Objective:To investigate the predictive value of preoperative coagulation function and inflammation response biomarkers for postoperative recurrence of non-muscle-invasive bladder cancer (NMIBC) patients.Methods:The clinical data of 390 NMIBC patients underwent surgical treatment from May 2014 to May 2021 in the Second Affiliated Hospital of Xi′an Jiaotong University were retrospectively analyzed. The baseline characteristics coagulation function, inflammation response indexes and tumor characteristics were recorded. The baseline characteristics included gender, age and smoking history; the coagulation function included prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB) and D-dimer; the inflammation response indexes included neutrophil count, lymphocyte count, platelet count and monocyte count, and the systemic inflammatory response index (SIRI) and systemic immune-inflammation index (SII) were calculated; tumor characteristics included TNM stage, pathological grade, tumor length, tumor amount and postoperative instillation drugs. The patients were followed up until May 2022, with recurrence records and grouping. The "pROC" package was used to draw the receiver operating characteristic (ROC) curve, and calculate the optimal cutoff values of biomarkers. Multivariate Cox regression analysis was used to analyze the independent risk factors of recurrence in patients with NMIBC (variables were selected with P<0.1). The nomogram and its calibration curve were drawn by the "survival" and "rms" packages, and the area under the curve (AUC) was calculated with the "pROC" package for assessing the predictive ability of the model. The "caret" package was used for ten-fold cross-validation to evaluate the external applicability of the nomogram. Results:The ROC curve analysis result showed that the optimal cutoff values of PT, APTT, FIB, D-dimer, SIRI and SII were 11.95 s, 17.65 s, 0.233 mg/L, 565 ng/L, 0.62 and 291.5, respectively. The 390 patients with NMIBC were followed up 29 to 71 months, with a median follow-up time of 49 months. Among them, 113 patients experienced postoperative recurrence (recurrence group), and the recurrence rate was 29.0%; while 277 patients did not experience recurrence (non-recurrence group). The rate of FIB≥0.233 mg/L, D-dimmer ≥565 ng/L, SIRI≥0.62 and SII≥291.5, T 1 stage, high-grade tumor, tumor length ≥2.3 cm and multiple tumor in recurrence group were significantly higher than those in non-recurrence group: 90.3% (102/113) vs. 71.5% (198/277), 33.6% (38/113) vs. 23.5% (65/277), 74.3% (84/113) vs. 56.7% (157/277), 84.1% (95/113) vs. 60.6% (168/277), 77.9% (88/113) vs. 38.6% (107/277), 25.7% (29/113) vs. 8.3% (23/277), 49.6% (56/113) vs. 32.1% (89/277) and 41.6% (47/113) vs. 19.9% (55/277), and there were statistical differences ( P<0.01 or <0.05); there were no statistical differences in gender ratio, age, smoking history, PT, APTT and postoperative instillation drugs between the two groups ( P>0.05). Multivariate Cox regression analysis result showed that FIB≥0.233 mg/L, SII≥291.5, T 1 stage, high pathological grade, tumor length≥2.3 cm and multiple tumor were independent risk factors of postoperative recurrence in patients with NMIBC ( HR = 2.186, 1.627, 3.182, 1.675, 1.775 and 2.052; 95% CI 1.149 to 4.159, 0.913 to 2.902, 1.988 to 5.095, 1.067 to 2.630, 1.208 to 2.608 and 1.388 to 3.033; P<0.1). A nomogram model was constructed to predict postoperative 1-, 3- and 5-year non-recurrence based on FIB, SII, T stage, tumor length, pathological grade and tumor amount. The calibration curve analysis result showed that the nomogram model predicted good consistency between the postoperative 1-, 3-, 5-year non-recurrence rates and the actual incidence rate in patients with NMIBC. ROC curve analysis result showed that the AUC of the nomogram model for predicting postoperative 1-, 3- and 5-year non-recurrence in patients with NMIBC were 0.746, 0.789 and 0.835 (95% CI 0.695 to 0.832, 0.703 to 0.875 and 0.756 to 0.915). The ten-fold cross-validation result showed that the nomogram model had good external applicability for predicting postoperative 1-, 3- and 5-year non-recurrence in patients with NMIBC, with AUC of 0.754, 0.781 and 0.832 (95% CI 0.689 to 0.817, 0.724 to 0.832 and 0.778 to 0.879). Conclusions:The nomogram model based on FIB, SII, T stage, tumor length, pathological grade and tumor amount can accurately predict the postoperative 1-, 3- and 5-year recurrence risks in patients with NMIBC. The model helps clinical doctors early identify high-risk recurrent NMIBC patients, and provides reference for the development of individualized treatment plans.

Supraclinoid internal carotid artery(ICA)fenestration is a rare vascular developmental variant,and this anomaly may be associated with aneurysm formation.Whether the fenestration is originated from the embryonic development of the ICA or the posterior communicating artery(PCoA)remains controversial.This article retrospectively analyzed the imaging data,diagnosis and treatment process of one patient with supraclinoid ICA fenestration combined with an aneurysm,and further literature review was conducted combining with the case study.The aim of this study was to analyze the etiology of supraclinoid ICA fenestration and its correlation with aneurysm formation,in order to improve clinicians' understanding of this rare anomaly and facilitate the formulation of appropriate treatment plans.

Purpose To evaluate the safety and efficacy of microwave ablation(MWA)treatment for papillary thyroid cancer(PTC)in patients with Hashimoto thyroiditis(HT).Materials and Methods A retrospective analysis was conducted on clinical data from April 2020 to May 2022,involving 181 patients who underwent MWA at the China-Japan Friendship Hospital.All patients were divided into experimental group(n=89 cases)and control group(n=92 cases).The technical success rate,tumor volume reduction rate(VRR),disease progression and incidence of complications were compared between the two groups,respectively.Results Both groups achieved a technical success rate of 100%,with a median follow-up time of(16.90±11.43)months.At 3,6,12,and 18 months post-ablation,the VRR in the experimental group was significantly lower than that in the control group(3 months:-405.10(-778.57,-119.64)%vs.-190.00(-525.62,0)%;6 months:-50.00(-318.00,45.52)%vs.52.75(-93.33,97.13)%;12 months:83.33(17.70,100.00)%vs.100.00(64.88,100.00)%;18 months:100.00(96.05,100.00)%vs.100.00(100.00,100.00)%,Z=-2.77,-3.70,-2.41,-2.18,all P<0.05).At the end of follow-up,there was no significant difference in the disease progression rates and the incidence of hoarseness between the two groups(5.61%vs.4.34%,2.24%vs.4.34%,both P>0.05).Conclusion Patients with HT who received MWA treatment demonstrate safety and effectiveness,with no significant differences in postoperative disease progression rates compared to the controls.

Purpose To evaluate the safety and efficacy of microwave ablation(MWA)treatment for papillary thyroid cancer(PTC)in patients with Hashimoto thyroiditis(HT).Materials and Methods A retrospective analysis was conducted on clinical data from April 2020 to May 2022,involving 181 patients who underwent MWA at the China-Japan Friendship Hospital.All patients were divided into experimental group(n=89 cases)and control group(n=92 cases).The technical success rate,tumor volume reduction rate(VRR),disease progression and incidence of complications were compared between the two groups,respectively.Results Both groups achieved a technical success rate of 100%,with a median follow-up time of(16.90±11.43)months.At 3,6,12,and 18 months post-ablation,the VRR in the experimental group was significantly lower than that in the control group(3 months:-405.10(-778.57,-119.64)%vs.-190.00(-525.62,0)%;6 months:-50.00(-318.00,45.52)%vs.52.75(-93.33,97.13)%;12 months:83.33(17.70,100.00)%vs.100.00(64.88,100.00)%;18 months:100.00(96.05,100.00)%vs.100.00(100.00,100.00)%,Z=-2.77,-3.70,-2.41,-2.18,all P<0.05).At the end of follow-up,there was no significant difference in the disease progression rates and the incidence of hoarseness between the two groups(5.61%vs.4.34%,2.24%vs.4.34%,both P>0.05).Conclusion Patients with HT who received MWA treatment demonstrate safety and effectiveness,with no significant differences in postoperative disease progression rates compared to the controls.

Objective:To investigate the predictive value of preoperative coagulation function and inflammation response biomarkers for postoperative recurrence of non-muscle-invasive bladder cancer (NMIBC) patients.Methods:The clinical data of 390 NMIBC patients underwent surgical treatment from May 2014 to May 2021 in the Second Affiliated Hospital of Xi′an Jiaotong University were retrospectively analyzed. The baseline characteristics coagulation function, inflammation response indexes and tumor characteristics were recorded. The baseline characteristics included gender, age and smoking history; the coagulation function included prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB) and D-dimer; the inflammation response indexes included neutrophil count, lymphocyte count, platelet count and monocyte count, and the systemic inflammatory response index (SIRI) and systemic immune-inflammation index (SII) were calculated; tumor characteristics included TNM stage, pathological grade, tumor length, tumor amount and postoperative instillation drugs. The patients were followed up until May 2022, with recurrence records and grouping. The "pROC" package was used to draw the receiver operating characteristic (ROC) curve, and calculate the optimal cutoff values of biomarkers. Multivariate Cox regression analysis was used to analyze the independent risk factors of recurrence in patients with NMIBC (variables were selected with P<0.1). The nomogram and its calibration curve were drawn by the "survival" and "rms" packages, and the area under the curve (AUC) was calculated with the "pROC" package for assessing the predictive ability of the model. The "caret" package was used for ten-fold cross-validation to evaluate the external applicability of the nomogram. Results:The ROC curve analysis result showed that the optimal cutoff values of PT, APTT, FIB, D-dimer, SIRI and SII were 11.95 s, 17.65 s, 0.233 mg/L, 565 ng/L, 0.62 and 291.5, respectively. The 390 patients with NMIBC were followed up 29 to 71 months, with a median follow-up time of 49 months. Among them, 113 patients experienced postoperative recurrence (recurrence group), and the recurrence rate was 29.0%; while 277 patients did not experience recurrence (non-recurrence group). The rate of FIB≥0.233 mg/L, D-dimmer ≥565 ng/L, SIRI≥0.62 and SII≥291.5, T 1 stage, high-grade tumor, tumor length ≥2.3 cm and multiple tumor in recurrence group were significantly higher than those in non-recurrence group: 90.3% (102/113) vs. 71.5% (198/277), 33.6% (38/113) vs. 23.5% (65/277), 74.3% (84/113) vs. 56.7% (157/277), 84.1% (95/113) vs. 60.6% (168/277), 77.9% (88/113) vs. 38.6% (107/277), 25.7% (29/113) vs. 8.3% (23/277), 49.6% (56/113) vs. 32.1% (89/277) and 41.6% (47/113) vs. 19.9% (55/277), and there were statistical differences ( P<0.01 or <0.05); there were no statistical differences in gender ratio, age, smoking history, PT, APTT and postoperative instillation drugs between the two groups ( P>0.05). Multivariate Cox regression analysis result showed that FIB≥0.233 mg/L, SII≥291.5, T 1 stage, high pathological grade, tumor length≥2.3 cm and multiple tumor were independent risk factors of postoperative recurrence in patients with NMIBC ( HR = 2.186, 1.627, 3.182, 1.675, 1.775 and 2.052; 95% CI 1.149 to 4.159, 0.913 to 2.902, 1.988 to 5.095, 1.067 to 2.630, 1.208 to 2.608 and 1.388 to 3.033; P<0.1). A nomogram model was constructed to predict postoperative 1-, 3- and 5-year non-recurrence based on FIB, SII, T stage, tumor length, pathological grade and tumor amount. The calibration curve analysis result showed that the nomogram model predicted good consistency between the postoperative 1-, 3-, 5-year non-recurrence rates and the actual incidence rate in patients with NMIBC. ROC curve analysis result showed that the AUC of the nomogram model for predicting postoperative 1-, 3- and 5-year non-recurrence in patients with NMIBC were 0.746, 0.789 and 0.835 (95% CI 0.695 to 0.832, 0.703 to 0.875 and 0.756 to 0.915). The ten-fold cross-validation result showed that the nomogram model had good external applicability for predicting postoperative 1-, 3- and 5-year non-recurrence in patients with NMIBC, with AUC of 0.754, 0.781 and 0.832 (95% CI 0.689 to 0.817, 0.724 to 0.832 and 0.778 to 0.879). Conclusions:The nomogram model based on FIB, SII, T stage, tumor length, pathological grade and tumor amount can accurately predict the postoperative 1-, 3- and 5-year recurrence risks in patients with NMIBC. The model helps clinical doctors early identify high-risk recurrent NMIBC patients, and provides reference for the development of individualized treatment plans.

Supraclinoid internal carotid artery(ICA)fenestration is a rare vascular developmental variant,and this anomaly may be associated with aneurysm formation.Whether the fenestration is originated from the embryonic development of the ICA or the posterior communicating artery(PCoA)remains controversial.This article retrospectively analyzed the imaging data,diagnosis and treatment process of one patient with supraclinoid ICA fenestration combined with an aneurysm,and further literature review was conducted combining with the case study.The aim of this study was to analyze the etiology of supraclinoid ICA fenestration and its correlation with aneurysm formation,in order to improve clinicians' understanding of this rare anomaly and facilitate the formulation of appropriate treatment plans.

[Objective] To analyze factors influencing the postoperative progression-free survival (PFS) in patients with renal cell carcinoma (RCC), construct a nomogram model for predicting PFS, and compare it with other predictive models. [Methods] A retrospective analysis was conducted on the general and clinical data of 263 RCC patients who underwent surgery at the Department of Urology, the Second Affiliated Hospital of Xi'an Jiaotong University, during Apr.2014 and Nov.2021.Patients were divided into the progression group (n=34) and non-progression group (n=229). The data of the two groups were analyzed to identify prognostic variables associated with PFS, and a nomogram model was constructed.The performance of this model was compared with that of the University of California, Los Angeles Integrated Staging System (UISS) score, tumor staging, tumor size, tumor pathological grade, and tumor necrosis scoring system (SSIGN score), and Leibovich score by plotting receiver operating characteristic (ROC) curve and calculating the area under the curve (AUC). Calibration curve of the nomogram was used to validate the model's performance, and K-fold cross-validation was employed to assess its external validity. [Results] Multivariate Cox regression analysis revealed that age (HR=2.255, 95%CI: 1.032-4.926), T stage (HR=5.766, 95%CI: 2.351-14.142), pathological grade (HR=3.100, 95%CI: 1.445-6.651), and pathological necrosis (HR=2.656, 95%CI: 1.253-5.629) were independent risk factors of PFS (P<0.05). The nomogram model based on these four independent variables had AUCs (95%CI) of 0.750 (0.630-0.870), 0.803 (0.705-0.902), and 0.847 (0.757-0.937) for 1, 3, and 5 years, respectively, which were higher than those of UISS score, SSIGN score, and Leibovich score.The calibration curve of the nomogram showed good consistency between predicted and actual probabilities.In K-fold cross-validation, the average AUCs of the nomogram at 1, 3, and 5 years were 0.761, 0.808, and 0.842, indicating good external validity of the nomogram. [Conclusion] The nomogram based on age, T stage, pathological grade and pathological necrosis can accurately predict the risk of postoperative PFS in RCC patients at 1, 3, and 5 years, which can aid clinicians in the early identification of high-risk progression.

Background: This study aimed to compare the intercostal nerve block (ICNB) and thoracic paravertebral block (TPVB) for acute herpes zoster-associated pain (ZAP) and possible prophylaxis for post-herpetic neuralgia (PHN). Methods: This study enrolled 128 patients with ZAP. Their records were stratified into standard antiviral treatment (AVT) plus US-guided TPVB (the TPVB group), AVT plus US-guided ICNB (the ICNB group) or AVT alone (the control group). Herpes zoster (HZ)-related burden of illness (HZ-BOI) within the post-procedural 30 days was defined as the primary endpoint, determined by a composite of pain severity and follow-up duration. Procedure time, rescue analgesic requirement, PHN incidence, health-related quality of life and side effects were also recorded. Results: Significantly lower HZ-BOI-AUC 30 was reported in the TPVB and ICNB groups as compared to the control group, with a mean difference of 57.5 (P < 0.001) and 40.3 (P = 0.003), respectively. However, there was no difference between the TPVB and ICNB groups (P = 0.978). Both TPVB and ICNB reported significantly greater improvements in PHN incidence, EQ-5D-3L scores and rescue analgesic requirements during follow-up, as opposed to the control AVT. Shorter procedure time was observed in ICNB as compared to TPVB (16.47 ± 3.39 vs. 11.69 ± 2.58, P < 0.001). Conclusions Both US-guided TPVBs and ICNBs were effective for ZAP, and accounted for possible prophylaxis for PHN, as compared to AVT alone. The ICNB approach could be recommended as an alternative to conventional TPVB with a better consumed procedure time and side effect profile.

Background: This study aimed to compare the intercostal nerve block (ICNB) and thoracic paravertebral block (TPVB) for acute herpes zoster-associated pain (ZAP) and possible prophylaxis for post-herpetic neuralgia (PHN). Methods: This study enrolled 128 patients with ZAP. Their records were stratified into standard antiviral treatment (AVT) plus US-guided TPVB (the TPVB group), AVT plus US-guided ICNB (the ICNB group) or AVT alone (the control group). Herpes zoster (HZ)-related burden of illness (HZ-BOI) within the post-procedural 30 days was defined as the primary endpoint, determined by a composite of pain severity and follow-up duration. Procedure time, rescue analgesic requirement, PHN incidence, health-related quality of life and side effects were also recorded. Results: Significantly lower HZ-BOI-AUC 30 was reported in the TPVB and ICNB groups as compared to the control group, with a mean difference of 57.5 (P < 0.001) and 40.3 (P = 0.003), respectively. However, there was no difference between the TPVB and ICNB groups (P = 0.978). Both TPVB and ICNB reported significantly greater improvements in PHN incidence, EQ-5D-3L scores and rescue analgesic requirements during follow-up, as opposed to the control AVT. Shorter procedure time was observed in ICNB as compared to TPVB (16.47 ± 3.39 vs. 11.69 ± 2.58, P < 0.001). Conclusions Both US-guided TPVBs and ICNBs were effective for ZAP, and accounted for possible prophylaxis for PHN, as compared to AVT alone. The ICNB approach could be recommended as an alternative to conventional TPVB with a better consumed procedure time and side effect profile.

Background: This study aimed to compare the intercostal nerve block (ICNB) and thoracic paravertebral block (TPVB) for acute herpes zoster-associated pain (ZAP) and possible prophylaxis for post-herpetic neuralgia (PHN). Methods: This study enrolled 128 patients with ZAP. Their records were stratified into standard antiviral treatment (AVT) plus US-guided TPVB (the TPVB group), AVT plus US-guided ICNB (the ICNB group) or AVT alone (the control group). Herpes zoster (HZ)-related burden of illness (HZ-BOI) within the post-procedural 30 days was defined as the primary endpoint, determined by a composite of pain severity and follow-up duration. Procedure time, rescue analgesic requirement, PHN incidence, health-related quality of life and side effects were also recorded. Results: Significantly lower HZ-BOI-AUC 30 was reported in the TPVB and ICNB groups as compared to the control group, with a mean difference of 57.5 (P < 0.001) and 40.3 (P = 0.003), respectively. However, there was no difference between the TPVB and ICNB groups (P = 0.978). Both TPVB and ICNB reported significantly greater improvements in PHN incidence, EQ-5D-3L scores and rescue analgesic requirements during follow-up, as opposed to the control AVT. Shorter procedure time was observed in ICNB as compared to TPVB (16.47 ± 3.39 vs. 11.69 ± 2.58, P < 0.001). Conclusions Both US-guided TPVBs and ICNBs were effective for ZAP, and accounted for possible prophylaxis for PHN, as compared to AVT alone. The ICNB approach could be recommended as an alternative to conventional TPVB with a better consumed procedure time and side effect profile.