Volume 106 · Issue 14 · 2026

In recent years, significant progress has been made in gynecological oncology research in China. However, numerous challenges remain in the following field of area such as cancer prevention, early diagnosis and treatment, innovation in basic research, translational applications, and international influence. Against both global and domestic backdrops, this review systematically analyzes the distinctive features and strengths of gynecological oncology research in China in recent years, identifies existing bottlenecks, and proposes recommendations to strengthen original research, enhance multicenter collaboration, deepen integration between basic and clinical studies, and promote international engagement. These suggestions aim to provide insights for the high-quality development of gynecological oncology as a discipline in China in the future.

Surgery remains the cornerstone of treatment for advanced ovarian cancer. Advanced ovarian cancer can never be cured by surgery alone, but patients with ovarian cancer will ever lose the chance of long-term disease survival without surgery. However, debulking surgery is often associated with a lengthy operation time and more complications. We should pay more attention to several critical issues when performing debulking surgery for ovarian cancer. These include keeping a well balance between surgical efficacy and risk of complications, awaiting the results from randomized clinical trials regarding the optimal timing for surgery, and enhancing well understanding of tumor biology and its clinical implications of advanced ovarian cancer. The quality of surgical intervention is critical for improving survival, particularly long-term disease-free outcomes in women with advanced ovarian cancer. The technical demands of surgical procedures have not diminished, even though neoadjuvant chemotherapy may reduce the complexity of surgery and complications to some extent. Given that approximately 80% of ovarian cancer cases are likely to recur, it is essential to reinforce follow-up strategies and enhance patients′ education in understanding ovarian cancer.

Recent advancements in arteriovenous fistula (AVF) construction focus on addressing clinical challenges such as low maturation rates and limited primary patency. This article integrates relevant evidence-based data and clinical practice to review the major evolution of techniques for creating AVF, and discusses the applicability of different technical approaches and future development directions, with the aim of informing optimization of hemodialysis vascular access strategies. In open surgery, emphasis is placed on the"no-touch"vesselharvesting concept, optimization of anastomotic techniques and geometry, and control of spatial configuration. Regarding emerging technologies, the technical characteristics and evidence-based outcomes of percutaneous endovascular AVF (pAVF) are analyzed, alongside its clinical role as a "vessel-sparing" alternative. Overall, the philosophy of AVF construction has shifted from achieving simple anatomical patency toward a multi-faceted approach centered on minimizing vascular injury, optimizing hemodynamics, and prioritizing minimally invasive interventions.

Hepatocellular carcinoma with portal vein tumor thrombus (PVTT) has a high incidence and an extremely poor prognosis. Current international guidelines still exhibit discrepancies in the diagnosis and management of PVTT, while Chinese patients require individualized strategies due to differences in etiology and biological behavior. To adapt to the developments and changes in the clinical diagnosis and treatment of hepatocellular carcinoma with PVTT, and to standardize related clinical procedures, the Chinese Association of Liver Cancer and Chinese Medical Doctor Association initiated the revision of the"Chinese Guidelines for Diagnosis and Treatment of Hepatocellular Carcinoma with Portal Vein Tumor Thrombus (2026 Edition)"in 2025. This revision is based on new evidence that has emerged since the publication of the 2021 edition. This guideline was developed through a systematic literature search up to October 2025, evaluated the evidence using the GRADE system, and formulated recommendations via multidisciplinary expert consensus. The guideline recommends Cheng′s classification as the Chinese standard for PVTT typing, emphasizes a multidisciplinary team (MDT)-based approach, and advocates for individualized comprehensive treatment strategies based on liver function, tumor resectability, and PVTT type. For patients with resectable type Ⅰ/Ⅱ PVTT, surgical resection is the preferred option; for unresectable cases, a combination of local therapies such as hepatic arterial infusion chemotherapy (HAIC), transarterial chemoembolization (TACE), and radiotherapy with systemic therapies including targeted and immunotherapy is recommended. Furthermore, the guideline clarifies the importance of conversion therapy and supportive care, and outlines future research directions, including optimizing staging systems and deepening mechanistic studies. This guideline aims to provide the latest evidence-based basis for the standardized diagnosis and treatment of hepatocellular carcinoma with PVTT, with the goal of improving patient survival and quality of life.

Metagenomic next-generation sequencing (mNGS) has become an important tool in the diagnosis and treatment of infectious diseases due to its non-predefined and broad coverage, particularly in complex and critical infections. Meanwhile, its technical complexity also presents new challenges for quality assurance in clinical laboratories. Therefore, the China Association of Medical Equipment of Genetic Testing, the National Clinical Research Center for Medical Auxiliary Technology (Laboratory Medicine), and the Clinical Microbiology Group of the Laboratory Medicine Society of the Chinese Medical Association, in collaboration with experts in the field, have jointly developed the "Guidelines for standardized application of metagenomic high-throughput sequencing in clinical laboratories (2026 edition)". These guidelines aim to provide guidance for clinical laboratories at all levels to standardize the implementation of mNGS, thereby ensuring the accuracy and reliability of test results. Based on relevant domestic and international standards, guidelines, and the latest research evidence, the guidelines formulate 15 recommendations centered on 15 critical issues, systematically covering key aspects including laboratory zoning, personnel, instruments and equipment, reagents and consumables, software, databases, standard operating procedures, specimen collection, transportation, reception and storage, "wet lab" processes, "dry lab" processes, result interpretation, reference materials, performance validation, internal quality control, external quality assessment, as well as result reporting and interpretation, thereby providing comprehensive guidance for clinical laboratories to standardize their mNGS testing practices.

To evaluate the clinical performance of a human papillomavirus (HPV) testing based on PCR-based fluorescent-probe technology for cervical cancer screening.

From March 2018 to November 2022, eligible women aged 21 to 64 years were recruited from Zhungeer Banner in Ordos City, Inner Mongolia Autonomous Region; Liling City in Zhuzhou City, Hunan Province; and Shangdang District in Changzhi City, Shanxi Province. At baseline, all participants underwent HPV DNA (Sansure HPV), liquid-based cytology (LBC). Participants who were positive for HPV16/18, positive for high-risk HPV (HR-HPV) with atypical squamous cells of undetermined significance (ASC-US), or had LBC results of low-grade squamous intraepithelial lesion (LSIL) or worse were referred for colposcopy, with biopsy performed when indicated. Participants with any positive baseline result were followed annually. All participants were followed up at year 3 for repeat HPV and LBC. The study procedures were terminated for participants diagnosed with cervical intraepithelial neoplasia grade 2 or worse (CIN2+). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), area under the receiver operating characteristic curve (AUC), colposcopy referral rate and number of colposcopies needed to detect one lesion (NNC) were calculated to assess the performance of different screening strategies for detecting CIN2+lesions.

The age of 10 633 participants was (45.5±9.0) years. At baseline screening, 91 cases (0.86%) of CIN2+ were detected. The detection rates of CIN2+ were highest among participants positive for HPV16/18 and those with LSIL+, at 14.39% (62/431) and 16.62% (63/379), respectively. No CIN2+ lesions were detected among participants who were HPV-negative, whereas 15 cases (0.16%) were identified among participants with negative LBC results. Compared with the strategy of HR-HPV triage after LBC primary screening, the strategy of LBC triage after HR-HPV primary screening demonstrated higher sensitivity (100.00%) and AUC (0.973 0, 95%CI: 0.949 6-0.996 4) for detecting CIN2+, although its specificity was slightly lower (94.59%). During follow-up, 8 269 participants completed the 3-year follow-up, and 169 cases (2.04%) of CIN2+were cumulatively detected. The 3-year total detection rates of CIN2+ were highest among HPV16/18-positive participants and those with LSIL+, at 33.01% (101/306) and 28.28% (82/290), respectively. The total detection rate of CIN2+ among participants with negative LBC was higher than that among HPV-negative participants, at 0.82% (62/7 536). Compared with the strategy of HR-HPV triage after LBC primary screening, the strategy of LBC triage after HR-HPV primary screening showed a higher sensitivity (86.39%) and AUC (0.908 7, 95%CI: 0.878 7-0.938 7) for detecting CIN2+ within 3 years, with comparable specificity (95.35%). In addition, both triage strategies exhibited lower colposcopy referral rates and NNC. Compared with strategy of primary LBC alone, strategy of primary HPV testing showed a higher sensitivity (98.22%) but a lower specificity (84.31%) for detecting CIN2+ within 3 years. Strategy of co-testing yielded sensitivity (98.82%) comparable to strategy of HPV testing alone but the lower specificity (79.33%) for detecting CIN2+, along with the highest colposcopy referral rate and NNC.

Sansure HPV testing effectively identified high-grade cervical intraepithelial neoplasia and is suitable for primary screening for cervical cancer. The strategy of LBC triage after HR-HPV primary screening can maintain high sensitivity without increasing unnecessary colposcopy referrals, thereby optimizing resource utilization.

To investigate the prognostic factors associated with niraparib maintenance therapy in patients with homologous recombination-proficient (HRP) advanced ovarian cancer, and to develop and externally validate a nomogram prediction model.

A retrospective study. A training cohort of 129 patients with HRP advanced ovarian cancer who received first-line niraparib maintenance therapy at Xijing Hospital, Air Force Medical University, from January 2021 to October 2024. An external validation cohort of 45 patients from Tangdu Hospital was also included. Clinical characteristics, pathological features, and laboratory indicators were collected. Inflammation-related markers, including platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR) and the prognostic nutritional index (PNI) were calculated. The optimal cut-off values for these indices were determined using the maximum Youden index. Multivariate Cox proportional hazards models were employed to identify independent prognostic factors for progression-free survival (PFS) and to construct a nomogram. Model performance and clinical utility were evaluated using the concordance index (C-index), calibration curves, time-dependent receiver operating characteristic (ROC) curves, and decision curve analysis (DCA). Survival differences between high-risk and low-risk groups were analyzed using Kaplan-Meier curves.

There were no statistically significant differences in baseline clinical or pathological characteristics between the two cohorts (all P>0.05). The optimal cut-off values for PNI, PLR, NLR, LMR, and systemic inflammation index (SII) were 50.48, 137.01, 1.96, 4.99, and 314.53, respectively. Multivariate Cox regression analysis identified lymph node metastasis, neoadjuvant chemotherapy, the kinetic elimination rate of CA-125 (KELIM), PLR, and NLR as independent prognostic factors for PFS (all P<0.05). The nomogram demonstrated good discrimination, with a C-index of 0.767 (95%CI: 0.712-0.816) in the training cohort and 0.743 (95%CI: 0.633-0.853) in the external validation cohort. In the training cohort, the area under the curve (AUC) for predicting 1-, 2-, and 3-year PFS were 0.831 (95%CI: 0.760-0.902), 0.875 (95%CI: 0.779-0.972), and 0.807 (95%CI: 0.651-0.963), respectively. In the external validation cohort, the AUC for 1-year PFS was 0.737 (95%CI: 0.586-0.888). Calibration curves and DCA demonstrated the model′s excellent predictive accuracy and clinical net benefit in both cohorts. Furthermore, survival analysis showed that patients in the high-risk group had significantly shorter PFS compared to those in the low-risk group (P<0.001).

Lymph node metastasis, neoadjuvant chemotherapy, KELIM, PLR, and NLR are independent prognostic factors for HRP advanced ovarian cancer patients treated with niraparib. The constructed nomogram exhibits good discrimination and calibration, serving as a valuable quantitative tool for risk stratification and guiding personalized clinical management.

To compare the efficacy and safety of radical surgery versus concurrent chemoradiotherapy in patients with stage ⅠB2/ⅡA2 cervical adenocarcinoma (International Federation of Gynecology and Obstetrics 2009 criteria).

A retrospective cohort study. Clinical and pathological data of patients with stage ⅠB2/ⅡA2 cervical adenocarcinoma treated at the Department of Gynecological Oncology Surgery (n=184), Department of Gynecological Radiation Oncology (n=35) of Zhejiang Cancer Hospital, and the Department of Obstetrics and Gynecology of the First Affiliated Hospital of University of Science and Technology of China (n=3) from March 2012 to December 2022 were retrospectively analyzed. Patients were divided into radical surgery group and concurrent chemoradiotherapy group based on their treatment. The follow-up time [M (Q₁, Q₃)] was 94 (60, 114) months. Survival rates were calculated using the Kaplan-Meier method and survival curves were plotted; the log-rank test was used to assess differences in cumulative survival rates. A multivariate Cox proportional hazards regression model was used to analyze factors associated with progression-free survival (PFS) and overall survival (OS).

A total of 222 patients with stage ⅠB2/ⅡA2 cervical adenocarcinoma were included, comprising 187 in the radical surgery group and 35 in the concurrent chemoradiotherapy group. The mean age of the concurrent chemoradiotherapy group was higher than that of the radical surgery group [(59.0±9.5) vs (47.8±9.9) years, P<0.001]. The recurrence rate was lower in the radical surgery therapy group than in the concurrent chemoradiotherapy group [39.0% (73/187) vs 60.0% (21/35), P=0.021]. The 5-year PFS rate (62.3% vs 46.0%, P<0.05) and 5-year OS rate (74.1% vs 58.6%, P<0.05) were higher in the radical surgery group. The incidence of grade 3-4 complications was lower in the radical surgery group than in the concurrent chemoradiotherapy group [36.9% (69/187) vs 77.1% (27/35), P<0.05]. Multivariate analysis showed that in the radical surgery group, pelvic lymph node metastasis [PFS (HR=2.45, 95%CI: 1.39-4.31); OS (HR=1.96, 95%CI: 1.04-3.69)] and para-aortic lymph node metastasis [PFS (HR=2.19, 95%CI: 1.04-4.65); OS (HR=3.05, 95%CI: 1.38-6.72)] were risk factors for PFS and OS (all P<0.05).

For patients with stage ⅠB2/ⅡA2 cervical adenocarcinoma, radical surgery combined with adjuvant therapy can achieve better PFS and OS and a lower incidence of grade 3-4 complications. Pelvic lymph node metastasis and para-aortic lymph node metastasis are risk factors for PFS and OS in patients with stage ⅠB2/ⅡA2 cervical adenocarcinoma.

To construct and validate a diagnostic model for endometrial cancer (EC) using machine learning algorithms.

Case-control study. A total of 465 patients with endometrial agenesis (EC) and 182 non-EC patients from the Department of Oncology, Henan Provincial People′s Hospital and the Department of Gynecology, First Affiliated Hospital of Zhengzhou University, were collected from 2022 to 2023. They were randomly assigned to a training set (363 cases, including 272 EC patients and 91 non-EC patients) and an internal validation set (284 cases, including 193 EC patients and 91 non-EC patients) using a random number table. From January 2024 to February 2025, 188 EC patients and 93 non-EC patients from the same department were collected as an external validation set. Patient clinical characteristics (age, body mass index, etc.), imaging characteristics (abnormal endometrial echo), and laboratory indicators (tumor markers, etc.) were collected as predictive variables. The Least Absolute Shrinkage and Selection (LASSO) algorithm was used to screen features for EC diagnostic models. Three machine learning algorithms, namely logistic regression (LR), random forest (RF) and support vector machine (SVM), were used to build EC diagnostic models. The optimal algorithm was selected by combining specificity or sensitivity and internal and external validations were performed respectively. ROC curves and calibration curves were plotted to evaluate the diagnostic efficacy of the three EC diagnostic models.

The average age of the training set was (41.4±13.2) years; the average age of the internal validation set was (41.1±13.4) years; and the average age of the external validation set was (41.0±13.1) years. The levels of transcription factor-like protein 5 (TCFL5), carcinoembryonic antigen (CEA), carbohydrate antigen 153 (CA153), carbohydrate antigen 72-4 (CA72-4), neutrophil-to-lymphocyte ratio (NLR), adipokines (Apelin), human epididymal protein 4 (HE4), diabetes, and abnormal endometrial echogenicity were all significantly higher in the EC group than in the non-EC group (all P<0.001). SHAP analysis showed that the top three indicators of importance in the LR model were age, abnormal endometrial echogenicity, and TCFL5. In internal validation, the area uncler curve(AUC) (95%CI) of the LR, RF, and SVM models were 0.890 (0.849-0.923), 0.885 (0.843-0.919), and 0.845 (0.799-0.884), respectively. The Brier score of the LR model was lower than that of the RF and SVM models (both P<0.05). External validation showed that the AUC (95%CI) of the RF and SVM models were 0.918 (0.877-0.949) and 0.887 (0.841-0.924), respectively, while the AUC (95%CI) of the LR model was 0.932 (0.894-0.961), which was significantly higher than the former two (both P<0.05).

The EC diagnostic model constructed based on multiple dimensions of variables including age, diabetes, abnormal endometrial echo, TCFL5, CEA, CA153, CA72-4, NLR, Apelin, and HE4 has good efficacy, with the LR algorithm showing the best performance. It can provide a scientific reference for the early clinical identification and diagnosis of EC.

To identify metabolic-related genes (MRG) in cervical cancer patients based on bioinformatics methods and construct a Metabolic-Related Gene Prognostic Index (MRGPI) model to explore its value in evaluating the prognosis and immune characteristics of cervical cancer patients and its application in drug screening.

The Cancer Genome Atlas (TCGA) cervical cancer cohort (n=306) was used for model development and Gene Expression Omnibus (GEO) GSE44001 (n=300) for external validation. Patients′ transcriptome data, clinical characteristics, and survival information were collected. MRGs were integrated from Kyoto encyclopedia of genes and genomes (KEGG), Reactome, BRENDA, and Human Genome-scale Metabolic Model (Human-GEM). Weighted gene co-expression network analysis (WGCNA) co-expression map was established on the TCGA cervical cancer cohort to screen for key module genes that were significantly correlated with the International Federation of Gynecology and Obstetrics (FIGO) staging of cervical cancer. In the TCGA cervical cancer cohort, univariate and multivariate Cox regression analyses were used to screen for prognostic-related genes and construct the MRGPI model. Based on the median MRGPI score, patients were divided into high-score and low-score groups, and this model was externally validated in the GEO (GSE44001) cervical cancer cohort. Survival analysis was performed using the Kaplan-Meier method, and survival differences between groups were compared using the log-rank test. Immune features such as tumor mutational burden (TMB) were evaluated using gene set enrichment analysis (GSEA) and xCell. And drug sensitivity was predicted by pRRophetic/oncoPredict with molecular docking. Immunohistochemical detection of key MRG expression levels was performed on paraffin-embedded tumor tissue specimens from six cervical cancer patients at Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. In human cervical squamous carcinoma cells models SiHa and C33A, the Cell Counting Kit-8 (CCK-8) assay was used to assess cell viability under different concentrations of drug intervention, and quantitative real-time polymerase chain reaction (qPCR) was employed to verify MRG expression levels in cells following drug treatment.

Eleven metabolic modules were screened, and an MRGPI model composed of six key MRGs (DHRS7B, GNAQ, UAP1, PAPSS2, UCK2, GTF2F2) was constructed. In the TCGA cervical cancer cohort and the GEO external validation cervical cancer cohort, the cumulative survival rate of the low-MRGPI score group was higher than that of the high-MRGPI score group (both P<0.05). Analysis of immune features and prediction of response to immunotherapy showed that the high-MRGPI score group exhibited a metabolic phenotype of 'immune-cold tumors', and the TMB of the high-score group was higher than that of the low-score group (P<0.05). Drug sensitivity prediction results indicated that Salubrinal showed higher sensitivity in the high-MRGPI score group, and molecular docking results showed that Salubrinal could stably bind to the PAPSS2 protein (binding energy:-9.625 kcal/mol) and the GNAQ protein (binding energy:-10.743 kcal/mol). Immunohistochemical staining results indicated that GNAQ/UAP1 expression levels were upregulated in the advanced cervical cancer group; CCK-8 experiments confirmed that Salubrinal inhibited the high-MRGPI score cell model SiHa in a dose-dependent manner; qPCR detection showed that under the intervention of Salubrinal, some MRG in the SiHa cell line were transiently upregulated at 12 hours and generally downregulated after 36 hours, exhibiting time-dependent expression changes.

The MRGPI constructed in this study can be used for prognostic stratification of cervical cancer patients, with the high-score group having a worse prognosis. A high MRGPI score is associated with the 'immune cold tumor' phenotype and higher TMB. Salubrinal shows drug sensitivity in cervical cancer with a high MRGPI score.

To investigate the brain functional network characteristics in patients with low-frequency sudden sensorineural hearing loss and their relationship with clinical manifestations using functional near-infrared spectroscopy (fNIRS).

Patients with low-frequency sudden sensorineural hearing loss (patient group) who visited the Department of Otolaryngology-Head and Neck Surgery, the Chinese PLA General Hospital from June 2024 to April 2025 were prospectively enrolled. The Tinnitus Handicap Inventory (THI) was used to assess the severity of tinnitus in the patient group. All participants underwent low-frequency pure-tone audiometry and were evaluated using the 17-item Hamilton Depression Scale (HAMD-17), Hamilton Anxiety Scale (HAMA), and Montreal Cognitive Assessment (MoCA). Resting-state fNIRS data were collected to compare global mean functional connectivity, small-world network metrics, and standardized low-frequency fluctuation (zfALFF) characteristics between the two groups. Pearson correlation analysis was used to assess the relationships between small-world property metrics and clinical characteristics (degree of hearing loss, THI score, HAMA score, and HAMD-17 score) in the patient group.

A total of 23 patients [mean age: (41.6±12.4) years; 13 males, 10 females] and 22 controls [mean age: (37.5±9.7) years; 11 males, 11 females] were included. There were no significant differences in age or sex between the two groups (all P>0.05). Compared with the control group, the patient group exhibited significantly higher global mean functional connectivity strength (0.44±0.25 vs 0.38±0.24, t=5.595, P<0.001). Within the small-world network, the mean shortest path length (Lp) was higher at certain sparsity thresholds, whereas global efficiency and the small-worldness coefficient were lower (all P<0.05). The patient group also demonstrated significantly lower zfALFF in the middle temporal gyrus (BA 21) and higher zfALFF in the temporal pole (BA 38) compared to controls (all P<0.05).Correlation analyses demonstrated that the area under the curve (AUC) of the local clustering coefficient was negatively correlated with the low-frequency pure-tone average threshold (mean threshold at 125-1 000 Hz) and with THI scores (r=-0.462, P=0.043 and r=-0.569, P=0.011, respectively). The AUC of local efficiency was also negatively correlated with THI scores (r=-0.581, P=0.009). The correlations between small-world property metrics and the HAMA, HAMD-17, and MoCA scores were not statistically significant (all P>0.05).

Patients with low-frequency descending sudden sensorineural hearing loss exhibit central alterations characterized by enhanced functional connectivity, reduced global efficiency of small-world networks, and abnormal regional spontaneous activity. These findings suggest significant changes in the efficiency of information integration within the brain network while maintaining its basic topological structure.

To investigate the incidence and risk factors of postoperative acute kidney injury (AKI) following major surgery.

This prospective study included adult patients who underwent major surgery (duration≥2 hours with subsequent admission to the intensive care unit) at the First Affiliated Hospital of Nanjing Medical University between January and December 2024. Patient demographic data, perioperative information, and prognostic outcomes were recorded. The primary endpoint was the development of AKI within three days after surgery. Logistic regression analysis was used to identify risk factors for postoperative AKI, and the Shapley Additive Explanations (SHAP) method was applied to quantify the contribution of each risk factor.

A total of 2 947 patients were enrolled, with 1 877 males (63.7%) and a median (Q₁, Q₃) age of 64 (56, 71) years. The incidence of AKI within three days post-surgery was 23.8% (702/2 947). Among patients with AKI, 34.3% (241/702) were diagnosed solely based on urine output criteria. The incidence of AKI was 24.6% (496/2 014) in cardiac surgery, 21.9% (164/748) in general surgery, 22.7% (34/150) in neurosurgery, and 22.9% (8/35) in orthopedic surgery, with no statistically significant difference among these surgical specialties (P=0.506). The postoperative dialysis rate was 2.3% (69/2 947), and the in-hospital mortality rate was 3.1% (92/2 947). The risk factors for postoperative AKI, ranked by contribution, were lower baseline estimated glomerular filtration rate (eGFR) [per 1 ml·min^-1·(1.73 m²)^-1 increase, OR=0.99, 95%CI: 0.98-1.00, P=0.001; SHAP=0.043], intraoperative red blood cell transfusion volume (per 100 ml increase, OR=1.07, 95%CI: 1.04-1.11, P<0.001; SHAP=0.036), intraoperative platelet transfusion volume (per 1 U increase, OR=1.05, 95%CI: 1.02-1.07, P<0.001; SHAP=0.036), operative duration (per 1 hour increase, OR=1.18, 95%CI: 1.11-1.26, P<0.001; SHAP=0.033), emergency surgery (OR=1.69, 95%CI: 1.13-2.52, P=0.010; SHAP=0.025), hypertension (OR=1.33, 95%CI: 1.08-1.64, P=0.008; SHAP=0.025), absence of preoperative beta-blocker use (OR=0.75, 95%CI: 0.59-0.94, P=0.011; SHAP=0.022), preoperative use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (OR=1.40, 95%CI: 1.11-1.77, P=0.004; SHAP=0.021), atrial fibrillation/flutter (OR=1.60, 95%CI: 1.22-2.11, P<0.001; SHAP=0.019), age (per 10-year increase, OR=1.15, 95%CI: 1.04-1.27, P=0.008; SHAP=0.019), preoperative use of statins (OR=1.35, 95%CI: 1.06-1.71, P=0.016; SHAP=0.019), male sex (OR=1.26, 95%CI: 1.02-1.56, P=0.031; SHAP=0.019), absence of contrast agent exposure within one week preoperatively (OR=0.67, 95%CI: 0.51-0.87, P=0.004; SHAP=0.018), intraoperative use of dobutamine (OR=1.37, 95%CI: 1.06-1.77, P=0.014; SHAP=0.016), and tumor (OR=1.33, 95%CI: 1.02-1.75, P=0.038; SHAP=0.013).

The incidence of AKI, defined by serum creatinine/urine output criteria, is 23.8% within three days after major surgery. Urine output can independently identify more than one-third of AKI patients. Reduced baseline eGFR and increased intraoperative red blood cell and platelet transfusion volume were the main risk factors for AKI following major surgery.

This study evaluated the efficacy and safety of poly(ADP-ribose) polymerase inhibitors (PARPi) in the treatment of advanced ovarian cancer (OC) through a meta-analysis.

Literature retrieval was performed in four major databases, including PubMed, Web of Science, the Cochrane Library, and Embase, to identify studies on the efficacy of PARPi in advanced OC. The retrieval period was from the establishment of each database to April 17, 2025. Literature screening and data extraction were independently conducted by two researchers in accordance with the inclusion and exclusion criteria. The Cochrane Risk of Bias Assessment Tool was used to evaluate the quality of the included studies. Meta-analysis was performed using Review Manager 5.4 and Stata 18.0 software. Hazard ratio (HR) was adopted as the effect size for survival outcomes, while relative risk (RR) was used for adverse events. The experimental group comprised advanced OC patients who received PARPi maintenance therapy after chemotherapy, and the control group received placebo or standard treatment. Outcome measures included progression-free survival (PFS), overall survival (OS), and the incidence of adverse events.

Compared with placebo, PARPi maintenance therapy in the first-line setting significantly prolonged PFS in advanced OC patients, reducing the risk of disease progression by 57% (HR=0.43, 95%CI: 0.38-0.49, I²=16%). Subgroup analysis showed more significant benefits in the BRCA-mutated subgroup (HR=0.38, 95%CI: 0.32-0.46, I²=0) and the homologous recombination deficiency (HRD)-positive subgroup (HR=0.48, 95%CI: 0.40-0.57, I²=0). In platinum-sensitive recurrence patients, PARPi maintenance therapy also reduced the risk of disease progression (HR=0.32, 95%CI: 0.23-0.43, P<0.001, I²=75%) with significant PFS benefits observed in all subgroups regardless of BRCA or HRD status. Safety data showed that PARPi maintenance increased the incidence of grade≥3 adverse events, with hematological toxicities being most prominent, particularly anemia (RR=20.95, 95%CI: 12.92-33.97, I²=0) and thrombocytopenia (RR=18.57, 95%CI: 5.50-62.68, I²=65%). Non-hematological toxicities were mainly fatigue/asthenia (RR=4.70, 95%CI: 2.88-7.69, I²=0).

This study demonstrates that PARPi maintenance therapy in first-line and platinum-sensitive recurrence settings for advanced OC can significantly reduce the risk of disease progression, especially in BRCA-mutated and HRD-positive populations. However, the risk of hematological toxicities and other adverse events must be vigilantly monitored during maintenance therapy, and clinical decisions should balance efficacy and safety parameters.

This paper reports a case of refractory pemphigus vulgaris (PV) with multiple infections. The patient, a 50-year-old female, went to the Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology on April 30, 2025 due to "repeated systemic erythema, blisters with erosion for more than 20 years, aggravated for half a month". The patient suffered from osteoporosis, thoracic compression fracture and femoral head necrosis due to long-term glucocorticoid use in the past. This time, the skin lesions were aggravated due to self-stopping hormones, accompanied by bacterial, fungal and viral infections, combined with severe anemia, hypoalbuminemia and severe malnutrition. After multidisciplinary team diagnosis and treatment, on the basis of active anti-infection, bone protection, nutritional support, etc., glucocorticoid treatment was restarted, the skin lesions were improved, the infection was controlled, and the condition was stable and the hospital was discharged. Skin lesions recurred during outpatient follow-up and the condition was controlled with the addition of rituximab.

A rare case of amorphous lambda light chain proximal tubulopathy complicated with multiple myeloma is reported. A 63-year-old male was admitted to the hospital because "urinary microalbumin was found to be elevated for more than half a year". It was found that the 24-h urine protein quantification was inconsistent with the urine protein qualitative and urine microalbumin degree, and the serum protein electrophoresis M protein was positive, and the serum free κ/λ ratio decreased; Further pathological biopsy of renal tissue, bone marrow biopsy and immunohistochemistry were used to confirm the diagnosis of light chain proximal renal tubulopathy with multiple myeloma (light chain lambda type). The treatment was successively treated with exatuximab + bortezomib + lenalidomide for 1 course/pomalidomide + dexamethasone for 2 courses. The efficacy of multiple myeloma was evaluated as very good partial remission (VGPR). After 3 months of treatment, M protein turned negative, urine protein decreased significantly at 24 hours, and renal function was stable after six months of follow-up.

This paper reports a case of laparoscopic resection of hepatic hemangioma. The 43-year-old female was seen at 7:00 on January 28, 2026 at the Department of Hepatobiliary and Pancreatic Surgery, First Medical Center, PLA General Hospital because of "the discovery of hepatic hemangioma for more than 1 year". Hepatic hemangioma was found during ultrasound examination at physical examination 1 year ago; Mild tenderness in the right upper abdomen without rebound pain; Preoperative abdominal enhanced MRI findings revealed multiple cavernous hemangiomas in the left lateral lobe of the liver, measuring 6.6 cm ×3.4 cm. Then a "modeled laparoscopic left lateral lobectomy" was performed at 9:20 on the day of admission. The intracavitary operation time was 65 minutes, no hilar occlusion was performed, and the intraoperative bleeding volume was 20 ml without blood transfusion. There were no serious complications such as hemorrhage, bile leakage and hepatic insufficiency after operation. The postoperative pathology was hepatic cavernous hemangioma. The patient was discharged from the hospital at 18:00 on the same day and was followed up until the 14th postoperative day on 11 February 2026. The patient had no complications and was still under continuous follow-up.

The autocrine motor factor (ATX) /lysophosphatidic acid (LPA) signaling pathway plays a key role in lung inflammation. Beta-catenin, the core hub of the classical Wnt pathway, interacts with the ATX/LPA signaling pathway. The role and mechanism of ATX/LPA signaling pathway in pulmonary inflammation were reviewed. The role of β-catenin in the airway and alveolar epithelial barrier not only maintains the integrity of the airway and alveolar epithelial barrier, but also participates in the regulation of lung inflammation; The Interaction and Mechanism of ATX/LPA/β-catenin Signaling Pathway; At the same time, the therapeutic potential of ATX/LPA/β-catenin signaling pathway in lung inflammation was elucidated. Targeting the ATX/LPA/β-catenin axis has emerged as a potential therapeutic strategy for inflammatory diseases of the lung. Inhibiting ATX activity, antagonizing LPA receptors (such as LPA2) or regulating β-catenin stability have shown anti-inflammatory and anti-remodeling effects in models such as asthma and pulmonary fibrosis, providing a new direction for future drug development.