Objective To analyze the potential profiles of discharge readiness in patients after 125I seed implantation and the influencing factors of different profiles.Methods A total of 221 patients who underwent 125I seed implantation in the Interventional Therapy Department,Zhejiang Cancer Hospital from October 2023 to October 2024 were selected as the research objects by convenient sampling method.The general information questionnaire,discharge readiness scale and social support rating scale were used for investigation.Mplus8.3 software was used to conduct latent profile analysis on the discharge readiness of patients after 125I seed implantation,and multivariate Logistic regression model was used to analyze the influencing factors of different discharge readiness profiles.Results The discharge readiness of patients after 125I seed implantation was divided into three potential profiles,"low discharge readiness-low self-care group"(10.41％),"medium discharge readiness-low others care group"(32.58％)and"high discharge readiness-high emotional support group"(57.01％).Logistic regression analysis showed that the number of short-term complications and the level of social support were the influencing factors of the potential profiles of discharge readiness in patients after 125I seed implantation(P＜0.05).Conclusion There is heterogeneity in the discharge readiness of patients after 125I seed implantation,and personalized intervention strategies should be formulated according to different profiles.

Objective To compare and analyze the impact of intraocular higher-order aberrations and total ocular higher-order aberrations on visual quality after the implantation of different types of multifocal intraocular lenses(MIOL),in order to provide personalized MIOL selection recommendations for patients.Methods A total of 107 patients(107 eyes)with age-related cataract were selected and divided into the SBL-3,MF15,ZMB00,and Zeiss809 groups based on the type of MIOL implanted.Uncorrected distance visual acuity(UCDVA),best-corrected distance visual acuity(BCDVA),best-corrected near visual acuity(BCNVA),optical parameters and wavefront aberrations were compared 3 months postop-eratively.Results Preoperatively,there were no statistically significant differences in any optical parameters or visual acuity among the four groups(all P＞0.05).At three months postoperatively,there were no significant differences in UCD-VA,BCDVA,BCNVA,corneal aberration,or intraocular spherical aberration among the four groups(all P＞0.05).How-ever,significant differences were observed in the predicted visual acuity at 100％,20％,and 9％contrast(100％VA,20％VA,9％VA),streller ratio(SR),modulation transfer function cutoff frequency(MTF cutoff),intraocular coma,intraocu-lar trefoil,total higher-order aberrations,and the average modulation transfer function height values(MTF AH)of the en-tire eye across various spatial frequencies showed significant differences(all P＜0.05).Pairwise comparisons showed that the ZMB00 and Zeiss809 groups had significantly better 100％VA,20％VA,9％VA,SR,MTF cutoff,and MTF AH,and sig-nificantly lower intraocular coma,intraocular trefoil,and total higher-order aberrations than the SBL-3 group(all P＜0.05).The MF15 group only had significantly lower intraocular trefoil than the SBL-3 group(P＜0.05).Correlation analy-sis results at 3 months postoperatively showed that in the SBL-3 and MF15 groups,UCDVA(logMAR)was positively corre-lated with the objective scattering index and negatively correlated with 100％VA,20％VA,9％VA,SR,and MTF cutoff(all P＜0.05).MTF AH was negatively correlated with intraocular coma and total higher-order aberrations,and positively cor-related with intraocular spherical aberration(all P＜0.05).In the ZMB00 and Zeiss809 groups,MTF AH was negatively cor-related with intraocular coma,intraocular trefoil,and total higher-order aberrations(all P＜0.05),but showed no correla-tion with intraocular spherical aberration(all P＞0.05).Conclusion There are no differences in UCDVA,BCDVA,or BCNVA among patients implanted with the four types of MIOLs,but differences existed in objective visual quality.The ob-jective visual quality of ZMB00 and Zeiss809 is significantly better than that of SBL-3,making them the preferred choices for patients with high-quality visual demands;SBL-3 is suitable for basic demand scenarios;MF15,which is only superior to SBL-3 in terms of intraocular trefoil,can be a compromise option for those sensitive to trefoil aberration.

The axillary management of breast cancer patients after neoadjuvant therapy(NAT)is undergoing optimization.Sentinel lymph node biopsy(SLNB)has become an important means for evaluating the status of axillary lymph node(ALN),especially in early-stage breast cancer patients with initially clinically negative ALN(cN0),where it can replace traditional ALN dissection(ALND)to reduce unnecessary surgical risks and complications.However,SLNB has some limitations in terms of false negative rate(FNR)and variability when applied to breast cancer patients with initially clinically positive ALN(cN+)after NAT.By removing≥3 SLN,using dual tracers(such as radioactive isotopes combined with blue dye),and conducting pathological assessment in combination with immunohistochemistry(IHC),the FNR can be significantly reduced to an acceptable range(4.9%-9.1%).Moreover,various optimization schemes have been developed,such as marking ALN with radioactive iodine(MARI),targeted axillary dissection(TAD),and radioactive iodine seed placement in the axilla with SLNB(RISAS),all of which demonstrate low FNR.Not only that,non-invasive imaging techniques such as positron emission tomography and computed tomography(PET/CT),magnetic resonance imaging(MRI),conventional ultrasound and contrast-enhanced ultrasound(CEUS)can all be used to evaluate the axillary response after NAT,with varying diagnostic efficacies.This article summarized recent studies on the optimization of axillary management and SLNB diagnosis and treatment for breast cancer patients with cN+after NAT.

The axillary management of breast cancer patients after neoadjuvant therapy(NAT)is undergoing optimization.Sentinel lymph node biopsy(SLNB)has become an important means for evaluating the status of axillary lymph node(ALN),especially in early-stage breast cancer patients with initially clinically negative ALN(cN0),where it can replace traditional ALN dissection(ALND)to reduce unnecessary surgical risks and complications.However,SLNB has some limitations in terms of false negative rate(FNR)and variability when applied to breast cancer patients with initially clinically positive ALN(cN+)after NAT.By removing≥3 SLN,using dual tracers(such as radioactive isotopes combined with blue dye),and conducting pathological assessment in combination with immunohistochemistry(IHC),the FNR can be significantly reduced to an acceptable range(4.9%-9.1%).Moreover,various optimization schemes have been developed,such as marking ALN with radioactive iodine(MARI),targeted axillary dissection(TAD),and radioactive iodine seed placement in the axilla with SLNB(RISAS),all of which demonstrate low FNR.Not only that,non-invasive imaging techniques such as positron emission tomography and computed tomography(PET/CT),magnetic resonance imaging(MRI),conventional ultrasound and contrast-enhanced ultrasound(CEUS)can all be used to evaluate the axillary response after NAT,with varying diagnostic efficacies.This article summarized recent studies on the optimization of axillary management and SLNB diagnosis and treatment for breast cancer patients with cN+after NAT.

Objective To analyze the potential profiles of discharge readiness in patients after 125I seed implantation and the influencing factors of different profiles.Methods A total of 221 patients who underwent 125I seed implantation in the Interventional Therapy Department,Zhejiang Cancer Hospital from October 2023 to October 2024 were selected as the research objects by convenient sampling method.The general information questionnaire,discharge readiness scale and social support rating scale were used for investigation.Mplus8.3 software was used to conduct latent profile analysis on the discharge readiness of patients after 125I seed implantation,and multivariate Logistic regression model was used to analyze the influencing factors of different discharge readiness profiles.Results The discharge readiness of patients after 125I seed implantation was divided into three potential profiles,"low discharge readiness-low self-care group"(10.41％),"medium discharge readiness-low others care group"(32.58％)and"high discharge readiness-high emotional support group"(57.01％).Logistic regression analysis showed that the number of short-term complications and the level of social support were the influencing factors of the potential profiles of discharge readiness in patients after 125I seed implantation(P＜0.05).Conclusion There is heterogeneity in the discharge readiness of patients after 125I seed implantation,and personalized intervention strategies should be formulated according to different profiles.

Objective To compare and analyze the impact of intraocular higher-order aberrations and total ocular higher-order aberrations on visual quality after the implantation of different types of multifocal intraocular lenses(MIOL),in order to provide personalized MIOL selection recommendations for patients.Methods A total of 107 patients(107 eyes)with age-related cataract were selected and divided into the SBL-3,MF15,ZMB00,and Zeiss809 groups based on the type of MIOL implanted.Uncorrected distance visual acuity(UCDVA),best-corrected distance visual acuity(BCDVA),best-corrected near visual acuity(BCNVA),optical parameters and wavefront aberrations were compared 3 months postop-eratively.Results Preoperatively,there were no statistically significant differences in any optical parameters or visual acuity among the four groups(all P＞0.05).At three months postoperatively,there were no significant differences in UCD-VA,BCDVA,BCNVA,corneal aberration,or intraocular spherical aberration among the four groups(all P＞0.05).How-ever,significant differences were observed in the predicted visual acuity at 100％,20％,and 9％contrast(100％VA,20％VA,9％VA),streller ratio(SR),modulation transfer function cutoff frequency(MTF cutoff),intraocular coma,intraocu-lar trefoil,total higher-order aberrations,and the average modulation transfer function height values(MTF AH)of the en-tire eye across various spatial frequencies showed significant differences(all P＜0.05).Pairwise comparisons showed that the ZMB00 and Zeiss809 groups had significantly better 100％VA,20％VA,9％VA,SR,MTF cutoff,and MTF AH,and sig-nificantly lower intraocular coma,intraocular trefoil,and total higher-order aberrations than the SBL-3 group(all P＜0.05).The MF15 group only had significantly lower intraocular trefoil than the SBL-3 group(P＜0.05).Correlation analy-sis results at 3 months postoperatively showed that in the SBL-3 and MF15 groups,UCDVA(logMAR)was positively corre-lated with the objective scattering index and negatively correlated with 100％VA,20％VA,9％VA,SR,and MTF cutoff(all P＜0.05).MTF AH was negatively correlated with intraocular coma and total higher-order aberrations,and positively cor-related with intraocular spherical aberration(all P＜0.05).In the ZMB00 and Zeiss809 groups,MTF AH was negatively cor-related with intraocular coma,intraocular trefoil,and total higher-order aberrations(all P＜0.05),but showed no correla-tion with intraocular spherical aberration(all P＞0.05).Conclusion There are no differences in UCDVA,BCDVA,or BCNVA among patients implanted with the four types of MIOLs,but differences existed in objective visual quality.The ob-jective visual quality of ZMB00 and Zeiss809 is significantly better than that of SBL-3,making them the preferred choices for patients with high-quality visual demands;SBL-3 is suitable for basic demand scenarios;MF15,which is only superior to SBL-3 in terms of intraocular trefoil,can be a compromise option for those sensitive to trefoil aberration.

Objective:To explore a better measurement mode of shear wave elastography (SWE) in the skin of lymphedema limbs, and to test its diagnostic efficacy in lymphedema.Methods:Between 1st and 10th August, 2023, 22 healthy volunteers were recruited in the Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ulrasound, the First Afiliaed Hospital of Sun Yat-Sen University to measure the Young's modulus (E-value) of limb skin by SWE using a gel pad (GP group) and the thick-layer coupling gel (CG group) respectively. Then between 15th August and 28th September, 2023, 11 patients with 13 lower limb lymphedema, who were treated in the Department of Microsurgery, Orhopaedic Trauma and Hand Surgery, the First Affiliaed Hospital of Sun Yat-Sen University, were consecutively enrolled to find out the E-value of skin in oedematous limbs. The receiver operating characteristic curve (ROC) was constructed and the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated to evaluate the diagnostic efficiency. SPSS 26.0, R studio and GraphPad Prism 8 software were used for statistical analysis. Paired sample non-parametric test (Wilcoxon signed rank test) was used to compare the difference in E-value between the 2 groups. P<0.01 was considered statistically significant. Spearman correlation test was used to analyse the correlation of E-value values between the GP group and CG group. Results:Overall, it was found from the healthy volunteers that E-value of skin in distal limbs were higher than that in proximal limbs, especially in lower extremities. E-value of all scanned location in GP group were found higher than those of CG group with statistically significant difference ( P<0.01), and the values of interclass correlation coefficient (ICC) showed a good repeatability. The 11 patients with lymphedema in 13 lower extremities were examined with the thick-layer coupling gel. The skin E-value in calf of patients with lymphedema were significantly higher than that of the healthy volunteers ( P<0.01), except the skin of thighs ( P>0.01). A lymphedema was diagnosed while either a skin E-value was 27.6 kPa calculated by Youden index or with the thickness of skin was 2.3 mm. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy in the diagnosis of a lymphedema were found at 92.3%, 100%, 100%, 95.7% and 97.1%, respectively. The area under curve (AUC) of ROC was 0.962. The correlation coefficients (R) of E-value in arm, forearm, thigh and lower leg in the GP group and CP group were 0.665, 0.882, 0.850 and 0.815, respectively, which were all significantly correlated. Conclusion:Application of thick layer coupler in ultrasound skin SWE is highly feasible, and the combination of ultrasound skin SWE and skin thickness has higher diagnostic efficiency in the diagnosis of lower extremities lymphedema. It allows more accurate ultrasonic image technical support for early monitoring and diagnosis of lymphedema, microsurgical treatment and a quantitatively perioperative evaluation.

Objective To evaluate the clinical efficacy and safety of transcatheter arterial infusion with gemcitabine and nab-paclitaxel(GN)as first-line therapy in treating patients with advanced pancreatic cancer.Methods The clinical data of a total of 50 patients with advanced pancreatic cancer,who were treated with transcatheter arterial infusion chemotherapy with GN regimen at the Zhejiang Cancer Hospital of China between January 2016 and December2020,were collected The objective effective rate(ORR),progression-free survival(PFS),overall survival(OS)and treatment-related toxic reactions were analyzed.Results A total of 236 times of transcatheter arterial infusion chemotherapy were carried out in the 50 patients,with an average perfusion procedure of 4.72 times per patient.Complete remission(CR)was obtained in 0 patient,partial remission(PR)in 16 patients,and stable disease(SD)in 21 patients.The ORR was 32％,the median PFSwas5.1 months,and the OS was 9.8 months.The main adverse events included neutropenia,thrombocytopenia,vomiting,nausea,fatigue,etc.Conclusion For patients with advanced pancreatic cancer,transcatheter arterial infusion chemotherapy with GN regimen carries good short-term efficacy and safety,it can improve patient's PFS and OS to a certain extent.(J Intervent Radiol,2024,33:512-515)

Objective: To analyze the semen quality parameters of sperm donor volunteers, so as to provide insights into male infertility control and related research. Methods: A total of 155 sperm donors were recruited from the Human Sperm Bank of Zhejiang Province using the convenience sampling method from January to March 2021. Demographic information were collected through questionnaire surveys. Semen were collected, and parameters including semen volume, sperm concentration, total number of sperm, forward motility rate and total sperm viability were measured. Semen quality was evaluated according to the WHO Laboratory Manual for the Examination and Processing of Human Semen. : Results Conclusion There were 20.65% of the 155 sperm donors with unqualified semen, and the unqualified rates of forward motility rate and total sperm viability were relatively high.

Objective:To investigate the clinical and genetic characteristics of Simpson-Golabi-Behmel syndrome (SGBS) type Ⅰ caused by glypican-3 ( GPC3) gene mutations. Methods:Data of one neonate with SGBS type Ⅰ from Shenzhen Maternity and Child Healthcare Hospital Affiliated to Southern Medical University was reviewed retrospectively. Literature was retrieved to summarize the clinical and genetic characteristics of SGBS type Ⅰ caused by GPC3 mutations, using terms of "Simpson-Golabi-Behmel type Ⅰ", "GPC3" and "glypican-3" from China National Knowledge Infrastructure, VIP database, Wanfang database, and PubMed from January 2010 till April 2021. Results:The male infant was admitted to the hospital at 4 h after birth due to "abdominal distension for 1 h", presenting with dysmorphic facial features, including macrocephaly, coarse face, broad nasal bridge, macrostomia, tongue with a groove in the middle, as well as macrosomatia, supernumerary nipples, and hypospadias. Whole exome sequencing revealed a novel frameshift mutation (c.720delC) in GPC3 gene of the patient and his mother for hemizygous and heterozygous variation, respectively, based on which SGBS type Ⅰwas confirmed. During the follow-up, overgrowth, neuroblastoma, and motor development retardation were found in the boy. In addition to the index patient, 92 cases of SGBS type Ⅰ reported in 31 articles were analyzed, including 89(95.7%) males and 4(4.3%) females. The main clinical features were craniofacial dysmorphism, pre/postnatal overgrowth with multiple congenital anomalies. Most patients were combined with language disorders, motor retardation, and various degrees of dysnoesia, and were more likely to develop embryonic tumors. Among the 93 cases, 11(11.8%) suffered from tumors. Apart from 21 cases of termination, 63 cases were born alive and nine cases died after birth. Pathogenic variants in GPC3 gene were reported in 80 cases, which were nonsense mutation in 25 cases (31.2%), DNA fragment deletion in 21 cases (26.2%), frameshift mutation in 16 cases (20.0%), large duplications in eight cases (10.0%), missense mutation in five cases(6.2%), and splice site mutation in five cases(6.2%). Conclusions:SGBS type Ⅰ is an X-linked recessive genetic disease with various phenotypes. Patients with postnatal craniofacial dysmorphism, overgrowth, and multiple congenital anomalies should be highly suspected of SGBS type Ⅰ. Genetic testing is conducive to its early diagnosis. Treatment requires multidisciplinary cooperation and long-term follow-up, especially for those with tumors.