OBJECTIVE:To evaluate a two-stage tracheal reconstruction strategy for repairing extensive tracheal defects in well-differentiated thyroid carcinoma (WDTC) with tracheal invasion. METHODS:Seventy-four patients underwent tumor resection and tracheal excision, followed by staged reconstruction using a free posterior tibial flap (n = 28), pedicled thoracoacromial flap (n = 36), or pedicled supraclavicular flap (n = 10). Functional recovery, decannulation, complications, and survival were analyzed. RESULTS:Demographic characteristics were comparable across groups. Tracheal defects were significantly larger in the free posterior tibial artery perforator flap group (9.14 ± 1.57 rings) versus the pedicled thoracoacromial (5.89 ± 2.59 rings) and supraclavicular (6.30 ± 1.49 rings) flap groups. The overall endotracheal tube removal rate was 95.9%, with no intergroup differences (p = 0.533). Functional recovery (swallowing, speech, and respiration) was comparable among groups. The 3-year survival rate was 78.4%, with no significant differences across groups (p = 0.633). CONCLUSIONS:Two-stage tracheal reconstruction is a safe and effective approach for long-segment tracheal defects in WDTC patients, offering satisfactory functional recovery. Further studies with larger cohorts and longer follow-up are warranted to confirm long-term efficacy. LEVEL OF EVIDENCE: 4:

Laryngeal transplantation offers a promising avenue for functional restoration following total laryngectomy, yet concerns regarding cancer recurrence and perioperative challenges persist. This pilot study evaluates the preliminary outcomes of a refined surgical technique and postoperative follow-up protocol specifically for cancer patients. Between 2023 and 2024, four patients underwent laryngeal transplantation at West China Hospital, with immunosuppressive therapy, microbial prophylaxis, and postoperative rehabilitation. Over a follow-up period ranging from 10 to 26 months, outcomes were heterogeneous. Two recipients (T4 laryngeal squamous cell carcinoma) achieved excellent functional recovery in swallowing and phonation with sustained rejection-free survival for 20 and 23 months and disease-free survival for 20 and 26 months, respectively, though both remained tracheostoma dependent. One of these survivors is currently undergoing treatment for graft rejection after unilateral cessation of immunosuppressants. The remaining two patients succumbed to severe pneumonia with sepsis and tumor recurrence at 10 and 11 months posttransplant. Functional assessments in surviving cases indicated progressive nerve regeneration, with optimal voice and swallowing outcomes achieved approximately 6-8 months postsurgery. Ultimately, these findings demonstrate the technical feasibility of laryngeal transplantation in a pilot cohort of cancer patients, providing critical data for future protocol refinement.

Accumulating evidence indicates that N6-methyladenosine (m6A) modification of circular RNAs (circRNAs) plays a pivotal role in regulating cancer progression. However, in head and neck squamous cell carcinoma (HNSCC), the biological functions and underlying mechanisms of m6A modification in circRNAs remain insufficiently elucidated. In this study, we analyzed the association between the expression of IGF2BP3—an upstream m⁶A reader—and clinical outcomes of HNSCC patients, followed by investigating the interaction between IGF2BP3 and circHECTD2 as well as the effect of m⁶A modification on this interaction. Additionally, we explored the molecular mechanism by which IGF2BP3 and circHECTD2 regulate HNSCC progression, focusing on their roles in modulating microRNAs (miRNAs) and target mRNAs, and validated the functional impacts of the IGF2BP3/circHECTD2 axis on HNSCC cell proliferation, invasion, and metastasis. We found high expression of the m⁶A reader IGF2BP3 was significantly associated with poor clinical outcomes in HNSCC patients. Further experiments showed that IGF2BP3 directly bound to circHECTD2 and stabilized it, and m⁶A modification of circHECTD2 enhanced this binding and stabilization effect. Mechanistically, circHECTD2 functioned as a competing endogenous RNA (ceRNA) to sponge hsa-miR-4310 and hsa-miR-7157-5p, thereby preventing the miRNA-mediated degradation of SMAD2 mRNA. Ultimately, the IGF2BP3/circHECTD2/SMAD2 axis was shown to promote HNSCC cell proliferation, invasion, and metastasis. We delineate an m6A-dependent IGF2BP3/circHECTD2/SMAD2 regulatory axis that contributes to HNSCC malignancy. Elevated IGF2BP3 expression correlates with poor patient outcome and enhances circHECTD2 stability through m6A-facilitated binding; circHECTD2 in turn acts as a ceRNA to sequester hsa-miR-4310 and hsa-miR-7157-5p, thereby maintaining SMAD2 expression. Functionally, this axis promotes HNSCC cell proliferation, invasion and metastasis. Collectively, these findings suggest that IGF2BP3 and circHECTD2 may serve as promising prognostic biomarkers and therapeutic targets for HNSCC.

Reconstructing large, near-circumferential tracheal defects is a major surgical challenge, often resulting in severe stenosis and failed decannulation. We report a novel reconstructive approach using a “butterfly-shaped” bilateral deltopectoral (DP) flap. A 58-year-old male presented with a recurrence of squamous cell carcinoma in the suprasternal fossa, invading the anterior and lateral walls of the trachea. A radical resection was performed, preserving the posterior tracheal wall. The defect was reconstructed using bilateral DP flaps rotated medially. Most importantly, no internal silicone stent or T-tube was used. The patient recovered without complications and was successfully decannulated 15 weeks postoperatively. Endoscopic follow-up confirmed a patent airway with no stenosis. One year later, the persistent tracheostoma was successfully closed using a local turnover flap. This case shows that bilateral deltopectoral flap reconstruction is a feasible strategy for managing large tracheal defects. The opposing tension provided by the butterfly configuration supports the airway lumen, potentially reducing the risk of stenosis and enabling successful decannulation without permanent stenting.

To achieve rapid and sensitive screening for illicit feed additives, we developed a paper-based electrochemiluminescence (ECL) sensor for the quantitative detection of clenbuterol (CLB). The paper-based sensor was fabricated via screen printing, with the sensing interface constructed by sequentially drop-casting AgNPs and introducing diesel-derived CQDs. Here, K2S2O8 acted as the coreactant. The incorporation of AgNPs established a conductive network to reduce interfacial charge-transfer resistance and promote K2S2O8 reduction, possibly facilitating the formation of reactive sulfate-radical intermediates and enhancing the ECL emission of CQDs. Based on the concentration-dependent quenching effect of CLB on the ECL signal, the sensor exhibited a wide segmented linear response over 0.001-1.0 mu M and 1.0-100 mu M. The proposed method achieved a limit of detection (LOD) of 36 pM and a limit of quantification (LOQ) of 120 pM. In the analysis of real pork samples, the sensor afforded recoveries of 94.0%-108.3% with relative standard deviations (RSDs) below 4.7%, demonstrating its applicability as a reliable, low-cost platform for food safety monitoring.

Gel-based pressure sensors are widely used in wearable electronics to provide features of human activity detection like gesture, gait, and sitting posture recognition. Herein, we report a double-network (DN), non-swelling, and adhesive organogel by means of physical cross-linking. Two types of polyvinyl alcohol (PVA) were mixed at a mass ratio of 1 : 1.4 and used as the matrix of the hydrogel. 1.5 wt% of tannic acid (TA) was added as a cross-linking agent, and 2 wt% of carbon nanotubes (CNTs) was added as both the reinforcing framework and conductive material. After freeze-thaw treatment, the performance of the resistive pressure sensor was greatly improved. Fabricated using a binary solvent system of ethylene glycol (EG) and deionized (DI) water, the PVA/TA/CNT organogel exhibited excellent strength. The PVA/TA/CNT organogel sensor exhibited a sensitivity of 9.088% kPa-1, the highest pressure detection of 130.3 kPa, a response/recovery time (230 ms/450 ms), and excellent repeatability (2000 cycles). Additionally, a square-shaped organogel pressure sensor with a 3 cm side length was prepared. Combined with a circuit containing a microcontroller, multiplexer, operational amplifier, and other components, 13-channel resistance data acquisition was realized. This corresponded to a total of 156 virtual tactile points on the sensor to react to pressure on different sensor components. Four widely used gesture recognition types were achieved with an accuracy of 98.75% using the Convolutional Neural Network-Multilayer Perceptron (CNN-MLP) model. This study demonstrates the enormous potential of organogel-based materials for the creation of intelligent, flexible pressure sensors with exceptional stability.

Herein, we report a paper-based electrochemiluminescence (ECL) sensor for tetracycline (TC) determination, integrating a waste-derived luminophore preparation strategy with a disposable sensing format. To establish the sensing interface, graphene quantum dots (GQDs) were synthesized from industrial waste diesel via chemical vapor deposition and electrochemical exfoliation and subsequently introduced into the reaction zone of screen-printed paper electrodes to form a low-cost analytical platform. Control experiments and spectral-overlap analysis suggest that perturbation of the sulfate-radical-dependent ECL pathway and a possible inner filter effect may both contribute to the signal attenuation. Their relative contributions were not quantitatively resolved in the present work. Under optimized conditions, the ECL intensity showed a linear relationship with the logarithm of TC concentration over 0.01-100 µM, with a calculated limit of detection of 9.57 nM. The method was preliminarily evaluated using TC spiked into a pretreated commercial milk matrix. Overall, this work provides a waste-to-value route for petrochemical by-product upcycling and a paper-based ECL strategy for trace antibiotic screening.

To evaluate the therapeutic efficacy, long-term outcomes, and clinical applicability of partial laryngeal preservation surgery via the paraglottic space approach in the treatment of hypopharyngeal malignancies originating from the postcricoid region. This retrospective observational study included patients diagnosed with hypopharyngeal squamous cell carcinoma originating specifically from the postcricoid region, who underwent surgical treatment at Qilu Hospital of Shandong University and West China Hospital of Sichuan University between July 2017 and April 2025. Clinical data related to tumor resection and laryngeal function reconstruction were analyzed. Key outcome measures included postoperative decannulation rates, long-term recurrence and metastasis rates, survival status, as well as respiratory and swallowing function scores. All patients were followed for a minimum of five years. Four patients remained tracheostomy-dependent, including one patient who exhibited no dyspnea following tube occlusion. The overall decannulation rate was 63.64

Importance Hypopharyngeal squamous cell carcinoma (HPSCC) is an aggressive cancer with poor outcomes. Neoadjuvant therapy (NAT) may allow organ preservation, but determining safe surgical margins after NAT is a critical challenge.Objective To evaluate the safety of reduced surgical margins after neoadjuvant tislelizumab and afatinib in locally advanced HPSCC by comparing pathological margins to an upfront surgery control group.Design Prospective, single-center pilot cohort study.Setting Tertiary referral center in Western China.Participants Forty-one patients with locally advanced HPSCC; 32 received NAT (treatment group), and 9 served as an upfront surgery control group.Intervention or Exposures Treatment group: 2 cycles of neoadjuvant tislelizumab plus 6 weeks of afatinib. Control group: upfront surgery. Both groups underwent resection with a 1.5 cm naked-eye surgical margin.Main Outcome Measures Primary outcomes were minimal peripheral surgical margin (MPSM) and minimal deep surgical margin (MDSM). Secondary outcomes included radiological (RECIST v1.1) and pathological tumor response.Results The NAT group had a 20/32 (62.5%) radiological objective response rate and a 16/32 (50.0%) major pathological response rate [including 9/32 (28.13%) pathological complete response]. The mean MPSM was significantly greater in the treatment group versus control [3.38 mm vs 1.71 mm; 95% Confidence interval (CI): 0.10-3.24; P = .038]. The mean MDSM was also significantly greater in the treatment group versus control (2.09 mm vs 1.04 mm; 95% CI: 0.12-1.97; P = .029).Conclusions Combined immune-targeted NAT effectively downstages HPSCC. The significantly larger pathological margins observed support that reducing clinical surgical margins after this regimen is generally safe.Relevance This NAT regimen may allow for less extensive resections, facilitating laryngeal preservation and improving quality of life without compromising oncologic safety. Larger validation studies are needed.

Background SKV-012 is a novel engineered oncolytic virus (containing the viral neurovirulence ICP34.5 gene transcribed by the Survivin promoter with an upstream genetic component of interleukin-12 (IL-12) driven by the cytomegalovirus promoter) that preferentially replicates in tumors and helps stimulate antitumor immune responses.Methods We evaluated SKV-012’s safety and efficacy in preclinical models. In a phase I trial, patients with advanced solid tumors received intratumoral injections of escalating doses of SKV-012. Primary endpoints were safety and tolerability, while secondary endpoints were antitumor response and changes in the tumor microenvironment (TME), assessed by RECIST v1.1 criteria and multiplex immunohistochemistry and single-cell transcriptome analysis.Results SKV-012-infected tumor cells secreted high levels of IL-12 and exhibited increased ICP34.5 expression. The combination of oncolytic herpesvirus and IL-12 was proven to reshape the TME by increasing the infiltration of immune cells, thereby significantly inducing immune cell-mediated cytolysis of tumor cells both in vitro and in animal models. Based on this, we then tested the safety, efficacy and immunogenicity of SKV-012 in patients with advanced solid cancers in a phase I clinical trial (NCT06080984). No dose-limiting toxicities were observed, and adverse events were mild. Three patients achieved partial responses; one had stable disease and two had progressive disease. SKV-012 altered the TME, increasing CD8+ T cells, conventional dendritic cells, and programmed death-ligand 1 expression.Conclusions Intratumoral SKV-012 injections demonstrated a favorable safety profile and promising efficacy in animal models and patients with advanced cancers, thereby implicating its potential for clinical application in treatment-resistant advanced solid tumors.

BACKGROUND:This study aims to report and evaluate the efficacy of using a novel submental flap for addressing laryngeal stenosis. METHODS:This study involved patients with glottic and supraglottic laryngeal stenosis following horizontal/vertical partial laryngectomy who were refractory to repeated interventions. Kaplan-Meier curves were used to demonstrate the decannulation, and the Mantel-Cox Log-rank test was used to compare the rate difference in quality-of-life subgroup analysis. RESULTS:The average follow-up time was 30.04 ± 10.60 for all included patients; the flap survival was 100%, with only one patient in the horizontal laryngectomy group reported to have a flap-related complication. The decannulation rate was 93.75% and 80% in the horizontal and vertical groups, respectively, without any statistical analysis (p < 0.05). The average decannulation time was 10.17 ± 5.24 weeks in the horizontal group and 12.25 ± 5.56 in the vertical group. CONCLUSION:The modified submental flap technique provides a convenient and effective approach for laryngeal reconstruction in patients with postoperative laryngeal stenosis.

BACKGROUND:This study presents a modified platysma myocutaneous flap technique for reconstructing extensive laryngeal defects in patients with advanced-stage transglottic laryngeal carcinoma. METHODS:A retrospective cohort analysis was conducted on patients undergoing organ-preserving partial laryngectomy followed by reconstruction using a modified platysma flap. Primary endpoints included decannulation rate and 3-year overall survival. Functional recovery of respiration, swallowing, and phonation was evaluated using validated scales. RESULTS:Sixty patients (mean age: 62.85 ± 6.09 years) were enrolled across two centers. The overall decannulation rate was 85.0%, with significantly higher success rates observed in the partial laryngectomy group (p < 0.05). The 3-year survival rate was 78.3%. Swallowing and phonatory functions were well preserved, with median scores of 2 and 1, respectively. The technique was associated with a low incidence of flap-related complications (13.3%) and favorable mucosalization outcomes. CONCLUSION:The modified platysma flap offers a practical and effective reconstructive strategy for laryngeal defects in advanced carcinoma, achieving satisfactory respiratory decannulation and preservation of laryngeal function with minimal morbidity.

Despite receiving standard treatments, patients with locally advanced head and neck squamous cell carcinoma (LA-HNSCC) often still face significant risks of disease recurrence or metastasis. In this phase II neoCHANCE-1 study (NCT05517330), we evaluated the efficacy and safety of the dual-targeted blockade of the PD-1 and EGFR pathways in a neoadjuvant setting. The primary endpoint was the major pathological response (MPR) rate. The secondary endpoints included the pathological complete response (pCR) rate, overall response rate (ORR), safety, disease-free survival (DFS), and overall survival (OS). A cohort of 25 patients was subjected to a treatment regimen consisting of tislelizumab for two cycles, concomitant with daily intake of afatinib for six weeks. Among the 23 evaluable patients, eight (35%; 95% CI, 16%-57%) achieved an MPR that met the prespecified endpoint, and four (17%, 95% CI, 5%-39%) achieved a pCR of the primary tumor. The ORR was 48% (12/25, 95% CI: 28%-69%). The most common grade 3-4 adverse events included diarrhea (5/25), hypokalemia (4/25), and rash (3/25). This study highlights the encouraging antitumor activity, manageable toxicity profile, and promising immune activation caused by neoadjuvant tislelizumab plus afatinib treatment of HNSCC, which deserves further investigation.

Small interfering RNA (siRNA) has garnered tremendous interest as a potential therapeutic tool because of its intriguing gene-silencing ability. Toward the success in the manufacture of siRNA therapeutics for the potential treatment of choroidal neovascularization (CNV), siRNA conjugated with dual functional units of membrane-penetrating heptafluoropropyl and age-related macular degeneration-targeting cyclic Arg-Gly-Asp (RGD) peptide was attempted for transcellular transportation into the cell interiors. Of note, cyclic RGD allowed selective affinities toward the angiogenic endothelial cells in the pathological CNV. Noteworthy is the functional heptafluoropropyl group, due to its tempting lipophobic and hydrophobic properties, stimulating energy-independent transcellular trafficking behaviors to the cytoplasm directly from the extracellular compartments, namely, the nonendocytotic pathway. The behaviors manage to avoid the well-acknowledged drawback of endolysosomal entrapment, which is deemed to be the critical threat to the biovulnerable genomic therapeutics, thereby contributing to potent gene knockdown at the affected cells. Aiming for treatment of CNV, the siRNA duo was schemed with appropriate chemistry-based modifications for the targeted knockdown of both angiogenic VEGF-A and VEGF-R2. Subsequent investigations verified the potent reduction of vascular leakage, and our proposed siRNA duo accomplished a significant reduction of 67.3% in the mean area of the CNV lesion. Bioinformatic analysis has unveiled a multitude of therapeutic benefits conferred by anti-VEGF therapy, extending beyond the mere inhibition of angiogenesis, including the regulated leukocyte transendothelial migration, retinol metabolism, and estrogen signaling pathways. Hence, our proposed chemistry represents an interesting siRNA conjugate strategy accomplishing direct intracellular transportation of macromolecular biological payloads to the cytosol. Hence, this proposed fluorination strategy should be highlighted to encourage the development of appropriate prodrug chemistry in pursuit of transcellular trafficking of membrane-impermissible and biovulnerable biotherapeutics.

This study presents an electrochemiluminescence (ECL) sensing platform based on graphene quantum dots/silver nanoparticles (GQDs/AgNPs) composites, combined with a lightweight deep learning model within a portable detection system to achieve highly sensitive point-of-care monitoring of methimazole (MMI). By utilizing the synergistic effect of GQDs interface modification and AgNPs localized surface plasmon resonance (LSPR), the sensor significantly enhances the ECL signal intensity of tris(2,2 '-bipyridyl)ruthenium(II) (Ru(bpy)32+) on paperbased electrodes, while exhibiting excellent stability. In addition, for the problem of uneven luminescent spot distribution and edge blurring in ECL images, we use an improved U-Net neural network model to achieve accurate extraction of the center bright luminescent spot through sub-pixel level segmentation and background noise suppression. The detection system utilizes a Raspberry Pi core with a 3D printing module to significantly reduce the time and cost per test, and achieves a detection limit of 0.327 nM (linear range: 10-9-10-3 M). Through the design strategy of "material-algorithm-system", this study provides a highly sensitive, stable and practical solution for monitoring drug concentrations in the urine of hyperthyroid patients, which promotes the implementation of precision medicine in primary care.

Messenger RNA (mRNA) vaccines have demonstrated significant potential in cancer immunotherapy by activating both innate and adaptive immunity. However, the detailed cellular and molecular dynamics underpinning these systemic immune responses remain incompletely understood. In this study, we characterized the systemic immune landscape following human papillomavirus (HPV)-targeted mRNA-lipid nanoparticle (LNP) vaccination using single-cell RNA sequencing (scRNA-seq) in a murine model of HPV-positive head and neck squamous cell carcinoma (HNSCC). Our study revealed a coordinated remodeling of the systemic immune landscape, involving the tumor microenvironment (TME), tumor-draining lymph nodes (TDLNs), spleen, and blood. Notably, we pioneered a distinct interferon-stimulated gene (ISG) signature across multiple lymphoid subsets in TDLNs, driven by the LNP component, which contributed to rapid, non-antigen-specific immune activation. Additionally, HPV mRNA-LNP vaccination induced an antigen-specific cycling burst of immune cells that mediated tumor control through a systemic coordination of multi-directional differentiation into anti-tumor cell compositions. These findings enhance our understanding of how mRNA-LNP vaccination orchestrates systemic anti-tumor responses and highlight the therapeutic potential of targeting ISG-expressing and cycling immune cells to improve vaccine efficacy, paving the way for future clinical applications in HPV-related cancers.

This study presents a portable electrochemiluminescence (ECL) imaging system for rapid, on-site detection of hypochlorite (ClO-), leveraging the luminol-H2O2 reaction. The device integrates a microcontroller for electrochemical control, a CCD camera for signal acquisition, and a 3D-printed darkroom to minimize ambient interference. Under optimized conditions, the system exhibits a linear response to hypochlorite concentrations from 10 to 200 mu M, with a detection limit of 8.96 mu M (S/N = 3). Advanced image processing algorithms improve data reliability, resulting in a coefficient of determination (R2) of 0.992. The platform demonstrated high selectivity for hypochlorite over common interferents and achieved 90-102 % recovery in spiked tap water samples. By integrating low-cost paper-based electrodes, modular hardware, and proprietary PC software, this study developed a water quality monitoring solution that can be deployed on-site, effectively bridging the technical gap between laboratory analysis and real-world applications.

BACKGROUND:Acquired hemophilia A (AHA) is a rare autoimmune bleeding disorder characterized by autoantibodies against coagulation factor VIII (FVIII), leading to spontaneous bleeding in patients without a personal or family history of bleeding disorders. While AHA has been reported in association with various cancers, this case represents, to our knowledge, the first reported instance of AHA following head and neck cancer surgery and subsequent chemoradiotherapy. CASE SUMMARY:We present the case of a 65-year-old male with a history of hypopharyngeal squamous cell carcinoma (T4bN2cM0, AJCC 8th edition) who developed AHA after extensive surgical resection and chemoradiotherapy. He presented with recurrent hemoptysis and ecchymosis. Coagulation studies showed isolated prolonged activated partial thromboplastin time of 83.8 seconds that did not correct with mixing studies. FVIII activity was < 1%, and a Bethesda assay confirmed FVIII inhibitors with a titer of 18.4 Bethesda units. Hemostasis was initially achieved with tranexamic acid and batroxobin. Immunosuppression with prednisone and cyclophosphamide was started; due to gastrointestinal bleeding, rituximab was added. Treatment was later transitioned to azathioprine with prednisone, followed by tapering. FVIII activity recovered to 188.2%, and the patient remained in remission over six years without AHA or malignancy recurrence. CONCLUSION:This case underscores vigilance for AHA after head and neck cancer therapy to enable prompt treatment.

This study addresses the urgent need for sensitive and portable methods to detect 17 beta-estradiol (E2), a key hormone essential for environmental monitoring and health assessment. We developed a portable electro-chemiluminescence (ECL) imaging system that utilizes tris(bipyridine)ruthenium (II) (Ru(bpy)(3)(2+)) as the luminophore to enhance detection capabilities. The system integrates a Raspberry Pi 3B + as the central control unit, a custom-printed circuit board (PCB) for excitation, and a CCD camera for signal acquisition. Under optimized conditions, the system demonstrated high sensitivity to E2, with a linear response observed for concentrations ranging from 10(-9) to 10(-3) M, and a limit of detection (LOD) of 5.4 nM. Furthermore, ECL image data were processed using advanced algorithms, including edge detection, to validate the experimental results. The Raspberry Pi efficiently coordinates the PCB and CCD camera, facilitating the processes of electrochemical excitation, signal acquisition, and image processing. This user-friendly and cost-effective detection platform represents a promising novel approach for E2 detection, with potential applications in environmental monitoring and clinical diagnostics.

Airway stenosis (AS) is a fibroinflammatory disease characterized by abnormal activation of fibroblasts and excessive synthesis of extracellular matrix, which has puzzled many doctors despite its relatively low prevalence. Traditional treatment such as endoscopic surgery, open surgery, and adjuvant therapy have many disadvantages and are limited in the treatment of patients with recurrent AS. Therefore, it is urgent to reveal the pathogenesis of AS and accelerate its clinical transformation. Based on the discovered pathogenesis, including fibrosis, inflammation, epithelial–mesenchymal transition, metabolic reprogramming, microbiome, genetic susceptibility, and other mechanisms, researchers have developed a series of treatments, such as drug therapy, gene therapy, stem cell therapy, growth factor therapy, protein therapy, and photodynamic therapy. This review introduces the classification of AS, explores the existing pathogenesis and preclinical treatments developed based on the pathogenesis, and finally summarizes the current clinical management. In addition, the prospect of exploring the interaction between different types of cells and between microorganisms and cells to identify the intersection of multiple mechanisms based on single-cell RNA sequencing, 16S rRNA gene sequencing and shotgun metagenomic sequencing is worth looking forward to.