[Objective] To investigate the clinical features and treatment of renal cell carcinoma unclassified with medullary phenotype (RCCU-MP), so as to improve the clinical understanding of this disease. [Methods] The clinical data of 2 patients with pathological diagnosis of renal medullary carcinoma (RMC) in Zhujiang Hospital during 2019 and 2023 were retrospectively analyzed, and relevant literature was reviewed. [Results] Both patients had symptoms of backache, and imaging examination indicated renal space-occupying lesions.Case 1 was diagnosed as RMC by renal biopsy, and case 2 was pathologically diagnosed as RMC after surgery.Both cases lacked evidence of sickle cell trait or sickle cell disease, and were finally diagnosed as RCCU-MP.Case 1 did not receive antineoplastic therapy and died 5 months after diagnosis.Case 2 underwent laparoscopic nephrectomy, and then received gemcitabine + paclitaxel chemotherapy + immunotherapy.The patient's tumor progressed gradually after first-line treatment was abandoned due to concurrent hematologic infection, and he eventually died 7 months after surgery. [Conclusion] The clinical features of RCCU-MP are partially similar to those of RMC.The diagnosis of RCCU-MP requires pathological examinations and should exclude sickle cell trait or sickle cell disease.Due to the aggressive nature of the tumor, the prognosis of patients is poor.

Objective:This study uses two markers of resting-state functional MRI (r-fMRI) to investigate changes in spontaneous neural activity and their correlation with postpartum depression (PPD) severity.Methods:A total of 15 individuals with PPD, who met the diagnostic criteria for DSM-5 unipolar depression, 24-Item Hamilton Depression Scale (HAMD 24) scores greater than 20, Edinburgh Postnatal Depression Scale (EPDS) score≥12, and 16 postpartum healthy mothers (control group) matched with age and education were examined using r-fMRI. Two-sample t-test was used to compare the amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) values between groups. Pearson correlation analysis was used to determine the correlation between the ALFF and ReHo of the abnormal brain region and the HAMD 24 and EPDS scores. Results:Compared with the healthy control (HC), PPD showed increased ALFF in the right cerebellum anterior lobe culmen and the left dorsolateral prefrontal cortex (DLPFC), and decreased ALFF in the right parietal lobe (individual voxel P<0.005, cluster size >10 voxels, Alphasim correction). PPD had increased ReHo values in the left superior?frontal?gyrus,?orbital?part, inferior?frontal?gyrus,?orbital?part, middle?frontal?gyrus, precuneus, inferior?parietal lobule than HC. Decreased ReHo values were found in the right inferior?occipital?gyrus, inferior?frontal?gyrus, frontal lobule and left cerebellum inferior semi-lunar lobule (individual voxel P<0.005, cluster size>10 voxels, Alphasim correction). The ALFF value of the left DLPFC was positively correlated with the HAMD 24 score in PPD ( r=0.585, P=0.022). Age, body mass index and education years of each subject was included as covariates, partial correlation coefficient was still statistically significant ( r = 0.561, P = 0.046). Conclusion:This r-fMRI study suggested that changes in the spontaneous neural activity of these regions were related to emotional responses. PPD cases with high ALFF values in the left DLPFC had severe depression.

Objective:This study uses two markers of resting-state functional MRI (r-fMRI) to investigate changes in spontaneous neural activity and their correlation with postpartum depression (PPD) severity.Methods:A total of 15 individuals with PPD, who met the diagnostic criteria for DSM-5 unipolar depression, 24-Item Hamilton Depression Scale (HAMD 24) scores greater than 20, Edinburgh Postnatal Depression Scale (EPDS) score≥12, and 16 postpartum healthy mothers (control group) matched with age and education were examined using r-fMRI. Two-sample t-test was used to compare the amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) values between groups. Pearson correlation analysis was used to determine the correlation between the ALFF and ReHo of the abnormal brain region and the HAMD 24 and EPDS scores. Results:Compared with the healthy control (HC), PPD showed increased ALFF in the right cerebellum anterior lobe culmen and the left dorsolateral prefrontal cortex (DLPFC), and decreased ALFF in the right parietal lobe (individual voxel P<0.005, cluster size >10 voxels, Alphasim correction). PPD had increased ReHo values in the left superior?frontal?gyrus,?orbital?part, inferior?frontal?gyrus,?orbital?part, middle?frontal?gyrus, precuneus, inferior?parietal lobule than HC. Decreased ReHo values were found in the right inferior?occipital?gyrus, inferior?frontal?gyrus, frontal lobule and left cerebellum inferior semi-lunar lobule (individual voxel P<0.005, cluster size>10 voxels, Alphasim correction). The ALFF value of the left DLPFC was positively correlated with the HAMD 24 score in PPD ( r=0.585, P=0.022). Age, body mass index and education years of each subject was included as covariates, partial correlation coefficient was still statistically significant ( r = 0.561, P = 0.046). Conclusion:This r-fMRI study suggested that changes in the spontaneous neural activity of these regions were related to emotional responses. PPD cases with high ALFF values in the left DLPFC had severe depression.

Objective:To explore clinical significance of sinus heart rate turbulence (HRT) phenomenon in aged pa‐tients with stable angina pectoris (SAP) .Methods :A total of 120 aged SAP patients ,who received 24h DCG in our hospital from Jan 2013 to Oct 2015 ,were selected as SAP group .Meanwhile ,another 144 aged patients ,who re‐ceived 24h DCG examination simultaneously and coronary angiography results were normal ,were regarded as nor‐mal control group .According to coronary lesion severity ,SAP group was further divided into single vessel coronary disease group (single vessel group ,n=35) ,double‐vessel coronary disease group (double‐vessel group ,n=48) and multi‐vessel coronary disease group (multi‐vessel group ,n=37) .The 24h DCG ,HRT indexes ,including turbulence onset (TO) and turbulence slope (TS) ,were measured and compared among all groups .Results:Compared with normal control group ,there was significant rise in TO [(0.77 ± 0.37)% vs .(1.26 ± 0.92)% ] and significant reduc‐tion in TS [(5.45 ± 4.02) ms/RR interval vs .(1.53 ± 0.70) ms/RR interval] ,P<0.01 both ;significant rise in ab‐normal rates of TO (19.44% vs .42.50% ) ,TS (15.97% vs .31.67% ) and TO + TS (11.11% vs .30.83% ) in SAP group ,P<0.01 all .Compared with single vessel group ,there was significant rise in TO [(0.66 ± 0.22)% vs .(1.28 ± 1.11)% vs .(1.46 ± 1.20)% ] and significant reduction in TS [ (2.04 ± 0.82) ms/RR interval vs .(1.66 ± 0.38) ms/RR interval vs .(1.29 ± 0.58) ms/RR interval] in double‐vessel group and multi‐vessel group ,and TO of multi‐vessel group was significantly higher than that of double‐vessel group ,TS of multi‐vessel group was significantly low‐er than that of double‐vessel group , P<0.01 all .Conclusion:Sinus heart rate turbulence can be used as risk predic‐tor for aged patients with stable angina pectoris ,which can provide basis for clinical effective treatment and progno‐sis assessment .

Objective Using CT three-dimensional image technique to observe the pulmonary vein stenosis of circumferential pulmonary vein ablation (CPVA) for atrial ifbrillation (AF) on the structure of pulmonary vein before and after radiofrequency ablation. Methods 28 patients with AF who underwent CPVA were followed-up for a mean (6.5±3.9) months.The results of Pulmonary vein morphology study was compared with analysis of preablation, after following up radiofrequency catheter alation (6.5±3.9) months. Pulmonary vein diameters, cross-sectional area and left atrial volume were measured before and after CPVA using 64-slice multidector computed tomography (CT). Results Mild stenosis of pulmonary vein maximum diameter and pulmonary minimum diameter were 61.6%and 56.3%after CPVA. Moderate stenosis of pulmonary vein maximum diameter and pulmonary minimum diameter were 3.6%and 5.4%. All patients does not present symptoms of pulmonary vein stenosis at rest on during excercise during follow up. Conclusions Mild and moderate asymptomatic pulmonary vein stenosis may present in some patients after CPVA.