Objective:To analyze the relationship between CT characteristics and related quantitative parameters of spectral CT in diagnosing the nature of thyroid nodules and lymph node metastasis in patients.Methods:This retrospective analysis included 198 patients with thyroid nodules who visited Shangqiu First People’s Hospital between Jun. 2019 and Dec. 2024. The patients included 53 males and 145 females, aged (50.96 ± 5.36) years. A total of 105 patients were classified as benign nodules and 93 patients as malignant nodules (45 with metastasis and 48 without metastasis). All patients underwent spectral CT scans to analyze the efficacy of spectral CT in diagnosing the nature of thyroid nodules and lymph node metastasis in malignant nodules. Continuous data were expressed as ±s, and intergroup comparisons were performed using independent sample t-tests. Enumeration data were expressed as [n (%) ] and tested using the chi-squared test. Receiver-operating characteristic (ROC) curves were constructed to determine the diagnostic efficacy of various CT features and related quantitative parameters in diagnosing thyroid nodules and cervical lymph node metastasis. Results:The AUCs of capsule, edge and shape for diagnosing malignant nodules were 0.706, 0.701 and 0.735, respectively. The AUCs of IC, NIC and slope of energy spectrum curve in arterial phase and IC, NIC and slope of energy spectrum curve in venous phase for diagnosing malignant thyroid nodules were 0.967, 0.992, 0.966, 0.819, 0.991 and 0.986, respectively. The AUCs of nodule number, capsule, edge, shape and long diameter of nodule for diagnosing cervical lymph node metastasis in patients with malignant thyroid nodules were 0.642, 0.617, 0.643, 0.619 and 0.651, respectively. The AUCs of IC, NIC and slope of energy spectrum curve in arterial phase and IC, NIC and slope of energy spectrum curve in venous phase were 0.941, 0.941, 0.955, 0.786, 0.881 and 0.824, respectively. Multivariate analysis showed that multiple nodules, absence of capsule, blurred margins, irregular shape, nodule long diameter >10 mm, IC, NIC in the arterial and venous phases, and increased slope of the energy spectrum curve were independent risk factors for cervical lymph node metastasis in patients with malignant thyroid nodules ( OR=2.631, 1.854, 2.694, 1.936, 2.657, 2.064, 2.314, 2.525, 2.342, 2.712, 2.986, P<0.05) . Conclusions:In spectral CT examinations of patients with thyroid nodules, malignant nodules often show characteristics such as no capsule and blurred edges, accompanied by changes in relevant quantitative parameters. These CT characteristics and quantitative parameters have good diagnostic efficacy for the nature of thyroid nodules and cervical lymph node metastasis in patients with malignant nodules, and have high clinical application value.

Background and Aims:Coactivator-associated arginine methyltransferase 1(CARM1)is involved in the regulation of RNA and protein processing.Recent studies have revealed its crucial role in tumorigenesis and cancer progression.However,the correlation between CARM1 expression,pan-cancer prognosis,and the immune microenvironment remains unclear.This study was conducted to investigate the relationship between CARM1 expression and pan-cancer prognosis,immune microenvironment,and its potential biological mechanisms using bioinformatics approaches.Methods:Using the TCGA,GTEx,and HPA databases,the expression pattern of CARM1 in various cancers and its prognostic relevance were analyzed.The correlation between CARM1 expression and the tumor microenvironment,as well as immune checkpoint genes,were analyzed using TCGA data.The PPI network of CARM1-interacting genes was constructed using the STRING database.GSEA was performed to investigate the potential biological mechanisms of CARM1 in pan-cancer.Results:Compared to normal tissues,CARM1 was upregulated in most tumor tissues,and its expression was associated with prognosis in multiple cancers.CARM1 expression was correlated with immune cell infiltration and immune checkpoint gene expression.Enrichment analysis suggested that CARM1 might alter the biological function of urinary system tumors by affecting ribosome biogenesis.Additionally,it may influence the biological functions of digestive system tumors by modulating arginine biosynthesis,DNA replication,and the cell cycle.Conclusion:CARM1 is aberrantly expressed in tumor tissues and may serve as a prognostic biomarker for multiple cancers.It is associated with the tumor microenvironment and immune checkpoint gene expression in pan-cancer and may contribute to tumorigenesis through multiple biological pathways,making it a potential therapeutic target for pan-cancer treatment.

Objective To investigate the expression of ferritinophagy-related gene ELAV-like RNA binding protein 1(ELAVL1)in multiple myeloma(MM)and elucidate its diagnostic and prognostic value for MM.Methods First,we analyzed ELAVL1 expression level in healthy controls and MM patients using data from the GEO and TCGA databases.Subsequently,bone marrow specimens were collected from 28 newly diagnosed MM patients and 20 healthy controls,and qRT-PCR was employed to validate ELAVL1 expression.The diagnostic and prognostic potential of ELAVL1 was assessed using ROC curve analysis and Kaplan-Meier survival curves.Additionally,univariate and multivariate COX regression analyses were performed to identify independent risk factors for MM prognosis.Finally,KEGG and GO enrichment analyses were performed using the DAVID online platform.Results The level of ELAVL1 expression was significantly higher in newly diagnosed MM patients and refractory/relapsed MM patients than in the healthy controls(P＜0.001).Moreover,ELAVL1 expression was positively correlated with the International Staging System(ISS)stage of MM(P＜0.01).Furthermore,qRT-PCR validation confirmed that ELAVL1 expression was elevated in the 28 newly diagnosed MM patients compared to the 20 healthy controls(P＜0.001).ROC curve analysis demonstrated that ELAVL1 could effectively differentiate between newly diagnosed MM patients,healthy controls,and MGUS patients(P＜0.001 and P=0.000 2,respectively).Survival analysis revealed that high ELAVL1 expression was associated with shorter progression-free survival(P=0.0141)and overall survival(P=0.008 0).Univariate and multivariate COX regression analyses identified high ELAVL1 expression as an independent risk factor for poor MM prognosis(P=0.005 0).KEGG analysis suggested that ELAVL1 might be involved in the Hippo and MAPK signaling pathways.Conclusion High ELAVL1 expression in MM may serve as a biomarker for diagnosis and poor prognosis.ELAVL1 may promote MM initiation and progression via the Hippo and MAPK signaling pathways.

Objective To observe the volume changes of brain regions and their correlation with cognitive function in temporal lobe epilepsy(TLE)patients.Methods Fifty TLE patients(TLE group)and 34 healthy controls(control group)were prospectively enrolled.Brain 3D-T1WI was collected,brain regions were delineated with automated segmentation technique,and hippocampus was segmented additionally with hippocampal brain template(HBT).The volume of brain regions were compared between groups,and the correlation of brain region volume with Montreal cognitive assessment(MoCA)score were analyzed.Results Compared with control group,in TLE group,bilateral cerebrum white matter,right globus pallidus,left posterior cingulate gyrus,left precentral gyrus,right fusiform gyrus,left cerebellum white matter,corpus callosum,left hippocampus(HBT segmentation and conventional segmentation)and right thalamus volumes decreased significantly(all P＜0.05),while right choroid plexus volume increased significantly(P＜0.05).The volume of left hippocampus(HBT segmentation)and right fusiform gyrus were both positively correlated with MoCA score in TLE group(r=0.335,0.376,P=0.009,0.007).Conclusion Widespread atrophy of brain regions could be seen in TLE patients,which were correlated with cognitive function.

Background and Aims:Coactivator-associated arginine methyltransferase 1(CARM1)is involved in the regulation of RNA and protein processing.Recent studies have revealed its crucial role in tumorigenesis and cancer progression.However,the correlation between CARM1 expression,pan-cancer prognosis,and the immune microenvironment remains unclear.This study was conducted to investigate the relationship between CARM1 expression and pan-cancer prognosis,immune microenvironment,and its potential biological mechanisms using bioinformatics approaches.Methods:Using the TCGA,GTEx,and HPA databases,the expression pattern of CARM1 in various cancers and its prognostic relevance were analyzed.The correlation between CARM1 expression and the tumor microenvironment,as well as immune checkpoint genes,were analyzed using TCGA data.The PPI network of CARM1-interacting genes was constructed using the STRING database.GSEA was performed to investigate the potential biological mechanisms of CARM1 in pan-cancer.Results:Compared to normal tissues,CARM1 was upregulated in most tumor tissues,and its expression was associated with prognosis in multiple cancers.CARM1 expression was correlated with immune cell infiltration and immune checkpoint gene expression.Enrichment analysis suggested that CARM1 might alter the biological function of urinary system tumors by affecting ribosome biogenesis.Additionally,it may influence the biological functions of digestive system tumors by modulating arginine biosynthesis,DNA replication,and the cell cycle.Conclusion:CARM1 is aberrantly expressed in tumor tissues and may serve as a prognostic biomarker for multiple cancers.It is associated with the tumor microenvironment and immune checkpoint gene expression in pan-cancer and may contribute to tumorigenesis through multiple biological pathways,making it a potential therapeutic target for pan-cancer treatment.

OBJECTIVE: To evaluate the effectiveness of double joystick technique assisted closed reduction and Kirschner wire internal fixation in the treatment of Gartland type Ⅲ supracondylar fractures of the humerus (SCFH) in children. METHODS: A retrospective study was conducted on 28 cases of Gartland type Ⅲ SCFH with complete data available, who underwent closed reduction and Kirschner wire internal fixation with the double joystick technique between August 2022 and July 2024. There were 23 boys and 5 girls, with an average age of 6.4 years (range, 1-12 years). All fractures resulted from falls and were classified as extension-type. X-ray film showed the radial displacement of the distal fragment in 15 cases and unlar displacement in 13 cases. The interval from injury to operation was 3-36 hours (mean, 19.5 hours). X-ray film re-examination was conducted to evaluate the fracture healing, and the Baumann angle of affected elbow joint and carrying angle of bilateral elbow joints were measured. Elbow joint function was evaluated using the range of motion (flexion and extension) and the Flynn criteria. The above indicators were compared between affected and healthy sides. RESULTS: All operation were successfully completed. The operation time ranged from 15 to 40 minutes (mean, 25.2 minutes). The length of hospital stay was 2-5 days (mean, 3.5 days). All patients were followed up 3-24 months (mean, 11.8 months). X-ray film confirmed fracture healing in all patients, with a mean healing time of 5.4 weeks (range, 4-6 weeks). At last follow-up, the Baumann angle of the affected elbow joint was (73.50±3.46)°, and the carrying angle and the range of motion in flexion and extension of the affected elbow joint were significantly less than the contralateral side (P<0.05). According to the Flynn criteria, the elbow joint function of the affected elbow was evaluated as excellent in 25 cases and good in 3 cases, with an excellent and good rate of 100%. CONCLUSION The double joystick technique is a safe and effective method which can facilitate the closed reduction and Kirschner wire internal fixation of Gartland type Ⅲ SCFH in children without increasing risk of complications.
Humans ; Male ; Female ; Humeral Fractures/diagnostic imaging* ; Fracture Fixation, Internal/instrumentation* ; Child ; Retrospective Studies ; Bone Wires ; Child, Preschool ; Fracture Healing ; Treatment Outcome ; Infant ; Elbow Joint/physiopathology* ; Range of Motion, Articular ; Closed Fracture Reduction/methods*

Sacroiliac complex injuries are commonly seen in high-energy pelvic fractures. The injuries make a big difference in treatment patterns due to the diverse injury types, posing considerable challenges in formulating optimal treatment strategies, and hence are persistent clinical difficulties in orthopedic trauma. The clinical management of sacroiliac complex injuries presents several key challenges such as a non-negligible rate of missed diagnoses in associated vascular and visceral injuries, absence of standardized protocols for surgical approaches and reduction-fixation strategies across different injury patterns, and ongoing controversies regarding surgical indications and optimal timing for patients combined with concomitant lumbosacral plexus injuries. Currently, no systematic clinical guidelines are available for the diagnosis and treatment of sacroiliac complex injuries both domestically and internationally. To this end, the Pelvic and Acetabular Surgery Group, Orthopedic Branch, China International Exchange and Promotive Association for Medical and Health Care and Orthopedic Physician Branch, Chinese Medical Doctor Association organized a panel of domestic experts in the field to develop the Clinical guideline for the diagnosis and treatment of sacroiliac complex injuries ( version 2025), based on evidence-based medicine and adhering to the principles of scientific rigor, clinical applicability, and innovation. These guidelines provided 11 recommendations covering diagnosis, therapeutic principles and techniques, management protocols for lumbosacral plexus injuries, outcome evaluation, and postoperative rehabilitation pathways, etc., aiming to standardize the clinical management of sacroiliac complex injuries.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

Sacroiliac complex injuries are commonly seen in high-energy pelvic fractures. The injuries make a big difference in treatment patterns due to the diverse injury types, posing considerable challenges in formulating optimal treatment strategies, and hence are persistent clinical difficulties in orthopedic trauma. The clinical management of sacroiliac complex injuries presents several key challenges such as a non-negligible rate of missed diagnoses in associated vascular and visceral injuries, absence of standardized protocols for surgical approaches and reduction-fixation strategies across different injury patterns, and ongoing controversies regarding surgical indications and optimal timing for patients combined with concomitant lumbosacral plexus injuries. Currently, no systematic clinical guidelines are available for the diagnosis and treatment of sacroiliac complex injuries both domestically and internationally. To this end, the Pelvic and Acetabular Surgery Group, Orthopedic Branch, China International Exchange and Promotive Association for Medical and Health Care and Orthopedic Physician Branch, Chinese Medical Doctor Association organized a panel of domestic experts in the field to develop the Clinical guideline for the diagnosis and treatment of sacroiliac complex injuries ( version 2025), based on evidence-based medicine and adhering to the principles of scientific rigor, clinical applicability, and innovation. These guidelines provided 11 recommendations covering diagnosis, therapeutic principles and techniques, management protocols for lumbosacral plexus injuries, outcome evaluation, and postoperative rehabilitation pathways, etc., aiming to standardize the clinical management of sacroiliac complex injuries.

Objective To observe the volume changes of brain regions and their correlation with cognitive function in temporal lobe epilepsy(TLE)patients.Methods Fifty TLE patients(TLE group)and 34 healthy controls(control group)were prospectively enrolled.Brain 3D-T1WI was collected,brain regions were delineated with automated segmentation technique,and hippocampus was segmented additionally with hippocampal brain template(HBT).The volume of brain regions were compared between groups,and the correlation of brain region volume with Montreal cognitive assessment(MoCA)score were analyzed.Results Compared with control group,in TLE group,bilateral cerebrum white matter,right globus pallidus,left posterior cingulate gyrus,left precentral gyrus,right fusiform gyrus,left cerebellum white matter,corpus callosum,left hippocampus(HBT segmentation and conventional segmentation)and right thalamus volumes decreased significantly(all P＜0.05),while right choroid plexus volume increased significantly(P＜0.05).The volume of left hippocampus(HBT segmentation)and right fusiform gyrus were both positively correlated with MoCA score in TLE group(r=0.335,0.376,P=0.009,0.007).Conclusion Widespread atrophy of brain regions could be seen in TLE patients,which were correlated with cognitive function.