Objective:To explore the changes in plasma lipoprotein associated phospholipase A2(Lp-PLA2)and silencing information regulatory protein 1(SIRT1)in patients with sepsis complicated with acute kidney injury(AKI)and their relationship with short-term prognosis.Methods:243 sepsis patients who received treatment in our hospital from May 2022 to May 2024 were prospective selected,including 80 sepsis patients with AKI(AKI group)and 163 sepsis patients without AKI(non AKI group),the plasma Lp-PLA2 and SIRT1 levels between the two groups were compared.They were divided into good prognosis group and poor prognosis group according to 28 d prognosis after admission in AKI group.The influencing factors of short-term prognosis in sepsis patients complicated with AKI were analyzed by multiple logistic regression model.The short-term prognostic value of plasma Lp-PLA2 and SIRT1 alone and in combination for sepsis complicated with AKI patients was analyzed using receiver operating characteristic(ROC)curve.Results:Compared with non AKI group,AKI group had higher Lp-PLA2 and lower SIRT1(P＜0.05).39 deaths within 28 d after admission in AKI group(poor prognosis group),41 cases survived(good prognosis group),with poor prognosis rate of 48.75％(39/80).Sequential organ failure assessment(SOFA)score,acutephysiology and chronic health evaluationⅡ(APACHEⅡ)score,creatinine(Scr),lactate dehydrogenase albumin ratio(LAR)in poor prognosis group were higher than those in good prognosis group,while procalcitonin(PCT)was lower than that in good prognosis group(P＜0.05).Compared with the good prognosis group,poor prognosis group had higher Lp-PLA2 and lower SIRT1 at admission(P＜0.05).Elevated SOFA score,elevated Scr,elevated APACHEⅡ score,and elevated plasma Lp-PLA2 were risk factors for poor prognosis in sepsis patients complicated with AKI(P＜0.05),while elevated plasma SIRT1 was a protective factor(P＜0.05).ROC curve analysis results showed that,the combined detection of plasma Lp-PLA2 and SIRT1 predicted a poor prognosis for sepsis patients with AKI with an area under the curve(AUC)of 0.935,which was better than the prediction of 0.813 and 0.858 for plasma Lp-PLA2 and SIRT1 alone.Conclusion:Sepsis complicated with AKI patients have elevated plasma Lp-PLA2 and decreased SIRT1,combined detection of the two can assist in predicting the risk of poor prognosis.

Glucose-6-phosphate dehydrogenase(G6PD)deficiency is one of the most common monogenic genetic diseases in the world.China is the high incidence area of this disease.G6PD heterozygote is the main form of G6PD deficiency in females,which belongs to X-linked incomplete dominant inheritance.Therefore,the enzyme activities of female heterozygotes vary widely,showing normal to mild to moderate enzyme activi-ties.There is no unified calibrators for G6PD enzymatic detection reagents commonly used in clinical practice,and the results of the same sample detected by different kits from different manufacturers are different,so there is a phenomenon of missed detection in clinical screening of female G6PD heterozygotes.Although G6PD gene detection can effectively improve the detection rate of female heterozygotes,its clinical application is lim-ited due to cost and other reasons.Therefore,the development of detection methods that can improve the de-tection rate of female heterozygotes and are suitable for large-scale screening and clinical application will be an urgent need to be solved in clinical practice.This article reviews the epidemiology of G6PD deficiency,genetic characteristics of female G6PD gene,clinical manifestations and detection methods of G6PD female heterozy-gotes.

AIM:To investigate the effects of high-dose methotrexate(MTX)on alkaline phosphatase(ALP)and the effects of ALP changes on bone me-tabolism,bone marrow granulogram function,liver function and excretion.METHODS:Aspartate ami-notransferase(AST),alanine aminotransferase(ALT)and albumin(ALB)were used as liver function indi-cators,serum calcium(Ca)and phosphorus(P)were used as bone metabolism indicators,neutro-phil(ANC)and white blood cell count(WBC)were used as bone marrow granuloline function indica-tors,and methotrexate C48h concentration ≥1 μmol/L was used as the excretion delay.One-way ANOVA analysis was performed on the ALP levels before and after the first chemotherapy and the second chemotherapy,and the children were divided into normal group and low group according to the ALP level,and the seven indexes before and after che-motherapy were quantitatively and qualitatively an-alyzed,and univariate and multivariate Logistic re-gression analysis was performed on the concentra-tion of methotrexate C48h and the above indexes in the children treated with the second chemothera-py.RESULTS:After the first chemotherapy and the second chemotherapy,ALP was significantly de-creased[(204.0±83.6)U/L vs.(172.8±67.3)U/L,(179.4±59.3)U/L vs.(169.6±57.1)U/L,all P＜0.05],and the serum Ca,P,ANC,WBC,and ALB were sig-nificantly decreased(P＜0.05),and AST and ALT were increased(P＜0.05),and ALT was an indepen-dent risk factor for delayed excretion(OR=1.049,95％CI 1.023-1.077,P＜0.001),ALB was an indepen-dent protective factor for delayed excretion(OR=0.551,95％CI 0.460-0.660,P＜0.001),and ALP was not a significant contributor to MTX excretion de-lay.CONCLUSION:ALP is not a good predictor of liv-er function and bone marrow granulopathy func-tion due to a significant decrease in ALP caused by high-dose MTX,and ALP together with serum calci-um and phosphorus levels can constitute an early warning indicator of bone metabolism disorders.

AIM:To investigate the effects of high-dose methotrexate(MTX)on alkaline phosphatase(ALP)and the effects of ALP changes on bone me-tabolism,bone marrow granulogram function,liver function and excretion.METHODS:Aspartate ami-notransferase(AST),alanine aminotransferase(ALT)and albumin(ALB)were used as liver function indi-cators,serum calcium(Ca)and phosphorus(P)were used as bone metabolism indicators,neutro-phil(ANC)and white blood cell count(WBC)were used as bone marrow granuloline function indica-tors,and methotrexate C48h concentration ≥1 μmol/L was used as the excretion delay.One-way ANOVA analysis was performed on the ALP levels before and after the first chemotherapy and the second chemotherapy,and the children were divided into normal group and low group according to the ALP level,and the seven indexes before and after che-motherapy were quantitatively and qualitatively an-alyzed,and univariate and multivariate Logistic re-gression analysis was performed on the concentra-tion of methotrexate C48h and the above indexes in the children treated with the second chemothera-py.RESULTS:After the first chemotherapy and the second chemotherapy,ALP was significantly de-creased[(204.0±83.6)U/L vs.(172.8±67.3)U/L,(179.4±59.3)U/L vs.(169.6±57.1)U/L,all P＜0.05],and the serum Ca,P,ANC,WBC,and ALB were sig-nificantly decreased(P＜0.05),and AST and ALT were increased(P＜0.05),and ALT was an indepen-dent risk factor for delayed excretion(OR=1.049,95％CI 1.023-1.077,P＜0.001),ALB was an indepen-dent protective factor for delayed excretion(OR=0.551,95％CI 0.460-0.660,P＜0.001),and ALP was not a significant contributor to MTX excretion de-lay.CONCLUSION:ALP is not a good predictor of liv-er function and bone marrow granulopathy func-tion due to a significant decrease in ALP caused by high-dose MTX,and ALP together with serum calci-um and phosphorus levels can constitute an early warning indicator of bone metabolism disorders.

Objective:To explore the changes in plasma lipoprotein associated phospholipase A2(Lp-PLA2)and silencing information regulatory protein 1(SIRT1)in patients with sepsis complicated with acute kidney injury(AKI)and their relationship with short-term prognosis.Methods:243 sepsis patients who received treatment in our hospital from May 2022 to May 2024 were prospective selected,including 80 sepsis patients with AKI(AKI group)and 163 sepsis patients without AKI(non AKI group),the plasma Lp-PLA2 and SIRT1 levels between the two groups were compared.They were divided into good prognosis group and poor prognosis group according to 28 d prognosis after admission in AKI group.The influencing factors of short-term prognosis in sepsis patients complicated with AKI were analyzed by multiple logistic regression model.The short-term prognostic value of plasma Lp-PLA2 and SIRT1 alone and in combination for sepsis complicated with AKI patients was analyzed using receiver operating characteristic(ROC)curve.Results:Compared with non AKI group,AKI group had higher Lp-PLA2 and lower SIRT1(P＜0.05).39 deaths within 28 d after admission in AKI group(poor prognosis group),41 cases survived(good prognosis group),with poor prognosis rate of 48.75％(39/80).Sequential organ failure assessment(SOFA)score,acutephysiology and chronic health evaluationⅡ(APACHEⅡ)score,creatinine(Scr),lactate dehydrogenase albumin ratio(LAR)in poor prognosis group were higher than those in good prognosis group,while procalcitonin(PCT)was lower than that in good prognosis group(P＜0.05).Compared with the good prognosis group,poor prognosis group had higher Lp-PLA2 and lower SIRT1 at admission(P＜0.05).Elevated SOFA score,elevated Scr,elevated APACHEⅡ score,and elevated plasma Lp-PLA2 were risk factors for poor prognosis in sepsis patients complicated with AKI(P＜0.05),while elevated plasma SIRT1 was a protective factor(P＜0.05).ROC curve analysis results showed that,the combined detection of plasma Lp-PLA2 and SIRT1 predicted a poor prognosis for sepsis patients with AKI with an area under the curve(AUC)of 0.935,which was better than the prediction of 0.813 and 0.858 for plasma Lp-PLA2 and SIRT1 alone.Conclusion:Sepsis complicated with AKI patients have elevated plasma Lp-PLA2 and decreased SIRT1,combined detection of the two can assist in predicting the risk of poor prognosis.

Purpose: This study evaluated the value of contrast-enhanced ultrasonography (CEUS) in the ultrasound-guided microwave ablation (MWA) treatment of symptomatic focal uterine adenomyosis. Methods: This retrospective study was conducted between March 2020 and January 2023, enrolling 52 patients with symptomatic focal uterine adenomyosis who had undergone MWA. All patients were examined with CEUS before and after MWA. The non-perfused volume (NPV) was compared between CEUS and dynamic contrast-enhanced magnetic resonance imaging (DCEMRI) following ablation. Therapeutic efficacy and safety were evaluated at 3-, 6-, and 12-month follow-ups. Additionally, this study explored the correlations between pre-treatment CEUS features and a volume reduction ratio indicating sufficient ablation, defined as 50% or more at the 3-month follow-up. Results: No significant differences in NPV were noted between CEUS and DCE-MRI immediately after MWA and during follow-up (all P>0.05). At the 3-month follow-up, the median VRRs for the uterus and adenomyosis were 33.2% and 63.9%, respectively. Sufficient ablation was achieved in 69.2% (36/52) of adenomyosis cases, while partial ablation was observed in the remaining 30.8% (16/52). The identification of non-enhancing areas on pre-treatment CEUS was associated with sufficient ablation (P=0.016). At the 12-month follow-up, significant decreases were observed in both the uterine and adenomyosis volumes (all P<0.001). Dysmenorrhea and menorrhagia were significantly alleviated at 12 months, and no major complications were encountered. Conclusion CEUS can be used to evaluate the ablation zone of focal adenomyosis that has been treated with MWA, similarly to DCE-MRI. The identification of non-enhancing areas on pretreatment CEUS indicates satisfactory treatment outcomes.

Purpose: This study evaluated the value of contrast-enhanced ultrasonography (CEUS) in the ultrasound-guided microwave ablation (MWA) treatment of symptomatic focal uterine adenomyosis. Methods: This retrospective study was conducted between March 2020 and January 2023, enrolling 52 patients with symptomatic focal uterine adenomyosis who had undergone MWA. All patients were examined with CEUS before and after MWA. The non-perfused volume (NPV) was compared between CEUS and dynamic contrast-enhanced magnetic resonance imaging (DCEMRI) following ablation. Therapeutic efficacy and safety were evaluated at 3-, 6-, and 12-month follow-ups. Additionally, this study explored the correlations between pre-treatment CEUS features and a volume reduction ratio indicating sufficient ablation, defined as 50% or more at the 3-month follow-up. Results: No significant differences in NPV were noted between CEUS and DCE-MRI immediately after MWA and during follow-up (all P>0.05). At the 3-month follow-up, the median VRRs for the uterus and adenomyosis were 33.2% and 63.9%, respectively. Sufficient ablation was achieved in 69.2% (36/52) of adenomyosis cases, while partial ablation was observed in the remaining 30.8% (16/52). The identification of non-enhancing areas on pre-treatment CEUS was associated with sufficient ablation (P=0.016). At the 12-month follow-up, significant decreases were observed in both the uterine and adenomyosis volumes (all P<0.001). Dysmenorrhea and menorrhagia were significantly alleviated at 12 months, and no major complications were encountered. Conclusion CEUS can be used to evaluate the ablation zone of focal adenomyosis that has been treated with MWA, similarly to DCE-MRI. The identification of non-enhancing areas on pretreatment CEUS indicates satisfactory treatment outcomes.

Purpose: This study evaluated the value of contrast-enhanced ultrasonography (CEUS) in the ultrasound-guided microwave ablation (MWA) treatment of symptomatic focal uterine adenomyosis. Methods: This retrospective study was conducted between March 2020 and January 2023, enrolling 52 patients with symptomatic focal uterine adenomyosis who had undergone MWA. All patients were examined with CEUS before and after MWA. The non-perfused volume (NPV) was compared between CEUS and dynamic contrast-enhanced magnetic resonance imaging (DCEMRI) following ablation. Therapeutic efficacy and safety were evaluated at 3-, 6-, and 12-month follow-ups. Additionally, this study explored the correlations between pre-treatment CEUS features and a volume reduction ratio indicating sufficient ablation, defined as 50% or more at the 3-month follow-up. Results: No significant differences in NPV were noted between CEUS and DCE-MRI immediately after MWA and during follow-up (all P>0.05). At the 3-month follow-up, the median VRRs for the uterus and adenomyosis were 33.2% and 63.9%, respectively. Sufficient ablation was achieved in 69.2% (36/52) of adenomyosis cases, while partial ablation was observed in the remaining 30.8% (16/52). The identification of non-enhancing areas on pre-treatment CEUS was associated with sufficient ablation (P=0.016). At the 12-month follow-up, significant decreases were observed in both the uterine and adenomyosis volumes (all P<0.001). Dysmenorrhea and menorrhagia were significantly alleviated at 12 months, and no major complications were encountered. Conclusion CEUS can be used to evaluate the ablation zone of focal adenomyosis that has been treated with MWA, similarly to DCE-MRI. The identification of non-enhancing areas on pretreatment CEUS indicates satisfactory treatment outcomes.

Purpose: This study evaluated the value of contrast-enhanced ultrasonography (CEUS) in the ultrasound-guided microwave ablation (MWA) treatment of symptomatic focal uterine adenomyosis. Methods: This retrospective study was conducted between March 2020 and January 2023, enrolling 52 patients with symptomatic focal uterine adenomyosis who had undergone MWA. All patients were examined with CEUS before and after MWA. The non-perfused volume (NPV) was compared between CEUS and dynamic contrast-enhanced magnetic resonance imaging (DCEMRI) following ablation. Therapeutic efficacy and safety were evaluated at 3-, 6-, and 12-month follow-ups. Additionally, this study explored the correlations between pre-treatment CEUS features and a volume reduction ratio indicating sufficient ablation, defined as 50% or more at the 3-month follow-up. Results: No significant differences in NPV were noted between CEUS and DCE-MRI immediately after MWA and during follow-up (all P>0.05). At the 3-month follow-up, the median VRRs for the uterus and adenomyosis were 33.2% and 63.9%, respectively. Sufficient ablation was achieved in 69.2% (36/52) of adenomyosis cases, while partial ablation was observed in the remaining 30.8% (16/52). The identification of non-enhancing areas on pre-treatment CEUS was associated with sufficient ablation (P=0.016). At the 12-month follow-up, significant decreases were observed in both the uterine and adenomyosis volumes (all P<0.001). Dysmenorrhea and menorrhagia were significantly alleviated at 12 months, and no major complications were encountered. Conclusion CEUS can be used to evaluate the ablation zone of focal adenomyosis that has been treated with MWA, similarly to DCE-MRI. The identification of non-enhancing areas on pretreatment CEUS indicates satisfactory treatment outcomes.

177Lu-prostate specific membrane antigen(PSMA)radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China.Based on domestic clinical practice and experimental data and referred to international experience and viewpoints,the expert group forms a consensus on the clinical application of 177Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.