本期电子书封面故事整期封面整期目录
最新文章刊期浏览栏目浏览
2026
第9期
第8期
第7期
第6期
第5期
第4期
第3期
第2期
第1期
2025
2024
2023
2022
2021
2020
2019
2018
2017
摘要：Background:Bladder cancer (BLCA) is a prevalent malignancy characterized by high recurrence and poor prognosis, particularly muscle-invasive bladder cancer (MIBC). Histopathology, the gold standard for assessing muscle invasion, often suffers from sampling errors and operator dependency, underscoring the need for non-invasive, accurate preoperative assessment methods. This study aimed to develop and validate a hybrid artificial intelligence (AI) model based on computed tomography (CT) radiomics and deep learning (DL) to predict MIBC and overall survival (OS) preoperatively in BLCA patients.Methods:A total of 1370 patients from 6 academic medical centers were retrospectively included. Preoperative contrast-enhanced CT scans were analyzed to extract handcrafted radiomic features using PyRadiomics and DL features using ResNet101, followed by machine learning (ML)-based modeling for prediction. A hybrid model combining radiomic and DL features was constructed and validated in internal and external cohorts. Model performance was evaluated using metrics such as the area under the curve (AUC) and Cox proportional hazards analysis for OS prediction.Results:The DL radiomics nomogram (DLRN) model demonstrated superior diagnostic performance, achieving an AUC of 0.807 in the internal validation cohort and 0.783 in the external multi-center validation cohort for predicting muscle invasion. The DLRN generated an imaging-derived risk score (DLRN score), which was subsequently incorporated as one covariate into a multivariable Cox proportional hazards model together with clinicopathological variables to evaluate OS. Using this approach, patients were effectively stratified into high- and low-risk groups for OS, showing robust generalizability across diverse clinical settings. AI-assisted diagnostics significantly improved the sensitivity and accuracy of urologists, particularly among less experienced clinicians.Conclusion:The DLRN model provides a reliable, non-invasive tool for preoperative assessment of muscle invasion and prognosis in BLCA. Addressing histopathology limitations, it offers valuable insights for personalized treatment strategies, paving the way for precision oncology in real-world clinical applications.关键词：Bladder cancer (BLCA);Deep learning (DL);Multi-center study;Artificial intelligence (AI);Radiomics76|67|0<HTML><网络PDF> <Meta-XML>更新时间：2026-09-15
摘要：Background:Early recognition of sepsis remains difficult in clinical practice because conventional humoral biomarkers such as C-reactive protein, procalcitonin, and interleukin-6 (IL-6) exhibit unfavorable, slow-release kinetics and rise hours after the onset of infection. Flow cytometry enables upstream, cell-based immunomonitoring, but its clinical use is restricted by poor standardization of fluorescence measurements. In this study, the neutrophil cellular response capacity (CRC) was developed and evaluated as a standardized approach for rapid assessment of systemic inflammation in bacteremia and sepsis.Methods:The CRC is based on a flow cytometry-based framework that defines a stable maximal stimulation reference point for neutrophil granulocytes. The CRC was evaluated in a human ex vivo whole blood bacteremia model with graded exposure to Escherichia coli and compared with humoral inflammatory markers. Next, the CRC was assessed in a prospective intensive care unit sepsis cohort. Moreover, preliminary validation was performed in an independent sepsis cohort and in patients undergoing cardiac surgery.Results:In the bacteremia model, the CRC of neutrophil markers CD10, CD11b, and CD66b increased in a dose-dependent manner with increasing bacterial burden and detected inflammation at lower pathogen burdens than IL-6 and other humoral mediators, with a superior area under the receiver operating characteristic curve. In clinical sepsis, the CRC discriminated patients from age- and sex-matched healthy volunteers, with the CRC of CD11b showing the highest diagnostic performance. CRC values increased over time in patients with sepsis, consistent with immunological recovery. The maximal stimulation reference point for CD11b remained stable across inflammatory states, cohorts, and instruments. In addition, the CRC more precisely captured the onset and resolution of surgery-induced inflammation than conventional biomarkers.Conclusions:The CRC provides a rapid, standardized, and robust cell-based immunomonitoring tool that outperforms traditional humoral markers in experimental bacteremia and reliably identifies sepsis in clinical cohorts, strongly supporting its use as a novel biomarker for earlier, more precise sepsis diagnosis and monitoring.关键词：sepsis;Bacteremia;Immunomonitoring;Neutrophil granulocytes;flow cytometry;Escherichia coli (E. coli)62|34|0<HTML><网络PDF> <Meta-XML>更新时间：2026-09-15
RESEARCH
- 摘要：Post-traumatic stress disorder (PTSD) is a complex neurobehavioral disorder that disproportionately affects military service members. The clinical presentation of PTSD is heterogeneous and may overlap with other psychiatric conditions. According to the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), common symptoms include memory loss, mood and personality changes, impulsiveness, aggression, anxiety, and depression. The pathophysiological mechanisms underlying PTSD remain incompletely understood, although research implicates pathways involving the hypothalamic-pituitary-adrenal (HPA) axis, dysfunctional neural circuitry, neurochemical imbalances, neuroinflammatory processes, and genetic and epigenetic factors. Approximately 7% of the U.S. adult population has met the diagnostic criteria for PTSD in their lifetime, with a substantially higher prevalence of 12%–30% among military personnel. Multiple animal models, including single-stressor, intermediate complexity, social interaction, predator stress, and blast exposure paradigms, have been employed to investigate PTSD mechanisms. Current treatment strategies typically integrate pharmacotherapy and psychotherapy. Military service members are at increased risk for blast injuries, which frequently result in traumatic brain injury (TBI). Although some symptoms of TBI may resolve, approximately 20% of affected individuals develop new symptoms, including PTSD. Evidence suggests that exposure to blast shock waves (BSWs) serves as a critical trigger for the clinical manifestations of both TBI and PTSD. Recent studies have identified several mechanisms contributing to BSW-induced brain dysfunction, including intraneuronal accumulation of phosphorylated Tau (p-Tau), activation of the dynorphin/kappa opioid receptor, and activation of metabotropic glutamate receptor 2/3 signaling pathways. This review provides an overview of the clinical features, treatments, pathophysiology, and epidemiology of PTSD, as well as animal models and their limitations in replicating PTSD-like symptoms. It further examines the relationship between BSW exposure, brain injury, and PTSD, discusses animal models that simulate blast trauma and PTSD-like symptoms, and evaluates potential therapies to mitigate BSW-induced PTSD. Finally, the review addresses the limitations of current models and proposes future directions for elucidating the mechanisms linking brain trauma to PTSD.关键词：Post-traumatic stress disorder (PTSD);Traumatic brain injuries (TBIs);Axonal injury;Blast shock waves;Cognitive impairment;Hypothalamic-pituitary-adrenal axis;Mood dysfunction;Neuroinflammation46|34|0<HTML><网络PDF> <Meta-XML>更新时间：2026-09-15
摘要：Three-dimensional (3D) bioprinting integrates engineering, materials science, and biology to fabricate living tissues with precise spatial control. By enabling the layer-by-layer deposition of cells and biomaterials, it overcomes many limitations of traditional scaffold-based tissue engineering and offers new opportunities for regenerative and personalized medicine. This review presents a comprehensive overview of recent advances in 3D bioprinting. It introduces a systematic, ASTM-aligned classification of key bioprinting modalities, extrusion, jetting, and vat photopolymerization, along with their respective material and biological design requirements. It also summarizes recent progress in bio-ink development and crosslinking strategies that improve print fidelity and functional tissue maturation. In addition, the review highlights applications in both systemic disease modelling and treatment (such as cardiovascular, endocrine/metabolic, and neurodegenerative disorders) and localized tissue repair (including skin, musculoskeletal, cartilage, and bone), emphasizing their relevance to civilian healthcare and military medicine. By combining technological innovation, biological insights, and regulatory considerations, this review outlines how advances in multi-modal bioprinting and intelligent process control can accelerate the translation of laboratory research into clinically viable, patient-specific therapies, driving the next generation of regenerative medicine.关键词：Biofabrication;Three-dimensional (3D) bioprinting;Bio-inks;Disease modelling;Tissue regeneration;Clinical translation;Multi-modal bioprinting;Machine learning (ML);Regulatory challenges65|57|0<HTML><网络PDF> <Meta-XML>更新时间：2026-09-15Nanobodies in biomedicine: from molecular characteristics to fabrication and clinical translation AI导读
摘要：Nanobodies (Nbs), the antigen-binding single-domain fragments derived from camelid heavy-chain antibodies (Abs), have rapidly become a focus of biomedical research due to their compact size, high stability, strong antigen affinity, and ease of molecular engineering. This review systematically outlines their structural and functional features, current strategies for acquisition, screening, optimization, and large-scale production, and comprehensively discusses their wide-ranging applications in therapeutics, diagnostics, and basic research. Specifically, Nbs have shown outstanding efficacy in tumor, toxin, infectious, and cardiovascular disease treatments, while serving as versatile tools for molecular imaging, biosensing, protein purification, structural analysis, and intracellular regulation. The challenges of immunogenicity, off-target effects, and industrial-scale manufacturing are also critically examined. Furthermore, the integration of artificial intelligence in structure prediction, de novo design, and immunogenicity assessment has opened powerful new avenues for rational Nb engineering. Combined with emerging technologies such as gene therapy, nanomaterial delivery, and multispecific architectures, these advances promise to accelerate clinical translation. Overall, Nb technology is poised to become a cornerstone of next-generation precision medicine and biotechnology, offering innovative solutions for disease diagnosis, targeted therapy, and molecular discovery.关键词：Nanobody (Nb);Molecular structure;Functional characteristics;Preparation methods;Diagnostic and therapeutic applications58|36|0<HTML><网络PDF> <Meta-XML>更新时间：2026-09-15
摘要：Circadian rhythms play a critical role in regulating physiological and behavioral processes, such as the sleep-wake cycle, hormone secretion, and metabolism. These rhythms are controlled by endogenous biological clocks, which are synchronized with environmental cues, primarily the light-dark cycle. Notably, disruption or reprogramming of circadian rhythms is closely associated with cancer initiation, progression, and treatment response. At the molecular level, the dysregulation of core clock genes can disturb normal cellular rhythms, leading to aberrant cell proliferation, impaired DNA repair, altered metabolism, and disrupted immune responses. This review systematically summarizes the pivotal roles and molecular mechanisms of circadian rhythms in tumor development, with a particular focus on strategies to modulate clock genes through behavioral interventions, pharmacological approaches, and gene-editing techniques, highlighting their potential as novel therapeutic strategies and clinical applications in cancer management.关键词：Circadian clock;Cancer;DNA damage response;Metabolic reprogramming;Immunity;Hypoxia signaling;Chronotherapy49|34|0<HTML><网络PDF> <Meta-XML>更新时间：2026-09-15
REVIEW
关键词：Lean body mass (LBM);Cardiac elastances;Arterial elastance;Systemic vascular resistance (SVR);Female-prone cardiac concentric remodeling;Sex dimorphism23|32|0<HTML><网络PDF> <Meta-XML>更新时间：2026-09-15
LETTER TO THE EDITOR
