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Latest Issue
Volume 13 ， Issue 4 ， 2026
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Chinese expert consensus on prevention, diagnosis, and management of venous thromboembolism in adult burn patients (2024) AI Introduction
Abstract：Venous thromboembolism (VTE) management in adult burn patients has become a crucial focus in China. The intri-cate nature of VTE necessitates specialized anticoagulation strategies due to the unique challenges posed by burn injuries. To address this pressing issue, the Burn and Trauma Branch of the Chinese Geriatric Medical Association and Critical Care Group of Burn Surgery Branch of the Chinese Medical Association organized a panel of domestic experts in burn surgery, critical care medicine, vascular surgery, nursing, and health statistics and methodology from Chinese hospitals to discuss VTE-related issues in burn injury, the heightened risk factors such as extensive tissue damage and prolonged immobilization, and the delicate balance required in anticoagulation therapy to mitigate bleeding risks. Based on the latest available research evidence as well as the clinical experience of the panel experts, this consensus comprehensively evaluates factors such as generalizability, suitability, and the potential implications for resource allocation. It also appropriately weighs the clinical advantages against possible drawbacks, resulting in the formulation of 21 guideline recommendations.RegistrationPractice Guideline REgistry for transPAREncy (PREPARE): No. 2023CN656.Keywords：burn;Adult;Venous thromboembolism (VTE);diagnosis;Management;prevention;Consensus;Deep vein thrombosis (DVT);Pulmonary thromboembolism (PE);anticoagulation17|14|0Updated：2026-06-10
POSITION ARTICLE AND GUIDELINE
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Neurogenic organ dysfunction syndrome after acute brain injury AI Introduction
Abstract：Systemic complications are common after acute brain injury (ABI) and may trigger coagulation cascades, systemic inflammation, as well as dysfunction of the cardiovascular, respiratory, and gastrointestinal systems, etc. The patho-genesis of these systemic manifestations is multifactorial but not yet fully elucidated. This paper introduces the novel term neurogenic organ dysfunction syndrome (NODS) to characterize systemic instability arising from internal and external perturbations of the neuronal center following ABI. Elucidating the central neurogenic mechanisms of NODS is critical for early detection and prevention of complications, thereby reducing mortality and improving patient outcomes following ABI. In this paper, we explore the potential central neurogenic mechanisms of NODS from the perspective of complex brain network theory, focusing on the structural network of the central autonomic system (CAS) that maintains systemic stability, and the functional network governed by the central stress system (CSS). The CAS can be divided into the cortical autonomic network, which involves higher cortical regions, and the subcor-tical autonomic network, which is relatively conserved, with its main connections located in deep brain structures. The CSS is a large-scale complex network characterized by hierarchy, hubs, and modularity, which together enable the competitive optimization of functional segregation and integration. Under physiological conditions, modules (mediating functional segregation) and hubs (functional integration) within the CSS dynamically trade-off with each other to maintain the overall homeostasis. However, this balance is disrupted following pathological insults or injury, resulting in weakened functional integrity of the CSS following ABI, impaired module activity, and disturbed hub integration. This paper also demonstrates the distinct pathological manifestations arising from disturbances at differ-ent levels of the homeostatic system. Finally, this study proposes potential clinical interventions, including analgesia and sedation, neuromodulation, and receptor regulation, for early interventions and potential treatment of NODS, aiming to improve patient outcomes.Keywords：Neurogenic organ dysfunction syndrome;Acute brain injury;Hierarchical modular structure;Hierarchical hub;Small-world network;Systemic homeostasis13|22|0Updated：2026-06-10
PERSPECTIVE
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Abstract：BackgroundDiabetic foot ulcers (DFU), perpetually trapped in a vicious cycle of inflammation and ischemia, remain a significant clinical challenge. Exosomes (Exo) therapy holds promise for tissue repair, yet its functional potency and delivery efficiency are often limited.MethodsWe proposed an integrated strategy combining trace elements (TE) programming, Exo engineering, and intelligent delivery to overcome both functional and delivery constraints. Multiple TE (Fe, Mg, Zn, Mn, and Se)were incorporated into a three-dimensional (3D) dynamic culture system to construct high-activity engineered Exo (3D-TE-Exo). The biological mechanisms were explored via transcriptomics, mitochondrial function assays, and oxida-tive stress analyses. A dual-network hydrogel, incorporating dynamic Schiff base bonds and ultraviolet (UV)-triggered disulfide bond reorganization, was developed for precise and sustained Exo release in vivo.Results3D-TE-Exo achieved a yield of 1.9 × 1012 particles/ml, representing a 29-fold increase over conventional culture (6.5 × 1010 particles/ml). These Exo modulated the complement pathway, restored mitochondrial membrane potential, enhanced adenosine triphosphate (ATP) production, and activated autophagy, thereby alleviating oxidative stress, with complement 1q binding protein (C1QBP) identified as a key mediator. The hydrogel enabled prolonged Exo retention and controlled release at the wound site. In DFU rat models, this system achieved 89.71% wound clo-sure by day 14, significantly higher than the 50.64% observed in controls.ConclusionsThis study presents a synergistic approach integrating engineered Exo and smart biomaterials to accelerate DFU healing. The platform offers a multi-target intervention strategy with strong translational potential for the clinical management of chronic wounds.Keywords：Exosomes (Exo);Hydrogel;Trace element;Diabetic foot ulcers (DFU);Complement 1q binding protein (C1QBP)21|16|0Updated：2026-06-10 -
Abstract：BackgroundTraumatic amputations have increased worldwide over the past two decades and are expected to increase by 72% by 2050. Surgical replantation provides superior functional recovery and patient satisfaction but is limited to specialized centers and restricted by short ischemia times, due to life-over-limb prioritization in patient care. To overcome these limitations, we developed an ex vivo limb perfusion system (EVEP) to extend limb viability and, for the first time, investigate its impact on peripheral nerve regeneration, a key prerequisite for functional recovery following replantation.MethodsHind limbs of 6 healthy pigs were amputated, and after 2 h of warm ischemia, limbs were either perfused normothermally for 6 h with PerfadexPlus® ± medication using in-house developed EVEP or stored statically (4 °C vs.room temperature). Perfusion parameters, blood gas analysis, serum markers, cytokine levels, thermal imaging, colloid oncotic pressure, weight gain, joint mobility, peripheral nerve histomorphometric and stereological analyses were performed.ResultsData confirm a valid and reliable EVEP with an optimized perfusion protocol. Comparison of perfusion groups revealed lower serum injury markers in the medication group, which included methylprednisolone treatment. Additionally, the medication group exhibited reduced weight gain and preserved unrestricted joint mobility, but con-currently led to a significant decrease in pro-regenerative cytokine levels associated with Wallerian degeneration (WD).ConclusionsIn general, EVEP mitigates ischemia-related damage and facilitates ex vivo induction of WD, a criti-cal prerequisite for nerve regeneration, functional recovery, and prevention of neuroma formation with subsequent phantom pain, by establishing the pro-regenerative environment for WD, which is further amplified by omitting the anti-inflammatory methylprednisolone.Keywords：Ex vivo perfusion;Ex-situ perfusion;Ex vivo limb perfusion;Traumatic limb amputation;nerve regeneration;Autologous replantation;Wallerian degeneration;Peripheral nerve regeneration16|2|0Updated：2026-06-10 -
Abstract：Background:Working memory deficits, one of the earliest hallmarks of Alzheimer’s disease (AD), are closely linked to abnormal neural activity in the dorsolateral prefrontal cortex (DLPFC). Transcranial direct current stimulation(tDCS), a non-invasive neuromodulation therapy, has been shown to ameliorate early AD working memory deficits by modulating excitatory activity in the DLPFC, yet the underlying mechanisms remain incompletely understood.Methods:This investigation was structured around three experimental phases. We initially applied tDCS to stimulate the left prefrontal cortex (PFC) of transgenic mice with 5 familial AD (5×FAD) 5 d per week for 4 weeks. Subsequently, we employed optogenetic (Opt) techniques to modulate left PFC glutamatergic neurons. Finally, we inhibited soluble N-ethylmaleimide-sensitive factor attachment receptor (SNARE) expression in the left PFC to elucidate the essential function of SNARE complex assembly with chaperone molecules in orchestrating synaptic vesicle release.Results:tDCS treatment improved working memory deficits in early-stage AD mice. This was accompanied by increased cerebral blood flow, enhanced neuronal excitability, amelioration of neurochemical metabolic disorders, and reduced amyloid β-protein (Aβ) deposition in the left PFC. Opt stimulation of PFC glutamatergic neurons similarly improved working memory, indicating the association between tDCS’s therapeutic effects and synaptic plasticity of excitatory neurons. Crucially, tDCS facilitated synaptic vesicle fusion and release, evidenced by increased vesicle numbers, enhanced release probability, improved synaptic transmission efficacy, and upregulation of the SNARE complex, Snap25, and Syt1. Inhibiting SNARE expression in the left PFC attenuated the tDCS-induced improvements in synaptic vesicle release and working memory.Conclusion:These findings collectively demonstrate that left PFC-targeted tDCS modulates interactions between the SNARE complex and chaperone molecules, thereby promoting synaptic vesicle fusion and release. This mechanism underlies the amelioration of early AD-like working memory impairment by tDCS.Keywords：Transcranial direct current stimulation (tDCS);Dorsolateral prefrontal cortex (DLPFC);Glutamatergic neurons;Synaptic vesicle transport;Working memory13|14|0Updated：2026-06-10
RESEARCH
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The emerging role of ferroptosis in the pathological development and progression of sepsis AI Introduction
Abstract：Ferroptosis, a form of iron-dependent regulated cell death (RCD), is emerging as a critical mechanism in the patho-genesis and progression of sepsis. This review highlights the intricate molecular pathways and hallmark features of fer-roptosis, including lipid peroxidation, dysregulation of iron metabolism, and glutathione depletion, which exacerbate sepsis progression and sepsis-associated multi-organ damage. The systemic interactions of ferroptosis with inflam-mation, innate, and adaptive immunity, and organ injury are elucidated, emphasizing the role ferroptosis plays both in immunity including sepsis-associated immune cell damage/dysfunction, immune dysregulation, and immu-nosuppression, and in sepsis-associated multi-organ injury such as acute lung injury (ALI), acute kidney injury (AKI), acute hepatic injury (AHI), acute intestinal injury, septic cardiomyopathy, and septic encephalopathy. Therapeutic strategies targeting ferroptosis hold promise for improving sepsis outcomes. Approaches include pharmacological interventions of ferroptosis-associated pathways, nanoparticle-based delivery systems, and combinatorial therapies aimed at preventing immune dysfunction and protecting against multi-organ failure. Nonetheless, challenges remain in translating preclinical findings into clinical application, necessitating further research into ferroptosis-specific regulatory networks. This review underscores the potential of therapeutics targeting ferroptosis as a transformative approach to addressing sepsis, paving the way for innovative and precision-based clinical interventions.Keywords：sepsis;Ferroptosis;Lipid peroxidation;Inflammation;Immune dysregulation;Organ damage;Treatment25|27|0Updated：2026-06-10 -
Virtual medicine: medical AI in human health and diseases AI Introduction
Abstract：The evolution of medicine has progressed through distinct ages: from empirical observation and evidence-based practice to the current era of precision medicine. However, traditional healthcare paradigms remain constrained by data fragmentation, scalability limits, and the overwhelming complexity of multi-omics integration. In the rapid explosion of artificial intelligence (AI), a transformative paradigm is emerging. This review introduces the concept of “Virtual Medicine”, which is defined as a comprehensive ecosystem of AI-empowered medical practice that transcends physical limitations. This review systematically summarizes the technological foundations, historical evolution, and core applications of AI in medicine, including electronic health records (EHRs) analysis, medical imaging, multimodal diagnostics, drug discovery, precision oncology, intelligent surgery, and clinical decision support systems. It further highlights the role of medical AI in health management, public health surveillance, and healthcare delivery in resource-limited settings. Special attention is given to the transformative emergence of large language models (LLMs), such as medical large language models (MedLLM) and generative pre-trained transformer (GPT) architectures, emphasizing their potential to revolutionize virtual medical interaction, clinical reasoning, and documentation. Despite these advances, significant challenges remain regarding model transparency, data bias, fairness, and patient privacy. Overcoming these limitations necessitates standardized evaluation frameworks, interpretable algorithm designs, and strengthened privacy protections. Ultimately, these efforts aim to foster a trustworthy and equitable future for virtual medicine.Keywords：Medical artificial intelligence (AI);Clinical decision support;Virtual Medicine;Precision medicine;Large language models9|10|0Updated：2026-06-10
REVIEW
- Keywords：Cardiomyocyte computational models;Drug safety testing;Cardiac electrophysiology;In silico clinical trials;Artificial intelligence (AI)20|29|0Updated：2026-06-10
LETTER TO THE EDITOR
- Keywords：Portable endoscopy;YunSendo system;Single-use devices;Battlefield medicine;Infection control;Gastrointestinal endoscopy40|20|0Updated：2026-06-10
COMMENTARY
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