Objective:To investigate the clinical features and pregnancy outcomes of prolactin-secreting adenomas (PRLomas) complicating pregnancy.Methods:This retrospective study analyzed 53 pregnant women with PRLomas treated at Xuanwu Hospital, Capital Medical University between January 2013 and December 2023. Patients were stratified into microadenoma (<1 cm, n=46) and macroadenoma (≥1 cm, n=7) groups based on tumor size. Maternal complications, perinatal outcomes, and clinical characteristics of PRLomas diagnosed during pregnancy were evaluated. Statistical analysis was performed using independent samples t-test or Chi-square (or Fisher's exact) test. Results:(1) Among the 53 patients (mean age 31.9±7.1 years), 50 (94.3%) were primiparas and 48 (90.6%) were diagnosed before pregnancy, five (9.4%) during pregnancy. Maternal complications included hypothyroidism (14/53, 26.4%), gestational hyperglycemia (11/53, 20.7%), hypertensive disorders of pregnancy (7/53, 13.2%), pituitary apoplexy (6/53, 11.3%), postpartum hemorrhage (4/53, 7.5%), and fetal growth restriction (1/53, 1.9%). (2) Early pregnancy loss occurred in 7.5% (4/53) (<10 weeks' gestation), while 49 cases (92.5%) completed their pregnancies and delivered, including 18 vaginal deliveries (36.7%) and 31 cesarean deliveries (63.3%). The macroadenoma group had a higher preterm birth rate ≤34 weeks [2/7 vs. 2.2% (1/46), χ2=7.93, P=0.005] and shorter gestational age at delivery [(36±2) weeks vs. (38±6) weeks, t=3.03, P=0.003] compared to the microadenoma group. (3) Postpartum follow-up of 39 cases revealed 7.7% (3/39) required artificial feeding due to bromocriptine therapy, while 92.3% (36/39) breastfed for 12 (1-24) months. Postpartum MRI showed tumor resolution in 33.3% (13/39), though 66.7% (26/39) lacked imaging follow-up. (4) All five pregnancy-diagnosed PRLomas were >2 cm. One patient underwent surgical resection at 19 weeks with restored vision and term delivery, while four received postpartum surgery with improved visual deficits. Conclusions:Patients with pregnancy-associated PRLoma diagnosed during pregnancy all had tumors >2 cm in diameter. Management should be individualized based on tumor size, with intensified pregnancy monitoring and timely intervention to achieve favorable outcomes. Microadenoma cases demonstrated better pregnancy outcomes than macroadenoma cases.

Objective To explore the the detection of MMP-2,-7,-9,and-12 enzymatic activity using the CEACAM1-derived fluorescent peptide substrate Site 84,investigating the application of substrate Site 84 to distinguishing between MMP-2 and MMP-9 in the gelatinase spectrum of MMPs.Methods The fluorescent enzymatic method was employed to observe the detection of MMP-2,-7,-9,and-12 enzymatic activity using substrate Site 84;further observations were made on the sensitivity and specificity of substrate Site 84 to enzymatic activity of MMP-2 and MMP-9 within the gelatinase spectrum;the kinetic parameters(Km and Kcat)of the enzymatic reaction between substrate Site 84 and MMP-2 were obtained.Results Using Site 84 as a substrate,enzymic kinetics curves for MMP-12,-7,-2 were obtained,but no enzymatic activity curve for MMP-9 was observed.Furthermore,Site 84 specifically detected the enzymatic activity of MMP-2 within the gelatinase spectrum,capable of detecting low concentration(0.6 μM)of MMP-2 enzymatic activity,but no obvious enzymatic reaction was observed for high concentration(6 μM)of MMP-9;the kinetics parameters for the enzymatic reaction between Site 84 and MMP-2 were Km=315 μM,Kcat/Km=2 565/MS.Conclusion The CEACAM1-derived substrate Site 84 serves as a novel fluorescent peptide substrate,enabling the acquisition of enzymatic activity curves for MMP-12,-7 and-2,and specifically detecting the enzymatic activity of MMP-2 within the MMP gelatinase spectrum.

Objective To construct large medical model named by "Huaxi HongYi"and explore its application effectiveness in assisting medical record generation. Methods By the way of a full-chain medical large model construction paradigm of "data annotation - model training - scenario incubation", through strategies such as multimodal data fusion, domain adaptation training, and localization of hardware adaptation, "Huaxi HongYi" with 72 billion parameters was constructed. Combined with technologies such as speech recognition, knowledge graphs, and reinforcement learning, an application system for assisting in the generation of medical records was developed. Results Taking the assisted generation of discharge records as an example, in the pilot department, after using the application system, the average completion times of writing a medical records shortened (21 min vs. 5 min) with efficiency increased by 3.2 time, the accuracy rate of the model output reached 92.4%. Conclusion It is feasible for medical institutions to build independently controllable medical large models and incubate various applications based on these models, providing a reference pathway for artificial intelligence development in similar institutions.

Traditional development of small protein scaffolds has relied on display technologies and mutation-based engineering, which limit sequence and functional diversity, thereby constraining their therapeutic and application potential. Protein design tools have significantly advanced the creation of novel protein sequences, structures, and functions. However, further improvements in design strategies are still needed to more efficiently optimize the functional performance of protein-based drugs and enhance their druggability. Here, we extended an evolution-based design protocol to create a novel minibinder, BindHer, against the human epidermal growth factor receptor 2 (HER2). It not only exhibits super stability and binding selectivity but also demonstrates remarkable properties in tissue specificity. Radiolabeling experiments with ^99mTc, ⁶⁸Ga, and ¹⁸F revealed that BindHer efficiently targets tumors in HER2-positive breast cancer mouse models, with minimal nonspecific liver absorption, outperforming scaffolds designed through traditional engineering. These findings highlight a new rational approach to automated protein design, offering significant potential for large-scale applications in therapeutic mini-protein development.

Objective:To investigate the clinical features and pregnancy outcomes of prolactin-secreting adenomas (PRLomas) complicating pregnancy.Methods:This retrospective study analyzed 53 pregnant women with PRLomas treated at Xuanwu Hospital, Capital Medical University between January 2013 and December 2023. Patients were stratified into microadenoma (<1 cm, n=46) and macroadenoma (≥1 cm, n=7) groups based on tumor size. Maternal complications, perinatal outcomes, and clinical characteristics of PRLomas diagnosed during pregnancy were evaluated. Statistical analysis was performed using independent samples t-test or Chi-square (or Fisher's exact) test. Results:(1) Among the 53 patients (mean age 31.9±7.1 years), 50 (94.3%) were primiparas and 48 (90.6%) were diagnosed before pregnancy, five (9.4%) during pregnancy. Maternal complications included hypothyroidism (14/53, 26.4%), gestational hyperglycemia (11/53, 20.7%), hypertensive disorders of pregnancy (7/53, 13.2%), pituitary apoplexy (6/53, 11.3%), postpartum hemorrhage (4/53, 7.5%), and fetal growth restriction (1/53, 1.9%). (2) Early pregnancy loss occurred in 7.5% (4/53) (<10 weeks' gestation), while 49 cases (92.5%) completed their pregnancies and delivered, including 18 vaginal deliveries (36.7%) and 31 cesarean deliveries (63.3%). The macroadenoma group had a higher preterm birth rate ≤34 weeks [2/7 vs. 2.2% (1/46), χ2=7.93, P=0.005] and shorter gestational age at delivery [(36±2) weeks vs. (38±6) weeks, t=3.03, P=0.003] compared to the microadenoma group. (3) Postpartum follow-up of 39 cases revealed 7.7% (3/39) required artificial feeding due to bromocriptine therapy, while 92.3% (36/39) breastfed for 12 (1-24) months. Postpartum MRI showed tumor resolution in 33.3% (13/39), though 66.7% (26/39) lacked imaging follow-up. (4) All five pregnancy-diagnosed PRLomas were >2 cm. One patient underwent surgical resection at 19 weeks with restored vision and term delivery, while four received postpartum surgery with improved visual deficits. Conclusions:Patients with pregnancy-associated PRLoma diagnosed during pregnancy all had tumors >2 cm in diameter. Management should be individualized based on tumor size, with intensified pregnancy monitoring and timely intervention to achieve favorable outcomes. Microadenoma cases demonstrated better pregnancy outcomes than macroadenoma cases.

Temporomandibular joint (TMJ) diseases are common clinical conditions. The number of patients with TMJ diseases is large, and the etiology, epidemiology, disease spectrum, and treatment of the disease remain controversial and unknown. To understand and master the current situation of the occurrence, development and prevention of TMJ diseases, as well as to identify the patterns in etiology, incidence, drug sensitivity, and prognosis is crucial for alleviating patients′suffering.This will facilitate in-depth medical research, effective disease prevention measures, and the formulation of corresponding health policies. Cohort construction and research has an irreplaceable role in precise disease prevention and significant improvement in diagnosis and treatment levels. Large-scale cohort studies are needed to explore the relationship between potential risk factors and outcomes of TMJ diseases, and to observe disease prognoses through long-term follw-ups. The consensus aims to establish a standard conceptual frame work for a cohort study on patients with TMJ disease while providing ideas for cohort data standards to this condition. TMJ disease cohort data consists of both common data standards applicable to all specific disease cohorts as well as disease-specific data standards. Common data were available for each specific disease cohort. By integrating different cohort research resources, standard problems or study variables can be unified. Long-term follow-up can be performed using consistent definitions and criteria across different projects for better core data collection. It is hoped that this consensus will be facilitate the development cohort studies of TMJ diseases.

Objective To study the relationship between serum Melatonin,macrophage inflammatory pro-tein-1α(MIP-1α)and nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)inflamma-some and prognosis in children with acute respiratory distress syndrome(ARDS).Methods A total of 140 children with ARDS who were admitted to the hospital from January 2021 to January 2023 were enrolled as the ARDS group,and 100 healthy children who underwent physical examination during the same period were enrolled as the control group.According to the clinical outcome on 28 d after admission,the children with ARDS were divided into a death group(29 cases)and a survival group(111 cases).Enzyme-linked immu-nosorbent assay was used to detect the serum levels of Melatonin,MIP-1α,interleukin(IL)-1β,and IL-18.Re-al-time fluorescent quantitative PCR was used to detect the mRNA levels of NLRP3 and Caspase-1.Pearson correlation was used to analyze the correlation between serum levels of Melatonin and MIP-1α and NLRP3 in-flammasome related indicators(NLRP3 mRNA,Caspase-1 mRNA,IL-1β,IL-18)in children with ARDS.Mul-tivariate Cox regression analysis was used to analyze the factors affecting the prognosis of children with ARDS.According to the mean levels of serum Melatonin and MIP-1α,the children with ARDS were divided in-to a high/low Melatonin group and MIP-1α group.The Kaplan-Meier method was used to draw the survival curves of ARDS children with high/low levels of serum Melatonin and MIP-1α.The receiver operating charac-teristic(ROC)curve was used to analyze the predictive value of serum Melatonin and MIP-1α for death in children with ARDS.Results Compared with the control group,the ARDS group had a significantly decreased serum Melatonin level and significantly increased serum MIP-1α,IL-1β,IL-18 and NLRP3 mRNA and Caspase-1 mRNA levels in peripheral blood mononuclear cells(P＜0.05).Pearson correlation analysis showed that the serum Melatonin level of ARDS children was negatively correlated with NLRP3 mRNA,Caspase-1 mRNA,IL-1β and IL-18(P＜0.05),the level of MIP-1α was positively correlated with NLRP3 mR-NA,Caspase-1 mRNA,IL-1β and IL-18(P＜0.05).Multivariate Cox regression analysis showed that acute physiology and chronic health evaluation Ⅱ score,NLRP3 mRNA,Caspase-1 mRNA,IL-1β,IL-18 and MIP-1αwere independent risk factors affecting the prognosis of children with ARDS.Melatonin was an independent protective factor(P＜0.05).Kaplan-Meier survival curve analysis showed that the 28 d survival rate in high Melatonin group was higher than that in low Melatonin group(P＜0.05),and the 28 d survival rate in high MIP-1α group was lower than that in low MIP-1α group(P＜0.05).ROC curve analysis showed that the area under the curve of Melatonin and MIP-1α combined to predict the death of ARDS children was 0.881(95％CI 0.816-0.930).It was higher than 0.785(95％CI 0.708-0.850)and 0.778(95％CI 0.700-0.844)predic-ted by Melatonin or MIP-1α alone.Conclusion The serum Melatonin level is decreased and MIP-1α level is in-creased in children with ARDS,which is closely related to NLRP3 inflammasome and prognosis.Combined de-tection of serum Melatonin and MIP-1α levels has a high predictive value for the prognosis of children with ARDS.

Building a nationwide representative sibling information database of pediatric cancer is of great significance for the research of pediatric cancer. In October 2022, based on the national pediatric cancer surveillance platform, the National Center for Pediatric Cancer Surveillance(NCPCS) identified and integrated the information of pediatric cancer cases using the patient master index, and then determined and retrieved the diagnosis and treatment information of pediatric cancer siblings through the sibling pair matching algorithm system, to establish the sibling information database. The information database was stored in the sibling database module of the surveillance platform, which realized the dynamic update, retrieval, download, and analysis of sibling information. The database provided data and technical support for the further childhood cancer research among siblings, as well as provided a reference for the construction of research-oriented databases for other disease surveillance systems. As of March 2024, this database had included 2 980 childhood cancer patients, collecting nearly 30 000 related medical records. In the future, NCPCS should further improve the sensitivity of sibling decision logic and expand the functionality of the sibling information database, so as to better meet the diverse needs of clinical and scientific research.

Building a nationwide representative sibling information database of pediatric cancer is of great significance for the research of pediatric cancer. In October 2022, based on the national pediatric cancer surveillance platform, the National Center for Pediatric Cancer Surveillance(NCPCS) identified and integrated the information of pediatric cancer cases using the patient master index, and then determined and retrieved the diagnosis and treatment information of pediatric cancer siblings through the sibling pair matching algorithm system, to establish the sibling information database. The information database was stored in the sibling database module of the surveillance platform, which realized the dynamic update, retrieval, download, and analysis of sibling information. The database provided data and technical support for the further childhood cancer research among siblings, as well as provided a reference for the construction of research-oriented databases for other disease surveillance systems. As of March 2024, this database had included 2 980 childhood cancer patients, collecting nearly 30 000 related medical records. In the future, NCPCS should further improve the sensitivity of sibling decision logic and expand the functionality of the sibling information database, so as to better meet the diverse needs of clinical and scientific research.

Objective To observe the influence of different energy windows of the medium-energy general-purpose(MEGP)collimator on image quality,so as to optimize the energy window of yttrium-90(90Y)bremsstrahlung SPECT imaging.Methods 90Y bremsstrahlung spectrum was acquired,and the sensitivity,percentage of the source counts in useful field of view(S/FOV%)and signal-to-background ratio(S/B)of 90Y bremsstrahlung SPECT imaging at MEGP under different energy windows were compared.Results The energy spectrum of 90Y bremsstrahlung was a continuous curve,with the peak of 76.2 keV with MEGP collimator.The images obtained with MEGP collimator were clear,and no significant differences of S/FOV%nor S/B was found between 10%and 20%window width groups(both P＞0.05),but the sensitivities of the latter was higher than the former(P＜0.05).The sensitivity of 70-90 keV images was relatively high,while the S/FOV%and S/B had decreased.The S/FOV%and S/B of images ranging from 40-60 keV were high,but the sensitivity was low.Images acquired with 100 keV±20%showed fairly high sensitivity,S/FOV%and S/B,which was 69.73%,0.62 and 1.64,respectively.Conclusion When performing 90Y bremsstrahlung SPECT with MEGP collimator,the image quality at 20%window width was better than at 10%window width,and 100 keV±20%showed fairly high sensitivity and not significantly decreased S/FOV%and S/B.