This article reports a diagnostically and therapeutically challenging case of small intestinal marginal zone lymphoma. The patient presented with recurrent abdominal pain as the chief complaint, and imaging revealed multifocal small bowel wall thickening with high uptake, multisegmental luminal stenosis, and proximal dilation. Initial diagnostic workup, including gastroscopy, colonoscopy, and enteroscopy with biopsy, failed to establish a definitive diagnosis. Empirical anti-tuberculosis therapy was ineffective. A repeat enteroscopic biopsy performed over eight months after symptom onset eventually confirmed the diagnosis of mucosa-associated lymphoid tissue (MALT) extranodal marginal zone lymphoma. Despite three different chemotherapy regimens, the patient's intestinal obstruction symptoms persisted, with imaging still showing multifocal bowel wall thickening and hypermetabolic activity. A critical diagnostic dilemma arose regarding whether the PET/CT-positive lesions represented residual lymphoma or fibrotic scarring, whether further chemotherapy adjustments were warranted, and whether surgical resection was necessary. Multidisciplinary discussion concluded that imaging had limited discriminatory value in this scenario and that surgical intervention should be pursued if feasible. The patient successfully underwent partial small bowel resection, with postoperative pathology confirming no residual lymphoma but significant fibrotic changes. The patient has since resumed a normal diet, with body weight nearly restored to pre-illness levels. This case highlights that fibrotic transformation is a common sequela of treated marginal zone lymphoma and that PET/CT may misleadingly suggest residual disease, potentially leading to unnecessary chemotherapy. Timely surgical intervention is crucial in such scenarios.

Background Existing studies have confirmed that fine particulate matter (PM_2.5)is one of the important factors inducing pulmonary fibrosis. Pulmonary fibrosis is the terminal stage of a major category of lung diseases characterized by the destruction of tissue structure, and eventually leading lung ventilation and ventilation dysfunction. No effective pulmonary fibrosis treatment is available yet. Objective To investigate the protective effect of salidroside on pulmonary fibrosis induced by the exposure of PM_2.5 and its molecular mechanism. Methods Seventy 7-week-old male C57BL/6 mice were randomly divided into four groups: control group (intratracheal instillation of normal saline + saline by gavage, n=25), Sal group (intratracheal instillation of normal saline + Sal 60 mg·kg⁻¹ by gavage, n=10), PM_2.5 group (intratracheal instillation of PM_2.5 5 mg·kg⁻¹ + saline by gavage, n=10), and Sal + PM_2.5 group (intratracheal instillation of PM_2.5 5 mg·kg⁻¹ +Sal 60 mg·kg⁻¹ by gavage, n=10). The mice were administered by gavage once daily, intratracheal instillation once every 3 d, and every 3 d constituted an experimental cycle. At the end of the 26-30th cycles, 3 mice in the control group and 3 mice in the PM_2.5 group were randomly sacrificed, and the lung tissues were collected for Masson staining to verify whether the pulmonary fibrosis model was successfully established. After 30 cycles, the model was successfully constructed. After 1 week of continuous observation, the mice were sacrificed, and the blood and lung tissues of the mice were collected to make lung tissue sections. Assay kits were correspondingly employed to detect oxidative stress indicators such as serum malondialdehyde (MDA) and superoxide dismutase (SOD). Western blotting was used to detect the expression of fibrosis-related proteins (Collagen-III, α-SMA), mitochondrial dynamics-related proteins (MFN1, Drp1), and mitophagy-related proteins (PINK1, Parkin, and LC3). Results Compared with the control group, the weight gain rate of the PM_2.5 group was slowed down (P<0.05), which was alleviated by the Sal intervention (P<0.05). The lung coefficient increased after the PM_2.5 exposure (P<0.05), which was alleviated by Sal intervention. Compared with the control group, the PM_2.5 group showed severe alveolar structure damage, inflammatory cell infiltration, and blue collagen deposition, and significantly increased the lung injury score, collagen volume fraction (CVF), Szapiel score, and Ashcroft score (P<0.05), as well as serum oxidative stress levels (P<0.05). The protein expression levels of Collagen-III, α-SMA, Drp1, PINK1, Parkin, and LC3 II/I were increased (P<0.05), and the expression of MFN1 was decreased (P<0.05). Compared with the PM_2.5 group, the Sal intervention alleviated lung injury, reduced inflammatory cell infiltration and collagen deposition, showing decreased lung injury score, CVF, Szapiel score, and Ashcroft score (P<0.05), and decreased serum oxidative stress levels (P<0.05); the protein expression levels of Collagen-III, α-SMA, PINK1, Parkin, and LC3 II/I were decreased (P<0.05), the expression level of Drp1 was decreased, and the expression level of MFN1 was increased. Conclusion In the process of pulmonary fibrosis induced by PM_2.5 exposure in mice, Sal may affect mitochondrial autophagy through PINK1/Parkin pathway and play a protective role. The specific mechanism needs to be further verified.

Background::Although overnight fasting is recommended prior to endoscopic retrograde cholangiopancreatography (ERCP), the benefits and safety of high-carbohydrate fluid diet (CFD) intake 2 h before ERCP remain unclear. This study aimed to analyze whether high-CFD intake 2 h before ERCP can be safe and accelerate patients’ recovery.Methods::This prospective, multicenter, randomized controlled trial involved 15 tertiary ERCP centers. A total of 1330 patients were randomized into CFD group ( n = 665) and fasting group ( n = 665). The CFD group received 400 mL of maltodextrin orally 2 h before ERCP, while the control group abstained from food/water overnight (>6 h) before ERCP. All ERCP procedures were performed using deep sedation with intravenous propofol. The investigators were blinded but not the patients. The primary outcomes included postoperative fatigue and abdominal pain score, and the secondary outcomes included complications and changes in metabolic indicators. The outcomes were analyzed according to a modified intention-to-treat principle. Results::The post-ERCP fatigue scores were significantly lower at 4 h (4.1 ± 2.6 vs. 4.8 ± 2.8, t = 4.23, P <0.001) and 20 h (2.4 ± 2.1 vs. 3.4 ± 2.4, t= 7.94, P <0.001) in the CFD group, with least-squares mean differences of 0.48 (95% confidence interval [CI]: 0.26–0.71, P <0.001) and 0.76 (95% CI: 0.57–0.95, P <0.001), respectively. The 4-h pain scores (2.1 ± 1.7 vs. 2.2 ± 1.7, t = 2.60, P = 0.009, with a least-squares mean difference of 0.21 [95% CI: 0.05–0.37]) and positive urine ketone levels (7.7% [39/509] vs. 15.4% [82/533], χ2 = 15.13, P <0.001) were lower in the CFD group. The CFD group had significantly less cholangitis (2.1% [13/634] vs. 4.0% [26/658], χ2 = 3.99, P = 0.046) but not pancreatitis (5.5% [35/634] vs. 6.5% [43/658], χ2 = 0.59, P = 0.444). Subgroup analysis revealed that CFD reduced the incidence of complications in patients with native papilla (odds ratio [OR]: 0.61, 95% CI: 0.39–0.95, P = 0.028) in the multivariable models. Conclusion::Ingesting 400 mL of CFD 2 h before ERCP is safe, with a reduction in post-ERCP fatigue, abdominal pain, and cholangitis during recovery.Trail Registration::ClinicalTrials.gov, No. NCT03075280.

Objective:To investigate the characteristics of voice-personality perception in blind persons and its relationship with their self-evaluation of personality.Methods:A total of 68 blind persons and 68 sighted peers were respectively recruited to rated 30 short voice recordings on traits of voice-personality perception(including maturi-ty,sunshine,cuteness,indolence,seriousness,simpleness and honestness,gentleness,kindness,self-confidence and optimism).Meanwhile,data on self-evaluations of the above participants and speakers in those recordings,along with acquaintance's ratings on speakers'personality were collected.Results:The research found that compared to sighted peers,blind individuals had a lower voice-personality rating on speakers in traits of sunshine,seriousness,gentleness,kindness,self-confidence and optimism(Ps＜0.005).It also detected that the voice-personality ratings on these speakers by blind individuals had a greater deviation from the rating by these speakers/acquaintances in sunshine;gentleness;kindness and optimism(Ps＜0.005).Meanwhile,blind individuals had lower self-rating on personality in sunshine and optimism(Ps＜0.005).Furthermore,self-ratings of sunshine from blind individuals were positively associated with their voice-personality ratings of optimism on speakers(r=0.28,P＜0.05),and their self-ratings of optimism were positively related to their voice-personality ratings of sunshine and self-confi-dence on speakers(r=0.27,0.28,Ps＜0.05).Conclusion:The study shows that blind individuals have lower voice-personality ratings on others than their sighted peers,which might be due to some of their more negative per-sonality characteristics.

Objective To construct a pelvic floor muscle training program for patients undergoing radical prostatectomy,and to provide a reference for clinical practice.Methods The evidence related to pelvic floor muscle training in patients undergoing radical prostatectomy was systematically searched and the quality was evaluated.The draft of pelvic floor muscle training program for patients undergoing radical prostatectomy was constructed based on the KAP theory and it was demonstrated and revised by expert meetings.From February to March 2023,Delphi method was used to determine the final scheme.37 patients were selected as the control group and 38 patients as the experimental group to implement the scheme and evaluate the application effect.Results 2 rounds of Delphi consultations were conducted among 17 experts,and the recovery rate of the questionnaire was 100％.The expert authority coefficient was 0.89.The Kendall harmony coefficients of the importance and feasibility of the second round of consultation were 0.270 and 0.209(P＜0.001).The coefficient of variation of importance and feasibility of items were 0～0.18 and 0～0.20.The final program included 3 first-level items,8 second-level items and 29 third-level items.1 month after surgery,there was no significant difference in urinary incontinence score(P=0.242)and there was significant difference in pelvic floor muscle training compliance(P=0.011)between 2 groups.Conclusion The program was applied preliminary in clinical practice and it was confirmed with scientific and practical meaning,so it can provide a reference for clinical nursing.

To summarize the nursing care experience of a case of idiopathic multicentric Castleman's disease TAFRO syndrome complicated with diffuse alveolar hemorrhage.Key points of nursing:prone position ventilation with high blood risk nursing observation and bleeding prevention;early rehabilitation exercise and the reduction of the lymphedema;the optimization of transitional care to avoid unplanned returns to the ICU.The patient was transferred to the respiratory ward for further treatment after 19 days,and 33 days later,she recovered and was discharged.At 1 month of follow-up after discharge,the patient recovered well.

Objective To investigate the safety and effectiveness of laparoscopic orchiopexy assisted by needle grasper hydrodissection for cryptorchidism.Methods From September 2020 to September 2022,21 children with cryptorchidism on 25 sides underwent laparoscopic orchiopexy assisted by needle grasper hydrodissection in our department.The water injection function of needle grasper was applied to inject normal saline into the retroperitoneal space to fully separate the retroperitoneum from the vas deferens and spermatic cord,establishing a liquid barrier to protect the vas deferens and spermatic cord.Then the retroperitoneum was bridge-likely cut off with the assistance of needle grasper.The vas deferens and spermatic cord were completely released in accordance with the principle of integrity and non-destructiveness,then the testes were successfully induced and fixed.Results During the operation,15 cases of inguinal cryptorchidism and 6 cases of intra-abdominal cryptorchidism were confirmed.There were 17 cases of unilateral cryptorchidism and 4 cases of bilateral cryptorchidism.All the 25 testes were successfully re-located into the dartos pouch of the scrotum under laparoscopic guidance.The operation time was 35-75 min(mean,45.1±14.3 min),and there were no surgical complications.During follow-ups for 12-24 months in 21 cases,the testicles were found located in the scrotum without retraction,atrophy,incision infection,incision hernia,or inguinal hernia.Conclusions Needle grasper hydrodissection assisted laparoscopic orchiopexy can effectively protect the vas deferens and spermatic cord.The operation is simple,safe,and effective.

Objective:To observe the effect of bone forming protein 4 (BMP4) on the proliferation and migration of human retinal pigment epithelium (RPE) cells under oxidative stress, and to preliminarily explore its effect on epithelial-mesenchymal transition (EMT) of RPE cells.Methods:Human RPE cells cultured in vitro were divided into normal group, pure 4-hydroxynonenal (HNE) group (4-HNE group), 4-HNE+NC group and 4-HNE+ small interfering BMP (siBMP4) group. The effect of 4-HNE on the proliferation of RPE cells was detected by thiazole blue colorimetry. The effects of 4-HNE and BMP4 on cell migration were determined by cell scratch test. The expression of BMP4 was detected by immunofluorescence staining, Western blot and real-time quantitative polymerase chain reaction. The transfection efficiency of siBMP4 was observed by fluorescence microscopy. Mitochondrial reactive oxygen species (MitoSOX) were detected by flow cytometry. The expression of EMT markers E-cadherin and Fibronection were detected by immunofluorescence assay. t-test was used for comparison between the two groups, and one-way analysis of variance was used for comparison between the three groups. Results:Compared with normal group, cell proliferation and migration ability of 4-HNE group were significantly enhanced, with statistical significance ( t=21.619, 24.469; P<0.05). The expression of BMP4 in cells was significantly increased, and the difference was statistically significant ( t=19.441, P<0.05). The relative expression levels of BMP4 mRNA and protein were also significantly increased, with statistical significance ( t=26.163, 37.163; P<0.05). After transfection with siBMP4 for 24 h, the transfection efficiency of BMP4 in RPE cells was>90%. Compared with 4-HNE group and 4-HNE+NC group, the relative expression levels of BMP4 protein ( F=27.241), mRNA ( F=36.943), cell mobility ( F=46.723) and MitoSOX expression levels ( F=39.721) in normal group and 4-HNE+siBMP4 group were significantly decreased. The differences were statistically significant ( P<0.05). The epithelial marker E-cadherin increased significantly, while the mesenchymal marker Fibronection decreased significantly, with statistical significance ( F= 51.722, 45.153; P<0.05). Conclusions:BMP4 inhibits RPE proliferation and migration under oxidative stress. BMP4 is involved in inducing EMT in RPE cells.

The World Health Organization (WHO) classification serves as the internationally recognized standard for diagnosing and classifying hematopoietic and lymphoid tissue tumors(WHO-HEAM). Since 2001, it has undergone multiple upgrades and revisions, updating, clarifying, and refining previous tumor diagnostic and classification standards while incorporating numerous new genetic and molecular biological subtypes. In 2022, two classification proposals emerged due to a wealth of clinical and scientific research results: the fifth edition of the WHO hematopoietic and lymphoid tissue classification (WHO-HAEM5), published in Leukemia journal; and the International Consensus Classification (ICC), published in Blood journal. These two schemes differ in their approach to classifying hematopoietic and lymphoid tissue tumors, posing challenges for clinical laboratory diagnosis and treatment.

Objective:To investigate the complications and related etiologies after immediate silicone implant and immediate two-stage tissue expander/implant breast reconstruction.Methods:A retrospective study was conducted in 23 patients who underwent implant or tissue expander/implant breast reconstruction surgery from June 2016 to October 2019. The etiology, medical history and clinical symptoms of each patient were analyzed and related treatments were carried out depending on its complication.Results:All patients were followed up for 3-12 months after surgery. Among the 23 patients, a total of 8 patients had different types of postoperative complications. Partial necrosis of the nipple-areola complex occurred in 1 case, postoperative infection in 2 cases, 2 patients experienced deviation of the implant or tissue expander and displacement of the nipple-areola complex in 3 cases. All complications were treated accordingly, and a good therapeutic effect was finally maintained.Conclusions:For patients with complications after immediate silicone implant and two-stage tissue expander/implant breast reconstruction, treatment should be carried out according to the causes of complications in time. In this way, patient can get better prognosis.