Radiotherapy remains one of the essential treatment modalities for brain gliomas, brain metastases, pediatric neuroblastomas, and primary central nervous system lymphomas. With continuous advancements in modern radiotherapy techniques, patients have achieved significantly improved local control rates and prolonged survival. However, the long-term complications associated with radiotherapy have become increasingly evident. Radiation-induced brain injury (RIBI) is a clinical syndrome characterized primarily by neurological dysfunction following focal or whole-brain radiotherapy. It negatively impacts patients’ quality of life and imposes a considerable burden on families and society. With the rapid development of medical imaging and artificial intelligence technologies, multimodal imaging techniques, including structural magnetic resonance imaging, diffusion-weighted imaging, functional magnetic resonance imaging, perfusion imaging, positron emission tomography-computed tomography metabolic imaging, and radiomics, have demonstrated significant potential for early detection, dynamic monitoring, and quantitative evaluation of RIBI. Meanwhile, treatment strategies for RIBI are shifting from traditional symptomatic and supportive care toward multidimensional interventions aimed at protecting the blood-brain barrier, modulating neuroinflammation, and implementing precise targeted therapies. Additionally, emerging studies have explored neuromodulation techniques and gut-brain axis regulation, offering new directions for the prevention and treatment of RIBI. Although conventional imaging methods remain valuable for diagnosing RIBI, they exhibit notable limitations in the early stages of the disease and in differentiating RIBI from tumor recurrence. This review focuses on the current state of technological development, key findings, and existing limitations, with the aim of providing a theoretical foundation and technical support for the early identification and precise intervention of RIBI.

Further decompensation in cirrhosis is associated with increased mortality. However, reliable tools to predict further decompensation after transjugular intrahepatic portosystemic shunt (TIPS) are currently limited. This study aimed to investigate the incidence and risk factors of further decompensation within one year post-TIPS in patients with cirrhosis and to develop a predictive model for identifying high-risk individuals.

This retrospective cohort study enrolled 152 patients with cirrhosis undergoing TIPS for variceal bleeding and/or refractory ascites (January 2018–January 2024). Patients were stratified according to one-year decompensation outcomes. LASSO regression and multivariable logistic analysis were used to identify predictors, and a nomogram was constructed and internally validated using bootstrapping (1,000 replicates).

Among the 152 patients (median age 57.5 years [IQR 50.0–66.0]; 58.6% male; 58.6% viral/alcohol-associated etiology), 65.8% (100/152) achieved clinical stability at one year post-TIPS, while 34.2% (52/152) developed further decompensation. LASSO regression identified right hepatic lobe volume, spleen volume, and portal pressure gradient (PPG) reduction as key predictors, all independently associated with further decompensation risk in multivariable analysis (OR [95% CI]: 0.683 [0.535–0.873], 1.435 [1.240–1.661], and 0.961 [0.927–0.996], respectively). The nomogram demonstrated superior discrimination compared with PPG reduction alone and benchmark prognostic scores (AUC 0.854 [0.792–0.915] vs. 0.619–0.652; ΔAUC +0.201–+0.235, p < 0.001) with 92.3% sensitivity. High-risk patients (score > 86) had a 10.7-fold higher risk of further decompensation than low-risk patients (60.0% vs. 5.6%; p < 0.0001).

This validated model, combining hepatosplenic volumetry and PPG reduction, accurately stratifies further decompensation risk post-TIPS and may guide targeted surveillance and preventive interventions.

Fiberoptic bronchoscopy involves various topical airway anesthesia protocols, which can impact patient comfort, procedural ease, and overall outcomes. This study aimed to compare pre-procedure lignocaine spray (PPL) and spray-as-you-go (SAYG) airway anesthesia in terms of patient discomfort and operator comfort during fiberoptic bronchoscopy.

A single-blind randomized controlled trial was conducted at the Pulmonology Department of Shaikh Zayed Hospital, Lahore, Pakistan, from March 2021 to March 2022. Fifty participants were randomly assigned to two groups (n = 25 each). Standard procedural sedation with midazolam and 2 mL of 4% lignocaine spray in the oropharynx was used to suppress the gag reflex. Additionally, 2% lignocaine spray was administered during the procedure according to body weight (3 mg/kg) via oral scope insertion. Cough severity, pain perception, and operator comfort were assessed using the Visual Analogue Scale, Faces Pain Rating Scale, and a 4-point Likert scale, respectively.

Demographic characteristics were comparable between the groups, with a minor age difference (PPL: 53.25 years vs. SAYG: 50.88 years, p = 0.017). No significant differences were observed in pain perception, cough scores, or procedure duration between the PPL and SAYG groups. Operator comfort scores showed a trend favoring PPL (60% rated as “comfortable” or “very comfortable” vs. 28% in SAYG), though the difference was not statistically significant (p = 0.108).

Both PPL and SAYG topical airway anesthesia methods demonstrated similar effectiveness in pain control, cough suppression, operator comfort, and procedure duration. There was a slight, non-significant preference for PPL in operator comfort. These findings suggest that either technique may be effectively used, with potential implications for procedural efficiency and patient outcomes.

Peginterferon-α treatment exhibits low rates of the serological conversion rate of hepatitis B e antigen (HBeAg) and the negative conversion rate of hepatitis B virus (HBV) DNA, with significant myelosuppression leading to treatment discontinuation in some patients. Traditional Chinese medicine (TCM) may ameliorate liver inflammation and modulate immune responses. This study aims to investigate the efficacy of combining TCM with pegylated-interferon (PEG-IFN) α-2b and its impact on myelosuppression adverse effects.

This study included 117 HBeAg-positive chronic hepatitis B (CHB) patients who started initial antiviral therapy at Xiamen Hospital of TCM between June 2018 and January 2023. According to the treatment regimen, patients were divided into the observation group (n = 56, receiving PEG-IFN α-2b combined with Licorice 15 g, Angelica sinensis 20 g, Poria 20 g, Paeonia lactiflora 20 g, Rhizoma Atractylodis Macrocephalae 20 g, Radix Bupleurum Chinense 20 g, Mentha piperita 3 g, Ginger three slices for more than six months) and the control group (n = 61, receiving PEG-IFN α-2b alone). This study retrospectively analyzed etiological indicators, liver biochemical indicators, and blood routine tests before and after treatment.

After 24 and 48 weeks of treatment, the observation group demonstrated significantly superior outcomes to the control group in quantitative reduction of hepatitis B surface antigen, the serological conversion rate of HBeAg, and the reduction in HBV DNA quantification (P < 0.05). By week 48, the HBV DNA negative conversion rate in the observation group (46.67%) was significantly higher than that in the control group (26.67%) (P < 0.05). Regarding safety, the incidence of myelosuppression in the observation group was significantly lower than that in the control group at both 24 and 48 weeks of treatment (P < 0.05)

Real-world findings demonstrate that adjunctive TCM significantly enhances the antiviral efficacy of peginterferon α-2b in HBeAg-positive CHB patients while concurrently mitigating treatment-limiting myelosuppression. This combination strategy may represent a clinically valuable approach to optimizing interferon-based therapy for CHB.

Circular RNAs (circRNAs) are non-coding RNAs characterized by a strictly closed-loop covalent structure. They are abundantly detected in various cells due to their conserved nature. Studies have reported their potential association with chronic liver disease (CLD), including hepatitis, cirrhosis, and hepatocellular carcinoma (HCC), with possible roles as diagnostic and prognostic markers. This study aimed to analyze the potential use of serum-derived hsa_circ_101555 as a diagnostic tool for CLD without HCC, and to compare it with other known non-invasive parameters for liver disease severity and inflammation. Additionally, it aimed to evaluate its expression among non-HCC CLD patients, CLD with HCC cases reported in our published (phase I) study, and healthy controls.

A cross-sectional study (phase II) was conducted involving 30 clinically, laboratory, and radiologically diagnosed Egyptian non-HCC CLD patients and 30 healthy subjects. The serum expression level of hsa_circ_101555 was measured using real-time polymerase chain reaction. The diagnostic accuracy was assessed through receiver operating characteristic curve analysis, calculating the area under the curve to determine sensitivity and specificity. The study also compared hsa_circ_101555 levels with established non-invasive parameters such as the Child-Turcotte-Pugh and model for end-stage liver disease scores, as well as inflammatory markers like the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio.

hsa_circ_101555 demonstrated high diagnostic accuracy (area under the curve of 0.970) at a cutoff point of 2.088 for differentiating non-HCC CLD patients from healthy controls. Elevated circRNA levels were noted in patients with hepatic encephalopathy and ascites, correlating with advanced liver disease scores (Child-Turcotte-Pugh/model for end-stage liver disease scores). Mean circRNA values were highest in HCC cases, followed by non-HCC CLD patients, and lowest in healthy controls.

Serum-derived hsa_circ_101555 demonstrates high diagnostic accuracy in differentiating non-HCC CLD patients from healthy controls. These findings suggest that hsa_circ_101555 has the potential to serve as a reliable non-invasive biomarker for the early diagnosis of CLD, correlating with disease severity and inflammation markers. Further research with larger sample sizes is warranted to validate its clinical utility and enhance the management of CLD.

Various devices are used to study the unique electrical properties of acupuncture points (APs), with Voll’s electropuncture diagnostics (EAV) occupying a prominent role. The technical design of EAV allows for the testing of drugs to determine their individual selection and dosages. However, the physiological basis of this phenomenon remains unclear. This study investigated the feasibility of evaluating the electrodermal activity of APs to determine the daily dose of ribavirin using electroacupuncture according to the Voll diagnostic system in patients with long COVID.

This blind, randomized, placebo-controlled trial included 101 patients (aged 16 to 50) who met the definition of long COVID and were examined using an EAV testing system that measures the electrodermal activity of APs. Ribavirin was tested at the APs with established decreased electrical impedance readings to determine the daily doses. Fifty-two participants were randomized to the experimental group, and forty-nine to the placebo group. These patients were considered for data analysis.

The results of this study demonstrated the feasibility of using EAV to identify APs with decreased levels of electrodermal activity, followed by medicament testing (MT) of different ribavirin doses to restore the electrodermal activity at these points.

The results indicated that the tested doses of ribavirin in patients with long COVID correlate with electrodermal activity at certain APs along specific meridians. Higher doses of the drug were associated with lower electrodermal activity readings during MT using the EAV diagnostic system. However, further clinical and instrumental studies are needed to evaluate the clinical application of MT in the assessment of long COVID.

Laboratory-acquired infections (LAIs) have been documented since the first report of typhoid fever in 1885 and continue to endanger laboratory professionals despite decades of biosafety advances. This review provides a comprehensive overview of LAIs, emphasizing their history, modes of transmission, and strategies for prevention.

A systematic review of historical records, case series, and biosafety guidance (1885–2025) identified documented LAIs, their transmission routes, and preventive measures. Data were extracted on pathogen spectrum, geographic distribution, incident outcomes, and the effectiveness of biosafety interventions.

Historical analysis identified 50 laboratory-acquired typhoid infections with six deaths from 1885 to 1915, largely due to mouth pipetting and aerosol exposure. A sharp decline in fatal bacterial infections was observed following the introduction of Class II biosafety cabinets in the 1960s. From 2000 to 2021, 309 LAIs were reported across 94 studies, most commonly Salmonella enterica (56.6%), vaccinia virus (4.2%), and Brucella species (3.9%), with Brucella responsible for over half of hospital-laboratory cases (60 per 100,000 personnel-years). In Canada during 2023, 63 exposure events occurred, including three confirmed infections despite adherence to biosafety level protocols. Environmental persistence studies underscored surface-borne risks. The most effective preventative measures included abolishing mouth pipetting, mandatory use of gloves and eye/face protection, routine Class II biosafety cabinet use for aerosol-generating procedures, surface disinfection with 0.5% sodium hypochlorite, and annual competency-based biosafety training with incident reporting.

LAIs remain geographically widespread and pathogen-diverse. Quantitative historical trends and contemporary surveillance highlight critical transmission routes, including ingestion, inoculation, mucosal splash, and inhalation, while reinforcing evidence-based prevention strategies. Sustained investment in biosafety infrastructure, real-time exposure reporting, and pathogen-specific training is essential to further reduce LAI incidence and severity in the face of emerging antimicrobial resistance and novel agents.

Breast cancer remains one of the most common cancers affecting women globally, with late detection frequently contributing to its high mortality rate. Multiple factors drive these delays, including a lack of awareness, financial constraints in low-income countries, and limited access to non-invasive and accurate biomarkers. This review aims to introduce biomarkers, particularly hematological and biochemical serum markers, as essential, non-invasive, and accurate tools for improving the diagnosis, prognosis, and therapeutic management of breast cancer. Hematological markers are measurable blood parameters that reflect physiological and pathological processes such as inflammation, infection, cardiovascular stress, autoimmune conditions, and cancer. Routinely measured hematological markers, such as the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and red blood cell indices, are typically obtained from standard tests like the complete blood count. Regular monitoring through complete blood count is essential during cancer treatment to evaluate changes in blood cell counts and detect potential adverse effects. Because of their affordability, minimal infrastructure requirements, and broad accessibility, hematological parameters have been increasingly studied for their association with high-risk factors in breast cancer, particularly in resource-limited settings. Their utility underscores their critical role in improving patient outcomes across diverse healthcare environments. This review summarizes the clinical value of various hematological and serum-based biochemical markers in the screening and diagnosis of breast cancer. Prediction methods that incorporate hematological and serum-based biochemical parameters can support screening, diagnosis, and staging. Overall, individual or combined blood indicators hold significant potential to enhance diagnostic accuracy and effectiveness.

Hepatocellular carcinoma (HCC) is the most common subtype of primary liver cancer and continues to be a major cause of cancer-related mortality, particularly in regions of China with a high hepatitis B virus prevalence. Early-stage diagnosis remains challenging due to its asymptomatic onset and the limited sensitivity of conventional biomarkers, which together contribute to delayed detection, suboptimal therapeutic outcomes, and poor prognosis. These limitations underscore the urgent need for reliable, sensitive, and specific biomarkers to enable timely detection and targeted intervention. Protein induced by vitamin K absence or antagonist-II, an abnormal prothrombin variant generated under vitamin K deficiency or antagonism, has emerged as a promising candidate with diagnostic and therapeutic relevance in HCC. This review critically examines the molecular and biological characteristics of protein induced by vitamin K absence or antagonist-II, evaluates its clinical utility in HCC diagnosis and management, and delineates the current limitations hindering its broader application. Furthermore, future perspectives are proposed to guide translational research and clinical implementation. Collectively, this review aims to provide a comprehensive theoretical framework to advance precision diagnosis and individualized treatment strategies for HCC.