The tetraspanins are closely associated with the development and therapeutic prognosis of colorectal tumors. These proteins play a role in cell proliferation, metastasis, and invasion, regulate apoptosis and autophagy of colorectal tumor cells. affect immune escape by releasing exosomes, intervening the epithelial-mesenchymal transition process, and altering the tumor microenvironment, and enhance tumor stemness through specific pathways. This paper reviews the mechanisms and current research regarding the status of tetraspanins in colorectal cancer, aiming to improve early diagnosis and providing valuable insights for treatment strategies.

Objective:To investigate the impact of tumor origin (ventral pancreatic origin and dorsal pancreatic origin) on prognosis in patients with pancreatic head cancer.Methods:A retrospective analysis was performed on the clinical data of 150 patients with pancreatic head cancer who received surgical treatment at the First Affiliated Hospital of the Naval Medical University from October 2014 to December 2017. Among these patients, 92 were male and 58 were female, aged (61.2±8.8) years. The 150 patients were divided into two groups based on tumor origin: the ventral pancreatic cancer group ( n=72) and the dorsal pancreatic cancer group ( n=78). A comparative analysis of clinical, pathological, and imaging charac-teristics was conducted between the two groups. Univariate and multivariable Cox proportional hazards models were used to analyze the association between pancreatic head cancer origin and overall survival (OS). Results:Patients with pancreatic head carcinoma arising from the ventral and dorsal pancreas accounted for 48%(72/150) and 52%(78/150) of the study cohort, respectively. Pancreatic head carcinoma arising from the dorsal pancreas were more likely to show pathological features of pancreatic parenchymal atrophy [73.1%(57/78) vs. 47.2%(34/72), χ2=10.49, P=0.001] and pancreatitis [44.9%(35/78) vs. 29.2%(21/72), χ2=3.95, P=0.047]. In contrast, patients with pancreatic head carcinoma arising from the ventral pancreas was more frequently associated with contact with the superior mesenteric artery [25.0%(18/72) vs. 1.3%(1/78), χ2=19.04, P<0.001], perineural invasion [100%(72/72) vs. 88.5%(69/78), χ2=8.84, P=0.003], and positive surgical margins [15.3%(11/72) vs. 2.6%(2/78), χ2=7.65, P=0.006], with all differences statistically significant. The ventral pancreatic cancer group demonstrated cumulative survival rates of 33.2% and 0 at 1-year and 2-year postoperative intervals, respectively, while the dorsal pancreatic cancer group exhibited rates of 56.7% and 24.8% at the corresponding timepoints. Comparison of Kaplan-Meier survival curves between the two groups showed a statistically significant difference ( χ2=6.00, P=0.014). Multivariable Cox proportional hazards analysis identified dorsal pancreatic origin pancreatic head cancer as an independent predictor of increased mortality risk compared to ventral origin tumors ( HR=2.75, 95% CI: 1.52-4.98, P=0.001). Conclusion:The embryonic origin of pancreatic head cancer determines its clinical, pathological, and imaging heterogeneity, and pancreatic head cancer arising from the ventral pancreas demonstrates significantly worse prognostic outcomes compared to dorsal pancreatic origin.

Objective:To compare and analyze the differences in positioning errors and placement outside the target area between two different image-guided systems(Halcyon and Synergy)in radiotherapy for cervical cancer.Methods:The data of 40 patients with cervical cancer who received treatment in Dezhou People's Hospital from March 2023 to June 2023 were retrospectively selected.Each patient was treated respectively with Halcyon linear accelerator and Synergy linear accelerator,with 20 cases for each treatment method.All patients underwent cone beam computed tomography(CBCT)at kV level to conduct image scanning before radiotherapy,and the obtained CBCT images were matched with the positioned CT images by online.The registration results of left and right(x),head and foot(y)and front and back(z)of three translation direction,and pitch(Rx),rotation(Ry)and deflection(Rz)directions of rotation direction were respectively obtained.The margin of planning target volume(MPTV)was calculated according to positioning expansion formula.The differences of positioning errors and target area expansion between Halcyon and Synergy image-guided systems were compared and analyzed.Results:Halcyon and Synergy image-guided systems obtained respectively 479 and 447 sets of CBCT images.The translational errors of Halcyon image-guided system on x,y,and z directions were respectively(-0.03±0.21),(0.12±0.63)and(0.02±0.15)cm,and the rotational errors of that on Rx,Ry and Rz directions were respectively(0.38±1.26)°,(-0.40±1.02)°,and(0.07±1.07)°.The translational errors of Synergy image-guided system were respectively(-0.07±0.18),(0.08±0.49)and(0.11±0.22)cm on the three directions,and the rotational errors of that were respectively(0.28±1.29)°,(-0.29±1.29)° and(-0.16±1.20)°.The translational error values on the y direction of both image-guided system were larger than that on x and z directions,and the absolute values of the range of translational errors of them were basically within 5 mm.There were no statistically significant difference in the positioning errors of rotation on Rx and Ry directions between Halcyon and Synergy image-guided systems(P＞0.05),while there was a statistically significant difference in the positioning error of rotation on Rz direction between them(t=-3.06,P＜0.05).The MPTV values of Halcyon image-guided system on x,y and z directions were respectively 0.4,1.4 and 0.3 cm,and those of Synergy image-guided system were respectively 0.4,0.9 and 0.5 cm.The expansion boundary of target area of Halcyon image-guided system on the y direction was larger than that of Synergy image-guided system,and that on other directions were all less or equal to 0.5 cm.Conclusion:The MPTV values of Halcyon and Synergy image-guided systems can meet clinical requirements in radiotherapy.The positioning errors and the tube current of the scan of Halcyon image-guided system were larger than those of Synergy image-guided system,but the scanning time and treatment time of that were significantly lower than those of Synergy image-guided system.Different treatment systems can be selected individually for patients according to their different conditions.

Human herpesvirus-6B (HHV-6B) reactivation is a significant contributor to nonrelapse mortality following allogeneic hematopoietic stem cell transplantation (allo-HSCT). This retrospective analysis describes three cases of HHV-6B reactivation following allo-HSCT, all of which achieved viral clearance with maribavir treatment following failure or intolerance to first-line antiviral therapy with foscarnet sodium. One patient diagnosed with HHV-6B encephalitis recovered without neurological sequelae. No adverse drug reactions to maribavir were observed. These findings provide preliminary evidence that maribavir may serve as an effective and safe salvage therapy for HHV-6B reactivation in patients receiving allo-HSCT.

Objective:To evaluate the clinical value of peripheral blood monocyte subset analysis in the diagnosis and treatment of chronic myelomonocytic leukemia (CMML) .Method:We retrospectively enrolled 51 patients newly diagnosed with CMML at Guangdong Provincial People's Hospital between June 1, 2020, and December 31, 2024, according to the WHO 2022 diagnostic criteria. Twenty-three patients with other myeloid neoplasms (excluding CMML) and peripheral monocytosis (absolute count ≥0.5×10 9/L and percentage ≥10%) were included as the control group. All patients underwent bone marrow aspiration for examinations including bone marrow smears, biopsies, cytogenetics, and gene mutation analysis to establish a definitive diagnosis. Concurrently, flow cytometry was used to determine the proportions of peripheral blood monocyte subsets: classical (MO1, CD14 +CD16 -) , intermediate (MO2, CD14 +CD16 +) , and non-classical (MO3, CD14 lowCD16 +) . Differences between the groups were compared, and diagnostic efficacy was evaluated using receiver operating characteristic (ROC) curves. Result:Among the 51 CMML patients, the proportion of the peripheral blood MO1 subset was significantly higher than that in patients with other myeloid neoplasms ( P=0.027) , whereas there were no significant differences in the MO2 and MO3 subsets (all P>0.05) . Further analysis revealed that 43 (84.31%) of the CMML patients met the WHO diagnostic threshold for the MO1 subset (≥94%) , while the remaining 8 patients did not; 46 patients (90.20%) had MO3 subset proportions below the threshold proposed by Hudson (≤1.13%) , while the remaining 5 patients were above this threshold. In-depth analysis showed that among the 8 patients who did not meet the WHO criteria, 7 were experiencing inflammation. Similarly, all 5 patients who did not meet the Hudson criteria were in an inflammatory state. Subsequent ROC curve analysis of this cohort identified a cut-off value for the MO1 subset of 97.55% [Area Under the Curve (AUC) =0.661, P=0.027], which aligns with the WHO criteria. Conclusion:Peripheral blood monocyte subset analysis, particularly MO1 subset analysis, can effectively assist in CMML diagnosis, but exclusion of inflammatory conditions is required.

OBJECTIVE: To investigate the influence of different scanning conditions on the image quality of medical electron accelerator cone-beam computed tomography (CBCT) and provide a reference for the selection of scanning conditions for different body parts. Methods Set different scanning conditions, the Catphan 503 phantom was scanned using CBCT parameters to analyze the influence of spatial resolution, noise, uniformity, spatial geometric accuracy, and low-contrast resolution on the image quality of CBCT. RESULTS: For the head, chest, and abdomen, with the increase in scanning parameter values, the noise value decreased by 47.4%, 26.1%, and 51.3% respectively, and the uniformity values decreased by 30.2%, 26.6%, and 47.9% respectively. The low-contrast resolution values decreased by 50.6%, 34.2%, and 12.0%. The influence of different scanning conditions on spatial geometric accuracy and spatial resolution is not significant. CONCLUSION Different scanning parameters have a certain influence on the image quality of medical electron accelerator CBCT. Lower scanning parameters can be selected based on individual patients to reduce the additional radiation dose, providing a reference for the safe application of CBCT image guidance in radiotherapy.
Cone-Beam Computed Tomography/instrumentation* ; Phantoms, Imaging ; Particle Accelerators

Objective To analyze the computed tomography(CT)imaging features of urachal carcinoma and evaluate its diagnostic value.Methods The clinical data of 20 patients with urachal carcinoma confirmed by surgery and pathology,who were admitted to The First Affiliated Hospital of Naval Medical University from Dec.2012 to Dec.2022,were collected.Seventeen of the 20 patients underwent enhanced CT urography and 3 underwent pelvic CT plain scan+enhanced scan.After scanning,multiplanar reconstruction was performed on the post-processing workstation.The general data,clinical symptoms,CT imaging findings,pathological data,and prognosis of the patients were analyzed and summarized.Results The patients included 16 males and 4 females,aged 27 to 75 years old,with a median age of 61.50(41.50,71.25)years old.The tumors were all located in the anterior wall of the bladder,along the urachus,with a maximum diameter of 1.72-5.55 cm and a median maximum diameter of 3.34(2.48,3.71)cm.Fourteen cases had cystic-solid lesions and 6 had solid lesions.In the cystic-solid lesions,9 cases showed the"upper cystic and lower solid"sign on the sagittal plane.Calcification was noted in 17 cases.After enhanced scanning,18 cases showed progressive enhancement,and 2 cases showed"fast in and fast out"enhancement.Tumor invasion extended beyond the urachus and/or bladder muscle layer in 19 cases.At the end of follow-up,3 cases had recurrence,2 had metastasis,5 had no recurrence after surgery,3 died,and 7 were lost to follow-up.Conclusion Urachal carcinoma has certain characteristic manifestations on CT imaging.Reconstructing the sagittal plane with enhanced CT scanning and multiplanner reformation can help preoperative diagnosis and prognostic evaluation of urachal carcinoma.

In this study, we employed a combination of genome mining and heteronuclear single quantum coherence (HSQC)-based small molecule accurate recognition technology (SMART) technology to search for fernane-type triterpenoids. Initially, potential endophytic fungi were identified through genome mining. Subsequently, fine fractions containing various fernane-type triterpenoids were selected using HSQC data collection and SMART prediction. These triterpenoids were then obtained through targeted isolation and identification. Finally, their antifungal activity was evaluated. As a result, three fernane-type triterpenoids, including two novel compounds, along with two new sesquiterpenes and four known compounds were isolated from one potential strain, Diaporthe discoidispora. Their structures were elucidated through analysis of high-resolution electrospray ionization mass spectrometry (HR-ESI-MS) and nuclear magnetic resonance (NMR) spectroscopic data. The absolute configurations were determined using single-crystal X-ray diffraction analysis and electron capture detector (ECD) analysis. Compound 3 exhibited moderate antifungal activity against Candida albicans CMCC 98001 and Aspergillus niger.
Triterpenes/isolation & purification* ; Antifungal Agents/isolation & purification* ; Molecular Structure ; Candida albicans/drug effects* ; Ascomycota/genetics* ; Magnetic Resonance Spectroscopy ; Aspergillus niger/drug effects* ; Genome, Fungal ; Microbial Sensitivity Tests

Objective:To investigate the molecular epidemiological characteristics of norovirus (NoV) among infectious diarrhea patients in Linyi from 2021 to 2023, and provide the scientific evidence for norovirus control and prevention.Methods:The epidemiological information and fecal samples of patients with infectious diarrhea in Linyi from 2021 to 2023 were collected and detected by real-time fluorescent quantitative PCR. The RdRp and capsid gene VP1 region of norovirus-positive specimens were amplified and sequenced used to analyze their genotype, phylogeny and homology.Results:Among the 2 311specimens, 123 (5.32%) were positive of NoV, with GI/GII group infection accounted for 17.07% (21/123) and 77.24% (95/123), respectively, GI/GII group mixed infection accounted for 5.69% (7/123). The detection rate of <1 year age group was the highest (8.86%), followed by the 1-3 years group (7.11%, 30/422) and the over 60 years group (5.29%, 23/123). The highest NoV detection rate was 7.96% (45/565) in the urban area, and the most abundant genotypes were found in the northern mountainous area. Sequence analysis showed that 61 identified NoV strains could be divided into 12 genotypes, with 4 NoV GI and 8 NoV GII. The dominant genotype differed during the 3 years, with GII.4 Sydney [P16] in 2021, GII.4 Sydney [P31] in 2022, and GII.2[P16] in 2023.Conclusions:NoV GII group was the main NoV infection in Linyi from 2021-2023 and genotypes were diverse. Children under 3 years of age and elderly people over 60 years old as susceptible groups should be given special protection. In addition, the monitoring of NoV genotype diversification should be strengthened in northern mountainous areas.

Objective:To compare the effects of erector spinae plane block at T 2 (T 2-ESPB) and nerve root block at C 5 (C 5-NRB) in patients undergoing arthroscopic shoulder surgery with general anesthesia. Methods:This was a randomized, controlled, non-inferiority study. Sixty American Society of Anesthesiologists Physical Status classification I or Ⅱ patients, aged 45-75 yr, with body mass index ≤35 kg/m 2, scheduled for elective arthroscopic shoulder surgery at Jining No. 1 People′s Hospital from April 2023 to February 2024, were included and divided into 2 groups ( n=30 each) using a random number table method: C 5-NRB group (group C) and T 2-ESPB group (group T). In group C, C 5-NRB was carried out by injecting 0.5% ropivacaine 5 ml. In group T, T 2-ESPB was performed by injecting 0.25% ropivacaine 30 ml. The efficacy of nerve block was assessed using a prick test at 30 min after administration, and then total intravenous anesthesia was performed in both groups. The time to first rescue analgesia (the non-inferiority boundary Δ =2 h), requirement for rescue analgesia within 24 h after operation and intraoperative consumption of anesthetics were recorded. The motor function of the affected limb during shoulder abduction, elbow flexion and elbow extension was assessed and scored using the modified Bromage scale (MBS) at 30 min and 4 and 12 h after nerve block. The diaphragmatic excursion was measured and recorded using M-mode ultrasound before nerve block and at 30 min after nerve block to evaluate the occurrence of diaphragmatic paralysis. Complications such as local anesthetic toxicity, recurrent laryngeal nerve block and pneumothorax were also recorded. Results:The mean difference (95% confidence interval) for the time to first rescue analgesia between the two groups was 5.551 (1.875-9.148) h, with the upper limit exceeding the non-inferiority boundary. Compared with group T, the intraoperative consumption of remifentanil was significantly reduced, the time to first rescue analgesia was prolonged, the consumption of morphine for rescue analgesia was decreased, MBS scores during shoulder abduction, elbow flexion and elbow extension were decreased at 30 min after block, and MBS scores during shoulder abduction and elbow flexion were decreased at 4 and 12 h after block in group C ( P<0.05). There was no significant difference in the diaphragmatic excursion, incidence of diaphragm paralysis and incidence of complications before and after block in the two groups ( P>0.05). Conclusions:C 5-NRB provides superior efficacy compared to T 2-ESPB when used for arthroscopic shoulder surgery under general anesthesia.