Persistent left superior vena cava is a rare venous variant that is often combined with cardiovascular malformations. In thoracic surgery, especially mediastinal tumor resection, neglect of this variant may make the surgery difficult and risky, and careful preoperative imaging interpretation and adequate preoperative evaluation play an important role in the perioperative safety of the patient. In this paper, we reported a case of a 17-year-old female patient with a persistent left superior vena cava combined with mediastinal tumors. She was successfully discharged 5 days after thoracoscopic surgery, and after 3 years of postoperative follow-up, no tumor recurrence was observed.

Objective:To investigate the iodine nutrition status of children and pregnant women in different water iodine areas of Shandong Province.Methods:From February to September 2023, Leling City (iodine deficient), Gaotang County (moderate iodine), and Liangshan County (high iodine) in different water iodine areas of Shandong Province were selected as survey sites. One village was selected from each county (city) in five directions: east, west, south, north, and center. Forty children aged 8 to 10 years (balanced in age, half male and half female) and 20 pregnant women were selected as survey subjects in each village. Random urine samples of children and pregnant women were collected to test for urinary iodine. Meanwhile, thyroid examinations were conducted on children to calculate the goiter rate.Results:A total of 600 urine samples of children were tested, with a median urinary iodine level of 246.0 μg/L. The median urinary iodine levels of children in iodine deficient, moderate iodine and high iodine areas were 219.6, 208.0 and 446.0 μg/L, respectively ( n = 200, 200, 200). The median urinary iodine level of children in high iodine area was significantly higher than that in iodine deficient and moderate iodine areas ( P < 0.05). A total of 600 children underwent thyroid examinations, with a goiter rate of 5.8% (35/600). The goiter rate of children in iodine deficient, moderate iodine, and high iodine areas were 4.0% (8/200), 1.0% (2/200), and 12.5% (25/200), respectively. The goiter rate of children in high iodine area was significantly higher than that in iodine deficient and moderate iodine areas ( P < 0.05). A total of 247 urine samples of pregnant women were tested, with a median urinary iodine level of 158.2 μg/L. The median urinary iodine levels of pregnant women in iodine deficient, moderate iodine, and high iodine areas were 75.3, 175.2 and 321.2 μg/L, respectively ( n = 98, 84, 65). The median urinary iodine level of pregnant women in high iodine area was significantly higher than that in iodine deficient and moderate iodine areas, and the median urinary iodine level of pregnant women in moderate iodine area was significantly higher than that in iodine deficient area ( P < 0.05). Conclusion:The urinary iodine levels of children and pregnant women and the goiter rate of children in high iodine area of Shandong Province are significantly increased, and water iodine may be a key factor affecting the iodine nutrition status of the population.

Stroke-associated pneumonia(SAP),a frequent complication of stroke,adversely affects clinical outcomes and functional recovery.Identifying SAP risk factors and developing robust predictive models are critical for improving patient management.This article reviews recent research advances in SAP risk factors and risk prediction,emphasizes emerging risk factors-including sarcopenia epidemiology,gut microbiota dysbiosis,and thyroid dysfunction-and novel predictive approaches such as risk stratification scores,neuroimaging,biomarkers,and artificial intelligence.We aim to enhance clinical recognition of SAP to facilitate early intervention,reduce incidence,and optimize stroke prognosis.

Objective To investigate the differences in Mandarin vowel space area(VSA)across geographic regions and genders.Methods Healthy college students residing in Beijing(62 cases,32 males and 30 females)and Shanghai(62 cases,32 males and 30 females)were selected to study the Mandarin VSA with six Chinese vowels(/a/,/e/,/i/,/u/,/o/,/ü/,and the short text Vacation)as the corpus,respectively.Results The differences in VSA between genders were extremely significant(P＜0.001),and the VSA of females was significantly larger than that of males.Simple effect tests for speech material and region showed that when the speech material was con-tinuous speech,the VSAs of Beijing and Shanghai subjects showed no significant difference,but when the speech material was unitary speech,the VSAs of Shanghai subjects were significantly larger than those of Beijing subjects(P=0.003,P＜0.01).Conclusion The VSAs of female adults were larger than those of male adults,and the front vowels of females were more fronted and the back vowels were more backward.The differences produced by different regions based on the Mandarin system of pronunciation were not significant.

Objective:To report the preliminary clinical exploration result of spatially fractionated radiation therapy (SFPT) using the pencil-beam-scanning (PBS) technique at a single center for the treatment of patients with bulky tumors.Methods:Data on the clinical characteristics, tumor characteristics, and dosimetric parameters were retrospectively collected from patients with bulky tumors at the Radiation Oncology Department, Ion Medical Center, First Affiliated Hospital of University of Science and Technology of China (i.e., the Hefei Ion Medical Center) from April 2024 to December 2024. Three-dimensional lattice radiotherapy (LRT) was primarily utilized in the SFRT, with multi-field robust optimization performed using pencil beam scanning. SFRT target volumes (STVs) were defined as 1.0 cm-diameter spheres. Primary observation indicators included the remission rate of tumor-associated symptoms, followed by the local tumor control rate.Results:A total of 12 patients were enrolled in this study, with a median age of 61 years (28-85 years). The primary tumors included hepatocellular carcinoma (six patients), sarcomas (three patients), and lung cancer (two patients). Eight patients received concurrent systemic therapy. The SFRT plans showed a median gross tumor volume (GTV) of 429.63 cm 3 (120.60-2 053.30 cm 3), a median STV number of 8 (3-20), a single-fraction dose to STVs of 10 GyE, a median irradiation quantity of 6 (3-8), a median STV of 8 cm 3 (3-20 cm 3), a median STV proportion of 2.09% (0.62%-3.30%), a median GTV corresponding to a single STV of 52.91 cm 3 (30.25-159.82 cm 3), and a median peak-to-valley dose ratio of 3.37 (2.29-7.60). All patients received conventionally fractionated proton therapy (CFPT), with a median prescription dose of 50 GyE (40-60 GyE). Furthermore, these patients showed a median follow-up time of 174 d (133-235 d), a remission rate of tumor-associated symptoms of 75%, and a local control rate of 100%. Four patients experienced grade 1-2 treatment-related adverse events, suggesting high overall tolerability of the patients. Conclusions:SFRT represents a promising technique with high control rates and tolerability for bulky tumors, providing the possibility for quick symptom relief and the control of tumor progression.

Objective To investigate the expression level and clinical application value of circular RNA hsa_circ_0001766 in gastric cancer(GC)tissues and serum of patients with GC.Methods The PCR amplification products from GES-1 cells of normal gastric mucosa were analyzed for the cyclic sites of hsa_circ_0001766 by the Sanger sequencing technique.The expression levels of hsa_circ_0001766 in GES-1 cells treated or untreated with RNase R(RNase R)were detected by real-time fluorescence quantitative PCR(qRT-PCR).The expression levels of hsa_circ_0001766 in GC and adjacent tissues of 73 GC patients and serum samples of 34 GC patients were also detected by qRT-PCR.The receiver operating characteristics(ROC)curve was used to evaluate the clinical diag-nostic value of hsa_circ_0001766 in GC.The correlations between hsa_circ_0001766 and clinicopathological parameters in GC patients were also analyzed.Results There was cyclic sites in hsa_circ_0001766 and RNase R had no significant impact on the expression lev-el of hsa_circ_0001766 in GES-1 cells(t=1.678,P=0.169).Compared with adjacent tissues,the expression levels of hsa_circ_0001766 in GC tissues were significantly up-regulated(U=1 360,P<0.001).Compared with healthy controls,the expres-sion levels of hsa_circ_0001766 in serum of GC patients were significantly up-regulated(U=375,P<0.001).The area under the ROC curve(AUCROC),sensitivity,and specificity of hsa_circ_0001766 in GC tissues for diagnosing GC were 0.759(95％CI:0.682-0.837,P<0.000 1),79.45％,and 68.49％,respectively.The AUCROC,sensitivity,and specificity of serum hsa_circ_0001766 in diagnosing GC were 0.773(95％CI:0.662-0.884,P<0.000 1),73.53％,and 72.12％,respectively.The expression levels of hsa_circ_0001766 in GC tissues were correlated with lymph node metastasis(x2=5.509,P=0.019)and TNM staging(x2=5.161,P=0.023).The 3-year survival rate of GC patients with high expression of hsa_circ_0001766 in GC tissues was significantly lower than that with low ex-pression(x2=3.700,P=0.037).Conclusion The hsa_circ_0001766 in GC tissues and serum of GC patients is highly expressed,and its change in the expression level is of great significance for the diagnosis and prognostic evaluation of GC patients.

Stroke-associated pneumonia(SAP),a frequent complication of stroke,adversely affects clinical outcomes and functional recovery.Identifying SAP risk factors and developing robust predictive models are critical for improving patient management.This article reviews recent research advances in SAP risk factors and risk prediction,emphasizes emerging risk factors-including sarcopenia epidemiology,gut microbiota dysbiosis,and thyroid dysfunction-and novel predictive approaches such as risk stratification scores,neuroimaging,biomarkers,and artificial intelligence.We aim to enhance clinical recognition of SAP to facilitate early intervention,reduce incidence,and optimize stroke prognosis.

Jiegengtang is a basic formula for treating sore throat and cough. By means of bibliometrics， this study conducted a textual research and analysis on the key information such as formula origin， decocting methods， and clinical application of Jiegengtang. After the research， it can be seen that Jiegengtang is firstly contained in Treatise on Febrile and Miscellaneous Disease， which is also known as Ganjietang， and it has been inherited and innovated by medical practitioners of various dynasties in later times. The origins of Chinese medicines in this formula is basically clear， Jiegeng is the dried roots of Platycodon grandiflorum， Gancao is the dried roots and rhizomes of Glycyrrhiza uralensis， the two medicines are selected raw products. The dosage is 27.60 g of Glycyrrhizae Radix et Rhizoma and 13.80 g of Platycodonis Radix， decocted with 600 mL of water to 200 mL， taken warmly after meals， twice a day， 100 mL for each time. In ancient times， Jiegengtang was mainly used for treating Shaoyin-heat invasion syndrome， with cough and sore throat as its core symptoms. In modern clinical practice， Jiegengtang is mainly used for respiratory diseases such as pharyngitis， esophagitis， tonsillitis and lung abscess， especially for pharyngitis and lung abscess with remarkable efficacy. This paper can provide literature reference basis for the modern clinical application and new drug development of Jiegengtang.

Jiegengtang is a basic formula for treating sore throat and cough. By means of bibliometrics， this study conducted a textual research and analysis on the key information such as formula origin， decocting methods， and clinical application of Jiegengtang. After the research， it can be seen that Jiegengtang is firstly contained in Treatise on Febrile and Miscellaneous Disease， which is also known as Ganjietang， and it has been inherited and innovated by medical practitioners of various dynasties in later times. The origins of Chinese medicines in this formula is basically clear， Jiegeng is the dried roots of Platycodon grandiflorum， Gancao is the dried roots and rhizomes of Glycyrrhiza uralensis， the two medicines are selected raw products. The dosage is 27.60 g of Glycyrrhizae Radix et Rhizoma and 13.80 g of Platycodonis Radix， decocted with 600 mL of water to 200 mL， taken warmly after meals， twice a day， 100 mL for each time. In ancient times， Jiegengtang was mainly used for treating Shaoyin-heat invasion syndrome， with cough and sore throat as its core symptoms. In modern clinical practice， Jiegengtang is mainly used for respiratory diseases such as pharyngitis， esophagitis， tonsillitis and lung abscess， especially for pharyngitis and lung abscess with remarkable efficacy. This paper can provide literature reference basis for the modern clinical application and new drug development of Jiegengtang.

The clinical characteristics, diagnosis and treatment process of a patient with type Ⅰ sialidosis (ST-1) caused by a homozygous mutation in the NEU1 gene who was missed diagnosis for 5 years were retrospectively analyzed to improve the understanding of the disease. A 16-year-old female patient presented with episodic limb shaking for more than 5 years and single generalised tonic-clonic seizure. Electroencephalogram (EEG) tests conducted at external hospital did not show any abnormalities, and head magnetic resonance imaging (MRI) showed general normality. Multiple antiepileptic drugs could not control the attack and the symptoms gradually worsened. After admission, the patient was found to have symptoms of easy wrestling and decreased vision, as well as signs of nystagmus and ataxia. The reexamination of the EEG showed extensive spike-and-slow complexes, and the brain MRI showed cerebellar atrophy. Furthermore, the whole-exome gene testing revealed the c.544A>G homozygous mutation in the NEU1 gene, leading to the diagnosis of ST-1. Levetiracetam tablets and clonazepam were given to improve the patient′s symptoms. During the follow-up, sleep improved compared to before, and myoclonus was significantly reduced. Therefore, patients with recurrent myoclonus, ataxia, and visual impairment without cognitive impairment should be aware of the possibility of sialidosis. Genetic testing plays an important role in the diagnosis of sialidosis.