Volume 106 · Issue 05 · 2026

Spontaneous intracerebral hemorrhage (ICH) is characterized by acute onset and high rates of disability and mortality. Although surgical intervention is theoretically capable of decreasing intracranial pressure efficiently and mitigating secondary brain injury, its clinical benefit has long lacked high-level evidence. This article systematically reviews the evolution of ICH surgical treatment—from empirical attempts in the 17th century, through the establishment of early evidence-based guidelines in the CT era of the 20th century, to the conceptual innovation driven by minimally invasive technology in the 21st century. Currently, critical unresolved issues include optimal timing of surgery, selection of surgical approach, intelligent surgical technologies, selection for deep hemorrhage patients, and the surgery in brainstem hemorrhage. Future progress requires multicenter, high-quality clinical research to advance standardized, visualized, precise, intelligent, and homogeneous surgical interventions, thereby providing high-quality evidence from Chinese populations for the diagnosis and treatment of spontaneous ICH worldwide.

Sarcopenic obesity is a clinical syndrome in which sarcopenia coexists with obesity. It is characterized by a decline in muscle mass and function combined with an increase in fat mass, thereby increasing the risk of adverse clinical outcomes in patients. For a long time, the lack of standardized diagnostic criteria has made it difficult to accurately determine the prevalence of sarcopenic obesity. In 2022, the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) jointly launched an initiative, for the first time reaching an expert consensus on the definition and diagnostic standards for sarcopenic obesity. This article focuses on recent advances in sarcopenic obesity, systematically summarizing its pathogenesis from four aspects: body composition changes, lifestyle and dietary alterations, metabolic/hormonal dysregulation, and gut microbiota dysbiosis, with emphasis on domestic and international diagnostic strategies. Meanwhile, it further explores the multifaceted detrimental effects on elderly quality of life and life expectancy, and proposes a comprehensive prevention and treatment framework centered on combined lifestyle and nutritional interventions, supplemented by pharmacotherapy, with multidisciplinary treatment (MDT) as the key strategy, aiming to provide theoretical basis and practical direction for clinical diagnosis and treatment of this disease.

Bone homeostasis essentially represents a balanced interplay among bone cells, dynamically maintaining bone mass and structural stability under the influence of both internal and external factors of the body. Bone tissue receives various types of neural innervation and, through the secretion of signaling factors, influences the function of bone cells, collectively forming the core framework of the "neuro-skeletal axis". This review systematically analyzes the roles of multiple neural regulatory mechanisms in the maintenance of bone homeostasis and the repair of bone injuries, as well as their translational applications. The autonomic nervous system mainly regulates immune niches and maintains the dynamic balance between osteogenesis and osteoclastogenesis by coordinating sympathetic and parasympathetic nerve tones. Sensory nerves promote bone regeneration through neuropeptides and mechanosignal coupling. The central nervous system further integrates peripheral signals and exerts feedback regulation on bone metabolism through multiple pathways. Although approaches such as receptor blockers, neural magnetic stimulation, and bioengineered scaffolds have gradually shown clinical application potential, their safety, efficacy, and underlying mechanisms still require further investigation. Future research should focus on multidisciplinary efforts to develop precise and controllable neural modulation strategies, providing novel cross-scale interventions for diseases such as osteoporosis and fractures.

Robot-assisted deep brain stimulation (DBS) surgical systems in neurosurgery have demonstrated significant advantages in enhancing operative precision, reducing complications, and improving clinical outcomes. With advancements in robot-assisted surgical systems and surgical techniques, coupled with their wider adoption in DBS procedures, there is a growing need to further standardize and improve surgical workflows, technical details,etc. This consensus focuses on neurosurgery robot-assisted DBS surgery. Through proposing recommendation questions, summarizing and evaluating evidence, formulating recommendations, expert discussions and clinical practice, eight recommendations were developed covering aspects such as indications, preoperative preparation, surgical planning, registration, anesthesia, key operative steps, and postoperative assessment. The aim is to enhance surgical precision and safety, improve patient prognosis, comprehensively present the latest research progress in robot-assisted DBS surgery, and the collective expertise and opinions of experts in the field, thereby providing guidance for the clinical practice of DBS surgery.

Pain management, sedation, and delirium control are critical components in managing adult patients receiving extracorporeal membrane oxygenation (ECMO). Appropriate management of these interventions is essential for mitigating pain-induced stress, maintaining patient-ventilator synchrony, and reducing complications. However, as an extracorporeal life support technology, ECMO may significantly alter the pharmacokinetics and pharmacodynamics of analgesics and sedatives through mechanisms such as drug adsorption and an increased volume of distribution. Additionally, the complex pathophysiological status of ECMO patients, including multi-organ dysfunction and exacerbated inflammatory responses, further amplifies challenges in analgesia, sedation, and delirium management. Currently, there are no specific guidelines addressing ECMO patients globally, resulting in substantial heterogeneity and uncertainty in clinical practice. To address this gap, the Extracorporeal Life Support Professional Committee of the Chinese Medical Doctor Association and Chinese Society of Anesthesiology developed this expert consensus based on evidence-based principles. Through systematic literature analysis and a modified Delphi method for expert opinion aggregation, 15 key clinical questions were refined, culminating in 25 evidence-based recommendations. This consensus aims to standardize analgesia-sedation strategies, optimize delirium management protocols, and provide a scientific, consistent framework for clinical practice to improve patient outcomes.

To investigate the association between latent class growth model (LCGM)-derived dynamic Glasgow Coma Scale (GCS) trajectories and in-hospital mortality in patients with intracerebral hemorrhage (ICH).

Eligible ICH patients were retrospectively included from the Medical Information Mart for Intensive Care Ⅳ (MIMIC-Ⅳ, 2008-2022), the eICU Collaborative Research Database (eICU, 2014-2015), and the Neurosurgical Intensive Care Unit cohort of Nanjing Drum Tower Hospital (NSICU, 2024-2025). GCS scores within 120 h after ICU admission were time-gridded at 8-h intervals, and trajectory subtypes were identified using LCGM. Cox proportional hazards regression model was applied to evaluate the association between GCS trajectory classes and in-hospital mortality. Kaplan-Meier curves for in-hospital survival within 28 d after ICU admission were generated, and differences between groups were copmared using the log-rank test.

A total of 5 443 patients with cerebral hemorrhage were included [2 893 males and 2 550 females, aged (64±16) years]. Five GCS trajectory classes were identified: consistently high (33.0%, n=1 796), rapidly improving (39.0%, n=2 121), persistently moderate (16.2%, n=879), gradually deteriorating (5.2%, n=283), and persistently low (6.7%, n=364). In the fully adjusted Cox model, in-hospital mortality risk for the rapidly improving, persistently moderate, gradually deteriorating, and persistently low classes were significantly higher than that of consistently high class, with HR of 3.06 (95%CI: 2.09-4.50), 10.13 (95%CI: 6.86-14.97), 13.27 (95%CI: 8.85-19.88), and 33.71 (95%CI: 22.44-50.64), respectively (all P<0.001). Kaplan-Meier analysis demonstrated significant differences in 28-day in-hospital survival among the five classes (P<0.001), with cumulative survival rates of 89.8%, 85.7%, 60.8%, 56.1% and 33.6%, respectively.

LCGM-derived dynamic GCS trajectories are closely associated with in-hospital mortality in ICH and may aid early risk stratification and in-hospital mortality risk assessment.

To identify neurological recovery trajectories in patients with spontaneous intracerebral hemorrhage (ICH) using a latent class mixed model (LCMM), to examine the related clinical and meteorological factors, and to develop a predictive model for adverse neurological outcomes.

A total of 1 067 patients with spontaneous ICH admitted to the First Affiliated Hospital of Harbin Medical University in 2023 were retrospectively enrolled. Demographic, clinical, imaging, and meteorological data on the day of onset were collected. All patients were followed up from the time of admission at a unified time point, and modified Rankin Scale (mRS) scores were recorded at discharge and at 3, 6, and 12 months after discharge. Based on the mRS scores, LCMM was applied to identify neurological recovery trajectories. Univariate and multivariate multinomial logistic regression analyses were performed to determine influencing factors. On the basis of the LCMM-derived categories, certain subgroups were strategically merged to construct a binary predictive model for risk of poor neurological outcomes in patients. Model performance and interpretability were evaluated through ROC curve, calibration curves, and SHAP (Shapley Additive Explanations) analysis.

A total of 1 067 ICH patients [690 males (64.7%) and 377 females (35.3%)], aged[M(Q₁, Q₃)] 61 (53, 69)years, were included. Four neurological function recovery trajectories were identified in the study: partial improvement group(611 cases, 57.3%), gradual improvement group(203 cases, 19.0%), rapid improvement group(182 cases, 17.1%), and persistent disability group(71 cases, 6.7%). Different trajectory types were associated with GCS scores, hematoma location, hematoma volume, and meteorological variables. The patients in the gradual improvement group were associated with higher maximum temperature (OR=1.10, 95%CI: 1.06-1.15), lower minimum temperature (OR=0.91, 95%CI: 0.88-0.95), smaller diurnal temperature variation (OR=0.83, 95%CI: 0.78-0.88), onset in autumn (OR=4.06, 95%CI: 1.87-8.85), onset in winter (OR=4.18, 95%CI: 1.74-10.03), no history of cardio-cerebrovascular disease (OR=1.64, 95%CI: 1.08-2.50), higher GCS scores (OR=1.29, 95%CI: 1.18-1.40), and lobar hemorrhage (OR=2.66, 95%CI: 1.37-5.14). The patients in the rapid improvement group were associated with no history of cardio-cerebrovascular disease (OR=2.35, 95%CI: 1.45-3.84), shorter hospital stays (OR=0.93, 95%CI: 0.88-0.98), higher GCS scores (OR=2.29, 95%CI: 1.87-2.80), no midline shift (OR=2.10, 95%CI: 1.09-4.06), right-sided hemorrhage (OR=1.64, 95%CI: 1.10-2.46), as well as lobar hemorrhage (OR=3.58, 95%CI: 1.70-7.51) and infratentorial hemorrhage (OR=3.02, 95%CI: 1.61-5.66). The patients in the persistent disability group were associated with smaller diurnal temperature variation (OR=0.89, 95%CI: 0.81-0.97), shorter hospital stays (OR=0.95, 95%CI: 0.91-1.00), lower GCS scores (OR=0.82, 95%CI: 0.74-0.90), larger hematoma volumes (OR=1.02, 95%CI: 1.00-1.03), and infratentorial hemorrhage (OR=4.71, 95%CI: 1.67-13.30). The constructed binary predictive model for neurological functional outcomes demonstrated good performance(AUC=0.812, 95%CI: 0.786-0.838) and satisfactory calibration curve fit(Brier score=0.168). SHAP analysis identified GCS score and meteorological variables(maximum temperature, minimum temperature, and diurnal temperature range)(mean absolute Shapley values of 1.07, 0.50, 0.45, 0.32)as the most influential predictors in the model.

LCMM can effectively identify dynamic neurological recovery trajectories in ICH patients. GCS score and meteorological factors are key predictors, and the constructed model exhibited good predictive performance and interpretability.

To explore the effect and prognosis of neuroendoscopic intraventricular hematoma evacuation for ventricular cast hemorrhage (VCH) in high-altitude regions.

A total of 66 VCH patients who underwent surgical treatment at Changdu Municipal People's Hospital between September 2023 and December 2024 were enrolled and divided into two groups based on the surgical procedure: the high-altitude endoscopy group and the high-altitude drainage group. Additionally, 29 VCH patients who underwent surgical treatment at the First Affiliated Hospital of Chongqing Medical University between September 2022 and December 2024 were included as the plain drainage group. The operation duration, hematoma clearance rate, complication rate, duration of drainage catheter indwelling, hospital stay, Glasgow Coma Scale (GCS) score at 15 days postoperatively, and Glasgow Outcome Scale (GOS) score at 3 months postoperatively were compared respectively between the high-altitude endoscopy group and the high-altitude drainage group, as well as between the high-altitude drainage group and the plain drainage group to evaluate the therapeutic effect and prognosis.

A total of 95 VCH patients (62 males and 33 females)with an age of [M(Q₁, Q₃)] 55 (51, 58) years, comprising 36 cases in the high-altitude endoscopy group, 30 cases in the high-altitude drainage group, and 29 cases in the plain drainage group. No statistically significant differences were observed among the three groups in terms of gender, age, volume of hemorrhage, or GCS score on admission (all P>0.05).The hematoma clearance rates in the high-altitude drainage group on postoperative days 1, 3, and 7 were 47% (46%, 50%), 61% (56%, 71%), and 72% (68%, 75%), respectively, which were lower than those in the plain drainage group [56% (53%, 58%), 71% (62%, 76%), and 78% (75%, 82%), respectively], and the incidence of various complications was also higher than that in the plain drainage group. The catheter indwelling duration 7 (7, 8) days and hospital stay (23.3±3.4) days in the high-altitude drainage group were higher than those in the plain drainage group, which were 5(5, 6) days and (19.0±4.7) days . Furthermore, the high-altitude drainage group had lower GOS score a at 3 months after operation [3.5 (2.8, 4.0)], compared to that in the plain drainage group [4.0 (3.0, 5.0)] (all P<0.025).In comparison with the high-altitude drainage group, the high-altitude endoscopy group demonstrated higher hematoma clearance rates [82% (80%, 85%), 87% (84%, 89%), and 93% (92%, 96%)] on days 1, 3, and 7, respectively(all P<0.025) .Compared with the high-altitude drainage group, patients in the high-altitude endoscopy group had reduced complication rate, shorter hospital stay[(20.2±4.8) d], and higher GOS scores at 3 months[4.0(4.0, 5.0)] postoperatively (all P<0.025).

External ventricular drainage alone yields suboptimal outcomes for VCH patients in high-altitude regions compared to those in plain areas. Neuroendoscopic hematoma evacuation in high-altitude areas can reduce postoperative complications and improve short-term prognosis compared to external ventricular drainage.

To evaluate the efficacy and safety of a quadruple therapy consisting of magaldrate granules combined with rabeprazole, amoxicillin, and clarithromycin for Helicobacter pylori (Hp).

The patients diagnosed with chronic gastritis and Hp positive via gastroscopy for the first time were prospectively collected from 11 centers in China from June 2021 to May 2024. The patients were divided into three groups according to random number table method: Group A (magaldrate granules quadruple therapy for 14 days), Group B (magaldrate granules quadruple therapy for 10 days and magaldrate granules for 18 days), and Control Group (bismuth quadruple therapy for 14 days). The patients were followed up 3 days after treatment, and 4 weeks after the end of treatment. The analysis data set was used for effectiveness analysis [the eradication rate of Hp was analyzed using the full analysis dataset (FAS) and the per-protocol dataset (PPS)], and non-inferiority evaluation was conductedusing (comparing the rate difference and 95%CI of the eradication rate of Hp. If the lower limit was greater than the preset -10%, the non-inferiority test standard was met). The occurrence of symptoms and adverse reactions were analyzed in each group.

A total of 557 patients were enrolled, with 227 males and 330 females, aged (46±12) years (18-65 years). The Hp eradication rates according to FAS were 84.6% (159/188) in Group A, 83.2% (153/184) in Group B, and 85.4% (158/185) in Control Group, respectively. A total of 527 cases were included in PPS analysis, and the Hp eradication rates were 88.8% (158/178), 88.8% (150/169),and 87.2% (157/180) in the three groups, respectively. In the FAS and PPS analyses, there was no significant difference in the Hp eradication rates between Group A and Control Group, or Group B and Control Group (all P>0.05). The rate differences and 95%CI were -0.83% (-8.08%-6.42%) and 1.54% (-5.19%-8.27%) between Group A and Control Group. The rate differences and 95%CI were -2.25% (-9.68%-5.17%) and 1.54% (-5.28%-8.35%) between Group B and Control Group. The lower limits of all confidence intervals exceeded the pre-specified non-inferiority margin of -10%, meeting the criteria for non-inferiority. All three groups of patients exhibited symptoms such as epigastric distension, belching, epigastric pain, and poor appetite. After 3 days of treatment, the relief rate from epigastric pain in Group A [85.9% (55/64)] and Group B [91.2% (52/57)] was higher than Control Group [70.2% (40/57)] (both P<0.05). Adverse reactions of varying severity, including dizziness, nausea, vomiting, abdominal pain, diarrhea, and rash, were reported in all three patient groups. No statistically significant differences were found in the incidence rates of these adverse events between Group A and Control Group, or Group B and Control Group (all P>0.05).

The quadruple therapy combining magaldrate granules with rabeprazole, amoxicillin, and clarithromycin demonstrates good Hp eradication efficacy and high safety.

To investigate the clinical characteristics and prognostic factors for patients with cerebrospinal fluid positivity for torque teno virus (TTV) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).

A retrospective analysis was conducted on the patients who received allo-HSCT at Hebei Yanda Lu Daopei Hospital from 2022 to 2023 year and showed positive cerebrospinal fluid metagenomic next-generation sequencing (mNGS) results post-transplantation, with their clinical data collected accordingly. The patients were categorized into TTV-negative and TTV-positive groups based on the detection of TTV in cerebrospinal fluid. The TTV-positive group was further subdivided into low-RPM [TTV reads per million sequencing reads (TTV-RPM)<1] and high-RPM (TTV-RPM≥1) subgroups using the threshold of TTV-RPM. The patients were followed until December 9, 2025, to investigate the clinical features of cerebrospinal fluid TTV positive patients after allo-HSCT. The survival curve was drawn to compare the difference of survival rate between groups. The influencing factors of patient prognosis were analyzed using a multivariate Cox regression model.

A total of 134 patients were enrolled: sixty in the TTV-negative group, including 35 males and 25 females, aged [M (Q₁, Q₃)] 30 (14, 42) years, and 74 in the TTV-positive group, including 45 males and 29 females, aged 24 (15, 40) years. Within the TTV-positive group, 44 were classified as low-RPM subgroup and 30 as high-RPM subgroup. Baseline characteristics, including gender, age, primary disease, donor type, neutrophil engraftment time, platelet engraftment time, whether acute graft-versus-host disease (aGVHD) occurred, and other microbial infections in cerebrospinal fluid, showed no significant differences between the TTV-negative and TTV-positive groups, or between the low-RPM and high-RPM subgroups (all P>0.05). The median follow-up time was 30.0(18.0, 35.4) months, the median survival period was not reached in the low-RPM subgroup, while that in the high-RPM subgroup was 25.6 months (95%CI: 5.3-45.9), and the 3-year survival rate was lower than that in the low-RPM subgroup (41.1% vs 76.8%, P=0.014). Multivariate Cox regression analysis confirmed high TTV-RPM level (≥1) in cerebrospinal fluid as a risk factor for mortality in allo-HSCT patients (HR=2.57, 95%CI: 1.09-6.08).

There is no difference in clinical characteristics among allo-HSCT patients with or without TTV infection or with different TTV viral loads. A high TTV-RPM value (≥1) in cerebrospinal fluid is a risk factor for mortality in allo-HSCT patients.

A retrospective analysis was conducted on the clinical data of newly diagnosed pediatric acute myeloid leukemia (AML) children [excluding acute promyelocytic leukemia (APL)] in Shanghai Children′s Hospital between January 2019 and April 2024. The patients were followed up until April 30, 2025. Minimal residual disease (MRD) was detected to analyze the prognostic impact of MRD assessed by different methods on pediatric AML patients. Among the 52 enrolled patients, 35 were male and 17 were female. The median age at initial diagnosis was 99 months (range: 9-188 months), with a median follow-up [M (Q₁, Q₃)] of 3.2 (1.2, 4.7) years. The 3-year overall survival rates and event-free survival (EFS) rates were 80.7% and 69.4%, respectively. Multivariate Cox regression analysis revealed that gene MLL rearrangement (excluding MLL-AF9) (HR=3.071, 95%CI: 1.024-9.205) and positive molecular MRD after Induction Course Ⅱ therapy (HR=5.571, 95%CI: 1.244-24.957) were risk factors for EFS in pediatric AML patients.

This study explored the feasibility of an optical navigation system based on ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) data for treating chronic osteomyelitis of long bones of extremities, and a retrospective analysis was conducted on 7 patients with chronic osteomyelitis of long bones of extremities admitted to the Department of Orthopedic Surgery, PLA General Hospital, from May 2023 to May 2024. Of the patients, there were 6 males and 1 female with a mean age of (47.4±13.7) years, and the lesion sites involved 1 case in the femur, 3 cases in the tibia, and 3 cases in the humerus. All the patients received treatment with the combination of an optical navigation system based on preoperative imaging planning via ¹⁸F-FDG PET/CT, where in the first-stage surgery, the scope of bone and soft tissue infection was determined according to imaging results, precise debridement and antibiotic-loaded bone cement packing were completed under real-time intraoperative navigation guidance, direct wound suture was performed in 6 cases, and flap transplantation was conducted for repair in 1 case due to poor soft tissue conditions. The bacterial culture results showed 5 cases of Staphylococcus aureus, 1 case of Pseudomonas aeruginosa, and 1 case of Klebsiella pneumoniae. In the second-stage surgery, the navigation system was used to calculate the volume of bone defects, and bone reconstruction was implemented using the Masquelet technique combined with autologous bone grafting, with an average clinical healing time of (3.4±0.4) months; 12-month postoperative follow-up indicated that all patient scores were improved compared with preoperative values, specifically the Self-Rating Anxiety Scale (SAS) score, Activities of Daily Living (ADL) Scale score, Disabilities of the Arm, Shoulder and Hand (DASH) Scale score, Lower Extremity Functional Scale (LEFS) score, and visual analogue scale (VAS) of pain [(35.6±3.6) vs (49.4±3.9) points, (96.4±4.8) vs (53.6±11.8) points, (28.7±8.5) vs (60.3±7.0) points, (63.5±4.1) vs (20.8±4.8) points, (0.7±0.9) vs (5.6±1.1) points, all P<0.05]. In conclusion, the ¹⁸F-FDG PET/CT-based navigation system can achieve preoperative independent planning, intraoperative lesion debridement with real-time monitoring, and precise treatment of chronic osteomyelitis of long bones of extremities.

A 26-year-old female suffered from recurrent left chest pain with elevated troponin T 5 months before admission. The electrocardiogram showed acute ST-segment elevation myocardial infarction-like changes. Coronary angiography showed coronary artery spasm. Due to the elevation of peripheral blood eosinophils (EOS), she was transferred from the cardiology department to the hematology department. Bone marrow puncture and bone marrow biopsy excluded hematological tumors. After the proposed diagnosis of "eosinophilia" and glucocorticoid (GC) treatment, there was no recurrent chest pain. EOS decreased, but repeated thrombocytopenia with skin ecchymosis occurred during the reduction of GC, and bone puncture again showed bone marrow megakaryocyte maturation disorder. He was consulted in the rheumatology and immunology department due to elevated rheumatoid factor (RF), and his medical history was followed up. He had previous bronchial asthma, allergic rhinitis and suspected EOS enteritis, and was diagnosed with eosinophilic granulomatous polyangiitis (EGPA) and secondary immune thrombocytopenia (ITP). After high-dose GC combined with rituximab treatment, his condition was in remission, and his condition was stable after 1 year follow-up. This case suggests that coronary artery spasm that is ineffective for antispasmodic and crown expansion treatment, especially coronary arteritis caused by systemic vasculitis should be considered when it is accompanied by systemic manifestations. The rare disease EGPA has three rare clinical manifestations at the same time-coronary arteritis, secondary ITP and RF elevation, which brings great clinical challenges. Multidisciplinary cooperation may reduce clinical misdiagnosis and missed diagnosis.

The patient, a 70-year-old male, went to the Department of Urology, Beijing Anzhen Hospital affiliated to Capital Medical University on April 2, 2025 because of "physical examination found left renal hilum mass for more than 5 years". Previous history of Stanford type B aortic dissection, hypertension, diabetes, hyperlipidemia, emphysema and pulmonary fibrosis. Laparoscopic partial left nephrectomy was performed after abdominal enhanced CT and CT angiography. Three-dimensional holographic image reconstruction technique was used before operation to clearly show the spatial relationship between tumor and renal vascular and aortic dissection, and to plan and determine the safe renal artery occlusion point. Laparoscopic partial left nephrectomy was performed under real-time navigation during the operation. Postoperative pathology confirmed that it was clear cell carcinoma of the left kidney (negative margin). The patient recovered smoothly and the renal function remained stable.

This paper reports two cases of middle-aged male patients, all of whom went to the Air Force Special Medical Center for diabetic foot ulcer. The clinical manifestations are old face, thin body, accompanied by insulin resistance, hyperlipidemia and fatty liver. Two patients were found to carry WRN mutant gene by genetic testing, and were diagnosed as Werner syndrome. Two patients with foot ulcer were treated with traditional debridement and dressing change and negative pressure suction. Modified platelet-rich fibrin was prepared from autologous blood to cover the wound surface, and the wound surface healed. There was no recurrence of foot ulcer in 2 patients after discharge and follow-up until November 2025.

The patient, a 63-year-old female, went to Linyi Cancer Hospital on February 4, 2025 due to "vaginal mass for half a year and a small amount of vaginal bleeding for 1 week". The patient started with a vaginal opening mass, and transvaginal ultrasound showed a hypoechoic mass protrusion in the posterior wall of the vagina, which was not excluded as malignant. The initial diagnosis was vaginal tumor. Because the patient felt unwell and had vaginal bleeding, surgical treatment was required, and transvaginal mass resection + vaginoplasty was performed. During the operation, it was found that the tumor was located in the rectovaginal septum, with a size of about 5.3 cm ×3.0 cm ×3.0 cm, and the mass was completely removed along the capsule. The postoperative pathology was diagnosed as rectovaginal extragastrointestinal stromal tumor (EGIST) (high-risk group) after consultation, and then oral imatinib (400 mg/d) was treated for 3 years. Abdominal and pelvic CT was re-examined 6 months after surgery (August 2025), and there was no recurrence or metastasis.

Single bacterial transcriptome sequencing (RNA-seq) is a technique to capture and quantify transcript expression at the level of single bacteria, which provides an important means for in-depth analysis of bacterial heterogeneity. This paper systematically reviews the development of single bacterial RNA-seq, focuses on the methods and strategies adopted to break through the bottlenecks of key technologies, such as split cell combination index and droplet microfluidic technology, during the evolution of this technology from low-throughput manual operation to high-throughput automated platform, and compares the core principles and characteristics of representative sequencing platforms. At the same time, the application potential of this technology in the study of pathogen resistance heterogeneity, host-pathogen interaction and microbiome function analysis were discussed in this paper. Finally, although single-bacteria RNA-seq technology still has certain challenges in terms of sensitivity, throughput and cost, with the increasing maturity of the technology and the gradual reduction of experimental cost, this technology is expected to develop into a conventional research method in the field of microbiology, thus promoting microbiology research to a deeper and more refined level.

The patient, a 54-year-old male, was admitted to the Third Hospital of Peking University on June 26, 2024 due to "blood in the stool for 3 months". Three months ago, the patient had blood in the stool without obvious trigger, which was bright red and coffee-colored stool alternately, shaped soft stool, accompanied by abdominal pain and abdominal distension, which was slightly aggravated in the past 3 weeks, about 3 to 4 times/d, occasionally visible mucus, pus and blood in the stool, accompanied by severe feeling after tenesmus, the correlation with eating was unclear, and there were no other complaints of discomfort. There was no family history of gastrointestinal tumor and no history of travel outside the epidemic area. The whole body examination is nothing special. Colonoscopy: Scattered irregular ulcers of different sizes can be seen in the cecum, appendix and upper segment of ascending colon (Figure 1, shown by arrows), with congestion around the ulcers and dirty coating attached to the surface. There are multiple irregular ulcers from 18 cm in the rectum to the anus (Figures 2 and 3, shown by arrows). Some ulcers are crater-shaped with different sizes. The surrounding mucosa is congested and edematous, the mucosa is rough and uneven, and the surface is attached to dirty coating, accompanied by spontaneous bleeding. The biopsy part is brittle. Endoscopic diagnosis: the nature of multiple ulcers in the cecum, ascending colon and rectum is to be determined. Pathology suggests proximal ileocecal valve ulcer of ascending colon: chronic active inflammation of mucosa with ulcer formation, inflammatory exudation and necrosis, basically regular crypt arrangement, occasional cryptitis, formation of lymphoid follicles in lamina propria, and amoebic trophozoites (Figure 4, HE staining ×400, indicated by arrows); (Rectal ulcer) Chronic active inflammation of the mucosa with necrosis and exudation, with amoebic trophozoites visible. Special staining results: Schiff periodate stain (PAS) (+), hexamine silver periodate stain (PASM) (+). Polymerase chain reaction Mycobacterium tuberculosis nucleic acid detection (PCR-TB) (-). Consistent with amoebic enteritis. Perfect inspection and examination, no other organ involvement. In summary, the diagnosis of amoebic enteropathy is clear and there is no involvement of peripheral organs. Metronidazole combined with diclonide was intermittently treated for 90 days. After 1 month of stopping the drug, colonoscopy was repeated: only a little erythema in the rectum, and the pathology suggested chronic active inflammation of the mucosa. Follow-up until January 14, 2025, and endoscopy revealed cure.