Gorham-Stout disease(GSD) is a rare osteolytic disorder characterized by spontaneous and progressive osteolysis, along with abnormal angiogenesis and lymphangiogenesis, with no new bone formation. We present a case of a 15-year-old female admitted due to " recurrent right leg pain for 5 years, 11 months after undergoing right femoral fracture surgery". Through comprehensive integration of the patient's clinical phenotype, laboratory tests, imaging findings, pathological examinations, and molecular biological test results, GSD was considered highly likely. A multidisciplinary treatment approach was conducted, including a combination of zoledronic acid and sirolimus to inhibit osteolysis, along with rehabilitation training and orthopedic intervention, providing a personalized and comprehensive treatment strategy.

Objective:To explore the relationship between spondin 2(SPON2)and metastasis associated in colon cancer-1(MACC1)proteins expression in hepatocellular carcinoma cancer(HCC)tissues and clinicopathological features and transcatheter arterial chemoembolization(TACE)efficacy.Methods:140 patients who were diagnosed with HCC and underwent TACE from March 2022 to September 2024 in our hospital were collected as research subjects,and the SPON2,MACC1 protein expression in the cancer tissue and paracancer tissue of HCC patients were detected and compared.The correlation between SPON2 and MACC1 protein expression in HCC tissues was analyzed.SPON2 and MACC1 proteins expression in cancer tissues of different clinicopathological features were compared.After 3 months of follow-up,HCC patients were divided into ineffective group and effective group according to the TACE efficacy.Multivariate logistic regression was used to analyze the influencing factors of TACE efficacy,and receiver operating characteristic(ROC)curve was used to analyze the predictive value of SPON2 and MACC1 protein expression of TACE efficacy.Results:SPON2 and MACC1 proteins positive expression rates in HCC cancer tissues were significantly higher than those in paracancer tissues(P＜0.05).There was a positive correlation between SPON2 and MACC1 protein expression in HCC cancer tissues(P＜0.05).SPON2 and MACC1 proteins positive expression rates in HCC cancer tissues were significantly correlated with Child-Pugh grade,tumor diameter,differentiation degree,Chinese liver cancer(CNLC)staging,microvascular invasion,lymph node metastasis,portal vein cancer thrombolus and alpha-fetoprotein(AFP)level(P＜0.05).Multivariate logistic regression analysis showed that Child-Pugh grade B,low differentiation degree,microvascular invasion,lymph node metastasis,AFP level＞400 μg/L,SPON2 and MACC1 protein positive expression were risk factors for poor TACE efficacy in HCC patients(P＜0.05).ROC curve analysis showed that,the area under curve(AUC)of SPON2 and MACC1 protein expression combined to predict TACE efficacy in HCC patients was 0.882,which was significantly higher than that of 0.807 and 0.786 by single detection(P＜0.05).Conclusion:SPON2 and MACC1 positive protein expression in HCC tissues are closely related to clinicopathological features of patients,and they are risk factors for poor TACE efficacy,which can be used as predictors for TACE efficacy in patient with HCC.

Objective To investigate and analyze the current situation of the construction of Smart Hospital in the dis-trict-level hospital of Beijing,and to provide reference for thedistrict-level hospitals to promote the construction of Smart Hospitals.Methods A questionnaire survey was conducted in Beijing district-level hospitals,and the construc-tion of Smart Hospital was analyzed by descriptive statistical analysis.Results The overall construction rate of Beijing district-level hospitals smart service business function was 50.98％,and the overall average construction rate of hos-pital smart management business function was 46.72％.93.75％hospitals thought that the investment in Smart Hos-pital construction was insufficient.The functions of smart service and management in different grades and categories of hospitals were different.Conclusion In order to promote the construction of Smart Hospital in Beijingdistrict-level hospitals,we should improve the top-level system such as strategic planning for the construction of smart hospi-tals,increase the investment in hospital informatization and talent teams,strengthen the standardization of intercon-nection between different hospitals,enhance the sharing and utilization of medical data and information,and strengthen the application of new hospital technologies and hospital information security.

The objective of this study was to develop a rapid and precise detection technique for por-cine Senecavirus A(SVA)employing reverse transcription recombinase polymerase amplification(RT-RAA)in conjunction with CRISPR Cas13a technology.Additionally,the study aimed to opti-mize the assay's reaction conditions to enhance amplification efficiency.Eight RT-RAA primer sets were designed based on the conserved gene sequence of porcine SVA,and a series of reaction condi-tions were evaluated to refine the RT-RAA reaction system.Subsequently,CRISPR-derived RNA(crRNA)sequences were developed and selected to construct the RT-RAA-CRISPR reaction sys-tem.The method's specificity was determined by examining six prevalent porcine pathogenic nucleic acids,while its sensitivity was assessed using SVA cRNA standards quantified by digital PCR.The method's stability and the consistency of clinical sample analysis were also evaluated.The findings revealed that the optimized RT-RAA and CRISPR reaction systems exhibited the highest amplifi-cation efficiency at a reaction temperature of 37 ℃.Among the eight crRNAs,five were identified as exhibiting the strongest detection signals.The formulated RT-RAA-CRISPR Cas13a method demonstrated exceptional specificity,showing no cross-reactivity with other common porcine disea-ses,including ASFV,PRRSV,PEDV,PCV2,CSFV,and PRV.The method achieved high sensitivi-ty,detecting as low as 0.86 copies/μL of SVA,and exhibited stable fluorescence output,robust re-producibility,and the ability to complete clinical sample analysis within 50 minutes.Consistency e-valuation with six positive and 58 negative samples indicated 100％agreement in outcomes.These results substantiate that the study successfully established a rapid and specific RT-RAA-CRISPR Cas13a detection method for the on-site identification of porcine Senecavirus A,demonstrating high specificity and sensitivity,and holds promise for application in SVA monitoring and control initia-tives.

Objective:To investigate the expression, prognosis, and role of G protein-coupled receptor kinase-interacting protein 1 (GIT1) in patients with hepatocellular carcinoma (HCC) tumor micro environments.Methods:Clinical data of 140 cases who underwent complete HCC surgical resection from January 2015 to December 2021 in Subei People's Hospital affiliated to Yangzhou University, Jiangsu Province, were included. Tumor tissue and adjacent tissue samples were collected for immunohistochemical analysis. The patients were divided into a high expression group and a low expression group according to the expression of GIT1. Cox regression was used to analyze the risk factors for prognosis in patients with HCC. Fifteen pairs of cancer tissues and adjacent tissues were randomly matched for quantitative polymerase chain reaction (RT-PCR), western blot (WB), and immunohistochemical analysis. GITI knockout or overexpression cell lines of human hepatoma cell lines HepG2, HuH7 and MHCC97-H, and mouse hepatoma cell line Hepa 1-6 were constructed. The effects on M2 macrophage polarization were analyzed by flow cytometry. A mice tumor model was constructed. The growth curve of tumor tissue overexpressing GIT1 was plotted. Bioinformatics analysis of the Cancer Genome Atlas (TCGA) data was performed using OncoLnc, Kaplan-Meier Plotter, UALCAN, and GEPIA databases to explore the differential expression of GIT1 in HCC patients and its effect on prognosis.Results:Bioinformatics analysis showed that the expression level of GIT1 was significantly higher in HCC tissues than in normal liver tissues ( P<0.05). RT-PCR and WB experiments showed that GIT1 was highly expressed in HCC. The follow-up results showed that high expression of GIT1 was associated with poor prognosis in patients with HCC. The high expression of GIT1 was an independent risk factor for the prognosis in patients with HCC ( HR=2.562, 95% CI: 0.231-0.704, P<0.05). Functional enrichment analysis combined with TIMER database analysis found that GIT1 expression level was associated with multiple immune cell infiltrations in HCC, but the correlation coefficient with macrophage infiltration was the highest ( r=0.545, P<0.001). Mice tumorigenesis experiments showed that the tumor volume of GIT1-overexpressing mice was significantly increased ( P<0.05). Additionally, flow cytometry indicated that after GIT1 overexpression, there was a low degree of M1 infiltration/polarization (wild type: 5.06%±0.11%, overexpression type: 4.09%±0.04%; P<0.05) and a high degree of M2 infiltration/polarization (wild type: 10.20%±0.33%, overexpression type: 14.7%±0.12%; P<0.05). Conclusion:GIT1 serves as a prognostic biomarker in HCC, promoting tumor progression through its high expression and enhances M2 macrophage infiltration.

Objective:To investigate the effect of laparoscopic splenectomy and azygoportal disconnection (LSD) on liver synthesis and development of liver cirrhosis.Methods:This is a prospective case series study.The clinical data of liver cirrhotic patients with portal hypertension who received LSD at the Department of Hepatobiliary Surgery of Northern Jiangsu People′s Hospital Affiliated to Yangzhou University from September 2014 to January 2016 were included. This study analyzed the diameter of the portal vein, the velocity of portal blood flow, the routine blood parameters, the liver function, the synthetic proteins of liver (antithrombin Ⅲ (AT-Ⅲ), protein S, protein C), and the serum content of liver fibrotic markers(collagen type Ⅳ, procollagen type Ⅲ, laminin, hyaluronidase). Repeated measures ANOVA was used for comparison between multiple groups, and least significance difference was used for post-hoc multiple comparison.Results:A total of 106 patients were included in the study, including 70 males and 36 females, aged (51.8±9.8) years(range: 28 to 75 years).Compared with the preoperative results, the diameter of portal vein and the velocity of portal vein decreased after surgery ( F=14.03, 12.15, respectively, both P<0.01). Compared with the preoperative results, the total bilirubin, albumin, prothrombin time, international normalized ratio, Child-Pugh score and classification were improved ( F=17.96, 56.01, 66.63, 35.83, 33.49, and 27.50, respectively, all P<0.01), and the AT-Ⅲ, protein S, protein C,collagen type Ⅳ, procollagen type Ⅲ, laminin and hyaluronidase levels were also improved ( F=47.87, 36.26, 18.02, 2.79, 14.58, 44.35, and 14.38, respectively, all P<0.01). Compared with the preoperative period, the diameter of portal vein was reduced from the first week to the 24 th month after surgery ( t=5.45 to 9.39, all P<0.01). Compared with the preoperative period, the velocity of portal vein blood from the first week after surgery to the 24 th month after surgery was decreased ( t=4.02 to 8.43, all P<0.01). Compared with the preoperative period, routine blood parameters (white blood count, hemoglobin, platelet count), liver function (total bilirubin, albumin, prothrombin time, international normalized ratio, Child-Pugh score), liver synthetic protein (AT-Ⅲ, protein S, protein C) and liver fibrotic markers (collagen type Ⅳ, procollagen type Ⅲ, laminin, hyaluronidase) were improved to varying degrees at the 24th month after surgery ( t=-20.46 to 11.93, all P<0.01). Conclusion:Preliminary findings show that LSD can reduce portal vein pressure, restore blood cell number, and improve liver synthesis function and the degree of liver fibrosis in patients with portal hypertension in liver cirrhosis.

Objective:To investigate the effect of laparoscopic splenectomy and azygoportal disconnection (LSD) on liver synthesis and development of liver cirrhosis.Methods:This is a prospective case series study.The clinical data of liver cirrhotic patients with portal hypertension who received LSD at the Department of Hepatobiliary Surgery of Northern Jiangsu People′s Hospital Affiliated to Yangzhou University from September 2014 to January 2016 were included. This study analyzed the diameter of the portal vein, the velocity of portal blood flow, the routine blood parameters, the liver function, the synthetic proteins of liver (antithrombin Ⅲ (AT-Ⅲ), protein S, protein C), and the serum content of liver fibrotic markers(collagen type Ⅳ, procollagen type Ⅲ, laminin, hyaluronidase). Repeated measures ANOVA was used for comparison between multiple groups, and least significance difference was used for post-hoc multiple comparison.Results:A total of 106 patients were included in the study, including 70 males and 36 females, aged (51.8±9.8) years(range: 28 to 75 years).Compared with the preoperative results, the diameter of portal vein and the velocity of portal vein decreased after surgery ( F=14.03, 12.15, respectively, both P<0.01). Compared with the preoperative results, the total bilirubin, albumin, prothrombin time, international normalized ratio, Child-Pugh score and classification were improved ( F=17.96, 56.01, 66.63, 35.83, 33.49, and 27.50, respectively, all P<0.01), and the AT-Ⅲ, protein S, protein C,collagen type Ⅳ, procollagen type Ⅲ, laminin and hyaluronidase levels were also improved ( F=47.87, 36.26, 18.02, 2.79, 14.58, 44.35, and 14.38, respectively, all P<0.01). Compared with the preoperative period, the diameter of portal vein was reduced from the first week to the 24 th month after surgery ( t=5.45 to 9.39, all P<0.01). Compared with the preoperative period, the velocity of portal vein blood from the first week after surgery to the 24 th month after surgery was decreased ( t=4.02 to 8.43, all P<0.01). Compared with the preoperative period, routine blood parameters (white blood count, hemoglobin, platelet count), liver function (total bilirubin, albumin, prothrombin time, international normalized ratio, Child-Pugh score), liver synthetic protein (AT-Ⅲ, protein S, protein C) and liver fibrotic markers (collagen type Ⅳ, procollagen type Ⅲ, laminin, hyaluronidase) were improved to varying degrees at the 24th month after surgery ( t=-20.46 to 11.93, all P<0.01). Conclusion:Preliminary findings show that LSD can reduce portal vein pressure, restore blood cell number, and improve liver synthesis function and the degree of liver fibrosis in patients with portal hypertension in liver cirrhosis.

Purpose: This study aimed to assess the impact of aerobic exercise at different intensities over an eight-week period on the expression and activation of cortical synaptic proteins, with the potential to reduce anxiety and improve memory in young mice. Methods: Seven-week-old C57BL/6 mice were subjected to treadmill exercises at low (n = 10), moderate (n = 10), and high intensity (n = 10) for eight weeks. Behavioral assessments were conducted to evaluate anxiety and cognitive function. To explore the underlying mechanisms, we measured the phosphorylated levels of extracellular signal-regulated kinase (ERK), cyclic adenosine monophosphate response-binding protein (CREB), protein kinase (AKT), adenosine monophosphate activated protein kinase (AMPK), synapsin (S9, S549, S609), and PSD-95 in the cortex, as these are associated with synaptic strength. Additionally, the expression of doublecortin (DCX), a neurogenic factor, was analyzed in the hippocampus. Results: Exercise led to reductions in depressive and anxiety-related behaviors and elevated the levels of phosphorylated ERK, CREB, AKT, AMPK, synapsin (S9, S549, S609), and PSD-95 in the cortex of young mice. Furthermore, exercise increased DCX expression in the hippocampus. Moderate-intensity exercise yielded more pronounced effects than other intensities. Conclusion The findings of this research indicate that consistent moderate-intensity exercise increases synaptic strength and reduces depression and anxiety in young mice by activating multiple factors.

Objective To develop and evaluate a diagnostic model for autoimmune liver disease(AILD)using clinical indicators.Methods A total of 181 AILD patients(AILD group)diagnosed in the Department of Gastroenterology or Rheumatology and Immunology,the First Medical Center of Chinese PLA General Hospital,from June 2019 to February 2024,133 patients with hepatitis B virus cirrhosis(HBVC)(HBVC group),and 100 healthy individuals(HC group)were included in the study cohort for retrospective analysis.Clinical data,blood routine tests,and biochemical indicators were compared among the groups.Propensity score matching was used to balance the effects of factors such as gender and age.Multivariate logistic regression analysis was applied to identify characteristic indicators for AILD.Receiver operating characteristic(ROC)curves were used to evaluate the diagnostic efficacy of single and combined indicators,and the optimal diagnostic model for AILD was constructed.The Hosmer-Lemeshow test was performed to assess the model's goodness-of-fit,while ROC analysis was employed to evaluate the predictive validity.Additionally,an independent validation cohort,including 91 AILD patients(AILD validation group),82 HBVC patients(HBVC validation group),and 40 healthy individuals(HC validation group)who visited during the same period,was used to validate the diagnostic model.False-positive and false-negative rates were calculated to assess the diagnostic efficacy and clinical utility of the model.Results The age and the proportion of male patients in AILD and HBVC groups were higher than those in HC group,and the proportion of male patients in AILD group was higher than in HBVC group,the differences were statistically significant(P＜0.05).Prior to matching,compared with HC group,HBVC group and AILD group had significantly lower levels of hemoglobin(HB),red blood cell count(RBC),white blood cell count(WBC),platelet count(PLT),and albumin(ALB)(P＜0.05),but significantly higher levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP),gamma-glutamyl transferase(GGT),total bilirubin(TBIL),and direct bilirubin(DBIL)(P＜0.05).Compared with HBVC group,AILD group had significantly higher levels of WBC,PLT,ALB,ALP,and GGT(P＜0.05 or P＜0.001)but significantly lower levels of TBIL and DBIL(P＜0.001).After maching,compared with HC group,AILD group still had significantly lower levels of HB,RBC,WBC,PLT,and ALB,but significantly higher levels of ALT,AST,ALP,GGT,TBIL,and DBIL(P＜0.05).Compared with HBVC group,AILD group had significantly higher levels of HB,RBC,WBC,PLT,ALB,ALT,ALP,and GGT,but significantly lower levels of DBIL(P＜0.05).ROC analysis results showed that AST,GGT,ALP,and DBIL had high predictive values for differentiating AILD from HC(AUC=0.843,0.804,0.802,0.773),while PLT,WBC,GGT,and ALP had high predictive values for differentiating AILD from HBVC(AUC=0.780,0.739,0.729,0.702).For distinguishing AILD from HC,the combined model of AST,ALP,and DBIL(Model e)had an AUC of 0.887,with a sensitivity of 82.2％,and a specificity of 94.7％.For distinguishing AILD from HBVC,the combined model of ALP,GGT,and PLT(Model D)had an AUC of 0.829,with a sensitivity of 78.5％and a specificity of 80.6％.Conclusions The combined diagnostic model based on AST,ALP,and DBIL can effectively differentiate healthy individuals without liver diseases from AILD patients,while the combined diagnostic model based on PLT,ALP,and GGT can effectively distinguish HBVC from AILD patients.

Expert consensus, as an important supplement to clinical practice guidelines, supports clinical decision-making when evidence is lacking or controversial. Compared to clinical practice guidelines, the presentation of expert consensus is more diverse. Currently, there are no reporting guidelines for expert consensus in clinical and public health decision-making. The RIGHT (Reporting Items for Practice Guidelines in Healthcare) checklist is the most commonly used international guideline reporting standard, and is often referred to when writing expert consensus. However, the RIGHT checklist does not include a section on consensus formation methods; while the ACCORD (ACcurate COnsensus Reporting Document) checklist includes reporting requirements for consensus formation methods, but not for reporting recommendations. Therefore, this article integrates the RIGHT and ACCORD reporting checklists and proposes an integrated reporting framework (TIMER-DO) to help authors combine these two commonly used international reporting standards and complete the standardized reporting of expert consensus.