Objective To use imaging features of pulmonary nodules to predict the risk of lymph node metastasis in patients with cT1-stage non-small cell lung cancer (NSCLC), providing a reference for clinical decision-making. Methods A retrospective analysis was conducted on the imaging features and postoperative pathological results of cT1 NSCLC patients who underwent surgical treatment at Linyi People’s Hospital from July 2019 to July 2022. Patients were grouped and analyzed according to lymph node metastasis status. Results A total of 1 123 patients were included, comprising 471 males and 652 females, with a median age of 59 (52, 66) years. Comparative analysis revealed that sex, age, nodule location, nodule size on imaging, solid component size, consolidation tumor ratio (CTR), average CT value, and tumor proximity to the pleura all influenced lymph node metastasis. A nomogram was constructed, indicating that the probability of lymph node metastasis in cT1 NSCLC was positively correlated with solid component size, CTR, and average CT value of the pulmonary nodule, and negatively correlated with patient age. The area under the receiver operating characteristic curve was 0.929. Conclusion For cT1 NSCLC patients, the probability of lymph node metastasis can be predicted by measuring the solid component size, CTR, and average CT value of the pulmonary nodule, in conjunction with patient age. However, relying solely on pulmonary nodule imaging characteristics is insufficient to determine a specific lymph node dissection strategy.

Objective To explore the value of deep learning image reconstruction(DLIR)by comparing subjective and objec-tive evaluation of DLIR and adaptive statistical iterative reconstruction(ASIR-V)images in gastric cancer CT.Methods Abdominal CT images in the venous phase of 80 untreated patients with primary gastric cancer were included,and five CT reconstruction meth-ods of 50％ASIR-V,80％ASIR-V,DLIR-low(DLIR-L),DLIR-medium(DLIR-M)and DLIR-high(DLIR-H)were adopted,respec-tively.The objective evaluation included background standard deviation(SD),signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR)values and pericancerous fat density resolution.The subjective evaluation included SD,overall image quality,the display of gastric cancer lesions,and diagnostic confidence in whether the serosal surface of the gastric wall was infiltrated.Results The subjective and objective evalua-tion indicators showed statistically significant differences among the five reconstruction models(P＜0.001).In terms of objective evalua-tion,the SD value of gastric cancer lesions in the DLIR-H was the lowest,while the SNR and CNR values were the highest among the five groups.In terms of subjective evaluation,the DLIR-M had the highest scores in gastric cancer lesions display,overall image quality and diagnostic confidence among the five groups.Conclusion Compared with ASIR-V,DLIR can significantly reduce image noise and improve image quality,and DLIR-M and DLIR-H are respectively the optimal subjective and objective reconstruction models for showing gastric cancer lesions.

Objective:To compare the clinical efficacy and adverse events of different postoperative radiotherapy strategies (adjuvant radiotherapy versus salvage radiotherapy) and different irradiation fields (prostate bed versus prostate bed + pelvic radiation) in patients after radical prostatectomy for prostate cancer.Methods:This retrospective analysis included clinical data from 115 patients with localized or locally advanced prostate cancer who received intensity-modulated radiotherapy (IMRT) after radical prostatectomy at Beijing Hospital between March 2014 and September 2023. Among them, 40 patients received adjuvant radiotherapy, and 75 received salvage radiotherapy. And 74 patients received irradiation to both the prostate bed and pelvic (prostate bed + pelvic radiation group), while 41 patients received irradiation to the prostate bed alone (prostate bed irradiation group). Comparison was made between the adjuvant radiotherapy group and salvage radiotherapy group, as well as between prostate bed + pelvic radiation group and prostate bed irradiation group, in terms of overall survival (OS), progression-free survival (PFS), locoregional recurrence-free survival (LRRFS), and the incidence of adverse events. Clinical characteristics were compared using the chi-square test. Survival rates were calculated using the Kaplan-Meier method and compared using the log-rank test. Prognostic factors affecting survival were analyzed using Cox multivariate regression.Results:The median follow-up duration was 73.1 months. The 5-year OS, PFS and LRRFS rates for the entire cohort were 96.4%, 86.4%, and 93.2%, respectively. A total of 59 patients (51.3%) experienced grade 1-2 acute radiotherapy-related adverse events, while 43 patients (37.4%) experienced grade 1-2 late radiotherapy-related adverse events. No grade ≥ 3 late adverse events were observed. There were no statistically significant differences in OS, PFS, or LRRFS between the adjuvant and salvage radiotherapy groups ( P = 0.807, 0.996, and 0.976, respectively), or in the incidence of grade 1-2 acute or late adverse events ( P > 0.05). The OS rate in the prostate bed + pelvic radiation group was significantly lower than that in the prostate bed irradiation group ( P = 0.036), while no significant differences were found in PFS or LRRFS ( P = 0.109 and 0.190, respectively), or in the incidence of grade 1-2 acute or late adverse events ( P > 0.05). Multivariable analysis showed no statistically significant differences in OS, PFS, or LRRFS between the adjuvant and salvage radiotherapy groups, or between the prostate bed and prostate bed + pelvic irradiation groups ( P = 0.756, 0.341, 0.605; 0.938, 0.987, 0.605, respectively). Conclusions:In the era of modern IMRT, both adjuvant and salvage radiotherapy, as well as prostate bed and prostate bed + pelvic irradiation, demonstrate similar efficacy and safety profiles after radical prostatectomy for prostate cancer. Treatment outcomes were favorable, and adverse events were minimal.

Objective:To investigate the clinical characteristics and prognosis of follicular lymphoma (FL) patients with different primary sites using the Surveillance, Epidemiology, and End Results (SEER) database.Methods:Clinical data of 7167 patients with early-stage FL (stage I-II) from the SEER database between 2000 and 2015 were respectively analyzed. Primary sites were divided into intranodal and extranodal types. Intranodal primary sites included supradiaphragmatic lymph nodes (LN), subphrenic lymph nodes and Waldeyer's ring. Extranodal primary sites consisted of skin, gastrointestinal tract, duodenum, head and neck, other sites. Prognostic factors and overall survival (OS) in patients with different primary sites were analyzed. OS rate was evaluated using Kaplan-Meier method and survival difference between primary sites was compared with log-rank test. Inverse probability treatment weighting (IPTW) and multi-variable analysis were applied to adjust for confounding factors. Multivariate Cox regression analysis of influencing factors of OS was performed.Results:The median age was 63 years old, with the median follow-up time of 63 months. There was no difference in prognosis among the intranodal groups or between the intranodal and extranodal groups. The 10-year OS rates of the supradiaphragmatic lymph LN ( n=2146), subdiaphragmatic LN ( n=2811), and the Waldeyer's ring ( n=151) groups were 70.7%, 69.9% and 73.4%, respectively ( P=0.422 for infradiaphragmatic LN vs. supradiaphragmatic LN, P=1.000 for Waldeyer's ring vs. supradiaphragmatic LN), and 70.3% and 68.9% for intranodal ( n=5108) and extranodal ( n=2059), respectively. There was no significant difference in OS between the groups ( P=0.581) after IPTW adjustment. The most common primary sites in extranodal disease were skin, gastrointestinal tract, head and neck, and duodenum. The 10-year OS for skin, gastrointestinal tract, and cutaneous was 74.2%, 74.7%, and 87.3%, respectively, significantly higher than 55.6% for other sites (duodenum vs. others sites, gastrointestinal vs. others sites, skin vs. others sites: all P<0.001). Multivariate Cox regression analysis revealed that difference in OS was not significant among the intranodal groups or between the intranodal and extranodal groups. However, different extranodal primary site was an independent prognostic factor for OS. Conclusions:Early FL patients with supradiaphragmatic LN, subdiaphragmatic LN and Waldeyer's ring, and between the intranodal and extranodal primary sites obtain similar prognosis. However, early-stage FL patients with different extranodal primary sites have prognostic differences. The prognosis of primary skin, gastrointestinal tract and duodenum is significantly better than that of other extranodal primary sites.

Objective:To explore the relationship between coronary artery measurements combined with C-reactive protein(CRP), erythrocyte sedimentation rate(ESR) and coronary artery lesionsin(CAL) with incomplete Kawasaki disease (IKD) in children.Methods:Sixty-eight cases of pediatric IKD admitted to Huaibei Maternal and Child Health Care Hospital from January 2020 to April 2024 were selected as the IKD group, and 34 healthy children undergoing physical examination during the same period were selected as the control group according to the principle of 2∶1 pairing. Echocardiographic Z values including left coronary artery (LCA)-Z, right coronary artery (RCA)-Z, left anterior descending branch (LAD)-Z, left circumflex branch (LCX)-Z and CRP, ESR were compared between the two groups. General information of children with or without CAL were compared. The multivariate Logistic regression was used to screen the risk factors of IKD combined with CAL, and receiver operating characteristic (ROC) curve was used to analyze the predictive value of each index to IKD combined with CAL.Results:The LCA-Z, RCA-Z, LAD-Z, LCX-Z and the levels of CRP, ESR in the IKD group were higher than those in the control group: 3.26 ± 0.97 vs. 1.35 ± 0.28, 3.46 ± 0.92 vs. 1.01 ± 0.29, 3.18 ± 0.69 vs. 1.18 ± 0.34, 2.97 ± 0.68 vs.1.27 ± 0.34, (39.97 ± 9.03) mg/L vs. (4.21 ± 1.05) mg/L, (59.67 ± 16.34) mm/1 h vs. (12.85 ± 2.43) mm/1 h, there were statistical differences ( P<0.05). The duration of fever, intravenous immunoglobulin (IVIG) treatment response, IVIG start time, creatine kinase (CK), creatine kinase-MB(CK-MB), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) between the children with IKD and CAL, IKD without CAL: (10.02 ± 2.45) d vs. (7.68 ± 1.43) d, 65.22%(15/23) vs. 88.89%(40/45), 60.87%(14/23) vs. 86.67%(39/45), (236.78 ± 59.74) U/L vs. (192.67 ± 35.41) U/L, (45.19 ± 9.85) U/L vs. (33.18 ± 9.87) U/L, (1.78 ± 0.32) μg/L vs. (0.92 ± 0.20) μg/L, there were statistical differences ( P<0.05). Logistic regression analysis showed that the duration of fever, IVIG treatment response, IVIG initiation time, CK, CK-MB, NT-proBNP, echocardiographic Z value, CRP and ESR levels were independent risk factors for IKD combined with CAL ( P<0.05). ROC curve analysis results showed that the area under the curve of IKD combined with CAL predicted by LCA-Z, RCA-Z, LADE-Z, LCX-Z, CRP and ESR was the largest, which was 0.917 (95% CI 0.824 - 0.970), which was higher than that diagnosed by each index alone ( P<0.05). Conclusions:There is a certain relationship between the echocardiographic Z values, CRP and ESR in children with IKD and CAL, which can be used to assist in the evaluation of IKD complicated with CAL.

Objective To explore the value of deep learning image reconstruction(DLIR)by comparing subjective and objec-tive evaluation of DLIR and adaptive statistical iterative reconstruction(ASIR-V)images in gastric cancer CT.Methods Abdominal CT images in the venous phase of 80 untreated patients with primary gastric cancer were included,and five CT reconstruction meth-ods of 50％ASIR-V,80％ASIR-V,DLIR-low(DLIR-L),DLIR-medium(DLIR-M)and DLIR-high(DLIR-H)were adopted,respec-tively.The objective evaluation included background standard deviation(SD),signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR)values and pericancerous fat density resolution.The subjective evaluation included SD,overall image quality,the display of gastric cancer lesions,and diagnostic confidence in whether the serosal surface of the gastric wall was infiltrated.Results The subjective and objective evalua-tion indicators showed statistically significant differences among the five reconstruction models(P＜0.001).In terms of objective evalua-tion,the SD value of gastric cancer lesions in the DLIR-H was the lowest,while the SNR and CNR values were the highest among the five groups.In terms of subjective evaluation,the DLIR-M had the highest scores in gastric cancer lesions display,overall image quality and diagnostic confidence among the five groups.Conclusion Compared with ASIR-V,DLIR can significantly reduce image noise and improve image quality,and DLIR-M and DLIR-H are respectively the optimal subjective and objective reconstruction models for showing gastric cancer lesions.

Objective:To explore the relationship between coronary artery measurements combined with C-reactive protein(CRP), erythrocyte sedimentation rate(ESR) and coronary artery lesionsin(CAL) with incomplete Kawasaki disease (IKD) in children.Methods:Sixty-eight cases of pediatric IKD admitted to Huaibei Maternal and Child Health Care Hospital from January 2020 to April 2024 were selected as the IKD group, and 34 healthy children undergoing physical examination during the same period were selected as the control group according to the principle of 2∶1 pairing. Echocardiographic Z values including left coronary artery (LCA)-Z, right coronary artery (RCA)-Z, left anterior descending branch (LAD)-Z, left circumflex branch (LCX)-Z and CRP, ESR were compared between the two groups. General information of children with or without CAL were compared. The multivariate Logistic regression was used to screen the risk factors of IKD combined with CAL, and receiver operating characteristic (ROC) curve was used to analyze the predictive value of each index to IKD combined with CAL.Results:The LCA-Z, RCA-Z, LAD-Z, LCX-Z and the levels of CRP, ESR in the IKD group were higher than those in the control group: 3.26 ± 0.97 vs. 1.35 ± 0.28, 3.46 ± 0.92 vs. 1.01 ± 0.29, 3.18 ± 0.69 vs. 1.18 ± 0.34, 2.97 ± 0.68 vs.1.27 ± 0.34, (39.97 ± 9.03) mg/L vs. (4.21 ± 1.05) mg/L, (59.67 ± 16.34) mm/1 h vs. (12.85 ± 2.43) mm/1 h, there were statistical differences ( P<0.05). The duration of fever, intravenous immunoglobulin (IVIG) treatment response, IVIG start time, creatine kinase (CK), creatine kinase-MB(CK-MB), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) between the children with IKD and CAL, IKD without CAL: (10.02 ± 2.45) d vs. (7.68 ± 1.43) d, 65.22%(15/23) vs. 88.89%(40/45), 60.87%(14/23) vs. 86.67%(39/45), (236.78 ± 59.74) U/L vs. (192.67 ± 35.41) U/L, (45.19 ± 9.85) U/L vs. (33.18 ± 9.87) U/L, (1.78 ± 0.32) μg/L vs. (0.92 ± 0.20) μg/L, there were statistical differences ( P<0.05). Logistic regression analysis showed that the duration of fever, IVIG treatment response, IVIG initiation time, CK, CK-MB, NT-proBNP, echocardiographic Z value, CRP and ESR levels were independent risk factors for IKD combined with CAL ( P<0.05). ROC curve analysis results showed that the area under the curve of IKD combined with CAL predicted by LCA-Z, RCA-Z, LADE-Z, LCX-Z, CRP and ESR was the largest, which was 0.917 (95% CI 0.824 - 0.970), which was higher than that diagnosed by each index alone ( P<0.05). Conclusions:There is a certain relationship between the echocardiographic Z values, CRP and ESR in children with IKD and CAL, which can be used to assist in the evaluation of IKD complicated with CAL.

Objective:To investigate the clinical characteristics and prognosis of follicular lymphoma (FL) patients with different primary sites using the Surveillance, Epidemiology, and End Results (SEER) database.Methods:Clinical data of 7167 patients with early-stage FL (stage I-II) from the SEER database between 2000 and 2015 were respectively analyzed. Primary sites were divided into intranodal and extranodal types. Intranodal primary sites included supradiaphragmatic lymph nodes (LN), subphrenic lymph nodes and Waldeyer's ring. Extranodal primary sites consisted of skin, gastrointestinal tract, duodenum, head and neck, other sites. Prognostic factors and overall survival (OS) in patients with different primary sites were analyzed. OS rate was evaluated using Kaplan-Meier method and survival difference between primary sites was compared with log-rank test. Inverse probability treatment weighting (IPTW) and multi-variable analysis were applied to adjust for confounding factors. Multivariate Cox regression analysis of influencing factors of OS was performed.Results:The median age was 63 years old, with the median follow-up time of 63 months. There was no difference in prognosis among the intranodal groups or between the intranodal and extranodal groups. The 10-year OS rates of the supradiaphragmatic lymph LN ( n=2146), subdiaphragmatic LN ( n=2811), and the Waldeyer's ring ( n=151) groups were 70.7%, 69.9% and 73.4%, respectively ( P=0.422 for infradiaphragmatic LN vs. supradiaphragmatic LN, P=1.000 for Waldeyer's ring vs. supradiaphragmatic LN), and 70.3% and 68.9% for intranodal ( n=5108) and extranodal ( n=2059), respectively. There was no significant difference in OS between the groups ( P=0.581) after IPTW adjustment. The most common primary sites in extranodal disease were skin, gastrointestinal tract, head and neck, and duodenum. The 10-year OS for skin, gastrointestinal tract, and cutaneous was 74.2%, 74.7%, and 87.3%, respectively, significantly higher than 55.6% for other sites (duodenum vs. others sites, gastrointestinal vs. others sites, skin vs. others sites: all P<0.001). Multivariate Cox regression analysis revealed that difference in OS was not significant among the intranodal groups or between the intranodal and extranodal groups. However, different extranodal primary site was an independent prognostic factor for OS. Conclusions:Early FL patients with supradiaphragmatic LN, subdiaphragmatic LN and Waldeyer's ring, and between the intranodal and extranodal primary sites obtain similar prognosis. However, early-stage FL patients with different extranodal primary sites have prognostic differences. The prognosis of primary skin, gastrointestinal tract and duodenum is significantly better than that of other extranodal primary sites.

Objective:To compare the clinical efficacy and adverse events of different postoperative radiotherapy strategies (adjuvant radiotherapy versus salvage radiotherapy) and different irradiation fields (prostate bed versus prostate bed + pelvic radiation) in patients after radical prostatectomy for prostate cancer.Methods:This retrospective analysis included clinical data from 115 patients with localized or locally advanced prostate cancer who received intensity-modulated radiotherapy (IMRT) after radical prostatectomy at Beijing Hospital between March 2014 and September 2023. Among them, 40 patients received adjuvant radiotherapy, and 75 received salvage radiotherapy. And 74 patients received irradiation to both the prostate bed and pelvic (prostate bed + pelvic radiation group), while 41 patients received irradiation to the prostate bed alone (prostate bed irradiation group). Comparison was made between the adjuvant radiotherapy group and salvage radiotherapy group, as well as between prostate bed + pelvic radiation group and prostate bed irradiation group, in terms of overall survival (OS), progression-free survival (PFS), locoregional recurrence-free survival (LRRFS), and the incidence of adverse events. Clinical characteristics were compared using the chi-square test. Survival rates were calculated using the Kaplan-Meier method and compared using the log-rank test. Prognostic factors affecting survival were analyzed using Cox multivariate regression.Results:The median follow-up duration was 73.1 months. The 5-year OS, PFS and LRRFS rates for the entire cohort were 96.4%, 86.4%, and 93.2%, respectively. A total of 59 patients (51.3%) experienced grade 1-2 acute radiotherapy-related adverse events, while 43 patients (37.4%) experienced grade 1-2 late radiotherapy-related adverse events. No grade ≥ 3 late adverse events were observed. There were no statistically significant differences in OS, PFS, or LRRFS between the adjuvant and salvage radiotherapy groups ( P = 0.807, 0.996, and 0.976, respectively), or in the incidence of grade 1-2 acute or late adverse events ( P > 0.05). The OS rate in the prostate bed + pelvic radiation group was significantly lower than that in the prostate bed irradiation group ( P = 0.036), while no significant differences were found in PFS or LRRFS ( P = 0.109 and 0.190, respectively), or in the incidence of grade 1-2 acute or late adverse events ( P > 0.05). Multivariable analysis showed no statistically significant differences in OS, PFS, or LRRFS between the adjuvant and salvage radiotherapy groups, or between the prostate bed and prostate bed + pelvic irradiation groups ( P = 0.756, 0.341, 0.605; 0.938, 0.987, 0.605, respectively). Conclusions:In the era of modern IMRT, both adjuvant and salvage radiotherapy, as well as prostate bed and prostate bed + pelvic irradiation, demonstrate similar efficacy and safety profiles after radical prostatectomy for prostate cancer. Treatment outcomes were favorable, and adverse events were minimal.

A total of 290 prescriptions in Treatise on Typhoid and Miscellaneous Diseases （《伤寒杂病论》） and Synopsis of the Golden Chamber （《金匮要略》） and 191 prescriptions in Prescriptionology were selected as representatives of classical prescriptions of traditional Chinese medicine （TCM）， which were translated into Chinese and Japanese. The prescription names were used as keywords for search， and the patent application data up to June 2022 were retrieved. The retrieved results underwent data cleaning and manual noise reduction. Taking the important applicants as the starting point， the key technologies were divided and indexed according to the technical improvement characteristics of classic TCM prescriptions， and the intelligence information of patent applications for classic TCM prescriptions in the two countries was deeply excavated. The differences in the patent applications and layout strategies of classic TCM prescriptions between China and Japan were further compared. This paper drew up an accurate and targeted search strategy for more accurate and comprehensive retrieval， collation， and statistics of patent data of classic TCM prescriptions of representative patent applicants in China and Japan. At the same time， this paper deeply explored the information on Chinese patent applications in Japan and compared the differences in patent application strategies and patent protection of classic TCM prescriptions and Chinese prescriptions in Japan taking the layout of classic TCM prescriptions of representative patent applicants in China and Japan as the entry point. On one hand， it can accurately grasp the current patent application status of classic TCM prescriptions in the two countries， and on the other hand， it can also provide some references for the secondary development and research， patent application， and layout of classic prescriptions of enterprises， universities， and research institutions in China.