Objective:To analyze the relationship between CT characteristics and related quantitative parameters of spectral CT in diagnosing the nature of thyroid nodules and lymph node metastasis in patients.Methods:This retrospective analysis included 198 patients with thyroid nodules who visited Shangqiu First People’s Hospital between Jun. 2019 and Dec. 2024. The patients included 53 males and 145 females, aged (50.96 ± 5.36) years. A total of 105 patients were classified as benign nodules and 93 patients as malignant nodules (45 with metastasis and 48 without metastasis). All patients underwent spectral CT scans to analyze the efficacy of spectral CT in diagnosing the nature of thyroid nodules and lymph node metastasis in malignant nodules. Continuous data were expressed as ±s, and intergroup comparisons were performed using independent sample t-tests. Enumeration data were expressed as [n (%) ] and tested using the chi-squared test. Receiver-operating characteristic (ROC) curves were constructed to determine the diagnostic efficacy of various CT features and related quantitative parameters in diagnosing thyroid nodules and cervical lymph node metastasis. Results:The AUCs of capsule, edge and shape for diagnosing malignant nodules were 0.706, 0.701 and 0.735, respectively. The AUCs of IC, NIC and slope of energy spectrum curve in arterial phase and IC, NIC and slope of energy spectrum curve in venous phase for diagnosing malignant thyroid nodules were 0.967, 0.992, 0.966, 0.819, 0.991 and 0.986, respectively. The AUCs of nodule number, capsule, edge, shape and long diameter of nodule for diagnosing cervical lymph node metastasis in patients with malignant thyroid nodules were 0.642, 0.617, 0.643, 0.619 and 0.651, respectively. The AUCs of IC, NIC and slope of energy spectrum curve in arterial phase and IC, NIC and slope of energy spectrum curve in venous phase were 0.941, 0.941, 0.955, 0.786, 0.881 and 0.824, respectively. Multivariate analysis showed that multiple nodules, absence of capsule, blurred margins, irregular shape, nodule long diameter >10 mm, IC, NIC in the arterial and venous phases, and increased slope of the energy spectrum curve were independent risk factors for cervical lymph node metastasis in patients with malignant thyroid nodules ( OR=2.631, 1.854, 2.694, 1.936, 2.657, 2.064, 2.314, 2.525, 2.342, 2.712, 2.986, P<0.05) . Conclusions:In spectral CT examinations of patients with thyroid nodules, malignant nodules often show characteristics such as no capsule and blurred edges, accompanied by changes in relevant quantitative parameters. These CT characteristics and quantitative parameters have good diagnostic efficacy for the nature of thyroid nodules and cervical lymph node metastasis in patients with malignant nodules, and have high clinical application value.

Background and Aims:Coactivator-associated arginine methyltransferase 1(CARM1)is involved in the regulation of RNA and protein processing.Recent studies have revealed its crucial role in tumorigenesis and cancer progression.However,the correlation between CARM1 expression,pan-cancer prognosis,and the immune microenvironment remains unclear.This study was conducted to investigate the relationship between CARM1 expression and pan-cancer prognosis,immune microenvironment,and its potential biological mechanisms using bioinformatics approaches.Methods:Using the TCGA,GTEx,and HPA databases,the expression pattern of CARM1 in various cancers and its prognostic relevance were analyzed.The correlation between CARM1 expression and the tumor microenvironment,as well as immune checkpoint genes,were analyzed using TCGA data.The PPI network of CARM1-interacting genes was constructed using the STRING database.GSEA was performed to investigate the potential biological mechanisms of CARM1 in pan-cancer.Results:Compared to normal tissues,CARM1 was upregulated in most tumor tissues,and its expression was associated with prognosis in multiple cancers.CARM1 expression was correlated with immune cell infiltration and immune checkpoint gene expression.Enrichment analysis suggested that CARM1 might alter the biological function of urinary system tumors by affecting ribosome biogenesis.Additionally,it may influence the biological functions of digestive system tumors by modulating arginine biosynthesis,DNA replication,and the cell cycle.Conclusion:CARM1 is aberrantly expressed in tumor tissues and may serve as a prognostic biomarker for multiple cancers.It is associated with the tumor microenvironment and immune checkpoint gene expression in pan-cancer and may contribute to tumorigenesis through multiple biological pathways,making it a potential therapeutic target for pan-cancer treatment.

Background and Aims:Coactivator-associated arginine methyltransferase 1(CARM1)is involved in the regulation of RNA and protein processing.Recent studies have revealed its crucial role in tumorigenesis and cancer progression.However,the correlation between CARM1 expression,pan-cancer prognosis,and the immune microenvironment remains unclear.This study was conducted to investigate the relationship between CARM1 expression and pan-cancer prognosis,immune microenvironment,and its potential biological mechanisms using bioinformatics approaches.Methods:Using the TCGA,GTEx,and HPA databases,the expression pattern of CARM1 in various cancers and its prognostic relevance were analyzed.The correlation between CARM1 expression and the tumor microenvironment,as well as immune checkpoint genes,were analyzed using TCGA data.The PPI network of CARM1-interacting genes was constructed using the STRING database.GSEA was performed to investigate the potential biological mechanisms of CARM1 in pan-cancer.Results:Compared to normal tissues,CARM1 was upregulated in most tumor tissues,and its expression was associated with prognosis in multiple cancers.CARM1 expression was correlated with immune cell infiltration and immune checkpoint gene expression.Enrichment analysis suggested that CARM1 might alter the biological function of urinary system tumors by affecting ribosome biogenesis.Additionally,it may influence the biological functions of digestive system tumors by modulating arginine biosynthesis,DNA replication,and the cell cycle.Conclusion:CARM1 is aberrantly expressed in tumor tissues and may serve as a prognostic biomarker for multiple cancers.It is associated with the tumor microenvironment and immune checkpoint gene expression in pan-cancer and may contribute to tumorigenesis through multiple biological pathways,making it a potential therapeutic target for pan-cancer treatment.

Objective To investigate the expression of ferritinophagy-related gene ELAV-like RNA binding protein 1(ELAVL1)in multiple myeloma(MM)and elucidate its diagnostic and prognostic value for MM.Methods First,we analyzed ELAVL1 expression level in healthy controls and MM patients using data from the GEO and TCGA databases.Subsequently,bone marrow specimens were collected from 28 newly diagnosed MM patients and 20 healthy controls,and qRT-PCR was employed to validate ELAVL1 expression.The diagnostic and prognostic potential of ELAVL1 was assessed using ROC curve analysis and Kaplan-Meier survival curves.Additionally,univariate and multivariate COX regression analyses were performed to identify independent risk factors for MM prognosis.Finally,KEGG and GO enrichment analyses were performed using the DAVID online platform.Results The level of ELAVL1 expression was significantly higher in newly diagnosed MM patients and refractory/relapsed MM patients than in the healthy controls(P＜0.001).Moreover,ELAVL1 expression was positively correlated with the International Staging System(ISS)stage of MM(P＜0.01).Furthermore,qRT-PCR validation confirmed that ELAVL1 expression was elevated in the 28 newly diagnosed MM patients compared to the 20 healthy controls(P＜0.001).ROC curve analysis demonstrated that ELAVL1 could effectively differentiate between newly diagnosed MM patients,healthy controls,and MGUS patients(P＜0.001 and P=0.000 2,respectively).Survival analysis revealed that high ELAVL1 expression was associated with shorter progression-free survival(P=0.0141)and overall survival(P=0.008 0).Univariate and multivariate COX regression analyses identified high ELAVL1 expression as an independent risk factor for poor MM prognosis(P=0.005 0).KEGG analysis suggested that ELAVL1 might be involved in the Hippo and MAPK signaling pathways.Conclusion High ELAVL1 expression in MM may serve as a biomarker for diagnosis and poor prognosis.ELAVL1 may promote MM initiation and progression via the Hippo and MAPK signaling pathways.

Objective:To analyze the relationship between CT characteristics and related quantitative parameters of spectral CT in diagnosing the nature of thyroid nodules and lymph node metastasis in patients.Methods:This retrospective analysis included 198 patients with thyroid nodules who visited Shangqiu First People’s Hospital between Jun. 2019 and Dec. 2024. The patients included 53 males and 145 females, aged (50.96 ± 5.36) years. A total of 105 patients were classified as benign nodules and 93 patients as malignant nodules (45 with metastasis and 48 without metastasis). All patients underwent spectral CT scans to analyze the efficacy of spectral CT in diagnosing the nature of thyroid nodules and lymph node metastasis in malignant nodules. Continuous data were expressed as ±s, and intergroup comparisons were performed using independent sample t-tests. Enumeration data were expressed as [n (%) ] and tested using the chi-squared test. Receiver-operating characteristic (ROC) curves were constructed to determine the diagnostic efficacy of various CT features and related quantitative parameters in diagnosing thyroid nodules and cervical lymph node metastasis. Results:The AUCs of capsule, edge and shape for diagnosing malignant nodules were 0.706, 0.701 and 0.735, respectively. The AUCs of IC, NIC and slope of energy spectrum curve in arterial phase and IC, NIC and slope of energy spectrum curve in venous phase for diagnosing malignant thyroid nodules were 0.967, 0.992, 0.966, 0.819, 0.991 and 0.986, respectively. The AUCs of nodule number, capsule, edge, shape and long diameter of nodule for diagnosing cervical lymph node metastasis in patients with malignant thyroid nodules were 0.642, 0.617, 0.643, 0.619 and 0.651, respectively. The AUCs of IC, NIC and slope of energy spectrum curve in arterial phase and IC, NIC and slope of energy spectrum curve in venous phase were 0.941, 0.941, 0.955, 0.786, 0.881 and 0.824, respectively. Multivariate analysis showed that multiple nodules, absence of capsule, blurred margins, irregular shape, nodule long diameter >10 mm, IC, NIC in the arterial and venous phases, and increased slope of the energy spectrum curve were independent risk factors for cervical lymph node metastasis in patients with malignant thyroid nodules ( OR=2.631, 1.854, 2.694, 1.936, 2.657, 2.064, 2.314, 2.525, 2.342, 2.712, 2.986, P<0.05) . Conclusions:In spectral CT examinations of patients with thyroid nodules, malignant nodules often show characteristics such as no capsule and blurred edges, accompanied by changes in relevant quantitative parameters. These CT characteristics and quantitative parameters have good diagnostic efficacy for the nature of thyroid nodules and cervical lymph node metastasis in patients with malignant nodules, and have high clinical application value.

OBJECTIVE:External fixators and plate internal fixation are commonly used treatments for comminuted distal radius fractures,each with its own advantages and disadvantages in clinical practice. To systematically evaluate the clinical efficacy and safety of external fixator and plate internal fixation in the treatment of comminuted distal radius fractures,and to provide a basis for the development of guidelines for the diagnosis and treatment of distal radius fractures with integrated traditional Chinese and Western medicine. METHODS:PubMed,Web of Science,Embase,Cochrane Library,China National Knowledge Infrastructure,China Biomedical Literature Database,VIP,andWanFang databases were systematically searched to include randomized controlled trials on external fixators and internal plate fixation for the treatment of comminuted distal radial fractures published from October 2013 to October 2023. The literature was screened according to the inclusion and exclusion criteria. Review Manager was used for literature quality evaluation and meta-analysis.RESULTS:(1) Eight articles were included,including 4 in Chinese and 4 in English,with a total sample size of 648 cases,including 328 cases in the external fixation stent group and 320 cases in the internal fixation plate group. (2) At 3 months after operation,the internal fixation plate group was superior to the external fixation stent group in the range of dorsal extension,palmar flexion and supination. At 12 months after operation,the grip strength,palmar inclination,palmar flexion,pronation and supination in the internal fixation plate group were better than those in the external fixation stent group. The postoperative infection in the internal fixation plate group was better than that in the external fixation stent group,and there was no statistical difference in other outcome indicators.CONCLUSION:Eight evidences showed that in the choice of treatment for comminuted distal radius fracture,both external fixation stent and incision plate internal fixation had good therapeutic effect,and plate internal fixation was better than other factors. However,for some special patients with highly severe comminuted distal radius fractures,poor bone quality,severely contaminated open fractures,and soft tissue swelling that did not allow incision surgery,external fixation was the first choice. The results of this study have limitations,and more high-quality,large-sample,multi-center randomized controlled trials are needed in the future,emphasizing the observation of long-term efficacy and other secondary indicators,and supplementing and optimizing the current research results.

Objective To investigate the expression of ferritinophagy-related gene ELAV-like RNA binding protein 1(ELAVL1)in multiple myeloma(MM)and elucidate its diagnostic and prognostic value for MM.Methods First,we analyzed ELAVL1 expression level in healthy controls and MM patients using data from the GEO and TCGA databases.Subsequently,bone marrow specimens were collected from 28 newly diagnosed MM patients and 20 healthy controls,and qRT-PCR was employed to validate ELAVL1 expression.The diagnostic and prognostic potential of ELAVL1 was assessed using ROC curve analysis and Kaplan-Meier survival curves.Additionally,univariate and multivariate COX regression analyses were performed to identify independent risk factors for MM prognosis.Finally,KEGG and GO enrichment analyses were performed using the DAVID online platform.Results The level of ELAVL1 expression was significantly higher in newly diagnosed MM patients and refractory/relapsed MM patients than in the healthy controls(P＜0.001).Moreover,ELAVL1 expression was positively correlated with the International Staging System(ISS)stage of MM(P＜0.01).Furthermore,qRT-PCR validation confirmed that ELAVL1 expression was elevated in the 28 newly diagnosed MM patients compared to the 20 healthy controls(P＜0.001).ROC curve analysis demonstrated that ELAVL1 could effectively differentiate between newly diagnosed MM patients,healthy controls,and MGUS patients(P＜0.001 and P=0.000 2,respectively).Survival analysis revealed that high ELAVL1 expression was associated with shorter progression-free survival(P=0.0141)and overall survival(P=0.008 0).Univariate and multivariate COX regression analyses identified high ELAVL1 expression as an independent risk factor for poor MM prognosis(P=0.005 0).KEGG analysis suggested that ELAVL1 might be involved in the Hippo and MAPK signaling pathways.Conclusion High ELAVL1 expression in MM may serve as a biomarker for diagnosis and poor prognosis.ELAVL1 may promote MM initiation and progression via the Hippo and MAPK signaling pathways.

Objective To observe the volume changes of brain regions and their correlation with cognitive function in temporal lobe epilepsy(TLE)patients.Methods Fifty TLE patients(TLE group)and 34 healthy controls(control group)were prospectively enrolled.Brain 3D-T1WI was collected,brain regions were delineated with automated segmentation technique,and hippocampus was segmented additionally with hippocampal brain template(HBT).The volume of brain regions were compared between groups,and the correlation of brain region volume with Montreal cognitive assessment(MoCA)score were analyzed.Results Compared with control group,in TLE group,bilateral cerebrum white matter,right globus pallidus,left posterior cingulate gyrus,left precentral gyrus,right fusiform gyrus,left cerebellum white matter,corpus callosum,left hippocampus(HBT segmentation and conventional segmentation)and right thalamus volumes decreased significantly(all P＜0.05),while right choroid plexus volume increased significantly(P＜0.05).The volume of left hippocampus(HBT segmentation)and right fusiform gyrus were both positively correlated with MoCA score in TLE group(r=0.335,0.376,P=0.009,0.007).Conclusion Widespread atrophy of brain regions could be seen in TLE patients,which were correlated with cognitive function.

[This corrects the article DOI: 10.1016/j.apsb.2022.05.019.].

Objective To observe the volume changes of brain regions and their correlation with cognitive function in temporal lobe epilepsy(TLE)patients.Methods Fifty TLE patients(TLE group)and 34 healthy controls(control group)were prospectively enrolled.Brain 3D-T1WI was collected,brain regions were delineated with automated segmentation technique,and hippocampus was segmented additionally with hippocampal brain template(HBT).The volume of brain regions were compared between groups,and the correlation of brain region volume with Montreal cognitive assessment(MoCA)score were analyzed.Results Compared with control group,in TLE group,bilateral cerebrum white matter,right globus pallidus,left posterior cingulate gyrus,left precentral gyrus,right fusiform gyrus,left cerebellum white matter,corpus callosum,left hippocampus(HBT segmentation and conventional segmentation)and right thalamus volumes decreased significantly(all P＜0.05),while right choroid plexus volume increased significantly(P＜0.05).The volume of left hippocampus(HBT segmentation)and right fusiform gyrus were both positively correlated with MoCA score in TLE group(r=0.335,0.376,P=0.009,0.007).Conclusion Widespread atrophy of brain regions could be seen in TLE patients,which were correlated with cognitive function.