Abstract:Objective To explore the efficacy of different ranges of peritumoral radiomics modles combined with clinical imaging information on the differentiation of benign and malignant pulmonary nodules.Methods Clinical and CT imaging data from 190 patients with pulmonary nodules in Maoming People's Hospital from February 2018 to July 2021 were retrospectively collected.The dataset was divided into training group and validation group in a 7∶3 ratio.Based on preoperative chest CT images,regions of interest(ROI)of 3 mm,5 mm,and 10 mm peritumoral area were delineated,and the features were extracted,and screened and modeled.Model performance was compared across these areas,and Radiomics scores(Radscore)were calculated.Combined with clinical imaging features,the nomogram of clinical imaging modle,omics model and fusion model was developed respectively,and compared with the MAYO and Peking University models.Additionally,85 patients from August 2021 to August 2022 were collected as the test group,and the modle was externally validated.Results The radiomics model in the range of 3 to 5 mm around the tumor had better predictive performance than other ranges.The AUC values in the training group were 0.939 and 0.936,while those in the validation group were 0.800 and 0.740.In the test group,the AUC values were 0.684 and 0.715.The Radscore of 5 mm peritumoral area had a higher correlation coefficient than other areas in Logistic regression analysis.The fusion model constructed by combining clinical imaging information had better prediction efficiency than the clinical model and radiomics model,with an AUC of 0.956 in the training group and 0.851 in the validation group,and 0.821 in the test group.Conclusions Radiomics features within the 3-5 mm peritumoral range are more effective in differentiating benign from malignant pulmonary nodules.Radiomics models combined with clinical imaging information can enhance the predictive efficacy for preoperative benign and malignant nodules,thereby aiding in clinical decision-making.

Abstract:Objective To investigate the incidence,mortality,and trends of colorectal cancer in Suzhou City from 2012 to 2021.Methods Demographic data and colorectal cancer incidence and mortality data of Suzhou's registered population from 2012 to 2021 were collected.Crude incidence rates,crude mortality rates,age-standardized rates,and average annual percentage changes(AAPC)were calculated.Results From 2012 to 2021,there were 31,653 new colorectal cancer cases in Suzhou,with an average crude incidence rate of 45.59/100 000,the age-standardized incidence rate by Chinese standard population(ASIRC)was 21.86/100 000,and by world standard population(ASIRW)was 21.48/100 000.The ASIRC was 25.80/100 000 for males and 18.17/100 000 for females,with males having a 1.42 times higher incidence than females.The ASIRC showed an annual increase of 2.12％during this period.There were 12,571 colorectal cancer deaths,with an average crude mortality rate of 18.10/100 000,the age-standardized mortality rate by Chinese standard population(ASMRC)was 7.74/100 000,and by world standard population(ASMRW)was 7.60/100 000.The ASMRC was 9.28/100 000 for males and 6.37/100 000 for females,with males having a 1.46 times higher mortality rate than females.The ASMRC increased annually by 3.90％,with a more pronounced upward trend in males(AAPC=5.43％)compared to females(AAPC=2.62％).Conclusions Both the incidence and mortality of colorectal cancer in Suzhou showed an increasing trend,with higher rates among males than females.Comprehensive strategies targeting high-risk populations should be implemented to further reduce the disease burden of colorectal cancer.

Abstract:Objective To analyze the trends in mortality from respiratory malignant tumors among registered residents in Lishui District,Nanjing from 2007 to 2021,and to evaluate their impact on life expectancy.This study aims to provide data support for the development of prevention and control strategies for respiratory malignant tumors in the region.Methods Demographic data and mortality surveillance data for respiratory malignant tumors among registered residents in Lishui District from 2007 to 2021 were collected.Abridged life tables and cause-eliminated life tables were used to calculate life expectancy,cause-eliminated life expectancy(CELE),potential gains in life expectancy(PGLEs).The average annual percentage change(AAPC)was computed using Joinpoint software.The Arriaga decomposition method was applied to estimate the contribution of mortality changes across age groups to life expectancy.Results From 2007 to 2021,the average crude mortality rate of respiratory malignant tumors in Lishui District was 46.50 per 100 000,with an age-standardized mortality rate(ASMR)of 26.26 per 100 000.The standardized mortality rate for respiratory malignant tumors showed a declining trend(AAPC=-3.32％,P＜0.05).The life expectancy of registered residents increased 8.22 years.Reduced mortality from respiratory malignant tumors contributed positively to this increase,accounting for 0.47 years.All age groups except 35-39 years(which showed a negative contribution)contributed positively,with the largest positive contribution from the 70-74 age group(0.10 years).The respiratory malignant tumors CELE increased by 8.36 years(AAPC=0.82％,P＜0.05),though changes in PGLEs and life loss rate were not statistically significant(AAPC=-1.98％and-2.68％,respectively;P＞0.05).Conclusions The standardized mortality rate for respiratory malignancies among registered residents in Lishui District showed a downward trend,positively contributing to gains in life expectancy.

Abstract:Objective To investigate the expression of glucocorticoid induced protein kinase 1(SGK1)and fat obesity related genes(FTO)in rectal cancer tissues,and to analyze their relationship with neoadjuvant chemoradiotherapy(NACRT)sensitivity and prognosis.Methods One hundred and twenty rectal cancer patients who received NACRT from January 2019 to January 2021 were collected and divided into an ineffective group of 45 cases and an effective group of 75 cases based on the efficacy of NACRT treatment.Immunohistochemistry was used to detect the expression of SGK1 and FTO proteins in cancer and adjacent tissues.Chi square test was used to compare the differential expression of SGK1 and FTO proteins in rectal cancer patients with different clinical pathological features.Univariate and multivariate analyses were performed to explore the factors affecting the efficacy of NACRT in patients with rectal cancer.The impact of SGK1 and FTO protein expression on the prognosis of rectal cancer patients was conducted by Kaplan Meier curve analysis.Results The positive rate of SGK1 in cancer tissues was higher than that in adjacent tissues(68.33％vs.16.67％,P＜0.001).The positive rate of FTO in cancer tissues was higher than that in adjacent tissues(71.67％vs.15.00％,P＜0.001).The positive rates of SGK1 and FTO in cancer tissue of patients with TNM stage Ⅲ rectal cancer were higher than those of patients with TNM stage Ⅱ(both P＜0.05).There were 45 cases in the NACRT ineffective group and 75 cases in the effective group.The proportion of patients with TNM stage Ⅲ,SGK1 positive rate,and FTO positive rate in the ineffective group were higher than those in the effective group(all P＜0.05).SGK1 positivity,FTO positivity,and TNM stage Ⅲ were risk factors affecting the efficacy of NACRT in rectal cancer(P＜0.05).The 3-year overall survival rate of SGK1 positive group was lower than that of negative group patients(47.56％vs.84.21％,P＜0.001).The 3-year overall survival rate of FTO positive group was lower than that of negative group patients(50.00％vs.82.35％,P=0.002).Conclusions The increased expression of SGK1 and FTO in rectal cancer tissue is associated with TNM stage and serves as tumor markers for evaluating the sensitivity and prognosis of NACRT treatment in rectal cancer.

Abstract:Objective To analyze the spatial clustering and changing trends of lung cancer mortality in Jiangsu Province from 2018 to 2022,and to provide evidence for lung cancer prevention and control across the province.Methods Lung cancer mortality data from 2018 to 2022 were obtained from the Jiangsu Provincial Population Death Registration Information System.Joinpoint analysis was used to assess the trends in lung cancer mortality,ArcGIS 10.5 was employed to analyze the spatial characteristics of lung cancer mortality,and SaTScan was utilized to examine the spatiotemporal clustering of lung cancer mortality.Results From 2018 to 2022,the crude mortality rate of lung cancer in Jiangsu Province showed an upward trend(APC:1.59％,95％CI:0.62％-2.57％),while the standardized mortality rate exhibited a downward trend(APC:-2.33％,95％CI:-3.16％to-1.49％).The increase in crude mortality was higher among males than females,and the decrease in standardized mortality was lower among males than females.Spatial analysis revealed that lung cancer mortality in the province exhibited spatial clustering.Local spatial analysis indicated that central and northern Jiangsu were high-risk areas for lung cancer mortality,while southern Jiangsu was a low-risk area.The distribution of lung cancer mortality differed between males and females.Spatiotemporal scan analysis identified multiple high-risk clusters of lung cancer mortality in Jiangsu Province.The primary cluster was mainly located in central and northern Jiangsu,covering 20 monitoring sites,predominantly rural areas,where the lung cancer mortality rate was 1.27 times higher than that in other regions.Conclusions From 2018 to 2022,lung cancer mortality in Jiangsu Province showed an upward trend and exhibited spatial clustering.The trends and spatial clustering of lung cancer mortality varied by gender.Strengthening lung cancer prevention and control measures for populations in central and northern Jiangsu is essential.Additionally,further exploration of risk factors associated with lung cancer mortality is needed to provide a theoretical basis for developing practical regional lung cancer prevention and control strategies.

Abstract:Objective To explore the clinical value of pre-ablation needle biopsy in the differential diagnosis of patients suspected with liver metastases.Methods A retrospective analysis was conducted on the clinical data and pathological examination results of 32 patients suspected with liver metastases who underwent needle biopsy before ablation at the Hepatobiliary and Pancreatic Center of Dongguan Hospital of Guangzhou University of Chinese Medicine and the Department of Hepatobiliary and Pancreatic Surgery of the Tenth Affiliated Hospital of Southern Medical University from January 2023 to April 2025.Results All patients in the group were preoperatively diagnosed with suspected liver metastases.Postoperative pathological diagnosis confirmed liver metastases in 22 cases(68.8％)and non-liver metastases in 10 cases(31.2％).The latter included hepatocellular carcinoma in 5 cases,cholangiocarcinoma in 1 case,hepatocellular adenoma in 1 case,neuroendocrine carcinoma in 1 case,hepatic hemangioma in 1 case,and inflammatory nodular lesion of the liver in 1 case.The consistency rate between preoperative diagnosis and postoperative pathological diagnosis was 68.8％.The success rate of needle biopsy and microwave ablation surgery was 100％for the entire group.Postoperative complications included minor perihepatic hemorrhage and small right pleural effusion in 1 case each(3.1％),both of which resolved spontaneously without special treatment.Postoperative enhanced CT scans at 2-4 weeks evaluated the ablation effect,showing complete ablation in all 32 cases(100％)with no cases of partial ablation.Conclusions Pre-ablation needle biopsy is simple,safe,and reliable.It can achieve differential diagnosis through pathological analysis,thereby avoiding misdiagnosis and mistreatment.Therefore,it is recommended to routinely perform needle biopsy for patients suspected with liver metastases before implementing precise microwave ablation.

Abstract:Laparoscopic surgery has evolved from an exploratory technique to a standard treatment option in the treatment of locally advanced gastric cancer(LAGC),and its minimally invasive advantages and oncological efficacy have been verified by multiple randomized controlled trials.The surgical methods are mainly distal gastrectomy and total gastrectomy,and the choice is individualized based on the tumor location,pathological classification and patient needs.D2 lymph node dissection significantly improves the detection rate of lymph nodes through precise anatomical techniques,while the innovation of digestive tract reconstruction technology takes into account both functional preservation and safety.The comprehensive model of neoadjuvant therapy combined with laparoscopic surgery creates conditions for minimally invasive surgery by downstaging,and the perioperative management integrates radiomics,ctDNA monitoring and ERAS protocol to improve prognosis.The application of intraoperative navigation technology and high-definition equipment has further enhanced the accuracy of the surgery.In the future,efforts should be focused on the verification of long-term survival data,the popularization of robotic surgery,and the optimization of individualized treatment strategies to promote the standardized development of LAGC laparoscopic surgery.

Abstract:Gallbladder cancer(GBC)is the most common malignant tumor of the biliary system,with a highly aggressive and poor prognosis profile.Due to its insidious onset,most patients are already in the middle or late stages at the time of diagnosis,and have few opportunities for surgical resection.This article summarizes the current research of targeted therapy for GBC,foucsing on the key signaling pathways-related targets,such as the ErbB receptor,VEGF/VEGFR pathway,MAPK pathway,and PI3K/Akt/mTOR pathway.Some targeted drugs have shown certain efficacy in clinical trials,but there are still problems such as tumor heterogeneity,molecular mechanism of drug resistance,and detection techniques bottleneck.Bioinformatics methods have identified emerging potential targets and their drug candidates such as PTBP3 and WEE1,which are still in the basic research stage.Therefore,GBC still faces many challenges,and future research needs to focus on the integration of multi-omics technology,the optimization of combination treatment regimens,the innovation of high-sensitivity detection methods,and international multi-center collaboration to promote therapeutic breakthroughs.

Abstract:Lung cancer is the most common malignant tumor with the highest morbidity and mortality rate worldwide.2022 Chinese cancer statistics show that there are as many as 1.6 million new cases of lung cancer and 733.3 thonsand deaths in China,accounting for 22.0%and 28.5%of all malignant tumors,respectively.With the popularization of low-dose CT screening,early and accurate diagnosis and individualized treatment of lung cancer through imaging means have become the focus of clinical attention.In recent years,artificial intelligence technology has made significant progress in medical imaging,and its application value in lung cancer diagnosis and treatment has become increasingly prominent.This paper systematically reviews the current status of the application of AI imaging technology in lung cancer screening,diagnosis,treatment decision-making and prognosis assessment,aiming to elucidate the value of AI imaging methods in the diagnosis and treatment of lung cancer,to provide a stronger basis for the precise treatment of lung cancer patients,and to put forward an outlook on the future development direction.

Abstract:Objective To evaluate the clinical value of preoperative CT imaging-derived quantitative parameters in assessing pathological malignancy and predicting postoperative survival outcomes in lung cancer patients.Methods A total of 215 patients who underwent surgical treatment for lung cancer at our hospital between April 2020 and April 2024 were enrolled.All cases were confirmed as lung cancer via postoperative pathology.Preoperative high-resolution CT scans were performed,and tumor-related quantitative parameters were analyzed,including sphericity,eccentricity,surface-to-volume ratio,solid component ratio,mean CT value,standard deviation(SD),skewness,kurtosis,energy,and entropy.Patients were divided into low-grade and high-grade malignancy groups based on pathological results.Differences in CT parameters between groups were compared.Multivariate Logistic regression identified independent risk factors for high-grade malignancy,while receiver operating characteristic(ROC)curves evaluated diagnostic efficacy for preoperative malignancy assessment.Follow up until May 2025,based on the follow-up results,patients were categorized into survival group of 146 cases and mortality group of 63 cases.Clinical data differences were analyzed,and multivariate Logistic regression identified independent risk factors for poor postoperative outcomes.ROC curves further assessed prognostic prediction accuracy.Results Based on pathological findings,87 patients were classified as low-grade malignancy and 128 as high-grade malignancy.Significant differences were observed in sphericity,eccentricity,surface-to-volume ratio,solid component ratio,mean CT value,SD,energy,and entropy(all P<0.05).Multivariate analysis identified surface-to-volume ratio,solid component ratio,and entropy as independent risk factors for high-grade malignancy,while sphericity and energy acted as protective factors(all P<0.001).ROC analysis demonstrated areas under the curve(AUCs)of 0.747(entropy),0.788(SD),0.794(solid component ratio),0.768(kurtosis),and 0.774(surface-to-volume ratio).The combined model achieved an AUC of 0.891(95%CI:0.850-0.932),significantly outperforming individual metrics(DeLong test:Z=2.162,P=0.008).During follow-up,6 patients were lost to follow-up.The mortality group showed higher proportions of poorly/undifferentiated tumors and significant differences in surface-to-volume ratio,solid component ratio,SD,energy,and entropy(all P<0.05).Multivariate analysis confirmed solid component ratio,and entropy as independent predictors of poor prognosis(all P<0.001).ROC analysis yielded AUCs of 0.824(solid component ratio),0.794(SD),and 0.852(entropy).The combined model achieved an AUC of 0.896(95%CI:0.850-0.942),demonstrating superior performance over single indicators(DeLong test:Z=3.525,P=0.001).Conclusions CT quantitative parameters exhibit robust efficacy in preoperative malignancy assessment and prognostic prediction for lung cancer patients.Surface-to-volume ratio,solid component ratio,and entropy are independent risk factors for high-grade malignancy,while sphericity and energy serve as protective factors.The combined diagnostic performance outperforms individual parameters.Solid component ratio,SD,and entropy also independently predict poor postoperative outcomes,with combined analysis offering enhanced predictive accuracy.

Abstract:Objective To evaluate the recognition efficacy and protective role of probe-based laser-induced fluorescence technique on parathyroid gland in total thyroidectomy,so as to provide a basis for optimizing surgical stratedies.Methods A retrospective analysis was conducted on the clinical data of 100 patients with papillary thyroid carcinoma who underwent total thyroidectomy at Jiangsu Cancer Prevention and Treatment Institute,from January to November 2024.The patients were divided into the probe group(using probe-based laser-induced fluorescence technique,50 cases)and the traditional group(relying on inspection and palpation recognition,50 cases)according to intraoperative parathyroid gland recognition methods.The differences between the two groups were compared in terms of the quantity and accuracy of parathyroid glands recognition,preservation of parathyroid gland functions,duration of surgery and postoperative complications(such as hypoparathyroidism).Results Thequantity and accuracy of parathyroid recognition in the probe group were higher than those in the traditional group(P<0.05);in the case of bilateral total thyroidectomy,and the incidence of postoperative hypoparathyroidism in the probe group was significantly lower than that in the traditional group(P<0.05).There was no significant difference in operation duration between the two groups(P>0.05).Conclusions Theprobe-based laser-induced fluorescence technique can improve the recognition accuracy and protection role of parathyroid gland in total thyroidectomy,effectively reduce the incidence of postoperative hypoparathyroidism,and has important clinical application value and promotion prospects.

Abstract:Objective To investigate the challenges and clinical efficacy of the posterior median approach for microsurgical resection of craniovertebral junction(CVJ)tumors.Methods Clinical data were collected from 35 CVJ tumor patients treated in the Department of Neurosurgery of Beijing Jishuitan Hospital affiliated to Capital Medical University between January 2021 and May 2024.According to the tumor location within the CVJ,different techniques were employed:midline incision for dorsal spinal cord tumors;enlarged laminectomy for ventral spinal cord tumors;and separation for dumbbell-shaped tumors in the intervertebral foramen region.Intraoperative monitoring of somatosensory evoked potentials(SEP)and motor evoked potentials(MEP)was performed throughout surgery,with an alarm threshold set at a>50%decrease in amplitude or>10%prolongation of latency to ensure neurological safety.Results Gross total resection was achieved in all patients with no residual tumor.The operative time ranged from 2 to 7 hours,with a mean of(3.90±1.29)hours.The patients showed significant symptomatic improvement after surgery,and no major complications occurred.During the follow-up period(6-36 months),no tumor recurrence was observed in any patient.Conclusions Microsurgical resection of CVJ tumors via the posterior median approach is a safe,effective,and widely applicable technique.It effectively preserves neurological function and maintains cervical stability.Intraoperative neurophysiological monitoring is a crucial adjunct for ensuring surgical safety.

Abstract:Adult diffuse glioma is the most common primary malignant tumor of the central nervous system,whose diagnosis and prognosis are closely related to the histological and genetic features of the tumor.The 2021 fifth edition of the World Health Organization Classification of Central Nervous System Tumors incorporates genetic characteristics as diagnostic criteria for gliomas.Noninvasively predicting the genetic information of gliomas through preoperative magnetic resonance imaging is important for early diagnosis,surgical planning,and prognostic evaluation.This review integrates the updated glioma classification guidelines,radiomics,deep learning,and other information technologies to elucidate the latest advances in imaging genetics of adult diffuse gliomas,while also explores the potential applications and challenges of glioma imaging genetics in future intelligent medical systems.

Abstract:Objective To investigate the value of diffusion-weighted imaging(DWI)in assessing the texture of pituitary adenoma(PA)and predicting the extent of neuroendoscopic.resection.Methods A retrospective analysis was conducted on 231 patients with PA,including general clinical data(age,gender,symptoms,etc.),pathological data(tumor texture,collagen content),and imaging data(tumor size,ADC ratio,etc.)in the Affiliated Hospital of Xuzhou Medical University from January 2020 to December 2022.Patients were divided into soft group and hard group according to intraoperative pathological results,and the ability of DWI to predict tumor texture was evaluated.According to the postoperative reexamination imaging results,the application value of DWI in the degree of tumor resection was discussed.Correlation analysis and multiple linear regression were used to analyze the relationship between ADC ratio and tumor texture and collagen content,with ROC curves for validating its diagnostic efficacy.Logistic regression was applied to analyze the relevant factors influencing tumor resection under neuroendoscopy.Results All patients underwent neuroendoscopic transsphenoidal surgery for pituitary adenoma.All patients underwent neuroendoscopic transsphenoidal resection for pituitary adenoma.There were differences in collagen content,ADC ratio,and degree of tumor resection between the soft and hard groups.Multiple linear regression analysis showed that the effects of collagen content and tumor texture on ADC ratio were statistically significant.Spearman's correlation analysis showed that there was a correlation between ADC ratio and tumor texture and collagen content,and collagen content was also significantly correlated with tumor texture.Univariate regression analysis showed that tumor volume,tumor size,tumor texture,ADC ratio,collagen content,and tumor invasiveness were the influencing factors of total tumor resection.Multivariate regression analysis showed that tumor size and ADC ratio were independent influencing factors for total tumor resection.Conclusions The application of DWI before neuroendoscopic transsphenoidal pituitary adenoma resection can effectively assess the tumor texture and provide important reference information for surgery,thereby reducing the risk of excessive traction and pituitary injury during surgery,and improving the tumor resection rate.

Abstract:Objective To investigate the independent risk factors for short-term recurrence and construct a predictive model in patients with esophageal squamous cell carcinoma(ESCC)undergoing radical surgery combined with neoadjuvant chemoradiotherapy.Methods A cohort of 110 ESCC patients who underwentneoadjuvant chemoradiotherapy followed by radical surgery at the 904th Hospital of People's Liberation Army Joint Logistics Support Force between January 2022 and December 2023 was enrolled.Categorical variables were analyzed using the χ2 test to screen factors associated with postoperative short-term recurrence.Independent risk factors were identified via multivariate logistic regression analysis.A nomogram prediction model was developed using R software,and model efficacy was assessed using the receiver operating characteristic(ROC)curve.Results The 1-year recurrence rate was 18.2%(20/110).Factors significantly correlated with short-term recurrence included age,ypT stage,ypN stage,neoadjuvant treatment regimen,microvascular invasion,lymphatic invasion,preoperative hypoalbuminemia,abnormal platelet count,abnormal prognostic nutritional index(PNI),and abnormal systemic immune-inflammation index(SII)(P<0.05).Independent risk factors comprised age≥65 years,preoperative hypoalbuminemia,neoadjuvant treatment regimen,high pathological stage,absence of tumor volume reduction,and postoperative abnormal platelet count.The nomogram prediction model,based on these six indicators,achieved an area under the ROC curve(AUC)of 0.823(95%CI:0.751-0.894).Conclusions This model enables preoperative risk quantification and postoperative dynamic monitoring of high-risk indicators.Enhanced follow-up protocols are recommended for ESCC patients with age≥65 years,preoperative hypoalbuminemia,high pathological stage,absence of tumor volume reduction,or postoperative abnormal platelet count to provide evidence-based support for early intervention.

Abstract:Objective To investigate the regulatory effect of cysteine protease inhibitor(CST1)on proliferation,migration,invasion and cycle of breast cancer cells and its potential mechanism.Methods The UALCAN and GEPIA databases were used to analyze the expression levels of CST1 in different cancer tissues in the Cancer Gene Atlas(TCGA)database.The expression level of CST1 in breast cancer and its relationship with clinical features and survival prognosis were further analyzed.Signaling pathway enrichment analysis of CST1 was performed by CANCERTOOL and GeneCards databases.The correlation between CST1 and cell cycle-related proteins(P21,P27,CyclinD1 and CDK1)was analyzed based on Metabric database.MDA-MB-231 cells were divided into four groups:OE-NC group(high expression control group),OE-CST1 group(high expression group),sh-NC group(low expression control group),and sh-CST1 group(low expression group).CCK-8,scratch assay and Transwell assay were used to detect the effects of CST1 on cell proliferation,migration and invasion.Western blot was used to detect the expression levels of CST1 and its downstream proteins(P21,P27,CyclinD1,CDK1).Results The analysis results of public databases indicated that CST1 was abnormally expressed in various tumor tissues,and the expression of CST1 in breast cancer was higher than that in nomal tissues(P<0.05),and was positively correlated with age,lymph node metastasis and clinical stage(P<0.05),and the overall survival of patients with high expression of CST1 was worse(P<0.05).Pathway enrichment analysis showed that the cell cycle signaling pathway was at the forefront,and was correlated with P21,P27,CyclinD1,and CDK1(P<0.05).The results showed that high expression of CST1 promoted the proliferation,migration and invasion of breast cancer cells,(P<0.05),However,low expression of CST1 inhibited the above phenotype(P<0.05).The result of western blot assay showed that the protein level of CST1 in breast cancer cells in the low expression group was significantly lower than that in the high expression group(P<0.05).In addition,the protein levels of P21 and P27 significantly decreased in the CST1 high expression group,and the protein levels of CyclinD1 and CDK1 increased significantly(P<0.05).However,the low expression group of CST1 showed the opposite trend.Conclusions The expression of CST1 can regulate the proliferation,migration,invasion ability of breast cancer cells,and can also target regulate the expression of P21,P27,CyclinD1and CDK1,thereby affecting the breast cancer cell cycle.

Abstract:Objective To investigate the MRI imaging features and clinical features of chordoid meningioma(CM).Methods The data of 21 patients with chordoid meningioma confirmed by surgical pathology in the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine/Jiangsu Provincial Hospital of Traditional Chinese Medicine and the First Affiliated Hospital of Nanjing Medical University/Jiangsu Provincial People's Hospital from January 2008 to December 2023 were collected retrospectively.The CT and MRI manifestations,pathological features,treatment options and prognosis were analyzed.Twenty-eight patients with non-CM meningioma were included as controls,matching gender,age and admission time.Results Of the 21 cases,the tumors were located in the skull in 20 cases and in the cervical vertebra in 1 case.MRI features:tumors were mostly patchy,with isointensity or hypointensity on T1-weighted imaging(T1WI),slightly hyperintense or hyperintense on T2-weighted imaging(T2WI),and obvious enhancement after enhanced scanning;No hypointensity was observed by diffusion-weighted imaging(DWI),and the apparent diffusion coefficient(ADC)value was significantly higher than that of non-chordoid meningiomas group(P<0.05).Pathological features:the fusiform or epithelioid tumor cells were arranged in strips or clusters,and the cytoplasmic vacuoles and"droplet-like"cells were distributed in the rich basophilic mucus-like stroma.Eighteen patients with chordoid meningioma were followed up for 8-147 months(n=18),seven cases relapsed in situ and three cases died.The recurrence rate of patients with total resection of chordoid meningioma was significantly lower than that of patients with subtotal resection(P<0.05),and the recurrence rate of patients with skull involvement was significantly higher than that of patients without skull involvement(P<0.05).Conclusions Apparent diffusion coefficient(ADC)values in MRI are expected to be a reliable indicator to distinguish chordoid meningioma from other meningioma tissues.Total resection of the tumor is the best treatment for chordoid meningioma at present.

Abstract:Objective To clarify the levels and clinical significance of serum growth differentiation factor-15(GDF-15)and chemokine(C—C motif)ligand 20(CCL20)in prostate cancer patients.Methods From January 2022 to September 2024,128 prostate cancer patients accepted by the Second Affiliated Hospital of Heibei North University were included as the research subjects.Complying with the different Gleason scores,scores of 6 or below were considered low-risk,while scores between 7 and 10 were considered high-risk.Therefore,all research subjects were assigned into high-risk group(58 cases)and low-risk group(70 cases).Compare differences in serum GDF-15 and CCL20 levels and the proportion of muscle infiltration between the two groups.Pearson method was used to analyze the correlation between serum GDF-15 and CCL20 in high-risk prostate cancer patients.Logistic method was used to analyze the related factors of high-risk prostate cancer.ROC curve was used to analyze the efficacy of serum GDF-15 and CCL20 in predicting high-risk prostate cancer.Results The proportion of muscle infiltration in the high-risk group was prominently higher than that in the low-risk group(P<0.05).The serum GDF-15 and CCL20 in the high-risk group were prominently higher than those in the low-risk group(all P<0.05).The serum GDF-15 and CCL20 in high-risk prostate cancer patients were positively correlated(r=0.601,P<0.001).Logistic method showed that muscle infiltration,and high serum GDF-15 and CCL20 were independent risk factors for high-risk prostate cancer(all P<0.05).The area under the ROC curve(AUC)of serum GDF-15 and CCL20,and their combination in predicting high-risk prostate cancer was 0.837,0.741,and 0.892,respectively.The combined prediction of the two was superior to the individual diagnoses(all P<0.05).Conclusions Serum GDF-15 and CCL20 are upregulated in high-risk prostate cancer patients,combined detection improves the diagonstic performance for high-risk prostate cancer and has potential clinical value.

Abstract:Objective To explore the association between intraoperative hypotension and postoperative delirium(POD)in patients undergoing cervical intraspinal schwannoma resection,and to provide a basis for optimizing perioperative management.Methods A total of 110 patients with cervical intraspinal schwannoma were selected as the research subjects,who underwent schwannoma resection at the Affiliated Hospital of Shaanxi University of Chinese Medicine from January 2019 to January 2024.The research subjects were divided into the POD group and the non-Pod group based on whether Pods occurred.The general and clinical data of the two groups of patients were collected and compared,including mean arterial pressure(MAP),duration of hypotension,minimum MAP value,etc.Multivariate Logistic regression was used to analyze the influencing factors of POD in patients with cervical intraspinal schwannoma and evaluate the relationship between intraoperative hypotension and POD.The receiver operating characteristic(ROC)curve was plotted to evaluate the predictive efficacy of intraoperative hypotension for the occurrence of POD in patients with cervical intraspinal schwannoma.Results Among the 110 patients,a total of 20 patients developed POD,including 12 cases of inhibitory activity,5 cases of hyperactive type,and 3 cases of mixed type.There were statistically significant differences between the POD group and the non-POD group in terms of cerebrovascular history,duration of hypotension,and minimum MAP value(P<0.05).The results of multivariate regression analysis showed that the history of cerebrovascular disease(OR=2.330,95%CI:2.224-2.437)and the duration of intraoperative hypotension(OR=1.982,95%CI:1.892-2.072)are independent risk factors for POD in patients with cervical intraspinal schwannoma,and minimum MAP value(OR=0.524,95%CI:0.062-0.986)is a protective factor for POD in patients with cervical intraspinal schwannoma.The ROC curve showed that the area under the curve(AUC)for the duration of intraoperative hypotension and minimum MAP value was 0.794 and 0.772,respectively(95%CI:0.752-0.812,0.747-0.802),and the AUC for combined detection was 0.869(95%CI:0.853-0.897,and the Delong test results showed that the combined diagnostic efficacy was superior to that of a single indicator(Z=2.162,P=0.008).Conclusions Among patients undergoing surgery for intraspinal schwannoma of the cervical spinal canal,the duration of intraoperative hypotension and the amplitude of MAP fluctuation are independent risk factors for POD.The lowest MAP value is a protective factor for POD,and the predictive efficacy of combined detection is higher than that of single detection.Perioperative MAP can be used as an auxiliary indicator to assess the risk of POD occurrence in patients with cervical intraspinal schwannoma.

Abstract:Renal cell carcinoma(RCC),one of the most prevalent urological malignancies worldwide,continues to impose a growing disease burden.According to the latest epidemiological data,RCC ranks as the 14th most common cancer globally,accounting for approximately 2%of all new cancer cases.In 2022,there were an estimated 434 800 new RCC diagnoses and 156 000 deaths,with significant geographical disparities in disease burden and notable differences in clinical management between Eastern and Western populations.To address these variations and standardize evidence-based practices,the European Association of Urology(EAU)has updated its guidelines,emphasizing multidisciplinary collaboration and outlining current research priorities.The EAU RCC Guideline Panel conducted a structured evaluation of the latest advancements,integrating new evidence to refine evidence-based recommendations for RCC management.These updates aim to provide clinicians with clearer therapeutic strategies and decision-making pathways,ultimately improving patient outcomes.