We report a case of adult-onset Still's disease(AOSD)presenting with fever,myalgia,and pleural effusion.The patient exhibited significantly elevated inflammatory markers and exudative pleural effusion with markedly elevated leukocyte count showing neutrophilic predominance.After comprehensive exclusion of infectious etiologies,the diagnosis of AOSD was established.Clinical symptoms resolved following anti-inflam-matory therapy with glucocorticoids and tocilizumab.This case highlights a critical clinical insight:while infec-tion is a common cause of elevated inflammatory markers,it is not an invariable etiology.In such presentations,meticulous clinical observation,thorough diagnostic screening,and systematic inference are es-sential for accurate diagnosis.

The preferred treatment for adrenal functional tumors is laparoscopic surgical resection. However, in recent years, various ablation techniques have gradually been applied in the treatment of adrenal tumors. This report presents the successful diagnosis and treatment experience of 4 aldosterone-producing adenomas and 1 cortisol-secreting adenoma treated with a combined cold and hot ablation system at Xi’an Daxing Hospital from Dec. 2023 to Dec. 2024, providing a new treatment approach for clinical exploration.

Objective:To explore the application effect of phased target teaching combined with case teaching method in neurosurgery intern nurses.Methods:A convenient sampling method was used to select 96 intern nurses in the neurosurgery department of Shandong Provincial Hospital Affiliated to Shandong First Medical University from January 2022 to December 2023. The participants were divided into a control group and an observation group. The control group received conventional teaching, while the observation group was given phased target teaching combined with case teaching method based on the control group's curriculum. The clinical work ability, critical thinking ability, teaching performance, teaching satisfaction and cooperation of the intern nurses in both groups were compared.Results:After the intervention, the observation group scored higher in clinical work ability, critical thinking ability, teaching satisfaction and cooperation, teaching performance compared to the control group ( P<0.05) . Conclusions:The application of phased target teaching combined with case teaching method for neurosurgery intern nurses can improve their clinical work ability, critical thinking ability, academic performance, teaching satisfaction and cooperation. This method is worth recommending.

Pediatric T-cell acute lymphoblastic leukemia (T-ALL) has been attracted much attention due to its high aggressiveness and complexity of treatment. Recently, with the development of technology and clinical research, the curative effect of T-ALL in children has been significantly improved. However, the presence of minimal residual disease (MRD) is still a key factor affecting the outcomes of children with T-ALL. With the continuous development of detection methods, the clinical applications of real-time quantitative PCR, multi-parameter flow cytometry, and high-throughput sequencing technology, MRD can be detected accurately to achieve personalized and precise treatment for each patient. The purpose of this article is to review the current detection methods of MRD in T-ALL, the clinical significance of MRD monitoring and evaluation in multi-agent combined chemotherapy and hematopoietic stem cell transplantation, and applying MRD to measure the responsiveness and effectiveness of new therapies in recent T-ALLs. Research directions and potential treatment strategies in the near future were also proposed.

Pediatric T-cell acute lymphoblastic leukemia (T-ALL) has been attracted much attention due to its high aggressiveness and complexity of treatment. Recently, with the development of technology and clinical research, the curative effect of T-ALL in children has been significantly improved. However, the presence of minimal residual disease (MRD) is still a key factor affecting the outcomes of children with T-ALL. With the continuous development of detection methods, the clinical applications of real-time quantitative PCR, multi-parameter flow cytometry, and high-throughput sequencing technology, MRD can be detected accurately to achieve personalized and precise treatment for each patient. The purpose of this article is to review the current detection methods of MRD in T-ALL, the clinical significance of MRD monitoring and evaluation in multi-agent combined chemotherapy and hematopoietic stem cell transplantation, and applying MRD to measure the responsiveness and effectiveness of new therapies in recent T-ALLs. Research directions and potential treatment strategies in the near future were also proposed.

Programmed cell death plays an important role in the growth and development of organ-ism and homeostasis of tissues and organs.Necroptosis,a new mode of programmed cell death,characterized by necrosis in morphology,can cause cell breakdown and release of a significant num-ber of damage-associated molecular patterns,which play an important role in the occurrence and development of diseases.Viral infection is a serious health risk to both humans and domestic ani-mals.Research has confirmed that necroptosis functions as a cell death pathway in viral infections.In this paper,we review the current research advances on necroptosis related to viral infections,e-lucidate the molecular mechanism of mutual regulation between viral infection and necroptosis,and discuss the progress in the application of necroptosis inhibitors,to provide new ideas for the pre-vention and treatment of viral infections.

Objective To analyze the relationship of capillary index score(CIS)with postoperative outcome in the patients with middle cerebral artery(MCA)M1 segment stenosis after endovascu-lar stent implantation.Methods A total of 122 eligible patients in our hospital from April 2021 to April 2023 were retrospectively recruited,and according to postoperative status,they were classi-fied into a good prognosis group(89 cases)and a poor prognosis group(33 cases).The clinical data were collected,and the preoperative and postoperative CIS values were evaluated.Spearman correlation analysis was applied to analyze the correlation of CIS with prognosis of the patients.ROC curve was plotted to evaluate the value of CIS in predicting postoperative prognosis,and multivariate logistic regression analysis was utilized to analyze the factors affecting the postopera-tive prognosis.Results The poor prognosis group exhibited significantly lower CIS,and larger proportions of aged ≥75 years,diabetes and history of stroke than the good prognosis group(P＜0.05,P＜0.01).Spearman correlation analysis found that CIS was positively correlated with prog-nosis after endovascular stent implantation in the patients with MCA M1 segment stenosis(r=0.446,P=0.000).ROC curve analysis revealed that the AUC,cut-off value,sensitivity and speci-ficity of CIS in predicting the postoperative outcomes in these patients was 0.790(95％CI:0.706-0.858),2.17,84.85％and 66.29％,respectively(P＜0.05).Multivariate logistic analysis suggested that age ≥75 years,history of stroke,and concurrent diabetes were high risk factors for poor prognosis in the patients after endovascular stent implantation(P＜0.05,P＜0.01),and CIS was a protective factor(OR=0.439,95％CI:0.294-0.655,P=0.000).Conclusion CIS is closely correlated with the prognosis of patients with MCA M1 segment stenosis after endovascular stent implantation.Early evaluation of CIS can provide certain predictive value for postoperative out-comes of these patients.

Objective:To investigate the clinical significance of monitoring SIL::TAL1 fusion transcripts in the evaluation of treatment response and prognosis of children with T-acute lymphoblastic leukemia (T-ALL).Methods:A retrospective cohort study was conducted to analyze the clinical data of 46 newly diagnosed pediatric T-ALL with SIL::TAL1 fusion transcripts treated at Beijing Children′s Hospital Capital Medical University from November 2004 to December 2022. The SIL::TAL1 fusion transcripts were quantitatively detected at the initial diagnosis (TP0) and early stage of induction therapy (TP1), at the end of induction remission therapy (TP2), before consolidation therapy (TP3) and subsequent treatment. Patients were divided into negative and positive groups on SIL::TAL1 fusion transcripts level, differences of clinical features and survival among groups at TP0 to TP3 were analyzed. The χ2 test or Fisher exact test or Mann-Whitney U test was used to compare the clinical difference. Survival analysis was estimated by Kaplan-Meier method with Log-Rank testing. Multivariate analysis was conducted by Cox proportional hazards models. Results:Among the 46 children with SIL::TAL1 fusion transcripts, 36 were males and 10 were females, with the onset age of 6.8 (3.4, 9.5) years. The negative rates of SIL::TAL1 fusion transcripts for TP1,TP2, TP3, before delayed intensification Ⅰ treatment (TP4), before maintenance therapy (TP5) were 36% (13/36), 78% (32/41), 76% (32/42), 15/16, and 12/12, respectively. No significant difference was found on clinical features and prednisone response between groups at TP0-TP3 (all P>0.05). The 5-year events free survival (EFS) rate of patients classified as negative (32 cases) and positive (9 cases) groups at TP2 was (78±8)% and (33±16)%, respectively ( χ2=9.86, P=0.002), the 5-year overall survival (OS) rate was (81±7)% and (44±17)%, respectively ( χ2=6.40, P=0.011). The 5-year EFS rate of patients classified as negative (32 cases) and positive (10 cases) groups at TP3 was (78±8)% and (30±15)%, respectively ( χ2=13.04, P<0.001) and the 5-year OS rate was (84±6)% and (30±15)%, respectively ( χ2=15.95, P<0.001). Cox multivariate regression showed that positive of SIL::TAL1 transcript at TP3 was adverse independent prognostic factors for EFS and OS (EFS: HR=6.70, 95% CI 2.01-22.35, P=0.002; OS: HR=10.73, 95% CI 2.50-46.09, P=0.001). Conclusions:Monitoring SIL::TAL1 fusion transcripts can reflect the clinical treatment response. The level of SIL::TAL1 fusion transcripts at early period can predict long-term outcomes of these patients.

BACKGROUND:Three-dimensional(3D)Motion Capture Technology can build accurate,objective,and quantized medical virtual simulation model,which is conducive to clinical learners'precise and in-depth understanding and mastery of various traditional therapies.The virtual simulation model of traditional Chinese medicine based on the 3D Motion Capture Technology has been reported,but such a system of traditional Mongolian medicine therapy has not been reported.OBJECTIVE:To construct an interactive 3D visualization virtual simulation model based on the 3D Motion Capture Technology.METHODS:Motion capture data of the professor of Mongolian Medicine Department were collected using the 3D optical motion capture system(Motion Analysis)and Plantar Force Platform.The 3D motion model of brain vibration therapy was constructed using Motion Builder software,and the role model was constructed using Maya software matched with the action model.Unity3D software was used to build a virtual simulation system of Mongolian medical brain vibration therapy.The system integrated information on 3D animation,kinematic and dynamic parameters of Mongolian medical brain vibration therapy.RESULTS AND CONCLUSION:By using 3D Motion Capture Technology and Computer Simulation Technology to reconstruct the operation of Mongolian medical brain vibration therapy,it can display the posture of the operator and subject and record the key parameters of spatial position and changes of joint motion to obtain kinematic and dynamic parameters.The interactive 3D virtual simulation technology is used to realize the visual presentation of 3D virtual simulation of Mongolian medical brain vibration therapy.It lays a foundation for the standardization,digitization and visualization of Mongolian medical brain vibration therapy.

The preferred treatment for adrenal functional tumors is laparoscopic surgical resection. However, in recent years, various ablation techniques have gradually been applied in the treatment of adrenal tumors. This report presents the successful diagnosis and treatment experience of 4 aldosterone-producing adenomas and 1 cortisol-secreting adenoma treated with a combined cold and hot ablation system at Xi’an Daxing Hospital from Dec. 2023 to Dec. 2024, providing a new treatment approach for clinical exploration.