Spontaneous intracerebral hemorrhage (sICH) is a devastating form of stroke with high mortality and disability rates. Hematoma expansion (HE) occurs in over 30% of sICH patients and serves as a critical predictor of poor outcomes. This review aims to synthesize current evidence on clinical factors predicting HE in sICH patients. We conducted a comprehensive literature search of major databases from inception to December 2024. Included studies examined clinical, radiological, and biochemical factors associated with HE in sICH. Multiple factors demonstrate predictive value for HE, including hematoma volume, irregular shape, ultra-early growth rate, coagulation status, blood pressure parameters, and specific imaging markers. Emerging technologies including advanced MRI and biomarker assays show promise for improved prediction. Multimodal prediction models incorporating clinical and imaging data demonstrate superior predictive accuracy compared to single parameters. Early identification of HE risks factors enables targeted intervention and may improve clinical outcomes. Future research should focus on validating multimodal prediction tools and developing targeted therapies for high-risk patients.

This study aimed to characterize pediatric nasal button battery impactions and evaluate, in an in vitro septum model, the efficacy of household reagents in mitigating alkaline-induced injury. We retrospectively reviewed 230 pediatric cases over ten years. Demographic characteristics, presentation times, and complications were recorded. In vitro, sheep septal cartilage segments (2-3mm thick) were immersed in saline at 36°C and exposed to a 3V button battery for 15, 30, 45, or 60min to determine the critical injury window. In the 30min group, interventions with honey, MOH (a honey-olive oil mixture), vinegar, vitamin D, glycerin, and saline were applied, and the tissue pH, residual battery voltage, and injury depth were measured. A retrospective analysis of 230 children revealed that 61.7% were male, 97.8% were aged 1-5years, and 87.4% presented within 24h of battery impaction; the incidence of nasal septal perforation was 16.5%. In vitro experiments identified 30min as the critical window for rapid tissue injury progression, with a mean injury depth of 2160 ± 43.8μm. Intervention assays demonstrated that honey (685.3 ± 92.2μm), MOH (1038 ± 145.1μm), and glycerin (1275 ± 39.6μm) significantly reduced injury depth without breaching the perichondrial layer. Honey and MOH best neutralized the pH, whereas glycerin and vitamin D inhibited battery discharge the most. Saline, vinegar, or vitamin D alone had no protective effect on depth. Alkaline burns from nasal button batteries progress rapidly within 30min. Household reagents-especially honey, MOH, or glycerin-neutralize pH, inhibit discharge, and attenuate tissue damage. In prehospital settings where immediate care is delayed, early application of honey, MOH, or glycerin is recommended to minimize severe complications.

Pediatric soft tissue sarcomas (STS) are rare malignancies that present significant challenges in diagnosis and treatment. Comprehensive genomic profiling holds promise in addressing these challenges by revealing the molecular drivers of these tumors. In this study, we conducted DNA sequencing on 50 pediatric STS samples, encompassing a diverse range of histologies. Utilizing advanced sequencing technologies and analytical tools, we identified recurrent genetic alterations that may guide diagnostic and therapeutic strategies. The most frequent mutations included alterations in EWSR1-FLI1, TP53, KRAS, and IGF1R. Notably, 34% of patients harbored mutations in the RTK-RAS signaling pathway, and 11 previously unreported gene mutations were identified. Gene amplifications were more common in rhabdomyosarcoma, while gene fusions were predominantly observed in non-rhabdomyosarcoma subtypes, particularly Ewing sarcoma. Our analysis of cooperative mutations revealed four groups of co-occurring genetic alterations, with no evidence of mutually exclusive mutations. Clinically, we observed significant correlations between specific genetic mutations and clinical parameters, such as age at diagnosis and fibrinogen levels, providing insights into potential prognostic factors. These findings offer a detailed genetic landscape of pediatric STS, emphasizing the importance of genomic profiling in improving diagnostic accuracy and identifying new therapeutic targets for this rare cancer.

Sepsis is a serious complication after ureteroscopic lithotripsy (URSL), but its accurate pre-operative prediction remains difficult. This study aims to evaluate novel immunonutritional-inflammatory indices, which reflect the "nutrition-immunity-inflammation" axis, for predicting post-URSL sepsis. We conducted a retrospective cohort study of 569 patients undergoing URSL. Postoperative sepsis was diagnosed per Sepsis-3 criteria. A base clinical model was built using pre-operative variables from multivariate analysis. We then assessed the incremental predictive value of adding five indices (CALLY, PNI, CAR, NAR, NPAR) by evaluating discrimination (AUC), calibration, reclassification (NRI, IDI), and clinical utility (Decision Curve Analysis). A nomogram and web calculator were developed based on the CALLY-augmented model for clinical use. Of 569 patients, 41 (7.2%) developed sepsis. The base model (including gender, platelet count, operation time, hydronephrosis, leukocyte esterase, and urine culture) had an AUC of 0.832. The CALLY index provided the most significant improvement, increasing the AUC to 0.918 (P = 0.007). The model with CALLY also showed superior reclassification (NRI = 0.404, IDI = 0.134; both P < 0.001) and significantly better fit (Likelihood Ratio Test P < 0.001). Decision curve analysis confirmed its greater net clinical benefit across practical risk thresholds. Immunonutritional-inflammatory indices, particularly the CALLY index, significantly improve the prediction of post-URSL sepsis over clinical factors alone. The developed tool enables personalized risk estimation, supporting precision medicine in perioperative care. Chinese Clinical Trial Registry, ChiCTR2400092429. Registered 15 November 2024. Retrospectively registered.

With the rollout of HPV vaccination in China from 2018, the epidemiological distribution of female HPV infections has changed. We aimed to characterize the vaginal microecology (VME), ThinPrep cytologic test (TCT) results, and HPV infection epidemiology among women in Western China and to analyze their correlations to inform cervical cancer screening. We retrospectively analyzed VME, TCT, and HPV results for all women who underwent voluntary screening for gynecological diseases at Chongqing Cancer Hospital in 2023 to assess epidemiological characteristics and correlations among VME, TCT, and HPV infection. VME and TCT results were available for a subset of 1,718 participants who completed all three tests, allowing correlation analyses. Among 8,528 patients, 9.53% were HPV positive. The three most common HPV types were 52, 58, and 16; HPV 18 fell from the previous top three to 10th. Multiple HPV infections occurred in 1.31% of patients, most frequently involving types 52, 58, and 51.The HPV infection rate in the 40-49year-old group (8.07%) was the fifth highest across all age groups, differing markedly from previous studies. In total, 1,718 participants completed VME, TCT, and HPV testing, in which the HPV-positive cases accounted for 6.11%. Patients with bacterial vaginosis and dysbiosis had significantly higher HPV infection rates (P = 0.016 and P = 0.01, respectively) than those with normal flora, whereas patients with vulvovaginal candidiasis (VVC) had significantly lower rates (P = 0.044). Abnormal TCT rates showed a similar pattern: significantly higher in bacterial vaginosis (P = 0.012) and significantly lower in VVC (P = 0.029). The distribution of HPV types and age groups in Western China differs from previous reports. This may be attributable to HPV vaccination and may reflect selection bias related to reduced reproductive health attention among postmenopausal women. VME is differentially associated with cervical HPV infection and TCT findings. The correlation among VME, TCT, and HPV infection warrants further investigation. Not applicable.

5-Aminolevulinic acid (5-ALA) reportedly improves overactive bladder (OAB) symptoms by reducing reactive oxygen species derived from vascular endothelial cells to protect vascular function and enhance bladder blood flow and by inhibiting bladder C-fiber activity. This double-blind, randomized controlled trial aimed to evaluate the efficacy and safety of 5-ALA in participants with OAB. This randomized, prospective study classified the participants into the 5-ALA and placebo groups. The 5-ALA group received oral 5-ALA phosphate at 150mg/day for 12weeks. The efficacy of 5-ALA was determined by assessing the changes in the Overactive Bladder Symptom Score (OABSS) and the Overactive Bladder Questionnaire Short Form from baseline to weeks 4 and 12 after treatment initiation, as well as the post-void residual urine volume. Regarding safety, we evaluated participants' blood pressure and adverse events. This study enrolled and randomized 49 participants, with 23 in the 5-ALA group and 26 in the placebo group. Ultimately, 47 participants completed the study (21 and 26 in the 5-ALA and placebo groups, respectively). From baseline to week 12, OABSS significantly decreased from 8.81 to 6.52 (- 2.29) in the 5-ALA group and from 8.54 to 6.35 (- 2.35) in the placebo group (both: p = 0.008). However, no significant difference was noted between the two groups at week 12 (p = 0.956). Using a mixed model for repeated measures with a random intercept, the model-adjusted between-group difference in the change from baseline to week 12 in the OABSS between the 5-ALA and placebo groups was 0.06 points (95% confidence interval, - 1.63 to 1.75; p = 0.944). This study found no significant improvement in OAB symptoms with 5-ALA administration. Nevertheless, given that no previous double-blind, randomized controlled trial has assessed 5-ALA's efficacy in patients with OAB, this study holds important value as a pilot study. This study was prospectively registered in the Japan Registry of Clinical Trials (jRCT); registration number: jRCTs061220050; registration date: [August 29, 2022].

Major adverse cardiovascular events (MACE) remain common after surgery in neonates with critical congenital heart disease (CCHD). We aimed to identify the incidence and independent risk factors for postoperative MACE and develop a predictive nomogram for individualized risk assessment. This retrospective cohort included neonates undergoing cardiopulmonary bypass surgery for CCHD at Beijing Anzhen Hospital from January 2018 to December 2024. MACE was defined as a composite of mortality, cardiopulmonary resuscitation, unplanned reoperation, and extracorporeal membrane oxygenation (ECMO) support. Univariate and multivariable logistic regression analyses, together with least absolute shrinkage and selection operator (LASSO) regression, were used to identify independent predictors and to construct a nomogram. Model performance was evaluated by discrimination, calibration, and clinical utility. Among 302 neonates, 48 (15.89%) experienced postoperative MACE, including mortality (8.61%), cardiopulmonary resuscitation (9.60%), unplanned reoperations (8.94%), and ECMO (3.31%). Multivariable logistic regression identified low birth weight (< 2.5kg; OR = 5.728, 95% CI 2.130-15.496), emergent surgery (OR = 3.996, 95% CI 1.458-10.878), prolonged aortic cross-clamp time (OR = 1.021, 95% CI 1.003-1.040), repeated aortic cross-clamping (OR = 5.464, 95% CI 1.002-28.377), elevated maximum vasoactive-inotropic score within 24h postoperatively (OR = 1.050, 95% CI 1.012-1.091), and elevated lactate at surgery completion (OR = 1.180, 95% CI 1.065-1.339) as independent risk factors for MACE, whereas prenatal diagnosis was protective (OR = 0.316, 95% CI 0.136-0.732). The nomogram demonstrated excellent performance (C-index: 0.839, AUC: 0.859) and good calibration. In neonates with CCHD, independent risk factors for postoperative MACE included low birth weight, emergency surgery, prolonged or repeated ACC, elevated maximum VIS within 24h postoperatively, and elevated lactate at surgery completion, whereas prenatal diagnosis was protective. The nomogram accurately predicts perioperative MACE in CCHD neonates, aiding individualized risk assessment and management.

Ostealgia in bone malignancies primarily results from bone loss, underscoring the importance of osteogenic induction as a vital therapeutic strategy. We investigated the role of Long noncoding RNA H19 (LncRNA H19) in regulating Bone Marrow Stromal Cell (BMSC) differentiation. We first analyzed the single-cell transcriptomic landscape of the human bone marrow niche using the GSE253355 dataset, comprising 82,742 cells across 12 samples. Cell annotation and CytoTrace trajectory analysis were employed to define lineage potentials. Findings were validated in vitro by manipulating H19 levels in BMSCs and assessing mineralization and signaling pathways. Single-cell analysis identified 35 distinct cell clusters (including Adipo-MSC, Fibro-MSC, Osteo-MSC, and Osteoblast). Among bone lineage populations, Osteo-MSCs and Osteoblasts exhibited the lowest differentiation potential scores, indicating terminal differentiation. Crucially, H19 was specifically upregulated in these mature osteogenic clusters. Consistent with this, H19 overexpression in vitro significantly enhanced mineralization, cell viability, and osteogenic markers (ALP, Runx2, Col1) by activating BMP2, NF-κB, and Wnt5a signaling. Conversely, H19 knockdown reversed these phenotypes. LncRNA H19 acts as a lineage-specific driver of osteogenic differentiation via the BMP2/NF-κB/Wnt5a axis. Targeting H19 represents a promising approach to promote bone regeneration and potentially modulate pathways associated with cancer-associated ostealgia.

Surgery, chemotherapy, radiotherapy, and immune checkpoint blockade remain the mainstays of lung cancer treatment. Despite these approaches, lung cancer continues to be the second leading cause of cancer-related deaths worldwide. Recent insights into the metabolic reprogramming of lung tumors and their interplay with immune cells termed immunometabolism have revealed crucial mechanisms shaping tumor progression and therapeutic response. In lung cancer, T lymphocytes, natural killer cells, and macrophages undergo metabolic alterations that tumors exploit to create an immunosuppressive microenvironment, while tumor cells adopt metabolic switches that support growth, survival under stress, and evasion of immune surveillance. The dynamic regulation of glucose, oxygen, and amino acid availability in the lung tumor microenvironment influences T cell activation, macrophage polarization, and recruitment of immunosuppressive cells. Key oncogenic pathways, including c-Myc, HIF-1α, and PI3K-AKT-mTOR, coordinate these metabolic and immune adaptations. These insights have inspired novel therapeutic strategies that combine tumor metabolism-targeting with immune metabolism modulation to enhance antitumor immunity, often in conjunction with immune checkpoint blockade or adoptive cell therapy. Advances in single-cell and spatial metabolomics now enable precise characterization of metabolic heterogeneity in lung tumors, paving the way for personalized interventions exploiting immunometabolic vulnerabilities. This review emphasizes lung cancer-specific immunometabolism as a promising avenue for improving treatment outcomes, integrating molecular mechanisms, clinical trials, and emerging technologies.

BackgroundEye disease is a global health issue, and current diagnostic methods are complex, costly and more suitable for final diagnosis. In order to detect abnormal eyes earlier, it is necessary to develop a simple and low-cost method for preliminary diagnosis of eye health. Ocular aberration measurement is a safe routine eye examination, and using its results for diagnosis will be valuable.MethodsUsing the wavefront parameters of ocular aberrations for diagnosis, including root-mean-square (RMS), peak-to-valley and entropy, were presented in this work. A combined diagnosis was also made with their results through majority voting. The frequency distributions of the parameters for normal and abnormal eye groups were statistically analyzed from 610 sets of aberrations. Subject was diagnosed as the group with a higher frequency by comparing its parameter with the distributions, because it has a higher probability of belonging to the dominant group. 66 test samples were diagnosed, and diagnostic performance was calculated by comparing their results with pathological decisions. The performance of using different parameters and order aberrations for diagnosis was investigated.ResultsFor the two groups of each parameter by using the 2nd−8th orders, the data distributions are significantly different at significance level of 0.05 via both Mann-Whitney test and t-test, and the frequency distributions are also obviously different. The method by using the RMS parameter and the 2nd−8th orders has the best performance, with a sensitivity of 81.8%, a specificity of 90.9%, an accuracy of 86.4%, a positive predictive value of 90.0%, and a negative predictive value of 83.3%.ConclusionsThe best performing method can basically meet the preliminary diagnostic requirement of eye health. It is safe, simple, low-cost, and potentially applicable in abnormal eye screening and assisted medical shunting.Supplementary InformationThe online version contains supplementary material available at 10.1186/s40001-026-03839-6.