Objective:To explore diagnostic value of the parameters of transvaginal color Doppler flow imaging(CDFI)on ovarian cancer of elderly,and the correlation between that and pathological characteristics.Methods:The data of 120 elderly patients with ovarian cancer admitted to General Hospital of Northern Theater Command of the Chinese PLA from February 2023 to May 2024 were retrospectively collected,and they were included in the observation group.The data of 120 elderly patients with benign ovarian lesions admitted at the same period were collected,and they were included in the control group.Both groups underwent transvaginal CDFI,and the peak systolic blood flow velocity(PSV),end diastolic blood flow velocity(EDV),resistance index(RI),and pulsatility index(PI)of transvaginal CDFI parameters were compared between the two groups.The receiver operating characteristic(ROC)curve was drawn,and the diagnostic values of transvaginal CDFI parameters alone and the combined examination of various parameters for ovarian cancer of elderly were analyzed.And then,the correlation factors between transvaginal CDFI parameters and pathological characteristics of elderly patients with ovarian cancer were analyzed.Results:The PSV and EDV of the observation group were respectively(21.55±2.50)cm/s and(12.84±2.10)cm/s,which were higher than those(15.41±1.95)cm/s,(8.11±1.20)cm/s of the control group.The RI and PI of the observation group were respectively(0.51±0.12)and(0.95±0.14),which were lower than those(0.79±0.20)and(1.50±0.25)of the control group.The differences of the above 4 indicators between two groups were statistically significant(t=21.214,21.423,13.151,21.027,P<0.05).The area under curve(AUC)values of the ROC curves of PSV,EDV,RI and PI were respectively 0.882,0.876,0.800 and 0.882 in diagnosing ovarian cancer of elderly,all of which had diagnostic value.The value of combined examination of these indicators was higher,which AUC was 0.976.The PSV and EDV of elderly patients with ovarian cancer at tumor stages III-IV were higher than those of elderly patients at tumor stages I-II,while RI and PI were lower than those of elderly patients at tumor stages I-II,and the differences were statistically significant(F=16.232,13.743,6.671,11.846,P<0.05).The PSV and EDV of elderly patients with ovarian cancer who occurred lymph node metastasis were higher than those who did not occur lymph node metastasis,and the RI and PI were lower than those who did not occur lymph node metastasis.The differences of the above 4 indicators between two kinds of patients were statistically significant(t=15.185,15.168,5.598,9.796,P<0.05).Logistic regression analysis showed that increased PSV and EDV were risk factors for tumor staging and lymph node metastasis in elderly patients with ovarian cancer(OR=6.168,5.044,5.302,8.417,P<0.05).The increased RI and PI were protective factors for tumor staging and lymph node metastasis in elderly patients with ovarian cancer(OR=0.005,0.010,0.001,0.002,P<0.05).Conclusion:Transvaginal CDFI parameters have higher diagnostic value for ovarian cancer of elderly,and they correlate with tumor staging and lymph node metastasis,which can be used as important indicators in diagnosing ovarian cancer of elderly,and assessing pathological characteristics.

Based on the theory of circulation of qi,a theoretical model of the circulation of phase fire in the human body was con-structed.It is proposed that cancer toxicity is the key factor that triggers the disorder of phase fire and hinders the circulation of phase fire.The disorder of phase fire and poor circulation are important pathogenesis of the occurrence and development of cancer toxicity.With the principle of strengthening healthy qi and eliminating evil qi,the Wenzi Jiedu method is used to treat tumors,which plays an important role in warming and nourishing,regulating yin and yang,and eliminating cancer toxicity.The combination of war-ming,nourishing and detoxification can promote the return of the phase fire and make the human body's generation and transformation active,providing a new treatment idea for TCM diagnosis and treatment of tumors with mainly cold poison or mixed cold and heat.

Objective To analyze the application value of 3D Slicer software in endoscopic transsphenoidal surgery for pituitary adenoma resection.Methods A retrospective analysis was made on the clinical data of 36 patients with pituitary adenomas treated with 3D Slicer-assisted endoscopic transsphenoidal surgery(3D Slicer group)in the Department of Neurosurgery,The Second Affiliated Hospital of Xi'an Jiaotong University,from January 2024 to December 2024.Preoperatively,multimodal images were fused and reconstructed using 3D Slicer software to systematically evaluate bony anatomical structures such as sphenoid sinus ostia,intrasphenoidal septa,and sellar floor structures,design the size of pedicled nasoseptal flaps,and clarify the positional relationships between pituitary adenomas and surrounding vital structures including the internal carotid artery,pituitary gland,and optic chiasm,so as to provide real-time guidance for intraoperative procedures.Meanwhile,45 patients with pituitary adenomas treated with neuronavigation-assisted endoscopic transsphenoidal surgery from January 2023 to December 2023 were included as the control group(neuronavigation group).The surgical outcomes and postoperative complications were compared between the two groups.Results Compared with the neuronavigation group,the 3D Slicer group demonstrated higher identification rates of the optic nerve groove and carotid artery impression(94.4％vs.77.8％),shorter operative time[(2.9±0.6)h vs.(3.5±0.9)h],less intraoperative bleeding[(159.7±70.5)mL vs.(237.8±96.0)mL],and a lower incidence of postoperative olfactory dysfunction(8.3％vs.26.7％),with statistically significant differences(P＜0.05).However,there were no statistically significant differences between the two groups in the identification rate of the sphenoid sinus ostium(100.0％vs.97.8％),gross total resection rate(75.0％vs.64.4％),and the incidence of other postoperative complications,including cerebrospinal fluid leakage(0.0％vs.6.7％),intracranial infection(2.8％vs.11.1％),transient diabetes insipidus(30.6％vs.22.2％),and hypopituitarism(38.9％vs.37.8％,P＞0.05).Conclusion 3D Slicer software helps improve the mastery of anatomical basics in endoscopic transsphenoidal approach among junior and primary physicians,enhancing the clinical efficacy and safety of pituitary adenoma resection,and thus is worthy of clinical promotion.

Based on the theory of circulation of qi,a theoretical model of the circulation of phase fire in the human body was con-structed.It is proposed that cancer toxicity is the key factor that triggers the disorder of phase fire and hinders the circulation of phase fire.The disorder of phase fire and poor circulation are important pathogenesis of the occurrence and development of cancer toxicity.With the principle of strengthening healthy qi and eliminating evil qi,the Wenzi Jiedu method is used to treat tumors,which plays an important role in warming and nourishing,regulating yin and yang,and eliminating cancer toxicity.The combination of war-ming,nourishing and detoxification can promote the return of the phase fire and make the human body's generation and transformation active,providing a new treatment idea for TCM diagnosis and treatment of tumors with mainly cold poison or mixed cold and heat.

Objective To analyze the application value of 3D Slicer software in endoscopic transsphenoidal surgery for pituitary adenoma resection.Methods A retrospective analysis was made on the clinical data of 36 patients with pituitary adenomas treated with 3D Slicer-assisted endoscopic transsphenoidal surgery(3D Slicer group)in the Department of Neurosurgery,The Second Affiliated Hospital of Xi'an Jiaotong University,from January 2024 to December 2024.Preoperatively,multimodal images were fused and reconstructed using 3D Slicer software to systematically evaluate bony anatomical structures such as sphenoid sinus ostia,intrasphenoidal septa,and sellar floor structures,design the size of pedicled nasoseptal flaps,and clarify the positional relationships between pituitary adenomas and surrounding vital structures including the internal carotid artery,pituitary gland,and optic chiasm,so as to provide real-time guidance for intraoperative procedures.Meanwhile,45 patients with pituitary adenomas treated with neuronavigation-assisted endoscopic transsphenoidal surgery from January 2023 to December 2023 were included as the control group(neuronavigation group).The surgical outcomes and postoperative complications were compared between the two groups.Results Compared with the neuronavigation group,the 3D Slicer group demonstrated higher identification rates of the optic nerve groove and carotid artery impression(94.4％vs.77.8％),shorter operative time[(2.9±0.6)h vs.(3.5±0.9)h],less intraoperative bleeding[(159.7±70.5)mL vs.(237.8±96.0)mL],and a lower incidence of postoperative olfactory dysfunction(8.3％vs.26.7％),with statistically significant differences(P＜0.05).However,there were no statistically significant differences between the two groups in the identification rate of the sphenoid sinus ostium(100.0％vs.97.8％),gross total resection rate(75.0％vs.64.4％),and the incidence of other postoperative complications,including cerebrospinal fluid leakage(0.0％vs.6.7％),intracranial infection(2.8％vs.11.1％),transient diabetes insipidus(30.6％vs.22.2％),and hypopituitarism(38.9％vs.37.8％,P＞0.05).Conclusion 3D Slicer software helps improve the mastery of anatomical basics in endoscopic transsphenoidal approach among junior and primary physicians,enhancing the clinical efficacy and safety of pituitary adenoma resection,and thus is worthy of clinical promotion.

Objective:To explore diagnostic value of the parameters of transvaginal color Doppler flow imaging(CDFI)on ovarian cancer of elderly,and the correlation between that and pathological characteristics.Methods:The data of 120 elderly patients with ovarian cancer admitted to General Hospital of Northern Theater Command of the Chinese PLA from February 2023 to May 2024 were retrospectively collected,and they were included in the observation group.The data of 120 elderly patients with benign ovarian lesions admitted at the same period were collected,and they were included in the control group.Both groups underwent transvaginal CDFI,and the peak systolic blood flow velocity(PSV),end diastolic blood flow velocity(EDV),resistance index(RI),and pulsatility index(PI)of transvaginal CDFI parameters were compared between the two groups.The receiver operating characteristic(ROC)curve was drawn,and the diagnostic values of transvaginal CDFI parameters alone and the combined examination of various parameters for ovarian cancer of elderly were analyzed.And then,the correlation factors between transvaginal CDFI parameters and pathological characteristics of elderly patients with ovarian cancer were analyzed.Results:The PSV and EDV of the observation group were respectively(21.55±2.50)cm/s and(12.84±2.10)cm/s,which were higher than those(15.41±1.95)cm/s,(8.11±1.20)cm/s of the control group.The RI and PI of the observation group were respectively(0.51±0.12)and(0.95±0.14),which were lower than those(0.79±0.20)and(1.50±0.25)of the control group.The differences of the above 4 indicators between two groups were statistically significant(t=21.214,21.423,13.151,21.027,P<0.05).The area under curve(AUC)values of the ROC curves of PSV,EDV,RI and PI were respectively 0.882,0.876,0.800 and 0.882 in diagnosing ovarian cancer of elderly,all of which had diagnostic value.The value of combined examination of these indicators was higher,which AUC was 0.976.The PSV and EDV of elderly patients with ovarian cancer at tumor stages III-IV were higher than those of elderly patients at tumor stages I-II,while RI and PI were lower than those of elderly patients at tumor stages I-II,and the differences were statistically significant(F=16.232,13.743,6.671,11.846,P<0.05).The PSV and EDV of elderly patients with ovarian cancer who occurred lymph node metastasis were higher than those who did not occur lymph node metastasis,and the RI and PI were lower than those who did not occur lymph node metastasis.The differences of the above 4 indicators between two kinds of patients were statistically significant(t=15.185,15.168,5.598,9.796,P<0.05).Logistic regression analysis showed that increased PSV and EDV were risk factors for tumor staging and lymph node metastasis in elderly patients with ovarian cancer(OR=6.168,5.044,5.302,8.417,P<0.05).The increased RI and PI were protective factors for tumor staging and lymph node metastasis in elderly patients with ovarian cancer(OR=0.005,0.010,0.001,0.002,P<0.05).Conclusion:Transvaginal CDFI parameters have higher diagnostic value for ovarian cancer of elderly,and they correlate with tumor staging and lymph node metastasis,which can be used as important indicators in diagnosing ovarian cancer of elderly,and assessing pathological characteristics.

The dynamic tracking of antibody‒drug conjugates (ADCs) in serum is crucial. However, a versatile bioanalytical platform is lacking due to serious matrix interferences, the heterogeneity and complex biotransformation of ADCs, and the recognition deficiencies of traditional affinity technologies. To overcome this, a multiepitope recognition technology (MERT) was developed by simultaneously immobilizing CDR and non-CDR ligands onto MOF@AuNPs. MERT's excellent specificity, ultrahigh ligand density, and potential synergistic recognition ability enable it to target the different key regions of ADCs to overcome the deficiencies of traditional technologies. The binding capacity of MERT for antibodies is ten to hundred times higher than that of the mono-epitope or Fc-specific affinity technologies. Since MERT can efficiently capture target ADCs from serum, a novel bioanalytical platform based on MERT and RPLC‒QTOF-MS has been developed to monitor the dynamic changes of ADCs in serum, including the fast changes of drug-to-antibody ratio from 3.67 to 0.22, the loss of payloads (maytansinol), and the unexpected hydrolysis of the succinimide ring of the linker, which will contribute to clarify the fate of ADCs and provide a theoretical basis for future design. In summary, the MERT-based versatile platform will open a new avenue for in-depth studies of ADCs in biological fluids.

Dynamic tracking analysis of monoclonal antibodies (mAbs) biotransformation in vivo is crucial, as certain modifications could inactivate the protein and reduce drug efficacy. However, a particular challenge (i.e. immune recognition deficiencies) in biotransformation studies may arise when modifications occur at the paratope recognized by the antigen. To address this limitation, a multi-epitope affinity technology utilizing the metal organic framework (MOF)@Au@peptide@aptamer composite material was proposed and developed by simultaneously immobilizing complementarity determining region (CDR) mimotope peptide (HH24) and non-CDR mimotope aptamer (CH1S-6T) onto the surface of MOF@Au nanocomposite. Comparative studies demonstrated that MOF@Au@peptide@aptamer exhibited significantly enhanced enrichment capabilities for trastuzumab variants in comparison to mono-epitope affinity technology. Moreover, the higher deamidation ratio for LC-Asn-30 and isomerization ratio for HC-Asn-55 can only be monitored by the novel bioanalytical platform based on MOF@Au@peptide@aptamer and liquid chromatography-quadrupole time of flight-mass spectrometry (LC-QTOF-MS). Therefore, multi-epitope affinity technology could effectively overcome the biases of traditional affinity materials for key sites modification analysis of mAb. Particularly, the novel bioanalytical platform can be successfully used for the tracking analysis of trastuzumab modifications in different biological fluids. Compared to the spiked phosphate buffer (PB) model, faster modification trends were monitored in the spiked serum and patients' sera due to the catalytic effect of plasma proteins and relevant proteases. Differences in peptide modification levels of trastuzumab in patients' sera were also monitored. In summary, the novel bioanalytical platform based on the multi-epitope affinity technology holds great potentials for in vivo biotransformation analysis of mAb, contributing to improved understanding and paving the way for future research and clinical applications.

In recent years, traditional Chinese medicine (TCM) has made great progress in the prevention and treatment of cancer. It has gradually revealed its characteristics and advantages in clinical practice, including alleviating clinical symptoms, prolonging survival time, decreasing the adverse effects of chemotherapy, and improving living quality. However, clinical TCM treatment of cancer lacks systematic theoretical guidance, because ancient TCM has not formed a recognized theoretical system of cognitive cancer, and there still are different opinions on the pathogenesis of cancer. Due to the complexity of cancer, the essence of cancer pathogenesis has not been described accurately by using common pathogenic factors, such as pathogenic wind, cold, dampness, summer heat, dryness, and fire. Ancient and modern TCM physicians have a similar understanding that the occurrence of cancer is related to toxin. In the 1990s, the thought of cancerous toxin was first proposed by Prof Zhou Zhongying, a TCM master based on more than 60 years of clinical practice, who used “pandemic Qi (Li-Qi) is a specific pathogenic factor of epidemic disease” in Wenyi Lun (Treatise on Pestilence) for references. The pathogenesis theory of cancerous toxin was gradually established under the guidance of the thought of cancerous toxin. It holds that the cancerous toxin, a special pathogenic factor of cancer, is the key pathogenesis of the occurrence of malignant tumors. According to the pathogenesis theory of cancerous toxin, the basic pathogenesis of malignant tumors is the accumulation of pathogenic factors and cancerous toxin, and the deficiency of the vital Qi (Zheng-Qi). Therefore, the treatment principle involves eliminating pathogenic factors, resolving cancerous toxin, and supporting the vital Qi. The anticancer detoxification methods and the classification of Chinese medicinal herbs with anticancer detoxification effects were put forward. System theory has much in common with the concepts in the theory system of TCM, such as the universal relation theory, asking for a concrete analysis of concrete conditions, the humanism thought, and so on. This article aims to describe, review, and analyze the pathogenesis theory of cancerous toxin based on system theory for clinical practices.

Dynamic tracking analysis of monoclonal antibodies(mAbs)biotransformation in vivo is crucial,as certain modifications could inactivate the protein and reduce drug efficacy.However,a particular chal-lenge(i.e.immune recognition deficiencies)in biotransformation studies may arise when modifications occur at the paratope recognized by the antigen.To address this limitation,a multi-epitope affinity technology utilizing the metal organic framework(MOF)@Au@peptide@aptamer composite material was proposed and developed by simultaneously immobilizing complementarity determining region(CDR)mimotope peptide(HH24)and non-CDR mimotope aptamer(CH1S-6T)onto the surface of MOF@Au nanocomposite.Comparative studies demonstrated that MOF@Au@peptide@aptamer exhibited signifi-cantly enhanced enrichment capabilities for trastuzumab variants in comparison to mono-epitope af-finity technology.Moreover,the higher deamidation ratio for LC-Asn-30 and isomerization ratio for HC-Asn-55 can only be monitored by the novel bioanalytical platform based on MOF@Au@peptide@aptamer and liquid chromatography-quadrupole time of flight-mass spectrometry(LC-QTOF-MS).Therefore,multi-epitope affinity technology could effectively overcome the biases of traditional affinity materials for key sites modification analysis of mAb.Particularly,the novel bioanalytical platform can be suc-cessfully used for the tracking analysis of trastuzumab modifications in different biological fluids.Compared to the spiked phosphate buffer(PB)model,faster modification trends were monitored in the spiked serum and patients'sera due to the catalytic effect of plasma proteins and relevant proteases.Differences in peptide modification levels of trastuzumab in patients'sera were also monitored.In summary,the novel bioanalytical platform based on the multi-epitope affinity technology holds great potentials for in vivo biotransformation analysis of mAb,contributing to improved understanding and paving the way for future research and clinical applications.