod and double-rod to select the internal fixation method.

A total of 32 polyformaldehyde mixed-rod and double-rod models of long oblique, long spiral, wedge-shaped with large fragment and supracondylar fractures were made. Among them, there were 4 mixed-rod models and 4 double-rod models for each type of fractures. Axial compression test was conducted on all fracture models using the microcomputer-controlled electronic universal testing machine. When the compression displacement was 2.0 mm, the axial compression yield loads, which were the maximum effective loads, and the average load was calculated and compared with the reference value of 2 475 N. When the compression displacement was less than 2.0 mm, if there was an obvious break point in the load-displacement curve, the maximum load was invalid.

The average loads of models for different types of femoral fractures were as follows: the load of long oblique fracture with mixed-rod and double-rod models was (7 603.5±471.7) N and (4 117.5±29.2) N, respectively; the load of long spiral fractures was (2 890.1±139.4) N and(2 500.6±74.5)N, respectively; the load of wedge-shaped fracture with larger fragment was (5 110.2±489.0) N and(4 234.3±256.0)N, respectively; and the load of supracondylar fracture was (9 071.3±1 444.3) N and(9 403.1±1 649.6)N, respectively. The average loads of all the mixed-rod and double-rod models of femoral fractures were greater than the reference value.

For long oblique, long spiral, wedge-shaped with large fragment and supracondylar fractures of the femur, the double-rod of bridge system can meet the fixation requirements, and it is recommended to use the double-rod of bridge system in terms of open reduction and internal fixation.

To explore the clinical and pathological characteristics of reoperation cases after thermal ablation treatment for thyroid carcinoma, the restrospective analysis included 40 patients with thyroid cancer who underwent reoperation after thermal ablation treatment in the Department of Thyroid Surgery of the First Hospital of China Medical University from December 2014 to April 2025, with an average age of (48.3±12.9) years including 9 male patients. A total of 49 cancer foci underwent thermal ablation treatment. Before thermal ablation, fine-needle aspiration was performed in all 40 patients (49 cancer foci), but 31 patients (37 cancer foci) underwent thermal ablation without obtaining cytological pathology. The maximum diameter of the cancer foci before thermal ablation was (1.50±0.99) cm, with 29 cancer foci≥1 cm and 20 cancer foci <1 cm. Nineteen cancer foci were adjacent to the thyroid capsule. Postoperative pathology confirmed that 29 patients (33 cancer foci) still had residual cancer foci. The residual rate of lesions with a maximum diameter≥1 cm was higher than that of lesions with a maximum diameter<1 cm [79.3% (23/29) vs 50.0% (10/20), P=0.032]. The residual rate of cancer foci adjacent to the thyroid capsule was higher than that of those far from the thyroid capsule [89.5% (17/19) vs 53.3% (16/30), P=0.009)]. Three cases had occult multifocal cancer, and 14 patients had metastatic lymph nodes. One patient with follicular carcinoma had multiple bone metastases. The results of this study suggest that non-standard initial thermal ablation treatment may lead to residual cancer foci or metastatic lymph nodes. For patients that are eligible for surgery,thermal ablation should not be blindly promoted or overused as an initial treatment.

A retrospective analysis of clinicopathological features was conducted on 10 cases of thyroid tumors with PTEN mutations from Shanghai Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Fujian Provincial Hospital, and the Affiliated Hospital of Qingdao University from 2020 to 2024. Histomorphological features were quantified using the Thyroid Histomorphological PTEN Hamartoma Syndrome (PHTS) scoring system(THiPS), immunophenotypic profiling and genetic features were examined via immunohistochemical staining and next-generation sequencing respectively. The cohort included 3 males and 7 females, with the age [M(Q₁,Q₃)] of 68.0(53.0, 74.0) years. Those 10 cases included papillary thyroid carcinomas (3 cases), oncocytic carcinoma of the thyroid (2 cases), follicular thyroid carcinoma (1 case), differentiated high-grade thyroid carcinoma (1 case), and thyroid low risk neoplasm (3 cases). The cases in this study had low THiPS scores [(1.0±1.15) scores], and all lacked the characteristic morphological features of PHTS. Immunohistochemical staining showed that loss of PTEN expression was confirmed in 7 cases, positive expression was found in 3 cases with non-sense PTEN mutation. Molecular analysis revealed co-mutations with PTEN in 80% of cases (8/10), including BRAF^V600E(3 cases), TERT promoter (4 cases), and TP53 mutations (2 cases), while 2 cases harbored PTEN-only mutations. Follow-up data were obtained for 6 cases, with a follow-up period of 15.0 (9.0, 20.0) months. Among them, 1 case was initially diagnosed with OCT pulmonary metastasis, while the remaining 5 cases showed no recurrence or metastatic lesions during the follow-up period. The THiPS score has limited diagnostic value for thyroid tumors with PTEN alteration. Negative PTEN immunohistochemical staining may suggest a PTEN mutation, but positive staining does not exclude a genetic alteration. PTEN gene mutations can be combined with BRAF, TERT, and TP53 alteration.

A retrospective study was conducted on the patients with hematological disease who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) at Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between February 2023 and July 2024. The patients were divided into the luspatercept group and the control group according to whether luspatercept was administered after allo-HSCT. The luspatercept group was further subdivided into the matched group and the mismatched group according to ABO blood group compatibility between the donor and recipient, to compare the recovery of hematopoietic function before and after treatment in each group.The luspatercept group included 39 patients [18 males and 21 females; aged (47±13) years], and the control group included 94 patients [53 males and 41 females; aged (44±13) years]. In the luspatercept group, the hemoglobin (Hb) rose from (54.0±10.2) g/L at baseline to (95.8±19.7) g/L 21 days later, with 84.6% (33/39) of patients achieving an erythroid response (Hb increase≥20 g/L). Among luspatercept-treated patients, 17 were ABO-matched and 22 were ABO-mismatched. The baseline and day-21 Hb levels did not differ significantly between both groups (both P>0.05). Although the baseline Hb level was higher in the control group than that in the luspatercept group [(75.2±13.4) vs (54.0±10.2) g/L, P<0.001], there was no statistically significant difference in Hb levels between the two groups after 21 days of treatment (P=0.392). One-year overall survival and disease-free survival in the luspatercept group were 84.1% and 81.5%, respectively, while those in the control group were 92.9% and 88.6%. The differences in one-year overall survival and disease-free survival were not statistically significant (both P>0.05). Adverse events in the luspatercept group were predominantly grade 1-2, inclued diarrhea, nausea, and hypertension. Early administration of luspatercept after allo-HSCT can safely accelerate erythroid recovery.

The patient, a 36-year-old male, was admitted to Liaoning Cancer Hospital on March 7, 2023 due to "palpation of left neck mass for 2 months". He had undergone radical left thyroidectomy in another hospital in 2016, and the postoperative pathology reported papillary thyroid carcinoma. The ultrasound of the admitted neck showed multiple lymph nodes in the left cervical region, and the clinical diagnosis was secondary malignant tumor of the cervical lymph nodes. Left cervical lymph node dissection was performed, and postoperative pathological initial diagnosis: metastatic adenocarcinoma. Pathology was diagnosed as metastasis of papillary thyroid carcinoma by consultation in other hospitals. In January 2024, the left cervical lymph node recurred and metastasized, and second-generation sequencing detection suggested the presence of an ETV6-NTRK3 fusion variant. Pathological sections were reviewed, and the final pathological diagnosis was metastatic primary salivary gland secretory carcinoma of the thyroid (left neck). The patient had poor results after treatment with traditional Chinese medicine, and underwent left cervical lymphadenectomy again in December 2024. The patient received oral maintenance therapy with emtricinib after surgery, and the patient's condition was stable after follow-up until July 2025.

The patient, a 68-year-old female, went to Beijing Tongren Hospital affiliated to Capital Medical University on Nov. 9, 2023 due to "progressive vision loss in both eyes for 3 years". The patient was diagnosed with cerebral infarction 5 years before admission, after which the cognitive function gradually declined. The history of epilepsy was 3 years and the history of paroxysmal vertigo was 2 years. Optical coherence tomography (OCT) revealed thinning of the ellipsoid band, foveal hyperreflective dots, and diffuse thinning of the retinal ganglion cell complex in the macular area; Skin biopsy revealed p62, ubiquitin positive staining inclusion bodies; Genetic testing confirmed that the number of repeated amplifications of GGC in the 5' untranslated region of NOTCH2NLC gene on both alleles was 14 and 115, respectively. Consistent with the diagnosis of neuronal intranuclear inclusion body disease (NIID). The symptoms did not improve after treatment with methylcobalamin to nourish nerves and ginkgo biloba leaves to activate blood circulation. Follow-up as of Nov. 3, 2025, the patient still had memory decline, and no seizures of epilepsy and vertigo occurred again.

Thyroid cancer is the fastest-growing malignant tumor of the endocrine system in the world. Although the 5-year survival rate exceeds 98%, patients often face physical and psychosocial quality of life problems, which seriously affect their long-term prognosis. This paper sorts out the classification of various thyroid cancer quality of life assessment tools, and systematically sorts out the applicable scenarios and limitations of seven commonly used assessment tools; From the long-term and short-term functional and psychological changes of quality of life, the changes of quality of life before and after surgery and radioactive iodine therapy (RAI), the present situation of patients' quality of life was comprehensively analyzed; The key factors affecting quality of life were summarized, including treatment-related factors (e.g. surgical strategy, treatment modality, RAI and postoperative complications), demographic factors (e.g. age and gender) and social factors (e.g. education level, economic factors, marriage and social support). It provides a reference for clinical optimization of treatment plan and formulation of personalized nursing strategy, and emphasizes the need to improve the long-term quality of life of thyroid cancer patients through standardized assessment tool development, long-term follow-up research and psychosocial intervention.

As a complex disease, thyroid cancer is usually thought to be the result of the interaction between genetics and environmental factors. However, existing evidence suggests that genetic diversity and environmental exposure cannot fully explain the heterogeneity of clinical characteristics of thyroid cancer. Recent studies have shown that epigenetics (especially DNA, RNA and histone methylation) play an important role in the pathogenesis of thyroid cancer. DNA methylation and histone methylation are involved in the differentiation of innate and adaptive immune cells, and regulate tumor migration, proliferation, apoptosis and interstitial characteristics. Epigenetic regulation of immune genes and inflammatory pathways provides a plausible explanation for the dynamic expression network of thyroid cancer. This article reviews the evidence that DNA, RNA and histone methylation modifications are involved in the pathogenesis of thyroid cancer and their potential as predictors of disease activity and drug response, as well as exploring the opportunities and challenges of current epigenetic research. The epigenetic module provides a molecular interface for the synergistic action of genetic and environmental risk factors and is expected to be a new target for thyroid cancer therapy.

As the main weight-bearing joint of human body, cartilage injury of hip joint is very common in clinical practice. Although the existing clinical repair methods can relieve the symptoms in a short time, it is difficult to reconstruct the structure and function of native cartilage, and there are obvious limitations. In recent years, with the rapid development of regenerative medicine and tissue engineering, a series of new repair strategies have been emerging. The application of new biomaterials and seed cells provides new ideas and potential treatment options for the clinical repair of hip cartilage injury. This article reviews the traditional repair techniques and their limitations of hip cartilage injury, the cutting-edge progress of hip cartilage repair techniques and cross-field reference, including the selection of scaffolds/carriers (such as synthetic biomaterials, natural biomaterials, etc.), and the selection of cell sources (costal/nasal cartilage, stem cells, organoids, etc.), for the reference of colleagues in the industry.

With the emergence of arsenic trioxide (ATO), the prognosis of acute promyelocytic leukemia (APL) has been significantly improved, and it has become the best prognostic hematological malignancy, but relapse resistance will still occur in 5% to 10% of patients. The appearance of ATO resistance in PML::RARA fusion gene-positive APL patients is the result of multiple factors, including ATO binding to PML::RARA fusion protein (such as PML gene mutation), PML::RARA fusion protein degradation (such as epigenetic regulation), APL cell apoptosis (such as down-regulation of reactive oxygen species level and increased expression of anti-apoptotic protein), intracellular available arsenic concentration (such as abnormal ATO metabolism, reduced uptake, and high expression of efflux transporter), etc. This article will review the research progress of the above contents.