Highlights

PIVKA-II outperforms AFP as a prognostic biomarker in hepatocellular carcinoma. In hepatocellular carcinoma (HCC) patients with normal serum alpha-fetoprotein (AFP) levels (<20 ng/mL), there remains a critical need for reliable prognostic biomarkers. This retrospective study evaluated 330 treatment-naïve patients within this subgroup to assess the prognostic significance of Protein Induced by Vitamin K Absence or Antagonist II (PIVKA-II). The analysis revealed that elevated PIVKA-II levels (>100 mAU/mL) were significantly associated with larger, more aggressive tumors and markedly poorer overall survival (OS). Importantly, multivariate analysis confirmed PIVKA-II as an independent predictor of OS, highlighting its potential utility in risk stratification and clinical decision-making. These findings support the role of PIVKA-II as a valuable prognostic biomarker for AFP-negative HCC populations.1 Synergistic intracranial control: Osimertinib combined with radiotherapy in EGFR-mutant NSCLC. This retrospective study evaluated the therapeutic impact of combining intracranial radiotherapy (RT) with a blood–brain barrier–penetrant epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI), such as osimertinib, in Asian patients with EGFR-mutated lung adenocarcinoma and brain metastases. The combined approach significantly enhanced both local and distant intracranial tumor control, with the RT-plus-TKI group achieving a markedly higher 3-year control rate (77%) compared with the TKI-alone group (23%). Although overall survival was not prolonged, the addition of RT conferred substantial intracranial benefits without increasing systemic toxicity. These findings underscore the value of multimodal precision therapy and support integrating intracranial radiotherapy into osimertinib-based regimens to optimize neurological outcomes in advanced NSCLC.2 Traditional meets modern: Ban-Xia-Hou-Pu-Tang Enhances Western Therapy for Globus Sensation. This randomized, placebo-controlled trial investigated the therapeutic potential of combining Ban-Xia-Hou-Pu-Tang (BXHPT, 半夏厚朴湯), a traditional Chinese medicine formula, with standard Western medication for patients experiencing globus sensation—a common, non-painful throat discomfort that currently lacks standardized treatment. Participants were randomly assigned to receive either BXHPT plus Western therapy or Western therapy with placebo. The combined treatment group demonstrated significantly greater improvements in Reflux Finding Scores (RFS), laryngoscopic inflammation, and symptom severity (as measured by the Glasgow Edinburgh Throat Score and the Reflux Symptom Index) compared with the control group. Importantly, the regimen was well tolerated, with no hepatic or renal toxicity observed. These findings support BXHPT as a safe and effective adjunctive therapy, offering a promising integrative approach that bridges traditional Chinese medicine and evidence-based clinical practice in the management of globus pharyngeus.3 Timing and Fracture Pattern Predict Open Surgery in Ulnar-Sided CMC Joint Injuries. This 13-year retrospective study examined ulnar-sided carpometacarpal joint (CMCJ) fracture-dislocations—a rare and frequently overlooked hand injury that often requires surgical intervention. Analyzing cases treated between 2009 and 2022, the study identified surgical delay (≥2 weeks) and intra-articular comminution as key factors necessitating open reduction rather than closed techniques to achieve accurate fracture alignment. Despite delayed intervention in some cases, 95% of patients attained anatomical reduction and favorable functional recovery. These findings provide valuable clinical guidance for determining optimal surgical strategies and underscore the importance of early diagnosis and timely management to preserve hand function and prevent long-term complications.4 Endovascular strategy for dual aortic pathology: Managing type 3A dissection with infrarenal AAA. This retrospective study evaluated the feasibility and safety of endovascular management in patients simultaneously presenting with acute DeBakey type 3A aortic dissection and a degenerative infrarenal abdominal aortic aneurysm (AAA)—a rare and surgically challenging dual pathology. Eleven patients underwent either a one-stage or two-stage endovascular approach, incorporating thoracic endovascular aortic repair (TEVAR) and endovascular aneurysm repair (EVAR). The results demonstrated that both strategies were technically feasible and well tolerated, with no cases of spinal cord ischemia reported. Long-term outcomes were acceptable across the cohort. These findings provide important evidence that tailored endovascular sequencing offers a safe and effective solution for managing complex aortic presentations with minimal neurological risk.5 CONFLICTS OF INTEREST Dr. Jong-Ling Fuh, an editorial board member at the Journal of the Chinese Medical Association, had no role in the peer review process of or decision to publish this article.