Invasive pituitary adenomas with infrasellar extension can present with symptoms such as epistaxis and nasal obstruction, closely mimicking the clinical and radiological characteristics of nasopharyngeal carcinoma, which frequently leads to misdiagnosis. This report discusses the case of a 32-year-old male who was initially misdiagnosed with nasopharyngeal carcinoma for approximately one month and subsequently underwent radiotherapy and chemotherapy. However, a multidisciplinary assessment at our institution, incorporating magnetic resonance imaging findings of an invasive sellar mass, serum prolactin levels exceeding 2,000 ng/mL, and positive immunohistochemistry for PIT-1 and prolactin, established the diagnosis of an invasive prolactinoma. Treatment with bromocriptine led to significant tumor reduction. However, this was complicated by cerebrospinal fluid leakage, which subsequently resulted in an intracranial infection. The patient underwent surgical resection of the tumor and repair of the cerebrospinal fluid leak, with postoperative pathology confirming a PIT1-lineage, densely granulated, prolactin-secreting adenoma. The patient experienced a favorable recovery, with prolactin levels normalizing under continued bromocriptine therapy. This case highlights the critical importance of routine hormonal screening, thorough evaluation of nasopharyngeal mucosal integrity, and multidisciplinary collaboration in the diagnostic process.

Despite the emergence of new approaches in acute myeloid leukemia (AML) treatment in recent years, the overall prognosis remains poor. Particularly for elderly patients and relapsed/refractory cases, the five-year survival rate consistently remains below 30%. While traditional chemotherapy regimens can rapidly suppress tumor burden and alleviate clinical symptoms, they suffer from limitations such as insufficient targeting, prominent toxic side effects, and a tendency to induce drug resistance. Immunotherapy offers a novel therapeutic pathway for AML due to its advantages of precise targeting, long-lasting antitumor effects, and a controllable safety profile. However, single-agent immunotherapy demonstrates limited clinical response rates in AML and struggles to achieve complete tumor cell clearance. In this context, combination regimens of chemotherapy and immunotherapy are increasingly becoming the focus of research. This review aims to summarize the rationale and advances in the combination of immune checkpoint inhibitors, chimeric antigen receptor T-cell therapy, antibody-drug conjugates, bispecific antibodies, and cancer vaccines with chemotherapy for the treatment of AML. We have detailed the preclinical research and clinical trial progress of each combined regimen, analyzed the core challenges—including off-target toxicity, high tumor heterogeneity, and limited efficacy in specific AML subtypes—and further propose targeted solutions and future development directions, such as exploring novel specific antigens, developing multi-targeted drugs, and formulating precision individualized treatment plans. The clinical application of such combined strategies is attracting increasing attention. In conclusion, chemo-immunotherapy combinations represent a highly promising therapeutic paradigm for AML, harnessing the synergy of chemotherapy-mediated immune microenvironment remodeling and the specific antitumor activity of immunotherapies to overcome single-agent limitations and deliver meaningful survival benefits.

Colorectal polyp detection from endoscopic images is critical for the early diagnosis of colorectal cancer. However, traditional deep learning methods often suffer from limited generalization when deployed across datasets containing different polyp morphologies. This work aimed to investigate whether vision-language foundation models can facilitate zero-shot generalization across multiple polyp datasets without target-domain fine-tuning.

We introduced a zero-shot colorectal polyp detection framework based on Contrastive Language-Image Pretraining (CLIP) to improve cross-dataset detection performance. Key innovations include: (1) a background patch contrastive loss using pseudo-normal tissue patches to teach the model to distinguish normal mucosa from polyps; (2) attribute-enhanced text prompts that incorporate domain-specific descriptors of polyp appearance, improving the model’s semantic generalization to novel polyp morphologies; and (3) an enhanced CLIP visual adapter with per-layer adaptive feature fusion and generalized mean pooling to capture multi-scale features for better polyp localization. During training, we use one annotated colorectal polyp dataset (e.g., CVC-ColonDB) to learn patch-level image-text correspondence. The model is then evaluated in a zero-shot manner on different polyp datasets (CVC-ClinicDB, Kvasir-SEG, and CVC-300), where we evaluate pixel-level anomaly detection performance.

The framework demonstrated robust zero-shot generalization on unseen test cohorts. Without any dataset-specific fine-tuning, the model achieved a mean pixel-level AUROC of 0.94 and a mean average precision of 0.81 across the 12 leave-one-dataset-out zero-shot transfer settings. In the CVC-ColonDB-source benchmark, the model achieved a mean Dice coefficient of 0.84 across CVC-ClinicDB, Kvasir-SEG, and CVC-300. This high level of performance was consistent across datasets with distinct visual characteristics, underscoring the ability of the model to detect diverse polyp morphologies that it had not been explicitly trained to recognize.

Our findings demonstrate that an anomaly-aware vision-language model significantly improves cross-dataset polyp detection generalization without requiring normal images for training. This multimodal strategy may facilitate the robust deployment of artificial intelligence-based colorectal screening systems by enabling reliable detection of diverse polyp morphologies across different clinical settings. Extension to non-polyp colorectal pathologies (e.g., ulcerative colitis and colorectal tumors) remains an important direction for future work, pending the availability of pixel-level annotated datasets for these lesion categories.

Metabolic dysfunction-associated fatty liver disease (MAFLD) represents a predominant cause of chronic liver disease, underscoring the demand for accessible, non-invasive diagnostic tools. Tongue diagnosis in Traditional Chinese Medicine provides a distinctive perspective on systemic health, though it remains largely subjective. This study aimed to develop an interpretable multimodal deep learning model for MAFLD screening by integrating quantitative tongue image features with routine clinical data.

From 904 screened candidates, 477 subjects (157 healthy, 320 MAFLD) were included and randomly allocated to training, validation, and test sets in an 8:1:1 ratio. All participants underwent standardized tongue imaging (International Commission on Illumination L*a*b color features) and comprehensive clinical evaluation. We constructed a dual-stream deep learning model, combining a ConvNeXt-Tiny network for tongue images and a multilayer perceptron for clinical variables. Feature fusion was achieved via a Dynamic Affine Feature Transformation module, and the model was trained using weighted cross-entropy loss.

MAFLD patients showed significant metabolic abnormalities compared to healthy controls. A progressive decrease in tongue yellowness (b* value) was observed with advancing fibrosis. On an independent test set (n = 48), the multimodal model achieved 97.92% accuracy, Quadratic Weighted Kappa of 0.9538, and 96.88% sensitivity, and 100% specificity, outperforming single-modality and serological models. Interpretability analyses confirmed the model’s focus on clinically relevant tongue regions and key metabolic drivers.

We developed an accurate and interpretable multimodal model that synergizes tongue image features with metabolic indicators for MAFLD screening. This approach presents a promising, low-cost tool potentially well-suited for resource-limited settings.

PVT is a harmful event in cirrhosis, and the prevention and treatment of PVT are important in the management of cirrhosis and portal hypertension. The study aimed to observe the efficacy of Danggui Buxue Decoction (DBD) on portal vein thrombosis (PVT) in cirrhosis and to elucidate the related mechanism using a modified animal model.

A model of PVT in cirrhosis was established by partial portal vein ligation and intraperitoneal injection of CCl4 in rats, which showed obvious PVT with intra- and extravenous thrombosis as well as liver cirrhosis. Rats were randomly assigned into four groups and received intragastric administration of DBD (12 g/kg/day) or rivaroxaban (20 mg/kg/day) for 6 weeks.

DBD attenuated collagen deposition and reduced thrombus formation in model livers, increased portal vein blood flow, expanded the portal vein diameter, and reduced prothrombin time and international normalized ratio in the model rats. In addition, DBD reduced hepatic von Willebrand factor and plasminogen activator inhibitor-1 expression and increased hepatic fibrin degradation product content in the liver tissues of model rats.

We modified a model of cirrhotic PVT in rats and found that DBD had a good effect on PVT and liver fibrosis, with the mechanisms related to the enhancement of portal vein blood flow and the protection against endothelial cell injury.

Cardiorenal syndrome is associated with high morbidity and mortality and is characterized by bidirectional interactions between cardiac and renal dysfunction. The advent of sodium-glucose cotransporter 2 inhibitors (SGLT2i) and the nonsteroidal mineralocorticoid receptor antagonist finerenone has substantially changed the therapeutic landscape. Combination therapy with SGLT2i and finerenone may provide additional benefits through complementary mechanisms, representing a potential paradigm shift in the management of cardiorenal syndrome. In this review, we examine the pathophysiological pathways that characterize cardiorenal syndrome, clinical data from major randomized controlled trials, and the rationale for the concomitant use of these two drug classes. SGLT2 inhibitors significantly reduce hospitalization for heart failure, slow renal function decline, and provide benefits in both heart failure with reduced ejection fraction and heart failure with preserved ejection fraction, irrespective of diabetes status. Finerenone has been shown to reduce the risk of cardiovascular events and chronic kidney disease progression in patients with type 2 diabetes and chronic kidney disease, with a more favorable safety profile than steroidal mineralocorticoid receptor antagonists. Emerging evidence suggests that combination therapy may reduce hospitalizations for heart failure and slow renal disease progression beyond the effects of either monotherapy. However, implementation of these therapeutic options requires careful patient selection, ongoing monitoring of renal function and electrolytes, and close collaboration between cardiologists and nephrologists.

Infectious diarrhea is a gastrointestinal illness that results in around 1.7 billion cases and 525,000 deaths annually, particularly among children under five, according to the World Health Organization. While some Cameroonian medicinal plants show promise for treating diarrhea, many plants are used without established scientific evidence of their efficacy. These plants include Tithonia diversifolia (T. diversifolia) and Solanum torvum (S. torvum), which are traditionally used to treat diarrheal symptoms. This study sought to investigate the anti-Shigella activity of leaf extracts from T. diversifolia and S. torvum.

Extracts from T. diversifolia and S. torvum were obtained by successive maceration in solvents of increasing polarity, including hexane, dichloromethane, ethyl acetate, methanol, and water. The as-prepared extracts (10) were evaluated for antibacterial activity against selected Shigella species using an in vitro experiment. The mode of action of the bioactive extracts was determined in Shigella through growth kinetic analysis.

Hexane extract from S. torvum (St-HEX-F) and dichloromethane extract from T. diversifolia (Td-DCM-F) inhibited the growth of Shigella flexneri NR-518 and Shigella boydii NR-521 with minimum inhibitory concentration (MIC) values of 500 and 1,000 µg/mL, respectively. Shigella flexneri and Shigella boydii were the most sensitive strains, whereas Shigella sonnei was the most resistant strain. Bacterial growth kinetics revealed that St-HEX-F and Td-DCM-F are bacteriostatic at MIC and bactericidal at 2×MIC and 4×MIC.

Extracts from T. diversifolia and S. torvum possess anti-Shigella activity and could be used as a potential source of active ingredients for developing new treatments against diarrhea caused by multidrug-resistant Shigella.

The long-term clinical outcomes of patients with hepatitis B virus (HBV)-related cirrhosis receiving nucleos(t)ide analog (NA) therapy according to virological response patterns remain inadequately defined. This study aimed to investigate the association between virological response patterns and clinical outcomes in a large, long-term, real-world cohort.

This retrospective–prospective cohort study enrolled patients with HBV-related cirrhosis receiving NA therapy from 2009 to 2019. According to the serum HBV DNA levels during the initial two years of antiviral treatment, patients were categorized as having a complete (CVR) or partial virological response (PVR). Patients with CVR were further stratified according to their dynamic HBV DNA changes during follow-up into maintained virological response (MVR) or virological breakthrough (VBT) patterns. The primary clinical outcomes included hepatocellular carcinoma (HCC), acute-on-chronic liver failure, and liver-related death. Secondary endpoints included recompensation and progression to decompensation. Cox proportional hazards regression was used to assess the association between virological response patterns and clinical endpoints.

In total, 1,869 patients were enrolled. During a median follow-up of seven years, the MVR, VBT, and PVR rates were 65.4%, 26.5%, and 8.1%, respectively. The cumulative serum hepatitis B surface antigen (HBsAg) clearance rate was 9.8%. Moreover, 34.9% of patients with HBsAg < 100 IU/mL at baseline experienced HBsAg clearance. Compared with patients with VBT and PVR, those with MVR had a lower five- and ten-year cumulative incidence of HCC in both the compensated (five-year: 10.1% vs. 17.0%; ten-year: 14.2% vs. 33.6%; P < 0.001) and decompensated cirrhosis subgroups (five-year: 19.5% vs. 36.7%; ten-year: 25.7% vs. 49.7%; P < 0.001). Similarly, patients with MVR also had a lower cumulative incidence of liver-related death. Additionally, a higher hepatic recompensation rate was observed in patients with MVR than in those with VBT (34.1% vs. 22.5%, P < 0.001). Importantly, patients achieving HBsAg clearance and undetectable serum HBV DNA levels (“functional cure” during ongoing NA therapy) had the lowest five- and ten-year cumulative incidence of HCC (3.9% and 8.7%, respectively).

Patients with long-term MVR exhibited a lower incidence of HCC and liver-related death in both compensated and decompensated HBV-related cirrhosis subgroups, especially those achieving “functional cure.” However, more than 30% of patients experienced PVR or VBT during long-term NA antiviral therapy. These findings highlight the importance of long-term, rigorous monitoring after initial CVR to optimize outcomes and support clinical decision-making.

Breast cancer (BCA) is one of the most common cancers worldwide, with a high rate of mortality and morbidity in women. This review focuses on the applications of nanotechnology, nanomaterials, and nanoparticles (NPs) in BCA, encompassing diagnosis and therapy. Nanotechnologies, nanocarriers, and nano-encapsulations versus their corresponding counterparts for BCA diagnosis and therapy have been discussed. Various drug formulations into different nanocarriers (lipid NPs, nanoemulsions, polymeric NPs, and metal-based NPs) enhanced their bioavailability and therapeutic efficacy, overcoming the limitations of conventional formulations. Additionally, clinical specialists have achieved improved outcomes in the detection and monitoring of BCA at various stages using nanotechnology, ultimately leading to an improved quality of life for patients.

Comparative data on sequential transarterial chemoembolization (TACE) after stereotactic body radiation therapy (SBRT) in recurrent hepatocellular carcinoma (HCC) remain limited. This study aimed to evaluate the efficacy of this combination.

We retrospectively reviewed 152 patients with recurrent HCC who met predefined eligibility criteria; 109 received SBRT alone and 43 received SBRT plus TACE. To minimize selection bias, a 2:1 propensity score matching was performed, resulting in 68 patients in the SBRT-alone group and 36 in the SBRT plus TACE group for the final comparative analysis. Overall survival, progression-free survival, and local control were assessed using the Kaplan-Meier method.

The SBRT plus TACE group was associated with numerically higher survival rates, although this difference did not reach statistical significance. The cumulative one-, three-, and five-year overall survival rates were 91.2%, 76.3%, and 61.8% for SBRT alone, compared to 100.0%, 86.1%, and 77.5% for the combination therapy ( p = 0.069). The corresponding progression-free survival rates were 73.1%, 51.1%, and 32.3% versus 88.9%, 58.1%, and 52.3% ( p = 0.091). No acute grade ≥3 toxicities were observed in either group.

In this exploratory analysis of recurrent HCC, the combination of SBRT and TACE demonstrated a favorable trend toward improved survival compared with SBRT alone, without an increase in severe toxicity. While these findings did not reach statistical significance, they establish the safety profile of the combined approach and provide preliminary evidence supporting its potential therapeutic role. This hypothesis-generating study justifies and informs the design of larger, prospective trials to definitively evaluate the efficacy of this regimen.