Objective: To establish and identify hepatocyte-specific transmembrane protein 121 ( Tmem121 ) knockout mice． Methods: The hepatocyte-specific Tmem121 knockout mice ( Tmem121flox / flox / Cre，Tmem121ΔHep) were obtained by crossbreeding of Tmem121flox / + / Cre and Tmem121flox / flox mice，which were generated using the CRISPR / Cas9 and Cre / Loxp systems．The genotype was verified by PCR using genomic DNA extracted from mouse tails as template．The growth，reproduction and organ development of both control and knockout mice were ob- served and analyzed．PCR and Western blot methods were performed to assess the knockout efficiency of Tmem121 in mouse primary hepatocytes．CellMaskTM Deep Red plasma membrane staining was employed to compare the mor- phological differences in primary hepatocytes between control and knockout mice． Results: Tmem121flox / flox / Cre mice were successfully obtained according to genotype identification analysis，and there were no significant differ- ences between control and knockout mice in body mass，reproductive ability，growth and development of liver．The specific knockout of Tmem121 gene in primary hepatocytes did not significantly affect the morphological structure or pathological characteristics of liver tissue．However，compared to the control group，the levels of Tmem121 mRNA and protein in the primary hepatocytes of the knockout group were significantly reduced ( P ＜0. 01) ．CellMaskTM Deep Red plasma membrane staining indicated that the proportion of binucleated hepatocytes in Tmem121-deficient mice significantly increased ( P＜0. 05) ，while the cell area was significantly reduced ( P＜0. 001) ． Conclusion Hepatocyte-specific Tmem121 knockout mice are successfully constructed，which provides an animal model for further exploration of the function and mechanism of Tmem121 gene in liver diseases．

Objective:To conduct a scoping review of the role responsibilities and competencies of oncology nurse specialist in the management of cutaneous immune-related adverse events (cirAEs), with a view to providing scientific guidance and reference for nursing practice in the field of oncology immunotherapy.Methods:Using the scoping review methodology as the framework, the relevant literatures on oncology nurse specialist in the management of cirAEs in databases including PubMed, Web of Science, CINAHL, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, and China Biology Medicine from their inception to September 20, 2024 were systematically searched. Two researchers independently screened the included literature, extracted information, and conducted a summary analysis.Results:A total of 24 articles were included. Based on the summary and categorization of the literature, six categories were identified, including dynamic monitoring and assessment, classification and intervention of cirAEs, precise symptom management, multidisciplinary management, continuity of care, and specialized training, along with 18 related responsibility items.Conclusions:Oncology nurse specialist plays a significant role in the management of cirAEs. In the future, it should draw on the training models and curricula of advanced practice oncology nurses from abroad to optimize oncology nurse specialist training and nursing practices, thereby enhancing the professionalism of nursing services and the quality of patient care.

Objective To compare the efficacy of recombinant human interleukin-11(rhIL-11)and herombopag olamine tablets on chemotherapy-induced thrombocytopenia(CIT)in breast cancer.Methods Eighty-six prospectively selected breast cancer patients with CIT were randomly divided into the control group(administered rhIL-11)and the study group(administered herombopag olamine tablets),with 43 cases in each group.Before treatment and 14 days after treatment,platelet parameters[platelet count(PLT),plateletcrit(PCT),platelet distribution width(PDW)and mean platelet volume(MPV)]and flow cytometry were measured by automated hematology analyzer.Cellular immune indicators(CD3+,CD4+,CD8+and CD4+/CD8+)were detected by flow cytometer.Enzyme-linked immunosorbent assay was used to determine the levels of thrombopoietin(TPO)and interleukin-11(IL-11).The above parameters were compared between the two groups,and the incidence of adverse reactions in the two groups was recorded.Results After treatment,PLT,PCT,CD3+,CD4+,CD4+/CD8+,TPO and IL-11 in both groups were higher than before treatment,and which was higher in the study group than the control group(P＜0.05).After treatment,PDW,MPV and CD8+of both groups were lower than before treatment,and the study group was lower than the control group(P＜0.05).There was no significant difference in the overall incidence of adverse reactions between the two groups(P＞0.05).Conclusion Both rhIL-11 and herombopag olamine tablets are effective in treating breast cancer with CIT.Compared with rhIL-11,herombopag olamine tablets have more advantages in improving platelet parameters,cellular immune indicators,TPO and IL-11,and do not increase the adverse reactions.

Objective To observe CT and MRI manifestations of polymorphous low-grade neuroepithelial tumor of the young(PLNTY).Methods Totally 21 cases of PLNTY confirmed by pathology were retrospectively enrolled,and CT and MRI manifestations of the lesions were observed.Results Single supratentorial tumor was found in all 21 cases,including 13 cases of isolated brain parenchymal type,6 cases of diffuse brain parenchymal type and 2 cases of extra parenchymal type PLNTY.Diffusion weighted imaging(DWI)showed no diffusion limitation in all 21 cases,and a few cases with mild peritumoral edema.Among 13 cases of isolated brain parenchymal PLNTY,7 cases presented as calcified nodules,5 cases presented as cystic lesions and 1 case as solid nodule.After administration of contrast agents,no enhancement was found in 11 cases,while mild local enhancement was observed in 2 cases.Six cases of diffuse brain parenchymal PLNTY presented as diffuse thickening of the cortex in lesion area,with abnormal signals in the subcortical white matter in 4 cases.After administration of contrast agents,no enhancement was found in 4 cases,while mild local enhancement was noticed in 2 cases.Two cases of extra parenchymal PLNTY presented as solid mass with calcification,with equal density on CT and mild local enhancement on enhanced MRI.Conclusion CT and MRI manifestations of PLNTY had certain characteristics.

Objective To observe clinical characteristics and ultrasonic manifestations of ovarian dysgerminoma.Methods Clinical and ultrasonic data of 35 patients with surgically and pathologically confirmed ovarian dysgerminoma were retrospectively analyzed.Results The mean age of 35 patients was(23.3±9.4)years.Predominant clinical manifestations of ovarian dysgerminoma included pelvic mass(30/35,85.71％),menstrual irregularities(9/35,25.71％)and abdominal pain(7/35,20.00％),7 cases(7/35,20.00％)were found with gonadal dysgenesis.Elevated serum human chorionic gonadotropin(HCG)level and carbohydrate antigen 125 level were observed in 96.00％and 83.33％cases,respectively.The lesions mainly present as unilateral(right-sided),large(mean maximum diameter of[11.60±4.98]cm),lobulated(67.57％)and well-defined(72.97％)solid mass,with internal lobular structures(64.86％)and cord-like septations(62.16％).CDFI revealed abundant blood flow(predominantly grade 3)with low resistance index(mean 0.44±0.11).Conclusion Ovarian dysgerminoma predominantly occurred in young women,typically presented as a large unilateral solid mass,with characteristic fibrovascular septa and abundant low-resistance blood flow showed on ultrasound.

Objective:To investigate the incidence and risk factors associated with poor healing in closed drainage incisions among elderly lung cancer patients(aged ≥65 years)undergoing thoracoscopic pulmonary resection.Methods:A retrospective cohort study was conducted involving 471 elderly lung cancer patients who underwent single utility port video-assisted thoracic surgery(VATS)pulmonary resection at Beijing Hospital from January 1, 2022, to December 31, 2023.Patients were categorized into'healed’and'poor healing’groups based on the development of grade B/C healing following the removal of the closed drainage tube.A comparative analysis of demographic characteristics, medical history, and perioperative parameters between the groups was performed.Multivariate logistic regression analysis was employed to identify independent risk factors for poor incision healing.Results:A total of 471 elderly lung cancer patients who underwent VATS lobectomy were enrolled, with a mean age of 71.16 ± 3.44 years. Among them, 200(42.46%)were male and 271(57.54%)were female.Among 471 patients, 101(21.44%)developed poor healing, all classified as grade B. Univariate analysis revealed statistically significant differences between the two groups regarding BMI( χ2=1.632, P=0.004), diabetes mellitus( χ2=1.558, P=0.004), prolonged drainage duration ( χ2=1.829, P=0.002), and the extent of pulmonary resection( χ2=2.571, P=0.042).Multivariate logistic regression analysis indicated that a BMI of ≥24 kg/m 2( OR=1.534, 95% CI: 1.191-3.289, P=0.033), drainage tube indwelling time exceeding 4 days postoperatively( OR=1.712, 95% CI: 1.014-3.791, P=0.036), and diabetes mellitus( OR=1.855, 95% CI: 1.418-4.015, P=0.002)were significant factors influencing poor wound healing, with statistically significant differences noted( P<0.05). Conclusions:BMI, prolonged drainage duration, diabetes mellitus, and the extent of pulmonary resection are independent risk factors for poor healing of closed drainage incisions in elderly lung cancer patients following VATS.Clinical strategies should prioritize the control of BMI, perioperative glycemic management, real-time monitoring of drainage, and timely removal of tubes to mitigate complications.

Objective To analyze the effects of nasal endoscopic low temperature plasma ablation combined with nasal dynamical system-assisted resection on inflammatory markers in peripheral blood of sinonasal inverted papilloma(SINP)and their correlations with recurrence.Methods A retrospective analysis was performed on 60 SINP patients admitted to Chengdu First People's Hospital from May 2021 to May 2023,all of whom were treated with endoscopic low temperature plasma ablation and nasal dynamical system-assisted resection;and another 60 healthy persons who underwent physical examination in the same period were enrolled and set as control group.The changes of peripheral blood inflammatory markers before and at various time points after operation were compared between control group and SINP patients.General data of patients were collected by self-made scales.The recurrence was recorded,and its influence factors were analyzed for further exploring and the correlation between recurrence and levels of peripheral blood inflammatory factors.Results Statistically significant differences between control group and SINP group were found in serum tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),interleukin-6(IL-6),interleukin-8(IL-8),eosinophilic cationic protein(ECP)and eosinophilic granulocytes(EOS)before operation,3 days and 1 month after operation(all P<0.001).Univariate analysis identified that TNF-α,CRP,IL-6,IL-8,mitotic counts,atypical hyperplasia and course of disease were associated with postoperative recurrence in SINP patients.Spearman correlation analysis showed that the postoperative recurrence in SINP patients showed no correlation with IL-6 level(P>0.05),but positively correlated with TNF-α,CRP and IL-8 levels(P<0.05).Conclusion Nasal endoscopic low temperature plasma ablation combined with nasal dynamical system-assisted resection is effective for SINP,with a low postoperative recurrence rate.Moreover,peripheral blood inflammatory markers are closely related to the occurrence and development of SINP,which may be involved in the recurrence,and there is a synergistic effect.

Objective To explore the independent risk factors influencing the poor prognosis after transnasal-intestinal obstruction catheterization under endoscopic ultrasound,construct a nomogram for predicting poor postoperative prognosis,and conduct external validation of the nomogram.Methods Clinical data of 451 patients with intestinal obstruction who underwent endoscopic ultrasound transnasal-intestinal obstruction catheterization from February 2019 to February 2022 were collected to establish a nomogram.Then,194 sets of data with the same conditions from February 2022 to February 2024 were collected as the external validation group to validate the model externally.The recovery at 30 d after operation was observed and divided into good prognosis group and poor prognosis group.Multivariate Logistic regression model was used to analyze the independent risk factors influencing the poor prognosis after transnasal-intestinal obstruction catheterization under endoscopic ultrasound.Using R 3.6.3 software and the RMS package,a nomogram model for predicting the risk of poor prognosis after intestinal obstruction catheterization under endoscopic ultrasound was constructed..The discrimination and consistency of the model were evaluated using receiver operator characteristic curve(ROC curve)and calibration curve.Results The patients in the poor prognosis group were older than those in the good prognosis group,the levels of C-reactive protein(CRP),procalcitonin(PCT)and neutrophil to lymphocyte ratio(NLR)were higher than those in the good prognosis group,the length of hospital stay was longer than that in the good prognosis group,and the proportion of diabetes,abdominal pain and hormone using were higher than those in the good prognosis group,body mass index(BMI),preoperative albumin level and preoperative nutritional support ratio were lower than those of the good prognosis group,with statistical significance(P<0.05).Multivariate Logistic regression analysis(introduction level was 0.05,exclusion level was 0.107)showed that:age≥68 years(OR＾=2.631,95%CI:1.927～3.593),BMI<22.31 kg/m2(OR＾=2.142,95%CI:1.436～3.195),preoperative albumin<32.47g/L(OR＾=1.962,95%CI:1.506～2.556)and preoperative nutritional non-support(OR＾=2.814,95%CI:1.401～5.654)were independent risk factors affecting the poor prognosis after endoscopic transnasal-intestinal obstruction catheterization(P<0.05).The column nomogram showed that old age,low BMI,low preoperative albumin,and no preoperative nutritional support all increased their corresponding weights.Internal and external validation results indicated good consistency and discrimination of the model.Conclusion age≥68 years,BMI<22.31 kg/m2,preoperative albumin<32.47 g/L,and no preoperative nutritional support are all independent risk factors affecting the ineffective of intestinal obstruction catheterization under endoscopic ultrasound.The nomogram model established in this study based on these four factors has high reliability and practicality.

Objective:To investigate the efficacy and safety of trastuzumab deruxtecan (T-DXd) in the treatment of metastatic breast cancer.Methods:A retrospective case series study was conducted. The clinical data of 38 breast cancer patients with metastasis in other parts who received T-DXd treatment in Xi'an International Medical Center Hospital from August 2021 to August 2024 were analyzed. The clinical efficacy and incidence of adverse reactions in patients were recorded, comparison of clinical efficacy in stratified patients based on clinical characteristics was performed, and the progression-free survival (PFS) was analyzed using Kaplan-Meier method.Results:All 38 patients were female, with a median age [ M ( Q1, Q3)] of 55 (42, 60) years; according to the guidelines of the American Society of Clinical Oncology/College of American Pathologists, 13 cases (34.2%) were positive for human epidermal growth factor receptor 2 (HER2) and 25 cases (65.8%) were low in HER2 expression; the Eastern Cooperative Oncology Group (ECOG) physical status scores of 23 cases (60.5%) were 0-2 points and 15 cases (39.5%) were 3-4 points; the median number of T-DXd treatment lines was 4 (2,16) lines. According to the Response Evaluation Criteria in Solid Tumors 1.1, the objective response rate (ORR) of T-DXd treatment was 34.2% (13/38), and the disease control rate (DCR) was 78.9% (30/38); the ORR of patients aged ≤ 50 years old was higher than that of patients aged >50 years old [56.3% (9/16) vs. 18.2% (4/22)], patients with HER2 positive was lower than that of patients with low HER2 expression [100.0 (13/13) vs. 68.0% (17/25)], patients with previous tyrosine kinase inhibitor (TKI) treatment was higher than that of patients without TKI treatment [100.0% (12/12) vs. 69.2% (18/26)], and the DCR of patients with T-DXd treatment for ≥ 4 cycles was higher than that of patients with T-DXd treatment for 1-3 cycles [100.0% (25/25) vs. 38.5% (5/13)], and the differences were statistically significant (all P < 0.05). Among the 38 patients, 19 (50.0%) stopped medication due to disease progression, 11 (28.9%) stopped medication due to economic reasons, 1 (0.8%) stopped medication due to grade 3 nausea and vomiting, and 1 (0.8%) stopped medication due to grade 2 interstitial lung disease (ILD), while the remaining 6 (15.8%) were undergoing T-DXd treatment. The median follow-up time was 9.5 (3.9, 17.8) months, and 16 cases (42.1%) progressed and died; the median PFS time was 5.9 months (95% CI: 3.1-8.7 months). Adverse reactions were mostly grade 1-2; common hematological adverse reactions included leukopenia [18 cases (47.3%)], neutropenia [16 cases (42.1%)], thrombocytopenia [11 cases (28.9%)], and anemia [15 cases (39.5%)]. Non-hematological adverse reactions included nausea [28 cases (73.7%)], vomiting [15 cases (39.5%)], decreased appetite [20 cases (52.6%)], fatigue [22 cases (57.9%)], alopecia [22 cases (57.5%)], elevated aspartate aminotransferase [20 cases (52.6%)], and elevated alanine aminotransferase [15 cases (39.5%)] were more common. Two cases developed interstitial lung disease (ILD), classified as grade 1 and grade 2, respectively. After discontinuation of medication and treatment with methylprednisolone, they returned to normal. Conclusions:T-DXd ≥ 2 line therapy has good efficacy and safety in the treatment of HER2 positive or low expression metastatic breast cancer. Bone marrow suppression and gastrointestinal adverse reactions are the most common, and the occurrence of ILD should be noted in the treatment.

Objective:To investigate the utility of a computational pathology-based tumor microenvironment(TME)score derived from whole slide images(WSIs)in predicting the efficacy of epidermal growth factor receptor tyrosine kinase inhibitors(EGFR-TKIs)in patients with EGFR mutation-positive non-small cell lung cancer(NSCLC).Methods:This retrospective study collected 240 EGFR-mutant NSCLC pa-tients treated with EGFR-TKIs at The First Affiliated Hospital of Wannan Medical College and analyzed hematoxylin-eosin(H&E)-stained WSIs of biopsy specimens,along with clinical and imaging data.The patients were randomly assigned into a training cohort(n=160)and an inde-pendent validation cohort(n=80)in a 2:1 ratio.Treatment response was assessed based on CT findings at 3 months after EGFR-TKIs initi-ation.Computational pathology was employed to automatically quantify the proportions of four TME components(tumor epithelium,stroma,lymphocytes,and vasculature)within the tumor regions of WSIs.Multivariate Logistic regression in the training cohort identified TME components independently predictive of treatment response(P<0.05),which were then integrated into a TME-score.The predictive performance was evaluated using receiver operating characteristic(ROC)curve analysis and area under the curve(AUC).The TME-score model was compared with a clinical-feature-based model and a combined model(TME-score+clinical features).Finally,the models were val-idated in the independent cohort.Results:In the training cohort,the TME-score,incorporating epithelial and stromal proportions,achieved an AUC of 0.827(95%CI:0.749-0.892)for predicting treatment response,while the validation cohort yielded an AUC of 0.845(95%CI:0.735-0.937).Both outperformed the clinical model(AUCs=0.730[95%CI:0.645-0.804]and 0.712[95%CI:0.586-0.824],respectively).The combined model(TME-score+clinical features,including cytokeratin 19 fragment and non-contrast CT values)further improved predictive performance(AUCs=0.884[95%CI:0.827-0.932]and 0.882[95%CI:0.798-0.950],respectively).Delong's test for pairwise model comparis-ons showed significant differences(all P<0.05)except TME-score and the combined model in the validation cohort(P=0.289).Conclusions:TME-score outperformed clinical models in predicting EGFR-TKIs efficacy in EGFR mutation-positive NSCLC patients and may serve as a novel tool for identifying patients likely to benefit from targeted therapy.