Objective To summarize the clinical characteristics and analyze prognostic factors of neuroblastoma (NB) in infants (≤12 months) at a single center. Methods A retrospective analysis was conducted on the clinical data of infant patients (≤12 months) diagnosed with NB and treated between January 2014 and December 2022. Clinical features were analyzed, and comparisons between two sample rates were performed using the χ² test. Univariate prognostic analysis was conducted using the log-rank test, and survival outcomes were analyzed using the Kaplan-Meier method. Results A total of 42 infants (≤12 months) with NB were enrolled. Low-risk patients underwent surgical resection alone; intermediate-risk patients received surgery combined with chemotherapy with or without maintenance therapy; high-risk patients were treated with surgery and chemotherapy with or without maintenance therapy or radiotherapy. The 5-year event-free survival (EFS) rate was (92.7±4.9)%, and the 5-year overall survival rate was (95.2±3.6)%. Only two patients died because of tumor recurrence or progression. Univariate analysis identified MYCN amplification and the initial lactate dehydrogenase (LDH) level ≥ five times the upper limit of the normal were significantly associated with poor prognosis (5-year EFS: 33.3% vs. 97.4% and 60.0% vs. 97.3%, P<0.0001 and P=0.0035). Conclusion Infant NB has a favorable overall prognosis. MYCN amplification and markedly elevated initial LDH are associated with poor outcomes.

Objectives: This study evaluates the efficacy of a new temporomandibular joint (TMJ) capsule suspension technique for stabilizing the TMJ after free fibular flap reconstruction of the mandibular condyle. Patients and Methods: Patients undergoing the TMJ capsule suspension technique during free fibular flap reconstruction after mandibulectomy with condylectomy (study group; n=9) were compared with a control group (n=9). Mandibular movement trajectory and surface electromyographic signals of bilateral masseters were recorded. The neocondyle–disc relationship was examined with magnetic resonance imaging (MRI) at 6 months after surgery. Results: Maximal mouth opening and bilateral marginal movement distances were comparable between the two groups (P>0.05). The asymmetry index of the condyle path length was significantly higher in controls (P=0.02). Bilateral mouth opening trajectories were symmetric in 7 patients and deviated to the affected side in 2 patients in the study group; they deviated to the affected side in all controls. The mean electromyographic values of the masseter on the affected side in resting, maximum bite, and chewing states were comparable between the two groups (P=0.13, P=0.65, and P=0.82, respectively). On MRI at 6 months, the thicknesses of the anterior, medial, and posterior bands and TMJ disc length were similar on the affected and normal sides in the study group (P=0.57, P=0.13, P=0.48, and P=0.87, respectively). Conclusion The proposed TMJ capsule suspension technique could improve postoperative TMJ structure and function after fibular free flap reconstruction following mandibulectomy with condylectomy.

Objective To propose a dynamic electrical impedance tomography imaging algorithm based on complementary information fusion network(CIFN)to enhance image quality of dynamic electrical impedance imaging.Methods There were three modules for initialization,multi-frame complementary information extraction and information fusion involved in the CIFN.Firstly,multi-frame dynamic conductivity distribution images were obtained by the initialization module;secondly,spatial complementary information was extracted from the images by using the multi-frame complementary information extraction module;finally,the fusion of lesion target distribution information and target re-reconstruction were realized by the information fusion module to aquire high-quality EIT images.With a 16-electrode multilayer cranial simulation model,the CIFN-based imaging method was compared with Tikhonov regularization algorithm,spectral constraint algorithm and U-Net algorithm in terms of imaging results of types of lesions to verify its performance.Results Compared with the Tikhonov regularization algorithm,spectral constraint algorithm and U-Net algorithm,the proposed CIFN-based algorithm exhibited the lowest mean absolute error(MAE)and the highest structural similarity(SSIM)when used to image different lesion targets,which accurately reconstructed the distribution of lesion targets and gained high imaging stability under common noise levels.Conclusion The proposed CIFN-based imaging algorithm obtains high imaging quality on a cranial simulation model and reconstruction results close to the real model distribution,which provides algorithmic support for subsequent clinical studies on electrical impedance imaging.[Chinese Medical Equipment Journal,2025,46(6):1-6]

Objective:To explore the effect of circ_0101145 on immune escape of gastric cancer(GC)cells through miR-548c-3p/programmed death-ligand 1(PD-L1)axis.Methods:RT-qPCR and Western blot were used to detect circ_0101145,miR-548c-3p,PD-L1 mRNA and protein levels in GC tissue and cell lines,the relationship between circ_0101145 level and clinical patho-logical parameters of patients was analyzed;dual Luciferase experiment was used to verify the regulatory relationship of circ_0101145 on miR-548c-3p,miR-548c-3p on PD-L1;liposome transfection method was used to structure BGC-823 transfected cell line,divided into circ-NC group,circ_0101145 group,si-circ-NC group,si-circ_0101145 group,circ_0101145+NC group,circ_0101145+miR-548c-3p group,miR-548c-3p+NC group,miR-548c-3p+PD-L1 group.CD8+T cells were separated from human peripheral blood and cocultivate with BGC-823 cell;flow cytometry was used to detect CD8+T cells apoptosis rate;ELISA was used to detect TNF-α,IFN-γ levels in coculture medium;CCK-8,EdU staining,Transwell assay were used to detect cell proliferation,invasion ability.Nude mice was subcutaneous inject with BGC-823 cell suspension of knockdown circ_0101145,after 30 days,growth of transplanted tumors were measured.Results:Compared with adjacent cancer tissues or normal cells,miR-548c-3p level in GC tissues and cell lines were de-creased,while circ_0101145,PD-L1 mRNA and protein levels were increased,and the higher circ_0101145 level,the higher TNM stage,the lower degree of tumor differentiation,the easier microvascular infiltration,and the easier lymph node metastasis(P<0.05);circ_0101145 targeted miR-548c-3p,miR-548c-3p targeted PD-L1.In the cocultivation system,overexpression of circ_0101145 could increase CD8+T cells apoptosis rate,and TNF-α,IFN-γ levels in coculture supernatant were reduced,the A value after 1 day,2 days and 3 days,EdU positive rate and the number of invasive cell were increased(P<0.05).Knock down of circ_0101145 could de-crease the apoptosis rate of CD8+T cells,and TNF-α,IFN-γ levels in coculture supernatant were increased;the A value after 1 day,2 days and 3 days,EdU positive rate and the number of invasive cell were decreased(P<0.05).Overexpression of miR-548c-3p could partially reverse the effect of overexpression of circ_0101145 on the above indicators(P<0.05).Overexpression of PD-L1 could partially reverse the effect of overexpression of miR-548c-3p on the above indicators(P<0.05).Knock down of circ_0101145 could inhibit the growth of transplanted tumors in mice(P<0.05).Conclusion:circ_0101145 promotes immune escape of GC cells through miR-548c-3p/PD-1 axis.

Objective:To investigate the serum metabonomics of pancreatic cancer and chronic pancreatitis patients and screen the differential metabolites for differentiating pancreatic cancer from chronic pancreatis.Methods:From June 2021 to June 2022, the clinical data of 54 patients diagnosed with pancreatic ductal adenocarcinoma in the Department of Hepatobiliary, Pancreatic and Splenic Surgery of the First Affiliated Hospital of Naval Medical University were collected. A total of 54 patients with chronic pancreatitis who were admitted at the same time were selected as the control group. UHPLC/Q-TOF MS-based metabonomics techniques were applied to analyze the difference in serum metabolites in the two groups with multivariate and univariate statistical method, and the different metabolites were screened and identified in accordance with the molecular weight, metabolites databases and mass spectrometry (MS)/MS information. Two-thirds of the cases were randomly selected from patients with pancreatic cancer and chronic pancreatitis as the modeling population, and the remaining population was used as the validation population. In the modeled population, the receiver operating characteristic curve (ROC) of the screened differential metabolites was plotted and the area under the curve (AUC) was calculated. Differential metabolite variables with AUC ≥75%, a VIP value ≥1.5 were selected into the logistic multivariate regression analysis model, and the regression equation and the regression coefficients of each selected independent variable were obtained by stepwise regression by backward method. The final selected differential metabolites were evaluated by the formula P=1/{1+Exp[-(β0+β1X1+β1X1+…+βiXi)]} to establish a diagnostic model and predict the clinical application value of the model by evaluating it compared to the CA19-9 ROC curve. At the same time, the non-parametric Bootstrap method was used to verify the diagnostic performance of the model in the validation population. Results:There were 18 kinds of different serum metabolits in the final screening and identification in the two groups. The level of hypoxanthine, L-carnitine, acetylcarnitine, C16 sphinganine, linoleic acid, palmitoylcarnitine, linoleyl carnitine, uracil deoxynucleotide, glycocholic chenodeoxycholic acid in serum of pancreatic cancer patients were higher than that in the chronic pancreatitis patients; Uric acid, tryptophan, indoxylsulfuric acid, 1-palmitoyl lysophosphatidic acid, LPA(18∶2/0∶0), LysoPE (18∶1/0∶0), LysoPC (14∶0), LysoPC(15∶0), LysoPC(16∶1) in the serum were lower in patients with pancreatic cancer compared with that in chronic pancreatitis patients, and all the differences were statistically significant (all P value <0.05). In the modeled population, the ROC curve was established according to the peak intensity of 18 differential metabolites, and the metabolic differentiators with AUC of ≥75% and VIP value of ≥1.5 were selected for logistic multivariate analysis, and finally linoleoleic carnitine and LPA (18∶2/0∶0) were included in the logistic regression model. The prediction model of pancreatic cancer with two serum metabolites linoleyl carnitine and LPA (18∶2/0∶0) was established. The AUC value (95% CI) of the prediction model was 0.91 (0.85-0.97), which was higher than that of CA19-9 (0.85, 0.76-0.94), the sensitivity and specificity were 86.4% and 80.6%, respectively, and the sensitivity was higher than that of CA19-9 (77.3%), but the specificity was lower than that of CA19-9 (91.7%). Internal validation showed than the AUC value (95% CI) of the prediction model was 0.91 (0.79-0.94), which was higher than that of CA19-9 ( P<0.05). Conclusions:The serum metabolites linolein carnitine and LPA(18∶2/0∶0) may be potential diagnostic markers to distinguish pancreatic cancer from patients with chronic pancreatitis.

In this study,we aim to evaluate the immunogenicity of the whole-cell proteins isolated from Mycobacterium marinum(MM).The findings of this research may provide scientific basis for the development of new candidate tuberculosis vaccines.Both MM 95014 and Mycobacteriumtuberculosis(MTB)H37Rv cells were routinely cultured and collected.After inactivation,whole-cell proteins were extracted by low-temperature ultrasonic fragmentation and mixed with DDA/Poly:IC adjuvant.The mixture was administered to BALB/c mice subcutaneously with 50 mg/mouse twice with an interval of 10 days.Blood sample was collected before each immunization,as well as 10 days after the last immunization.Blood samples and spleen tissue extracts were measured for serum antibody potency and cytokine levels by an enzyme-linked immunosorbent assay.An in vitro growth inhibition assay(MGIA)was used to assess the ability of mouse bone marrow-derived macrophages,collected after immunization with MM whole-cell proteins,to inhibit MTB growth.A MTB whole mycobacterium proteome microarray was applied to analyze the interaction between the serum in MM immunization group and MTB proteins.Our results indicated that,compared with the adjuvant group,MM whole-cell proteins induced higher levels of Th1 cytokines(IL-2,IFN-γ,IL-12,TNF-α)in the mice.The IgG and IgM antibody titers induced by MM immunization group reached 1∶608 874 and 1∶304 437,respectively.The MGIA results showed that the MM immunization group was able to significantly inhibit MTB growth in vitro.The MTB proteome microarray results indicated that there were 226 and 324 cross-proteins with IgG and IgM antibodies,respectively.This study suggested that MM whole-cell proteins can induce high levels of cellular and humoral immune responses in mice and exhibit strong inhibition of MTB growth in vitro.The results may suggest potential application value of MM whole-cell proteins as a novel candidate vaccine for tuberculosis.

Objective To evaluate the feasibility and effectiveness of 3D digital holographic imaging combined with intraoperative navigation technology in the context of partial nephrectomy.Methods A total of 46 patients who underwent laparoscopic partial nephrectomy in the Department of Urology at the Second People's Hospital of Hefei City between June 2023 and January 2025 were randomly assigned to either the experimental group or the control group.The experimental group(n=23)utilized preoperative planning and intraoperative real-time navigation based on 3D digital holographic imaging,whereas the control group(n=23)relied on preoperative planning using optimized two-dimensional images obtained via contrast-enhanced CT and MRI scans.Preoperative data—including gender,age,body mass index(BMI),tumor diameter,and RENAL score—were collected.Intra-operative parameters such as total operative time,warm ischemia time,intraoperative blood loss,hemoglobin levels,postoperative hospitalization duration,and time to drain removal were recorded.Renal function changes were assessed by comparing serum creatinine levels and estimated glomerular filtration rates(eGFR)before surgery and one month post-surgery.Additionally,the incidence of intraoperative complications—particularly injury to the renal collecting system—and postoperative complications—including positive surgical margins,bleeding,subcutaneous emphysema,and urinary fistula—was analyzed.Results In this study,holographic images were successfully reconstructed for 23 patients with renal tumors in the experimental group.Each anatomical structure—including the kidney and tumor lesions,collecting system,renal arteries and veins,adrenal glands,and inferior vena cava—was color-coded to enable intuitive visualization.These images were used for preoperative planning and provided real-time spatial orientation to accurately locate and guide resection of the tumor during surgery.In the control group,23 patients underwent preoperative planning based on contrast-enhanced CT and MRI scans acquired using optimized parameters.All 46 patients underwent laparoscopic partial nephrectomy performed by the same qualified surgeon,and postoperative pathological analysis confirmed renal tumors,including 27 cases of clear cell carcinoma,7 cases of chromophobe cell carcinoma,5 cases of papillary cell carcinoma,2 cases of sarcomatoid carcinoma,and 5 cases of angiomyolipoma.No significant differences were observed in baseline clinical characteristics(including age,body mass index,tumor diameter,and RENAL score)between the two groups(P＞0.05).The experimental group showed significantly lower values in total operative time,warm ischemia time,intraoperative blood loss,pre-to postoperative hemoglobin changes,and pre-surgical to one-month post-surgical creatinine changes compared to the control group(P＜0.01).Additionally,the experimental group exhibited smaller changes in hospitalization duration,time to drain removal,and glomerular filtration rate from preoperative to one month post-surgery;however,these differences were not statistically significant(P=0.175,P=0.331,and P=0.273).There were no intraop-erative complications or damage to the collecting system in either the experimental or control groups.Postopera-tively,the control group experienced one case of positive surgical margin,one case of hemorrhage,and one case of subcutaneous emphysema.No statistically significant differences were observed between the groups(P＞0.05).Conclusions 3D digital holographic imaging combined with intraoperative navigation technology,based on the fusion of MRI and CT data,facilitates preoperative planning and precise intraoperative guidance.This approach helps reduce operative time,preserve renal function,and lower perioperative risks while ensuring therapeutic efficacy.

Objective:To explore the trajectory and influencing factors of oral frailty in first-onset elderly patients with ischemic stroke.Methods:A total of 240 inpatients from the neurology departments of Wutaishan Hospital and Northern Jiangsu People's Hospital between October 2022 and February 2024 were selected by convenience sampling. Oral frailty scores were assessed dynamically at four time points: 1 day before discharge (T 1) , 1 month after discharge (T 2) , 3 months after discharge (T 3) , and 6 months after discharge (T 4) . Latent growth modeling was used to identify potential trajectory categories and analyze their influencing factors. Results:A total of 240 questionnaires were distributed, with 220 valid responses, yielding a response rate of 91.67%. A total of three trajectory types of oral frailty were identified: non-oral frailty group ( n=92) , low-decline group ( n=66) , and high-decline group ( n=62) . Age, marital status, smoking history, dysphagia, National Institute of Health Stroke Scale score, oral health, nutritional status, oral health-related self-efficacy, monthly per capita household income, polypharmacy, denture use, and cognitive function were influencing factors of oral frailty in first-onset elderly patients with ischemic stroke ( P<0.05) . Conclusions:From 1 day before discharge to 6 months after discharge, there are 3 distinct oral frailty trajectories in first-onset elderly patients with ischemic stroke. Medical staff should implement individualized interventions based on the identified influencing factors.

Objective:To investigate the clinical manifestations, histological features, immunophenotype, molecular characteristics, and treatments of uterine inflammatory myofibroblastic tumor (UIMT).Methods:Clinical and pathological data of 4 UIMT cases diagnosed at the Peking Union Medical College Hospital, Beijing, China from 2020 to 2024 were collected. Their clinicopathological and genetic characteristics were analyzed.Results:The patients′ ages were 63, 42, 53 and 37 years, respectively. The tumors were located in the submucosa and intermuscular walls of the uterus, with a diameter ranging from 1.5 to 6.0 cm. All tumors were suspected by the clinician as leiomyosarcoma. Histologically, 3 of the 4 tumors showed spindle cells that appeared like leiomyoma. Prominent myxoid stroma and inflammatory cells infiltration were observed, with mitotic figures of 1-2 per 10 high-power fields. One case was primarily composed of spindle cells arranged in fascicles, with inflammatory cell infiltration, inconspicuous myxoid stroma and mitotic figures of 3 per 10 high-power fields. Two cases exhibited a pushing pattern of invasion and slightly unclear boundaries, while the other two showed infiltrative growth with unclear boundaries. The immunohistochemistry revealed diffuse and strong, cytoplasmic granular staining of ALK in all 4 cases. RNA sequencing was performed in 3 cases, of which 2 cases showed ALK gene rearrangements, and 1 case did not. One case underwent FISH testing and showed ALK gene translocation. Follow-up showed that no recurrence or metastasis was observed after surgery in all patients.Conclusions:UIMT is a rare mesenchymal tumor of the uterus and lacks specific clinical manifestations. When tumor cells exhibit mild atypia, indistinct borders, myxoid stroma, inflammatory cell infiltration, and decreased expression of ER and PR on immunohistochemistry, immunohistochemical staining of ALK is recommended to confirm the diagnosis of UIMT. This tumor shares many features with myogenic tumors and endometrial stromal sarcomas. Molecular testing may also be needed to assist in diagnosis when necessary. For patients who are not suitable for surgery or have recurrence and metastasis, targeted therapy with ALK inhibitors can be used.

Metastatic Crohn's disease (MCD) represents one of the rare cutaneous extraintestinal manifestations in patients with Crohn's disease. The genital area, particularly the vulva in females, is the most commonly affected site in MCD. However, clinical cases of metastatic vulval Crohn's disease (MVCD) are relatively scarce, and the symptoms often lack specificity, making differential diagnosis challenging. This article aims to summarize the clinical characteristics, diagnostic approaches, and treatment modalities of MVCD, thereby providing a reference for the clinical management of this condition.