Objective:To explore the feasibility and preliminary efficacy of domestic single-port robotic surgical system in the surgical treatment of thyroid cancer. Methods:Thyroid cancer patients who underwent domestic single-port robotic surgery in the Department of Head and Neck Surgery of Sichuan Cancer Hospital from June 2024 to January 2025 were prospectively included. Clinical data, oncological characteristics, and perioperative indicators were systematically collected. Results:A total of 7 patients were included, including 3 males and 4 females, with an age of （34.57±10.26） years. All procedures were successfully completed without conversion to open surgery. Operative time was（180.00±30.41） minutes. Blood loss was（5.00[15.00 ]）mL. Postoperative drainage volume was （167.86±130.95） mL. The postoperative pathological results were all thyroid papillary carcinoma. There were no system failures, no device-related complications and adverse events were observed during the operation and perioperative period. No tumor recurrence or metastasis was observed during the follow-up period. Conclusion:Preliminary data indicate that the domestic single-port robotic surgical system is safe and feasible for the surgical treatment of thyroid cancer, providing a practical basis for subsequent multi-disease, multi-center, and large-sample studies.
Humans ; Thyroid Neoplasms/surgery* ; Robotic Surgical Procedures/instrumentation* ; Male ; Female ; Adult ; Thyroidectomy/methods* ; Operative Time ; Middle Aged ; Prospective Studies

BACKGROUND: This study aimed to investigate programmed death-ligand 1 tumor proportion score in predicting the safety and efficacy of PD-1/PD-L1 antibody-based therapy in treating patients with advanced non-small cell lung cancer (NSCLC) in a real-world setting. METHODS: This retrospective, multicenter, observational study enrolled adult patients who received PD-1/PD-L1 antibody-based therapy in China and met the following criteria: (1) had pathologically confirmed, unresectable stage III-IV NSCLC; (2) had a baseline PD-L1 tumor proportion score (TPS); and (3) had confirmed efficacy evaluation results after PD-1/PD-L1 treatment. Logistic regression, Kaplan-Meier analysis, and Cox regression were used to assess the progression-free survival (PFS), overall survival (OS), and immune-related adverse events (irAEs) as appropriate. RESULTS: A total of 409 patients, 65.0% ( n = 266) with a positive PD-L1 TPS (≥1%) and 32.8% ( n = 134) with PD-L1 TPS ≥50%, were included in this study. Cox regression confirmed that patients with a PD-L1 TPS ≥1% had significantly improved PFS (hazard ratio [HR] 0.747, 95% confidence interval [CI] 0.573-0.975, P = 0.032). A total of 160 (39.1%) patients experienced 206 irAEs, and 27 (6.6%) patients experienced 31 grade 3-5 irAEs. The organs most frequently associated with irAEs were the skin (52/409, 12.7%), thyroid (40/409, 9.8%), and lung (34/409, 8.3%). Multivariate logistic regression revealed that a PD-L1 TPS ≥1% (odds ratio [OR] 1.713, 95% CI 1.054-2.784, P = 0.030) was an independent risk factor for irAEs. Other risk factors for irAEs included pretreatment absolute lymphocyte count >2.5 × 10 9 /L (OR 3.772, 95% CI 1.377-10.329, P = 0.010) and pretreatment absolute eosinophil count >0.2 × 10 9 /L (OR 2.006, 95% CI 1.219-3.302, P = 0.006). Moreover, patients who developed irAEs demonstrated improved PFS (13.7 months vs. 8.4 months, P <0.001) and OS (28.0 months vs. 18.0 months, P = 0.007) compared with patients without irAEs. CONCLUSIONS A positive PD-L1 TPS (≥1%) was associated with improved PFS and an increased risk of irAEs in a real-world setting. The onset of irAEs was associated with improved PFS and OS in patients with advanced NSCLC receiving PD-1/PD-L1-based therapy.
Humans ; Carcinoma, Non-Small-Cell Lung/metabolism* ; Male ; Female ; Retrospective Studies ; Middle Aged ; Lung Neoplasms/metabolism* ; Aged ; B7-H1 Antigen/metabolism* ; Programmed Cell Death 1 Receptor/metabolism* ; Adult ; Aged, 80 and over ; Immune Checkpoint Inhibitors/therapeutic use*

BackgroundSchizophrenia is a highly heterogeneous disease with different clinical subtypes. Artificial intelligence technology represented by deep learning models has provided considerable benefits for the electroencephalogram （EEG）-based schizophrenia diagnosis， treatment and research， however， to date little research has been conducted regarding any of these benefits among Chinese schizophrenic patients. ObjectiveTo investigate the application of deep learning techniques utilizing EEG parameters for the diagnosis of first-episode schizophrenia and grading of EEG abnormalities in patients， with the aim of contributing to improved clinical diagnosis and treatment strategies for the disorder. MethodsFrom January 2020 to January 2023， a total of 130 patients with first-episode schizophrenia who met the diagnostic criteria of International Classification of Diseases， tenth edition （ICD-10）， and attended at the Third People's Hospital of Fuyang， along with 150 health checkup examinees， were enrolled. All of them underwent EEG examination. An optimized long short-term memory （LSTM） deep learning model was developed utilizing EEG signals. Ten-fold cross-validation method was employed to evaluate the model's performance. The dataset was then split into two components： a training set （90%） for LSTM model development and a test set （10%） for validation. The accuracy， recall rate， precision， F1-score， schizophrenia diagnosis and EEG abnormality grading were used as evaluation indicators， and the results of the proposed model were compared to the assessments made by experienced psychiatrists. ResultsFor schizophrenia diagnosis， the modeling group achieved the following performance metrics： precision （94.40±3.03）%， recall rate （94.30±3.23）%， accuracy （94.60±2.22）%， and F1-score （94.20±2.20）%. In the validation group， the corresponding metrics were precision （90.90±2.85）%， recall rate （92.20±1.14）%， accuracy （92.20±1.69）%， and F1-score （91.50±1.78）%. Statistical analysis revealed no significant differences between the LSTM diagnostic model and the experienced psychiatrists in terms of precision， recall rate， accuracy， and F1-score for schizophrenia diagnosis （χ²=1.500， 0.750， 2.722， 1.056， P>0.05）. The modeling group demonstrated an accuracy rate of （91.71±1.73）% in grading EEG abnormalities. For Grade 1 abnormalities， the modeling group reported a precision of （96.40±2.39）%， a recall rate of （94.77±1.40）%， and an F1-score of （95.55±1.14）%. In the case of Grade 2 abnormalities， the precision was （85.89±2.04）%， the recall rate was （88.10±6.18）%， and the F1-score was （87.06±3.12）%. For the more severe Grade 3 abnormalities， the modeling group's precision was （79.61±7.33）%， the recall rate was （81.79±9.87）%， and the F1-score was （80.41±6.79）%. Additionally， the validation group exhibited an accuracy rate of （85.61±6.16）%. The precision， recall rate， and F1-score for Grade 1 abnormalities were （91.43±6.25）%， （92.64±9.65）% and （91.56±4.83）%， respectively. For Grade 2 abnormalities， these metrics were （71.17±19.02）%， （77.64±17.24）% and （71.88±11.33）%. In the case of Grade 3 abnormalities， the precision was （90.00±21.08）%， the recall rate was （80.00±25.82）%， and the F1-score was （81.67±19.95）%. There was no significant difference in the accuracy， recall， accuracy and F1 value between LSTM model and senior doctors in evaluating the abnormal degree of EEG in schizophrenia （χ²=0.098， 0.036， 0.020， 0.336， P>0.05）. The LSTM model takes less time to diagnose schizophrenia and EEG abnormalities than senior doctors， and the differences were statistically significant （t=57.147， 43.104， P<0.01）. ConclusionThe study utilizes an EEG-based LSTM deep learning model for diagnosing first-episode schizophrenia and grading EEG abnormalities， and the model not only matches the performance of experienced psychiatrists but also significantly reduces the time required for diagnosis.

Objective:To investigate the therapeutic effect and potential mechanism of Nepetoidin B on rheumatoid arthritis (RA).Methods:DBA/1 mice were divided into four groups using the random number method, namely the control group, model group, methotrexate group, and Nepetoidin B group. The collagen-induced arthritis (CIA) model was prepared. Mice were treated from day 21th to day 60th. Arthritis symptoms were evaluated every three days during treatment. At the end of treatment, pathological changes of joint tissue were observed through HE staining. Serum IL-17, IL-6, MDA, and NO levels were measured using ELISA and biochemical colorimetric assays. The Nrf2/HO1 pathway in joint tissues was detected using western blot. A group of CIA mice was treated with Nepetoidin B, followed by an Nrf2 inhibitor to validate the mechanism. One-way analysis of variance was used to compare between multiple groups with homogeneity of variance, pairwise comparison using LSD- t test. Results:The study found that mice treated with methotrexate and Nepetoidin B exhibited a significant reduction in arthritis scores(CIA+Meth group 5.2±1.3, CIA+NepB group 6.8±1.2 vs. CIA group 11.0±1.7, t=6.69, P=0.004; t=5.00, P=0.009), and joint histopathology compared to the CIA mice(CIA+Meth group 1.5±1.0, CIA+NepB group 2.2±0.8 vs. CIA group 4.0±0.9, t=4.44, P<0.001; t=3.84, P=0.005). Additionally, there was a significant decrease in serum IL-17[CIA+Meth group(257±69)ng/ml, CIA+NepB group (279±103)ng/ml vs. CIA group(414±71)ng/ml, t=3.86, P=0.006; t=2.63, P=0.020], IL-6[CIA+Meth group(32±6)ng/ml, CIA+NepB group (44±5)ng/ml vs. CIA group(56±11)ng/ml, t=4.69, P<0.001; t=2.48, P=0.040) ,MDA [CIA+Meth group(22±4)μmol/L, CIA+NepB group(22±8)μmol/L vs. CIA group(34±11)μmol/L, t=2.77, P=0.038; t=2.29, P=0.049]and NO[ CIA+Meth group(37±12)μmol/L, CIA+NepB group(37±11)μmol/L vs. CIA group(56±12)μmol/L, t=2.71, P=0.040; t=2.90, P=0.035] levels, and a significant elevation in the Nrf2( 0.263±0.021, 0.273±0.022 vs. 0.221±0.034, t=3.18, P=0.044; t=2.70, P=0.049)/HO1 (0.524±0.021, 0.501±0.014 vs. 0.453±0.033, t=3.95, P=0.006; t=3.41, P=0.032) pathway in methotrexate and Nepetoidin B treated group. It was also observed that Nrf2 inhibitors could counteract the treatment effects of Nepetoidin B on arthritis (1.8±0.8 vs. 3.2±0.8, t=3.07, P=0.024). Conclusion:Nepetoidin B has the ability to inhibit oxidative stress by activating the Nrf2/HO1 pathway, which alleviates collagen-induced arthritis in mice.

Objective:To summarize the diagnosis and treatment experience of kidney graft’s ureteral obstruction secondary to ureteral inguinal hernia.Methods:Clinical data of a patient with kidney graft’s ureteral obstruction secondary to ureteral inguinal hernia in the Second Xiangya Hospital of Central South University in December 2023 was retrospectively analyzed.This was a male patient with 44 years old. Eleven years after kidney transplantation, he was admitted to the hospital because his serum creatinine increased for one day, accompanied by oliguria and edema of both lower limbs. His previous basal creatinine was maintained in the range of 60-70 μmol/L. Physical examination showed a mass of about 4 cm×3 cm in the right groin. The patient complained of anuria lasting for 7 hours on the second day after admission, and the serum creatinine increased to 406 μmol/L. B-ultrasound showed obstruction of the transplanted kidney and ureteral hydrops. Abdominal CT scan suggested that the right inguinal hernia (transplanted kidney ureteral hernia) was suspected.Preoperative diagnosis of ureteral obstruction secondary to inguinal hernia of the transplanted kidney was made. Percutaneous nephrostomy was performed under local anesthesia, and postoperative anti-infection and indwelling catheter treatments were given. The serum creatinine dropped significantly and the inguinal mass disappeared. A follow-up color ultrasound showed that the transplanted kidney ureteral obstruction and hydrops were alleviated than before. The patient was discharged 2 days after the nephrostomy operation. He was recommended to visit the general surgeon for hernia repairment in a timely manner after a stable renal function was achieved. The patient's renal function basically returned to normal during the following 3 weeks after discharge, and no hernia repair was performed. He was then readmitted to the hospital in order to remove the nephrostomy tube. The patient's nephrostomy tube and urinary catheter both drained almost 1000ml every day. After being informed of the risk of recurrence of obstruction among others, the nephrostomy was removed. Oliguria occurred on the day of nephrostomy tube removal, slight swelling and pain in the transplanted kidney area, and recurrence mass in the groin was seen. The color ultrasound showed recurrence of hydroureteral obstruction and hydrops in the transplanted kidney, and a transplanted nephrostomy was performed again along the original stoma. The postoperative recovery was smooth. One week later, a MDT by general surgeons and the urologists were conducted for choices of surgery. Traditional inguinal hernia repair (Bassini method) and double J-tube insertion under flexible ureteroscope were performed. Results After the operation, anti-infection with cefuroxime, immunosuppression, wound dressing change were given among other treatments. The nephrostomy tube and urinary catheter were removed before discharge. The double J-tube was removed 2 months after discharge. The outpatient follow-up was carried out until 9 months after the initial nephrostomy. The follow-up serum creatinine was at 62 umol/L. The color Doppler ultrasound showed only localized fluid accumulation and no recurrence of ureteroinguinal hernia.Conclusions:Ureteral inguinal hernia of the transplanted kidney is rare and can lead to hydroureteral obstruction and renal insufficiency in the transplanted kidney. Abdominal CT examination is the first choice, combined with abdominal physical examination for diagnosis. Nephrostomy is an effective measure to relieve obstruction and promote recovery of renal function. Hernia repair surgery is an effective measure to prevent the recurrence of kidney graft’s ureteral inguinal hernia, and Bassini method hernia repair is a feasible treatment measure.

The Baihe Dihuang Decoction(BDD) is a representative traditional Chinese medicine formula that has been used to treat depression. This study employed metabolomics and network pharmacology to investigate the mechanism of BDD in the treatment of depression. Fifty male Sprague-Dawley(SD) rats were randomly assigned to the normal control group, model group, fluoxetine group, and high-and low-dose BDD groups. A rat model of depression was established through chronic unpredictable mild stress(CUMS), and the behavioral changes were detected by forced swimming test and open field test. Metabolomics technology was used to analyze the metabolic profiles of serum and hippocampal tissue to screen differential metabolites and related metabolic pathways. Additionally, network pharmacology and molecular docking techniques were used to investigate the key targets and core active ingredients of BDD in improving metabolic abnormalities of depression. A "component-target-metabolite-pathway" regulatory network was constructed. BDD could significantly improve depressive-like behavior in CUMS rats and regulate 12 differential metabolites in serum and 27 differential metabolites in the hippocampus, involving tryptophan metabolism, phenylalanine, tyrosine, and tryptophan biosynthesis, alanine, aspartate, and glutamate metabolism, tyrosine metabolism, and purine metabolism. Verbascoside, isorbascoside, and regaloside B were the key active ingredients for improving metabolic abnormalities in depression. Epidermal growth factor receptor(EGFR), protooncogene tyrosine-protein kinase(SRC), glycogen synthase kinase 3β(GSK3β), and androgen receptor(AR) were the key core targets for improving metabolic abnormalities of depression. This study offered a preliminary insight into the mechanism of BDD in alleviating metabolic abnormalities of depression through network regulation, providing valuable guidance for its clinical use and subsequent research.
Animals ; Drugs, Chinese Herbal/administration & dosage* ; Male ; Rats, Sprague-Dawley ; Rats ; Metabolomics ; Depression/genetics* ; Antidepressive Agents/chemistry* ; Network Pharmacology ; Hippocampus/drug effects* ; Humans ; Molecular Docking Simulation ; Behavior, Animal/drug effects* ; Disease Models, Animal

OBJECTIVES: To evaluate the efficacy of molecular targeted agents in children with progressive pediatric low-grade gliomas (pLGG). METHODS: A retrospective analysis was conducted on pLGG patients treated with oral targeted therapies at the Department of Pediatrics, Beijing Shijitan Hospital, Capital Medical University, from July 2021. Treatment responses and safety profiles were assessed. RESULTS: Among the 20 enrolled patients, the trametinib group (n=12, including 11 cases with BRAF fusions and 1 case with BRAF V600E mutation) demonstrated 4 partial responses (33%) and 2 minor responses (17%), with a median time to response of 3.0 months. In the vemurafenib group (n=6, all with BRAF V600E mutation), 5 patients achieved partial responses (83%), showing a median time to response of 1.0 month. Comparative analysis revealed no statistically significant difference in progression-free survival rates between the two treatment groups (P>0.05). The median duration of clinical benefit (defined as partial response + minor response + stable disease) was 11.0 months for vemurafenib and 18.0 months for trametinib. Two additional cases, one with ATM mutation treated with olaparib for 24 months and one with NF1 mutation receiving everolimus for 21 months, discontinued treatment due to sustained disease stability. No severe adverse events were observed in any treatment group. CONCLUSIONS Molecular targeted therapy demonstrates clinical efficacy with favorable tolerability in pLGG. Vemurafenib achieves high response rates and induces early tumor shrinkage in patients with BRAF V600E mutations, supporting its utility as a first-line therapy.
Humans ; Glioma/genetics* ; Male ; Female ; Child ; Child, Preschool ; Retrospective Studies ; Brain Neoplasms/genetics* ; Molecular Targeted Therapy/adverse effects* ; Adolescent ; Infant ; Proto-Oncogene Proteins B-raf/genetics* ; Pyrimidinones/therapeutic use* ; Mutation

Objective Itproposes a WISN staffing demand model for clinical physicians to address the challenge that current physicians staffing standards fail to meet the operational needs of general hospitals.Methods Collect the 2023 annual operation data of a tertiary general hospital,using inpatient visits and surgeries as benchmarks to measure the workload demands of physicians in internal medicine and surgery,respectively.Additionally,integrate non-clinical workloads of physicians and the workload of resident physicians in standardized training to address the limitation of traditional models that focus solely on clinical tasks.Results The good applicability and robustness of the model in practical applications are verified through model comparison and sensitivity analysis,accurately reflecting the demand for physicians.Conclusion The model accurately reflects the workload of physicians in general hospitals,providing a quantitative estimation formula for physicians staffing.It has broad applicability and significant potential for wider adoption.

Objective To explore the traditional Chinese medicine(TCM)syndrome characteristics of patients with Chikungunya hemorrhagic fever and to provide empirical data to support the application of TCM in diagnosing and treating Chikungunya hemorrhagic fever.Methods A cross-sectional survey was conducted to collect clinical data(sex,age,days since onset,and comorbidity underlying disease conditions)and TCM with four-examination information(symptoms,tongue manifestations,and pulse manifestations)from 255 patients with Chikungunya hemorrhagic fever who visited Lecong Hospital of Shunde,Foshan,the Third People's Hospital of Shunde District of Foshan,Shunde Hospital of Southern Medical University Affiliated Chencun Hospital between July 23 and July 29,2025.Factor and cluster analyses were used to summarize TCM syndrome characteristics and analyze core pathogenesis in conjunction with clinical features.Results Among the 255 patients with Chikungunya hemorrhagic fever,131 were male and 124 were female,with a age of(49.05±17.93)years and a disease duration of(3.26±1.78)days.Among the four types of examination information in TCM,35 items exhibited a frequency exceeding 10%.The most prevalent symptoms were arthralgia(180 patients,70.59%),exanthem(153 patients,60.00%),fatigue(99 patients,38.82%),anhidrosis(98 patients,38.43%),pruritus(96 patients,37.65%),and fever(92 patients,36.08%).Tongue and pulse manifestations were primarily white fur(155 patients,60.78%),pink tongue(111 patients,43.53%),slippery pulse(143 patients,56.08%),and greasy fur(134 patients,52.53%).Patients with disease onset≤3 d had a higher incidence of arthralgia,fatigue,fever,aversion to cold,generalized muscle pain,aversion to wind,insomnia,headache,sweating,low-grade fever,poor appetite,loose stool,hyperhidrosis,and red tongue than those with disease onset≥4 d(P<0.05).Patients with disease onset≥4 d had a higher incidence of pink tongue and thick fur than those with disease onset≤3 d(P<0.05).The syndrome elements in patients with Chikungunya hemorrhagic fever predominantly manifested on the defensive exterior,with involvement of the sinew-bone joints,skin-muscle,and spleen.Pathogenic factors were primarily characterized by external winds,dampness,and heat.Factor and cluster analysis result indicated three TCM pathogenesis progression patterns:imbalance of the defensive exterior with wind-dampness conflict and heat transformation;dampness-heat flowing into muscles and meridians causing joint obstruction and qi blood stasis;and dampness-heat congelation resulting in qi mechanism obstruction,consumption of body fluids,and infiltration of the skin.Conclusion Patients with Chikungunya hemorrhagic fever primarily present with fever,joint pain,and rashes.In TCM,this condition falls under the category of"dampness-warmth"syndrome.Its etiology is attributed to pathogens,with transmission occurring through mosquito bites.The core pathogenesis of TCM is the invasion of the defensive exterior and dampness-toxic heat accumulation.The therapeutic principles focus on clearing heat pathogens,resolving dampness pathogens,dispersing wind pathogens,and promoting the resolution of rashes.

Cyclic GMP-AMP synthase(cGAS)is a congenital immune sensor that can recognize cytoplasm abnormal dsDNA.By catalyzing the second messenger cyclic GMP-AMP(cGAMP)formation,it activates stimulator of interferon genes(STING),releases type Ⅰ interferon and inflammatory cytokines,activates the host immune response,and participates in cerebral ischemia reperfusion injury(CIRI)cascade reaction.This article reviews the research progress of the mechanism of cGAS-STING signaling pathway participation in CIRI,hoping to provide ideas for its treatment.