In contemporary practice, elevated 24-hour urinary copper excretion (24-h UCE) often triggers referral for suspected Wilson disease (WD). In this hypercupriuric referral setting, interpretation of 24-h UCE may be distorted by spectrum effects. In this study, we aimed to compare conventional copper biomarkers in hypercupriuric referrals and evaluate whether a Leipzig-aligned ceruloplasmin (Cp) framework could provide a clinically useful triage approach.

We retrospectively studied consecutive, untreated patients evaluated for suspected WD with hypercupriuria between February 2017 and February 2025. The final diagnosis was established using a prespecified Leipzig-based algorithm, with ATP7B testing when indicated. Diagnostic performance of Cp and 24-h UCE was compared. A prespecified Cp three-zone framework was evaluated using <0.10 g/L, 0.10–0.20 g/L, and >0.20 g/L as high-probability, indeterminate, and low-probability zones, respectively.

Among 541 untreated hypercupriuric patients, 65 had WD and 476 had adjudicated non-WD liver disease. Cp outperformed 24-h UCE for diagnosing WD (AUROC, 0.988 vs. 0.762). The optimal Cp cutoff was 0.15 g/L, with 90.8% sensitivity and 97.7% specificity. Cp < 0.10 g/L defined a high-probability zone with 98.0% WD prevalence, whereas Cp > 0.20 g/L defined a low-probability zone with 0.5% WD prevalence. Among non-WD controls, higher urinary copper was independently associated with higher bilirubin, prolonged international normalized ratio, and lower albumin.

In hypercupriuric referrals for suspected WD, Cp retained strong diagnostic performance and outperformed 24-h UCE. A Leipzig-aligned Cp three-zone framework may support probability-based triage in contemporary referral practice.

Nitric oxide (NO) is a crucial regulator of hepatic and systemic vascular tone. Abnormal distribution of NO in various anatomical locations is a pathogenetic characteristic of portal hypertension. Under normal portal pressure conditions, liver sinusoidal endothelial cells produce NO, which promotes both vasodilation and hepatic stellate cell relaxation. In portal hypertension, endothelial dysfunction, imbalance of asymmetric dimethylarginine levels, and production of superoxide result in impaired intrahepatic NO availability, leading to activation and contraction of hepatic stellate cells and worsening portal hypertension. Excess extrahepatic NO levels in the splanchnic vasculature result in systemic vasodilation, hyperdynamic circulation, and collateral vascular formation, worsening portal pressure. Abnormal clearance and production of NO can lead to extrahepatic complications, including hepatorenal syndrome and hepatopulmonary syndrome. Therapies including statins, phosphodiesterase-5 inhibitors, and midodrine have been developed to restore NO homeostasis but have achieved only partial success in modulating NO production, bioavailability, and distribution. The aim of this review is to update the understanding of the mechanisms and effects of NO dysregulation in cirrhosis as they relate to current and future therapeutic options.

Non-motor symptoms of Parkinson’s disease, including sleep disturbance, cognitive impairment, depression, and anxiety, are common and often undertreated, yet their responsiveness to mind-body exercises remains unclear. This scoping review evaluated the currently available evidence on the effects of Tai Chi and Qigong interventions on non-motor symptoms in patients with Parkinson’s disease.

We searched six databases (PubMed, Google Scholar, EMBASE, CINAHL, Web of Science, and PEDro) through February 28, 2026, for randomized controlled trials (RCTs). We included English-language RCTs that evaluated the effects of Qigong and Tai Chi interventions on non-motor outcomes in Parkinson’s disease and excluded non-RCTs, review articles, and protocol articles. We were predominantly interested in the following non-motor outcome measures: cognition, depression, anxiety, fatigue, and sleep quality.

This review identified 18 RCTs that met the inclusion criteria, including nine Tai Chi studies and nine Qigong studies. Most of the reviewed studies were of high quality according to the PEDro scale, but the small sample sizes limited our analysis to identifying trends in outcomes. A strong trend toward a beneficial effect was found for sleep quality and cognition, a moderate trend toward improvement was found in depression, anxiety and quality of life, and weak or unclear effects were found for other non-motor symptoms such as fatigue. Several studies also had high dropout rates.

Although these studies suggest that Tai Chi and Qigong may improve sleep quality and cognition, the evidence supporting their benefits in alleviating other non-motor symptoms is generally weak, primarily because of small sample sizes. The heterogeneity in methodologies across the reviewed studies and high dropout rates in some studies are significant limitations of previous RCTs.

Sepsis is a life-threatening syndrome associated with high morbidity and mortality, underscoring the urgent need for early diagnostic biomarkers and therapeutic targets. However, current diagnostic strategies remain insufficiently precise because of the complex immune dysregulation and immune microenvironment heterogeneity that characterize sepsis. This study aimed to identify reliable diagnostic biomarkers for sepsis and explore their immune regulatory mechanisms together with potential therapeutic relevance using multidimensional bioinformatic analyses.

Single-cell transcriptomic and bulk RNA sequencing datasets were integrated to screen candidate diagnostic genes for sepsis. Immune infiltration, co-expression network and pathway enrichment analyses were performed to explore immune regulatory mechanisms. Machine-learning approaches were used to validate the diagnostic signature, and molecular docking was conducted to predict candidate targeted compounds.

A total of 346 differentially expressed genes were identified and were mainly enriched in immune, coagulation, and metabolic pathways. CIBERSORT and single-cell analyses revealed increased neutrophils, monocytes, and γδ T cells and reduced CD8+ T cells and resting natural killer cells. Four diagnostic genes (S100A12, CD22, CSTA, and UPP1) were prioritized. The four-gene model showed robust external performance (area under the receiver operating characteristic curve = 0.860; sensitivity = 0.781; specificity = 0.780), and interpretability analysis highlighted UPP1 and S100A12 as dominant predictors. Molecular docking suggested potential interactions between these targets and anti-inflammatory compounds.

This integrative framework identifies four immune-related diagnostic genes for sepsis and links them to immune-cell remodeling and candidate therapeutic interactions, providing a basis for future mechanistic and clinical validation.

Given that hemodynamic fluctuations acutely escalate the risk of devastating rebleeding and secondary neurological deficits in unsecured ruptured intracranial aneurysms, this study aimed to synthesize the best available evidence for blood pressure management in this population and to provide an evidence-based foundation for clinical nursing practice.

A systematic search was conducted in domestic and international databases and relevant websites for evidence pertaining to blood pressure management in patients with ruptured intracranial aneurysms, including clinical practices, guidelines, expert consensuses, evidence summaries, and systematic reviews/meta-analyses. The search period covered database inception up to June 2025. Two researchers independently performed literature quality assessments and evidence extraction, with particular attention to nursing-relevant evidence on hemodynamic monitoring, bedside assessment, complication prevention, fluid management, and follow-up coordination.

A total of 17 studies were included, comprising 11 guidelines, 4 expert consensuses, and 2 clinical decision entries. The synthesized evidence yielded 32 recommendations, structured into 6 core clinical domains: personnel and environmental configuration, individualized blood pressure targeting, precision hemodynamic monitoring, complication prevention, fluid therapy strategy, and longitudinal follow-up protocols. These recommendations further clarified key nursing responsibilities in triage coordination, continuous blood pressure surveillance, neurological assessment, delayed cerebral ischemia surveillance, fluid balance monitoring, and long-term follow-up.

Blood pressure management in patients with ruptured intracranial aneurysms should be individualized and multidisciplinary. The synthesized evidence highlights key nursing priorities in hemodynamic monitoring, delayed cerebral ischemia surveillance, fluid management, and follow-up coordination, and may inform standardized clinical nursing protocols.

Bladder cancer (BC) remains a major public health concern in China, but comprehensive and up-to-date assessments of its burden and temporal patterns remain limited. This study aimed to systematically evaluate the current burden, temporal trends, and future projections of BC in China using data from the Global Burden of Disease Study 2023.

Data on BC incidence, mortality, disability-adjusted life years, and risk-attributable mortality in China from 1990 to 2023 were extracted from the Global Burden of Disease Study 2023. Temporal trends were assessed using Joinpoint regression, with a maximum of six joinpoints allowed, to estimate annual percentage changes and average annual percentage changes. Age-period-cohort models based on log-linear Poisson regression were used to examine age, period, and cohort effects. Bayesian age-period-cohort models were then applied to project incidence and mortality rates to 2030 while accounting for age-period-cohort effects and demographic changes.

From 1990 to 2023, crude incidence, mortality, and disability-adjusted life year rates increased, whereas age-standardized rates generally declined (average annual percentage changes = −0.32%, −1.31%, and −1.62%, respectively). Recent upward trends were nevertheless observed across all three indicators, particularly for incidence and mortality during 2020–2023 (annual percentage changes = 5.05% and 4.39%, respectively). Local drifts were negative in most age groups but approached or exceeded zero in the oldest groups. The incidence local drift was 0.35% (95% confidence interval [CI]: −0.07%, 0.78%) in the 85–89-year age group and 0.64% (95% CI: −0.31%, 1.61%) in the 90–94-year age group, whereas the corresponding mortality local drifts were −0.70% (95% CI: −0.97%, −0.43%) and −0.18% (95% CI: −0.72%, 0.36%), respectively. Compared with the reference period (2004–2008), the relative risks for incidence and mortality in 2019–2023 were 0.95 (95% CI: 0.91–0.98) and 0.75 (95% CI: 0.71–0.78), respectively. Compared with the reference cohort (1951–1956), earlier birth cohorts had elevated risks; in the 1901–1906 cohort, the relative risks were 1.13 (95% CI: 0.82, 1.57) for incidence and 2.10 (95% CI: 1.75, 2.52) for mortality. During 2024–2030, both crude incidence and crude mortality rates were projected to increase further.

Despite long-term declines in age-standardized rates, BC remains a substantial burden in China, and recent upward trends warrant attention. These findings support targeted primary prevention and risk-stratified early-detection strategies for high-risk populations.

Early detection of gastric cancer is critical for reducing incidence and mortality, as well as for improving survival outcomes. Although gastroscopy remains the gold standard for gastric cancer screening and diagnosis, its invasiveness, discomfort during the procedure, and limited acceptability restrict population participation and screening coverage. Recently, rapid advances in liquid biopsy technologies have led to the discovery of numerous multi-omics biomarkers spanning genomics, transcriptomics, proteomics, and metabolomics, with promising diagnostic performance. However, their translational value for population-based gastric cancer screening and control remains insufficiently characterized. This review aims to provide a comprehensive overview of multi-omics biomarkers for gastric cancer screening and to evaluate their potential role in advancing population-level gastric cancer control. First, we synthesize multi-omics biomarkers with diagnostic and screening relevance across the continuum of gastric carcinogenesis, from chronic inflammation and atrophy to intestinal metaplasia, dysplasia, and early gastric cancer. Furthermore, we highlight the integrative value of multi-omics biomarkers, current limitations, translational challenges, and future opportunities for moving biomarkers from discovery to implementation in organized screening programs. In conclusion, multi-omics biomarkers have the potential to complement existing screening strategies by providing scalable, non-invasive, and risk-adapted approaches for early gastric cancer detection. Bridging the gap between biomarker discovery and real-world implementation will be essential for realizing their value in future gastric cancer screening programs.

Thyroid nodules are increasingly detected in clinical practice, and accurate imaging evaluation is essential for risk stratification, treatment planning, and postoperative surveillance of thyroid cancer. Although ultrasound remains the first-line modality for thyroid nodule assessment, the roles of computed tomography (CT), spectral CT, magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET-CT) vary across clinical scenarios, and the optimal integration of these modalities remains insufficiently standardized. In particular, existing studies often focus on individual imaging techniques, while practical guidance on modality selection for initial screening, preoperative anatomical assessment, recurrence monitoring, and high-risk disease evaluation remains limited. This narrative review summarizes the imaging principles, clinical indications, diagnostic value, advantages, and limitations of ultrasound, CT, spectral CT, MRI, and PET-CT in the evaluation of thyroid nodules and thyroid cancer. Future advances should focus on standardized multimodal imaging strategies, quantitative functional imaging, radiomics, and carefully validated artificial intelligence-assisted approaches to improve individualized diagnosis and management of thyroid nodules and thyroid cancer.