Objective To analyze the clinical and therapeutic characteristics of Epstein-Barr virus (EBV)-negative posttransplant lymphoproliferative disease (PTLD) with diffuse large B-cell lymphoma (DLBCL) in the context of specific cases and literature. Methods A case of EBV-negative DLBCL (GCB type) after kidney transplantation is reported. The patient was a 45-year-old male who underwent living-related kidney transplantation in 2016 and has been receiving triple immunosuppressive therapy with tacrolimus, mycophenolate mofetil and methylprednisolone since then. In 2024, the patient presented with intermittent fever, night sweats and gastrointestinal symptoms. The diagnosis was confirmed by endoscopic pathology, immunohistochemical staining and positron emission tomography/computed tomography. The R-CDOP regimen (rituximab + cyclophosphamide + liposomal doxorubicin + vincristine + dexamethasone) was used for treatment. Results The patient was diagnosed with EBV-negative DLBCL (GCB type, Ann Arbor stage Ⅳ B). After 4 cycles of R-CDOP chemotherapy, the efficacy assessment was partial remission, and the transplant kidney function remained stable. Conclusions For EBV-negative PTLD after kidney transplantation, it is necessary to break through the "virus-dependent" diagnostic thinking. In clinical practice, the focus should be on protecting the transplant kidney, and individualized treatment plans should be developed for patients.

Objective To analyze the expression levels of a-smooth muscle actin (α-SMA) and Vimentin in spindle cells and their relationship with the prognosis of patients with myxofibrosarcoma (MFS). Methods The imaging, clinical, and pathological data of 61 patients with MFS were collected. All patients were confirmed by surgical and postoperative pathological examination. Immunohistochemical methods were used to determine the positive proportion of α-SMA and Vimentin. The correlation between the expression levels of α-SMA and Vimentin in spindle cells and prognosis was analyzed. Results The positive rates of α-SMA and Vimentin expression in MFS tissues were 68.85% and 60.66%, respectively. The expression of Vimentin was not significantly correlated with 3-year OS and DFS (P=0.351, P=0.284). The expression of α-SMA was significantly correlated with OS and DFS (P=0.030, P=0.017), and patients with high expression of α-SMA have shorter OS and DFS. Conclusion Determining α-SMA level can help evaluate the prognosis of patients with MFS and guide clinical treatment.

Hepatocellular carcinoma(HCC)is a cancer with extremely high mortality and incidence rates.In recent years,with the development of multidisciplinary approaches,key characteristics of cancer have gradually been revealed.Studies have shown that dysregulated energy metabolism and metabolic reprogramming in tumor cells form the basis for tumor cell growth and are critical factors in shaping the tumor microenvironment,immune evasion,and drug resistance.Non-coding RNAs(ncRNAs),as important regulatory factors,play a crucial role in the metabolic reprogramming of HCC.This article focuses on summarizing the mech-anisms by which ncRNAs regulate metabolic repro-gramming in HCC and explores their applications in clinical diagnosis,treatment,and prognostic assess-ment,aiming to provide new perspectives for effec-tive HCC treatment and the development of novel drug targets.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

Objective To investigate the clinical advantages and safety of an acupoint auto-positioning moxibustion robot combined with massage techniques in the treatment of lumbar disc herniation.Methods Totally 114 patients with lumbar disc herniation treated between June 2021 and December 2023 at Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,the Outpatient Department of Rehabilitation Medicine,Changhai Hospital and Shanghai Third Rehabilitation Hospital were divided into control group and experimental group with random number table method,with 57 cases in each group.The control group received conventional moxibustion combined with massage techniques,while the experimental group was treated using an acupoint auto-positioning moxibustion robot combined with massage techniques.Both groups underwent treatment once every three days,totaling 10 sessions over one month.Clinical efficacy was observed between the two groups by comparing pre-treatment and post-treatment(after 3,6 and 10 sessions)scores on the visual analogue scale(VAS)for pain,the Japanese Orthopaedic Association(JOA)lower back pain score,and lumbar range of motion(LROM).Adverse reactions during the intervention were recorded.Satisfaction with the moxibustion robot in the experimental group was assessed using a Likert scale.Additionally,20 healthy subjects were recruited to evaluate the accuracy of the robot's acupoint auto-positioning function.Results The overall effective rate was 91.23%(52/57)in the experimental group and 94.74%(54/57)in the control group,without statistical significance between the two groups(P>0.05).Compared to pre-treatment,both groups showed significant improvements in VAS scores,JOA scores and LROM across all measured directions after 3,6,and 10 treatment sessions(P<0.001).In the Likert scale assessment,86.96%of subjects agreed that the device was convenient to use,87.72%agreed that the device was safer than conventional moxibustion therapy,and 94.74%were willing to recommend the device to other patients.The accuracy evaluation of the acupoint auto-positioning moxibustion robot demonstrated that the average deviation between robot-positioned acupoints and standard acupoints was(1.68±0.46)mm,achieving a positioning accuracy rate exceeding 95%.No adverse reactions were reported during the intervention.Conclusion The combination of an acupoint auto-positioning moxibustion robot with massage techniques is as effective as conventional moxibustion combined with massage techniques in improving clinical symptoms,alleviating pains,enhancing lumbar function and increasing lumbar mobility in patients with lumbar disc herniation.Participants have exhibited a high willingness to use the device,and the robot achieved a high accuracy rate in acupoint positioning.

Objective To investigate the clinical advantages and safety of an acupoint auto-positioning moxibustion robot combined with massage techniques in the treatment of lumbar disc herniation.Methods Totally 114 patients with lumbar disc herniation treated between June 2021 and December 2023 at Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,the Outpatient Department of Rehabilitation Medicine,Changhai Hospital and Shanghai Third Rehabilitation Hospital were divided into control group and experimental group with random number table method,with 57 cases in each group.The control group received conventional moxibustion combined with massage techniques,while the experimental group was treated using an acupoint auto-positioning moxibustion robot combined with massage techniques.Both groups underwent treatment once every three days,totaling 10 sessions over one month.Clinical efficacy was observed between the two groups by comparing pre-treatment and post-treatment(after 3,6 and 10 sessions)scores on the visual analogue scale(VAS)for pain,the Japanese Orthopaedic Association(JOA)lower back pain score,and lumbar range of motion(LROM).Adverse reactions during the intervention were recorded.Satisfaction with the moxibustion robot in the experimental group was assessed using a Likert scale.Additionally,20 healthy subjects were recruited to evaluate the accuracy of the robot's acupoint auto-positioning function.Results The overall effective rate was 91.23%(52/57)in the experimental group and 94.74%(54/57)in the control group,without statistical significance between the two groups(P>0.05).Compared to pre-treatment,both groups showed significant improvements in VAS scores,JOA scores and LROM across all measured directions after 3,6,and 10 treatment sessions(P<0.001).In the Likert scale assessment,86.96%of subjects agreed that the device was convenient to use,87.72%agreed that the device was safer than conventional moxibustion therapy,and 94.74%were willing to recommend the device to other patients.The accuracy evaluation of the acupoint auto-positioning moxibustion robot demonstrated that the average deviation between robot-positioned acupoints and standard acupoints was(1.68±0.46)mm,achieving a positioning accuracy rate exceeding 95%.No adverse reactions were reported during the intervention.Conclusion The combination of an acupoint auto-positioning moxibustion robot with massage techniques is as effective as conventional moxibustion combined with massage techniques in improving clinical symptoms,alleviating pains,enhancing lumbar function and increasing lumbar mobility in patients with lumbar disc herniation.Participants have exhibited a high willingness to use the device,and the robot achieved a high accuracy rate in acupoint positioning.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

Reninoma is a rare renal secretory tumor，prevalent in the young population. This disease is mostly surgically resected，and the use of microwave ablation to treat reninoma in children is scarce. A case of reninoma in a child was reported in this paper. The patient presented with refractory hypertension，hypokalemia，hyperreninemia and hyperaldosteronemia. Enhanced CT and contrast-enhanced ultrasound showed mass in the lower pole of the right kidney，which was considered as reninoma and microwave ablation was performed. The renin concentration decreased to 68.42 pg/ml at 4 hours after surgery. After 1 year of postoperative follow-up，there was no recurrence of hypertension and hypokalemia，and no signs of tumor recurrence were seen on repeated ultrasound examinations.

OBJECTIVE To explore the clinical effect of meropenem combined with cefotaxime sodium on treatment of interstitial pneumonia(IP)patients complicated with pulmonary infection and observe the influence on vascular endothelial growth factor(VEGF),Toll-like receptor 2(TLR2)and transforming growth factor β1(TGF-β1)so as to provide guidance for treatment of the IP patients complicated with pulmonary infection and assessment of curative effect.METHODS A total of 102 IP patients complicated with pulmonary infection who were treated in Guiyang Second People's Hospital from Feb,2022 to Feb,2024 were recruited as the research subjects and were randomly divided into the CTX group and the combination group,with 51 cases in each group.The CTX group was treated with cefotaxime sodium,and the combination group was given meropenem combined with cefotaxime sodium.The curative effect,lung function indexes,blood gas indexes,T lymphocyte subsets,peripheral blood VEGF,TLR2 and TGF-β1 were observed and compared between the two groups.RESULTS There was significant difference in the effective rate of treatment between the combination group and the CTX group(Z=7.229,P=0.007).The lung function of the combination group was better than that of the CTX group after the treatment for 7 days(P＜0.05);the levels of helper T cell type 1(Th1),Th1/Th2 and CD4+Foxp3+Treg of the combination group were higher than those of the CTX group(P＜0.05),while the Th2 level of the combination group was low-er than that of the CTX group(P＜0.05).The levels of VEGF,TLR2 mRNA and TGF-β1 of the combination group were respectively(32.14±8.77)pg/ml,(1.23±0.30)mRNA and(17.25±4.56)pg/ml,lower than those of the CTX group(P＜0.05).There were no significant differences in the drug-induced adverse reactions between the two groups of patients.CONCLUSIONS Meropenem combined with cefotaxime sodium can boost the curative effect on IP patients complicated with pulmonary infection,improve the lung function and blood gas indexes,reg-ulate the immune response,intensify the immune function,reduce the expression levels of VEGF,TLR2 mRNA and TGF-β1,and promote the rehabilitation of the patients.

OBJECTIVE To explore the clinical effect of meropenem combined with cefotaxime sodium on treatment of interstitial pneumonia(IP)patients complicated with pulmonary infection and observe the influence on vascular endothelial growth factor(VEGF),Toll-like receptor 2(TLR2)and transforming growth factor β1(TGF-β1)so as to provide guidance for treatment of the IP patients complicated with pulmonary infection and assessment of curative effect.METHODS A total of 102 IP patients complicated with pulmonary infection who were treated in Guiyang Second People's Hospital from Feb,2022 to Feb,2024 were recruited as the research subjects and were randomly divided into the CTX group and the combination group,with 51 cases in each group.The CTX group was treated with cefotaxime sodium,and the combination group was given meropenem combined with cefotaxime sodium.The curative effect,lung function indexes,blood gas indexes,T lymphocyte subsets,peripheral blood VEGF,TLR2 and TGF-β1 were observed and compared between the two groups.RESULTS There was significant difference in the effective rate of treatment between the combination group and the CTX group(Z=7.229,P=0.007).The lung function of the combination group was better than that of the CTX group after the treatment for 7 days(P＜0.05);the levels of helper T cell type 1(Th1),Th1/Th2 and CD4+Foxp3+Treg of the combination group were higher than those of the CTX group(P＜0.05),while the Th2 level of the combination group was low-er than that of the CTX group(P＜0.05).The levels of VEGF,TLR2 mRNA and TGF-β1 of the combination group were respectively(32.14±8.77)pg/ml,(1.23±0.30)mRNA and(17.25±4.56)pg/ml,lower than those of the CTX group(P＜0.05).There were no significant differences in the drug-induced adverse reactions between the two groups of patients.CONCLUSIONS Meropenem combined with cefotaxime sodium can boost the curative effect on IP patients complicated with pulmonary infection,improve the lung function and blood gas indexes,reg-ulate the immune response,intensify the immune function,reduce the expression levels of VEGF,TLR2 mRNA and TGF-β1,and promote the rehabilitation of the patients.