Cardiovascular diseases (CVD) have emerged as a major disease burden affecting public health both globally and in China. The research and development of innovative technologies for heart and vascular health represent the implementation of whole-life-cycle management for CVD. This approach integrates early detection and reversal strategies with interventional and surgical treatments, establishing a collaborative prevention-diagnosis-treatment-rehabilitation model that bridges tertiary hospitals and community healthcare systems. This initiative implements integrated traditional Chinese-Western medicine strategies for early prevention and rehabilitation of CVD, while promoting the paradigm shift toward primordial prevention in CVD management. The integration of digitization, intelligent healthcare, and deep learning has significantly improved the prospects for CVD prevention. The research and development of cardiovascular health technologies—based on traditional and non-traditional risk factors, clinical and laboratory tests, imaging data, wearable devices, sensor data, and biological datasets—combined with the advancement of information technology and artificial intelligence, will enable the creation of an intelligent whole-life-cycle digital management system for cardiovascular health. This strategy will form a robust prevention and control framework for CVD, greatly helping to implement the "healthy China 2030" plan.

Knee osteoarthritis (KOA) is a common degenerative joint disease primarily caused by cartilage damage. The exact mechanism of its pathogenesis remains unclear, but known risk factors include age, obesity, inflammation, trauma, and genetic factors. This study aimed to identify disease-associated genes related to KOA by conducting whole-genome sequencing on a high-incidence KOA family and performing preliminary validation in the general population.

Six members from a three-generation, 18-member high-incidence KOA family were recruited, including four with KOA and two without. Whole-genome sequencing was performed on these six family members, and single nucleotide polymorphisms (SNPs) were screened using three deleteriousness prediction models: SIFT4G_Pred, Polyphen2_HDIV_Pred, and Polyphen2_HVAR_Pred. Additionally, 49 individuals from the general population were recruited, including 27 KOA patients and 22 healthy controls. MassArray SNP genotyping was conducted on these 49 individuals.

Whole-genome sequencing on the high-incidence KOA family members, combined with the three deleteriousness prediction models, identified 33 SNPs potentially associated with KOA. Based on these 33 SNPs and an additional 54 SNPs retrieved from the literature, preliminary validation was performed in the general population. The results revealed four SNPs that may be associated with KOA: rs10843013, rs12119908, rs2075164, and rs7953280. Among these, rs10843013 and rs7953280 were previously reported in the literature.

This study demonstrates that the development and progression of KOA are closely related to SNPs. When certain SNPs cluster within a family, the probability of KOA occurrence significantly increases. Moreover, these SNP loci also play an important role in influencing KOA susceptibility in the general population.

To investigate the clinical curative effect and feasibility of two-needle sutures anastomosis of microvessels and micronerves to replant tiny fingertips under suspended two-point support balance.

A retrospective analysis was performed on 26 patients (26 digits) with completely severed ting fingertips who were admitted to the Department of Hand and Foot Microsuegery of Nanjing Jiangbei Hospital from July 2021 to September 2024. Under the balance of suspended two-point support, two points were located at 12 (9) o’clock and 6 (3) o’clock on the ruptured microvessels and micronerves. One needle suture was performed at 12 (9) o’clock, and the other was performed at 6 (3) o’clock. A total of two needle sutures were performed for end-to-end anastomosis of microvessels and micronerves to restore superior digital arch artery and fingertip nerve connection and balance. The ratio of anastomosed vessels and nerves was 1:1. All patients were entered into scheduled follow-ups through a combination of visit of outpatient clinics or WeChat and telephone reviews, and the recovery of finger shape, function, and sensation was recorded. The clinical efficacy was evaluated according to the standard functional evaluation issued by the Hand Surgery Association of Chinese Medical Association.

All 26 ting fingertips survived completely, and the blood circulation of replanted fingertip was stable after operation. No vascular crisis occurred. The follow-up period ranged from 6 to 22 months, with an average of 8.5 months. At the final follow-up, the appearance and functional recovery of replanted fingertips were good, with the appearance being close to that of the contralateral healthy finger. According to the standard functional evaluation issued by the Hand Surgery Association of Chinese Medical Association: the function was excellent in 23 cases and good in 3 cases, with an excellent/good rate of 100%.

Two-needle suture anastomosis of microvessels and micronerves under suspended two-point support balance is an effective method to replant tiny fingertips, and it can achieve sensory recovery, increased survival rate, and good long-term appearance and functional recovery with no vascular crisis.

Takeuchi type III hinge fracture is a serious intraoperative complication of medial open wedge high tibial osteotomy (MOWHTO), which can lead to a decrease in the mechanical stability of the osteotomy site and affect the prognosis. This study evaluated the changes in the mechanical stability of the osteotomy site after adding an auxiliary fixation system (AFS) to the original internal fixation, with an aim of providing new ideas for the treatment of type III hinge fractures.

CT scan data of human lower limb bones and TomoFix plates and screws were used to establish the intact hinge MOWHTO model A and type III hinge fracture model B. Model C was constructed by adding an AFS on the basis of model B. Sitting to standing, walking, and twisting states were simulated. Different loads were applied above the tibial plateau of the models. The maximum stress of the internal fixation and the maximum displacement of the medial osteotomy site and the lateral hinge part were measured to evaluate the changes in the mechanical stability of the osteotomy site.

From the sitting to standing state, compared with model A, the maximum stresses of the plates in models B and C increased by 85.5% and 25.3%, respectively; the maximum displacement at the medial osteotomy site increased by 6.0% and 3.7%, respectively; and the maximum displacement at the lateral hinge position increased by 19.2% and 10.1%, respectively. In the working state, the maximum stress of the plates in models B and C increased by 62.8% and 14.4%, respectively; the maximum displacement at the medial osteotomy site increased by -3.4% and -6.9%, respectively; and the maximum displacement at the lateral hinge position increased by 106.4% and 89.3%, respectively. Under torsional load, the maximum stresses of the plates in models B and C increased by 25.5% and -10.2%, respectively; the maximum displacement at the medial osteotomy site increased by 16.8% and 9.3%, respectively; and the maximum displacement at the lateral hinge position increased by 8.5% and 1.6%, respectively.

This study demonstrates that type III hinge fractures reduce the stability of the osteotomy site, leading to an increase in the stress of the plate internal fixation and the displacement of the fracture site on the lateral tibial plateau. It has the greatest impact on the stability of the osteotomy site during the sit-to-stand transition, necessitating either avoidance of the movement or implementation of protective measures. AFS can distribute the stress of the internal fixation device, reduce the displacement of the fracture site on the tibial plateau, improve the stability of the osteotomy site, theoretically reducing the incidence of failure of the internal fixation device, loss of the alignment, and non-union of the osteotomy site. Compared with the original internal fixation, AFS can partially bear weight earlier, provide safer early functional exercise, facilitate rapid recovery, and reduce complications. It can be considered for the treatment of type Ⅲ hinge fractures. However, further biomechanical studies are needed to confirm this finding.

To investigate the relationship of high-sensitivity C-reactive protein (hs-CRP), neutrophil/lymphocyte ratio (NLR), and inflammatory burden index (IBI) with malnutrition in patients with chronic heart failure (CHF).

A total of 128 patients with CHF diagnosed in the General Medicine Department of the Eastern Theater Command Hospital of the People's Liberation Army of China from June 2023 to November 2024 were selected. The patients were divided into a mild malnutrition group (CONUT score 2~4), a moderate malnutrition group (CONUT score 5~8), and a normal nutritional status group (CONUT score 0~1) based on the controlled nutritional status (CONUT score). General data, hs-CRP, neutrophils, lymphocytes, albumin, total cholesterol, and other related data of the three groups of patients were collected. The indicators were compared between groups, and Logistic regression analysis was conducted on the inflammatory indicators related to the nutritional status of patients with CHF. The area under the receiver operating characteristic curve (AUC) values of hs-CRP, NLR, and IBI were compared to evaluate their predictive effectiveness for the risk of malnutrition in patients with CHF.

There were statistically significant differences in lymphocyte count, NLR, and IBI between the normal nutritional status group and the mild malnutrition group, and between the moderate malnutrition group and the normal nutritional status group (P<0.05); in hs-CRP between the moderate malnutrition group and the normal nutritional status group (P<0.05); and in hs-CRP and IBI between the moderate malnutrition group and the mild malnutrition group (P<0.05). Malnutrition had significant negative correlations with hs-CRP and IBI (P<0.05). Total cholesterol was weakly negatively correlated with hs-CRP (r=-0.143, P=0.079), NLR (r=-0.081, P=0.323), and IBI (r=-0.155, P=0.057). hs-CRP predicted malnutrition in CHF patients with an AUC of 0.76, a sensitivity of 0.65, and a specificity of 0.86. NLR predicted malnutrition in CHF patients with an AUC of 0.73, a sensitivity of 0.65, and a specificity of 0.84. IBI predicted malnutrition in CHF patients with an AUC of 0.80, a sensitivity of 0.65, and a specificity of 0.86.

The levels of hs-CRP, NLR, and IBI are closely related to the nutritional status of CHF patients, and they have high predictive value for malnutrition in CHF patients. Moreover, the area under the curve of IBI for predicting malnutrition in CHF is larger.

To explore the predictive value of obesity-related metrics based on CT measurements for anastomotic complications within three months after laparoscopic intersphincteric resection (Lap-ISR).

A total of 192 patients who underwent Lap-ISR for ultra-low rectal cancer at the Characteristic Medical Center of PLA Rocket Force from May 2022 to June 2024 were included. Data on anastomotic complications within three months after surgery were collected. The patients were divided into groups based on the occurrence of complications. Univariate analysis was performed to screen risk factors, and further multivariate logistic regression analysis, gender-stratified analysis, and receiver operating characteristic (ROC) curve analysis were conducted to evaluate the predictive effectiveness of visceral fat area (VFA) and perirenal fat area (PFA) for Lap-ISR anastomotic complications.

The incidence of anastomotic complications was 18.2% (35/192). Univariate analysis showed that male gender (P=0.013), diabetes (P=0.036), partial ISR (vs subtotal/complete ISR, P=0.026), VFA≥100 cm² (P=0.009), and PFA ≥25 cm² (P=0.007) significantly increased the risk of anastomotic complications. Multivariate logistic regression confirmed that male gender (odds ratio [OR]=2.84, 95% confidence interval [CI]: 1.12~7.21, P=0.042), VFA≥100 cm² (OR=3.12, 95%CI: 1.15~8.45, P=0.028), and PFA ≥25 cm² (OR=4.25, 95%CI: 1.82~9.92, P=0.006) were independent risk factors. Gender-stratified analysis showed that PFA≥25 cm² was significantly associated with complications (P=0.032) only in males, but not in females (P=0.62). ROC curve analysis showed that PFA had a better predictive performance (area under the curve [AUC]=0.659, 95%CI: 0.549~0.769, P=0.003) compared to VFA (AUC=0.642, 95%CI: 0.530~0.754, P=0.009).

PFA is a reliable indicator for predicting anastomotic complications after Lap-ISR, with particular significance for male patients. A preoperative PFA≥25 cm² indicates a high risk, suggesting that surgery should be performed by an experienced surgeon with enhanced perioperative management.

To investigate the role of a novel circular RNA, circ_0136474, in regulating chondrocyte autophagy in osteoarthritis (OA) and explore its potential mechanism in OA prevention and treatment, in order to provide a new theoretical basis for clinical treatment.

The SW1353 chondrocyte cell line was used to establish an OA cell model, and BALB/c mice were used to establish an OA mouse model. The expression level of circ_0136474 was detected by qRT-PCR, and autophagy-related proteins were analyzed using Western blot (WB). Safranin O-fast green staining was used to observe the pathological changes in cartilage tissue. A specific shRNA targeting circ_0136474 was used to knock down circ_0136474 in SW1353 cells, and the dynamic changes of autophagosomes and autolysosomes were analyzed using immunofluorescence and the autophagy double marker lentivirus mRFP-GFP-LC3. In addition, an AAV virus was used to establish a circ_0136474 knockdown mouse model to evaluate joint damage and the changes in chondrocyte autophagy levels.

HE staining showed that the joint cartilage structure in the control group was intact, with a smooth and clear surface, while the cartilage in the OA group had disrupted surface integrity and disordered arrangement of chondrocytes. Safranin O-fast green staining revealed a significant loss of chondrocytes in OA mice. The OARSI score showed a significant increase in the OA group. Circ_0136474 expression was upregulated in the OA mouse model. Meanwhile, in the OA model, the expression levels of LC3BII/I and Beclin-1 were significantly decreased, and p62 expression was increased. Silencing circ_0136474 in both cell and animal models resulted in a significant decrease in circ_0136474 levels and restoration of autophagy. Pathological examination showed that in the circ_0136474 silencing group, the cartilage surface was more intact, the chondrocytes were more orderly arranged, the OARSI score significantly decreased, and the number of chondrocytes increased.

Both in vivo and in vitro experiments confirmed the abnormal expression of circ_0136474 in OA model chondrocytes. Ssilencing circ_0136474 in chondrocytes enhanced autophagy levels in OA and alleviated cartilage damage in OA. This finding provides a new theoretical basis for the prevention and treatment of OA.

Methylmalonic acidemia (MMA) is a severe form of organic acidemia that can cause growth and developmental disorders, as well as multi-system and multi-organ damage. In China, over two decades have passed since Shanghai Xinhua Hospital pioneered the first neonatal tandem mass spectrometry screening techniques. Early screening and diagnosis of patients with MMA can now be achieved in the neonatal period, before clinical symptoms appear. Together with effective treatments, the survival rate and prognosis of MMA patients have greatly improved. However, as MMA is a metabolic disease that affects the whole body, patients are still at risk of neurological, renal, and other multi-organ complications. This article will elaborate on the clinical manifestations, pathogenesis, early detection and recognition, and treatment of renal complications in patients with MMA, with the aim of improving clinicians’ understanding of renal complications in MMA.

Tumor-associated macrophages (TAMs) are essential components of the hepatocellular carcinoma (HCC) tumor microenvironment (TME) and participate in processes such as tumor cell proliferation, invasive migration, angiogenesis, and progression of liver fibrosis in HCC. TAMs can regulate angiogenesis in HCC by secreting pro-angiogenic factors, interacting with endothelial cells, and increasing vascular permeability. This article reviews the role of TAMs in angiogenesis of HCC, aiming to identify potential targets for inhibiting tumor angiogenesis by targeting TAMs.

According to the pathological types, primary liver cancer is mainly divided into three common subtypes: hepatocellular carcinoma, intrahepatic cholangiocarcinoma, and combined hepatocellular-cholangiocarcinoma. Due to the difference in treatment and prognosis, the differential diagnosis of the three is very important. Contrast-enhanced ultrasound can realize real-time contrast imaging of tissue microvascular perfusion and has high potential in the diagnosis of primary liver cancer. Each type of liver cancer has its own characteristics, but there is still overlap in imaging features. In order to improve the accuracy of diagnosis of liver cancer, tumor markers are often analyzed. The application of some new methods is expected to contribute to the differential diagnosis of primary liver cancer subtypes by contrast-enhanced ultrasound.

To investigate the clinical features, treatment strategies, and prognosis of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) with nasal symptoms as the initial manifestation.

A retrospective analysis was conducted on three AAV patients treated at the Department of Otolaryngology-Head and Neck Surgery, Huai’an Hospital Affiliated to Xuzhou Medical University between January 2019 and December 2024. Clinical data, diagnostic and therapeutic interventions, and follow-up outcomes were systematically reviewed.

All patients initially exhibited chronic sinusitis-like symptoms: recurrent epistaxis (n=1) and nasal obstruction with headache (n=2). Pulmonary manifestations (lung nodules, localized calcification, or interstitial changes) were observed in all cases. Case 1 was hospitalized for recurrent epistaxis and diagnosed with chronic sinusitis via sinus CT, and he underwent endoscopic sinus surgery (ESS). Postoperative persistence of epistaxis, headache, and orbital pain prompted ANCA serology testing, which confirmed AAV. Immunosuppressive therapy initiated after rheumatology referral achieved symptom remission, though nasal symptoms recurred during follow-up. Case 2 presented with sinusitis. His nasal obstruction and headache improved after minimally invasive ESS. Persistent cough led to ANCA detection and subsequent immunosuppressive treatment with resolution of symptoms. Case 3 was initially diagnosed with chronic sinusitis and a nasal mass at an external institution. ESS failed to alleviate nasal obstruction/headache. Anti-inflammatory therapy was ineffective. Rheumatology consultation confirmed AAV. Cyclophosphamide and corticosteroid treatment resulted in clinical improvement.

AAV with initial sinonasal involvement typically manifests as nasal obstruction, headache, epistaxis, nasal ulceration, and/or polyposis. Otolaryngologists may reflexively resort to ESS for symptom management, potentially resulting in delayed diagnosis and inappropriate initial management. While ANCA serology testing provides critical diagnostic support, definitive diagnosis requires integrated assessment of clinical manifestations, histopathological findings (where available), and immunological parameters to facilitate early disease confirmation. Multidisciplinary collaboration is essential to mitigate diagnostic errors.