Objective On the basis of the theory of the tumor metastatic state, this work aims to explore the metastasis trajectories and peripheral immune response patterns in patients with non-small cell lung cancer (NSCLC) receiving vital qi-strengthening and toxin-eliminating therapy (Fuzheng Juandu) and reveal the value of peripheral immunity in assessing vital qi deficiency during metastasis. Methods A retrospective study design was adopted. Patients with NSCLC admitted from January 1, 2018, to October 31, 2025 were enrolled. Data on metastasis status and peripheral immune indices were collected at the follow-up time points of one, two, three, and five years. Group-based trajectory modeling was used to fit metastasis trajectories, and the independent predictors of trajectory grouping were analyzed through multifactor and multiclassification logistic regression. Results A total of 184 patients with NSCLC were included, and three different groups of metastasis trajectories were identified, namely, the low-risk stable (46.74%, n=86), low-risk rising (13.59%, n=25), and high-risk stable (39.67%, n=73) groups. Univariate analysis revealed substantial differences in peripheral immune indices among the three trajectory groups. Multivariate analysis showed that TNM stage, absolute neutrophil count, lymphocyte count, absolute monocyte count, platelet volume, SAA:CRP ratio, and NLR were independent predictors of the low-risk rising group, whereas TNM stage, absolute monocyte count, basophil count, SII, and NLR were independent predictors of the high-risk stable group. Conclusion Under Fuzheng Juandu therapy, patients with NSCLC exhibit three distinct metastasis trajectories, each corresponding to a specific peripheral immune response pattern. Elucidating these peripheral immune response patterns may facilitate the objective quantification of the degree of vital qi deficiency, prediction of future metastasis risk, and providing an important reference for the individualized clinical implementation of Fuzheng Juandu therapy.

ObjectiveTo evaluate whether the use of intrapartum ultrasound （IPUS） to monitor the labor process， as alternative method of traditional vaginal examination （VE）， could reduce the incidence of postpartum complications associated with vaginal delivery. MethodsA total of 360 primiparas who underwent cervical dilation balloon induction of labor （IOL） and achieved successful vaginal delivery after childbirth at the Third Affiliated Hospital of Sun Yat-sen University between January 2022 and December 2023， were included in the retrospective study with half assessed for labor progress using IPUS （n=180） and the other half using VE （n=180）. The differences in the relevant indicators of the labor process and the complications of vaginal delivery were compared between the two groups of pregnant women. ResultsThere was no significant difference in the duration of membrane rupture， the first stage of labor and the second stage of labor between the two groups. However， the number of VE in the IPUS group was significantly lower ［nulliparous： 4 （3-4） vs. 6 （5-8）， P＜0.001； multiparous： 2 （2-3） vs. 4 （3-5）， P＜0.001］. The IPUS group experienced a lower incidence of postpartum fever compared to the VE group ［1.67%（3/180） vs. 7.22%（13/180）， P=0.006］， while other complications of vaginal delivery， such as fever during labor， postpartum hemorrhage （PPH）， laceration， poor wound healing and uroschesis， were not significantly different （all P ＞ 0.05）. The logistic regression analysis confirmed that the use of IPUS served as a protective factor for postpartum fever with an OR of 0.06 ［95% CI （0.01， 0.36）； P=0.002］， while the duration of membrane rupture was a risk factor ［OR： 1.12； 95% CI （1.03， 1.22）； P = 0.011］. ConclusionsIPUS， as an alternative to traditional VE， does not affect the progress of labor. However， it can significantly reduce the frequency of VE and the incidence of postpartum fever， thereby facilitating the rapid recovery of postpartum women， which makes it clinically valuable for application.

Objective To explore the efficacy of a model combining clinicopathological characteristics and multiparametric MRI features for predicting BRCA-mutated breast cancer(BC).Methods A total of 256 BC patients were retrospectively selected and divided into BRCA mutation group(116 cases)and BRCA wild group(140 cases)based on the BRCA results.Chi-square tests or independ-ent sample t-tests were used to compare the differences in clinicopathological characteristics and multiparametric MRI features between the BRCA mutation group and the wild group.Risk factors for BRCA-mutated BC were identified through univariate and multivariate logistic regression ananlyses,and a combined predictive model was constructed.Receiver operating characteristic(ROC)curve was used to ana-lyze the diagnostic efficacy of the model.Results There were statistically significant differences in T stage,human epidermal growth factor receptor 2(HER-2),Ki-67,non-mass enhancement,enhancement pattern,time-signal intensity curve(TIC)type,and apparent diffusion coefficient(ADC)values between the BRCA mutation group and the wild group.Univariate logistic regression analysis showed that T stage,HER-2,Ki-67,non-mass enhancement,enhancement pattern,TIC type,and ADC values were risk factors for BRCA-mutated BC(P<0.05).Multivariate logistic regression analysis revealed that T stage,HER-2,Ki-67,enhancement pattern,and TIC type were independent risk factors for BRCA-mutated BC(P<0.05).The combined model incorporating T stage,HER-2,Ki-67,enhancement pattern,and TIC type had the best diagnostic efficacy in predicting BRCA-mutated BC,with an area under the curve(AUC)of 0.751.Conclusion The combined model integrating T stage,HER-2,Ki-67,enhancement pattern,and TIC type has good efficacy in predicting BRCA-mutated BC.

Objective:To investigate the protective effects of Mailuoning(MLN)against cisplatin(CP)-induced acute kidney injury(AKI)utilizing network pharmacology and to analyze the underlying mechanism of action related to anti-apoptotic pathways.Methods:Active components of MLN and targets related to AKI were identified using network pharmacology.The active components of MLN were sourced from the TCMSP and ETCM 2.0 databases.The targets of components were predicted using the Swiss Target Prediction tool,and subsequently the targets related to AKI were retrieved from the GeneCards database to identify intersecting targets.A protein-protein interaction network was constructed using the STRING database,and a topological analysis was performed using Cytoscape to identify core targets.Gene Ontology(GO)functional annotation and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway en-richment analyses were conducted on these core targets.For the animal experiments,forty mice were randomly assigned to four groups:solvent control,MLN toxicity control,CP model,and CP+MLN groups.The MLN group received intraperitoneal injections of MLN at a dose of 15 mL/(kg·d)for ten consecutive days.The CP model and CP+MLN groups were administered a single intraperitoneal injec-tion of CP at 20 mg/kg on day 7.Three days after the CP treatment,plasma levels of blood urea nitrogen(BUN)and creatinine(Cre)were measured.The pathological injury of kidney tissues was as-sessed using hematoxylin-eosin staining.Western blot analysis was utilized to determine the expression of neutrophil gelatinase-associated lipocalin(NGAL)and apoptosis-related proteins in kid-ney tissues.Results:A total of 104 active components of MLN and 224 targets were identified using network pharmacology,and 2 465 targets were identified to be related to AKI,resulting in 117 intersecting targets,of which,17 targets were classified as core targets.KEGG and GO analyses indicated that the apoptosis-related signal transduction pathway might be a crucial pathway through which MLN provided protective effects against AKI.The results of animal experiments confirmed the successful establishment of CP-induced AKI models in mice.Compared with the CP model group,MLN treatment significantly reduced plasma levels of BUN and Cre(P<0.05),inhibited NGAL protein expression in the kidneys(P<0.05),and improved the pathological injury observed in kidney tissues.Furthermore,MLN markedly reduced the expression levels of p-P53(ser 15)and cleaved caspase-3 proteins,as well as the Bax/Bcl-2 ratio in kidney tissues of AKI model mice(P<0.05),while upregulating protein kinase B phosphorylation levels(P<0.05).Conclusion:MLN demonstrates protective effects against CP-induced AKI in mice,potentially through mechanisms related to its anti-apoptotic properties.

Objective:To investigate the association between exposed cardia glands and gastroesophageal reflux disease (GERD) and identify risk factors for exposed cardia glands.Methods:Patients who underwent gastroscopy at Chengde Central Hospital from December 2023 to March 2024 were prospectively enrolled. Patients with exposed cardia glands meeting inclusion criteria comprised the observation group, while controls had no exposed cardia glands but met identical criteria. Demographic, lifestyle, and endoscopic characteristics were compared between the two groups.Results:A total of 204 patients were included in the observation group, while 310 in the control group. Univariate analysis demonstrated statistically significant differences between the observation group and the control group in the following factors: body mass index, waist circumference, smoking, alcohol consumption, tea/coffee intake, spicy food preference, sleeping posture, use of calcium channel blockers, Helicobacter pylori infection, peptic ulcer disease, and GERD ( P<0.05). Binary logistic regression analysis identified the following independent risk factors for exposed cardia glands: waist circumference ( P=0.012, OR=1.070, 95% CI: 1.015-1.129), alcohol consumption ( P=0.003, OR=2.166, 95% CI: 1.293-3.631), spicy food preference ( P=0.048, OR=1.611, 95% CI: 1.004-2.582), right-side sleeping posture ( P<0.001, OR=3.219, 95% CI: 1.696-6.108), use of calcium channel blockers ( P<0.001, OR=3.871, 95% CI: 2.263-6.621), Helicobacter pylori infection ( P<0.001, OR=3.512, 95% CI: 1.953-6.317), and GERD ( P<0.001, OR=2.905, 95% CI: 1.829-4.613) .Conclusion:Exposed cardia glands demonstrates significant association with GERD. Key independent risk factors include waist circumference, alcohol consumption, spicy diet, right-side sleeping position, calcium channel blockers use, and Helicobacter pylori infection.

Objective:To investigate the feasibility and clinical value of artificial intelligence-assisted compressed sensing (ACS) technology in accelerating MR simulation (MR-sim) for radiotherapy of nasopharyngeal carcinoma (NPC).Methods:Thirty patients with NPC scheduled to receive radical radiotherapy at Sun Yat-sen University Cancer Center were prospectively enrolled. All patients underwent head and neck MR-sim on a 3.0 T scanner, with axial T 1 weighted imaging (WI), T 2WI, contrast-enhanced T 1WI, and fat-suppressed contrast-enhanced T 1WI images acquired using both ACS and parallel imaging (PI) techniques. Paired-sample t tests or rank-sum tests were used to compare scan time, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of MR-sim images between the two techniques. A 5-point Likert scale was applied to evaluate tumor lesion visualization, lesion margin clarity, artifacts, and overall image quality, with chi-square tests used to compare subjective image quality scores between the two techniques. Tumor target volumes were delineated on MR-sim images obtained by both ACS and PI techniques after fusion with CT simulation images, and consistency was assessed using the Dice similarity coefficient (DSC). Results:For both individual sequences and overall protocols, ACS significantly reduced MR-sim acquisition time compared with PI ( P < 0.001). The total acquisition time with ACS was (378.60±17.07) s versus (694.93±17.07) s with PI, representing a 45.52% time reduction. SNR, CNR, tumor lesion identification, margin clarity, artifacts, and overall image quality scores of MR-sim images did not differ significantly between ACS and PI ( P > 0.05). Tumor target volumes delineated from ACS- and PI-based MR-sim images showed high consistency after fusion with CT simulation images ( P > 0.05), with mean DSC values of primary tumors and metastatic cervical lymph nodes approaching 1. Conclusion:Compared with conventional MR acceleration methods (PI), ACS enables faster MR-sim acquisition in NPC without compromising image quality or the accuracy of tumor target delineation.

ObjectiveTo investigate the perceived experience and acceptance of intrapartum ultrasound （IPUS） as a novel method for labor progress assessment among pregnant women. MethodsFrom February 2023 to December 2024， a total of 180 pregnant women admitted to the Labor Ward of Lingnan Hospital， the Third Affiliated Hospital of Sun Yat-sen University， who were planned for vaginal trial of labor ， were accessed for labor progress using IPUS and vaginal examination （VE） after the onset of labor and prior to the initiation n of labor analgesia. A self-designed questionnaire was used to investigate the women's perceived experiences with both examination methods and their acceptance of IPUS. The pain intensity associated with the examinations was evaluated using the visual analogue pain scale （VAS）. Differences in the women's experiences and pain intensity between the two labor progress assessment methods were compared. ResultsThe acceptance rate of IPUS was 96.67% （174/180）， with the remaining 6 cases undecided. Over 60% of the pregnant women reported IPUS assessment as comfortable and none of them felt discomfort， whereas 32.8% felt uncomfortable with VE （χ²=196.02， P＜0.001）. Nearly two-thirds of the pregnant women believed that VE would cause psychological distress， while none reported such effect with IPUS （χ²=261.52， P＜0.001）. Approximately 77.78% （140/180） of the pregnant women believed that IPUS could reduce their fear of vaginal delivery and enhance their confidence if it replaced VE. The VAS score for IPUS ［0 （0， 2）］ was significantly lower than that for VE ［4 （4， 6）］ （Z=-14.62， P＜0.001）. Further stratified analysis showed that over 90% （164/180） of the pregnant women found IPUS painless， with no moderate or severe pain reported， compared to 43.33% （78/180） experienced moderate or severe pain with VE （P＜0.001）. ConclusionAs a novel approach for labor progress assessment， IPUS not only alleviates the pain and discomfort associated with traditional VE and reduces the fear of childbirth but also enhances women's confidence in delivery， thereby achieving a high level of acceptance among parturient women in China.

Lung cancer is the malignant tumor with the highest morbidity and mortality. The tumor-node-metastasis (TNM) staging has gradually shown its limitations in the accurate prediction of lung cancer, so it is urgent to construct a new clinical predictive model to guide the prevention and treatment of lung cancer. In recent years, as a comprehensive evaluation system based on peripheral immune related parameters, the value of peripheral immunoscore in the construction of predictive model has gradually become prominent. By quantifying the quantity and proportion of immune components in peripheral blood, the score can dynamically reflect the overall immune function and tumor microenvironment characteristics of the body. This paper systematically summarizes the latest research progress of peripheral immunoscore in early diagnosis, drug efficacy prediction, early warning of adverse reactions and prognosis evaluation of lung cancer, aiming to tap its potential clinical application value and provide some ideas and directions for developing new lung cancer-related predictive models.
.
Humans ; Lung Neoplasms/drug therapy* ; Tumor Microenvironment ; Prognosis

Objective:To investigate the feasibility and clinical value of artificial intelligence-assisted compressed sensing (ACS) technology in accelerating MR simulation (MR-sim) for radiotherapy of nasopharyngeal carcinoma (NPC).Methods:Thirty patients with NPC scheduled to receive radical radiotherapy at Sun Yat-sen University Cancer Center were prospectively enrolled. All patients underwent head and neck MR-sim on a 3.0 T scanner, with axial T 1 weighted imaging (WI), T 2WI, contrast-enhanced T 1WI, and fat-suppressed contrast-enhanced T 1WI images acquired using both ACS and parallel imaging (PI) techniques. Paired-sample t tests or rank-sum tests were used to compare scan time, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of MR-sim images between the two techniques. A 5-point Likert scale was applied to evaluate tumor lesion visualization, lesion margin clarity, artifacts, and overall image quality, with chi-square tests used to compare subjective image quality scores between the two techniques. Tumor target volumes were delineated on MR-sim images obtained by both ACS and PI techniques after fusion with CT simulation images, and consistency was assessed using the Dice similarity coefficient (DSC). Results:For both individual sequences and overall protocols, ACS significantly reduced MR-sim acquisition time compared with PI ( P < 0.001). The total acquisition time with ACS was (378.60±17.07) s versus (694.93±17.07) s with PI, representing a 45.52% time reduction. SNR, CNR, tumor lesion identification, margin clarity, artifacts, and overall image quality scores of MR-sim images did not differ significantly between ACS and PI ( P > 0.05). Tumor target volumes delineated from ACS- and PI-based MR-sim images showed high consistency after fusion with CT simulation images ( P > 0.05), with mean DSC values of primary tumors and metastatic cervical lymph nodes approaching 1. Conclusion:Compared with conventional MR acceleration methods (PI), ACS enables faster MR-sim acquisition in NPC without compromising image quality or the accuracy of tumor target delineation.

Objective To explore the efficacy of a model combining clinicopathological characteristics and multiparametric MRI features for predicting BRCA-mutated breast cancer(BC).Methods A total of 256 BC patients were retrospectively selected and divided into BRCA mutation group(116 cases)and BRCA wild group(140 cases)based on the BRCA results.Chi-square tests or independ-ent sample t-tests were used to compare the differences in clinicopathological characteristics and multiparametric MRI features between the BRCA mutation group and the wild group.Risk factors for BRCA-mutated BC were identified through univariate and multivariate logistic regression ananlyses,and a combined predictive model was constructed.Receiver operating characteristic(ROC)curve was used to ana-lyze the diagnostic efficacy of the model.Results There were statistically significant differences in T stage,human epidermal growth factor receptor 2(HER-2),Ki-67,non-mass enhancement,enhancement pattern,time-signal intensity curve(TIC)type,and apparent diffusion coefficient(ADC)values between the BRCA mutation group and the wild group.Univariate logistic regression analysis showed that T stage,HER-2,Ki-67,non-mass enhancement,enhancement pattern,TIC type,and ADC values were risk factors for BRCA-mutated BC(P<0.05).Multivariate logistic regression analysis revealed that T stage,HER-2,Ki-67,enhancement pattern,and TIC type were independent risk factors for BRCA-mutated BC(P<0.05).The combined model incorporating T stage,HER-2,Ki-67,enhancement pattern,and TIC type had the best diagnostic efficacy in predicting BRCA-mutated BC,with an area under the curve(AUC)of 0.751.Conclusion The combined model integrating T stage,HER-2,Ki-67,enhancement pattern,and TIC type has good efficacy in predicting BRCA-mutated BC.