Medical Specialties Commons^™

Veratridine Suppresses Rictor-Mtorc2 Signaling Pathway In Colon Cancer Patient-Derived Xenograft Cells, Morgan Daniel Montgomery

Honors Thesis

Colorectal cancer (CRC) remains the second deadliest and fourth most common cancer in the world. The metastatic form of CRC is especially devastating due to a lack of effective and safer therapeutic options. Another challenge includes an increasing number of younger patients. Among critical signaling pathways overactivated in CRC, mTORC2 plays a key role in the progression of metastatic CRC, yet there is no selective mTORC2 inhibitor in the clinic. Interestingly, a natural plant alkaloid from the Veratrum genus, Veratridine (VTD), shows promise as VTD can upregulate UBXN2A, a colon-specific tumor suppressor protein. UBXN2A works with E3 ligases to ubiquitinate …

Intraoperative Liposomal Bupivacaine Is Associated With Reduced Opioid Use And Enhanced Recovery After Total Knee Arthroplasty: A Multicenter Registry Study, Mitchell Ng, Jennifer Lin, Andrew Spitzer, Vinod Dasa, Adam Rivadeneyra, David Rogenmoser, Andrew Concoff, Mary Digiorgi, Joshua Urban, William Mihalko, Michael Mont

Rothman Institute Papers

BACKGROUND: With an annual volume of total knee arthroplasties (TKAs) in the United States projected to exceed 1.5 million by 2050, optimizing perioperative pain control and facilitating early discharge remain clinical priorities. This study evaluated the effectiveness of liposomal bupivacaine (LB) vs conventional bupivacaine/ropivacaine in opioid-naïve patients undergoing primary TKA, comparing/contrasting: (1) pain score improvements, (2) opioid usages, (3) functional recoveries, and (4) hospital lengths of stay.

METHODS:  Data from the Innovations in Genicular Outcomes Research (iGOR) registry were used to identify patients undergoing unilateral primary TKA between September 2021 and December 2024. Two hundred twenty-five patients were analyzed, 42 …

Powering Up Clinical Scholarship In Santa Fe Family Medicine, Evelyn Wang

HSLIC Faculty and Staff Instructional Resources

This presentation introduces family medicine residents and faculty in Santa Fe to clinical scholarship pathways, highlighting research question formulation, literature search strategies, full-text access tools, and HSLIC services that support evidence-based practice, quality improvement, and publication.

Indicators Of Fontan Circulatory Failure In Pediatric Patients: A Scoping Review Of Early Clinical And Hemodynamic Factors, Marina Mcmahon

Student Works

Structured Summary

a. Background/Introduction:

For patients with single ventricle congenital heart disease, the Fontan procedure is the definitive palliative procedure. Although advancements have been made in the surgical technique and management, the Fontan circulation is inefficient and prone to progressive dysfunction. Elevated central venous pressure, non-pulsatile pulmonary blood flow, and reduced cardiac output can lead to many complications, and eventual failure. These conditions can lead to protein losing enteropathy, plastic bronchitis, and hepatic fibrosis which often indicate advanced decline. Though a known problem, there is a lack of standardized criteria to guide optimal intervention timing of Fontan revision prior to …

Breakthroughs In Cervical Cancer Screening: Hpv Self-Collection At Pmg Milwaukie Family Medicine Clinic, Brandon Bartlett, Sataj Johnson, Emily Miyasako, Rachel Gallagher, Daniel Ruegg

Books, Presentations, Posters, Etc.

Background: Cervical cancer screening is a cornerstone of preventative healthcare and cancer screening in primary care. Based on data from the CDC, in the US alone, the rate of new cervical cancers each year is ~13,000, accounts for ~4,000 deaths annually, and disproportionally effects people of color and people of low SES (CDC, 2025). In our clinic (PMG Milwaukie), the rate of cervical cancer screening has remained around 70% for years, which is below the national average of ~75% (Healthy People, 2021). Primary HPV screening with self-collected swabs has been used successfully for years outside of the US, improving screening …

Improving Post-Hospital Medication Reconciliation In A Rural Primary Care Clinic Through An Rn-Led Workflow, Jack Kennady

Books, Presentations, Posters, Etc.

Context/background: Adverse events after hospital discharge are common and represent a major patient safety concern. Approximately 1 in 5 patients experience a safety event after discharge, and 39% of these events are adverse drug events (ADEs), with 26% considered preventable. Medication discrepancies during transitions of care contribute significantly to these events, with an estimated 40% of medication errors resulting from inadequate medication reconciliation. Rural primary care clinics face additional challenges, including limited communication between inpatient and outpatient systems and inconsistent reconciliation workflows. Improving medication reconciliation during the transition from hospital discharge to outpatient follow-up represents an important opportunity for family …

Improving Recognition Of Chronic Kidney Disease In A Federally Qualified Health Center Through A Quality Improvement Initiative, Rachel Monroe, Evan Saulino, Kathleen Mckenna

Books, Presentations, Posters, Etc.

Context/background: Chronic kidney disease (CKD) affects approximately 15% of adults in the United States, yet nearly 90% of affected individuals are unaware of their diagnosis. Early identification in primary care enables interventions such as blood pressure optimization, renin –angiotensin system blockade, and kidney -protective medications that can significantly delay disease progression and postpone dialysis. Screening and diagnosis gaps disproportionately affect high -risk populations, including Latinx patients and immigrant agricultural workers commonly served in federally qualified health centers (FQHCs). National CKD screening rates among patients with diabetes or hypertension remain low, leaving many high -risk individuals unscreened for kidney disease. Improving …

Increasing Structured Inpatient Teaching In A Family Medicine Residency, Eric Waelbroeck, Mh Choe

Books, Presentations, Posters, Etc.

Background: What is not measured cannot be improved. Residents at Providence Milwaukie Family Medicine Residency identified a need to increase structured teaching on inpatient rotations. Other projects aimed at increasing structured teaching during family medicine training have demonstrated improvements in resident confidence in key areas of practice, licensing exam performance, and resident satisfaction with their training. However, without a system of measurement, the number of teaching opportunities cannot be reliably improved. Objectives: Develop a method of documenting structured inpatient teaching that occurs at Providence Milwaukie Hospital. Then, implement interventions using a quality improvement model to increase structured teaching over time. …

Addressing Food Insecurity Through Partnering With The Community Teaching Kitchen On Lifestyle Medicine Hypertension Class, Emily Miyasako, Jill Christensen

Books, Presentations, Posters, Etc.

Background: Food insecurity is defined as limited or unreliable access to adequate and nutritious food. In Oregon, approximately 1 in 8 residents experience food insecurity, with rates disproportionately affecting low-income individuals, racial and ethnic minorities, and households with children or elderly individuals. Food insecurity remains a significant threat to our patients’ health and is associated with obesity, malnutrition, and poor mental health. As a primary care provider, I have seen the effects of food insecurity on my patients, but I am thankful for the presence of our Community Teaching Kitchen. The Community Teaching Kitchen (CTK) at Providence Milwaukie provides nutritional …

All-Inside Endoscopic Zone 1 Flexor Hallucis Longus Transfer: A Cadaveric Feasibility Study., Kevin D Martin, Yi Wei, Adam G F Smith, Franco Piscitani, Luke M Martin, Brian Steginsky, Brian Tscholl, Nathaniel A Bates

Surgery Articles

BACKGROUND: Endoscopic flexor hallucis longus (FHL) tendon transfer addresses chronic Achilles tendon ruptures. Traditional percutaneous plantar incisions gain FHL length but risk neurovascular injury. This study evaluated the feasibility of an all-inside endoscopic FHL zone 1 tenotomy and transfer technique, which avoids plantar incisions by using zone 1 of the FHL tendon. We hypothesized that this technique would (1) provide sufficient tendon length, (2) avoid neurovascular damage, and (3) securely anchor the FHL tendon without tunnel blowout.

METHODS: Ten cadaveric all-inside endoscopic zone 1 FHL tendon transfers were performed without fluoroscopic guidance. Specimens were independently assessed post hoc by 2 …

Erratum To ``Childhood Obesity: Global Burden, Multifactorial Etiologies, Biological Mechanisms, And Emerging Interventions For Prevention And Management'' [Saudi Medical Journal 2026; 47(2):183–194], Fahad H. Baali

Saudi Medical Journal

In the manuscript entitled: ``Childhood Obesity: Global Burden, Multifactorial Etiologies, Biological Mechanisms, and Emerging Interventions for Prevention and Management'' Published in Saudi Med J 2026; Vol. 47(2): 183–194. doi: 10.15537/1658-3175.1001
The tables included in the published version were incorrect due to a production error.

Erratum To ``The Association Between Inflammatory Bowel Disease And Ischemic Heart Disease: A Retrospective Cohort Study'' [Saudi Medical Journal 2025 Oct; 46(10):1174–1181], Mahmoud H. Mosli, Dima M. Alsulami, Yara K. Alghamdi, Abdullah S. Badahdah, Asmaa H. Alhibshi, Thamer M. Alamri, Maan S. Alkhattabi, Khames T. Alzahrani, Hadeel A. Alsufyani, Omar I. Saadah

Saudi Medical Journal

In the manuscript entitled ``The Association between Inflammatory Bowel Disease and Ischemic Heart Disease: A Retrospective Cohort Study,'' published in Saudi Med J 2025 Oct;46(10):1174–1181. doi: 10.15537/smj.2025.46.10.20250181, the affiliation of Dr. Maan Alkhattabi was omitted from the final published version.
The correct affiliation for Dr. Maan Alkhattabi is as follows:
Department of Medicine, Faculty of Medicine, King Abdulaziz University–Rabigh, Jeddah, Kingdom of Saudi Arabia.

Erratum To ``Unmasking Iron Deficiency And Iron Deficiency Anemia In Saudi Arabia'' [Saudi Medical Journal 2025; 46(9):1000–1007], Osman O. Radhwi, Omar M. Raslan, Eman M. Mansory

Saudi Medical Journal

In the manuscript entitled ``Unmasking Iron Deficiency and Iron Deficiency Anemia in Saudi Arabia,'' published in Saudi Med J 2025; Vol. 46(9):1000–1007. doi: 10.15537/smj.2025.46.9.20240970.
The correct affiliation should read as follows: Department of Basic Science, College of Medicine, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia.

Advancing Rheumatology In The Middle East: Mrc 2025 Abstracts, Martin Lee, Ahmed Zayat, Beena Hameed, Elsadeg Sharif, Fahda Al Okaily, Fehaid Alanazi, Francis Kynaston-Pearson, Khalid A. Alnaqbi, Mahmood Hachim, Mayam Al Nesf, Mira Mirashli, Mohammed Tariq, Ravi Gutta, Reem Abdwani, Saadeya Naji, Shamma Lootah, Tareq Al Araimi, Waleed Hafiz, Suad Hannawi

Saudi Medical Journal

No abstract provided.

Middle East Bifurcation Club Consensus Document On Percutaneous Revascularization Of Bifurcation Lesions In Association With The National Heart Center – Saudi Health Council, Khaled Al-Shaibi, Mirvat Alasnag, Haitham Amin, Ali Nazmi Calik, Ali Almasood, Abdullah Alenezi, Nouf Alanazi, Abdulrahman Almoghairi, Hadi Abu-Hantash, Khaled Almerri

Saudi Medical Journal

Bifurcation lesions are among the most challenging in percutaneous coronary intervention (PCI), with outcomes affected by anatomy, side-branch disease, and procedural variability. Existing European definitions and strategies require adaptation for Middle Eastern populations, where diabetes, obesity, and hypertension are highly prevalent and present earlier. The Middle East Bifurcation Club (MEBC), with the National Heart Center, used the Nominal Group Technique to standardize bifurcation PCI terminology, techniques, and treatment pathways tailored to regional demographics. The consensus provides evidence-based recommendations on imaging, provisional and 2-stent strategies, POT, and left main versus non-left main bifurcations, alongside practical algorithms and heart team guidance, highlighting …

Rethinking Health-Care Efficiency: A Call For A Multi-Dimensional Framework For Assessing Healthcare System Efficiency, Yasser K. Alotaibi, Ali N. Alharbi

Saudi Medical Journal

No abstract provided.

Prevalence Of Brca1 And Brca2 Germline Mutations In Western Saudi Patients With Epithelial Tubo-Ovarian Carcinoma, Wala Mehros, Faisal Aldaheri, Anas Alqarni, Saif Aljehani, Abdulrahman Alnamlah, Alaa Althubaiti, Safaa Huneef, Hatim Jifree

Saudi Medical Journal

Objective: Ovarian cancer represents the most lethal gynecologic malignancy, the epithelial type (EOC) being the most common. BRCA gene mutations are associated with ovarian cancer, younger age at presentation, strong family history of EOC, and multiple malignancies in a single patient. This study calculated the rate of BRCA-positive EOC and compared BRCA-mutated vs non-mutated EOC cases. Methods: This retrospective cohort study, conducted at Princess Noura Oncology Center between May 2016 and December 2023, explored outcomes in BRCA-positive EOC patients. The inclusion criteria covered all EOC cases. A total of 70 patients were selected. Results: Of the 70 …

The Nephroprotective Effects Of Dulaglutide In Patients With Type 2 Diabetes And Chronic Kidney Disease: A Multicenter Saudi Arabian Study, Maha H. Jamal, Hassan A. Alzahrani, Duaa M. Bakhshwin, Ranya A. Ghamri, Fatmah S. Binzomah, Wisam H. Jamal, Moaz W. Abulfaraj

Saudi Medical Journal

Objective: This study aimed to evaluate the effectiveness and safety of dulaglutide in individuals with chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM). Methods: This retrospective cohort study included 212 patients with CKD (stages 1–4) and T2DM treated with once-weekly dulaglutide (1.5 mg) for either 12 or 24 months at three tertiary care centers in Saudi Arabia from January 2021 to December 2023. Safety was assessed based on the presence of adverse events. Efficacy was measured using the changes in estimated glomerular filtration rate (eGFR), glycated hemoglobin (HbA1c), and body mass index (BMI). Changes in efficacy outcomes were …

Combined Predictive Value Of Serum Ngal, Cysc, Urinary Nag, And Egfr For Sepsis-Associated Acute Kidney Injury In Patients In Icu, Yu Han, Wenna Ning, Jian Lu, Jinwei Zhu, Zhiliang Qin, Xiao Wang

Saudi Medical Journal

Objective: To evaluate critically ill patients who had sepsis and how various kidney-related measurements, including eGFR, NGAL, CysC, and the urinary enzyme NAG, predict the onset of sepsis-induced renal damage. Methods: The 135 individuals who were admitted to our sepsis intensive care within 2 years to the end of early 2024 were recruited on a prospective basis and were enrolled based on the predefined criteria. Upon admission, they were dichotomized into 2 groups of participants who developed septic-associated kidney injury (82) and without (53). A comparison of baseline laboratory analyses and blood and urine baseline examinations in the groups was …

Comparison Of Clinical Outcome Of Mushroom Poisonings With And Without Specific Treatment: A 5-Year Retrospective Analysis, Kamil Deveci, Necmi Baykan, Baycan Kus, Fatma Ünlü, Ömer Salt, Serhat Koyuncu

Saudi Medical Journal

Objectives: To determine the demographic and clinical characteristics, potential specific antidote treatments, clinical outcomes, and organ failure (morbidity) rates of patients with mushroom poisoning admitted to our center. Methods: We included 425 patients admitted to the emergency department of Kayseri City Hospital complaining of mushroom poisoning, between May 2018 and December 2023, who met the study criteria. Results: The median age of the 425 patients admitted was 51 years (34–63); 49.5% were female (n = 211), and 75% (n = 319) were admitted by ambulance. According to the Poisoning Severity Score, 70.3% (n = 299) of cases were mild, 21.9% …

Ethnic Background As A Determinant Of Thyroid Cancer Risk: A Decade-Long National Cohort Study Reveals Divergent Epidemics In Saudi Arabia, Nizar A. Khamjan

Saudi Medical Journal

Objectives: To analyze and compare temporal trends, demographic characteristics, and stage at diagnosis for thyroid cancer (TC) between Saudi and non-Saudi populations in order to identify potential population-specific etiological drivers. Methods: We conducted a national retrospective cohort study of TC cases in Saudi Arabia from 2013–2022. To assess population-level trends, we computed age-standardized incidence rates (ASIRs) and multivariable Poisson regression alongside piecewise regression models for comparative analysis. Results: Among 14,159 total cases, TC incidence increased disproportionately in Saudi nationals, rising from 884 to 1,677 (90%), significantly outpacing the 184 to 275 (49%) increase observed in non-Saudis. The incidence rate ratio …

Comparison Of The Predictive Value Of Crp/Albumin, Crp/Prealbumin, And The Clinical Frailty Scale For Mortality In Geriatric Intensive Care Patients, Natali T. Aksoy, Bülent B. Güven, Sümeyya M. Soyalan, Dilek Metin Yamaç, Tuna Ertürk, Süheyla Abitağaoğlu

Saudi Medical Journal

Objectives: To evaluate the relationship between C-reactive protein (CRP)/prealbumin and CRP/albumin ratios, Clinical Frailty Scale (CFS) scores, and short-term (first 3 days) and long-term (28 days) mortality in geriatric patients hospitalized in the intensive care unit. Methods: After obtaining ethical approval and informed consent, 213 patients aged 65 years and older were included. Patients discharged within 24 hours, those discharged and readmitted during the study period, those receiving routine albumin replacement, and patients with cirrhosis or undergoing chronic dialysis were excluded. Demographic characteristics, admission diagnoses, chronic comorbidities, frailty scores at admission, and laboratory values, including albumin, prealbumin, and CRP …

Tumor-Associated Neutrophils In Advanced Non-Small Cell Lung Cancer Patients Predicted By Clinicopathologic Characteristics And Peripheral Blood Markers, Weiwei Hong, Xie Xiong, Chen Fang, Chuanhong Luo, Xiaoying Qian, Xinyuan Yao, Xin Ye, Biao Yu, Bingbiao Zhou, Dengying Chen, Chengsi Shu, Yong Wang, Yong Li

Saudi Medical Journal

Objectives: The process of analyzing tumor-associated neutrophils (TANs) types is complex. This study explored the relationships among clinicopathological characteristics, peripheral blood markers, and TANs. Methods: Clinical information was retrospective gathered for 115 patients in our hospital from May 2019 to May 2021, and multiplex immunofluorescence staining was utilized to access the expression of TANs and analyze the potential relationship between TANs and clinicopathological features or peripheral blood markers. Results: Among the 115 patients, the proportion of female patients within the neutrophils (N1)-low group was notably greater compared to the N1-high group (87.5% vs. 12.5%, p = 0.022). In nonsmoking patients, …

Clinical Role Of Hematologic Inflammatory Markers In The Diagnosis Of Missed Abortion, Mustafa Bakırcı, Çağlayan Ateş, Ethem S. Yalvaç

Saudi Medical Journal

Objectives: To evaluate the diagnostic value of hematological and biochemical inflammatory markers in distinguishing missed abortions from healthy pregnancies during the first trimester. Methods: This retrospective case-control study was conducted between May 2022 and May 2024, included 61 women diagnosed with missed abortion by ultrasound and 100 healthy pregnant women who acted as controls. The following inflammatory markers were calculated from routine blood and biochemistry results: neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), lymphocyte-monocyte ratio (LMR), systemic immune-inflammation index (SII) and C-reactive protein-albumin ratio (CAR). Intergroup comparisons and receiver operating characteristic (ROC) curve analyses were performed. Results: The …

Concurrent Appendectomy In Patients Undergoing Surgery For Gynecological Malignancies: A Retrospective Analysis From A Tertiary Referral Center, Gazi Güner, Can Tercan, Emrah Dağdeviren, Ali Selçuk Yeniocak, Ceylin Elbistanli, Sure Nur Erdoğmuş, Ayşe Hazirbulan, Yiğit Mert Bayrak, Neçirvan Çağdaş Çaltek, Gözde Şahin, Ergun Tercan, Figen Efe Çamili, Nazlıaylin Vural, Hüseyin Karatay, Saniye Merve Gül Kara, İlkbal Temel Yüksel

Saudi Medical Journal

Objectives: To evaluate appendectomy specimen findings and their association with tumor type and stage. Concurrent appendectomy is frequently performed during gynecologic oncology surgery to prevent postoperative appendicitis and detect occult pathology, yet its value remains debated. Methods: In this study, we reviewed the medical records of 300 women who underwent gynecologic oncologic surgery accompanied by appendectomy at Başakşehir Çam and Sakura City Hospital (Istanbul, Türkiye) over the period from July 2020 to April 2025. Clinical, surgical, andhistopathologic data were collected. Appendiceal pathologies were categorized as reactive hyperplasia, chronic inflammation, benign neoplasms, metastatic tumors, or primary. Statistical analyses included chi-square, t-test, …

Reliability And Validity Of The Arabic Version Of The Nose-Perf Scale, Rayan M. Alfallaj, Abdullah I. Binghaith, Mohammed Y. Alyoussef, Ahmed S. Alsaleh, Saad A. Alsaleh, Abdulaziz A. Alqahtani, Ahmad S. Alroqi

Saudi Medical Journal

Objectives: To assess the psychometric validity of the Arabic adaptation of the nasal obstruction symptom evaluation–perforation (NOSE-Perf) scale. To assess how reliable and valid the Arabic adaptation of the NOSE-Perf questionnaire is. Patients with septal perforations, particularly Arabic speakers, lack validated self-assessment tools for subjective symptom evaluation. Methods: Conducted between May 2024 and June 2025, the study included 100 participants—20 patients with septal perforation and 80 controls. Participants filled out a questionnaire consisting of demographic data as well as the Arabic forms of the Sino-Nasal Outcome Test-22 (SNOT-22), NOSE, and NOSE-Perf scales. Cronbach's alpha was applied to determine internal consistency, …

A Multi-Centre Study: Quantitative Evaluation Of Radiation Dose For Adults Head Computed Tomography, Abdulaziz A. Qurashi, Shrooq T. Aldahery

Saudi Medical Journal

Objectives: To determine regional radiation dose in adults head computed tomography (CT) examinations in Jeddah by assessing the volume computed tomography dose index (CTDI_vol) and dose length product (DLP) values. Methods: A retrospective study was conducted from February to April 2025 across 10 CT scanners from 5 governmental hospitals in Jeddah. Data for 20 head CT examinations per scanner were collected. Dose metrics including CTDI_vol and DLP (mGy·cm), were extracted from digital imaging and communications in medicine (DICOM) images. Mean values per scanner and the 75^th percentile were calculated across centres to identify the regional DRL. …

The Role Of The Delta Neutrophil Index In Determining The Severity Of Intrahepatic Cholestasis Of Pregnancy, Selçuk Atalay, Melike Çaltekin, Nihal Çallıoğlu, Fırat Ersan, Verda Alpay, Yasin Anasız, Ipek Geyikoğlu

Saudi Medical Journal

Objective: This study aimed to investigate the clinical utility of the delta neutrophil index (DNI) in distinguishing patients with intrahepatic cholestasis of pregnancy (ICP) from healthy pregnant women, and to assess its potential role in evaluating disease severity. Methods: This retrospective analysis included data from 249 pregnant women. Among them, 131 were identified with ICP, based on clinical symptoms and total bile acid levels ≥ 10 μ mol/L. The remaining 118 participants served as healthy controls. The ICP cases were categorized into mild (TBA 10–39 μ mol/L; n = 90) and severe (TBA ≥ 40 μ mol/L; n = 41) …

Integrative Approaches To Gut Microbiota: Biomarkers, Dysbiosis, And Therapeutic Potential, Zeyad M. Alharbi

Saudi Medical Journal

The human gut contains bacteria, viruses, and archaea that influence health depending on age, diet, and location. An individual harbours about 150 bacterial species. An imbalance of these microorganisms, known as dysbiosis, can negatively impact health. Commensal bacteria maintain microbial homeostasis by building short chain fatty acids. The 2-way communication channel that connects the gut and the brain is referred to as the gut-brain axis. Dysbiosis of the gut leads to some autoimmune diseases. A decline of beneficial bacteria causes the progression of rheumatoid arthritis. Gut dysbiosis increases intestinal permeability, allowing toxins and cytokines to enter the bloodstream and damage …

Emerging Nanotherapy Applications In Cancer Treatment: A Comprehensive Review, Waleed H. Mahallawi

Saudi Medical Journal

This comprehensive review synthesizes recent advances in cancer nanotherapy, focusing on 6 emerging categories: immunomodulation, gene/RNA delivery, theranostics, radiosensitization, biomimetic carriers, and artificial intelligence (AI)-guided formulations. These innovative platforms demonstrate transformative potential by overcoming key limitations of conventional cancer treatments. Immunomodulatory nanoparticles reprogram tumor microenvironments and convert immunologically ``cold'' tumors to ``hot'' responsive states. Gene delivery systems enable precise editing with >50% efficiency, while theranostic platforms integrate real-time imaging with targeted therapy. Radiosensitizers amplify local radiation dose by twofold, and biomimetic carriers achieve prolonged circulation through immune evasion. An AI-driven approaches optimize personalized formulations based on patient-specific biomarkers. Clinical evidence …