Objective To investigate the value of preoperative clinical data and computed tomography angiography (CTA) data in predicting perioperative mortality risk in patients with acute aortic dissection (AAD), and to construct a Nomogram prediction model. Methods A retrospective study was conducted on AAD patients treated at Affiliated Hospital of Zunyi Medical University from February 2013 to July 2023. Patients who died during the perioperative period were included in the death group, and those who improved during the same period were randomly selected as the non-death group using a random number table method. The first CTA data and preoperative clinical data within the perioperative period of the two groups were collected, and related risk factors were analyzed to screen out independent predictive factors for perioperative death. The Nomogram prediction model for perioperative mortality risk in AAD patients was constructed using the screened independent predictive factors, and the effect of the Nomogram was evaluated by calibration curves and area under the curve (AUC). Results A total of 270 AAD patients were included. There were 60 patients in the death group, including 42 males and 18 females with an average age of (56.89±13.42) years. There were 210 patients in the non-death group, including 163 males and 47 females with an average age of (56.15±13.77) years. Multivariate logistic regression analysis showed that type A AAD [OR=4.589, 95%CI (2.273, 9.267), P<0.001], irregular tear morphology [OR=2.054, 95%CI (1.025, 4.117), P=0.042], decreased hemoglobin [OR=0.983, 95%CI (0.971, 0.995), P=0.007], increased uric acid [OR=1.003, 95%CI (1.001, 1.005), P=0.004], and increased aspartate aminotransferase [OR=1.003, 95%CI (1.000, 1.006), P=0.035] were independent risk factors for perioperative death in AAD patients. The Nomogram prediction model constructed using the above risk factors had an AUC of 0.790 for predicting perioperative death, indicating good predictive performance. Conclusion Type A AAD, irregular tear morphology, decreased hemoglobin, increased uric acid, and increased aspartate aminotransferase are independent predictive factors for perioperative death in AAD patients. The Nomogram prediction model constructed using these factors can help assess the perioperative mortality risk of AAD patients.

As the main product of anaerobic or aerobic glycolysis,lactic acid has long been considered to be only the metabolic waste of this process,but now researches have are gradually revealing that lactic acid,as an important signaling molecule,plays a key immune regulatory role by acting on lactic acid transporters,lactate receptors and intracellular direct sensors in immune cells.In chronic inflammatory diseases,lactic acid helps maintain a pro-inflammatory environment that encourages immune cells to remain at the site of inflammation.In the event of infection,lactic acid impairs host immunity.In the tumor microenvironment(TME),the increase in lactic acid production and the resulting TME acidification promote tumor growth and invasion,and inhibit the body's immune response to tumor antigens.This review focuses on the recent research progress on the role of lactic acid in immune regulation.

Purpose To explore the value of predicting risk classification of gastrointestinal stromal tumors(GIST)based on the model established by dural-phase enhanced CT based radiomics.Materials and Methods Totally 200 patients with pathologically confirmed GIST from October 2017 to July 2023 in the Affiliated Hospital of Zunyi Medical University were enrolled,including 69 cases with low-risk group(very low-risk,low-risk)and 131 with high-risk group(medium-risk,high-risk).All patients were randomly divided into training set(n=139)and validation set(n=61)at the ratio of 7∶3.Univariate and multivariate Logistic regression analysis were used on clinical data and CT sings in the training set to obtain clinical-CT features for predicting the risk grade of GIST,and clinical-CT models were constructed.The radiomics features were extracted and screened from the three data sets of enhanced CT arterial phase,venous phase and arterial+venous phase,and the radiomics model was constructed to obtain the optimal radiomics features,respectively.The optimal radiomics features were obtained and combined with the clinical-CT features,a combination model was constructed and the normogram was drawn.The predictive efficiency of these models was evaluated by area under the curve(AUC).Results Tumor diameter was an independent predictor of GIST risk classification(OR=1.070,P＜0.001).The AUC of the combination model,model arterial+venous phase radiomics and model clinical-CT in the training set were 0.948,0.896 and 0.873,respectively;those in the validation set were 0.886,0.825 and 0.870,respectively.The AUC of the above three models showed statistical difference(Z=-3.167,-2.316,P＜0.05).Conclusion The radiomics features based on enhanced CT have good value in predicting risk classification of GIST.Compared with model clinical-CT and model radiomics,the combination model is the most effective in predicting the risk classification of GIST.

Objective:To investigate the clinical efficacy of arthroscopy combined with sodium hyaluronate and platelet-rich plasma in the treatment of Stoller grade III meniscus injury.Methods:Sixty patients with Stoller grade III meniscus injury who received treatment in The Second People's Hospital of Liaocheng from October 2019 to October 2020 were included in this study. They were randomly divided into an observation group and a control group ( n = 30 per group). Patients in the observation group were treated with arthroscopy combined with sodium hyaluronate and platelet-rich plasma, while patients in the control group were treated with arthroscopy combined with sodium hyaluronate. Before and 1, 3, and 6 months after surgery, the Visual Analogue Scale (VAS) score, Lysholm score, and The Western Ontario and McMaster Universities Arthritis Index (WOMAC) score of the knee joint were compared between the two groups. Results:There were no serious complications in each group. Compared with pre-treatment, the VAS and Lysholm scores of the knee joint in both groups significantly decreased at 1, 3, and 6 months after surgery, while the WOMAC score showed a significant increase ( F = 514.96, 673.19, 96.31, 124.16, 230.99, 531.84, all P < 0.001). After 3 and 6 months of treatment, the VAS score in the observation group was (1.1 ± 0.5) points and (0.8 ± 0.4) points, respectively, which were significantly lower than (2.5 ± 0.7) points and (1.3 ± 0.5) points in the control group ( t = 8.91, 4.28, both P < 0.001). After 3 and 6 months of treatment, the Lysholm score of the knee joint in the observation group was (86.2 ± 9.1) points and (93.8 ± 13.2) points, respectively, which were significantly higher than (79.8 ± 11.3) points and (87.5 ± 9.2) points in the control group ( t = 2.42, 2.14, both P < 0.05). After 3 and 6 months of treatment, the WOMAC score in the observation group was (17.5 ± 3.6) points and (16.5 ± 3.2) points, respectively, which were significantly lower than (25.4 ± 5.2) points and (24.8 ± 6.4) points in the control group ( t = 6.84, 6.35, both P < 0.001). Conclusion:Arthroscopy combined with sodium hyaluronate and platelet-rich plasma is more effective in treating Stoller III grade meniscus injury than arthroscopy combined with sodium hyaluronate. The former therapy can be promoted in the clinic.

Metal-organic frameworks (MOFs) are mixed porous materials which are composed of metal clusters or ions and organic pillars. Given their channel tunability, high porosity, large specific surface area, and good biocompatibility, MOFs can be combined with various biological macromolecules. In recent years, they have been widely studied in the field of biomedicine, especially in the loading of anti-tumor drugs, showing great application prospects. Multifunctional anti-tumor MOF combined with different therapeutic methods provides a new idea and method for tumor treatment. On the basis of the structure of MOF, this paper introduces the advantages of using MOF to load anti-tumor drugs and reviews the application of MOF in tumor therapy.

PLEK2 (Pleckstrin-2) is a subtype of platelets and leukocytes Pleckstrin, located at 14q23.3-q24.1. Its encoded protein contains 353 amino acids. It plays a role in a variety of cells other than immune cells. The research is relatively limited, mainly involved in the reorganization of cytoskeleton proteins and the regulation of cell extension and migration. PLEK2 plays an important role in the occurrence, development and metastasis of a variety of tumors, and can participate in the regulation of a variety of signal pathways, thereby regulating tumor cell proliferation, invasion and metastasis. PLEK2 is up-regulated in a variety of tumors and has carcinogenic properties. This article reviews the regulatory role of PLEK2 in tumorigenesis, development and metastasis and its impact on tumor prognosis.

Malignant tumor has become one of the main reasons threatening human health. Invasion and metastasis are the important biological characteristics of malignant tumor and the main cause of death of malignant tumor patients. CPNE is highly expressed in malignant tumors, and its family may interact with proteins and MicroRNA to participate in MAPK, PI3K/AKT and other signal pathways to mediate tumor cell proliferation, invasion and metastasis. This article reviews the expression of CPNE in malignant tumors and its effect on invasion and metastasis.

Objective ToimprovetherecognitionofovariancysticlesionsbyanalyzingCTand MRIappearances.Methods A retrospectivereviewofCTand MRIimagesof67caseswithpathologicallyprovenofovariancysticlesionswasperformed.Among which,58casescarriedoutplainCTscan,52casesunderwentenhancedCTscan,12casesunderwentplainMRIscan,and7casesunderwent enhancedMRIscan.Results 20caseswereovariancystadenomas,14caseswerecystadenocarcinomas,8caseswereteratomas(1case wasmalignant),5caseswerestrumaovarii,15caseswerecysts,3casesweremetastases,and2caseswereovariantuberculosis.The CTand MRIcharacteristicsofthecysticlesions,inculdingsize,shape,thicknessofcystwall,wallnodule,densityorsignalintensity andenhancementfeatureswerevaluableindifferentialdiagnosisofovariancysticlesions.Conclusion CTand MRIappearancesofovarian cysticlesionshavesomecharacteristics,includingcysticwallandseptaofcystadenocarcinomasirregularthickened,papillaryprotuberance andascites.Teratomasoftencontainfatandcalcification.Strumaovariipresentsmultilocularcystic-solidmass,withthesolidportions markedenhancement.Metastatictumorshaveahistoryofprimarygastrointestinalneoplasmsandperitonealeffusion.

Objective To analyze and evaluate the CT and MRI features of synovial sarcoma (SS).Methods Clinical and imaging data of 25 cases with SS confirmed by pathology were retrospectively analyzed.1 5 cases with CT scan,including 1 1 contrastGenhanced CT scan,and 1 2 cases with MRI scan,including 8 contrastGenhanced MRI scan.Results Among 25 cases,1 8 were located in the lower extremities,2 in the upper extremities and in the chest wall respectively,1 case in the lung parenchyma,mediastinum and spine respectively.1 8 cases were deep seated,while 1 9 cases were lobulated.On CT image,most of the lesions were isodense or hypodense to muscle,while 3 cases presented peripheral calcification,and 9 cases showed progressive enhancement.On MRI,10 cases were isointense or slight hypointense on T1 WI,while 9 cases presented hyperintense or slight hyperintense on T2 WI.9 cases showed cystic change (7 of them located in the periphery),and 8 cases showed short T1 signal.3 cases demonstrated "fluidGfluid levels",and 9 cases exhibited hypointense septa.7 cases revealed "triple sign"on T2 WI and 7 cases showed obviously heterogenous enhancement.Conclusion Synovial sarcomas are mostly located in the lower extremities,with clear margins,peripheral cystic changes,intramural hemorrhage,"triple sign"on T2 WI and progressive enhancement.

Objective To compare the CT features and pathology of pulmonary solitary fibrous tumor (SFT),to improve the diagnosis and differential diagnosis.Methods CT images and corresponding pathological results of 14 cases with pulmonary SFT were analyzed retrospectively. Results Among the 14 cases,6 were in the right lung and other 8 were in the left.The maximum diameters of tumors were ranged from 2.5 cm to 20.0 cm,and 6 cases were over 10.0 cm.All 14 cases represented as irregular solid nodule or mass,4 as unclear boundary and 1 as lobulation.Most of the cases showed heterogeneous and progressive enhancement.The light microscopy showed that tumor tissues were mainly composed of collagen fibers and spindle cells with different proliferation degrees,and 3 cases showed atypia cells.There were abundant blood vessels in the intercellular substance.Immunohistochemistry were done in 13 cases,presenting Bcl-2,CD99 and Vimentin positive expressions in all cases and CD34 expression in 9.Conclusion The CT features of pulmonary SFT are related to pathological features.CT scan is important in the localization and qualitative diagnosis of pulmonary SFT,and obvious inhomogeneous map-like and progressive enhancement should be considered for the diagnosis of SFT.