Objective To investigate the prevalence of thyroid nodules in the physical examination population in Mianyang region and analyze its association with metabolic syndrome. Methods A retrospective study was conducted on 9 978 individuals who underwent health examinations at our hospital from January 2024 to May 2025. Thyroid examinations were performed using color Doppler ultrasound to analyze the prevalence of thyroid nodules in this population. Clinical data of all subjects were collected, and logistic regression analysis was employed to assess the association between metabolic syndrome and the risk of thyroid nodule development. Results The prevalence of thyroid nodules in the physical examination population of Mianyang region was 17.98% (1 794/9 978). The logistic regression results showed that after adjusting for gender, age, BMI, occupation, consumption of non-iodized salt, staying up late, daily sleep duration, anxiety, and depression, metabolic syndrome (OR=6.593, 95% CI: 3.961-10.975) was associated with thyroid nodules (P<0.05). Conclusion The prevalence of thyroid nodules among the physical examination population in the Mianyang area is 17.98%, and metabolic syndrome remains associated with the risk of thyroid nodules after effectively controlling for confounding factors.

Objective To evaluate the effect of health education based on the transtheoretical model on pulmonary rehabilitation exercise in elderly outpatients with chronic obstructive pulmonary disease(COPD).Methods From January 2022 to April 2023,118 COPD patients from the internal medicine outpatient clinic of Beijing Tongren Hospital,Capital Medical University,were selected as study subjects and randomly divided in-to a control group and observation group using a random number table,with 59 patients in each group;the control group received routine health education,while the intervention group received health education guided by the transtheoretical model on top of the control group's regimen,with different health education strategies provided according to the patients'behavioral stages,and comparisons were made between the two groups be-fore and after the intervention in terms of quality of life,pulmonary function,blood gas analysis,inflammatory factors,modified Medical Research Council(mMRC)dyspnea scale,and 6-minute walk test(6MWD).Results After the intervention,there were statistically significant differences between the two groups in scores on the Short Form-36 Health Survey(SF-36),forced expiratory volume in one second(FEV1),percent-age of predicted forced expiratory volume in one second(FEV1%pred),partial pressure of oxygen(PaO2),levels of tumor necrosis factor-alpha(TNF-α),C-reactive protein(CRP),interleukin-6(IL-6),mMRC score,and 6MWD(P<0.05).Conclusion Health education guided by the transtheoretical model has significant ap-plication value in elderly outpatients with COPD and is worthy of further promotion in clinical practice.

BACKGROUND: Primary pulmonary mucoepidermoid carcinoma (PMEC) is an exceedingly rare malignancy originating from bronchial submucosal glands, accounting for <0.2% of lung cancers. Histologically characterized by a triphasic composition of mucinous, epidermoid, and intermediate cells, PMEC is classified into low-grade (favorable prognosis) and high-grade (aggressive behavior) subtypes. This study aimed to investigate the clinicopathological characteristics and prognostic indicators of PMEC. METHODS: Clinicopathological, radiological, molecular, and survival data from 26 PMEC patients were retrospectively analyzed, including immunohistochemical profiles and MAML2 rearrangement status, supplemented by literature review. RESULTS: The cohort comprised 14 males and 12 females (mean age: 55.6 years). Eight patients (30.8%) were smokers, and 19 (73.1%) presented with symptoms. Central tumors predominated (n=19, 73.1%) versus peripheral lesions (n=7, 26.9%). Computed tomography (CT) imaging consistently revealed hypo-to-isodense masses/nodules. Pathologically, 19 cases were low-grade and 7 high-grade. Immunohistochemically, the tumor cells were positive for CK7, P40, P63 and CK5/6, and the Ki-67 index ranged from 2% to 70%. MAML2 rearrangement was detected in 52.4% (11/21) of tested cases. Clinical staging distribution: stage I (n=14), stage II (n=8), stage III (n=3), stage IV (n=1). Treatment modalities: radical surgery alone (n=13), surgery with adjuvant chemotherapy (n=11), chemoradiotherapy (n=1), and conservative management (n=1). With a median follow-up of 57 months, 6 patients (23.1%) died. Prognostic analysis demonstrated: (1) Significantly inferior survival in high-grade versus low-grade groups (P<0.05); (2) Lymph node metastasis, advanced stage, Ki-67>20%, and high-grade histology significantly correlated with reduced overall survival (P<0.05); (3) Lymph node metastasis constituted an independent poor prognostic factor (HR=12.73, 95%CI: 1.22-132.96). CONCLUSIONS PMEC exhibits distinct clinicopathological features, with MAML2 rearrangement present in approximately half of cases. Lymph node metastasis, advanced stage, high Ki-67 proliferation index, and high-grade histology are key determinants of poor prognosis, with lymph node metastasis serving as an independent risk factor.
Humans ; Male ; Female ; Middle Aged ; Carcinoma, Mucoepidermoid/mortality* ; Lung Neoplasms/mortality* ; Trans-Activators/genetics* ; Prognosis ; Adult ; Gene Rearrangement ; Aged ; Retrospective Studies ; Transcription Factors/genetics* ; DNA-Binding Proteins/genetics*

Glaucoma is the leading cause of irreversible blindness worldwide. Reducing intraocular pressure through surgical interventions is a crucial approach for managing open-angle glaucoma(OAG). In recent years, minimally invasive glaucoma surgeries(MIGS)have gained prominence, providing a lot of options for the treatment of glaucoma. MIGS that target the trabecular meshwork-Schlemm's canal pathway act on the main pathway of aqueous humor outflow with less damage to the normal anatomical structures of the eye, and are gradually becoming the mainstream procedures. These surgeries can be categorized into three main types based on their mechanisms of action: trabeculotomy, trabecular meshwork bypass, and Schlemm's canal dilation. Representative procedures and devices include gonioscopy-assisted transluminal trabeculotomy(GATT), microcatheter-assisted trabeculotomy(MAT), Trabectome, kahook dual blade(KDB), tanito microhook(TMH), excimer laser trabeculotomy(ELT), iStent series, Hydrus, ABiC, PCP and 3T procedures. This article reviews the current literature on the application of MIGS targeting the trabecular meshwork-Schlemm's canal pathway in OAG. It aims to discuss the principles, efficacy and safety of such MIGS for the treatment of OAG, and to summarize the advantages and disadvantages of each procedure, with a view to informing the choice of surgical treatment and clinical research for OAG.

Objective To investigate the correlations of serum stromal cell-derived factor-1(SDF-1),chemokine receptor 7(CXCR7)and vascular density in the optic disc area with clinical stages in patients with normal-tension glaucoma(NTG).Methods A total of 157 patients with NTG were included in the NTG group and divided into stage Ⅰ group(n=29),stage Ⅱ group(n=88),and stage Ⅲ group(n=40)based on different clinical stages;additionally,56 healthy individuals with physical examinations in the same period were selected as control group.Serum SDF-1 and CXCR7 levels were compared between the NTG group and the control group;changes in vascular den-sity in the optic disc area among patients with different clinical stages were analyzed;the multivariate Logistic regression analysis was conducted to explore the risk factors for NTG.Results Compared with the control group,the NTG group had significantly increased serum levels of SDF-1 and CXCR7(P＜0.05).Compared with the control group,patients in the NTG group showed significantly decreased densities of large vessels,capillaries,and the entire area,as well as significantly increased density of avascular areas(P＜0.05).The densities of capillaries and the entire area were significantly lower in the stage Ⅱ group and stage Ⅲ group than the stage Ⅰ group,while the density of avascu-lar areas was significantly higher(P＜0.05).The densities of large vessels(r=-0.503,P=0.006),capillaries(r=-0.546,P＜0.001),and the entire area(r=-0.553,P＜0.001)were negatively significantly correlated with clinical stages,while the density of avascular area was positively significantly correlated with clinical stages(r=0.521,P=0.002).The proportions of patients with hypertension,history of alcohol consumption,family history of glaucoma,and high ser-um levels of SDF-1 and CXCR7 in the NTG group were significantly higher than those in the control group(P＜0.05).Multivariate Logistic regression analysis revealed that hypertension,family histo-ry of glaucoma,history of alcohol consumption,and high serum levels of SDF-1 and CXCR7 were risk factors for NTG(P＜0.05).Conclusion Patients with NTG have significantly increased ser-um levels of SDF-1 and CXCR7.The densities of large vessels,capillaries,and the entire area are negatively correlated with clinical stages,while the density of avascular areas is positively correlated with clinical stages.Serum levels of SDF-1 and CXCR7 can serve as effective reference indicators for the diagnosis and clinical staging of NTG.

Objective To explore the diagnostic value of epicardial adipose tissue(EAT)thickness combined with serum disintegrin metalloprotease 10(ADAM10)and stromal interaction molecule 1(STIM1)in coronary heart disease(CHD).Methods A total of 119 CHD patients were included as the study group,and 100 non-CHD patients in the same period were selected as the control group.The clinical data of the patients were collected.Serum ADAM10 and STIM1 levels were detected by enzyme-linked immunosorbent assay(ELISA).Color Doppler ultrasonography was applied to detect EAT thickness.Multivariate Logistic regression was used to analyze influencing factors of CHD occurrence.The diagnostic value of EAT thickness combined with serum ADAM10 and STIM1 levels in the diagnosis of CHD was analyzed by subject work characteristics(ROC)curves.Results The levels of triglycerides,low-density lipoprotein cholesterol(LDL-C),EAT thickness,serum ADAM10 and STIM1 were higher in the study group than those in the control group(P＜0.05).Logistic regression analysis showed that elevated EAT thickness,serum ADAM10,STIM1,triglyceride and LDL-C levels were independent risk factors for the occurrence of CHD(P＜0.05).ROC curve analysis showed that the area under the curve of EAT thickness combined with serum ADAM10 and STIM1 for the diagnosis of CHD[0.864(95%CI:0.811-0.907)]was higher than that of their respective individual diagnoses[0.801(95%CI:0.741-0.851),0.750(95%CI:0.687-0.806),respectively,0.799(95%CI:0.740-0.850)],and the sensitivity and specificity of the combined diagnosis were 82.35%and 83.00%,respectively.Conclusion EAT thickness,serum ADAM10 and STIM1 levels are obviously elevated in CHD patients,and the combination of the three tests has a high diagnostic value for CHD.

Objective:To investigate the current application of blood purification in the treatment of acute poisoning within Jiangsu Province and to evaluate the impact of extracorporeal blood purification on the clinical outcomes of critically poisoned patients.Methods:This multicenter, cross-sectional real-world observational study followed patients presenting with poisoning to the emergency departments of nine hospitals in Jiangsu Province between June 2015 and May 2019. Data were collected on demographic characteristics, vital signs within the first hour of emergency presentation, treatment modalities, length of hospital stay, and survival outcomes. Clinical data from patients who underwent extracorporeal blood purification were compared with those who did not, using the Wilcoxon rank-sum test and Chi-square test.Results:A total of 4 178 poisoning cases were included between June 2015 and May 2019. Among them, 21.7% (908/4 178) received blood purification therapy, while 78.3% (3 270/4 178) did not. Hemoperfusion (90.4%) was the most frequently employed method, followed by continuous renal replacement therapy (CRRT) (4.4%). In combined blood purification modalities, 4.8% underwent hemoperfusion combined with CRRT, 0.1% received hemoperfusion with plasma exchange, and another 0.1% underwent hemoperfusion combined with both CRRT and plasma exchange. Among patients who underwent blood purification, pesticide poisoning was the most prevalent (76.3%), with the most common toxic agents being paraquat (23.7%), dichlorvos (8.7%), methamidophos (5.2%), omethoate (4.0%), and glyphosate (3.7%). Compared to the non-blood purification group, patients in the blood purification group were more likely to present within the first hour with a low Glasgow Coma Scale (GCS) score (3-8) (22.6% vs. 9.7%, P <0.05), low mean arterial pressure (8.0% vs. 3.2%, P <0.05), longer hospital stays [5(3,9) days vs. 2(1,4) days, P <0.05] and a higher in-hospital mortality rate (21.1% vs. 5.3%, P <0.05). Follow-up via telephone 28 days after discharge revealed a survival rate of 78.9%, with a mortality rate of 21.1% in the blood purification group. Conclusions:Hemoperfusion is the most commonly utilized blood purification technique for treating poisoning in Jiangsu Province, with pesticides being the primary toxic agents treated. Although the mortality rate is higher in the blood purification group, the intervention may still contribute to improved patient outcomes.

Objective To assess the clinical value of a novel surgical technique—Tubeless subxiphoid uniportal video-assisted thoracoscopic surgery with percutaneous suspension technique via balance-shaped sternal elevation device in the resection of anterior mediastinal masses. Methods Patients who underwent tubeless subxiphoid uniportal video-assisted thoracoscopic surgery via balance-shaped sternal elevation device in anterior mediastinal masses process at the Department of Thoracic Surgery, West China Hospital, Sichuan University from March to April 2025 were included, and their clinical data were analyzed. Results A total of 4 patients were included, with 2 males and 2 females, aged 58-75 years. The diameter of the tumor was 2.5-3.0 cm. The operation time was 60.0-150.0 min, intraoperative blood loss was 5-10 mL, pain score on the 3rd day after surgery was 0 points, and postoperative hospital stay was 2-3 days. All patients achieved complete resection of the masses and thymus without perioperative complications. Conclusion The tubeless subxiphoid uniportal video-assisted thoracoscopic surgery with percutaneous suspension technique via balance-shaped sternal elevation device technique optimizes surgical visualization and instrument maneuverability while avoiding complications related to conventional anesthesia and tubing, thereby markedly enhancing the minimally invasive profile of anterior mediastinal masses resections. In addition to maintaining procedural safety, this approach effectively reduces postoperative pain and accelerates patient recovery, highlighting its potential for widespread clinical adoption.

Artificial intelligence (AI) technologies are being widely applied in radiotherapy. However, the integration of AI into clinical workflows of radiotherapy faces a series of challenges, such as poor model interpretability, domain shifts between clinical application and training data, and the inherent model uncertainties. Therefore, case-specific quality assurance (QA) is essential before deploying AI models in clinical practice. This paper reviews and summarizes QA methodologies for the application of AI models in radiotherapy across four key areas: image registration, image generation, region of interest segmentation, and treatment planning.

Objective:To investigate the effects of psychological state on the setup errors of radiotherapy for breast cancer patients.Methods:A prospective cohort study was conducted. A total of 193 breast cancer patients in Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from October 2022 to May 2023 were selected. Radiotherapy was performed after fixation with an integrated multi-functional device for the head, chest and abdomen. Psychological status of patients was assessed by using 9-item health questionnaire (PHQ-9) and generalized anxiety disorder 7 self-rating scale (GAD-7) before first radiotherapy, the 10th radiotherapy and the last radiotherapy. Based on the results of the questionnaires, patients were divided into psychological problem (anxiety or depression) group and non-psychological problem group. The general data and setup errors of radiotherapy in both groups were compared.Results:All the 193 patients were female, with a median age of 47 years. There were 53 patients in psychological problem group and they underwent a total of 507 image-guided procedures, with setup errors [ M ( Q1, Q3)] of 0.18 (0.07, 0.33), 0.20 (0.10, 0.33) and 0.19 (0.09, 0.30) in the left-right (X), superior-inferior (Y), and anterior-posterior (Z) directions, respectively; the remaining 140 patients in non-psychological problem group underwent 1 240 image-guided procedures, with setup errors [ M ( Q1, Q3)]of 0.17 (0.08, 0.30), 0.20 (0.10, 0.30) and 0.18 (0.09, 0.28) in the X, Y, and Z directions, respectively, and the differences were statistically significant ( Z values were -3.78, -2.00; P < 0.001, P = 0.046). Conclusions:Anxiety and depression have an influence on the setup errors of radiotherapy in patients with breast cancer. In the processs of radiotherapy for breast cancer, it is important to pay attention to the psychological status of patients.