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2026 Year 13 Volume 3 Issue
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Abstract：BackgroundEndovascular treatment (EVT) is gaining popularity for the management of severe forms of cerebral venous thrombosis (CVT), but the evidence supporting its efficacy and safety is limited.MethodsThis multicenter study included patients with CVT admitted to 104 hospitals in 31 provinces/cities in China between January 2018 and June 2022. Propensity score weighting models were used to adjust baseline confounding variables to determine the association of EVT on the primary outcome of good functional status, defined as score 0-1 on the modified Rankin Scale after hospital discharge.ResultsOf 3063 patients identified through hospital records searches, 2774 adults [age (42±15.8) years, female 50.3%] fulfilled eligibility criteria and agreed to be included, of whom 449 (16.2%) received EVT and 2325 (83.8%) received standard care. There was no significant difference between the EVT group and the standard care group in terms of the possibility of good functional recovery [weighted risk ratio = 1.00, 95% confidence interval (CI)0.96-1.03]. Similarly, there was no difference in the likelihood of death at hospital discharge (weighted risk ratio = 1.91, 95% CI 0.91-3.68). In subgroup analysis, the possibility of good functional recovery was lower in patients with intracerebral hemorrhage (weighted risk ratio = 0.88, 95% CI 0.79-0.98; P for interaction = 0.01) and seizures(weighted risk ratio = 0.86, 95% CI 0.76-0.95; P for interaction = 0.03).ConclusionIn this large nationwide study, EVT was not associated with improved functional outcomes compared to standard care in patients with CVT.Keywords：Cerebral venous thrombosis (CVT);Endovascular treatment (EVT);Standard care;Efficacy;Safety26|18|0Updated：2026-05-08 -
Abstract：BackgroundAt present, no commercially available endoscopic system is specifically designed for use in the battlefield, disaster relief, or unique environments with biosafety concerns. Therefore, this limitation stems from challenges such as limited portability, reliance on stable power, complex disinfection processes, and the risk of incomplete sterilization. To address these challenges, we developed a novel portable endoscopic system and evaluated its safety and effectiveness in both routine settings and specialized scenarios, including the global pandemic caused by a novel coronavirus, which represents an environment with biosafety concerns.MethodsAfter sample size calculation, 30 patients underwent esophagogastroduodenoscopy (EGD) or colonoscopy using the YunSendo (the experimental group) and Olympus systems (the control group) in a randomized order. Operation time, image quality, operational performance, lesion detection, and safety were assessed. Ten emergency patients with suspected upper gastrointestinal bleeding received bedside treatment using the YunSendo system during the global pandemic caused by a novel coronavirus. Clinical outcomes in emergency endoscopic treatment were assessed.ResultsNo significant differences were observed between the YunSendo and Olympus groups in terms of image quality, lesion detection, and overall procedural performance. YunSendo facilitated biopsy and colonic polyp removal; no adverse endoscopy events were reported. YunSendo successfully executed diagnostic and therapeutic procedures in emergencies, with no observed mortality at 1, 7, or 30 d, no rebleeding at 1 or 30 d, and no cross-infection rates.ConclusionsThe performance of the YunSendo portable endoscopic system was comparable to the Olympus system in terms of key metrics, demonstrating its utility in urgent scenarios. This novel system is particularly promising for medical rescue and military missions and for addressing battlefield and biosafety concerns.Keywords：Portable gastrointestinal endoscopy;Gastrointestinal bleeding;colonoscopy;Endoscopic procedures;Field endoscopy28|20|0Updated：2026-05-08 -
Abstract：BackgroundLipid metabolic reprogramming has been increasingly recognized as a key factor contributing to tumor immune evasion, therapeutic resistance, and plasticity, which collectively compromise the efficacy of targeted radionuclide therapy (TRT). Overcoming the immunosuppressive and hypoxic tumor microenvironment (TME) while interfering with tumor lipid metabolism may offer a promising strategy to potentiate TRT outcomes.MethodsIn this report, a radiopharmaceutical with multienzymatic catalysis activities is developed, wherein tumor cell membrane-coated manganese single-atom nanozymes (Mn/SAE@M) as supports deliver iodine-131 (131I) to the tumor. The Mn/SAE nanozyme core was synthesized in situ within hollow mesoporous zeolitic imidazolate frame-8 (ZIF-8) nanoparticles, then coated with homologous tumor cell membranes for targeted delivery and subsequently labeled with 131I using the Chloramine-T method. A series of in vitro and in vivo experiments was performed in non-small cell lung cancer (NSCLC) models to evaluate therapeutic efficacy and immune activation.Results131I-Mn/SAE@M exhibited efficient tumor targeting and internalization mediated by membrane camouflage. Within the TME, the radiopharmaceuticals initiated abundant oxygen (O2) release through catalase (CAT)-like catalysis, thereby mitigating a hypoxic microenvironment. In particular, it produced and enriched more reactive oxygen species(ROS) through oxidase (OXD)-, peroxidase (POD)-, and glutathione oxidase (GSHOx)-like catalytic processes. Importantly, 131I-Mn/SAE@M activated the cGAS-STING pathway, interfered with the lipid metabolic homeostasis of tumor cells, and induced ferroptosis, which is unraveled to take responsibility for the potentiated antitumor immunity. In bilateral NSCLC tumor-bearing mice, the treatment suppressed both the first and the second tumors, indicating the generation of systemic antitumor immune responses and immunological memory.ConclusionsSuch SAE-based radiopharmaceuticals provide a candidate platform to elevate TRT efficiency, and the proof-of-concept rationale of disrupting lipid metabolic homeostasis through multienzyme-mimicking cascade reactions also provides a general avenue to improve TRT and synergistically magnify antitumor immunity.Keywords：Lipid metabolism disruption;Multienzymatical catalysis;Targeted radionuclide therapy (TRT);Single-atom nanozyme-based radiopharmaceuticals;antitumor immunity26|18|0Updated：2026-05-08 -
Abstract：BackgroundSurface engineering has emerged as a promising strategy to enhance the performance of nanomedicines. In particular, the PEGylation levels for chemotherapy drug 7-Ethyl-10-hydroxycamptothecin (SN38) prodrug nanoparticles (NPs) play a crucial role in determining their stability, drug release kinetics, cytotoxicity, cellular uptake, in vivo pharmacokinetics, biodistribution, and antitumor efficacy. The study aims to investigate the surface engineering for chemotherapy drugs, providing new solutions for improving their in vivo delivery.MethodsWe systematically evaluated the effects of different PEGylation levels on NPs (WDSPE-mPEG2k/Wprodrug; 0%,5%, 20%, 40%, 60%, 80%, 100%, 150%, and 200% NPs) incorporated on SN38 prodrug NPs via surface engineering. Drug release was measured using high-performance liquid chromatography (HPLC), while cytotoxicity was assessed via the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Cellular uptake was accurately quantified using liquid chromatography–mass spectrometry (LC–MS). The in vivo pharmacokinetics of the NPs were evaluated in Sprague–Dawley rats, and the biodistribution and antitumor efficacy were assessed using a CT26 colon tumor-bearing BALB/c mice model. Additionally, we examined intestinal toxicity to evaluate the safety profile.ResultsAll the different PEGylation levels of SN38 prodrug NPs exhibited high drug loading (> 25%) but distinct behaviors depending on the PEGylation level. Low PEGylation (20%) led to poor colloidal stability, reduced cellular uptake, and rapid clearance by the mononuclear phagocyte system (MPS), resulting in unfavorable pharmacokinetics. Moderate PEGylation (80%) improved in vitro stability and uptake but remained insufficient to prevent rapid clearance in vivo. In contrast, high PEGylation (150%) significantly enhanced pharmacokinetic profiles, prolonged circulation, and increased tumor accumulation. The 150% NPs also showed superior antitumor efficacy without triggering antipolyethylene glycol (PEG) immune responses or accelerated blood clearance (ABC) effects. Although high PEGylation slightly reduced cellular uptake, it conferred essential stability for systemic delivery, improving in vivo therapeutic outcomes.ConclusionsThe high PEGylation (150% NPs) exhibited the best antitumor effect and the lowest degree of intestinal toxicity. Our findings underscore the critical impact of PEGylation level on enhancing the performance and safety of SN38 prodrug NPs.Keywords：Surface engineering;prodrug;Polyethylene glycol (PEG);SN38;Long circulation22|6|0Updated：2026-05-08 -
Abstract：BackgroundSteroid-refractory (SR) acute graft-versus-host disease (aGVHD) is the major cause of early mortality after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Xenopax, a novel and the only available humanized interleukin-2 (IL-2) receptor antagonist, has been approved as a category 2 biological product by the National Medical Products Administration. This study aims to evaluate the efficacy, safety, and prognostic factors of xenopax treatment for SR-aGVHD in real-world settings.MethodsThis was a multicenter, retrospective analysis that included SR-aGVHD patients who received xenopax at 17 hospitals across China. The data were collected from the electronic medical records in transplant databases. The primary endpoint was the 28-day overall response rate (ORR), encompassing both partial and complete responses. This study also included independent historical SR-aGVHD cohorts treated with best available treatments (BATs, n = 1009) as controls.ResultsIn total, 172 SR-aGVHD patients were included in this study. Xenopax was administered either as monotherapy (n = 60) or in combination with other second-line treatments (n = 112). The ORR was 64.5% [95% confidence interval (CI) 57.3–71.7%] on day 28 and 82.6% (95% CI 76.9–88.3%) at any time after xenopax treatment. The 2-year probabilities of disease-free survival, overall survival, non-relapse mortality (NRM), and relapse after xenopax treatment were 57.0% (95% CI 49.9–65.0%), 68.0% (95% CI 61.4–75.4%), 24.2% (95% CI 18.0–30.9%), and 19.0% (95% CI 12.8–25.2%), respectively. The ORR and survival were similar between patients with and without prior second-line treatments. The conditioning regimen and human leukocyte antigen disparity did not impact the efficacy of xenopax treatment. According to the multivariate analysis, the presence of grade III–IV aGVHD did not adversely affect the therapeutic response or survival. Xenopax also showed some superiority over BATs in historical cohorts.ConclusionsOur real-world findings suggest that xenopax is an effective and safe treatment for SR-aGVHD.Keywords：Xenopax;Acute graft-versus-host disease (aGVHD);Steroid refractory (SR);Allogeneic hematopoietic stem cell transplantation (allo-HSCT)27|20|0Updated：2026-05-08 -
Abstract：BackgroundHeart failure (HF) continues to be a public health issue in China with population aging and increasing disease drivers. The burden, spatial patterns, temporal trends, and underlying causes of HF in China at subnational lev-els remain inadequately understood. This study aims to assess the disease burden and causes of HF, and their regional disparities in China from 1990 to 2023.MethodsUtilizing the estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023, we assessed the prevalence and years lived with disability (YLDs) of HF and their trends in China at both national and subnational levels. Estimates were also compared by disease severity, sex, age group, cause, and region.ResultsIn 2023, China had an estimated 14.3 million HF cases, marking a significant 208.4% increase over the past three decades. Ischemic heart disease (IHD) has become the top cause of HF, compared with 1990, with hypertensive heart disease (HHD) at the top. Alongside chronic obstructive pulmonary disease (COPD), these three leading causes accounted for 77.4% of all HF cases. The burden of HF due to IHD and COPD exhibited distinct regional patterns and substantial disparities: regions in northern China exhibited notably higher age-standardized YLDs rates for HF due to IHD, while provinces in the western regions faced the highest burden from COPD. Six provinces with the highest tertile of YLDs rates in 2023 also experienced the most pronounced increases between 1990 and 2023.ConclusionsHF remains a significant public health challenge in China, with a marked increase in prevalence over the past three decades. The substantial regional variations highlight the need for targeted and region-specific public health strategies. Enhanced nationwide efforts should be made to reduce the geographical disparities in the burden of HF.Keywords：Heart failure (HF);China;Global Burden of Diseases;epidemiology25|17|0Updated：2026-05-08
RESEARCH
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Abstract：Clonal hematopoiesis of indeterminate potential (CHIP), driven by leukemia-related somatic mutations in hemat-opoietic stem cells, previously recognized as a major risk factor for hematological malignancies, has now emerged as a potent risk factor for chronic inflammation and diverse non-hematologic diseases. CHIP-associated DNA meth-yltransferase 3 alpha (DNMT3A), tet methylcytosine dioxygenase 2 (TET2), and additional sex combs like 1 (ASXL1)mutations alter epigenetic programs, skew myelopoiesis, and increase proinflammatory cytokines, resulting in chronic inflammation and immune imbalance. This review integrates mechanistic insights with clinical evidence to deline-ate CHIP’s roles in solid tumors, cardiovascular disorders, and metabolic dysregulation, with an extended discussion of renal dysfunction and neurodegenerative conditions. Furthermore, we also discuss CHIP’s diagnostic and therapeu-tic impacts across multiple disease contexts, advocating for mutation-specific diagnostic paradigms to guide thera-peutic interventions.Keywords：Clonal hematopoiesis of indeterminate potential (CHIP);Chronic inflammation;atherosclerosis;Solid tumors;infection28|8|0Updated：2026-05-08 -
Abstract：The worldwide dissemination of drug-resistant tuberculosis (TB) presents significant obstacles to conventional anti-TB treatment and prevention methods based on bactericidal antimicrobial drugs, greatly impeding advancements in combating this most lethal disease. With growing insights into the immunopathogenesis of TB, we are increas-ingly recognizing the potential of immunotherapeutic strategies aimed at targeting the host. After invading the host, Mycobacterium tuberculosis (M. tuberculosis) induces host cell exhaustion through its own molecules, such as early secretory antigen target-6 (ESAT-6) and di-O-acyl-trehalose, manifested as suppressed proliferative capacity, cytokine production, and cytotoxicity, thereby triggering the onset of TB. In response to this pathogenic mechanism, immuno-therapeutic strategies, including cell therapy and immune checkpoint inhibitors, have been developed to promote cytokine production, activate immune cells to exhibit anti-TB activities such as autophagy, and restore immune home-ostasis, including the balance between T helper 1 (Th1) and Th2 responses. These approaches have shown promise in restoring host immunity and demonstrating therapeutic effects against TB. However, a comprehensive evaluation of factors such as drug safety, optimal treatment duration, and others, is essential before these strategies can be integrated into routine clinical TB management. The advancement of immunotherapy has the potential to revolution-ize current TB management and provide further benefits to patients. This review aims to comprehensively explore the advancements in diverse TB immunotherapeutic strategies, including efficacy, safety, and administration methods, and to explore the challenges and prospects of TB immunotherapy.Keywords：Tuberculosis (TB);Cell exhaustion;Immunotherapy;Molecular mechanisms;Clinical trials25|9|0Updated：2026-05-08 -
Abstract：Monkeypox, a zoonotic illness caused by monkeypox virus (MPXV), has been declared a public health emergency of international concern by the World Health Organization (WHO) on 2 separate occasions. The rapid spread and widespread transmission are closely associated with various proteins involved in the MPXV lifecycle, particularly surface antigen proteins found in mature virion (MV) and enveloped virion (EV), such as A29L, M1R, B6R, and A35R. These antigens are highly conserved in monkeypox virus (MPXV) and vaccinia virus (VACV), possessing cross-protec-tive capabilities that can trigger broad immune protection against multiple orthopoxviruses, including MPXV. Vac-cines based on DNA, mRNA, and recombinant proteins, targeting these antigens effectively address the current lack of specific monkeypox vaccines by triggering strong immune responses and ensuring the prevention of monkeypox. Compared to traditional vaccines, multi-epitope vaccines designed using computational tools such as reverse vac-cinology and immunoinformatics offer lower development costs and faster validation processes. These multi-epitope vaccines also provide adaptability to mutations in MPXV strains. Additionally, these antigens and corresponding anti-bodies are useful for diagnosis and therapeutic monitoring, supporting early detection and offering novel treatments for cases resistant to existing antiviral drugs. This review provides a brief summary of recent progress and emerging trends in monkeypox detection, vaccine development, and antibody-based therapy targeting these antigens, offering new insights for monkeypox prevention and control.Keywords：Monkeypox;Monkeypox virus (MPXV);Antigens;Antibodies;Vaccines;Detection;Therapy;Monoclonal antibodies;Mature virion (MV);Enveloped virion (EV)24|15|0Updated：2026-05-08
REVIEW
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Keywords：Multicenter study;Optimized drug treatment;Acute type A aortic dissection;Clinical prognosis19|14|0Updated：2026-05-08 -
Keywords：sepsis;Immunoglobulin G (IgG);Intravenous Immunoglobulin;Mortality18|15|0Updated：2026-05-08
LETTER TO THE EDITOR
- Keywords：Artificial intelligence (AI);Precision medicine;Standard of care18|20|0Updated：2026-05-08
COMMENTARY
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