Volume 106 · Issue 04 · 2026

Individualized precision diagnosis and treatment of neurodegenerative diseases (Alzheimer′s disease, Parkinson′s disease, etc.) faces challenges due to overlapping early symptoms and clinical/pathological heterogeneity. PET-MRI multimodal imaging, integrating in vivo molecular pathological information from PET with brain structural/functional information revealed by MRI, has become a crucial cornerstone for precision diagnosis and treatment of neurodegenerative diseases. However, its clinical translation is limited by practical bottlenecks, such as complexities in data integration, and uneven distribution of resources. AI, with its unique strengths in multimodal data fusion, automated quantitative analysis, and cross-modal image synthesis, is gradually reshaping the paradigm of diagnostic and therapeutic landscape of neurodegenerative diseases. This article systematically explores the pivotal role of AI in PET-MRI, covering its contributions to improving diagnostic objectivity, deciphering disease heterogeneity, enabling stratified care pathways. It also critically addresses the multiple challenges hindering the clinical implementation of AI and proposes that future efforts should focus on the development of interpretable AI models, the construction of embedded clinical systems, and the exploitation of inclusive technological solutions to promote the deep integration of AI and PET-MRI, ultimately driving the transformation of neurodegenerative diseases towards a precision medicine paradigm of early prevention, early diagnosis, and early treatment.

Acute type A aortic dissection (ATAAD) involves complex pathology in aortic root, and appropriate surgical strategies are crucial to clinical outcomes. Recently, with significant improvements in the safety and short-term efficacy of ATAAD surgical strategies, maximizing the elimination of aortic root dissection and preserving well-functioning aortic valves during emergency surgery is directly related to the long-term survival quality of patients. David procedure is an effective aortic valve repair technique which has shown satisfactory long-term outcome in patients with aortic root aneurysm and aortic regurgitation. Due to its ability to eliminate aortic root dissection, preserve the aortic valve, and facilitate hemostasis, David procedure plays a significant role in the management of ATAAD aortic root pathology and has great potential for broader application. This article elaborates on the characteristics of ATAAD, treatment strategies, the technical features of David procedure, and progress in clinical practices, aiming to provide a reference for the rational application of David procedure in ATAAD and further improve the long-term efficacy and quality of life for patients with ATAAD.

Aortic dissection (AD) is a cardiovascular emergency with an extremely high mortality rate. This review delineates its molecular pathogenesis from four pivotal dimensions: structural and functional abnormalities of the vascular wall, inflammatory and immune dysregulation, hemodynamic disturbances, and epigenetic dysregulation, while critically assessing the translational prospects and challenges of novel therapeutic strategies targeting these mechanisms. Despite continuous advancements in surgical and interventional techniques, the long-term prognosis of AD remains suboptimal. Future research should focus on targeting key molecular pathways, facilitating individualized precision therapy, developing novel diagnostic tools, and innovating drug delivery systems, with the aim of overcoming current diagnostic and therapeutic bottlenecks in AD.​

Type 2 diabetes mellitus (T2DM) and metabolic dysfunction-associated steatotic liver disease (MASLD) are closely related to each other, and their bidirectional pathophysiological interactions significantly increase the risks of liver-related and extrahepatic adverse outcomes. Multidisciplinary management is essential to improve long-term outcomes and the overall quality of integrated care in individuals with T2DM and MASLD. The expert consensus "Chinese expert consensus on multidisciplinary management of type 2 diabetes mellitus complicated with metabolic-dysfunction associated steatotic liver disease (2026 edition)" was developed by multidisciplinary experts from Chinese Society of Health Management, Liver and Gallbladder Diseases Branch of China Association of Chinese Medicine and Liver Health Consortium in China (CHESS). By integrating expertise across specialties, a systematic and continuous care model can be established encompassing early screening, precision diagnosis, risk stratification, individualized interventions, and long-term management. Such an approach can optimize coordinated management strategies for T2DM and MASLD and improve quality of life and long-term survival.

To investigate the striatal dopamine transporter (DAT) distribution pattern and its relationship with iron deposition in the substantia nigra pars compacta (SNc) in patients with Parkinson′s disease (PD) using integrated ¹⁸F-N-(3-fluoropropyl)-2β-carbomethoxy-3β-

A case-control study. PD patients and sex-and age-matched control group who visited the Department of Nuclear Medicine/PET Center, Huashan Hospital, Fudan University from January 2023 to April 2024 were retrospectively enrolled. Differences in striatal (caudate, putamen) DAT specific binding ratio (SBR) and SNc iron deposition between the two groups were compared using ¹⁸F-FP-CIT PET-MRI. Pearson correlation analysis was used to assess the correlations of striatal DAT-SBR and SNc iron deposition with age, disease duration, Unified Parkinson′s Disease Rating Scale Part Ⅲ (UPDRS-Ⅲ) scores, and Mini-Mental State Examination (MMSE) scores were analyzed in the PD group. A non-linear mixed model was used to study the spatiotemporal distribution pattern of striatal DAT-SBR in PD patients and to explore the correlation between striatal DAT-SBR and SNc iron deposition.

The PD group consisted of 53 patients (34 males, 19 females) aged (64.5±9.4) years. The control group consisted of 10 subjects (7 males, 3 females) aged (60.2±10.4) years. DAT-SBR in the bilateral caudate (left: 4.50±1.89 vs 7.17±2.29; right: 4.22±1.72 vs 7.03±2.31) and bilateral putamen (left: 4.01±1.80 vs 8.48±2.09; right: 3.60±1.49 vs 8.17±2.12) were significantly lower in the PD group than those in the control group (all P<0.001). SNc iron deposition was significantly higher in the PD group than that in the control group [(96.93±29.94) vs (72.42±8.73)×10^-9, P<0.05]. In the PD group, DAT-SBR in the bilateral caudate and putamen was negatively correlated with age and disease duration (r=-0.535--0.350, all P<0.05), while SNc iron deposition showed no significant correlation with age or disease duration (all P>0.05). After adjusting for age and disease duration, DAT-SBR in the putamen was negatively correlated with UPDRS-Ⅲ scores (r=-0.380, P<0.05), but showed no significant correlation with MMSE scores (P>0.05). The non-linear mixed model results indicated that the decline in DAT-SBR in the caudate and putamen occurs 11.8-17.5 years before clinical onset. After further adjusting for age, disease duration, and UPDRS-Ⅲ scores, DAT-SBR in the bilateral caudate and the posterior part of the right putamen showed negative correlations with SNc iron deposition in the PD group (r=-0.548--0.422, all P<0.05).

At the time of clinical diagnosis, striatal DAT is already impaired and shows a negative correlation with SNc iron deposition, revealing a correlation between nigrostriatal pathway damage and DAT impairment in PD patients.

To explore the diagnostic value of ¹⁸F-9-fluoropropyl-(+)-dihydrotetrabenazine (¹⁸F-AV133) vesicle monoamine transporter type 2 (VMAT2) hybrid positron emission tomography PET-MRI for cognitive impairment (CI) in Parkinson′s disease (PD).

This was a cross sectional study. Fifty-seven PD patients who had visited the Department of Radiology and Nuclear Medicine at Xuanwu Hospital of Capital Medical University from March 2023 to August 2024 were included. All subjects had completed the hybrid PET-MRI examination and Montreal Cognitive Assessment Scale (MoCA) score, and the patients were divided into PD-CI group and PD cognitive normal (PD-CN) group. Using the occipital cortex as a reference area, the ¹⁸F-AV-133 VMAT2 specific uptake ratio (SUR) and asymmetry index of the caudate nucleus and putamen in PET images were measured. The anisotropy scores (FA) and mean diffusivity (MD) values of the caudate nucleus, thalamus, putamen, globus pallidus, red nucleus, substantia nigra, and hippocampus in diffusion tensor imaging (DTI) images were measured. The independent sample t-test was used for inter-group comparison, and Pearson correlation analysis was used to evaluate the correlation between MoCA score and SUR and asymmetry index in PET, as well as the FA and MD values in DTI. The area under the receiver operating characteristic (ROC) curve (AUC) was used to analyze the diagnostic efficacy of SUR, asymmetry index, FA and MD values, and combined indicators for the PD-CI group. The Delong test was used to compare differences in the AUC.

A total of 57 patients (23 males and 34 females) aged (63.7±4.9) years were included, with 27 in the PD-CI group aged (66.5±3.9) years and 30 patients in the PD-CN group aged (60.5±2.8) years. The age of patients in the PD-CI group was higher than that in the PD-CN group, and the education years were less than those in the PD-CN group [(7.7±1.3) vs (9.8±2.7) years], and the proportion of rapid eye movement sleep behavior symptoms was higher than those in the PD-CN group [63.0% (17/27) vs 36.7% (11/30)] (all P<0.05). The SUR of the caudate nucleus (2.77±0.08 vs 2.93±0.08), FA value (0.76±0.07 vs 0.80±0.06), SUR of the anterior part of the putamen (2.05±0.05 vs 2.20±0.07), and FA value of the putamen (0.70±0.08 vs 0.74±0.06) in the PD-CI group were all lower than those in the PD-CN group; and the asymmetry index of the caudate nucleus (0.029±0.001 vs 0.027±0.004), MD value (0.61±0.05 vs 0.57±0.05), asymmetry index of the anterior part of the putamen (0.031±0.003 vs 0.029±0.005), MD value of the putamen (0.34±0.09 vs 0.30±0.02), substantia nigra (0.89±0.04 vs 0.84±0.09), and hippocampus (0.78±0.07 vs 0.75±0.04) were all higher in the PD-CI group than in the PD-CN group (all P<0.05). The MoCA score was positively correlated with the SUR of the caudate nucleus and anterior putamen, the FA values of the caudate nucleus, and substantia nigra (r=0.708-0.783), and negatively correlated with the caudate nucleus asymmetry index and caudate nucleus MD value (r=-0.738--0.718) (all P<0.001). The combined parameter AUC of SUR, FA, and MD values was 0.953 (95%CI: 0.886-1.019), sensitivity was 92.30%, and specificity was 95.69%, whose diagnostic efficiency was higher than that of single parameter (all P<0.05).

Combined application of ¹⁸F-AV-133 VMAT2 hybrid PET-MRI parameters, including the SUR of caudate nucleus and anterior putamen, asymmetry index of the caudate nucleus, the FA and MD value of caudate nucleus and the FA value substantia nigra, could effectively distinguish between PD-CI and PD-CN.

To investigate dynamic positron emission tomography/magnetic resonance (dPET-MRI) using ¹⁸F-deoxyglucose (FDG) in distinguishing tumor progression (TP) from post treatment related change (PTRC) in patients with glioma.

This study is a cross-sectional study. From July 2022 to September 2024, a total of 15 suspected recurrent/progressing post-treatment glioma patients were recruited at the Cancer Prevention and Treatment Center of Sun Yat sen University. They underwent ¹⁸F-FDG PET-MRI examination after postoperative radiotherapy in terms of static parameters, the SUV_max, SUV_mean of all lesions and SUV_mean of normal brain (gray matter and white matter) were measured. Additionally, target-to-background ratios (TBR_gm and TBR_wm) and SUV corrected for blood glucose (SUV_{gluc max} and SUV_{gluc mean})were calculated. The two-tissue compartment model (2TCM) and Patlak plot were used to derive kinetic metrics, including K₁, k₂, k₃, 2TCM-K_i, 2TCM-MR_FDG, Patlak-K_i and Patlak-MR_FDG. Receiver operating characteristic (ROC) curve analysis was used to evaluate diagnostic performance for differentiating TP from PTRC.

Fifteen patients, aged 48 (41, 54) years, including 5 males (33.3%), were detected on enhanced MRI images with a total of 18 lesions detected. Ultimately, 13 lesions were confirmed to have progressed. The 2TCM-K_i [0.018 (0.015, 0.022) vs 0.013 (0.012, 0.014), P=0.016], 2TCM-MR_FDG [8.334 (7.041, 9.836) vs 6.281 (5.713, 7.469), P=0.046], Patlak-K_i [0.017 (0.014, 0.020) vs 0.010 (0.007, 0.011), P=0.004] and Patlak-MR_FDG [7.742 (6.904, 9.084) vs 4.892 (3.833, 5.640), P=0.003] were significantly higher in TP than in PTRC. The Patlak-K_i values exhibited the high distinguishing performance with the area under the curve (AUC) of 0.954 (95%CI: 0.856-1.000), and the sensitivity and specificity was 92.3% and 100.0%, respectively.

Kinetic metabolic parameters of ¹⁸F-FDG dPET-MRI, as a non-invasive biomarker, is hopeful as a non-invasive biomarker to distinguish TP from PTRC.

To evaluate the diagnostic value for temporal lobe epilepsy focus localization based on the asymmetry index (AI) derived from images reconstructed using the ordered subsets expectation maximization (OSEM) and the Bayesian penalized likelihood (BPL) methods on ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) PET-MRI.

This is a cross-sectional study. We collected and analyzed ¹⁸F-FDG PET-MRI brain images from 18 patients diagnosed with temporal lobe epilepsy at the PET Center of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, between January 2020 and June 2023. The acquired PET list-mode data for each patient were reconstructed using three methods respectively: OSEM, BPL (β=150), and BPL (β=350). Quantitative analysis was performed on 9 pairs of bilateral brain regions: cerebellar cortex, hippocampus, parahippocampal gyrus, superior temporal gyrus, middle temporal gyrus, inferior temporal gyrus, entorhinal cortex, transverse temporal gyrus, and temporal pole. The mean standardized uptake value (SUV_mean) for each region was extracted, and the AI for each region was calculated. The cerebellar cortex was considered the reference region, and other brain regions were classified into the epileptogenic zone (AI≥20%) and epileptic propagation zone (5%<AI<20%). Differences in SUV_mean and AI among the three reconstruction methods were analyzed using one-way ANOVA or the Friedman test.

A total of 18 patients with temporal lobe epilepsy were included [6 males, 12 females, mean age (29.5±14.7) years]. In both the right and left cerebellar cortex, the SUV_mean values in the BPL (β=150) and BPL (β=350) were higher than those in the OSEM (left: 6.88±1.86 vs 6.80±1.83 vs 6.57±1.76; right: 6.84±1.81 vs 6.76±1.79 vs 6.49±1.69; all P<0.001). There were no significant differences in AI among the three reconstruction methods for the cerebellar cortex and the epileptic propagation zone (all P>0.05). In the epileptogenic zone, the AI in the BPL (β=350) was lower than that in the OSEM (24.68±4.13 vs 25.42±3.64, P=0.048), while there was no significant difference in AI between the BPL (β=150) and OSEM (P>0.05).

Compared with the OSEM method, AI in images reconstructed with the BPL method demonstrates no significant difference for localizing epileptogenic foci in temporal lobe epilepsy on ¹⁸F-FDG PET-MRI.

To compare the clinical outcomes of emergency surgery and conservative treatment in patients with acute type A aortic intramural hematoma (IMH).

Patients with acute type A aortic IMH who were diagnosed atthe Department of Cardiovascular Surgery of Guangdong Provincial People′s Hospital between November 2011 and February 2023 were retrospectively enrolled. According to international guideline criteria, patients were divided into theemergencysurgery group (surgery group) and theconservative treatment group (conservative group). Baseline characteristics, in-hospital mortality, and 5-year survival after discharge were compared between the two groups.

A total of 224 patients with acute type A aortic IMH were included. There were 138 (61.6%) and 86 (38.4%)patients underwent emergent surgery andconservative treatment, respectively. There were no significant differences between the two groups in age, sex, height, weight, diabetes mellitus, dyslipidemia, renal insufficiency, history of cardiovascular disease, moderate to severe aortic regurgitation, or moderate to large pericardial effusion (all P>0.05). The proportions of hypertension [81.9% (113/138) vs 66.3% (57/86)] and coronary artery disease [37.0% (51/138) vs 18.6% (16/86)] were higher in the surgery group than those in the conservative group, whereas the proportions of chronic obstructive pulmonary disease [14.5% (20/138) vs 29.1% (25/86)], smoking history [18.1% (25/138) vs 40.7% (35/86)], Marfan syndrome [1.4% (2/138) vs 8.1% (7/86)], and bicuspid aortic valve [2.2% (3/138) vs 9.3% (8/86)] were lower in the surgery group than those in the conservative group (all P<0.05). Regarding imaging features, the prevalence of ulcer-like projection (ULP) was higher in the surgery group than that in the conservative group [44.9% (62/138) vs 29.1% (25/86), P=0.024]. In addition, ascending aortic length [12.1 (11.6, 13.4) cm vs 9.4 (8.7, 11.7) cm], maximal aortic diameter [44.8 (40.4, 50.0) mm vs 41.7 (37.5, 46.0) mm], and hematoma thickness [13.7 (11.0, 17.6) mm vs 8.0 (6.0, 9.6) mm] were all greater in the surgery group than those in the conservative group (all P<0.001). In-hospital mortality [14.0% (12/86) vs 15.9% (22/138)] and 5-year survival rate [90.1% (95%CI: 83.7%-96.9%) vs 83.5% (95%CI: 77.4%-90.1%)] did not differ significantly between the two groups (both P>0.05).

The study indicates that patients in the emergency surgery group had more high-risk imaging features compared with the conservative treatment group. This suggests that for patients with acute type A aortic IMH who are clinically and radiographically stable and strictly selected, conservative treatment can achieve survival outcomes similar to surgery in the mid-term follow-up.​​

To investigate the efficacy of selective sinus replacement (SSR) in the treatment of acute Stanford type A aortic dissection.

A retrospective analysis was conducted on patients who underwent selective aortic sinus replacement or aortic root replacement for aortic sinus involvement. These patients were among 310 emergency cases of Stanford type A aortic dissection admitted to the Division of Cardiovascular Surgery of the University of Hong Kong-Shenzhen Hospital between July 1, 2020, and December 31, 2024. Based on the surgical procedure performed on the aortic root, the patients were divided into three groups: the David group, the SSR group, and the bioprosthetic Bentall (Bio-Bentall) group. The operative time, intraoperative blood loss, cardiopulmonary bypass time, aortic cross-clamp time, postoperative hospital stay, complications, and follow-up outcomes including aortic valve function and changes in aortic root diameter were compared among the different surgical groups.

A total of 42 patients (34 males and 8 females) aged (48±21) years were included, with 11, 20 and 11 cases in the David group, the SSR group and the Bio-Bentall group, respectively. All surgeries were successfully completed without perioperative mortality or major cardiovascular events. The SSR group demonstrated shorter aortic cross-clamp time [(138±29) min vs (166±19) min], cardiopulmonary bypass time [(201±43) min vs (219±23) min], and operative time [(423±60) min vs (448±58) min] compared with the David group (both P<0.05). No statistically significant differences were observed in 30-day postoperative complications or long-term follow-up outcomes among the SSR, David, and Bio-Bentall groups (all P>0.05). During follow-up, all patients exhibited well aortic valve function, with no moderate or severe aortic regurgitation. In the SSR group, the aortic sinus diameter significantly decreased at 6 months postoperatively compared with the preoperative measurement [(36±3) mm vs (40±5) mm, P=0.032]. No statistically significant difference was observed between the measurements at 6 months and 1 year postoperatively [(36±3) mm vs (35±3) mm, P=0.522].

SSR represents a safe and effective surgical strategy for acute Stanford type A aortic dissection in carefully selected patients.

To evaluate the therapeutic efficacy of interventional radiology (IR) combined with delayed aortic repair in patients with acute type A aortic dissection (ATAAD) with concurrent mesenteric malperfusion syndrome (MeMPS), and explore the risk factors for visceral organ failure and death after IR.

A total of 693 patients with ATAAD admitted to Xijing Hospital from January 2018 to March 2022 were retrospectively analyzed. The therapeutic outcomes of IR combined with delayed aortic repair in patients with MeMPS were observed. Logistic regression was used to analyze the risk factors for mortality due to visceral organ failure after IR.

Among the 693 patients, 656 patients (507 males and 149 females) aged [M(Q₁, Q₃)] 52 (44, 58) years did not have any organ malperfusion syndrome, while all 37 (31 males and six females) aged 50 (46, 55) years with MeMPS underwent IR followed by delayed aortic repair after clinical improvement. The median symptom onset time in MeMPS patients was 0.3 (0.2, 0.4) d, and the overall in-hospital mortality was 43.2% (16/37). Some patients also had multiple organ malperfusion syndrome (kidney: 10 cases; lower extremity: two cases). Among the 24 MeMPS patients (64.9%) whose condition improved after IR and who subsequently underwent aortic repair, the in-hospital mortality rate showed no significant difference compared to patients without MeMPS [12.5% (3/24) vs 8.2% (54/656), P=0.714]. Similarly, there were no significant differences in the 1-, 3-, and 5-year survival rates between the two groups (79.2%, 54.4%, 54.4% vs 81.2%, 78.9%, 77.7%, respectively; P=0.300). After IR, death due to organ failure was the main reason preventing aortic repair in MeMPS patients (organ failure: 10 cases; aortic rupture: three cases). Compared with survivors after IR, patients who died of organ failure had higher age, creatinine, D-dimer, and fibrinogen degradation products (FDP), and a smaller true lumen diameter of the abdominal aorta at the diaphragm level (all P<0.05). Multivariate logistic regression analysis identified that the true lumen diameter of the abdominal aorta at the diaphragm level (OR=0.72, 95%CI: 0.52-0.99), FDP (OR=1.03, 95%CI: 1.01-1.06), and D-dimer (OR=1.07, 95%CI: 1.01-1.13) were risk factors for death due to visceral organ failure.

For ATAAD patients with concurrent MeMPS, salvage IR can serve as a bridging therapy prior to aortic repair. The true lumen diameter of the abdominal aorta at the diaphragm level, D-dimer, and FDP are risk factors for death due to visceral organ failure.

To analyze the metabolic characteristics of the healthy scalp microenvironment using spatial metabolomics and to compare them with those of psoriasis lesions.

Healthy skin tissue samples from various body sites were prospectively collected from patients undergoing skin biopsy in the Department of Dermatologic Surgery, Shanghai Dermatology Hospital between March 2024 and March 2025. Spatial metabolomics was performed to analyze metabolite differences between scalp skin and skin from other body regions (control group). Metabolic pathway analysis was conducted using the Kyoto Encyclopedia of Genes and Genomes (KEGG) database. Additionally, dataset GSE13355 (containing psoriatic lesional skin and healthy skin from healthy individuals) was downloaded from the Gene Expression Omnibus (GEO) database. Differential gene expression analysis was performed between psoriatic lesions and healthy control skin followed by KEGG enrichment analysis of the differentially expressed genes.

A total of 40 healthy skin tissue samples (2 cm×3 cm) were collected from 12 different body sites, including 4 scalp samples and 36 control samples. Spatial metabolomics identified 375 differential metabolites, of which 274 were upregulated in the scalp. The scalp exhibited enrichment of lipid and acidic metabolites, including fatty acyls, glycerides, glycerophospholipids, sphingolipids, organic acids and derivatives, and amino acids and metabolites (all P<0.05). KEGG pathway analysis revealed that scalp differential metabolites were primarily enriched in lipid metabolism and skin function-related pathways, particularly bile secretion, glycerophospholipid metabolism, and sphingolipid metabolism. KEGG enrichment analysis based on the GSE13355 dataset from the GEO showed significant enrichment of pathways related to unsaturated fatty acid biosynthesis, fatty acid metabolism, and cholesterol metabolism in psoriatic lesions (all P<0.05). These metabolic characteristics were similar to those observed in normal scalp tissue.

The healthy scalp region exhibits distinct lipid and acidic metabolic characteristics, while psoriasis lesions show disturbances in both lipid and acidic metabolism. Both share similar metabolic characteristic profiles.

This paper reports the procedure of balloon dilatation and anesthesia management in a child with subglottic stenosis after intubation. A male child, 3 months old and 6 days old, weighing 6 kg, went to Yuying Children's Hospital, the Second Affiliated Hospital of Wenzhou Medical University on June 13, 2025 because of "breathing difficulty for more than 2 months after tracheal intubation removal". After birth, the child had undergone tracheal intubation in another hospital for 15 days due to "neonatal meconium aspiration syndrome". After extubation, he developed breathing difficulty with inspiratory ringing of the larynx, and the three concave sign was positive. Electronic laryngoscopy showed subglottic stenosis, subglottic mucosal hyperplasia, about 60% of the obstruction surface, and airway stenosis Myer-Cotton grade II. Two-dimensional reconstruction of tracheal CT showed: C_5~7The trachea was slightly narrowed at all levels, and the diagnosis was "subglottic stenosis after neonatal intubation". The child underwent general anesthesia without intubation and spontaneous breathing, and balloon dilatation with laryngoscope was performed. Postoperatively, the child breathed spontaneously well without airway-related complications, and returned to the ward safely after recovery. On the second day after surgery, electronic laryngoscopy showed improvement of subglottic stenosis and was discharged.

Type A aortic dissection (TAAD) is an extremely dangerous and critical disease. Surgery is the main treatment, and the management of aortic root is the key factor affecting the success of surgery and the prognosis of patients. In recent years, the surgical technique of TAAD has made significant progress, and the treatment of aortic root has been continuously innovated and optimized. In addition, new technologies such as minimally invasive technology, artificial intelligence and new materials have also been tried to be applied to the surgical treatment of TAAD, further expanding the feasibility and safety of surgery. However, at present, there is no unified consensus on the best treatment of aortic root, and the long-term effect of related techniques still needs further follow-up verification. This article reviews the root management modalities in TAAD surgery, aiming to provide reference for clinical treatment.

Non-small cell lung cancer (NSCLC) is one of the malignancies with the highest morbidity and mortality rates worldwide. Although immune checkpoint inhibitors (ICIs) significantly improve prognosis in some patients, resistance problems still limit their efficacy. Studies have shown that tumor-associated macrophages (TAM) play a key role in the formation of immunosuppressive microenvironment and immune resistance, while lipid metabolism reprogramming is an important mechanism driving the functional transition of TAM. Myeloid cell trigger receptor 2 (TREM2), as a lipid recognition receptor on myeloid cells, not only regulates the lipid metabolism of macrophages, but also promotes the polarization of TAM to M2 type through various lipid metabolism regulatory pathways, thereby inhibiting immune cell function and promoting tumor progression. This article reviews TREM2⁺Advances in research on TAM and lipid metabolism in NSCLC, illustrating their roles in immunosuppressive microenvironment remodeling, immunotherapy resistance, and potential intervention strategies. Targeting TREM2 or lipid metabolism pathways in combination with immunotherapy is promising, but further mechanistic studies and clinical validation are still needed. Therefore, exploring the functional differences of TREM2 in different stages of lung cancer and its interaction with lipid metabolism regulation will provide new ideas for optimizing NSCLC immunotherapy and improving the efficacy of immunotherapy.