Abstract:Objective To evaluate the effectiveness of the"inquiry-based small-class"teaching model in enhancing dermocos-metic suture skills training for junior surgeons.Methods From June to July 2025,6 junior surgeons without plastic surgery specialization from Beijing Tsinghua Changgung Hospital,Tsinghua University,were enrolled as study subjects.They underwent a 6-week(13 contact hours)dermocosmetic suture skills training course.Instructors integrated diverse teaching modalities into inquiry-based teaching activities within the small-class framework.Baseline assessments and post-training practical skill evaluations were conducted.Results All 6 par-ticipants(100％)passed the post-training practical assessment.Significant improvements(P＜0.05)were observed in both subjective self-assessment scores and objective assessment scores across 6 domains:instrument handling,suturing technique,procedural fluency,mastery of relevant surgical knowledge,overall performance,and cosmetic outcome quality.Conclusion The"inquiry-based small-class"teaching model can effectively stimulate trainees' learning initiative and interest,significantly enhance their practical cosmetic suture skills and overall competence,and is worthy of promotion during the training phase for junior surgeons.

Abstract:Objective To investigate the clinical application of the Tenzel flap in the repair of eyelid defects following the resec-tion of eyelid tumors.Methods A total of 11 patients(11 eyes)with varying degrees of eyelid defects resulting from eyelid tumor resection were treated with the Tenzel flap.The eyelid morphology,eyelid closure status,and changes in the ocular surface were observed during the follow-up period.Results The follow-up period ranged from 3 to 12 months,with an average duration of 6 months.In all cases,the flaps survived postoperatively.The appearance of the eyelids was satisfactory,with good eyelid closure,smooth eyelid margin curvature,no en-tropion or ectropion,and no symblepharon.Conclusion The Tenzel flap is easy to harvest,with abundant blood supply ensuring high survival rate.It matches well with the recipient area in terms of color and thickness,and the postoperative scar is inconspicuous,resulting in high aesthetic appeal.It can not only be used to repair full-thickness eyelid defects independently but also be combined with orbital pe-riosteum or hard-palate mucosa to repair larger scale defects.Additionally,it can serve as an anterior-layer graft flap.It has a wide range of applications and remarkable effects in the repair of eyelid defects,making it worthy of widespread promotion.

Abstract:Objective To explore the effectiveness of a graded treatment protocol for conjunctival prolapse after correction of moderate to severe ptosis.Methods A total of 41 patients(49 eyes)with conjunctival prolapse after correction of moderate to severe ptosis admitted from January 2022 to June 2024 were included.According to the degree of prolapse,they were divided into mild(≤ 2 mm,19 eyes),moderate(＞2～5 mm,17 eyes)and severe(＞5 mm,13 eyes)groups.Combined with the time of prolapse occurrence,they were divided into early stage(within 7 d after surgery)and late stage(＞7 d after surgery).Targeted treatments including conservative treatment,fornix-skin anchoring suture and sutureless resection were adopted respectively.The main observation indicators included the effective rate of conjunctival prolapse treatment and patient satisfaction.Results The overall effective rate of treatment for all patients was 100％,with no recurrence during follow-up.The cure rate of mild prolapse patients within 7 d was 100％,that of moderate prolapse patients within 7 d was 94.12％,and that of severe prolapse patients was improved immediately after surgery with a cure rate of 100％within 7 d.The total patient satisfaction rate was 97.56％.Conclusion The graded treatment protocol based on the degree and occurrence time of prolapse is safe and effective,which can realize the individualized and precise treatment of conjunctival prolapse,and has important clinical application value.

Abstract:Objective To compare the effectiveness of a training system combining 3D printing with an augmented reality(AR)navigation system versus traditional video instruction for training plastic surgery specialists in harvesting the perpendicular plate of the ethmoid bone.Methods Fourteen specialist physicians trained at Peking University Third Hospital between January 2024 and December 2025 were randomly assigned to an AR group(n=7)or a video group(n=7).The AR group underwent preoperative simulation training using 3D-printed patient-specific head models with an AR navigation system,whereas the video group learned solely by watching instructional surgical videos.Subsequently,both groups independently performed simulated harvesting of the perpendicular plate of the ethmoid on eight differ-ent 3D-printed models without navigation guidance.The positioning errors at key anatomical points and the operation time were recorded and statistically compared.Results The median overall operative error in the AR group(6.250 mm)was significantly lower than that in the video group(7.810 mm),P＜0.0001,with the difference being more pronounced in models with complex anatomical structures.In indi-vidual model analysis,the AR group showed significantly lower error rates on the more structurally complex models ① and ④ compared to the video group(P=0.0020 and 0.0112,respectively).Regarding operation time,the average time for the AR group(32.02±21.83)s was slightly higher than that for the video group(21.49±11.28)s,but the difference was not statistically significant(P=0.2235).Analysis of errors at key points revealed that the greatest errors occurred at the posterior edge of the perpendicular plate(points C and E),and the errors in the AR group were lower than those in the video group in this region as well.Conclusion The integrated training system combining 3D printing and AR navigation can significantly improve the spatial localization and operative accuracy of plastic surgeons in harvesting the perpendicular plate of the ethmoid bone,particularly in cases with complex anatomy.This system provides an effective tool for simulation training in high-risk,precision-demanding surgeries and demonstrates promising potential for clinical application and educational dissemination.

Abstract:Objective To compare the clinical outcomes of FUE using flared punches versus sharp punches for follicular extrac-tion.Methods A retrospective analysis was conducted on the clinical data of 49 patients who underwent hair transplantation from Octo-ber 2024 to May 2025.Twenty-five received FUE with flared punches and 24 with sharp punches.Parameters included follicular extrac-tion time,total grafts harvested,transection rate,and postoperative donor-area complications.Results The average total numbers of hair follicles extracted were(5380±237)in flared punches group VS(5540±204)in sharp punches group,respectively,and the average ex-traction times were(89±23)min VS(93±28)min,respectively,with no statistically significant differences(P＞0.05).The average transec-tion rates were(4.37±0.31)％VS(7.02±0.39)％,respectively,showing a statistically significant difference(P＜0.05).Both groups showed similar donor-area recovery times(3±1)d and complication rates,with no significant differences in postoperative hair growth.Conclusion FUE flared punches have the advantage of reducing hair follicle damage demonstrate and are worthy of clinical promotion.

Abstract:Objective To investigate the clinical efficacy and safety of a sequential multi-subunit hybrid injection technique for non-surgical rhinoplasty in Chinese patients.Methods This study is a multicenter retrospective analysis,including 318 patients who underwent non-surgical rhinoplasty using the hybrid technique from May 2022 to January 2025.High-viscosity hyaluronic acid was injected in a sequential order of"nasal tip-nasal dorsum-glabellar triangle"with a total injection volume of 1.2 to 1.8 ml.Preopera-tive and 6-month postoperative evaluations were conducted using the FACE-Q scale and a 3D facial measurement system(MVS-N1).Results Postoperative 3D measurements revealed significant increases in nasal length,tip projection,and nasolabial angle,while the na-sofrontal angle significantly decreased(P＜0.001).FACE-Q scores showed significant improvements in nasal satisfaction,social function,and psychological well-being,with a marked reduction in appearance-related psychological distress(P＜0.001).No patients experienced nasal functional disorders or vascular complications;9 cases of transient erythema resolved either spontaneously or with conservative man-agement.Conclusion The hybrid injection technique employed in this study provides a safe,effective,and highly reproducible method for non-surgical rhinoplasty in Chinese populations,integrating multi-subunit strategies and layered injection principles.It's worthy of clinical application.

Abstract:Objective To investigate the efficacy of external washing with artemisia annua water decoction combined with triam-cinolone acetonide injection in treating keloids through a retrospective study.Methods A total of 94 patients with keloids treated in the Department of Plastic and Aesthetic Surgery,The People's Hospital of Liaoning Province from September 2024 to March 2025 were en-rolled.According to whether artemisia annua water decoction washing was used,they were divided into a control group(49 cases)and an experimental group(45 cases).The control group received triamcinolone acetonide injection,while the experimental group received triam-cinolone acetonide injection combined with external washing of artemisia annua water decoction.The treatment course for both groups was 3 months.Scar severity,clinical efficacy,pain degree,pruritus degree,quality of life,coping style,aesthetic satisfaction,incidence of ad-verse reactions,and recurrence rate were compared between the two groups before and After 3 months treatment.Results After 3 months treatment,scores for color,vascularity,pliability,thickness,and total score in both groups decreased compared to those before treatment(P＜0.05).Compared with the control group,all scar severity scores in the experimental group were lower(P＜0.05).After 3 months treat-ment,VAS and 12-PSS scores in both groups significantly decreased compared to before treatment(P＜0.05).Compared with the control group,the experimental group had lower VAS and 12-PSS scores(P＜0.05).After 3 months treatment,the total clinical effective rate in the experimental group was higher than that in the control group(P＜0.05).After 3 months treatment,the quality of life scores in both groups in-creased significantly compared to before treatment(P＜0.05).Compared with the control group,the experimental group had a higher quality of life score(P＜0.05).After 3 months treatment,the scores for resignation and avoidance decreased,while the score for confrontation in-creased in both groups compared to before treatment(P＜0.05).Compared with the control group,the experimental group had lower scores for resignation and avoidance,and a higher score for confrontation(P＜0.05).After 3 months treatment,aesthetic satisfaction in the experi-mental group was higher than that in the control group(P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the experimental group and the control group(P＞0.05).The recurrence rate in the experimental group(8.89％)was sig-nificantly lower than that in the control group(24.49％),P＜0.05.Conclusion The combination of external washing of artemisia annua de-coction and injection of triamcinolone acetonide has excellent therapeutic effects on scar tissue,high patient satisfaction with aesthetics,and has the potential for clinical promotion.

Abstract:Keloids,as a type of pathological scars,have always been a challenge in the clinical work of plastic surgery.Although there are various treatments available at present,its high recurrence rate leads to the unsatisfactory treatment effect.In recent years,with the extensive clinical application of superficial X-ray radiotherapy and the continuous in-depth research on it,this technology has shown significant advantages in suppressing the recurrence of keloids.This article reviews the clinical application status and research progress of superficial X-ray radiotherapy in the treatment of keloids,focusing on issues related to clinical application:indications,contraindications,side effects and prevention measures of superficial X-ray radiotherapy,formulation of radiotherapy plan,etc.,in order to provide theoretical reference and treatment ideas for clinical practice.

Abstract:Objective To explore the application effect of diclofenac sodium eye drops combined with conjunctival approach surgery in subconjunctival orbital fat prolapse.Methods A total of 96 patients with subconjunctival orbital fat prolapse admitted to De-partment of Ophthalmology of Huainan Oriental Hospital Group General Hospital from February 2022 to March 2024 were selected as the research subjects.They were divided into the control group(undergoing conjunctival approach surgery)and the observation group(receiving diclofenac sodium eye drops combined with conjunctival approach surgery)according to different intervention methods,48 patients in each group.The pain scores,inflammatory factors,quality of life and adverse reactions of the two groups were compared.Results The pain scores of the observation group at 2 hours,1 day,1 week and 1 month after the operation were all lower than those of the control group(P＜0.05).One month after the intervention,the indicators of TNF-α and TGF-β1 in the observation group were lower than those in the control group(P＜0.05).One month after the intervention,the quality of life score of the observation group was higher than that of the control group(P＜0.05).The total incidence of adverse reactions in the observation group was 6.25％(3/48),which was lower than 22.92％(11/48)in the control group(P＜0.05).Conclusion Diclofenac sodium eye drops combined with conjunctival approach surgery have a significant effect in the treatment of subconjunctival orbital fat prolapse.It can effectively alleviate postoperative pain in patients,reduce the levels of inflammatory factors,improve the quality of life,and reduce the occurrence of adverse reactions.

Abstract:Objective To study the effect of continuous double negative pressure drainage in the difficult refractory wound repair of artificial dermal stent.Methods From September 2023 to July 2024,50 patients with acute and chronic difficult refractory wounds treated in the Department of Burns and Plastic Surgery,Dongguan People's Hospital were selected as the study subjects.According to the random number table were divided into the observe group 25 cases(postoperative continuous double negative pressure drainage device on the artificial dermal stent wound)and the control group 25 cases(single continuous negative pressure drainage device on the artificial der-mal stent wound after surgery).Efficacy-related indicators,wound healing-related indicators,and secondary skin graft-related indicators were compared between the two groups.Results The daily secretion discharge of the observe group was more than the control group,and the plugging rate of the negative pressure device was lower than the control group,and the area of the artificial dermal stent was less than the control group(P＜0.05).The observe group of granulation growth coverage of 5 and 10 d after operation,the granulation growth coverage of artificial dermal stent and the vascular endothelial implantation rate under pathological biopsy HE staining were higher,while the infil-tration rate of inflammatory cells was lower than that of the control group(P＜0.05).The observe group had less time interval than the control group,while the survival of postoperative wounds was higher than the control group(P＜0.05).Conclusion The effect of continuous double negative pressure drainage in difficult refractory wound repair of artificial dermal stent is good,which can effectively promote wound heal-ing,accelerate the growth of granulation,and improve the survival rate of postoperative wound skin grafting,which is worth popularizing.

Abstract:Objective To investigate the effect of cold therapy on postoperative analgesia in children undergoing autologous rib cartilage transplantation for external ear reconstruction.Methods Fifty children with rib cartilage transplantation for external ear reconstruction who were admitted to the hospital in November 2023 were included in the control group,and 50 children with rib cartilage transplantation for external ear reconstruction who were admitted to the hospital in December 2023 were included in the intervention group by the convenience sampling method.The children in the control group were treated with conventional postoperative analgesia,and the children in the intervention group were treated with ice packs of 15％ethanol for twenty minutes at thirty-minute intervals during the 24 h postoperative period,on top of the control group.The Wong-Baker Facial Expression Pain Rating Scale was used to assess the pain scores of the children in the two groups at rest and during activity in the immediate postoperative period(4 h,8 h,12 h,16 h,20 h,and 24 h).Results The pain scores of children in the intervention group were significantly lower than those of the control group(P＜0.05);the consumption of analgesic pumps of children in the intervention group was significantly lower than that of the control group(P＜0.05);and the dosage and number of times of oral painkillers were significantly decreased in the intervention group compared to the control group(P＜0.05).Conclusion The use of cold therapy after autologous rib cartilage transplantation external ear reconstruction can effectively relieve the pain of children and reduce the use of intravenous and oral analgesics.

Abstract:Objective To investigate the effects and mechanisms of HGF in promoting wound healing in rats with total skin de-fects by targeting the TGF-β1/Smad signaling pathway.Methods From January 2021 to June 2021,Liupanshui People's Hospital(Dewu Campus)were used to establish full-thickness skin defect rat models.Forty-seven successful models were randomly divided into 23 full-thickness skin defect+HGF groups and 24 model groups,26 were normal SD rats..The wound healing conditions,healing rates,histopathological changes,HGF mRNA expression levels,blood flow intensities at different time points,expressions of inflammatory factors,proliferation abilities of vascular endothelial cells at different time points,and expression levels of TGF-β1/Smad proteins were compared among the groups at different time points.The targeting relationship between HGF and TGF-β1/Smad was verified by using the dual-lu-ciferase reporter gene assay.Results Compared with the control group,the model group showed decreased levels of HGF mRNA and IL-10,and increased levels of IL-1β,TGF-β1 mRNA expression,(12 h,24 h)vascular endothelial cell proliferation,p-Smad,IL-4,Smad mRNA expression,and IL-6,TGF-β1,and TNF-α;Vascular endothelial cell proliferation,IL-10,HGF mRNA levels were increased and IL-1β,Smad mRNA,IL-6,TGF-β1,p-Smad,IL-4,TGF-β1 mRNA,TNF-α levels were decreased in the whole skin defect+HGF group(12 h,24 h),and the difference was statistically significant(P＜0.05).Compared with the model group,the(7 d,14 d,21 d)wound healing rate,IL-10,(7 d,10 d,14 d post-injury)blood flow intensity,HGF mRNA expression,(12 h,24 h)vascular endothelial cell prolif-eration levels were increased in the full-layer skin defect+HGF group,and the levels of IL-4,IL-6,Smad mRNA,TGF-β1 mRNA,TNF-α,IL-1β levels decreased,and the difference was statistically significant(P＜0.05).The results of dual luciferase reporter gene showed that after co-transfection with HGF-mimic,the relative luciferase activity of the TGF-β1-3'-UTR-WT group decreased compared with that of the TGF-β1-3'UTR-MUT group,and the difference was statistically significant(P＜0.05).Conclusion HGF promotes wound healing by inhibiting the TGF-β1/Smad signaling pathway,promoting the proliferation of vascular endothelial cells in wounds,decreasing the level of inflammatory response in wounds,and increasing the intensity of blood flow.

Abstract:Objective To investigate the clinical effect and functional advantages of latissimus dorsi myocutaneous flap in repair-ing severe soft tissue defects after oral cancer surgery.Methods From April 2024 to April 2025,9 patients with stage T3-T4 oral cancer were treated.Radical neck dissection combined with extended tumor resection was performed,and free latissimus dorsi myocutaneous flaps were used to repair the remaining defects(6 cm × 9 cm to 8 cm × 16 cm).Postoperative follow-up was conducted for 3 to 6 month to elalu-ate the clinical outomes.Results The latissimus dorsi myocutaneous flaps survived in all 9 patients,the donor sites were closed and healed well,and there was no obvious limitation of mouth opening after operation.Conclusion Latissimus dorsi myocutaneous flap is an ideal choice for reconstruction of severe soft tissue defects after oral cancer surgery because of its large tissue mass,reliable blood supply,simple preparation and good morphological and functional reconstruction effect.

Abstract:Objective To evaluate the clinical efficacy of bilateral sagittal split ramus osteotomy(BSSRO)combined with mandibular angle contouring surgery performed simultaneously during bimaxillary orthognathic surgery for the correction of facial asymme-try.Methods A retrospective analysis was conducted on 15 patients with facial asymmetry treated between December 2023 and August 2024.All patients underwent bimaxillary orthognathic surgery,and the mandibular procedure invariably combined BSSRO with mandibular angle contouring surgery.For height asymmetry,mandibular angle osteotomy is recommended.Post-operative follow-up lasted 1 year.Pre-operative and 3-month postoperative CT data were collected,and three-dimensional reconstruction was performed using the digital soft-ware ProPlan 3.0(Materialise Medical,Belgium).Symmetry improvement was analyzed through measurements of bony landmarks,and clini-cal efficacy was comprehensively evaluated.Results All surgeries were successful,with primary healing achieved upon discharge.No cases exhibited injury to the inferior alveolar nerve and vessels,unexpected fractures,or required secondary surgery.No serious complications oc-curred,and all patients were satisfied with the treatment outcomes.Measurements indicated significant improvement in facial symmetry a-mong all 15 patients,with statistically significant differences between preoperative and postoperative values(P＜0.01).Conclusion For pa-tients with facial asymmetry,combining BSSRO with mandibular angle contouring surgery effectively improves symmetry in the mandibular angle region,demonstrating favorable clinical outcomes.In cases of mandibular angle width asymmetry,partial outer-cortex resection or interpositional bone grafting between the inner and outer cortices may be considered.This one-stage strategy enhances corrective efficacy while avoiding secondary adjustments,providing an improved design strategy for treating facial asymmetry.

Abstract:Cartilage tissue engineering technology provides a novel solution for the reconstruction of superficial organs,featuring precise repair,low donor-related injury,and long-term regenerative effects.The improvement of tissue-engineered cartilage technology has always been a central focus in the field in recent years,with significant progress achieved.However,the clinical translation of tissue-engi-neered cartilage induced by mesenchymal stem cells as seed cells still faces challenges.Specifically,the cartilage phenotype exhibits insta-bility after ectopic transplantation,manifested as chondrocyte hypertrophy,matrix mineralization,and cartilage ossification.The authors sum-marized the current potential mechanisms underlying ectopic cartilage ossification,classified and organized the methods for delaying ossifica-tion based on existing technical approaches,reviewed the strategies for enhancing its stability,and provided an outlook on future research.

Abstract:The surgery-first approach(SFA)has currently become a mainstream modality for treating severe skeletal malocclusion.Compared with the traditional orthodontic-first approach,SFA offers advantages such as shorter treatment duration,immediate restoration of facial aesthetics,and higher patient satisfaction,while demonstrating similar postoperative stability.However,SFA exhibits significant differences in postoperative orthodontic treatment compared with the traditional orthodontic-first approach.This article provides a compre-hensive review of simulation prediction and treatment planning under the SFA modality,surgical occlusion setup,timing of initiating post-operative orthodontic treatment,as well as novel orthodontic techniques.

Abstract:Objective To directly compare the immediate effects of large language model-based conversational learning versus traditional text-based learning in teaching medical students about flap transplantation,through a randomized controlled trial.Methods In October-November 2025,the Department of Plastic Surgery at Peking University Third Hospital recruited 20 medical students who had not systematically studied flap transplantation knowledge and randomly assigned them equally into either a large language model(LLM)learning group(experimental group,n=10)or a text-based learning group(control group,n=10).All participants studied the same core text on flap transplantation knowledge for 35 minutes.The experimental group learned through conversations with a large language model,while the control group only learned through the text.Knowledge assessments using tests of similar difficulty were conducted before and after the learning ses-sion.Results There were no significant differences in age or pre-test scores between the two groups,indicating comparable baseline levels.Post-test results showed that the LLM group's scores(72.2±13.0)were significantly higher than those of the text-based group(59.8±12.9)(P=0.045).In terms of knowledge improvement,the LLM group(62.0±25.3)％also significantly outperformed the text-based group(21.8±35.6)％(P=0.010).Within-group comparisons revealed that the LLM group showed a highly significant improvement in post-test scores com-pared to pre-test scores(P＜0.0001),whereas the improvement in the text-based group did not reach statistical significance(P=0.117).Con-clusion Within the same learning duration,conversational learning using large language models was significantly more effective than tradi-tional text-based learning in enhancing medical students' short-term mastery of flap transplantation knowledge.This confirms the potential of LLMs as efficient auxiliary tools in specialized medical education.Future research should focus on the development of domain-specific models and evaluate their long-term teaching effectiveness and feasibility in clinical applications.

Abstract:Objective To explore the clinical efficacy of comprehensive minimally invasive cosmetic injection of botulinum toxin type A in improving the contour of the upper face.Methods A retrospective analysis was conducted from January 2022 to December 2024 at the Department of Plastic Surgery of Affiliated The Second Hospital of Nanjing.The clinical data of 82 patients who improved the upper facial contour with this injection technique was analysed.Preoperative marking and line drawing are per-formed.By targeted injec-tion of botulinum toxin type A into the fusion area of the galea aponeurotica on the inner side of the hairline and the fronzal muscle,com-bined with dual-plane injection of the frontal muscle and the frontal dermis.The improvement of frontal wrinkles,the degree of frontal lift-ing,and patient satisfaction are evaluated.Results After treatment,all patients showed improvement in forehead wrinkles,and the height of the forehead increased to varying degrees.The difference was statistically significant(P＜0.05).No significant adverse reactions or post-operative complications occurred,and the patient satisfaction rate was 98％.Conclusion This injection technique can improve forehead wrinkles while lifting the upper facial contour,especially suitable for those with narrow foreheads,and has good clinical application value.

Abstract:Objective To explore the molecular characteristics and potential key factors across different severity levels of FIL patients by establishing a clinical grading system based on disease severity and combining it with serum Olink proteomic detection.Methods A retrospective analysis was conducted on 12 patients with facial infiltrating lipomatosis who were admitted to the Department of Plastic and Reconstructive Surgery at Shanghai Ninth People's Hospital,Shanghai JiaoTong University School of Medicine,between Jan-uary 2016 and December 2023.Serum samples were collected from the patients,with normal human serum used as controls.The Olink platform was used to detect 96 targeted proteins.Integrated with GO and KEGG functional enrichment analyses and subcellular localization prediction,the molecular characteristics of patients across different grades were systematically compared.Results Clinical grading de-fined Type Ⅰ patients with lesions involving 1-2 soft tissues and 1-2 jaw-facial bones;Type Ⅱ patients involved 3-4 soft tissues and 3 jaw-facial bones,with significant craniofacial bone deformities;Type Ⅲ patients involved ≥4 soft tissues and all jaw-facial bones,with unique manifestations such as temporalis muscle infiltration,ipsilateral frontal bone hyperplasia,and subcutaneous nodules of the scalp.Proteomic results indicated that differentially expressed proteins were primarily enriched in the TGF-β signaling pathway.GO anal-ysis revealed significant enrichment in"receptor-ligand activity,"while KEGG analysis highlighted enrichment in"signaling molecules and interactions."Subcellular localization results showed that approximately 60％of the differential proteins were secreted proteins.Further analysis identified that the inflammation-related secreted protein ARTN was most highly expressed in Type Ⅲ patients and positively correlated with disease severity.Conclusion This study proposes and validates a severity grading system for FIL based on clinical manifestations.Combined with serum proteomics,it reveals key molecular features associated with disease progression.ARTN may serve as an important molecular marker for FIL severity and could be a potential target for future clinical intervention and target-ed therapy.