Objective To explore the prognostic value and immune effects of insulin-like growth factor family 2(IGFL2)in bladder cancer based on data from TCGA,TIMER2.0 and HPA.Methods Bioinformatics analysis was conducted to analyze the expression of IGFL2 in bladder cancer and its relationship with survival and prognosis of bladder cancer patients.The receiver operating characteristic(ROC)curve and prognostic nomogram were plotted to analyze the diagnostic value of IGFL2 for bladder cancer and its ability to predict the 5-year overall survival rate of patients.IGFL2-related signaling pathways were analyzed with GSEA enrichment.The correlation between IGFL2 expression and immune cells was analyzed based on data from the TIMER database.Results IGFL2 was highly expressed in bladder cancer(P＜0.001).The high expression of IGFL2 was positively correlated with patients'age,pathological stage,histological grade and T stage(all P＜0.05).Patients'with high IGFL2 expression had shorter overall survival and disease-specific survival than those with low IGFL2 expression(all P＜0.05).IGFL2 could be used as an independent prognostic factor for bladder cancer with good diagnostic and predictive value.GSEA enrichment analysis showed that IGFL2 was involved in signaling pathways related to immunity,inflammation and tumor.High IGFL2 expression was positively correlated with the infiltration of most immune cells.Conclusion IGFL2 is highly expressed in bladder cancer and can be a biomarker for the diagnosis and prognosis of this disease.It may become a potential target for immunotherapy.

Objectives:To evaluate the performance of AVEIR VR single chamber leadless pacemaker(AVEIR VR)in the real world in China and the predictive factors of pacing threshold to assess the feasibility of AVEIRTM VR implantation in the domestic population.Methods:All patients who underwent AVEIR VR implantation by experienced operators from Peking University People's Hospital in multiple domestic hospitals from June 2024 to October 2024 were consecutively included,and their baseline characteristics,procedural data(including pacemaker electrical measurements at various stages),and follow-up results were observed,recorded,and statistically analyzed.Results:This study included 20 patients who met the indication for pacemaker implantation and underwent AVEIR VR implantation.Their mean age was(71.40±13.37)years,body mass index(BMI)was(23.05±3.71)kg/m2,body surface area(BSA)was(1.70±0.16)m2,all 20 patients were successfully implanted with pacemakers,there were no major complications(newly occurred pericardial effusion during the perioperative period,cardiac tamponade,poor pacemaker function,pacemaker dislocation/perforation,tricuspid valve injury,myocardial infarction,stroke,pulmonary embolism,and clinical death).One patient developed new frequent ventricular premature contractions after pacemaker release.The pacing threshold(PCT)at one week after implantation was correlated with PCT in tether mode(r=0.650,P=0.009)and PCT in release phase(r=0.596,P=0.019),but not with the sensing and impedance in each phase.Conclusions:This preliminary exploration study show that AVEIRTM VR implantation demonstrates satisfactory performance among real world patients in China,especially in elderly and low weight populations,confirming its safety.

Objective To explore the prognostic value and immune effects of insulin-like growth factor family 2(IGFL2)in bladder cancer based on data from TCGA,TIMER2.0 and HPA.Methods Bioinformatics analysis was conducted to analyze the expression of IGFL2 in bladder cancer and its relationship with survival and prognosis of bladder cancer patients.The receiver operating characteristic(ROC)curve and prognostic nomogram were plotted to analyze the diagnostic value of IGFL2 for bladder cancer and its ability to predict the 5-year overall survival rate of patients.IGFL2-related signaling pathways were analyzed with GSEA enrichment.The correlation between IGFL2 expression and immune cells was analyzed based on data from the TIMER database.Results IGFL2 was highly expressed in bladder cancer(P＜0.001).The high expression of IGFL2 was positively correlated with patients'age,pathological stage,histological grade and T stage(all P＜0.05).Patients'with high IGFL2 expression had shorter overall survival and disease-specific survival than those with low IGFL2 expression(all P＜0.05).IGFL2 could be used as an independent prognostic factor for bladder cancer with good diagnostic and predictive value.GSEA enrichment analysis showed that IGFL2 was involved in signaling pathways related to immunity,inflammation and tumor.High IGFL2 expression was positively correlated with the infiltration of most immune cells.Conclusion IGFL2 is highly expressed in bladder cancer and can be a biomarker for the diagnosis and prognosis of this disease.It may become a potential target for immunotherapy.

Objective:To evaluate the clinical feasibility of subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation following transvenous lead extraction (TLE).Methods:This was a retrospective study. Consecutive patients who underwent S-ICD implantation at Peking University People′s Hospital between June 2015 and October 2023 were enrolled. Patients were divided into the TLE group and the newly implanted group based on whether they received TLE prior to S-ICD implantation. Baseline characteristics, S-ICD indication, defibrillation threshold test results, complications, and postoperative follow-up data were collected and compared between the two groups.Results:A total of 27 patients were included, aged (49.2±14.2) years, including 19 males. There were 12 patients in the TLE group and 15 in the newly implanted group. Compared with the TLE group, patients in the newly implanted group were younger ((43.3±13.7) years vs. (55.6±12.0) years, P=0.013). The main S-ICD indication in the TLE group was high infection risk (9/12), whereas in the newly implanted group it was younger age (11/15). All patients underwent successful S-ICD implantation, with 18 patients completing defibrillation threshold testing (all successful). Additionally, the TLE group had longer follow-up duration than the newly implanted group (42 (19, 60) months vs. 12 (3, 28) months, P=0.001). No complications or deaths occurred during follow-up, with normal device function in both groups. A total of 17 ventricular tachycardia or fibrillation events were recorded, of which 7 met defibrillation criteria and all received effective therapy. Conclusion:S-ICD demonstrates safety and efficacy as a therapeutic option for patients after TLE, with comparable device functionality and follow-up outcomes to patients with newly implanted S-ICD.

Objective To develop a deep learning model based on fundus retinal images to improve the detection rate of mild cognitive impairment(MCI)in patients with coronary heart disease,achieve early intervention and improve prognosis.Methods The study was a single-center cross-sectional study that retrospectively included patients diagnosed with coronary heart disease(CHD)by coronary angiography(≥50％ stenosis of at least one coronary vessel)from Beijing Anzhen Hospital between November 2021 and December 2022.The whole data set was randomly divided into the training set and the testing set according to the ratio of 8∶2 for model development.After that,the patient data of the same center from January 2023 to April 2023 were included in the time verification method to verify the model.The diagnostic criteria for MCI were MMSE＜27 or MoCA＜26.Four kinds of convolutional neural network(CNN)architectures were used to train fundus images,and a comprehensive vision model of MCI detection was established through model integration.The area under the curve(AUC),sensitivity and specificity of the receiver operating curve(ROC)were used to evaluate the performance of the AI model.Results We collected 5 880 eligible fundus images from 3 368 CHD patients.Based on the results of the MMSE scale,the algorithm was labeled,including 2 898 males and 527 MCI patients.The AUC of the deep learning model in the test group is 0.733(95％CI 0.688-0.778),and the sensitivity of the algorithm in the test group is 0.577(95％CI 0.528-0.625)by using the operating point with the maximum sum of sensitivity and specificity.With a specificity of 0.758(95％CI 0.714-0.802),corresponding to a validated AUC of 0.710(95％CI 0.601-0.818).Based on the results of the MoCA scale,the algorithm labels 2 437 males and 1 626 MCI patients.The AUC of the deep learning model in the test group was 0.702(95％CI 0.671-0.733).The operating point with the maximum sum of sensitivity and specificity was selected,and the sensitivity of the algorithm was 0.749(95％CI 0.719-0.778)and the specificity was 0.561(95％CI 0.527-0.595),corresponding to the AUC value of the verification group was 0.674(95％CI 0.622-0.726).Conclusions The deep learning algorithm model based on fundus images has good diagnostic performance,and may be used as a new non-invasive,convenient and rapid screening method for MCI in CHD population.

Objective:To evaluate the efficacy and safety of blinatumomab in adult patients with relapsed/refractory(R/R)or measurable residual disease(MRD)positive B-cell acute lymphoblastic leukemia(B-ALL)in the real world.Methods:The clinical data of 30 B-ALL patients received at least 1 course of blinatumomab therapy in the Chinese PLA General Hospital from January 1st,2021 to December 31st,2023 were retrospectively analyzed,including pre-treatment baseline clinical feature,post-treatment complete response(CR),CR with partial hematologic recovery(CRh),CR with incomplete hematologic recovery(CRi),complete MRD response rate,MRD response rate(MRD＜10-4),overall survival(OS),and disease-free survival(DFS),as well as drug-related adverse reactions.Results:Among 5 patients who were not assessed 4 were MRD negative and 1 did not receive bone marrow biopsy.In the R/R B-ALL group(13 cases),11 patients achieved CR/CRh/CRi and 10 patients achieved complete MRD response.In MRD+group(12 cases),9 patients achieved overall MRD response and 7 patients achieved complete MRD response.The median follow-up time was 8.4(95％CI:6.3-10.4)months.The median OS was 15.5(95％CI:0.7-30.3)months in the R/R group,while not reached in the MRD+group.The median DFS of the two groups were not reached.Drug-related adverse reactions occurred in 22 patients,and pyrexia was the most common(13 cases).Grade ≥3 adverse reactions occurred in 15 patients,and neutropenia was the most common(9 cases).Cytokine release syndrome occurred in 6 patients,including 5 cases with grade 1 and 1 case with grade 3.No patients interrupted therapy or died due to drug-related adverse reactions.Conclusion:Blinatumomab is effective in the treatment of R/R or continuous MRD+B-ALL with acceptable adverse reactions.

Objective:To design two kinds of intensity modulated radiotherapy (IMRT) plans with different radiation field distributions,and to compare the dose differences of that at the dose of target region and organs at risk (OAR) for middle and lower esophageal cancer,so as to provide a reference for the design of IMRT plan. Methods:The data of 17 patients with middle and lower esophageal cancer who received IMRT at Shangluo Central Hospital from November 2022 to May 2023 were retrospectively analyzed. IMRT plans with different radiation fields for Plan 1 and Plan 2 were designed for each patient. The angles of radiation field for Plan 1 were 0°,80°,120°,160° and 200°,and those for Plan 2 were 30°,130°,180°,230° and 330°,respectively. The prescribed dose to the planning target volume (PTV) was 60 Gy/30 F. The differences in dosimetric parameters between the two plans were compared. Results:There were no statistically significant differences in the dose parameters of 2％,98％,50％ target dose (D2％,D98％,D50％),homogeneity index (HI),conformity index (CI) and monitor unit between the two groups (P>0.05). There were no significant differences in V5 of dual lungs,the mean dose (Dmean) of heart,and the maximum dose (Dmax) of spinal-cord between two groups (P>0.05). The volume percentage (V10,V20,V30) of dual lungs received radiation doses of 10,20 and 30 Gy,and the mean dose (Vmean) of lung in the Plan1 group reduced respectively 7.44％,21.16％,10.09％ and 5.31％ than those in the Plan2 group,and the differences of them were statistically significant (t=-5.845,-7.729,-2.247,-3.960,P<0.05). Heart V10 and V20 in the Plan1 group decreased respectively by 7.23％ and 5.78％,with statistical significance (t=-4.376,-3.523,P<0.01),while V30 and V40 of Plan 1 increased respectively by 2.7％ and 4.92％,without statistical significance (P>0.05). There was no significant difference in heart Dmean between the Plan1 group and the Plan2 group (P>0.05). Conclusion:Both two methods of distribution field can meet the clinical requirements,and Plan1 has more advantages in protecting organs at risk under the premise of meeting the requirements of target region.

Objectives:To evaluate the performance of AVEIR VR single chamber leadless pacemaker(AVEIR VR)in the real world in China and the predictive factors of pacing threshold to assess the feasibility of AVEIRTM VR implantation in the domestic population.Methods:All patients who underwent AVEIR VR implantation by experienced operators from Peking University People's Hospital in multiple domestic hospitals from June 2024 to October 2024 were consecutively included,and their baseline characteristics,procedural data(including pacemaker electrical measurements at various stages),and follow-up results were observed,recorded,and statistically analyzed.Results:This study included 20 patients who met the indication for pacemaker implantation and underwent AVEIR VR implantation.Their mean age was(71.40±13.37)years,body mass index(BMI)was(23.05±3.71)kg/m2,body surface area(BSA)was(1.70±0.16)m2,all 20 patients were successfully implanted with pacemakers,there were no major complications(newly occurred pericardial effusion during the perioperative period,cardiac tamponade,poor pacemaker function,pacemaker dislocation/perforation,tricuspid valve injury,myocardial infarction,stroke,pulmonary embolism,and clinical death).One patient developed new frequent ventricular premature contractions after pacemaker release.The pacing threshold(PCT)at one week after implantation was correlated with PCT in tether mode(r=0.650,P=0.009)and PCT in release phase(r=0.596,P=0.019),but not with the sensing and impedance in each phase.Conclusions:This preliminary exploration study show that AVEIRTM VR implantation demonstrates satisfactory performance among real world patients in China,especially in elderly and low weight populations,confirming its safety.

Objective:To evaluate the efficacy and safety of blinatumomab in adult patients with relapsed/refractory(R/R)or measurable residual disease(MRD)positive B-cell acute lymphoblastic leukemia(B-ALL)in the real world.Methods:The clinical data of 30 B-ALL patients received at least 1 course of blinatumomab therapy in the Chinese PLA General Hospital from January 1st,2021 to December 31st,2023 were retrospectively analyzed,including pre-treatment baseline clinical feature,post-treatment complete response(CR),CR with partial hematologic recovery(CRh),CR with incomplete hematologic recovery(CRi),complete MRD response rate,MRD response rate(MRD＜10-4),overall survival(OS),and disease-free survival(DFS),as well as drug-related adverse reactions.Results:Among 5 patients who were not assessed 4 were MRD negative and 1 did not receive bone marrow biopsy.In the R/R B-ALL group(13 cases),11 patients achieved CR/CRh/CRi and 10 patients achieved complete MRD response.In MRD+group(12 cases),9 patients achieved overall MRD response and 7 patients achieved complete MRD response.The median follow-up time was 8.4(95％CI:6.3-10.4)months.The median OS was 15.5(95％CI:0.7-30.3)months in the R/R group,while not reached in the MRD+group.The median DFS of the two groups were not reached.Drug-related adverse reactions occurred in 22 patients,and pyrexia was the most common(13 cases).Grade ≥3 adverse reactions occurred in 15 patients,and neutropenia was the most common(9 cases).Cytokine release syndrome occurred in 6 patients,including 5 cases with grade 1 and 1 case with grade 3.No patients interrupted therapy or died due to drug-related adverse reactions.Conclusion:Blinatumomab is effective in the treatment of R/R or continuous MRD+B-ALL with acceptable adverse reactions.

AIM To study the chemical constituents from Commelina communis L.METHODS The 95％ethanol extract from C.Communis was isolated and purified by activated charcoal,silica gel,Sephadex LH-20,and HPLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.RESULTS Seventeen compounds were isolated and identified as p-hydroxyl ethyl cinnamate(1),p-hydroxybenzaldehyde(2),vanillin(3),4-hydroxy-2,3-dimethyl-2-nonen-4-olide(4),hemeratrol A(5),chakyunglupulin B(6),chakyunglupulin A(7),2-(2-hydroxyethyl)-3-methylfumaric acid(8),N-cis-feruloyl tyramine(9),N-trans-coumaroyltyramine(10),5,6,7,3',4',5'-hexamethoxyflavone(11),N-trans-sinapoyltyramine(12),dihydro-feruloyltyramine(13),N-trans-feruloyltyramine(14),2-phenylethanol-β-D-glucoside(15),quercetin-3-O-β-D-glucoside(16),and isorhamnetin-3-O-β-D-glucopyranoside(17).CONCLUSION Compounds 4-8,10 and 11 are isolated from Commelina genus for the first time,and 1,9,12-15 are first isolated from this plant.