Objective:To develop a Problematic Short Video Use Scale(PSVUS)and evaluate its validity and reliability.Methods:Through literature review and interviews,and with reference to the Diagnostic and Statisti-cal Manual of Mental Disorders,Fifth Edition(DSM-5)diagnostic guidelines for internet gaming disorder,the items were compiled.Initially,979 individuals(aged 14-74 years)participated in the survey,and 362 of them were re-tested after two weeks.The Perceived Stress Scale(PSS-4),UCLA Loneliness Scale(ULS-8),Brief Self-Control Scale(BSCS),and Hospital Anxiety and Depression Scale(HADS)were used to test the criterion-related validi-ty.Multiple classification methods were used to determine the cut-off value.Additionally,a 9-item brief version of the scale(PSVUS-9)was developed.Results:The PSVUS consists of 27 items organized into 9 dimensions(preoc-cupation,with drawal,tolerance,unsuccessful attempts,escape,continuation despite harm,deception,loss of inter-est,and functional impairment),explaining 78.71％of the total variance,with item factor loadings ranging from 0.62 to 0.95.The nine-factor structure exhibited good fit(x2/df=2.00,CFI=0.97,RMSEA=0.05).The scores of the dimensions were correlated with the scores of the PSS-4,ULS-8,BSCS and HADS(ICC=|0.21|-|0.68|,Ps＜0.05).The Cronbach's α coefficient of the PSVUS was 0.95,and the test-retest reliability was 0.83.The cut-off score for problematic use was determineded to be 70 or above.The PSVUS-9 score was correlated with the scores of the criterion measures(ICC=|0.39|-|0.68|,Ps＜0.01).The Cronbach's α coefficient of PSVUS-9 was 0.86 and the test-retest reliability was 0.80.A score of 24 or higher on the PSVUS-9 was indicative of problematic use.Conclusion:The Problematic Short Video Use Scale(PSVUS)and its brief version demonstrate good validity and reliability,and could be used to measure and screen for problematic short video use.

Objective:To explore the relationship between serum thymic stromal lymphopoietin (TSLP) levels and the occurrence of pruritus as well as interstitial lung diseases (ILD) in patients with dermatomyositis (DM) or clinically amyopathic dermatomyositis (CADM) .Methods:A retrospective analysis was conducted on the clinical data from 61 diagnosed DM/CADM patients at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine between February 2019 and March 2022. Thirty-five age- and sex-matched healthy individuals were included as controls. Serum TSLP and anti-melanoma differentiation-associated gene 5 (MDA5) antibody levels were measured using enzyme-linked immunosorbent assay (ELISA) . A multiplexed flow cytometry assay was performed to detect the serum levels of 12 cytokines, including interferon (IFN) -α2, IFN-γ, interleukin (IL) -4, IL-5, etc. Pruritus severity in DM/CADM patients was assessed using the visual analog scale (VAS) . Relationships of serum TSLP levels with skin lesions, inflammatory markers, and the severity of ILD were analyzed using GraphPad Prism 8.0.1 and R (version 4.3.2) software.Results:Among the 61 patients with DM/CADM, 18 were males (13 with DM and 5 with CADM) and 43 were females (30 with DM and 13 with CADM) , with ages of 53.08 ± 14.97 years and disease duration of 6.27 ± 4.27 months. No significant differences were observed in sex or age between the DM/CADM group and the healthy control group (both P > 0.05) . Of the 61 patients, 15 (24.59%) were positive for anti-MDA5 antibodies, and 31 (51.67%) had ILD, including 11 with acute/subacute interstitial pneumonia (A/SIP) . The pruritus VAS score ( M[ Q1, Q3]) among the 61 patients was 3 (0, 6) points; 20 patients (32.79%) reported no pruritus, while 11 (18.32%) , 17 (27.87%) , and 13 (21.31%) experienced mild, moderate, and severe pruritus, respectively. Serum TSLP levels were significantly higher in the DM/CADM patients than in the healthy controls (91.0 [34.6, 273.0] vs. 25.0 [0.0, 83.5] pg/ml, Z = 1 502.50, P < 0.001]. The TSLP levels were significantly positively correlated with serum levels of alanine aminotransferase (ALT) , lactate dehydrogenase, C-reactive protein, erythrocyte sedimentation rate and ferritin, and significantly negatively correlated with pruritus VAS scores, eosinophil percentages, and eosinophil counts (all P < 0.05) . Serum TSLP levels were significantly higher in the anti-MDA5 antibody-positive patients than in the anti-MDA5 antibody-negative patients (273.0 [103.8, 2 576.0] pg/ml vs. 67.4 [16.9, 218.7] pg/ml, P = 0.002) , as well as in the patients with A/SIP than in those without A/SIP (390.0 [168.2, 2 869.6] vs. 67.5 [21.8, 235.9] pg/ml, P < 0.001) . ROC analysis showed that the combined detection of serum TSLP levels and anti-MDA5 antibodies had a higher predictive value for A/SIP in DM/CADM patients (AUC = 0.922) than either the detection of anti-MDA5 antibodies (AUC = 0.831) or TSLP (AUC = 0.824) alone did. Conclusions:Serum TSLP levels were significantly higher in patients with DM/CADM than in healthy controls, with particularly higher levels observed in anti-MDA5 antibody-positive patients and patients with coexisting A/SIP, and were correlated with several indicators of disease activity. The combination of serum TSLP levels and anti-MDA5 antibodies provided greater predictive value for A/SIP than either of them alone did.

Objective:To explore the clinical features, histopathological morphology, and differential diagnosis of lymphoepithelioma-like carcinoma with abnormal expression of follicular dendritic cell markers.Methods:From 2020 to 2021, 4 cases of lymphoepithelioma-like carcinoma with abnormal expression of follicular dendritic cell markers diagnosed in Fujian Cancer Hospital (2 cases) and the Second Affiliated Hospital of Fujian Medical University (2 cases) were collected. Different ancillary procedures such as HE, special stains, immunohistochemistry, and in situ hybridization techniques were used to assess the histopathological features and immunophenotypes. The clinical data were collected and literature was reviewed.Results:All 4 cases of lymphoepithelioma-like carcinoma with abnormal expression of follicular dendritic cell markers were male. They were 32, 45, 67 and 39 years old, respectively. The main clinical manifestations were bloody phlegm, abdominal pain, fatigue and anorexia. The clinical stages at diagnosis were stage Ⅳ (3 cases) and stage Ⅱ (1 case). Cases 2 and 3 had two pathological examinations at different sites, with a total of six pathological examinations. The histomorphology showed singly scattered or nests of tumor cells in a background of abundant small lymphocytes. The tumor cells were enlarged and pleomorphic, some appeared polygonal with inconspicuous cell borders, and they were arranged in a syncytial pattern. There were megakaryocytes, multinucleated tumor cells, and a few spindle-shaped cells seen. Atypical mitosis was commonly noted. By immunohistochemistry, the tumor cells were positive for CKpan(5/6), CK8/18(4/4), CAM5.2(2/5), CK-H(0/4), CK-L(3/4), EMA(4/5), CK5/6(3/6), p63(1/6), p40(1/6), E-cadherin (4/6), SSTR2(6/6), PD-L1(5/5), LCA(0/6), vimentin(5/6), CD2 (6/6), CD23(6/6), CD35(5/6), CXCL-13(4/5) and D2-40(1/5). The Ki-67 proliferative index was 60%-95%. In situ hybridization for EBER were all positive (6/6). Special stain for reticulin showed positive staining surrounding nests of tumor cells.Conclusions:The expression of follicular dendritic cell markers in lymphoepithelioma-like carcinoma is very rare, which may be related to EBV infection. Occasionally, it can overlap with follicular dendritic cell sarcoma by morphology and immunophenotype, which can lead to misdiagnosis. Only by combining clinical information, morphological characteristics and immunophenotype can an appropriate diagnosis be made.

Objective:To evaluate the survival benefit of surgical treatment for intrahepatic cholangiocarcinoma.Methods:This study is conducted based on the hepatobiliary tumor registry database. From May 2009 to December 2022,a total of 704 patients who were initially diagnosed with intrahepatic cholangiocarcinoma and underwent liver resection were consecutively enrolled at the Hepatobiliary Center of the First Affiliated Hospital of Nanjing Medical University. Among them,there were 380 males and 324 females,aged ( M(IQR)) 61(15) years(range:27 to 88 years). Twenty-six (3.7%) patients received neoadjuvant therapy before surgery. The overall survival(OS) and disease-free survival(DFS) rates were estimated by life table method, and Kaplan-Meier survival curves were plotted. Log-rank test was used to compare the survival difference among tumor-node-metastasis(TNM) staging or three periods. The OS and DFS differences among lymph node groups or adjuvant treatment groups were quantified as HR with 95% CI estimated using Cox proportional-hazards model with adjustment for prognostic factors. Results:Among the 704 patients,349 cases(49.6%) underwent major hepatectomy (≥3 segments),331(47.0%) had lymph node resection during surgery,and 524 cases(74.4%) achieved R0 resection. The morbidity of Clavien-Dindo grade Ⅲ or higher complications was 16.5%(116/704),with a mortality rate of 3.0%(21/704) within 30 days post-surgery. The median OS time was 27.1 months, and the OS rates at 1-,3-,5- and 10-year were 69.1%, 42.4%,34.1% and 24.5%,respectively. The median DFS time was 10.5 months,and the corresponding DFS rates were 46.0%,25.4%,21.9% and 16.9%,respectively. According to the 8 th edition of AJCC staging system, the 5-year survival rates for ⅠA,ⅠB,Ⅱ,ⅢA,ⅢB and Ⅳ were 68.4%, 43.2%, 30.3%,32.2%,14.0% and 0,respectively. The corresponding DFS rates were 55.8%, 28.1%,13.8%,21.2%,3.3% and 0,respectively. There were no statistically significant differences of OS or DFS between stage ⅠB and Ⅱ, stage ⅠB and ⅢA, or between stage Ⅱ and ⅢA(Log-rank test:all P>0.05),while there were significant differences of OS and DFS among other stages(Log-rank test:all P<0.05). Using Cox model with adjustment for prognostic factors, there were no statistically significant differences of OS and DFS between non-lymphadenectomy group or the biopsy-N0 group and dissection-N0 group(both P>0.05). However,the overall and disease-free survival of the biopsy-N1 group or dissection-N1 group were worse than those of dissection-N0 group(both P<0.05),with overall survival being better in dissection-N1 group than biopsy-N1 group( P=0.017). Overall survival in the period from 2019 to 2022 were significantly superior to that during the periods from 2009 to 2013 and 2014 to 2018(both P<0.01). Adjusting for prognostic factors, the disease-free and overall survival of the postoperative adjuvant therapy group were significantly better than those of the observation group in the period 2019 to 2022(both P<0.01). Conclusions:Surgery remains a milestone for achieving long-term survival for patients with intrahepatic cholangiocarcinoma. Regional lymph node dissection is required for patients with lymph node metastasis. Adjuvant therapy can significantly reduce tumor recurrence and prolong overall survival.

Objective:To investigate the influence of four preoperative CT image characteristics on the outcome of thoracoscopic surgery for chronic tuberculous empyema.Methods:This is a retrospective cohort study. Two hundred and eleven patients of tuberculous empyema who underwent video-assisted thoracic surgery(VATS) decortication at the First Department of Surgery , Wuhan Pulmonary Hospital from June 2020 to June 2023 were retrospectively analyzed. There were 162 male cases and 49 female cases, with an age ( M (IQR)) of 33 (27) years (range: 8 to 76 years). Patients were divided into two groups according to whether low-density lines, mass-patchy density, pleural fusion were observed, and the lesion size. Compare the clinical indicators of two groups of cases. Using the rapeutic efficacy as the dependent variable and four CT features as covariates, cases with cure or improve were included in Logistic regression analysis to calculate OR (95% CI) values. Results:Preoperative chest CT images showed that 127 cases (60.2%) had low-density lines, 102 cases (48.3%) had mass-patchy density, and 88 cases (47.7%) had pleural fusion. The lesions spanned 2 to 11 intercostal spaces, with a median of 7 intercostal spaces. The lesion size was divided into two groups according to <7 intercostal spaces and ≥7 intercostal spaces, with 101 cases (47.9%) and 110 cases (52.1%), respectively. In the intra-group comparison, there were no difference in age, lesion location and pulmonary tuberculosis. In the comparison of gender, except that the proportion of female patients in the group with lesion size <7 intercostal spaces ( χ2=6.064, P=0.010) was higher than ≥7 intercostal spaces, there were no significant difference between other groups. In low-density lines group, there was no difference in the incidence of anemia and hypoproteinemia between the two groups. Compared with the non low-density line group, patients with low-density line group exhibited fewer cases of abnormal elevation in ESR and CRP was lower(all P<0.01), the period of preoperative treatment ( U=7 281.00, P<0.01) was longer than the non low-density line group, while the operation time, intraoperative hemorrhage, postoperative drainage at 72 hours, postoperative drainage duration, lung re-expansion duration, and therapeutic efficacy were all better than the non low-density line group(all P<0.05). In the comparison between the mass-patchy density group, there were fewer cases of anemia, hypoproteinemia, abnormal elevation of ESR and CRP in the without mass-patchy density group(all P<0.05), and the period of preoperative treatmentwas shorter ( U=4 581.50, P=0.026), and the operation time, intraoperative hemorrhage, postoperative drainage at 72 hours, postoperative drainage duration, lung re-expansion duration and therapeutic effect were better too(all P<0.05). In the grouping comparison of pleural fusion, there were no difference in cases of anemia, hypoproteinemia, abnormal elevation of ESR and CRP, and the period of preoperative treatment between the two groups; the operation time, intraoperative hemorrhage, postoperative drainage at 72 hours, postoperative drainage duration, lung re-expansion duration, and therapeutic efficacy of the group without pleural fusion were better than the group with pleural fusion(all P<0.05). The group with <7 intercostal spaces had fewer cases of anemia, hypoproteinemia, abnormal elevation of ESR and CRP (all P<0.05), the period of preoperative treatment was longer ( U=4 295.00, P=0.004), the operation time, intraoperative hemorrhage, postoperative drainage at 72 hours,postoperative drainage duration, lung re-expansion duration and complications were less (all P<0.05), the therapeutic efficacy was better than the group with ≥7 intercostal spaces ( χ2=27.912, P<0.01). The Logistic regression analysis of cured and improved cases showed that mass-patchy density and lesion size were independent risk factors affecting the therapeutic efficacy (all P<0.05). Conclusions:For patients with CT images showing mass-patchy density, pleural fusion, and a large lesion size, the difficulty and risk of surgery may be relatively high.The preoperative CT images can provide objective reference for clinical preoperative evaluation.

Objective To investigate the impact of serine/threonine-protein kinase 1(AKT1)-mediated autophagy in hepatocellular carcinoma(HCC)cells on their sensitivity to 125I seed irradiation.Methods ① iProX database and STRING12.0 website were utilized to analyze the proteomic data of HCC before and after 125I seed irradiation to explore the differentially expressed proteins and associated functional connections.Meanwhile,The Cancer Genomics Atlas(TCGA)database was employed to analyze the relationship between AKT1 expression level and the survival of HCC patients.② Human HCC cell lines HUH7 and Hep3B were exposed to continuous irradiation from 125I radioactive seeds with an initial apparent activity of 0.8 mCi per seed for approximately 120 h,accumulating a total dose of 8 Gy,while the control cells were cultured under normal condition for 120 h.③ Autophagy inhibitor,chloroquine(CQ)and inducer,rapamycin(RAPA)were used to treat the HCC cells respectively to establish the CQ group and the RAPA group.The lentiviral transfection technique was employed to construct the HCC cells with overexpressed AKT1,namely the AKT1 group.The HCC cells treated in the same way were continuously irradiated with 125I seeds for 120 h to construct the CQ+125I group,the RAPA+125I group,and the AKT1+125I group.④The changes in microtubule-associated protein light chain 3(LC3),p62,AKT1 and p-AKT1 were detected by Western blotting.Cell immunofluorescence assay was employed to observe the expression of autophagy related proteins,such as LC3.The colony forming ability and apoptotic rate were detected with plate cloning assay and flow cytometry.Results ① Continuous irradiation with 125I seeds resulted in decreased expression of p62 and increased ratio of LC3Ⅱ/LC3Ⅰ(P＜0.05)when compared with the negative control(NC)group.Immunofluorescence assay revealed more green fluorescence spots of LC3.When compared with the 125I group,the CQ+125I group had significantly increased expression of p62(P＜0.01),decreased ratio of LC3Ⅱ/LC3Ⅰ(P＜0.01),lower apoptotic rate(P＜0.01),and more colony formations(P＜0.01).In contrast,the results in the RAPA+125I group were opposite to those of the CQ+125I group.② Analysis on the iProX database showed that the expression of AKT1 was decreased in the irradiated group,and analysis on the TCGA database indicated that high expression of AKT1 predicted a poor prognosis for HCC patients(P＜0.01).③After irradiation with 125I seeds,the expression of AKT1 at both the RNA and protein levels was decreased in the 125I group(P＜0.01).After overexpression of AKT1,the level of autophagy was decreased(P＜0.05).Irradiation of HCC cells with overexpressed AKT1 using 125I seeds could partially restore the level of autophagy.In the AKT1+125I group,the expression of AKT1,pAKT1 and p62 were all decreased,and the ratio of LC3Ⅱ/LC3Ⅰwas increased than the AKT1 group(P＜0.05).④ The apoptotic rate of the AKT1+125I group was lower than that of the 125I group(P＜0.05)and higher than that in the AKT1 group(P＜0.05).In HUH7 cells,the clonogenic ability of the AKT1+125I group was higher than that of the 125I group(P＜0.05).In Hep3B cells,the clonogenic ability of the AKT1+125I group was higher than that of the 125I group,and the clonogenic ability of the AKT1 group was higher than that of the NC group(P＜0.05).Conclusion 125I seed irradiation induce lethal autophagy in HCC cells by reducing the expression of AKT1,providing a new theoretical basis for the implantation of 125I radioactive seeds in the treatment of HCC.

Objectives:To investigate the coccygeal morphology in adult Chinese without coccydynia using CT scans,and to provide a morphological reference for assessing the risk of coccydynia in Chinese popula-tion.Methods:A retrospective analysis was conducted on 113 patients without coccydynia who underwent pelvic three-dimensional CT scans at the Second Affiliated Hospital of Wenzhou Medical University between August 2018 and August 2023.There were 67 males and 46 females,with a mean age of 53.5±19.1 years(range:18-93 years).The morphological characteristics of the sacrococcygeal anatomical structures,including coccyx number,coccyx type(modified Nathan classification),sacrococcygeal joint fusion,intercoccygeal joint subluxation,coccygeal sacralization,lateral deviation of coccygeal tip,ventral angulation of S5,and coccygeal bony spicule,were analyzed on the three-dimensional reconstructed CT images;And relevant morphological parameters were measured,such as the coccygeal straight length,sacral straight length,sacrococcygeal straight length,sacrolumbar angle,sacrococcygeal angle,sacrococcygeal joint angle,intercoccygeal angle,and first in-tercoccygeal joint angle,with consistency tests conducted for the measurements.The differences in morpholog-ical parameters were compared between different genders and age groups(＜50 years and ≥50 years).Results:Among the 113 asymptomatic adult Chinese subjects,88 cases(77.9％)had a 4-segment coccyx,and type Ⅰcoccyx(modified Nathan classification)was the most common type(53 cases),accounting for approximately 46.9％.The incidence of sacrococcygeal joint fusion,intercoccygeal joint subluxation,coccygeal sacralization,lateral deviation of the coccygeal tip,ventral angulation of S5,and coccygeal bony spicule were 52.2％(59 cases),25.7％(29 cases),20.4％(23 cases),53.1％(60 cases),7.1％(8 cases),and 15.0％(17 cases),respectively.The consistency test showed that the consistency of the measurement data among observers was good.In Chi-nese population,the coccygeal straight length was 3.59±0.72cm,sacral straight length was 10.97±0.92cm,and sacrococcygeal straight length was 12.68(11.99,13.69)cm.The lumbosacral angle,sacrococcygeal angle,inter-coccygeal angle,and first intercoccygeal joint angle were 38.0°±7.3°,110.6°±10.6°,173.1°(164.2°,178.2°),131.5°±21.5°,and 152.8°±17.1°,respectively.Gender comparisons showed that males had greater sacrococ-cygeal straight length and sacrococcygeal angle than females(P＜0.05).Age group comparisons revealed that subjects＜50 years had shorter coccygeal straight length,smaller lumbosacral angle,sacrococcygeal joint angle,and first intercoccygeal joint angle than those ≥50 years(P＜0.05),while the sacral straight length was longer in the＜50 years group(P＜0.01).Conclusions:Among the adult Chinese without coccydynia,4 coccygeal seg-ments and type Ⅰ(modified Nathan classification)are the most common.Sacrococcygeal joint fusion,coccygeal bony spicules,intercoccygeal joint subluxation,and coccygeal sacralization have relatively high incidences.Males have longer and straighter sacrococcygeal structures than females.Compared with those ≥50 years,subjects＜50 years have shorter coccyxes,longer sacra,and smaller lumbosacral angles.

Objective To investigate the impact of intergenerational caregiving on the brain structure and function of grandparents,and to analyze its correlation with caregiving factors.Methods Healthy adults(66 with grandchildren,24 without grandchildren)were recruited as study subjects,and clinical and MRI data were collected.Resting-state brain functional degree centrality(DC)and surface-based morphometry(SBM)methods were used to compare the differences in brain structure and function between the groups with and without grandchildren.The correlation between the differences in brain regions and △ values with grandchild's age,number,and time spent in childcare were assessed,respectively.Results Compared to the group without grandchildren,the group with grandchildren showed reduced surface area and cortical volume in the left middle temporal gyrus,as well as decreased DC values in the left medial superior frontal gyrus,bilateral orbital superior frontal gyrus,and left anterior cingulate and paracingulate gyrus(P＜0.05),respectively.In the grandchildren group,DC values and △ values in the left orbital superior frontal gyrus,left anterior cingulate and paracingulate gyrus were significantly positively correlated with time spent in childcare.Conclusion The brain structures and functions of grandparents related to empathy and motivation are changed in intergenerational caregiving,which may reveal the neuroplasticity after caring for their grandchildren.

Objective:To investigate the correlation between leucine-rich α2 glycoprotein (LRG) and endoscopic activity in patients with Crohn′s disease (CD), based on the assessment of inflammation in small intestinal lesion by double-balloon enteroscope (DBE).Methods:From 15 August 2022 to 22 August 2023, the clinical data of 139 patients with small bowel CD diagnosed by DBE at the First Affiliated Hospital of Anhui Medical University were prospectively collected, which included fecal calprotectin (FC), C-reactive protein (CRP), white blood cell count, hemoglobin, albumin, Crohn′s disease activity index (CDAI), and simple endoscopic score for Crohn′s disease (SES-CD). According to the SES-CD, endoscopic activity was classified as mucosal healing (0), endoscopic remission (0 to 2), mild activity (3 to 6), moderate activity (7 to 15), and severe activity (≥16). LRG levels were detected in all patients. Spearman rank correlation was used to analyze the correlation between LRG, clinical biochemical parameters and endoscopic scores. Receiver operating characteristic curve (ROC) was performed to determine the optimal cut-off value of LRG for evaluating endoscopic mucosal healing. Mann-Whitney U test, Kruskal-Wallis H test, and Bonferroni corrected test were used for statistical analysis. Results:Among 139 patients with small bowel CD, the LRG level was 17.3 (13.0, 25.2) mg/L, and SES-CD was 5 (1, 9); 32 patients achieved mucosal healing, 50 patients achieved endoscopic remission; 39 patients had mild activity, 40 patients had moderate activity, and 10 patients had severe activity. The SES-CD was negatively correlated with both hemoglobin and albumin ( r=-0.177 (95% confidence interval, 95% CI: -0.334 to -0.011), -0.293 (95% CI: -0.438 to -0.133)), with statistical significance ( P=0.037, <0.001). The SES-CD was positively correlated with CRP, CDAI, LRG and FC ( r=0.344 (95% CI: 0.188 to 0.482), 0.429 (95% CI: 0.282 to 0.556), 0.525 (95% CI: 0.393 to 0.636), 0.661 (95% CI: 0.556 to 0.745)), with statistical significant (all P<0.001). For the 64 small bowel CD patients with CRP in the normal reference value, SES-CD was positively correlated with CDAI, LRG and FC ( r=0.296 (95% CI: 0.054 to 0.505), 0.364 (95% CI: 0.129 to 0.559), 0.547 (95% CI: 0.348 to 0.699)), with statistical significance ( P=0.017, =0.003, <0.001). The LRG level of patients with endoscopic mucosal healing was significantly lower than that of patients with endoscopic remission (11.5 (10.1, 17.2) mg/L vs. 17.3 (13.4, 23.5) mg/L), with statistical significance ( Z=-3.25, P<0.001). ROC analysis showed that the area under the curve (AUC) of LRG in predicting endoscopic mucosal healing was 0.81 (95% CI: 0.73 to 0.89), with an optimal cut-off value of 15.27 mg/L. The sensitivity, specificity, positive predictive value and negative predictive value were 0.757, 0.718, 0.900 and 0.469, respectively. The accuracy of the combination of LRG and FC (AUC was 0.88, 95% CI: 0.82 to 0.94) in predicting endoscopic mucosal healing was higher than that of LRG alone (AUC was 0.81, 95% CI: 0.73 to 0.89), and the difference was statistically significant ( P=0.011). Conclusion:Based on the results of DBE, LRG may be a reliable biomarker for predicting endoscopic remission and mucosal healing in patients with small bowel CD.

Purpose To explore the clinicopathological features,diagnosis and differential diagnosis of mantle cell lymphoma(MCL)with aberrant expression of CD10.Methods 14 cases of MCL with aberrant expression of CD10 were analyzed using hematoxylin-eosin,immunohistochemical stains,in situ hybridization,and fluorescence in situ hy-bridization(FISH)techniques to observe the histological morphology,immunophenotype,and molecular genetic char-acteristics.The relevant literatures were reviewed.Results There were 11 males and 3 females,with a male-to-fe-male ratio of 11∶3.The age ranged from 49 to 80 years,with an average age of 64.4 years and a median age of 64 years.10 cases occurred in lymph nodes,1 case in the nasopharynx,1 case in the right colon,1 case in the right eye-lid,and 1 case in the right testis.According to the Ann Arbor staging system,8 cases were classified as stage Ⅳ and 5 cases as stage Ⅲ,and 1 case with undetermined staging.Histologically,there was diffuse effacement of the normal architecture by tumor cells infiltration.Transparent degenerate small blood vessels and scattered individual epithelial-like tissue cells could be observed in the background.Among them,8 cases(8/14,57.14％)were composed of uni-form small to medium-sized lymphocytes with slightly irregular nuclei,unevenly dispersed chromatin,inconspicuous nucleoli,and scant cytoplasm,along with observable mitotic figures.In 3 cases(3/14,21.43％),the tumor cells were large and markedly pleomorphic,with round or irregular nuclei,prominent nucleoli,frequent mitotic figures,and abundant pale cytoplasm.Tumor cells in 3 cases(3/14,21.43％)were resembling lymphoblasts,characterized by round nuclei,fine chromatin,inconspicuous nucleoli,frequent mitotic figures,and scant cytoplasm.Immunophenotyp-ically,CD21 staining showed residual follicular dendritic meshworks.The tumor cells were diffusely and strongly posi-tive for CD20(14/14),PAX5(7/7),CD5(14/14),Cyclin D1(14/14),SOX11(11/11),and BCL2(13/13),partially positive for BCL6(8/14,57.14％)and MUM1(6/9,66.67％),but negative for CD3(14/14)and CD23(14/14).Among 14 cases,10 cases were diffusely and strongly positive for CD10(10/14,71.43％),and 4 cases were partially positive for CD10(4/14,28.57％).The percentage of Ki67 index ranged from 10％to 90％.All cases were negative for EBER(8/8).FISH analysis was performed in 9 cases,among which 7 cases showed CCND1 gene rearrangement,another 2 cases failed to detect due to insufficient tissue samples.Bone marrow biopsy was performed in 13 cases,revealing involvement in 8 cases(8/13,61.54％)and no involvement in 5 cases(5/13,38.46％).Con-clusion MCL with aberrant expression of CD10 is very rare,which commonly exhibits a diffuse growth pattern and blastoid and pleomorphic variants.It often has a high Ki67 proliferation index and poorer prognosis,and should be dis-tinguished from other subtypes of CD1O-positive B-cell lymphomas.