Abstract:Objective To investigate the effect of single photon emission computed tomography(SPECT)/CT combined with serum carcinoembryonic antigen(CEA)and thyroid stimulating hormone(TSH)on lymph node metastasis after thyroid cancer surgery.Methods A total of 120 postoperative patients with differentiated thyroid cancer from January 2019 to December 2020 were selected.Serum CEA and TSH were examined before 131 I treatment,and SPECT/CT fusion imaging and postoperative pathological examination were performed after 7 days of 131 I treatment.Taking postoperative pathological examination as the"gold standard"for diagnosis,patients were divided into lymph node metastasis group(observation group)and lymph node non-metastasis group(control group)according to the gold standard,and the serum CEA and TSH levels of the two groups were compared.Kappa consistency test and ROC curve were used to analyze the value of SPECT/CT examination alone compared with serum CEA and TSH in the diagnosis of cervical lymph node metastasis after differentiated thyroid cancer operation.Results Serum CEA and TSH levels in the observation group were higher than those in the control group(P<0.05).Kappa consistency test showed that the detection of lymph node metastasis after differentiated thyroid cancer by SPECT/CT was generally consistent with the"gold standard"results(Kappa value=0.502,P<0.05).The ROC curves showed that the area under the curve was higher for the combined diagnosis than for the single diagnosis(P<0.05).Conclusions Serum CEA and TSH levels are increased in patients with cervical lymph node metastasis after differentiated thyroid cancer surgery,and combined SPECT/CT examination has significant diagnostic efficiency.

Abstract:Objective To investigate the expression characteristics and clinical significance of endoplasmic reticulum stress-related genes in colorectal cancer(CRC)and evaluate their potential application in diagnosis and prognosis.Methods This study selected three CRC datasets(GSE41258,GSE50760,and GSE5206)from the GEO database.After data preprocessing,differentially expressed genes(DEGs)were identified through differential expression analysis.The DEGs were intersected with endoplasmic reticulum stress-related genes,and key genes were identified using two machine learning methods:support vector machine-recursive feature elimination(SVM-RFE)and gradient boosted decision tree(GBDT).Seven intersecting genes(HSD11B2,GCG,RCN1,COL1A1,TRIB3,CCND1,and VEGFA)were ultimately selected.Based on the expression values of these genes,an artificial neural network(ANN)model was constructed to evaluate diagnostic performance,and its generalizability was assessed using ROC curve analysis in the combined dataset and individual datasets.The expression differences and correlations of key genes between cancer andnormal tissues were analyzed.Survival analysis was conducted using the TCGA database to explore the relationship between gene expression levels and overall survival(OS)in patients.Finally,potential drugs targeting these key genes were identified using the Enrichr database.Results The seven identified key genes exhibited significant expression differences in CRC tissues.GCG and HSD11B2 were highly expressed innormal tissues,while RCN1,COL1A1,TRIB3,CCND1,and VEGFA were highly expressed in cancer tissues.The ANN model achieved an AUC greater than 0.8 in both the training and validation groups,indicating good diagnostic performance.Survival analysis showed that high expression of GCG and HSD11B2 was associated with better prognosis,whereas high expression of the other genes was associated with poor prognosis.Drug screening identified potential agents such as Entinostat and Indomethacin that may regulate the expression of these genes.Conclusions The expression of HSD11B2,GCG,RCN1,COL1A1,TRIB3,CCND1,and VEGFA has significant diagnostic and prognostic value in CRC and may provide new directions for targeted therapy research.

Abstract:Objective To evaluate the clinical value of preoperative contrast-enhanced computed tomography(CT)in assessing T stage and regional lymph node metastasis in rectal cancer,and to provide reliable imaging evidence for individualized treatment strategies.Methods A total of 196 patients who underwent both non-contrast and contrast-enhanced CT scans at Jiangsu Province Hospital of Traditional Chinese Medicine between December 2019 and December 2023,and were pathologically confirmed to have rectal cancer postoperatively,were retrospectively included.Clinical data and preoperative contrast-enhanced CT images were collected.Imaging features such as degree of enhancement,tumor margins,morphology,and changes in perirectal fat planes were assessed.T and N stage were determined according to the 8th edition of the AJCC TNM classification.Postoperative pathological staging served as the reference standard.The diagnostic accuracy,sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)of CT in T and N stage were calculated.Results The accuracy of contrast-enhanced CT for T1-2,T3,and T4 stages was 82.69％,86.86％,and 85.71％,respectively,with an overall T stage accuracy of 85.71％.CT demonstrated the highest positive predictive value for T3 tumors(92.25％),the greatest sensitivity for T1-2 stages(90.28％),and a high NPV for T4 stage(99.42％).For N stage,the diagnostic accuracy for N0,N1,and N2 stages was 81.37％,63.64％,and 71.43％,respectively,with an overall accuracy of 73.98％.The specificity and NPV for N0 staging were relatively high(91.91％and 80.21％,respectively),while the PPV for N2 stage was relatively low(60.61％).The degree of enhancement showed a certain correlation with T and N stages,with moderate to marked enhancement more frequently observed in tumors staged T3 or higher.Conclusions Preoperative contrast-enhanced CT demonstrates high accuracy and clinical utility in the assessment of T stage and lymph node metastasis in rectal cancer.It provides important preoperative imaging information to guide the development of appropriate treatment strategies.

Abstract:While immune checkpoint inhibitors have shown substantial clinical benefits in treating breast cancer,their overall efficacy is limited by resistance mechanisms driven by the tumor microenvironment(TME).Notably,various immunosuppressive cell populations—such as regulatory T cells,tumor-associated macrophages,and myeloid-derived suppressor cells—play a crucial role in fostering therapeutic resistance through multiple pathways.In addition,cancer-associated fibroblasts and the hypoxic conditions characteristic of tumor regions further diminish the effectiveness of immunotherapy.This review offers a comprehensive examination of the latest strategies to modulate the TME and overcome immune resistance.The discussion spans targeted approaches against immunosuppressive cells,metabolic regulation,phototherapy,modulation of tumor immunogenetics,as well as combination therapies and nanoparticle-mediated treatment strategies.Collectively,these developments provide novel theoretical insights and practical avenues for enhancing the overall efficacy of immunotherapeutic interventions in breast cancer.

Abstract:The application of artificial intelligence(AI)in the pathological diagnosis of breast tumors is rapidly advancing and gradually transitioning into clinical practice.Leveraging deep learning and digital pathology platforms,AI models have demonstrated remarkable advantages in tasks such as automated lesion detection,quantitative biomarker analysis,and histological grading.Moreover,the integration of AI with molecular diagnostic technologies has enabled the exploration of correlations between genomic mutation profiles and histopathological features,thereby further promoting the implementation of precision medicine.With the enhancement of multimodal data integration,incorporating imaging,clinical records,histopathology,and molecular biology,AI is expected to achieve a higher level of intelligence and individualization in breast pathology diagnosis.However,its clinical application still faces multiple challenges,including discrepancies between AI technologies and clinical needs,regulatory and ethical risks,and resistance associated with restructuring pathological workflows.

Abstract:Medical imaging plays an indispensable role in tumor diagnosis and treatment,but traditional methods are plagued by prominent issues,including subjective interpretation and challenges in early lesion detection.In recent years,breakthroughs in artificial intelligence(AI)have brought a paradigm shift to tumor imaging.By leveraging machine learning and deep learning techniques,AI has substantially enhanced the sensitivity of early tumor detection,surgical precision,the accuracy of prognostic prediction,and the personalization of therapeutic decision-making.This article provides a systematic review of the developmental trajectory and core applications of AI in tumor imaging,analyzes current challenges,and outlines future directions,with the aim of offering theoretical support for the establishment of an AI-driven precision oncology diagnostic and treatment system.

Abstract:Objective To investigate the expression and clinical significance of cyclic RNA 0084927(Circ_0084927)and microRNA-1779(miR-1179)in colorectal cancer(CRC)patients.Methods 120 CRC patients admitted to Qidong People's Hospital from January 2019 to May 2021 were selected.Patients were divided into good and poor prognosis groups according to their prognosis;CRC tissues and paracancerous tissues were collected intraoperatively.qRT-PCR was used to detect the expression levels of Circ_0084927 and miR-1179;Pearson correlation analysis was performed to analyze the correlation between Circ_0084927 and miR-1179;χ2 test was used to determine the relationship between Circ_0084927/miR-1179 and clinicopatho-logical charcteristics;Kaplan-Meier survival curves were used to analyze the relationship between Circ_0084927 and miR-1179 with the prognosis of CRC patients;multifactorial COX regression was used to analyze the influencing factors of CRC patients'prognosis;and ROC curves were plotted to analyze the predictive value of Circ_0084927 and miR-1179 on the poor prognosis of CRC.Results The expression level of Circ_0084927 in CRC tissues was significantly higher than that in paracancerous tissues(P<0.05);the expression level of miR-1179 was significantly lower than that in paracancerous tissues(P<0.05).Circ_0084927 and miR-1179 were negatively correlated in CRC tissues(r=-0.783,P<0.05).Circ_0084927 and miR-1179 expression in CRC tissues was associated with clinical characteristics(TNM stage,degree of differentiation and lymph node metastasis)(P<0.05).Circ_0084927 and miR-1179 expression were correlated with clinical characteristics(TNM stage,differentiation degree,lymph node metastasis)(P<0.05).Survival rate of patients with high expression of Circ_0084927 was significantly lower than that of patients with low expression(χ2=12.986,P<0.05);survival rate of patients with high expression of miR-1179 was significantly higher than that of patients with low expression(χ2=11.858,P<0.05).Compared with the good prognosis group,Circ_0084927 expression level was significantly higher(P<0.05)and miR-1179 expression level was significantly lower(P<0.05)in the poor prognosis group.The results of multifactorial COX regression analysis showed that Circ_0084927(HR:3.512,95CI%:1.800-6.852),TNM staging(HR:2.147,95CI%:3.454,95CI%:1.353-8.815)were the risk factors affecting the prognosis of patients with CRC(P<0.05),and the expression level of miR-1179(HR:0.513,95CI%:0.293-0.899)was a protective factor(P<0.05).Circ_008492 and miR-1179 predicted the AUC of poor prognosis of CRC as 0.838 and 0.749,respectively;the combination of the two predicted the AUC of poor prognosis of CRC as 0.856,which was superior to the respective individual prediction(Z=2.635 and Z=2.627,both P<0.05).Conclusions Circ_0084927 expression level was increased and miR-1179 expression level was decreased in CRC tissues.Both were associated with patients'TNM stage,degree of differentiation,lymph node metastasis,and prognosis.In addition,the combined assay of Circ_0084927 and miR-1179 may have a predictive value for poor prognosis of CRC.

Abstract:Objective To investigate the influences of Glisson pedicle sheath external anatomical hepatectomy(AR)on the surgical parameters and liver function in patients with primary liver cancer(PLC).Methods The clinical data of 128 PLC patients who underwent laparoscopic selective hepatectomy via Glisson pedicle sheath in Qingdao Traditional Chinese Medicine Hospital from August 2019 to August 2022 were retrospectively analyzed.According to different methods of intraoperative hepatic blood flow blockade,they were divided into external anatomical group(n=61,external anatomical route operation was performed)and internal anatomical group(n=67,internal anatomy route was performed).SPSS 22.0 software was used to match patients with 1∶1 tendency score(PSM),and 48 patients in each group were finally included in this study.The operation indexes,liver function(total bilirubin,glutamic pyruvic transaminase,glutamic oxaloacetic transaminase)and postoperative complications were compared between the two groups.Results The operation time of external anatomy group(186.29±39.61)min was shorter than that of internal anatomy group(227.83±41.07)min(P<0.05),and the intraoperative blood loss(317.0±74.0)mL was less than that of internal anatomy group(351.2±78.4)mL(P<0.05);there were significant differences in the intersubject effect comparison of total bilirubin,glutamic pyruvic transaminase and glutamic oxaloacetic transaminase levels(P<0.05),significant differences in the main effect comparison between time points(P<0.05),and interaction between groups and time points(P<0.05).GPT,GOT and TBiL levels in two groups were higher than those before surgery 1 day and 1 week after surgery(P<0.05).However,the three liver function indexes of the external anatomy group were significantly lower than those of the internal anatomy group one day and one week after surgery(P<0.05);the incidence of postoperative complications in the external anatomy group was 4.17%,which was obviously lower than that in the internal anatomy group(18.75%,P<0.05).Conclusions The application of Glisson pedicle sheath external AR in PLC patients has the advantages of shorter operation time,less intraoperative blood loss,fewer postoperative complications,and faster recovery of liver function compared with the internal anatomical path.

Abstract:Gastric cancer is a highly prevalent malignant tumor worldwide,with nearly half of the global cases occurring in China,resulting in a significant epidemiological burden.Traditional diagnostic and therapeutic approaches face challenges such as late diagnosis,high tumor heterogeneity,and a lack of individualized treatment plans.Artificial Intelligence(AI)technology markedly enhances the efficacy of early lesion detection and the precision of pathological classification through the integration of multimodal data,including imaging features,pathomics,and clinical parameters.It supports the development of personalized treatment strategies and enables dynamic prognosis prediction.This technology is embedded within a comprehensive diagnostic and therapeutic system for gastric cancer,encompassing diagnosis,treatment,and prognosis follow-up,thereby establishing a novel pathway for precise gastric cancer management.However,the clinical translation of AI still encounters several challenges including insufficient data quality,limited model transferability,and low algorithm interpretability.In this paper,we review the application of AI in early screening,precision treatment,and prognosis prediction of gastric cancer and the current challenges,and propose innovative solutions.

Abstract:Objective To comprehensively evaluate the safety,feasibility,and efficacy of flupentixol and melitracen during the perioperative management of elderly patients with gastrointestinal malignancies.Methods In this randomized double-blind study,102 elderly patients with gastrointestinal malignant tumors undergoing surgical treatment were divided into two groups.Fifty-one patients in the study group were given oral or nasogastric feeding flupentixol and melitracen one tablet daily from 3 days before surgery to 1 week after surgery,and 51 patients in the control group were given oral or nasogastric feeding placebo.Hamilton anxiety scale(HAMA)was used to evaluate the anxiety status of patients on the 1st day before operation and 1st,3rd and 5th days after operation.The postoperative recovery was recorded and analyzed.The patients were followed up at 1 week,2 weeks and 1 month after surgery to record the nutritional prognosis index(PNI)and the symptoms related to adverse drug reactions.Results The recovery time of intestinal function and the time of first liquid intake in the study group were earlier than those in the control group(P<0.05).The time of getting out of bed within 5 days after surgery in the study group was significantly longer than that in the control group(P<0.001).The amount of postoperative abdominal drainage fluid in the study group was significantly less than that in the control group(P<0.001).On the 1st,4th,and 7th days after the operation,the C-reactive protein(CRP)in the peripheral blood of the study group was lower than that of the control group,but the difference was not statistically significant(P>0.05).The overall incidence of postoperative complications in the study group was significantly lower than those in the control group(P=0.007).The HAMA scores of the study group were lower than those of the control group on 1st day before surgery and 1st,3rd and 5th days after surgery(P<0.001).The serum prealbumin in the study group was higher than that in the control group on 4th and 7th days after operation(P<0.05).The PNI of the study group was significantly higher than that of the control group at 1 week,2 weeks and 1 month after operation(P<0.05).There was no significant difference in the incidence of adverse reactions of flupentixol and melitracen and placebo between the two groups at 1 week,2 weeks and 1 month after operation(P>0.05).Conclusions Perioperative flupentixol and melitracen is safe and effective in elderly patients with gastrointestinal cancer,which can effectively relieve anxiety/depression and promote postoperative recovery to a certain extent.

Abstract:Objective This study aims to explore the potential of CD4+and CD8+T lymphocyte apoptosis as biomarkers for predicting radiation-induced adverse effects in the breast following breast-conserving surgery(BCS)and subsequent simultaneous integrated boost hypofractionated radiotherapy(HFRT)for breast cancer.Methods Clinical data from 72 patients who underwent BCS followed by concurrent boost HFRT at Tangshan People's Hospital from July 2020 to September 2021 were collected.The severity of radiation-induced adverse effects in the breast was assessed according to common terminology criteria for adverse events.Fresh blood samples were collected,exposed to 8Gy X-ray irradiation,and analyzed using flow cytometry to evaluate CD4+and CD8+T lymphocyte apoptosis.Additionally,pre-and post-radiotherapy breast tissue samples were extracted for immunohistochemical analysis to assess CD4+and CD8+T cell infiltration.Cox regression was used to analyze the factors influencing the degree of adverse reactions.Spearman correlation analysis was used to evaluate the relationship between lymphocyte apoptosis and the severity of adverse effects.Receiver operating characteristic(ROC)curve analysis was employed to assess the predictive value of CD4+and CD8+T lymphocyte apoptosis for breast-related radiation adverse effects.The 2-year cumulative incidence rates of different lymphocyte apoptosis levels were compared,and multivariate regression analysis was used to adjust for potential confounding factors.Results A total of seventy two patients were followed up for at least 2 years.There were fifty one patients(70.8%)with grade≤1 and twenty one patients(29.2%)with grade≥2 breast related adverse reactions,respectively.The proportion of diabetes history and T2 stage in patients with≤grade 1 was higher than that in patients with≥grade 2,and the radiation induced lymphocyte apoptosis(RILA)level of CD8+T cell and CD4+T cell were higher than that in patients with≥grade 2,with statistical significance(P<0.05).Cox regression results showed that T stage(OR=11.143,95%CI:1.703-72.908),CD8+T cell RILA level(OR=0.273,95%CI:0.157-0.473)and CD4+T cell levels(OR=0.211,95%CI:0.103-0.431)were independent influencing factors for the degree of adverse reactions(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of CD8+T cell RILA to predict grade 2 breast related adverse radiation reactions was 0.947(95%CI:0.806-1.000),and the AUC of CD4+T cell RILA was 0.824(95%CI:0.654-1.000).,the difference was statistically significant(P<0.05).Conclusions CD8+T lymphocyte apoptosis,along with associated immune cell infiltration and gene expression changes,holds significant predictive value for radiation-induced adverse effects in the breast following BCS and SBRT for breast cancer.Integrating CD8+T cell apoptosis and immunohistochemical data can further enhance the predictive capability for radiotherapy-related risks and provide reference for personalized radiotherapy and prevention strategies.

Abstract:Objective To investigate the mechanism of long non-coding RNA(lncRNA)TTN-AS1 in regulating the biological behavior of osteosarcoma cells.Methods A total of fifty patients with osteosarcoma who were surgically treated in Cangzhou Central Hospital from February 2022 to October 2024 were collected,and the expression of TTN-AS1 in osteosarcoma and adjacent tissues was detected by qRT-PCR.Osteosarcoma Hos cells were divided into Vector group,TTN-AS1 group,TTN-AS1+miR-320a mimic group,and TTN-AS1+miR-320a mimic+CPEB1 group.143B cells were divided into Control group,sh-TTN-AS1 group,sh-TTN-AS1+miR-320a inhibitor group,and sh-TTN-AS1+miR-320a inhibitor+si-CPEB1 group.The expression level of TTN-AS1 in osteosarcoma cell lines was detected by qRT-PCR.The dual luciferase reporter gene experiment verified the targeting relationship between TTN-AS1 and miR-320a,as well as the targeting relationship between miR-320a and CPEB1.CCK8 assay and clone formation assay were used to detect cell proliferation ability,flow cytometry was used to detect cell apoptosis,and Transwell assay was used to detect cell migration and invasion ability.Results TTN-AS1 was highly expressed in both osteosarcoma tissues and cells(P<0.05).MiR-320a was the target gene of TTN-AS1,and CPEB1 was the target gene of miR-320a.Compared with the Vector group,the cell proliferation,migration and invasion abilities of Hos cells in the TTN-AS1 group were significantly increased(P<0.05),while the apoptosis rate was significantly decreased(P<0.05).Compared with the TTN-AS1 group,the cell proliferation,migration and invasion abilities of Hos cells in the TTN-AS1+miR-320a mimic group were significantly decreased(P<0.05),while the apoptosis rate was significantly increased(P<0.05).Compared with the TTN-AS1+miR-320a mimic group,the proliferation,migration and invasion abilities of Hos cells in the TTN-AS1+miR-320a mimic+CPEB1 group were significantly increased(P<0.05),while the apoptosis rate significantly decreased(P<0.001).Compared with the Control group,the cell proliferation,migration and invasion abilities of 143B cells in the sh-TTN-AS1 group were significantly decreased(P<0.05),while the apoptosis rate was significantly increased(P<0.001).Compared with the sh-TTN-AS1 group,the cell proliferation,migration and invasion abilities of 143B cells in the sh-TTN-AS1+miR-320a inhibitor group were significantly increased(P<0.05),while the apoptosis rate significantly decreased(P<0.001).Compared with the sh-TTN-AS1+miR-320a inhibitor group,the cell proliferation,migration,and invasion abilities of 143B cells in the sh-TTN-AS1+miR-320a inhibitor+si-CPEB group were significantly decreased(P<0.05),while the apoptosis rate significantly increased(P<0.001).Conclusions TTN-AS1 is up-regulated in osteosarcoma tissues and cells,and it affects the biological behavior of osteosarcoma cells by regulating the miR-320a/CPEB1 pathway.

Abstract:The 2025 Chinese Society of Clinical Oncology(CSCO)Guidelines for the Diagnosis and Treatment of Gastric Cancer have undergone crucial updates based on cutting-edge research and clinical practice experience.This article focuses on new targets and key points,comprehensively analyzing the changes in the guidelines.The emergence of new targets and the optimization of treatment strategies provide clinicians with more targeted treatment paths,which are expected to significantly improve the survival prognosis of gastric cancer patients and promote the diagnosis and treatment of gastric cancer into a new stage of precision and individualization.

Abstract:Objective To explore the predictive value of DCE-MRI radiomics features for sentinel lymph node(SLN)metastasis burden in invasive breast cancer.Methods From December 2022 to December 2024,186 breast cancer patients treated in our hospital were stratified and divided into a training set(n=130)and a validation set(n=56)in a 7∶3 ratio.Based on postoperative pathological lymph node metastasis status,the patients were further stratified into a high metastatic burden group(n=99)and a low metastatic burden group(n=87).Least Absolute Shrinkage and Selection Operator(LASSO)regression was employed to screen omics features.Multivariable Logistic analysis was conducted to investigate factors influencing sentinel lymph node metastasis,and a predictive model for sentinel lymph node metastasis was established to evaluate the predictive performance of each feature.Results Significant differences were observed between the high metastatic burden groupand the low metastatic burden group in terms of patient age,family history of cancer,and pathological type(P<0.05).DCE-MRI imaging data revealed statistically significant differences in the maximum tumor diameter,the proportion with lobulation,the proportion with irregular shapes,the proportion with unclear boundaries,the proportion with obvious background parenchymal enhancement,and the elastic strain rate in the high metastatic burden group(P<0.05).Multivariate analysis indicated that age,family history of cancer,pathological type,maximum tumor diameter,presence of lobulation,shape,boundary,background parenchymal enhancement,ADC value,elastic strain rate,DCE_wavelet-HH_glrim_ShortRunHighGrayLevelEmphasis,wavelet_glcm_wavelet-1lh-imc1,original_shape_leastaxislength,original_shape_majoraxislength,DCE_exponential_ngtdm_Complexity,and DCE_wavelet-LH_glcm_Clustershade were independent factors influencing sentinel lymph node metastasis.The predictive model established based on these factors had a sensitivity of 76.8%and a specificity of 83.6%on the Receiver Operating Characteristic(ROC)curve.The prediction model constructed based on influencing factors demonstrated an AUC of 0.853(95%CI:0.792-0.897)before internal validation and 0.867(95%CI:0.819-0.907)after validation,with sensitivities of 86.93%and 87.89%,and specificities of 91.05%and 93.82%,respectively.Conclusions DCE-MRI radiomics features have significant application value in predicting SLN metastasis burden in invasive breast cancer.This method can provide reference information for clinical diagnosis,subsequent treatment,and prognosis assessment.

Abstract:This article mainly explored the application of the"two wings flying together"model of Li Xinyu's surgical team in searching for avascular gaps in colon cancer surgery.The"two wings fly together"mode exerts symmetrical tension on organs and mesentery,forming an antagonistic tension with the main surgeon,thereby assisting the main surgeon in quickly identifying the target organ and its mesentery bed,mesentery fusion boundary,and entering the"Holy plane"without blood loss to complete the surgery under bloodless conditions.This model not only reduces tissue damage and postoperative complications,but also ensures tumor control effect and long-term treatment effectiveness.

Abstract:Objective To explore the ultrasound image findings and diagnostic value of ovarian Brenner's tumor.Methods The preoperative ultrasound findings of 35 patients with pathologically confirmed ovarian Brenner's tumor in Nanjing Maternal and Child Health Hospital from March 2014 to March 2024 were retrospectively analyzed,and compared with the pathological results.Results Among the pathological classifications,32 cases(91.43%)were benign,2 cases(5.71%)were borderline,and 1 case(2.86%)was malignant,Lesion characteristics:all were unilateral single lesions,23 cases(65.71%)on the left side of ovary and 12 cases(34.29%)on the right side of ovary.There were 13 cases(37.14%)of sacculated mass,4 cases(11.43%)of solid mass,6 cases(17.14%)of mixed cystic mass,and 12 cases(34.29%)of unconfirmed properties.Ultrasound image findings,echo type:there were 11 cases(31.43%)of anecho,20 cases(57.14%)of hypoecho,1 case(2.86%)of iso-hypoecho,2 cases(5.71%)of iso-echo,and 1 case(2.86%)iso-hyperecho.Blood flow distribution:32 cases(91.43%)with sparse blood flow signal,all of which were benign,and 3 cases(8.57%)had abundant blood flow.Conclusions Ultrasonography is of great value for the diagnosis of ovarian Brenner's tumor,and its characteristic manifestations include calcification,cystic-solid structure and blood flow distribution differences,benign blood flow is scarce,and borderline/malignant blood flow is abundant,which can provide a basis for pathological Nature identification.

Abstract:Malignancies are associated with metabolic reprogramming,with dysregulated protein metabolism being one of its key manifestations.This dysregulation is characterized by enhanced protein catabolism and suppressed anabolism,while tumor cells conversely exhibit enhanced protein synthesis.This imbalance leads to a state of negative nitrogen balance in the host.The underlying mechanisms involve the dysregulation of multiple signaling pathways,mediated both by the tumor microenvironment and the activation of systemic inflammatory response networks.This metabolic derangement not only drives cancer progression but also adversely impacts the efficacy of various anti-tumor therapies.Consequently,gaining an in-depth understanding of its mechanisms,achieving early identification,and implementing effective interventions have become crucial strategies for improving survival outcomes in patients with malignant tumors.

Abstract:Objective Albumin(ALB)is a sensitive and routinely measured immunonutritional marker in malignancies,and nutritional and inflammatory status in cancer patients are closely associated with prognosis.This study aimed to investigate the association between blood fatty acid levels and serum ALB levels in patients with advanced non-small cell lung cancer(NSCLC),thereby providing a theoretical basis for precision nutritional interventions using omega-3 polyunsaturated fatty acids in cancer management.Methods A cross-sectional study was conducted,enrolling 110 patients who visited the First Medical Center of the General Hospital of the People's Liberation Army between June 2025 and November 2025.Data on participants'baseline characteristics,clinical information,laboratory test results,and fasting blood fatty acid profiles were collected.Participants were divided into four groups according to quartiles of ALB levels,and intergroup differences in blood fatty acids and other variables were compared.Univariate linear regression analyses were performed between ALB and each of the aforementioned variables.Variables showing statistical significance in the univariate analyses were subsequently included in a multivariate linear regression model to assess their independent associations with ALB.Results Significant intergroup differences were observed in palmitic acid,margaric acid,heptadecenoic acid,stearic acid,docosahexaenoic acid,pentadecanoic acid,palmitoleic acid,α-linolenic acid,eicosapentaenoic acid(EPA),the ω-3 polyunsaturated fatty acids(PUFAs)index,the ω-6 PUFAs/ω-3 PUFAs ratio,the arachidonic acid(AA)/EPA ratio,ω-3 PUFAs,vitamins A and B6,β2-microglobulin,and transferrin.Univariate linear regression analyses revealed that γ-linolenic acid and EPA were positively associated with ALB levels in patients with advanced NSCLC,whereas stearic acid,eicosenoic acid,erucic acid,nervonic acid,and the AA/EPA ratio were negatively associated with ALB.Multivariate linear regression analysis further identified EPA and the AA/EPA ratio as independent factors associated with ALB levels in these patients:EPA showed a positive association(P=0.004),while the AA/EPA ratio exhibited a negative association(P＜0.001).Conclusions Blood EPA levels and the AA/EPA ratio were independently associated with serum ALB levels in patients with advanced NSCLC.Precision nutritional intervention through supplementation with EPA-containing compounds to elevate blood EPA levels may improve nutritional and inflammatory status,thereby potentially enhancing prognosis and prolonging survival in these patients.

Abstract:Objective To explore the clinical value of preoperative serum hsa_circ_0005397,alpha-fetoprotein(AFP)and carcinoembryonic antigen(CEA)in predicting the early recurrence after hepatocellular carcinoma(HCC)surgery.Methods A total of 125 patients who underwent laparoscopic radical resection of HCC in Rugao Hospital of Traditional Chinese Medicine from January 2020 to June 2023 were included.According to with or without recurrence in the early postoperative period(＜2 years),they were divided into the recurrence group and the non-recurrence group.The general information,tumor information,and preoperative serum-related indicators of the two groups were compared.Logistic regression was used to analyze the risk factors for early recurrence after HCC surgery.Based on this,a prediction model was constructed,and the predictive value of serum hsa_circ_0005397,AFP,and CEA levels for early recurrence was analyzed through the receiver operating characteristic(ROC)curve.Spearman correlation coefficient analysis was performed to explore the relationship between hsa-circ-005397 level and clinical pathological characteristios.Results The early postoperative recurrence rate of 125 HCC patients was 36%.The levels of hepatitis B virus(HBV)-DNA≥500 Iku/L,the tumor size≥5 cm,satellite nodules,BCLC stage B-C,microvascular invasion(MVI)rate,and preoperative serum hsa_circ_0005397,AFP and CEA levels in the recurrence group were significantly greater than those in the non-recurrence group(P＜0.05).Logistic regression analysis showed that the levels of MVI(OR=16.650),high serum hsa_circ_0005397(OR=68.856),AFP(OR=1.014),and CEA(OR=1.463)were independent risk factors affecting the early recurrence after HCC surgery(P＜0.05).The risk model of early recurrence after HCC surgery was constructed based on the independent influencing factors obtained from Logistic regression analysis(P)=-15.866+2.736×MVI+3.215×hsa_circ_0005397+0.011×AFP+0.408×CEA,and its area under the curve(AUC)for predicting early recurrence was 0.941.Hosmer-Lemeshow χ2=6.345,P＞0.05;Decision curve analysis showed that the threshold probability(red line)was distributed to the upper right of the None and All lines.The ROC curve showed that the AVC of preoperative serum hsa_circ_0005397,AFP,CEA and their combination for predicting early postoperative recurrence were 0.864,0.870,0.753 and 0.930,respectively.Preoperative serum hsa_circ_0005397 was positively correlated with tumor size,BCLC stage and MVI(all P＜0.001).Conclusions Preoperative serum hsa_circ_0005397,AFP and CEA all have certain predictive values for the early recurrence after HCC surgery.Especially the combined detection has a better predictive efficacy.Moreover,the risk prediction model constructed based on preoperative serum indicators and MVI has good discrimination,calibration ability and clinical practicability.

Abstract:Objective To investigate the expression of MICAL-L2 in WHO grade Ⅱ/Ⅲ glioma and its prognostic assessment value.Methods A total of 96 cases of surgically resected adult primary WHO gradeⅡ/Ⅲ glioma specimens from 2013 to 2019 at the Second People's Hospital of Liaocheng were collected,with 10 normal brain tissue specimens serving as controls.Immunohistochemistry(IHC)was employed to validate MICAL-L2 protein expression in WHO grade Ⅱ/Ⅲ glioma versus normal brain tissues.Associations between MICAL-L2 expression and clinicopathological parameters were analyzed.Prognostic differences in Kaplan-Meier curves were assessed using the Log-rank test.Univariate and multivariate Cox regression analyses were performed to identify potential risk factors.The prognostic value of MICAL-L2 in grade Ⅱ/Ⅲ glioma patients was evaluated by receiver operating characteristic(ROC)Area under the curve(AUG).Results MICAL-L2 protein expression was significantly elevated in 96 adult WHO grade Ⅱ/Ⅲ glioma tissues versus normal brain tissues(P＜0.05).Elevated MICAL-L2 expression correlated significantly with the age of patients,the level of tumor pathology,and the high expression of Ki-67(P＜0.01).The Kaplan-Meier survival curve indicated that the overall survival of patients with high expression of MICAL-L2 was lower than that of patients with low expression(P＜0.001).Multivariate Cox regression model analysis revealed that age greater than 46.5 years,WHO grade Ⅲ glioma and high MICAL-L2 expression were independent risk factors for patient prognosis(P＜0.05).The ROC curve demonstrated that MICAL-L2 achieved an area under the curve(AUC)of 0.837 in predicting the 5-year overall survival of WHO grade Ⅱ/Ⅲ glioma patients,indicating good prognostic predictive capability.Conclusions MICAL-L2 demonstrates elevated expression in WHO grade Ⅱ/Ⅲ glioma and exhibits a significant association with patient prognosis.It may serve as a novel biomarker for risk stratification in WHO grade Ⅱ/Ⅲ glioma and lays the theoretical foundation for developing new molecular therapeutic targets.