Abstract:Objective: To evaluate the efficacy and safety of targeted therapy plus immunotherapy ± transcatheter arterial chemoembolization (TACE)/radiotherapy for conversion therapy in initially unresectable intermediate-to-advanced hepatocellular carcinoma(HCC). Methods:We retrospectively analyzed 20 patients with Barcelona clinic liver cancer(BCLC) stage B/C HCC treated with targeted therapy and immunotherapy;19 received concurrent TACE,and 4 received radiotherapy among them. The evaluation indicators include objective response rate(ORR),microscopic margin-negative(R0) resection rate and safety. Results:The overall ORR and the disease control rate were 55% and 85%,respectively. Four patients(20%) successfully underwent R0 resection,with 2 achieving major pathological response. The incidence of grade ≥3 adverse events was 20%,primarily immune-related liver injury. At a median follow-up of 18.3 months,3 of the 4 resected patients remained recurrence-free 12 months post-surgery. Conclusion:The multimodal approach centered on targeted combined immunotherapy has a significant ability to downstage advanced HCC. The R0 resection rate is 20%,and the pathological remission is remarkable with controllable safety.

Abstract:Objective: To develop a radiomics-based model based on the immune response evaluation criteria in solid tumors (iRECIST) for predicting the response of patients with non-small cell lung cancer (NSCLC) to combined immunotherapy, so as to precisely screen patients who may derive clinical benefit at the pre-treatment or early treatment stage. Methods: A total of 75 patients with pathologically confirmed NSCLC and received combined immunotherapy were enrolled. All patients underwent chest computed tomography (CT) within one month before treatment. Based on the iRECIST, treatment efficacy after 4-6 cycles (12-18 weeks) of immunotherapy combination therapy was assessed, and patients were classified into the treatment-sensitive and non-sensitive groups. The patients were randomly divided into a training cohort (n=50) and a testing cohort (n=25) at a ratio of 2:1. Clinical feature models and radiomics prediction models were developed separately. The predictive performance and clinical utility of the models were compared using receiver operating characteristic (ROC) curves, the area under the curve (AUC), accuracy (ACC), and decision curve analysis (DCA). Results: After feature extraction and selection, a total of five radiomics features were obtained, including two first-order features and three texture features. After feature fusion and screening, and in order to reduce over-fitting, through three-fold cross-validation, the Naive Bayes was the most stable, with an AUC of 0.675 and accuracy of 0.720 in the training set, and an AUC of 0.647 and accuracy of 0.720 in the test set, respectively. Conclusion: Radiomics has certain potential and clinical application value for predicting the efficacy of immunotherapy combination therapy in NSCLC patients.

Abstract:Objective:To explore the added value of the Copenhagen index(CPH-I) in the diagnosis of adnexal masses with ovarian-adnexal reports and data systems (O-RADS) and the International Ovarian Tumor Analysis (IOTA) simple rules. Methods:The ultrasound images of 179 adnexal masses confirmed by pathological results were analyzed retrospectively in the First People's Hospital of Chuzhou,Anhui from October 2023 to October 2025. The O-RADS classification and IOTA simple rule were used for classification evaluation respectively,and CPH-I of each patient was calculated. Using pathological results as the gold standard,the optimal cutoff value for each diagnostic method was obtained by Youden index. The diagnostic efficacy of the two ultrasound models alone and in combination with CPH-I was compared. The diagnostic efficacy of O-RADS 4 masses and IOTA uncertain masses combined with CPH-I was calculated,too. Delong test was used to compare the area under the curve(AUC) of receiver operating characteristic curve for each model.Results:The optimal cutoff value for O-RADS diagnosis was O-RADS 4 tumors,the optimal cutoff value for IOTA simple rule diagnosis was uncertain masses,and the optimal cutoff value for CPH-I diagnosis was −2.165. The AUC values of O-RADS,IOTA simple rules,and CPH-I for the diagnosis of adnexal masses were 0.866,0.926 and 0.886,respectively. The AUC values of the two ultrasound models combined with CPH-I were 0.861 and 0.902,respectively. When CPH-I was applied separately to O-RADS 4 masses and IOTA uncertain masses,the AUC were 0.933 and 0.941,respectively,which were higher than those of O-RADS and IOTA simple rules alone(P=0.022,P=0.562). Conclusion:CPH-I has good added value to O-RADS and IOTA simple rules in diagnosing adnexal masses,especially when applied to O-RADS 4 masses and IOTA uncertain masses,which were with the best diagnostic performance.

Abstract:Objective: To identify risk factors for level Ⅱ and level Ⅳ lymph node metastasis in papillary thyroid carcinoma(PTC) and to evaluate the predictive value of different tumor location classification methods. Methods: A retrospective analysis was performed on PTC patients who underwent thyroid surgery between January 2022 and May 2025. Clinical and pathological variables were collected. Tumor location was classified using the conventional longitudinal trisection method and a middle thyroid vein-based method on preoperative contrast-enhanced CT images. Univariate and multivariate logistic regression were used to analyze factors related to level Ⅱ and Ⅳ lymph node metastasis, and ROC curves were used to compare the predictive ability of different tumor location classifications. Results: Among 152 patients, 59(38.82%)had level Ⅱ lymph node metastasis and 113(73.34%)had level Ⅳ lymph node metastasis. Univariate analysis revealed that tumor location was significantly associated with metastasis in both levels(P< 0.05). Multivariate analysis showed tumor location(conventional or middle vein-based)independently predicted level Ⅱ metastasis, while middle vein-based location and level Ⅵ metastasis independently predicted level Ⅳ metastasis. ROC analysis showed that the middle vein-based classification had a higher AUC for predicting level Ⅱ metastasis than the traditional method(0.749 vs. 0.608, P< 0.05). For level Ⅳ, the AUCs were 0.687 and 0.650. This indicates better performance for predicting level Ⅱ metastasis. Conclusion: Tumor location is closely associated with level Ⅱ and level Ⅳ lymph node metastasis in PTC. The middle thyroid vein-based classification may improve preoperative risk assessment of lateral cervical lymph node metastasis.

Abstract:Objective: To describe the clinical characteristics and prognosis of chronic myelomonocytic leukemia (CMML) patients co-occurrent with lymphoid/plasma cell neoplasms (LP-CMML). Methods: We retrospectively identified nine LP-CMML cases who visited the First Affiliated Hospital of Nanjing Medical University between January 2016 and August 2025, and compared their features with de novo CMML(DN-CMML). Results: The median age of LP-CMML patients was 66(58,76) years, with 8(88.9%) being male. All patients were classified as CMML-1. The most common co-existing lymphoid/plasma cell neoplasm was diffuse large B-cell lymphoma(3 cases). No differences were found between LP-CMML and DN-CMML in basic clinical characteristics, cytogenetic risk stratification and disease risk stratification. Based on the sequence of occurrence, 4 patients were classified as therapy-related CMML (tCMML) and 5 as non-tCMML. Compared with the non-tCMML patients, tCMML patients were younger(P=0.016) and the dysplastic phenotype predominance(P=0.048). Dynamic monitoring of one tCMML patient revealed a pre-existing CMML precursor state at the time of lymphoid neoplasm diagnosis, with clonal evolution during the disease course. Survival analysis showed shorter median overall survivals(6 months vs. 40 months,P < 0.001) and median progression free survivals(5 months vs. 29 months,P < 0.001) for LP-CMML than those of DN-CMML. No difference was found in survivals between tCMML and non-tCMML subgroups. Conclusion: LP-CMML indicates clinical heterogeneity and poor survival.

Abstract:Robotic surgical systems integrated with artificial intelligence (AI) algorithms, as a frontier product at the intersection of intelligent surgery and biomedical engineering, are reshaping the technological paradigm of colorectal cancer treatment. These systems incorporate high-precision robotic arms, multimodal image recognition, real-time decision-making algorithms, and knowledge transfer learning mechanisms, demonstrating advantages in critical procedures such as lymphadenectomy, anastomotic construction, and nerve preservation within the confined pelvic cavity. Compared with conventional laparoscopic surgery, AI-integrated robotic systems can achieve an operating precision of 0.5-1.0 mm, an intraoperative lymph node recognition accuracy of 98.7%, and a 15%-20% increase in the number of lymph nodes dissected. The incidence of anastomotic leakage decreases by approximately 2-3 percentage points (from 5.4% to 1.9% ), while mean intraoperative blood loss is reduced by 50-80 mL, significantly lower than the 90-120 mL typically observed in laparoscopic procedures. In recent years, driven by the rapid evolution of robotic platforms and the deep integration of technologies such as 5G remote communication, digital twins, and reinforcement learning, colorectal cancer robotic surgery systems are progressing toward higher levels of intelligence, individualization, and remote collaboration. Nevertheless, key challenges remain in clinical implementation, including the lack of tactile feedback, delays in multimodal data fusion, unclear regulatory pathways, and insufficient medical-engineering collaborative frameworks. This review systematically summarizes the developmental trajectory, clinical advantages, core technical bottlenecks, and future directions of AI-integrated robotic systems in colorectal surgery, with particular emphasis on their value in intelligent perception, intraoperative coordination, remote surgery, and clinical translation pathways. The aim is to provide interdisciplinary theoretical foundations and practical references for surgeons, engineering researchers, and healthcare policymakers.

Abstract:Colorectal cancer(CRC)is a common malignancy of the digestive system. Although multimodal treatment strategies have effectively prolonged patient survival, the prognosis of patients with advanced disease remains poor. Therefore, standardizing tertiary prevention of CRC is of great importance. The tertiary prevention strategies for CRC include: primary cause prevention, secondary early prevention, and tertiary clinical prevention. Ferroptosis, a new form of cell death characterized by the accumulation of intracellular iron ions and abnormal aggregation of lipid peroxides, has been exploited in the development of molecular targeted therapies for a variety of common cancers, including CRC. Therefore, investigating the regulatory mechanisms of ferroptosis in CRC and exploring its theoretical basis and emerging strategies within the framework of tertiary prevention can provide additional decision-making tools for cancer prevention and treatment.

Abstract:Objective: This study aimed to develop an antibiotic-free, multifunctional antibacterial hydrogel dressing that integrates rapid gelation, robust tissue adhesion, controllable self-degradation, fluorescence-enabled visualization, and broad-spectrum antibacterial activity, and to systematically evaluate its in vitro performance. Methods: An ultrafast in situ-forming isoindole-crosslinked hydrogel dressing, designated OSN, was fabricated through a ternary condensation reaction initiated by mixing precursor solutions of o-phthalaldehyde(OPA), four-arm poly(ethylene glycol) thiol(tetra-PEG-SH), and four-arm poly(ethylene glycol) amine (tetra-PEG-NH₂). By varying the molar ratio of OPA to the two polymer precursors (0.5:1:1, 1:1:1, and 2:1:1), three hydrogels, denoted OSN-1, OSN-2, and OSN-3, were prepared. Their gelation behavior, microstructure, mechanical properties, self-degradation profile, biocompatibility, and antibacterial activity were systematically characterized using scanning electron microscopy, rheological analysis, mechanical testing, UV-visible/fluorescence spectroscopy, cell-based assays (including CCK-8, live/dead staining, and scratch wound assays) and antibacterial evaluations (including colony counting, scanning electron microscopy, biofilm staining and flow cytometry). Results: The OSN hydrogels formed rapidly in situ within 10 s and exhibited a homogeneous three-dimensional network architecture. Increasing the OPA content accelerated gelation and imparted self-degradable behavior to the hydrogel matrix, with OSN-3 undergoing complete degradation within 24 h. The hydrogels demonstrated favorable tissue-adhesive strength, together with good biocompatibility. They also promoted the migration of L929 fibroblasts and exhibited potent antibacterial activity against both methicillin-resistant Staphylococcus aureus and Escherichia coli, effectively disrupting bacterial biofilms. In addition, degradation of the hydrogel was accompanied by attenuation and eventual disappearance of blue fluorescence, attributable to cleavage of the isoindole ring, indicating the potential for fluorescence-based visualization of the degradation process. Conclusion: This study successfully developed an antibiotic-free antibacterial OSN hydrogel dressing based on OPA-mediated ternary condensation. The resulting dressing combines injectability, rapid gelation, strong tissue adhesion, controllable self-degradation, fluorescence-enabled visualization, and broad-spectrum antibacterial activity, while maintaining good biocompatibility. These findings provide a novel and promising strategy for the development of antibiotic-free intelligent wound-management strategies.

Abstract:Objective: To investigate the association between the muscle-to-fat ratio (MFR) and metabolic dysfunction-associated fatty liver disease (MAFLD) in patients with type 2 diabetes mellitus (T2DM), and to evaluate its gender differences and diagnostic performance. Methods: A retrospective study was conducted on T2DM patients hospitalized in the Department of Endocrinology at the First Affiliated Hospital of Nanjing Medical University from September 2023 to August 2024. Clinical data were collected from the electronic medical record system. Body composition was measured by bioelectrical impedance analysis, and MFR was calculated as total skeletal muscle mass (kg)/total fat mass (kg). We measured controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) via FibroScan. Patients were divided into the non-MAFLD and MAFLD groups a ccording to whether they had MAFLD. MFR was stratified into gender-specific tertiles. Its association with MAFLD was analyzed using logistic regression and trend tests, with diagnostic performance evaluated via receiver operating characteristic (ROC) curve analysis. Results: A total of 2 056 T2DM patients were screened, of whom 448 met the inclusion criteria and were enrolled. The mean age was 55.33 ± 12.00 years, and the mean body mass index (BMI) was 25.13 ± 3.51 kg/m². The overall prevalence of MAFLD was 62.5% (280/448). The prevalence was lower in males (59.9%, 187/312) than in females (68.4%, 93/136). The MFR was significantly lower in the MAFLD group (n=280) than in the non-MAFLD group (n=168)[1.01 (0.77, 1.24) vs. 1.29(0.96, 1.74), P < 0.001]. MFR tertile analysis showed a decreasing prevalence of MAFLD with increasing MFR (P < 0.001). Multivariable logistic regression revealed gender-specific associations. Compared to the highest MFR tertile, males in the lowest and middle tertiles had a significantly higher risk of MAFLD[OR (95% CI): 3.36(1.49-7.57)and 2.03(1.02-4.03), respectively], with a significant linear trend (P for trend = 0.001). In contrast, among females, only the middle tertile showed a significantly increased risk [OR (95% CI): 3.53 (1.05-11.88)], with no linear trend (P for trend = 0.699). Additionally, mediation analysis demonstrated a statistically significant indirect effect of BMI in females (effect=- 3.59, Bootstrap 95% CI: -7.23--1.09). The area under the ROC curve of MFR for diagnosing MAFLD was 0.766 (cut-off value: 1.22) in males and 0.711 (cut-off value: 0.78) in females. Correlation analysis indicated that MFR was negatively correlated with obesity indices, homeostatic model assessment of insulin resistance, CAP, and LSM in both genders. However, age was negatively correlated with MFR only in females, whereas blood lipids, uric acid, and liver enzymes showed inverse correlations only in males. Conclusion: MFR is independently associated with MAFLD risk in patients with T2DM, and this association exhibits distinct gender-specific patterns, highlighting the importance of considering gender in clinical management.

Abstract:Objective: To explore potential heterogeneity in the association between psychological resilience and all-cause mortality across four obesity indices and to identify subpopulations warranting particular attention. Methods: This cohort study included 7 481 eligible participants from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) surveyed between 2011 and 2012. Cox proportional hazards model was employed to assess the associations between psychological resilience and all-cause mortality. Subpopulation treatment effect pattern plot(STEPP) analysis was further applied to investigate heterogeneity in this association strength among Chinese older adults. Results: Higher psychological resilience was significantly associated with a lower risk of all-cause mortality among Chinese older adults (all P < 0.001). Significant heterogeneity in the association strength was observed across subpopulations defined by a body shape index(ABSI) (P < 0.001), body roundness index(BRI) (P < 0.001), waist-to-height ratio (WHtR) (P < 0.001), and body mass index(BMI) (P < 0.001). Conclusion: The association strength between psychological resilience and all-cause mortality varies significantly among different subpopulations of Chinese older adults. Older adults classified as overweight by multiple indices are encouraged to maintain higher levels of psychological resilience to reduce all-cause mortality risk.

Abstract:Objective: To investigate the relationship between the number of parathyroid gland on ^99mTc-methoxyisobutylisonitrile (MIBI) single-photon emission computed tomography/computed tomography (SPECT/CT), preoperative laboratory parameters, peripheral blood inflammatory markers on bone hungry syndrome (HBS) after parathyroidectomy (PTX) in patients with renal secondary hyperparathyroidism (SHPT). Methods: The clinical and imaging data of 113 renal SHPT patients who underwent PTX in the Affiliated Jiangyin Hospital of Nantong University from Jun 2014 to Mar 2025 were retrospectively analyzed. The patients were divided into the HBS group and non-HBS group based on whether occurred HBS. Differences in various indices between the two groups were compared, multivariate logistic regression was used to analyze the influencing factors of HBS. The receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value. Results: Of all 113 patients, there were 63 patients in the HBS group and 50 patients in the non-HBS group. There were significant differences in age [(47.4±10.8) years vs. (54.1±9.2) years, P=0.001], preoperative alkaline phosphatase (ALP) [322.70(191.00, 636.10)U/L vs. 159.05(122.85, 221.88)U/L, P < 0.001], preoperative parathyroid hormone [171.10(114.00, 227.30)pmol/L vs. 120.95(98.40, 163.18)pmol/L, P=0.003], preoperative corrected calcium [2.43(2.24,2.53)mmol/L vs. 2.51(2.39,2.61)mmol/L, P=0.024], the number of SPECT/CT parathyroid gland≥4[74.6%(47/63) vs. 38.0%(19/50), P<0.001], and prognostic nutritional index (PNI) [49.95(46.20,52.00) vs. 46.60(43.74,50.10), P=0.003] between the two groups. Multivariate logistic regression showed that preoperative ALP(OR=1.005,95%CI:1.002-1.009,P=0.002), the number of SPECT/CT parathyroid gland≥4(OR=3.166,95%CI:1.235-8.113,P=0.016), and PNI(OR=1.112,95%CI:1.013-1.221,P=0.026) were independent risk factors for HBS. The ROC curve determined the optimal cut-off values of preoperative ALP and PNI as 278.0 U/L and 44.925. The combination of preoperative ALP≥278.0 U/L, the number of SPECT/CT parathyroid gland≥4 and PNI≥44.925 achieved sensitivity of 98.4% for diagnosing HBS, which were higher than individual indicator (all P < 0.05). Conclusion: The preoperative ALP, the number of SPECT/CT parathyroid gland≥4, and PNI were independent influencing factors for HBS, combined preoperative ALP≥278.0 U/L, the number of SPECT/CT parathyroid gland≥4 and PNI≥44.925 demonstrates high sensitivity in diagnosing HBS, thus have good clinical value.

Abstract:Objective: To investigate the influencing factors of radiation dose in patients undergoing coronary angiography (CAG) and percutaneous coronary intervention (PCI), and to develop a clinical prediction model for radiation dose. Methods: A total of 293 patients with obstructive coronary artery disease who underwent CAG at the First Affiliated Hospital of Nanjing Medical University from January 2020 to December 2024 were retrospectively enrolled. Patients were randomly divided into a training set (n=208) and a testing set (n=85) at a ratio of 7:3. Intraoperative radiation dose was defined as the outcome variable. Based on clinical characteristics and interventional procedure-related variables, multiple variable selection and modeling methods were applied to establish a multivariable linear regression prediction model, and a nomogram was constructed. Model performance was evaluated in the testing set using the root mean square error (RMSE), mean absolute error (MAE), coefficient of determination (R²), and calibration plot. Results: The final model included age, body mass index(BMI), triglycerides, high-density lipoprotein cholesterol (HDL-C), left ventricular end-diastolic diameter(LVDd), left ventricular ejection fraction (LVEF), procedure time, and fluoroscopy time. Multivariate analysis showed that BMI, LVDd, LVEF, procedure time, and fluoroscopy time were positively associated with radiation dose, whereas HDL-C was negatively associated with radiation dose. The model demonstrated good predictive performance in the testing set, with an RMSE of 170.1, MAE of 136.1, and R² of 0.55. The calibration plot showed good agreement between the observed and predicted radiation doses. Conclusion: The radiation dose prediction model based on routinely available clinical and interventional variables showed good predictive performance in internal validation, and may provide a useful reference for radiation risk assessment and dose management in patients undergoing CAG and PCI.

Abstract:Endometriosis(EMS), a chronic estrogen-dependent inflammatory disorder, affects 0.7%-8.6% of women in the general population and 9.0%-68.0% of those with subfertility, making it a leading cause of secondary infertility. The etiology of EMS is complex, and its clinical manifestations are diverse. EMS remains challenging to diagnose early in a noninvasive manner through conventional methods, with diagnostic delay averaging 8.6 years. Advances in detection technologies and bioinformatics have enabled metabolomics to serve as a powerful tool for biomarker discovery and mechanistic investigation of disease pathogenesis. Metabolomics analyses have identified multiple metabolic abnormalities in EMS patients, including dysregulation of carbohydrate, lipid, and amino acid metabolism, providing novel insights into disease mechanisms. This review comprehensively examines recent metabolomics research related to EMS pathophysiology, clinical features, noninvasive diagnostics, staging, therapeutic strategies, and risk factors, while critically evaluating methodological limitations. We highlight the clinical translational potential of metabolomics technology and multi-omics integration approaches, offering new perspectives to advance mechanistic understanding of EMS, facilitate development of early noninvasive diagnostic methods, and identify novel therapeutic targets.

Abstract:Gestational diabetes mellitus (GDM) is a common metabolic complication of pregnancy and may influence offspring skeletal development through intrauterine metabolic programming. Available evidence links GDM exposure to altered early linear growth, abnormal bone mass accrual or bone quality, increased fracture risk in later life, and a higher probability of selected skeletal congenital anomalies. However, results from different studies are inconsistent, and it is not yet possible to simply infer a direct causal relationship between GDM and the above skeletal outcomes. A mechanistic sequence can be proposed in which maternal metabolic load initiates placental-interface remodeling, modifies the fetal bone microenvironment, and shifts skeletal developmental programs. The intensity, duration, and timing of intrauterine hyperglycemia may affect mesenchymal stem cell osteogenic-adipogenic balance, growth-plate chondrocyte maturation, osteoblast mineralization, and bone remodeling through mitochondrial dysfunction, oxidative stress, low-grade inflammation, insulin/ insulin like growth factor (IGF)-axis disturbance, Wnt/β-catenin and bone morphogenetic protein (BMP) signaling imbalance, impaired placental calcium-phosphate transport, and epigenetic remodeling. Thus, the skeletal impact of GDM is more likely to follow a dynamic pattern characterized by early disruption, partial compensation, and residual risk rather than by a fixed reduction in bone density. Future studies should integrate maternal glycemic trajectories, placental multi-omics, cord-blood bone metabolic markers, offspring bone microarchitecture, and fracture outcomes to develop bone-oriented risk stratification and intervention strategies.

Abstract:Cardiothoracic surgery is associated with significant trauma, making effective postoperative pain management critical for enhanced recovery. Traditional regional analgesia is often limited by the short duration of single-dose local anesthetics or complications associated with continuous catheter techniques, which can hinder effective pain control during the intense 24-72 h postoperative period. Liposomal bupivacaine (LB), a multivesicular liposome formulation of bupivacaine, provides a single-dose analgesic effect lasting up to 72 h. This extended-release profile offers a novel, catheter-free approach to regional analgesia, with the potential to reduce catheter-related complications and serve as a key component of multimodal analgesia. This review systematically summarizes the pharmacological mechanisms and clinical applications of LB in cardiothoracic surgery. The evidence indicates that LB enables prolonged analgesia with a single dose, replacing continuous catheter techniques to mitigate catheter-associated complications, and exerting an opioid-sparing effect as a key component of multimodal analgesia. Meanwhile, this paper discusses ongoing controversies, including its comparative analgesic efficacy against established techniques like thoracic epidural analgesia, limitations due to its physical properties affecting tissue spread, and challenges related to its cost-effectiveness in different healthcare systems, so as to provide evidence-based references for rational clinical utilization.

Abstract:The cyclic GMP-AMP synthase-stimulator of interferon genes (cGAS-STING) signaling pathway is a pivotal innate immune mechanism for sensing cytosolic double-stranded DNA. Its canonical role is to exert antiviral immunity by inducing the expression of type I interferons and pro-inflammatory cytokines. However, recent studies have revealed that key components of this pathway possess non-canonical functions capable of inducing autophagy through diverse mechanisms. Recent studies have revealed that STING can also drive lysosomal biogenesis mediated by transcription factor EB(TFEB). These findings suggest that the cGAS-STING axis serves as a critical bridge linking innate immunity with the autophagy-lysosomal system. The activation of this pathway yields pleiotropic effects, ranging from homeostatic preservation to the aggravation of disease progression, depending on the specific pathological milieu. This review aims to summarize the latest advances in the molecular mechanisms and pathophysiological roles of the cGAS-STING-mediated activation of the autophagy-lysosomal system, providing a comprehensive framework for understanding its biological functions and informing potential therapeutic strategies for related diseases.