This article reports a diagnostically and therapeutically challenging case of small intestinal marginal zone lymphoma. The patient presented with recurrent abdominal pain as the chief complaint, and imaging revealed multifocal small bowel wall thickening with high uptake, multisegmental luminal stenosis, and proximal dilation. Initial diagnostic workup, including gastroscopy, colonoscopy, and enteroscopy with biopsy, failed to establish a definitive diagnosis. Empirical anti-tuberculosis therapy was ineffective. A repeat enteroscopic biopsy performed over eight months after symptom onset eventually confirmed the diagnosis of mucosa-associated lymphoid tissue (MALT) extranodal marginal zone lymphoma. Despite three different chemotherapy regimens, the patient's intestinal obstruction symptoms persisted, with imaging still showing multifocal bowel wall thickening and hypermetabolic activity. A critical diagnostic dilemma arose regarding whether the PET/CT-positive lesions represented residual lymphoma or fibrotic scarring, whether further chemotherapy adjustments were warranted, and whether surgical resection was necessary. Multidisciplinary discussion concluded that imaging had limited discriminatory value in this scenario and that surgical intervention should be pursued if feasible. The patient successfully underwent partial small bowel resection, with postoperative pathology confirming no residual lymphoma but significant fibrotic changes. The patient has since resumed a normal diet, with body weight nearly restored to pre-illness levels. This case highlights that fibrotic transformation is a common sequela of treated marginal zone lymphoma and that PET/CT may misleadingly suggest residual disease, potentially leading to unnecessary chemotherapy. Timely surgical intervention is crucial in such scenarios.

AIM:To explore the molecular mechanism by which treadmill exercise reshapes the homeostasis of mitochondrial dynamics and alleviates depression-like behavior.METHODS:The mouse model of depression-like be-havior was established by electronic foot shock plus restraint stress.The depression-like mice were intervened with tread-mill exercise.The neurobehavior of mice was evaluated using the open field test and elevated plus-maze test,neuronal in-jury was detected by Nissl staining and TUNEL,and the expression of mitochondrial dynamics-related proteins was detect-ed by Western blot and immunofluorescence.RESULTS:Five weeks of electronic foot shock plus restraint stress success-fully established the depression-like mouse model,and neurobehavioral tests showed that the mice exhibited depression-like behaviors.In depression-like mice,neuronal synapses were degraded and neuronal apoptosis increased,while tread-mill exercise reduced neuronal damage and alleviated abnormal neurobehavior in depression-like mice.The mechanism study shows that the expression of mitochondrial fission-related protein 1(Fis1)and dynamin-related protein 1(Drp1)in-volved in mitochondrial division is up-regulated,and the expression of mitofusin 2(MFN2)and optic atrophy 1 protein(OPA1)involved in mitochondrial fusion is down-regulated in the cerebral cortex of depression-like mice.Notably,tread-mill exercise reverses the expression of these mitochondrial dynamics-related proteins and reshapes the homeostasis of mi-tochondrial dynamics.CONCLUSION:Mitochondrial dynamics disorder is involved in the pathological process of neu-robehavioral changes in mice with depression-like behavior.Treadmill exercise reshapes the homeostasis of mitochondrial dynamics and alleviates depression-like behavior.This study provides a scientific reference for the clinical application of exercise therapy as an adjuvant therapy in the intervention of diseases associated with depression-like behavior.

In today's society， depression is a kind of highly prevalent chronic mental illness. It leads to a high disability rate and a heavy economic burden. Depression is defined by fundamental symptoms of low mood and diminished pleasure. Its causes and mechanisms remain unclear， and it presents a broad spectrum of symptoms and a persistent nature that significantly impacts both physical and mental well-being. Treatment in Western medicine primarily focuses on alleviating symptoms， yet it entails numerous adverse effects and contraindications. Traditional Chinese medicine （TCM） treatment is based on resolving depression， which is often accompanied by soothing liver， and the key medicine is Bupleuri Radix. Bupleuri Radix associated prescriptions refer to a class of prescriptions using Bupleuri Radix as the sovereign medicinal or having a high dose of Bupleuri Radix， which are widely used in the field of anti-depression. Previous studies from animal experiments， clinical research， and modern pharmacological research have confirmed that Bupleuri Radix associated prescriptions have precise anti-depression efficacy in multiple ways and at multiple levels， but lack a comprehensive and systematic summarization. This paper summarized and analyzed the literature related to the clinical application and mechanism of action of Bupleuri Radix associated prescriptions in anti-depression treatment. The results showed that the anti-depression mechanism of the Bupleuri Radix associated prescriptions （such as Xiaochaihu Tang， Xiaoyao San， Sini San， Chaihu Shugan San， and Chaihu jia Longgu Muli San） was associated with the effects of regulating monoamine neurotransmitters， the brain-derived neurotrophic factor （BDNF）， intestinal flora， and the hypothalamic-pituitary-adrenal （HPA） axis， inhibiting inflammatory responses， and modulating related signaling pathways. Applying them in clinical practice can effectively alleviate patient symptoms， lower the TCM syndrome score and the severity of depression， and also reduce adverse reactions. This underscores advantages of TCM in depression treatment， which offers patients a secure， effective， and more individualized alternative treatment regimen. On this basis， the shortcomings of current studies and the future trend were analyzed. This study aimed to provide an evidence-based medicine basis for the research and development of novel antidepressant medications.

A 65-year-old male was admitted to Peking Union Medical College Hospital. The patient had intermittent fever for 2 months with a maximum body temperature of 39.3 ℃ and elevated serum creatinine levels for 1 week. He had no other suggestive symptoms or positive signs. Laboratory test results suggested acute kidney injury and a sharp elevation in serum lactic dehydrogenase levels. Abdominal enhanced computed tomography (CT) revealed multiple low-density lesions, and further biopsy pathology demonstrated chronic inflammation. Thereafter, positron emission tomography (PET)/CT showed abnormally elevated uptake value for the bones throughout the entire body, in addition to the liver and brain. Repeated bone marrow biopsy finally confirmed metastatic bone cancer, which possibly originated from the kidney according to immunohistochemical staining. In this rare case of fever of unknown origin, the primary lesion was a renal tumor with bone, liver, and brain metastases. Enhanced CT and PET/CT provided negative results, and the diagnosis was eventually confirmed by repeated bone marrow pathology.

AIM:To explore the molecular mechanism by which treadmill exercise reshapes the homeostasis of mitochondrial dynamics and alleviates depression-like behavior.METHODS:The mouse model of depression-like be-havior was established by electronic foot shock plus restraint stress.The depression-like mice were intervened with tread-mill exercise.The neurobehavior of mice was evaluated using the open field test and elevated plus-maze test,neuronal in-jury was detected by Nissl staining and TUNEL,and the expression of mitochondrial dynamics-related proteins was detect-ed by Western blot and immunofluorescence.RESULTS:Five weeks of electronic foot shock plus restraint stress success-fully established the depression-like mouse model,and neurobehavioral tests showed that the mice exhibited depression-like behaviors.In depression-like mice,neuronal synapses were degraded and neuronal apoptosis increased,while tread-mill exercise reduced neuronal damage and alleviated abnormal neurobehavior in depression-like mice.The mechanism study shows that the expression of mitochondrial fission-related protein 1(Fis1)and dynamin-related protein 1(Drp1)in-volved in mitochondrial division is up-regulated,and the expression of mitofusin 2(MFN2)and optic atrophy 1 protein(OPA1)involved in mitochondrial fusion is down-regulated in the cerebral cortex of depression-like mice.Notably,tread-mill exercise reverses the expression of these mitochondrial dynamics-related proteins and reshapes the homeostasis of mi-tochondrial dynamics.CONCLUSION:Mitochondrial dynamics disorder is involved in the pathological process of neu-robehavioral changes in mice with depression-like behavior.Treadmill exercise reshapes the homeostasis of mitochondrial dynamics and alleviates depression-like behavior.This study provides a scientific reference for the clinical application of exercise therapy as an adjuvant therapy in the intervention of diseases associated with depression-like behavior.

A 65-year-old male was admitted to Peking Union Medical College Hospital. The patient had intermittent fever for 2 months with a maximum body temperature of 39.3 ℃ and elevated serum creatinine levels for 1 week. He had no other suggestive symptoms or positive signs. Laboratory test results suggested acute kidney injury and a sharp elevation in serum lactic dehydrogenase levels. Abdominal enhanced computed tomography (CT) revealed multiple low-density lesions, and further biopsy pathology demonstrated chronic inflammation. Thereafter, positron emission tomography (PET)/CT showed abnormally elevated uptake value for the bones throughout the entire body, in addition to the liver and brain. Repeated bone marrow biopsy finally confirmed metastatic bone cancer, which possibly originated from the kidney according to immunohistochemical staining. In this rare case of fever of unknown origin, the primary lesion was a renal tumor with bone, liver, and brain metastases. Enhanced CT and PET/CT provided negative results, and the diagnosis was eventually confirmed by repeated bone marrow pathology.

Objective To investigate the effect of silencing MFG-E8 gene on the sensitivity of SKOV3 cells to anticancer drugs and related mechanisms. Methods SKOV3 cells were transfected with MFG-E8 siRNA (Msi) and NC siRNA (Csi), respectively and the efficiency of transfection was confirmed by Western blot. The sensitivity of SKOV3 cells to cisplatin was observed by CCK-8 assay after transfection. The mRNA expression of ABCB1 and ABCC1 were detected by qRT-PCR. Effect of silencing MFG-E8 on the expression of ETM-related protein was detected by qRT-PCR and Western blot. Results MFG-E8 siRNA could effectively silence the expression of MFG-E8 protein. With the increasing drug concentration, the proliferation inhibition rate of each group also increased, and the cell proliferation inhibition rate of MFG-E8 siRNA group increased significantly (P < 0.01). Compared with NC siRNA group, downregulation of MFG-E8 expression led to decreased SKOV3 cell proliferation at 48h or 72h after 3 μg/ml cisplatin treat ment (P < 0.05). qRT-PCR results showed that the mRNA expression of ABCB1 and ABCC1 in Msi group were significantly lower than those in Csi group. qRT-PCR and Western blot results showed that silencing MFG-E8 gene down-regulated the mRNA and protein expression of N-Cadherin, Vimentin and Snail and up-regulated the expression of E-Cadherin. Conclusion Silencing the MFG-E8 gene can increase the sensitivity of SKOV3 cells against anti-tumor drugs and down-regulate the mRNA expression of ABCB1 and ABCC1, which may be related to the inhibition of EMT progression.

Objective:To develop and validate a nomogram for predicting the 1-and 3-year survival rates of patients receiving peritoneal dialysis.Methods:Patients who underwent peritoneal dialysis for the first time in Zhujiang hospital from January 1, 2010 to December 31, 2017 were enrolled. The patients from January 1, 2014 to December 31, 2017 were enrolled in a training dataset. Baseline clinical data were collected and the primary endpoint was all-cause death. Cox proportional hazard regression models were used to analyze risk factors affecting the survival rates. Nomograms were generated using the R rms package. The Harrell' concordance index (C-index), receiver operating characteristic curve and calibration curve were used to verify the performance of the model. Patients who underwent peritoneal dialysis from January 1, 2010 to December 31, 2013 were then selected to validate the external predictive accuracy of the prediction models.Results:The prediction cohort enrolled 457 patients, with a median follow-up time of 27.67(18.37, 39.22) months, and 64 patients (14.00%) died during follow-up. The 1-and 3-year cumulative survival rates were 96.4% and 83.0%. Multivariate analysis showed that aging (every 1 year old increase, HR=1.07, 95% CI 1.04-1.09, P<0.001), stroke ( HR=3.63, 95% CI 1.93-6.85, P<0.001), higher cholesterol (every 1 mmol/L increase, HR=1.51, 95% CI 1.20-1.89, P<0.001), higher neutrophil-to-lymphocyte ratio (every 1 increase, HR=1.12, 95% CI 1.05-1.20, P=0.001), and lower albumin ( HR=0.89, 95% CI 0.82-0.95, P=0.001) were independent risk factors affecting the survival rates of PD patients. The C-index of the prediction cohort and the validation cohort were 0.815(95% CI 0.765-0.865) and 0.804(95% CI 0.744-0.864, respectively). Both internally and externally verified calibration curves showed that the predicted results were close to the actual survival rates. Conclusion:Based on age, blood total cholesterol level, stroke history, and NLR, the prognosis prediction model of peritoneal dialysis patients established with nomogram can help predict the 1-year and 3-year survival rates of peritoneal dialysis patients.

Objective To study ARID1A expression and its role in pancreatic neuroendocrine tumors.Methods 51 cases of pancreatic neuroendocrine tumors were collected from July 2003 to May 2012 from Peking Union Medical College Hospital.Eighteen normal pancreatic tissues were used as positive control.HE staining method was used to observe general clinicopathological features.ARID1A expression was detected immunohistochemically by EnVision method.The relationship between ARID1A expression and tumor grade and stage was analyzed.Results The level of ARID1A expression was not associated with patients' gender,age,TNM stage,and tumor size (P ＞ 0.05);but showed significantly negative correlation with tumor grade (P ＜ 0.05).Conclusions Low ARID1A expression was significantly related to the high grade level of pancreatic neuroendocrine tumors.It has a certain effect on the clinical classification of pancreatic neuroendocring tumors.ARID1A may play a role as a tumor suppressor gene.