Volume 106 · Issue 18 · 2026

Pulmonary hypertension, especially pulmonary arterial hypertension, is a progressive disease that is difficult to treat and has a poor prognosis. This article summarizes the remarkable progress in pulmonary hypertension treatment over the past 30 years since the first targeted drug for pulmonary hypertension became available in 1995. Key advancements include the transition from no available treatments to abundant targeted therapies, the shift from monotherapy to early combined treatment strategies, and the evolution of therapeutic goals from symptom improvement to mortality risk reduction and significant hemodynamic parameter enhancement. The treatment paradigm has transformed from mere "vasodilation" to "anti-vascular remodeling", aiming to deepen understanding of pulmonary hypertension and elevate diagnostic and therapeutic standards.

Pulmonary hypertension (PH), especially pulmonary arterial hypertension (PAH), is a complex and life-threatening disorder with poor prognosis. Over the past two decades, PAH-targeted therapy in China has evolved through three distinct stages. Before 2006, the field was characterized by the absence of targeted therapies, limited disease awareness, and significant delays in diagnosis. Patients relied primarily on conventional treatments, with a 5-year survival rate of only 20.8%. Between 2006 and 2020, the introduction of targeted drugs such as iloprost and bosentan significantly improved patient outcomes. However, high costs and limited accessibility remained major barriers, with only around 20% of patients receiving targeted therapy and combination therapy used infrequently. Since 2020, expanded insurance coverage and the availability of domestic generics have substantially improved access to treatment. As a result, targeted therapy use has increased to nearly 80%, the 1-year mortality rate has declined to below 10%, and the 5-year survival rate now exceeds 70%. Meanwhile, clinical research has expanded rapidly, and nationwide specialist networks have been established, bringing standards of care closer to international levels. Looking forward, further efforts are needed to strengthen disciplinary development, promote multidisciplinary collaboration, and accelerate drug innovation to improve outcomes for patients with PAH in China.

Pulmonary hypertension (PH) is a heterogeneous disease driven by multiple pathological mechanisms. Its core characteristics include pulmonary vascular constriction and pulmonary vascular remodeling. Currently, the clinical treatment of PH primarily relies on vasodilatory drugs, including endothelin pathway antagonists, prostacyclin analogues, and regulators of the NO-sGC-cGMP pathway. Although these drugs can alleviate symptoms and improve hemodynamics to a certain extent, they are unable to fundamentally reverse pulmonary vascular remodeling and have limitations in improving the long-term prognosis of the disease. Therefore, developing drugs that can directly intervene and reverse pulmonary vascular structural abnormalities has become a new direction for treatment. Numerous studies, both at home and abroad, have demonstrated that targeted therapy has significant value in improving the prognosis of patients with PH. This article will discuss three aspects: the innovation of classic pathways, new drugs targeting remodeling, and cutting-edge translational research in metabolism and immunity, aiming to clarify the transformation of current treatment strategies from "vasodilation" to "inhibiting vascular remodeling".

Pulmonary arterial hypertension (PAH) is a severe cardiovascular disorder characterized by progressive elevation in pulmonary vascular resistance and sustained increase in right ventricular afterload, which may lead to right heart failure and sudden death as the disease advances. This article focuses on PAH-targeted drug research, reviews the development of classical pathway agents, and elaborates on the molecular mechanisms and translational prospects of novel pathway therapeutics. Evidence indicates that continuous advancements in targeted pharmacotherapies for PAH have significantly improved clinical outcomes, offering new directions for the management of this condition.

Pulmonary hypertension associated with left heart disease (PH-LHD) represents the most prevalent form of pulmonary hypertension. The concomitant elevation in pulmonary arterial pressure significantly exacerbates disease morbidity and mortality, leading to unfavorable prognosis. Despite sharing similar pathophysiological characteristics with pulmonary arterial hypertension (PAH), current clinical guidelines do not recommend PAH-targeted therapies for PH-LHD, as clinical trials conducted to date have failed to demonstrate the efficacy and safety benefits of such agents in PH-LHD patients. Novel therapeutic agents with distinct mechanisms—such as activin signaling inhibitors and long-acting relaxin analogs—have shown potential benefits in preliminary studies. It is anticipated that ongoing clinical investigations may yield favorable outcomes, thereby paving new avenues for the treatment of pulmonary hypertension associated with heart failure with preserved ejection fraction and improving clinical prognosis.

Hypoxia-associated pulmonary hypertension (PH) is a severe complication secondary to chronic lung diseases and/or hypoxia, significantly increasing patient mortality risk. Its core pathophysiological mechanisms involve multiple pathways, including hypoxic pulmonary vasoconstriction, active pulmonary vascular remodeling, endothelial dysfunction, and inflammatory responses. Targeted drug therapy in this field has long faced significant challenges. Clinical trials of classic targeted drugs for pulmonary arterial hypertension (PAH) in hypoxia-associated PH have yielded inconsistent results; some drugs may even exacerbate the disease by potentially worsening ventilation/perfusion mismatch. While research on classic targeted therapies continues, studies investigating drugs targeting alternative pathways, such as directly reversing pulmonary vascular remodeling, are gaining momentum. This article will focus on the progress of both classic and emerging targeted drug research for hypoxia-associated PH.

Chronic thromboembolic pulmonary hypertension (CTEPH) is a pulmonary vascular disease characterized by organized thrombotic obstruction of the pulmonary arteries and subsequent pulmonary vascular remodeling. The therapeutic strategy has evolved from a solely surgical approach to a comprehensive system incorporating pulmonary endarterectomy, balloon pulmonary angioplasty and targeted drugs. Although riociguat remains the only drug formally approved for patients with inoperable or residual/recurrent pulmonary hypertension in China, accumulating evidence suggests that other targeted agents, such as treprostinil, may also show clinical benefits in CTEPH. Current evidence highlights the importance of multimodal therapy. This review aims to comprehensively summarize recent advances in targeted drugs for CTEPH patients and to examine the current applications and unresolved challenges associated with multimodal therapy strategies in this field.

The vascular system serves as the central architecture of the human circulatory network, whose structural and functional integrity is vital for maintaining homeostasis and is closely associated with the development and progression of major diseases, including cardiovascular diseases, cerebrovascular diseases, hepatic disorders, ocular diseases, and renal conditions. Traditional single-dimensional research models present evident limitations in deciphering the complex vascular system. In this context, this article formally introduces the concept of "Vasomics". Vasomics is an emerging omics discipline that integrates clinical medicine, basic medicine, biology, computer science and artificial intelligence to systematically analyze the vascular system using multimodal and cross-scale approaches. This article elaborates on Vasomics from six key aspects: its background, core technologies and phenotyping, methodological framework, research progress, applications, and challenges and prospects. By enabling the integration of multi-scale vascular phenotypes from macroscopic to microscopic levels, Vasomics is poised to offer a new paradigm for deciphering vascular health and disease.

To further standardize the clinical application of integrated PET/MRI brain imaging for brain gliomas in China, improve the level of precision diagnosis and management, promote standardized care, and provide evidence-based and consensus recommendations for imaging professionals and clinicians, this guideline was jointly developed by the Chinese Society of Medical Imaging Technology, Chinese Society of Radiology, Chinese Society of Nuclear Medicine, the Beijing Society of Nuclear Medicine, and the Beijing Society of Radiology, with the participation of multidisciplinary experts from nuclear medicine, radiology, neurosurgery, neuro-oncology, and radiation oncology, through multiple rounds of consensus meetings. Brain gliomas are among the most common primary brain tumors of the central nervous system, encompassing a wide spectrum of tumor grades and diverse biological behaviors. Key aspects of their clinical management include accurate diagnosis and grading, tumor extent delineation, preoperative evaluation and radiation therapy target planning, as well as differentiation between post-treatment recurrence and treatment-related changes. Integrated PET/MRI enables simultaneous acquisition of PET molecular metabolic information and multiparametric MRI structural and functional information within a single examination, effectively facilitating the above processes and serving as an important imaging modality for the precise diagnosis and treatment of brain gliomas. As integrated PET/MRI systems become increasingly available in China, broader clinical implementation continues to face challenges in appropriate indication selection, standardization of imaging workflows and parameter settings, image post-processing and assessment, consistency of image interpretation, and reporting. Grounded in the current accessibility of integrated PET/MRI equipment and tracers in China and in the latest domestic and international evidence-based research, and closely aligned with the realities of Chinese clinical practice, this guideline provides recommendations across key domains—clinical indications, examination and quality-control workflows, image interpretation, and standardized reporting—with the aim of offering systematic and practical evidence-based guidance for imaging specialists and clinicians involved in glioma care.

To further standardize the clinical use of integrated PET/MRI brain imaging for refractory epilepsy in China, improve the level of individualized precision diagnosis and treatment, promote standardized management, and provide evidence-based and consensus recommendations for clinicians and imaging professionals, experts in nuclear medicine, radiology, neurology, and related fields developed this guideline through a consensus process informed by the available research evidence and clinical practice. Epilepsy is one of the most common chronic neurological disorders, and accurate preoperative localization of the epileptogenic zone in patients with refractory epilepsy remains a major clinical challenge. Integrated PET/MRI enables simultaneous, one-stop acquisition of multidimensional information, including cerebral metabolism, high-resolution anatomical detail, and functional features, and can be used for epileptogenic focus localization, surgical planning, and assessment of important functional regions, making it an important imaging tool for precision care in refractory epilepsy. As integrated PET/MRI systems become increasingly available in China, broader clinical implementation continues to face challenges, including appropriate patient selection and indications, standardization of scanning workflows, image quality control, consistency in image interpretation, and reporting standards. With a focus on clinical feasibility, this guideline provides recommendations across key domains, including indications, examination and quality-control procedures, image interpretation, and standardized reporting, to promote the standardized use of integrated PET/MRI in the care of refractory epilepsy and advance related clinical translation.

Postherpetic Neuralgia (PHN), as the most common complication of herpes zoster, significantly affects the quality of life of patients. The clinical diagnosis and treatment guidelines for PHN urgently need to be improved. This consensus was jointly formulated by experts from departments such as neurology, traditional Chinese medicine, pain management, acupuncture, and evidence-based medicine in China. Following the principles of evidence-based medicine and based on clinical evidence, a combined Chinese and Western medicine diagnosis and treatment framework for PHN was systematically constructed. Regarding 9 clinical issues, a total of 22 recommendations were formed, including 3 for diagnosis and 19 for treatment. In terms of diagnosis, a diagnostic model combining "precise assessment by Western medicine and overall syndrome differentiation by traditional Chinese medicine" was proposed. In terms of treatment strategies, it is advocated that the combination of Western and Chinese medicine for treating PHN should follow the principle of early initiation to achieve synergistic treatment and reduce side effects. The formulation of this consensus provides an important evidence-based basis for the standardized diagnosis and treatment of PHN and has significant clinical guiding value.

To analyze the clinical characteristics of smoking asthmatic patients and to evaluate the efficacy of long-acting muscarinic antagonist (LAMA) in treating smoking asthmatic patients.

The characteristic analysis study of smoking asthma was a case-control study, including 128 patients with bronchial asthma. According to whether the patients smoked, they were divided into the smoking asthma group and the non-smoking asthma group. The clinical data, blood indicators, lung function indicators [forced expiratory volume in one second (FEV₁), FEV₁/forced vital capacity (FEV₁/FVC), maximum mid-expiratory flow (MMEF 75/25)], and fractional exhaled nitric oxide (FeNO) were compared between the two groups. The efficacy of LAMA in treating smoking asthma patients was a randomized controlled trial. A total of 60 male patients with moderate to severe asthma, who were smokers and in a non-acute attack phase, were screened. According to computer-generated random numbers, they were divided into the intervention group [administered inhaled corticosteroid (ICS)+long-acting beta agonist (LABA)+LAMA for 1 month] and the control group (administered ICS+LABA for 1 month) in a 1∶1 ratio. Clinical characteristics, blood indicators, lung function indicators, asthma control test (ACT) scores, and Asthma Quality of Life Questionnaire (AQLQ) scores were collected before and after 1 month of treatment, and efficacy indicators were compared within and between groups before and after treatment.

A total of 98 patients were included in the non-smoking asthma group, aged (61.9±14.3) years, and 30 were male. A total of 30 patients were included in the smoking asthma group, aged (60.4±15.2) years, all of whom were male. The proportion of males in the smoking asthma group [30.0 (100.0)% vs 30.0 (30.6)%], blood neutrophil count [(4.5±1.9)×10⁹/L vs (3.3±2.0)×10⁹/L], and blood neutrophil ratio [(64.0±16.5)% vs (51.2±23.2)%] were higher than those in the non-smoking asthma group (all P<0.05). The blood eosinophil count of the non-smoking asthma group [(0.2±0.2)×10⁹/L vs (0.1±0.1)×10⁹/L], blood eosinophil ratio [(2.2±1.8)% vs (1.5±1.1)%], IgE [(374.5±496.5)u/ml vs (161.2±187.6) U/ml], FEV₁ [(1.9±0.6)L vs (1.4±0.5) L], FEV₁/FVC [(74.9±11.4)% vs (65.8±11.7)%], MMEF 75/25 [(1.8±1.0)L/s vs (1.3±0.8) L/s], and FeNO [M(Q₁, Q₃)][34.5 (17.3, 57.3) ppb vs 25.0 (17.0, 35.0) ppb (1 ppb=1×10^-9)] were all higher than those in the smoking asthma group (all P<0.05). In the study on the efficacy of LAMA treatment for smoking asthma, the intervention group included 30 cases, with an age of (49.6±10.5) years. There were 30 cases in the control group, aged (50.5±11.0) years. There was no significant difference between the two groups from baseline (all P>0.05). The number of cigarettes smoked in both groups decreased before and after treatment [intervention group: (20.3±8.0) cigarettes/d vs (8.7±6.2) cigarettes/d; control group: (20.5±7.6) cigarettes/d vs (8.3±5.3) cigarettes/d], but there was no significant difference between the two groups before and after treatment (all P>0.05). Intra-group comparison, FEV₁, FVC, FEV₁/FVC, MMEF 75/25, ACT score, and AQLQ score of intervention group after treatment were higher than those before treatment, and FeNO of intervention group after treatment was lower than before treatment (all P<0.05). After treatment, the ACT score and AQLQ score of control group were higher than those before treatment (all P<0.05). Between-group comparison showed that after treatment, the intervention group had higher FEV₁ [(2.5±0.7) L vs (1.9±0.7) L], FVC [(3.2±0.9) L vs (2.7±0.9) L], FEV₁/FVC [(78.6±6.7)% vs (72.8±11.7)%], ACT score [23.0 (23.0, 24.0) points vs 21.5 (20.3, 24.0) points], and AQLQ score [101.0 (98.0, 104.0) points vs 97.5 (93.0, 101.3) points], and lower FeNO [14.5 (10.0, 28.3) ppb vs 25.0 (19.3, 51.5) ppb] than the control group (all P<0.05).

This study indicates that smoking asthmatic patients have worse pulmonary function but lower FeNO and peripheral blood eosinophil counts than non-smoking asthmatic patients. Compared to ICS+LABA alone, the addition of LAMA to ICS+LABA significantly improves pulmonary function, reduces FeNO, and enhances symptom control and quality of life in smoking asthmatic patients.

To investigate the recurrent predictive value of morphologic features based on enhanced CT anterior commissure invasion (ACI) and tumor volume (TV) in patients with T1-stage glottic cancer (GC) following larynx-preserving surgery.

The clinical and enhanced CT images of patients with T1-staging GC treated with larynx-preserving surgery in Tianjin First Central Hospital from January 2015 to December 2019 were retrospectively analyzed. According to the postoperative follow-up results, they were divided into recurrence group and non-recurrence group. The morphological characteristics of tumors, including ACI status and quantitative characteristics (length, thickness, volume), were evaluated on enhanced CT images. The optimal cut-off values of each quantitative parameter for evaluating recurrence were determined by receiver operating characteristic (ROC) curve analysis, and the single or pairwise morphological characteristics with statistically significant differences (P<0.05) between groups were included in multivariate Cox regression to analyze the influencing factors of postoperative recurrence-free survival(RFS) and build morphological feature models. Harrell′s concordance index (C-index) was used to compare the predictive power of morphological association features with the AJCC-T1 staging system for postoperative recurrence. Calibration curves and decision curve analysis (DCA) were used to assess the calibration and clinical suitability of the model, respectively.

A total of 147 patients were included, the ratio of male to female was 11∶1, and the age was (62.6±8.7) years. The median follow-up time was 44 months, and there were 25 cases in relapse group and 122 cases in non-relapse group. ACI combined with TV, length combined with TV, thickness combined with TV were correlated with RFS (P<0.05). ACI+TV≥118.55 mm³ was a risk factor for RFS (HR=4.17, 95%CI:1.85-9.37, P=0.002). The C- index for predicting recurrence based on the combined morphological features of ACI and TV was higher than that of AJCC-T1 staging [0.73 (95%CI: 0.62-0.84) vs 0.65 (95%CI: 0.55-0.74), Z=2.84, P=0.004]. Calibration curves showed good agreement between model-predicted recurrence-free survival and actual recurrence-free survival, and DCA results indicated good clinical net benefit from the model.

Morphological characteristics of ACI combined with TV are associated with RFS after larynx-preserving surgery in patients with T1-staging GC, and anterior commissure invasion with larger tumor volume (ACI+TV≥118.55 mm³) at initial treatment are risk factors for postoperative recurrence.

To analyze the factors influencing early [postoperative prolonged ileus (PPOI)] and late [low anterior resection syndrome (LARS)] bowel dysfunction after primary cytoreductive surgery in patients with advanced ovarian cancer, and to evaluate the economic impact of postoperative bowel dysfunction.

A retrospective study was conducted on 275 patients with advanced epithelial ovarian cancer who underwent cytoreductive surgery at the First Affiliated Hospital of Air Force Medical University from January 2020 to December 2024. Patients were grouped based on postoperative bowel dysfunction: PPOI group (n=59) and non-PPOI group (n=216). Among 119 patients who underwent rectosigmoid resection, 77 completed questionnaire assessment and were included in LARS analysis, categorized into LARS group (n=30) and non-LARS group (n=47). Perioperative clinical data were collected, and univariate and multivariate logistic regression models were used to identify risk factors for PPOI and LARS.

A total of 275 patients with a mean age of (56.7±9.1) years were included, of whom 21.5% (59/275) developed PPOI. Among 77 patients who completed LARS assessment [mean age (55.2±10.1) years], 39.0% (30/77) developed LARS. Multivariate analysis showed that preoperative prognostic nutritional index (PNI)≤45 (OR=3.059, 95%CI: 1.481-6.593), history of prior abdominal surgery (OR=2.511, 95%CI: 1.196-5.274), total psoas area index (TPAI)≤266.2 mm²/m² (OR=7.725, 95%CI: 3.621-16.483), intraoperative rectal resection (OR=6.816, 95%CI: 3.143-14.782), and total pelvic peritonectomy (OR=2.947, 95%CI: 1.372-6.328) were independent risk factors for PPOI (all P<0.05). Total pelvic peritonectomy (OR=3.547, 95%CI: 1.048-11.612) was identified as a risk factor for LARS (P=0.036). Furthermore, the PPOI group had significantly higher hospitalization costs and longer hospital stays (all P<0.001).

Poor preoperative nutritional status and specific surgical procedures are risk factors for PPOI after cytoreductive surgery in advanced ovarian cancer patients, with total pelvic peritonectomy being a common risk factor for both PPOI and LARS. Additionally, PPOI increases the economic burden of medical care.

To compare the efficacy and safety of thoracoscopic-assisted left intercostal small incision and median sternotomy coronary artery bypass grafting (CABG) in the treatment of multi-vesselcoronary disease patients with concomitant type 2 diabetes mellitus (T2DM).

The clinical data of multi-vessel coronary disease patients with concomitant T2DM who were admitted to Fuwai Huazhong Cardiovascular Hospital from January 2020 to January 2024 were retrospectively collected. According to the treatment regimen, patients who underwent minimally invasive left intercostal small incision CABG were included in the minimally invasive group, and patients who underwent median sternotomy CABG were included in the traditional group. The perioperative indicators, intraoperative bypass grafts, and the incidence of major adverse cardiac and cerebrovascular events (MACCE) at 1 year after operation were compared between the two groups.

After propensity score matching, there were 51 patients in the minimally invasive group, including 28 males and 23 females, with an average age of (62.6±2.1) years. There were 51 patients in the traditional group, including 31 males and 20 females, with an average age of (63.2±2.7) years. No statistically significant differences were detected in age, gender, body mass index, preoperative fasting blood glucose, glycosylated hemoglobin, comorbidities, smoking history, previous myocardial infarction history, left ventricular ejection fraction, SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery (SYNTAX) score, and duration of diabetes between the two groups (all P>0.05). The operation time in the minimally invasive group was longer than that of the traditional group [(245.3±35.1) min vs (215.7±28.4) min]. However, the postoperative mechanical ventilation time [(10.2±2.3) h vs (14.8±3.2) h], length of intensive care unit (ICU) stay [(25.3±4.1) h vs (28.4±6.3) h], and hospitalization time [(7.8±1.5) d vs (10.9±2.4) d] were shorter in the minimally invasive group than in the traditional group (all P<0.05). The perioperative blood transfusion rate [9.8% (5/51) vs 31.4% (16/51)] and the incidence of complications [7.8% (4/51) vs 37.3% (19/51)] were lower than those in the traditional group (all P<0.05). No significant differences were observed between the two groups in the mean blood flow and pulsatility index of all bypass grafts [(35.2±8.7) ml/min vs (36.1±9.2) ml/min; 2.4±0.6 vs 2.3±0.5], the left internal mammary artery (LIMA) [(28.1±6.8) ml/min vs (27.8±7.1) ml/min; 1.9±0.5 vs 2.0±0.5], or the great saphenous vein [(45.6±10.3) ml/min vs (46.7±11.0) ml/min; 2.8±0.7 vs 2.7±0.6] (all P>0.05). The total incidence of MACCE at 1 year after operation in the minimally invasive group was 5.9% (3/51), which was not significantly different from that in the traditional group [9.8% (5/51)] (P=0.475).

Compared with median sternotomy CABG, thoracoscopic-assisted left intercostal small incision CABG has a lower proportion of postoperative blood transfusion and a shorter recovery process in the treatment of multi-vessel coronary artery disease patients with concomitant T2DM. The incidence of MACCE is similar between the two procedures at 1 year after surgery.

To examine the association between the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (NHHR) and the occurrence of dementia in patients undergoing maintenance hemodialysis (MHD).

A multicenter cross-sectional study was conducted, involving MHD patients from 10 hemodialysis centers in Guizhou Province between May 2019 and November 2023. Cognitive function was assessed using the mini-mental state examination (MMSE), and the presence of dementia was determined according to the corresponding criteria based on the patient′s educational level. NHHR was used as a marker of lipid metabolism. Patients were categorized into four groups (Q1-Q4) according to NHHR quartiles: Q1 group (NHHR<1.89), Q2 group (NHHR 1.89-<2.55), Q3 group (NHHR 2.55-<3.42), and Q4 group (NHHR≥3.42). The association between NHHR and the risk of dementia was assessed through multivariate logistic regression, multiple linear regression, restricted cubic splines (RCS), subgroup analysis, and interaction testing.

A total of 2 279 MHD patients (1 385 males and 894 females) aged 58 (49, 68) years were included in the study. Among these patients, 179 cases (7.9%) (103 males and 76 females) were diagnosed with dementia, with the age of 69 (60, 77) years. Multivariate logistic regression analysis revealed that, after adjusting for relevant confounding factors, the risk of dementia in the Q3 group was 1.98 times greater than that in the Q1 group (OR=1.98, 95%CI: 1.20-3.27, P=0.007). Furthermore, the risk of dementia in the Q4 group was 2.56 times that of the Q1 group (OR=2.56, 95%CI: 1.56-4.20, P<0.001). Multiple linear regression analysis indicated a negative correlation between NHHR and the total MMSE score (β=-0.25, 95%CI:-0.38--0.12, P<0.001). Subgroup analysis demonstrated an interaction between gender and NHHR (P_interaction=0.005). Among female MHD patients, the risk of dementia in the NHHR Q4 group was 6.04 times that of the Q1 group (OR=6.04, 95%CI: 2.59-16.54), whereas no significant correlation was observed between NHHR and dementia in male MHD patients (all P>0.05). Restricted cubic splines analysis indicated a linear relationship between NHHR and the risk of dementia (P_nonlinearity=0.240).

Elevated NHHR levels areassociated with an increased risk of dementia in MHD patients, with a more pronounced effect observed in female patients.

This paper reports a case of autosomal dominant tubulointerstitial nephropathy (ADTKD) with AarF domain containing kinase 4 (ADCK4) associated glomerulopathy (coenzyme Q10 deficiency associated nephropathy) and psoriasis, who died after maintenance hemodialysis. A 20-year-old female was admitted to hospital on November 20, 2019 due to the discovery of elevated serum creatinine and proteinuria. She had a history of psoriasis, her mother suffered from psoriasis and her grandfather suffered from diabetes. Genetic testing showed that the patient had heterozygous variation of HNF1B gene and complex heterozygous variation of CoQ8B gene. The clinical manifestation was renal insufficiency, and the pathological diagnosis was ADTKD-HNF1B, ADCK4-associated glomerulopathy, and IgA nephropathy (secondary to psoriasis not excluded). Methylprednisolone combined with tacrolimus and plasma exchange were given successively, but the efficacy was not good; Hemodialysis has been performed regularly since July 2020, during which hemoglobin and albumin and other related indicators are poor. On 24 Feb 2022, the patient developed diarrhea, sudden loss of consciousness and circulatory failure after admission, and eventually died. This case suggests that the prognosis of ADTKD with ADCK4-associated glomerulopathy and psoriasis is poor, and emphasizes the importance of individualized treatment and long-term follow-up.

Gynecological malignancies are a serious threat to women's health, with complex pathogenesis and significant molecular and pathological heterogeneity among patients, which pose a severe challenge to the implementation of accurate diagnosis and treatment strategies. Organoids are "micro-organs" with organ-like structures formed by three-dimensional self-assembly of stem cells. They can highly simulate the structural and functional characteristics of tumors in vivo, and are highly consistent with patient source tissues at multiple molecular levels such as gene expression profile, proteomic characteristics and drug reactivity, providing a highly fidelity in vitro research platform for gynecological tumor research. This article systematically reviews the application status of organoid technology in common gynecological malignant tumors such as ovarian cancer, cervical cancer and endometrial cancer, focusing on its value in disease mechanism research, drug screening and individualized treatment, and looks forward to the challenges and future development directions in this field. In-depth understanding of the application prospect of organoid technology is of great significance for promoting the basic research and clinical translation of gynecological malignant tumors.

Topical finasteride (2.275 mg/ml, 0.25%) spray is a novel treatment for androgenic alopecia (AGA) in adult men. Currently, the Food and Drug Administration has approved two drugs for the treatment of AGA in men: oral finasteride and topical minoxidil. This phase III study aimed to evaluate the efficacy and safety of topical finasteride spray in Chinese male patients with AGA.