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Influenza is an acute respiratory infectious disease caused by influenza viruses, and it poses a serious threat to global public health. High-risk groups include the elderly, infants and young children, pregnant women, and patients with chronic underlying diseases. These groups are prone to developing severe illness after infection, which can lead to serious complications and even death. Early antiviral treatment is key to reducing the rate of severe illness and death. Currently, authoritative guidelines at home and abroad recommend early, single-agent antiviral therapy as the standard regimen. However, anti-influenza virus monotherapy has problems such as drug resistance and poor therapeutic effect. To address these problems, this consensus was developed by organizing experts from the departments of Infectious Diseases, Respiratory Medicine, Critical Care Medicine, and Pharmacy. These experts systematically sorted out domestic and international evidence on combined antiviral therapy for influenza and formulated expert recommendations on combined antiviral therapy for influenza in specific populations.

Aging constitutes a major risk factor for pan-cancer development, with epidemiological studies indicating that 60% of new malignancies occur in adults age 65 and older. This review synthesizes cutting-edge insights from single-cell sequencing databases (e.g., TCGA and GEO) that decipher how aging reprograms the tumor microenvironment (TME) to fuel carcinogenesis. Single-cell RNA sequencing (scRNA-seq) has revealed that senescent cell subpopulations (e.g., CDKN2A⁺/LMNB1^- cells) accumulate in aged tissues at frequencies up to 15%, driving genomic instability and secrete pro-tumorigenic senescence-associated secretory phenotype (SASP) factors (IL-6 and TGF-β). These factors remodel the TME by inducing fibroblast activation and extracellular matrix degradation, accelerating metastasis by 40-70% in murine models. Crucially, immunosenescence diminishes anti-tumor immunity, with scRNA-seq profiling showing 40-60% increases in exhausted PD-1⁺ T cells and immunosuppressive myeloid cells in aged TMEs. Pan-cancer analyses have identified conserved aging gene signatures (e.g., p16INK4a upregulation in 12+ cancer types) that correlate with 30-50% poorer survival. While technical challenges persist - including batch effects in scRNA-seq data and low senescent cell abundance (< 5%) - emerging solutions like deep learning can enhance detection sensitivity. Therapeutically, senolytic strategies deplete senescent cells, improving drug response by 3.5-fold in preclinical trials. Future research must integrate multi-omics and AI to examine aging-related targets, advancing personalized interventions for aging-associated malignancies.

The medical metaverse, with its potential for efficient care delivery, improved patient outcomes, and reduced healthcare costs, is profoundly impacting global healthcare systems. Scholars researching this topic primarily focus on exploring specific scenarios for its use. This article aims to analyze the development trajectory, potential applications, and directions for management optimization within the medical metaverse. Through a case study of China, we review the current status of use of the medical metaverse and systematically examine its future prospects and challenges. We contend that the medical metaverse offers significant value in enabling equitable distribution of healthcare resources, enhancing medical care efficiency, promoting the integration of medical education, research, and clinical practice, and assisting in public health management. To ensure sustainable development, however, the imperative task is to proactively devise technical standards and legal regulatory frameworks and to dynamically monitor the effectiveness of medical metaverse technologies, with the ultimate aim of maximizing the value of the medical metaverse.

Early-stage diagnosis offers the greatest survival advantage in oncology, and yet conventional liquid-biopsy markers - circulating tumor DNA (ctDNA) and circulating tumor cells (CTCs) - depend on cell death or mechanical shedding and therefore appear late in disease progression. Exosomes, 40-160 nm lipid-bilayer vesicles secreted by viable cells, emerge earlier, outnumber CTCs by several orders of magnitude, and preserve multi-omic cargo that mirrors intratumor heterogeneity. Rapid advances in enabling technologies are driving continual breakthroughs in exosome-based liquid biopsy, laying a solid foundation for its accelerated translation into clinical practice. Key hurdles remain: standardizing exosome isolation, defining quantitative cut-offs that separate malignant from inflammatory EV surges, and building probabilistic multi-omic models to pinpoint tissue origin. Eliminating these obstacles could advance detection by months and shift care from late salvage to true early interception.

Neurotropin, a non-protein extract widely used for the treatment of neuropathic pain, has recently been reported to protect against ischemic brain injury, enhance remyelination in demyelinating diseases, and ameliorate neuroinflammation and memory deficits. However, its role in microglial polarization and mitochondrial dysfunction in Alzheimer's disease (AD) remains poorly understood. In this study, we investigated the therapeutic potential of Neurotropin in the 5xFAD mouse model of AD. Neurotropin administration alleviated cognitive decline, reduced amyloid-β (Aβ) deposition, suppressed neuroinflammation, and preserved neuronal density. Mechanistically, Neurotropin improved mitochondrial morphology, restored ATP production, increased mitochondrial DNA copy number, and reduced oxidative stress while promoting a shift in microglial polarization from the pro-inflammatory M1 phenotype toward the anti-inflammatory M2 phenotype. Transcriptomic and molecular analyses revealed that calcium homeostasis modulator family member 2 (Calhm2) was markedly upregulated in 5xFAD mice, colocalized with microglia, and transcriptionally regulated by fused in sarcoma (FUS), while Calhm2 interacted with EF-hand domain containing protein D2 (EFhd2). Neurotropin suppressed FUS-mediated Calhm2 transcription and attenuated Calhm2-EFhd2 interaction. Importantly, overexpression of Calhm2 in both microglial cells and 5xFAD mice abolished the beneficial effects of Neurotropin, leading to exacerbated mitochondrial dysfunction, oxidative stress, and inflammatory cytokine release. Together, these findings identify Calhm2 as a critical mediator of Neurotropin's neuroprotective effects and demonstrate that Neurotropin alleviates AD pathology by suppressing FUS-dependent Calhm2 transcription and blocking the Calhm2/EFhd2 interaction. This study provides new insights into the mechanism of Neurotropin action and highlights its therapeutic potential for AD.

The persistent mutation of the novel coronavirus (SARS-CoV-2) not only remains a threat to human health but also continues to challenge existing antiviral therapeutic strategies. In current clinical practice, the resistance of novel coronavirus to antivirals, the rebound of viral load after treatment with drugs such as nirmatrelvir/ritonavir (NTV/r), and the urgent need for rapid clearance of the virus in the management of critically and emergently ill patients suggest that the existing single-drug regimens may have limitations and that the intensity of suppression may be insufficient in some cases. In clinical practice, we have observed that a combination of antivirals with different mechanisms of action can result in better efficacy and not significantly increase adverse drug reactions (ADRs). For some immunosuppressed, post-transplantation, or other special patients in particular, such as those in whom COVID-19 nucleic acids tended not to be negative after conventional treatment, when virus clearance is still the main goal, the combination of small-molecule antivirals can help to clear the virus as early as possible and attempt to improve the success rate of salvage. Based on evidence-based medicine and in light of the current situation of China, we assembled experts from disciplines such as infectious diseases, respiratory medicine, critical care medicine, and clinical pharmacy into a group to carry out a systematic literature search and identify key issues and to put forward relevant recommendations to reach an Expert Consensus on Combined Use of Oral Small-molecule Antivirals to Treat COVID-19, which is intended to serve as a reference for clinical practice.

Surgical resection of the caudate lobe of the liver remains the final hurdle for liver surgeons, not only in open hepatectomy but also in recent minimally invasive hepatectomy. In the dawn of liver surgery, Prof. Kumon made hepatic casts and showed the anatomy of the caudate lobe of the liver based on the portal segmentation in the National Cancer Center Hospital, Tokyo. Meanwhile, liver surgeons in the center successfully performed isolated caudate lobectomy of the liver for liver cancers one after another. Prof. Kumon is still dissecting hepatic casts to demonstrate the right border of the paracaval portion of the caudate lobe against segment VIII of the liver. An approach to right hemihepatectomy preserving the paracaval portion of the caudate lobe was developed thanks to the detailed anatomical knowledge of the liver based on hepatic casts.

Chikungunya virus (CHIKV), an emerging mosquito-borne alphavirus, poses an escalating global public health threat due to its rapid geographic expansion and increasing outbreak frequency. While most infections present with acute fever and severe polyarthralgia, a significant proportion of patients develop chronic, disabling joint symptoms. Recent local transmission in subtropical urban regions of China, and particularly Guangdong Province, where over 4,800 cases were reported in Foshan alone by July 2025, highlights the virus's adaptability to new environments. Globally, over 220,000 cases and 80 deaths were reported in the first half of 2025 across 14 countries, with Brazil accounting for the majority of the reported cases. Climate factors, viral evolution, and human mobility are major drivers of the virus' spread. Despite the growing threat, no specific antiviral treatment or licensed vaccine is currently available. An effective response requires integrated strategies combining vaccine development, vector control, early warning systems, and climate-adaptive public health planning to mitigate further transmission and its health and socioeconomic impact.

The role of laparoscopy for complex resections like right hemihepatectomy for hepatocellular carcinoma (HCC) remains contentious, and its assessment is often hampered by traditional metrics that fail to reflect the comprehensive quality of perioperative management. Therefore, this study used the textbook outcome (TO), a composite endpoint, to compare the laparoscopic (LRH) and open (ORH) approaches for HCC within a propensity score-matched (PSM) analysis. We retrospectively analyzed 435 patients who underwent curative-intent right hemihepatectomy. After 1:3 PSM, a final cohort of 121 patients who underwent LRH and 242 who underwent ORH was included for analysis. Results indicated that the rate of TO achievement was comparable between the LRH and ORH groups (62.0% vs. 65.3%, p = 0.563), with intraoperative complications (17.4%), post-hepatectomy liver failure (14.9%), and major postoperative complications (13.5%) as the primary barriers to achieving a TO. No significant differences in overall survival (OS) or disease-free survival (DFS) were observed, although the LRH group had a significantly shorter duration of hospitalization (p = 0.006). In multivariable Cox regression models, achieving a TO was confirmed as an independent protective factor for both OS (HR: 0.46, 95% CI: 0.34-0.63, p < 0.001) and DFS (HR: 0.44, 95% CI: 0.33-0.58, p < 0.001). For right hemihepatectomy, clinical practice should focus on maximizing the rate of TO achievement through systematic perioperative management, as a key strategy to improve long-term prognosis.

Chikungunya fever is a mosquito-borne disease caused by an RNA virus of the Alphavirus genus and is characterized by fever and severe joint pain. The disease is primarily transmitted by Aedes aegypti and Ae. albopictus mosquitoes. Since its re-emergence in 2005, chikungunya has spread extensively, affecting more than 2.8 billion people across 119 countries worldwide. This article reviews the global epidemiological features of chikungunya, with a focus on its transmission dynamics, the characteristics of the virus and its vectors, as well as the influence of ecological and climatic factors. The article also discusses public health response measures, including the Wolbachia strategy, vaccine development, and integrated vector management. Despite China being a non-epidemic area, imported cases have led to localized outbreaks, prompting the implementation of the 'Four Pests-free Village' initiative to reduce mosquito density and improve public health. Notably, as of July 31, 2025, Guangdong Province in China has reported over 5,158 chikungunya cases and has initiated a Level 3 emergency response in the City of Foshan. In the face of global challenges such as climate change and the spread of invasive species, establishing a normalized rapid response system and enhancing monitoring, early warning, and inter-departmental collaboration are crucial to controlling the spread of mosquito-borne diseases and protecting public health.