Objective: To summarize the circumstances of rescue events in hospitalized patients after radiotherapy for head and neck cancer in order to provide a reference for clinical decision-making. Methods: This study was approved by the hospital's medical ethics committee. A retrospective analysis was conducted on the clinical data of 86 hospitalized patients admitted between 2015 and 2023 for oral and maxillofacial diseases following radiotherapy for head and neck cancer. Based on the occurrence of rescue events, patients were divided into a rescue group (n=20) and a non-rescue group (n=66). In addition, 20 healthy subjects matched for age and gender with the rescue group were included as a control group. First, baseline characteristics were compared between the rescue and non-rescue groups. Second, a descriptive analysis of the clinical characteristics and rescue events of the rescue group patients was performed. Third, differences in laboratory inflammatory and nutritional indicators, as well as tracheostomy status, were compared between the rescue and non-rescue groups. Fourth, Dolphin Imaging software was used to measure cone beam computed tomography images of the rescue group, non-rescue group, and control group. Upper airway parameters were measured, including the sagittal and coronal diameters of the nasopharyngeal, palatopharyngeal, glossopharyngeal, and laryngopharyngeal segments Results: ① A comparison of baseline characteristics between the rescue and non-rescue groups showed no statistically significant differences in age, gender, or body mass index, but the proportion of patients with comorbid pulmonary diseases was higher in the rescue group (P<0.05). ② In the rescue group, the primary reasons for radiotherapy were nasopharyngeal carcinoma (65%) and tongue cancer (25%). The mean age was (54.75 ± 11.59) years, with a male-to-female ratio of 3:1. The main reasons for this admission included radio-osteomyelitis in the mandible (55%) and recurrence of oral and maxillofacial tumors or new primary tumors in the oral and maxillofacial region (40%). The primary reason for rescue during hospitalization was dyspnea (55%), followed by acute massive hemorrhage (15%) and cardiac arrest (15%). Rescue events occurred mostly postoperatively (65%), with a median time of occurrence at 5 days post-operatively; 30% occurred preoperatively, and 5% occurred intraoperatively. ③ Laboratory indicators and tracheostomy status: preoperative and postoperative neutrophil counts, as well as the proportion of patients undergoing tracheostomy, were higher in the rescue group compared to the non-rescue group, while postoperative albumin levels were lower (P<0.05). ④ Upper airway measurements: the coronal and sagittal diameters of the nasopharyngeal segment and the coronal diameter of the glossopharyngeal segment were smaller in both the rescue and non-rescue groups compared to the control group (P<0.001). Conclusion The data from this study indicate that hospitalized patients experiencing rescue events after radiotherapy for head and neck cancer often have comorbid pulmonary diseases or tumor recurrence/new primary tumors, and frequently present with dyspnea. They exhibit a higher inflammatory state, poorer nutritional status, a greater need for emergency airway intervention, and share a common anatomical basis for dyspnea--upper airway narrowing. Clinical attention should be fully given to high-risk patients with these characteristics.

ObjectiveTo analyze the current research status, hotspots and future trends of the application of digital health technology (DHT) in the rehabilitation of upper limb motor function after stroke. MethodsRelevant literature on the application of DHT in upper limb motor rehabilitation for stroke patients published between January, 2015 and December, 2025 was retrieved from Web of Science Core Collection, CNKI and Wanfang database. CiteSpace 6.4.R1 was used for visualized bibliometric analysis. ResultsA total of 1 295 publications were included, comprising 454 in Chinese and 841 in English. The annual number of publications generally showed an upward trend. China ranked first in publication output in English literature. The institutions with the highest numbers of publications were Huashan Hospital Affiliated to Fudan University and Swiss Federal Institute of Technology in Zurich. Both Chinese and English keywords formed ten clustering groups. Chinese clusters mainly involved occupational therapy, neural mechanisms and home-based rehabilitation, whereas English clusters focused on virtual reality, brain-computer interfaces and machine learning. High-frequency keywords included virtual reality, brain-computer interface, machine learning and deep learning. Chinese keywords with a strong burst included rehabilitation training, while deep learning showed a strong burst in English keywords. Stroke was the most frequently cited journal. Highly cited journals covered multiple disciplines, including rehabilitation medicine, neuroscience and computer science, reflecting the interdisciplinary characteristics of this field. ConclusionResearches on DHT for upper limb motor function rehabilitation in stroke are increasing annually, focusing on core interaction technologies, neural mechanism and artificial intelligence. Future research trends may include inter-disciplinary integration of artificial intelligence with core rehabilitation technologies, neuroimaging-guided targeted interventions, optimisation of home-based rehabilitation systems, and development of multidimensional quantitative assessment models.

Objective:To evaluate the impact of deep learning reconstruction (DLR) on the image quality of carotid CT angiography (CTA), and to explore the visibility of black blood techniques for carotid atherosclerotic plaques and its ability to evaluate the degree of luminal stenosis.Methods:This was a cross-sectional study. A total of 122 carotid atherosclerotic plaques were retrospectively analyzed from 77 patients with soft plaques in the carotid artery CTA of Affiliated Zhongshan Hospital of Dalian University from March 2024 to March 2025. The CTA images were reconstructed using the hybrid iterative reconstruction (HIR) algorithm (HIR group) and DLR algorithm (DLR group). Objective image quality was evaluated by measuring the CT values and image noise (SD) of the carotid, sternocleidomastoid muscle and neck subcutaneous fat, then calculating the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Subjective image quality was assessed using a 5-point scale. The reconstruction algorithm with better image quality was selected for black blood image reconstruction. In CTA and black blood images, the CT values and SD of soft plaques, sternocleidomastoid muscle and neck subcutaneous fat were measured, SNR and CNR were calculated, and visibility of plaques were scored using a 5-point scale. The objective indicators between two groups were compared using paired sample t-test or Wilcoxon signed rank test, and the subjective scores were compared using Wilcoxon signed rank test, the degree of luminal stenosis was compared using χ2 test, and the consistency evaluation was evaluated using weighted Kappa test. Results:In the DLR group, the CT values and SD of the aortic arch, brachiocephalic trunk, left common carotid artery origin, left subclavian artery origin, mid-segment of bilateral common carotid arteries, carotid bifurcation, internal carotid artery origin, and siphon were lower than those in the HIR group (all P<0.001). The SNR and CNR were higher than those in the HIR group (all P<0.001). The image quality score of CTA images in the DLR group was higher than that in the HIR group ( Z=7.44, P<0.001). Black blood images were reconstructed from DLR CTA images with higher image quality. The CT values, SNR, and CNR of soft plaques in the black blood images were higher than those in the DLR CTA images, and the SD was lower than that in the DLR CTA images (all P<0.05). Subjective evaluation showed that the visibility score of soft plaques in black blood images was higher than in DLR CTA images ( Z=-8.92, P<0.001). In DLR CTA images, there were 60 mildly narrowed lumens, 38 moderately narrowed lumens, and 24 severely narrowed lumens. In the black blood images, there were 54 mildly narrowed lumens, 39 moderately narrowed lumens, and 29 severely narrowed lumens. There was no statistically significant difference in the diagnosis of luminal stenosis between black blood images and DLR CTA images ( χ2=0.80, P=0.670), and the diagnostic consistency was good ( Kappa=0.893, P<0.001). Conclusion:DLR algorithm can significantly improve the image quality and reduce image noise. DLR algorithm combined with the black blood technique can significantly enhance the visualization of soft plaques.

Objective To evaluate the efficacy and safety of Mirabegron combined with transcutaneous tibial nerve stimulation (TTNS) in the treatment of drug-refractory overactive bladder (OAB), so as to alleviate patients'symptoms, improve their quality of life with optimized treatment plan, and provide reference for clinical practice. Methods A retrospective analysis was conducted on 56 patients with drug-refractory OAB treated at the Department of Urology of Gansu Provincial Hospital during Jan.2023 and Dec.2024. Based on the treatment methods, the patients were divided into two groups:the TTNS group and the combined treatment group, with 28 patients in either group. The daytime urination frequency, nocturia frequency, urgency episodes, urinary incontinence, functional bladder capacity (FBC), OAB symptom scores (OABSS), and incontinence quality of life questionnaire (I-QoL) scores were collected before and after treatment. The therapeutic efficacy was evaluated using the Nimodipine method. Results After 12 weeks of treatment, the 24-hour urination indicators in both groups including daytime urination frequency, nocturia frequency, urgency episodes and FBC, as well as OABSS and I-QoL scores, showed a significant improvement compared to baseline (P<0.001). The combined treatment group exhibited fewer urgency episodes than the TTNS group [ (1.07±0.66) times/24 h vs. (1.64±0.62) times/24 h, P<0.05]. However, no statistically significant differences were observed between the two groups in other urinary parameters (P>0.05). The total effective rate in the combined treatment group was 96.43%, which was significantly higher than that in the TTNS group (82.14%, P<0.05). During treatment, one patient (3.57%) in the TTNS group experienced mild skin allergy, which recovered following symptomatic management. Conclusion The combination of TTNS and Mirabegron in drug-refractory OAB not only alleviates clinical symptoms and improves quality of life, but also shows superior efficacy in reducing urgency episodes. This approach is a safe and effective treatment option.

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a refractory condition characterized by chronic inflammation of the bladder wall, disruption of the urothelial barrier, and neural sensitization. Current therapies, such as oral pentosan polysulfate sodium (PPS) or intravesical hyaluronic acid instillations, offer limited efficacy due to transient effects and an inability to reverse tissue fibrosis. Platelet-rich plasma (PRP), a regenerative medicine approach, has demonstrated significant therapeutic potential in urological disorders through the synergistic actions of its multiple growth factors. This review summarizes the latest advances in PRP therapy for IC/BPS, revealing that the underlying mechanisms primarily involve the release of diverse growth factors, suppression of inflammatory responses, restoration of the urothelial barrier, and modulation of nerve axonal regeneration. Clinically, PRP therapy significantly alleviates symptoms including pelvic/bladder pain, urinary frequency, nocturia episodes, and improves patients'quality of life. Furthermore, it offers advantages such as convenient administration, a favorable safety profile, and strong feasibility, presenting new therapeutic methods and options for the clinical treatment of IC/BPS.

Among tumor microenvironment (TME), the entire metabolic characteristics of tumor-resident cells are reprogrammed to benefit the expansion of tumor cells, which count on glutamine in large part to fuel the tricarboxylic acid cycle for energy generation and anabolic metabolism support. Endothelial cells that are abducted by tumor cells to form a pathological tumor vascular network for constructing the hypoxic immunosuppressive TME, also rely on glutaminolysis as the "engine" of angiogenesis. Additionally, the glutamine metabolic preference benefits the polarization of TAMs towards pro-tumoral M2 phenotype as well. Herein, we developed a type of siRNA micelleplexes (MH@siGLS1) to reverse immunosuppressive TME by targeting glutaminolysis within tumor-resident cells for tumor vasculature normalization- and TAMs repolarization-enhanced photo-immunotherapy. Tumor cell starvation and antioxidant system destruction achieved by MH@siGLS1-mediated glutaminolysis inhibition could promote photodynamic therapy efficacy, which was available to trigger immunogenic cell death for adaptive antitumor immune responses. Meanwhile, glutaminolysis inhibition of tumor endothelial cells and TAMs could realize tumor vascular normalization and TAMs repolarization for antitumor immunity amplification. This study provides a unique perspective on cancer treatments by focusing on the interrelations of metabolic characteristics and the biofunctions of various cell types within TME.

Prostate cancer is the most prevalent malignant tumor among men, ranking first in incidence and second in mortality globally. Novel hormone therapies (NHT) targeting the androgen receptor (AR) pathway have become the standard of care for metastatic prostate cancer. This review offers a comprehensive overview of NHT, including abiraterone, enzalutamide, apalutamide, darolutamide, and rezvilutamide, which have demonstrated efficacy in delaying disease progression and improving patient survival and quality of life. Nevertheless, resistance to NHT remains a critical challenge. The mechanisms underlying resistance are complex, involving AR gene amplification, mutations, splice variants, increased intratumoral androgens, and AR-independent pathways such as the glucocorticoid receptor, neuroendocrine differentiation, DNA repair defects, autophagy, immune evasion, and activation of alternative signaling pathways. This review discusses these resistance mechanisms and examines strategies to counteract them, including sequential treatment with novel AR-targeted drugs, chemotherapy, poly ADP-ribose polymerase inhibitors, radionuclide therapy, bipolar androgen therapy, and approaches targeting specific resistance pathways. Future research should prioritize elucidating the molecular basis of NHT resistance, optimizing existing therapeutic strategies, and developing more effective combination regimens. Additionally, advanced sequencing technologies and resistance research models should be leveraged to identify novel therapeutic targets and improve drug delivery efficiencies. These advancements hold the potential to overcome NHT resistance and significantly enhance the management and prognosis of patients with advanced prostate cancer.

Objective:To evaluate the impact of deep learning reconstruction (DLR) on the image quality of carotid CT angiography (CTA), and to explore the visibility of black blood techniques for carotid atherosclerotic plaques and its ability to evaluate the degree of luminal stenosis.Methods:This was a cross-sectional study. A total of 122 carotid atherosclerotic plaques were retrospectively analyzed from 77 patients with soft plaques in the carotid artery CTA of Affiliated Zhongshan Hospital of Dalian University from March 2024 to March 2025. The CTA images were reconstructed using the hybrid iterative reconstruction (HIR) algorithm (HIR group) and DLR algorithm (DLR group). Objective image quality was evaluated by measuring the CT values and image noise (SD) of the carotid, sternocleidomastoid muscle and neck subcutaneous fat, then calculating the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Subjective image quality was assessed using a 5-point scale. The reconstruction algorithm with better image quality was selected for black blood image reconstruction. In CTA and black blood images, the CT values and SD of soft plaques, sternocleidomastoid muscle and neck subcutaneous fat were measured, SNR and CNR were calculated, and visibility of plaques were scored using a 5-point scale. The objective indicators between two groups were compared using paired sample t-test or Wilcoxon signed rank test, and the subjective scores were compared using Wilcoxon signed rank test, the degree of luminal stenosis was compared using χ2 test, and the consistency evaluation was evaluated using weighted Kappa test. Results:In the DLR group, the CT values and SD of the aortic arch, brachiocephalic trunk, left common carotid artery origin, left subclavian artery origin, mid-segment of bilateral common carotid arteries, carotid bifurcation, internal carotid artery origin, and siphon were lower than those in the HIR group (all P<0.001). The SNR and CNR were higher than those in the HIR group (all P<0.001). The image quality score of CTA images in the DLR group was higher than that in the HIR group ( Z=7.44, P<0.001). Black blood images were reconstructed from DLR CTA images with higher image quality. The CT values, SNR, and CNR of soft plaques in the black blood images were higher than those in the DLR CTA images, and the SD was lower than that in the DLR CTA images (all P<0.05). Subjective evaluation showed that the visibility score of soft plaques in black blood images was higher than in DLR CTA images ( Z=-8.92, P<0.001). In DLR CTA images, there were 60 mildly narrowed lumens, 38 moderately narrowed lumens, and 24 severely narrowed lumens. In the black blood images, there were 54 mildly narrowed lumens, 39 moderately narrowed lumens, and 29 severely narrowed lumens. There was no statistically significant difference in the diagnosis of luminal stenosis between black blood images and DLR CTA images ( χ2=0.80, P=0.670), and the diagnostic consistency was good ( Kappa=0.893, P<0.001). Conclusion:DLR algorithm can significantly improve the image quality and reduce image noise. DLR algorithm combined with the black blood technique can significantly enhance the visualization of soft plaques.

To address the challenge of unclear features and difficulties in pulmonary nodule CT image detection,an efficient attention feature pyramid network is proposed.The network firstly employs a feature pyramid of multi-scale feature fusion as the backbone network for effectively preserving both low-and high-level features,and uses the depthwise separable convolutional neural network to extract feature information.Then,the attention mechanism is integrated into the backbone network for assigning weights to salient feature information.Finally,the proposed algorithm is applied to Lung-PET-CT-Dx dataset and Luna16 dataset,and the experimental results demonstrate that the proposed algorithm has higher precision,recall rate and mAP value than the existing comparative algorithms,substantiating its superiority in pulmonary nodule detection.

Vertebral artery hypoplasia(VAH)may lead changes of hemodynamic status in the posterior circulation,promote occurrence of intracranial atherosclerotic disease and formation of thrombi,hence result in hypoperfusion and infarction in posterior circulation cerebral tissue,which is potentially associated with posterior circulation cerebral vascular degeneration,vertebral artery dissection,cardiac disease and so on,also is a risk factor for posterior circulation infarction(PCI).The progresses of imaging researches revealing the association between VAH and PCI were reviewed in this article.