ObjectiveTo analyze the research hotspots and development trends in the field of spinal cord stimulation (SCS) for spinal cord injury (SCI). MethodsLiterature about SCS for SCI was retrieve from the Web of Science (WOS) Core Collection database, with a time range from January, 1999 to July, 2025. VOSviewer 1.6.20 and CiteSpace 6.4.R2 were used to analyze the annual publication volume, countries, authors, institutions, journals and keywords. ResultsA total of 636 literatures were included. From 1999 to 2025, the overall publication trend in this field showed an upward trajectory, with recent years fluctuating but tending to stabilize. The country with the most publications was the United States (429 papers), followed by Russia (98 papers) and China (70 papers). The institution with the highest number of publications was the University of California, Los Angeles (76 papers), the author with the most publications was V. Reggie Edgerton (70 papers), and the journal with the most publications was Journal of Clinical Medicine (31 papers). The most frequently cited study focused on exploring the combination of epidural spinal cord stimulation with task-specific training to restore motor function in patients with complete SCI. Keyword analysis showed that the research hotspots in this field were mainly focused on neuroregulation mechanisms, recovery of motor and autonomic nervous dysfunction, artificial intelligence, closed-loop stimulation and brain-computer interface technology innovations. In recent years, the research focus gradually shifted from basic mechanisms to personalized and precise multifunctional rehabilitation strategies. ConclusionThe field of SCS for SCI has undergone phases of basic mechanism exploration and clinical application expansion. Current research hotspots and future trends focus primarily on the development of new stimulation paradigms and combined innovative technologies.

Objective:To report on a case of mosaicism involving trisomy 21, maternal uniparental isodisomy, and normal diploid cells in uncultured amniocytes, and to explore the discrepancies between conventional cytogenetic and molecular cytogenetic techniques during prenatal diagnosis.Methods:A 30-year-old pregnant woman who presented to Boai Hospital of Zhongshan on June 27, 2023 has undergone amniocentesis at 16 weeks of gestation. The amniotic fluid sample was subjected to quantitative fluorescent PCR (QF-PCR), G-banded karyotype analysis, and chromosomal microarray analysis (CMA). The discrepancies between the results of each method were analyzed. This study was approved by Medical Ethics Committee of Boai Hospital of Zhongshan (Ethics No.: KY-2024-001-01).Results:Non-invasive prenatal testing (NIPT) at 12 weeks indicated a high risk of trisomy 21. QF-PCR of uncultured amniocytes revealed a pattern of trisomy 21. After one week of cell culture, G-banding analysis showed mos 47, XX, + 21[1]/46, XX[72]. CMA revealed a homozygous state of chromosome 21 in cultured cells, while uncultured amniocytes showed mosaic trisomy 21 with an estimated proportion of 50%. These findings suggested a complex chromosomal mosaicism in the fetus, which may result from a trisomy rescue event during early embryogenesis, leading to coexistence of three cell lines including trisomy 21, maternal uniparental isodisomy, and normal diploid cells.Conclusion:In prenatal diagnosis, discrepancies may arise between QF-PCR and conventional chromosomal karyotyping analysis, particularly in complex genetic phenomena such as trisomy rescue and uniparental disomy. For cases where NIPT indicated a high risk of trisomy 21 but G-banding karyotype analysis yielded a normal result, further molecular genetic testing using uncultured cells is recommended.

OBJECTIVE: To report on a case of mosaicism involving trisomy 21, maternal uniparental isodisomy, and normal diploid cells in uncultured amniocytes, and to explore the discrepancies between conventional cytogenetic and molecular cytogenetic techniques during prenatal diagnosis. METHODS: A 30-year-old pregnant woman who presented to Boai Hospital of Zhongshan on June 27, 2023 has undergone amniocentesis at 16 weeks of gestation. The amniotic fluid sample was subjected to quantitative fluorescent PCR (QF-PCR), G-banded karyotype analysis, and chromosomal microarray analysis (CMA). The discrepancies between the results of each method were analyzed. This study was approved by Medical Ethics Committee of Boai Hospital of Zhongshan (Ethics No.: KY-2024-001-01). RESULTS: Non-invasive prenatal testing (NIPT) at 12 weeks indicated a high risk of trisomy 21. QF-PCR of uncultured amniocytes revealed a pattern of trisomy 21. After one week of cell culture, G-banding analysis showed mos 47,XX,+21[1]/46,XX[72]. CMA revealed a homozygous state of chromosome 21 in cultured cells, while uncultured amniocytes showed mosaic trisomy 21 with an estimated proportion of 50%. These findings suggested a complex chromosomal mosaicism in the fetus, which may result from a trisomy rescue event during early embryogenesis, leading to coexistence of three cell lines including trisomy 21, maternal uniparental isodisomy, and normal diploid cells. CONCLUSION In prenatal diagnosis, discrepancies may arise between QF-PCR and conventional chromosomal karyotyping analysis, particularly in complex genetic phenomena such as trisomy rescue and uniparental disomy. For cases where NIPT indicated a high risk of trisomy 21 but G-banding karyotype analysis yielded a normal result, further molecular genetic testing using uncultured cells is recommended.
Humans ; Female ; Mosaicism ; Pregnancy ; Uniparental Disomy/diagnosis* ; Adult ; Down Syndrome/diagnosis* ; Prenatal Diagnosis/methods* ; Diploidy ; Karyotyping ; Amniocentesis

Objective To explore the value of diffusion-weighted imaging(DWI)and apparent diffusion coefficient(ADC)in magnetic resonance imaging(MRI)in differential diagnosis of benign and malignant cervical lymph nodes in patients with nasopharyngeal carcinoma.Methods Clinical data of 98 patients diagnosed with nasopharyngeal carcinoma were retrospectively analyzed.This cohort included 65 patients with pathologically confirmed malignant lymph nodes and 33 patients with benign lymph nodes.Prior to pathological diagnosis,all patients underwent routine MRI scans and DWI.ADC values of both benign and malignant lymph nodes were recorded.The diagnostic performance was evaluated using receiver operating characteristic(ROC)curve analysis.Additionally,the diagnostic efficacy of MRI and ADC values in distinguishing benign and malignant lymph nodes of nasopharyngeal carcinoma was compared.Results Of the 65 patients with malignant lymph nodes,42 cases were accompanied by liquefactive necrosis,and 13 cases were accompanied by extracapsular invasion.Most benign lymph nodes showed no signal on DWI sequence,while malignant lymph nodes showed obvious high signal or mixed signals.The ADC value of benign lymph nodes was(1.724±0.365)×10-3 mm2/s,which was higher than that of malignant nodes(1.022±0.210)×10-3 mm2/s(P＜0.01).The ROC curve analysis results showed that the area under the curve of ADC value for diagnosing benign and malignant lymph nodes was 0.843(95%CI:0.782-0.904),with a cutoff value of 1.363×10-3 mm2/s.At this point,the sensitivity and specificity for differentiating benign and malignant lymph nodes were 0.856 and 0.849,respectively,and Youden index was 0.705.When the ADC value was lower than the cutoff value,the accuracy,sensitivity and specificity for differentiating cervical lymph nodes in nasopharyngeal carcinoma patients were 0.878,0.892 and 0.848,respectively,which were superior to MRI(P＜0.05).Conclusion The DWI images of malignant lymph nodes in patients with nasopharyngeal carcinoma show high signal and low ADC,and ADC has high efficiency in the differential diagnosis of benign and malignant cervical lymph nodes.

Objective To explore the value of diffusion-weighted imaging(DWI)and apparent diffusion coefficient(ADC)in magnetic resonance imaging(MRI)in differential diagnosis of benign and malignant cervical lymph nodes in patients with nasopharyngeal carcinoma.Methods Clinical data of 98 patients diagnosed with nasopharyngeal carcinoma were retrospectively analyzed.This cohort included 65 patients with pathologically confirmed malignant lymph nodes and 33 patients with benign lymph nodes.Prior to pathological diagnosis,all patients underwent routine MRI scans and DWI.ADC values of both benign and malignant lymph nodes were recorded.The diagnostic performance was evaluated using receiver operating characteristic(ROC)curve analysis.Additionally,the diagnostic efficacy of MRI and ADC values in distinguishing benign and malignant lymph nodes of nasopharyngeal carcinoma was compared.Results Of the 65 patients with malignant lymph nodes,42 cases were accompanied by liquefactive necrosis,and 13 cases were accompanied by extracapsular invasion.Most benign lymph nodes showed no signal on DWI sequence,while malignant lymph nodes showed obvious high signal or mixed signals.The ADC value of benign lymph nodes was(1.724±0.365)×10-3 mm2/s,which was higher than that of malignant nodes(1.022±0.210)×10-3 mm2/s(P＜0.01).The ROC curve analysis results showed that the area under the curve of ADC value for diagnosing benign and malignant lymph nodes was 0.843(95%CI:0.782-0.904),with a cutoff value of 1.363×10-3 mm2/s.At this point,the sensitivity and specificity for differentiating benign and malignant lymph nodes were 0.856 and 0.849,respectively,and Youden index was 0.705.When the ADC value was lower than the cutoff value,the accuracy,sensitivity and specificity for differentiating cervical lymph nodes in nasopharyngeal carcinoma patients were 0.878,0.892 and 0.848,respectively,which were superior to MRI(P＜0.05).Conclusion The DWI images of malignant lymph nodes in patients with nasopharyngeal carcinoma show high signal and low ADC,and ADC has high efficiency in the differential diagnosis of benign and malignant cervical lymph nodes.

Objective:To report on a case of mosaicism involving trisomy 21, maternal uniparental isodisomy, and normal diploid cells in uncultured amniocytes, and to explore the discrepancies between conventional cytogenetic and molecular cytogenetic techniques during prenatal diagnosis.Methods:A 30-year-old pregnant woman who presented to Boai Hospital of Zhongshan on June 27, 2023 has undergone amniocentesis at 16 weeks of gestation. The amniotic fluid sample was subjected to quantitative fluorescent PCR (QF-PCR), G-banded karyotype analysis, and chromosomal microarray analysis (CMA). The discrepancies between the results of each method were analyzed. This study was approved by Medical Ethics Committee of Boai Hospital of Zhongshan (Ethics No.: KY-2024-001-01).Results:Non-invasive prenatal testing (NIPT) at 12 weeks indicated a high risk of trisomy 21. QF-PCR of uncultured amniocytes revealed a pattern of trisomy 21. After one week of cell culture, G-banding analysis showed mos 47, XX, + 21[1]/46, XX[72]. CMA revealed a homozygous state of chromosome 21 in cultured cells, while uncultured amniocytes showed mosaic trisomy 21 with an estimated proportion of 50%. These findings suggested a complex chromosomal mosaicism in the fetus, which may result from a trisomy rescue event during early embryogenesis, leading to coexistence of three cell lines including trisomy 21, maternal uniparental isodisomy, and normal diploid cells.Conclusion:In prenatal diagnosis, discrepancies may arise between QF-PCR and conventional chromosomal karyotyping analysis, particularly in complex genetic phenomena such as trisomy rescue and uniparental disomy. For cases where NIPT indicated a high risk of trisomy 21 but G-banding karyotype analysis yielded a normal result, further molecular genetic testing using uncultured cells is recommended.

BACKGROUND: LY01005 (Goserelin acetate sustained-release microsphere injection) is a modified gonadotropin-releasing hormone (GnRH) agonist injected monthly. This phase III trial study aimed to evaluated the efficacy and safety of LY01005 in Chinese patients with prostate cancer. METHODS: We conducted a randomized controlled, open-label, non-inferiority trial across 49 sites in China. This study included 290 patients with prostate cancer who received either LY01005 or goserelin implants every 28 days for three injections. The primary efficacy endpoints were the percentage of patients with testosterone suppression ≤50 ng/dL at day 29 and the cumulative probability of testosterone ≤50 ng/dL from day 29 to 85. Non-inferiority was prespecified at a margin of -10%. Secondary endpoints included significant castration (≤20 ng/dL), testosterone surge within 72 h following repeated dosing, and changes in luteinizing hormone, follicle-stimulating hormone, and prostate specific antigen levels. RESULTS: On day 29, in the LY01005 and goserelin implant groups, testosterone concentrations fell below medical-castration levels in 99.3% (142/143) and 100% (140/140) of patients, respectively, with a difference of -0.7% (95% confidence interval [CI], -3.9% to 2.0%) between the two groups. The cumulative probabilities of maintaining castration from days 29 to 85 were 99.3% and 97.8%, respectively, with a between-group difference of 1.5% (95% CI, -1.3% to 4.4%). Both results met the criterion for non-inferiority. Secondary endpoints were similar between groups. Both treatments were well-tolerated. LY01005 was associated with fewer injection-site reactions than the goserelin implant (0% vs . 1.4% [2/145]). CONCLUSION: LY01005 is as effective as goserelin implants in reducing testosterone to castration levels, with a similar safety profile. TRIAL REGISTRATION ClinicalTrials.gov, NCT04563936.
Humans ; Male ; Antineoplastic Agents, Hormonal/therapeutic use* ; East Asian People ; Gonadotropin-Releasing Hormone/agonists* ; Goserelin/therapeutic use* ; Prostate-Specific Antigen ; Prostatic Neoplasms/drug therapy* ; Testosterone

Objective:To analyze the factors influencing dysphagia after an injury to the cervical spinal cord (CPCI) to provide a basis for clinical screening and intervention.Methods:A total of 110 CPCI patients with dysphagia were divided into a severe dysphagia group ( n=19), a mild dysphagia group ( n=35), and a control group ( n=56) according to their functional oral intake scale scores. Data on gender, age, level of injury, degree of damage, duration of injury, causes of injury, surgical mode, tracheotomy status, occurrence of pneumonia and pharynx swelling were collected. Univariate and multivariate logistic regressions were evaluated to identify factors affecting swallowing. Results:The regressions highlighted age, the severity of the spinal cord injury, tracheotomy status, and the occurrence of pneumonia and pharyngeal swelling during hospitalization as the best predictors of swallowing difficulties. Multifactoral logistic regression analysis revealed that undergoing tracheotomy and catching pneumonia during hospitalization were major risk factors for severe dysphagia.Conclusions:Tracheotomy and pneumonia during hospitalization are useful predictors of severe dysphagia after a cervical spinal cord injury.

Objective:To explore the diagnostic value of quantitative 99Tc m-hydrazinonicotinamide(HYNIC)-prostate specific membrane antigen (PSMA) SPECT/CT in patients with prostate cancer. Methods:From November 2018 to March 2021, the data of 56 patients ((69.8±8.0) years) with clinically suspected prostate cancer, who had elevated radioactive uptake in prostate on 99Tc m-HYNIC-PSMA SPECT/CT images in Henan Provincial People′s Hospital, were retrospectively analyzed. According to the pathological results, patients were divided into prostate cancer group ( n=45) and non-prostate cancer group ( n=11). The xSPECT-QUANT software was used to quantitatively analyze the high uptake area of the prostate, and SUV max was measured. The independent-sample t test, Mann-Whitney U test, ROC curve and Spearman correlation analysis were used for data analysis. Results:The prostate cancer group had higher SUV max than non-prostate cancer group (10.79±5.96 vs 3.60±1.27; t=7.43, P<0.001). When SUV max≥6.46, the AUC of prostate cancer was 0.887, with the diagnostic sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of 73.3%(33/45), 11/11, 100%(33/33), 47.8%(11/23), 78.6%(44/56), respectively. The SUV max of prostate cancer group was positively correlated with Gleason score ( rs=0.632, P<0.001). The SUV max of 29 patients with Gleason score≥8 was higher than that of 16 patients with Gleason score≤7 ( z=-3.89, P<0.001). There was no statistical difference in PSA level between patients with Gleason score≤ 7 and patients with non-prostate cancer ( z=-1.63, P=0.110), but the SUV max was significantly different ( z=-2.22, P=0.026). The SUV max of 23 patients with metastases was higher than that of 22 patients without metastasis (12.99±5.85 vs 8.50±5.28; t=2.69, P=0.010). ROC analysis showed that the AUC was 0.709; with SUV max≥13.02 as the threshold, the sensitivity for diagnosing prostate cancer metastases was 56.5%(13/23), the specificity was 86.4%(19/22), and the accuracy was 71.1%(32/45). Conclusions:The 99Tc m-HYNIC-PSMA SPECT/CT quantitative analysis is feasible in patients with prostate cancer. SUV max of 99Tc m-HYNIC-PSMA can be used in the diagnosis of prostate cancer, assessment of the malignancy and prediction of metastasis.

Objective To study the clinical value of retroperitoneoscope-assisted intraperitoneal approach in the treatment of large renal tumors.Methods A total of 89 patients with large renal tumors (d ＞7 cm) were involved from January 2014 to December 2017.Among them,32 cases were treated by retroperitoneoscope-assisted intraperitoneal approach (group A),including 18 males and 14 females,aged (63.5±7.5)years,with 20 cases on the left and 12 on the right,and mean tumor diameter of (7.9 ± 0.6).Thirty cases were treated by laparoscopy (group B),including 17 males and 13 females,aged (64.5 ±7.3)years,with 16 cases on the left and 14 cases on the right,and the average tumor diameter of (7.6 ±0.7) cm.Twenty-seven cases underwent open surgery (C group),including 15 males and 12 females,aged (64.9 ±5.7) years,with 13 cases on the left side and 14 cases on the right,and the average tumor diameter of (7.9 ±0.6) cm.There was no statistically significant difference among the three groups in term of demographics (P ＞ 0.05).The clinical data was collected and statistical analysis was made for comparison among the three groups,including operation time,blood loss,surgical complications,postoperative intestinal recovery and postoperative hospital stay.All the patients were with single renal tumor,and no other major comorbidities were found.Results All of the 89 surgeries were successful.Hypercapnia was found in 2 cases (6.3％) in Group A,and recoverd 15 minutes after stopping pneumoperitoneum and anesthesia.The operation time was 120-200 minutes with an average of (155.0 ± 22.1) minutes.The average amount of bleeding was (141.6 ± 33.8) ml.Bowel recovered 3 (3-5) days after operation.The patients were hospitalized for 7 (7-9) days.In group B,hypercapnia was found in 2 patients (6.7％) and recoverd after stopping pneumoperitoneum and anesthesia.The time of operation was (184.2 ± 20.6) min,the amount of bleeding was (191.5 ± 46.2) ml,the bowel recovered 4 (4-6) days after operation,and the postoperative hospitalization duration was 7.5 (6-9) days.The operation time of group C was (54.0 ± 16.6) min,blood loss was (309.6 ± 50.2) ml,postoperative intestinal recovery was 5 (4-6)days,and the postoperative hospitalization time was 8 (7-12)days.Group A had less operation time than Group B(P ＜0.05),and no difference with Group C(P ＞0.05).Group A had advantages in term of blood loss and postoperative intestinal recovery time compared with B and C (P ＜ 0.05).Groups A and B had no difference in term of surgical complications and postoperative hospital stay (P ＞ 0.05),but both of the two groups had obvious advantages over group C (P ＜ 0.05).Conclusions Retroperitoneoscopeassisted intraperitoneal approach is the synergetic application of two endoscopic approaches,which is superior to any single operation for the treatment of large renal tumor,such as less bleeding,shorter operation time,faster postoperative recovery,and so on.This method not only reduces the difficulty of operation,provides an alternative for laparoscopic treatment of large renal tumors,but also has a good application for complex renal tumors complicated with renal vein and inferior vena cava tumor thrombus.