AIM: To investigate the diagnostic and prognostic value of differential expression of Cyclin D1 and p53 in eyelid tumors.METHODS: This retrospective study enrolled patients who underwent surgical resection for eyelid tumors at our hospital between March 2018 and March 2023. Participants were categorized into benign and malignant groups based on tumor characteristics. Clinical data were collected. Genetic data for eyelid tumors were obtained from the GEO database, and differential gene analysis, including volcano plot visualization and KEGG pathway enrichment analysis, was performed using the Sangerbox 3.0 platform. Immunohistochemistry was used to detect the expression levels of Cyclin D1, p53, and BAX in tissue samples. Correlations with clinical features were analyzed using Spearman analysis, and prognostic factors were identified via Logistic regression analysis.RESULTS: This study included 69 patients with eyelid tumors(78 eyes), categorized into a benign group(37 patients, 41 eyes)and a malignant group(32 patients, 37 eyes)based on tumor characteristics. There were significant differences between the two groups in histological subtype, TNM staging, vascular invasion, differentiation status, and local infiltration(all P<0.05). Among benign tumors: pigmented nevi in 11 eyes(27%), hemangiomas in 9 eyes(22%), squamous cell papillomas in 5 eyes(12%), epidermoid cysts in 5 eyes(12%), seborrheic keratoses in 4 eyes(10%), neurofibromas in 3 eyes(7%), and both calcifying epithelioma and xanthelasma in 2 eyes each(5%); among malignant tumors: basal cell carcinoma in 18 eyes(49%), meibomian gland carcinoma in 8 eyes(22%), squamous cell carcinoma in 5 eyes(14%), sebaceous gland carcinoma in 4 eyes(11%), lymphoma and malignant melanoma each in 1 eye(3%). At the follow-up cutoff date of March 2025, the 2-year survival rate in the benign group(95%)was significantly higher than that in the malignant group(78%; P<0.05). Bioinformatics analysis identified 4 103 differentially expressed genes, including Cyclin D1, p53, and BAX, which were predominantly involved in pathways such as the p53 signaling pathway and calcium-related signaling. Spearman analysis revealed that local invasion(rs=0.71, P<0.05)and TNM stage(rs=0.73, P<0.05)correlated with Cyclin D1 expression; local invasion(rs=0.76, P<0.05)and histological subtype(rs=0.65, P<0.05)correlated with p53 expression. Logistic regression results indicated that Cyclin D1, p53, TNM staging, and local invasion were prognostic risk factors. ROC curve analysis demonstrated that the combined detection of these four indicators had the highest predictive value for prognosis(AUC=0.83).CONCLUSION: High expression of cyclin D1 and p53 serves as molecular markers for distinguishing benign from malignant eyelid tumors and assessing prognosis. Combined detection of these markers with TNM staging and local invasion demonstrates high predictive value for prognosis.

BackgroundWith the acceleration of population aging in China， studies have documented an increased prevalence of dementia in the elderly. Behavioral and psychological symptoms and impaired cognitive function are important problems affecting the quality of life in the elderly with dementia. It has been noted that there are certain limitations on the management of problems mentioned above by drug treatment alone， while its combination with music intervention is emerging as an effective approach. However， the application of this approach in the elderly with moderate to severe dementia is still in its relative infancy. ObjectiveTo investigate the effect of music assisted drug treatment on behavioral and psychological symptoms and cognitive function in the elderly with moderate to severe dementia， so as to provide insights for the development of effective intervention. MethodsA randomized controlled study was utilized to enroll a coherent of 43 elderly patients with moderate to severe dementia who were hospitalized in Geriatric Psychiatry of Deyang Mental Health Center from January to July 2023 and met the International Classification of Diseases， tenth edition （ICD-10） diagnostic criteria for dementia. Eligible subjects were divided into study group （n=22） and control group （n=21） based on random allocation using SPSS 26.0. Both groups received routine drug treatment and nursing care， while the study group added music intervention， which consisted of two 30-minute sessions per week for 8 weeks. Neuro Psychiatric Inventory （NPI） and Mini-Mental State Examination （MMSE） were administered to all patients before and after intervention. ResultsA total of 36 patients completed the study， including 20 case in study group and 16 case in control group. No statistical difference was noted in baseline NPI score and MMSE score between two groups （P>0.05）. After intervention， study group reported a statistical reduction in NPI total score ［58.00 （49.00， 79.25） vs. 78.50 （55.00， 95.50）， Z=-3.902， P<0.01）］ along with a clinically unremarkable increase in MMSE score （P>0.05） compared with baseline data. After intervention， NPI total score and scores on sub-domains including agitation/aggression， depression/dysphoria， anxiety and aberrant motor behavior were all significantly lower in study group than those in control group （Z=-2.183， -2.438， -2.691， -3.716， -2.250， P<0.05 or 0.01）， while there was no significant difference in MMSE score between two groups （P>0.05）. ConclusionMusic assisted drugintervention may ameliorate behavioral and psychological symptoms in the elderly with moderate to severe dementia， while no significant improvement is documented on cognitive function. ［Fund by the "14^th Five Year Plan" for Philosophy and Social Sciences Research in Deyang （number， DY232C002）］

Objective:To investigate the potential characteristic manifestations and application value of the Dynamic Visual Acuity Test（DVAT） in vestibular migraine（VM）. Methods:A total of 50 VM patients（case group） and 50 healthy subjects（control group） diagnosed at the Department of Otorhinolaryngology Head and Neck Surgery, First Hospital of Shanxi Medical University between November 1, 2023, and December 31, 2024, were enrolled. The case group underwent DVAT, video head impulse test（vHIT）, caloric test, and Dizziness Handicap Inventory（DHI） assessment, whereas the control group only received DVAT. Group-based analyses were conducted to examine the effect of age on Dynamic Visual Acuity Loss（DVALoss）, as well as the correlations of DVALoss with vestibular function tests and DHI scores. Results:DVALoss in the case group was significantly higher than that in the control group（P<0.001）. In both groups, age was significantly and positively correlated with DVALoss（P<0.001）. Within the case group, DVALoss was strongly and positively correlated with DHI scores（r=0.807, P<0.001）; it was negatively correlated with the vestibulo-ocular reflex（VOR） gain in vHIT, though without clinical significance, and showed no significant association with the caloric test. Age and DVALoss collectively accounted for 71.3% of the variance in DHI scores（R²=0.713）, with age exerting a relatively minor actual impact. Conclusion:DVAT can sensitively identify the core functional impairments of VM. DVALoss, as a direct functional reflection of the pathological mechanism of VM, is strongly correlated with DHI scores. Incorporating DVALoss into standardized assessments may provide an objective basis for the diagnosis and management of VM.
Humans ; Migraine Disorders/diagnosis* ; Visual Acuity ; Case-Control Studies ; Head Impulse Test ; Vestibular Function Tests ; Female ; Male ; Adult ; Vestibular Diseases/physiopathology* ; Middle Aged ; Caloric Tests

Advanced atherosclerosis is the major global cause of death, as featured by the aggregation of apoptotic cells (ACs) in necrotic cores. The defective efferocytosis and dysfunctional cholesterol efflux of macrophages are the main reasons for forming necrotic cores in advanced atherosclerosis. In this study, we constructed self-assembled procyanidins (PC) NPs for loading pitavastatin (Pita). The designed HA@PC@Pita NPs with hyaluronic acid (HA) modification combined the advantages of efferocytosis restoration of Pita and cholesterol efflux enhancement of PC. In vitro assay indicated that HA@PC@Pita NPs could induce M1/M2 repolarization and upregulate ERK5/Mertk expression to restore efferocytosis of macrophages. Simultaneously, HA@PC@Pita NPs notably promoted cholesterol efflux by promoting macrophage lipophagy, a selective autophagy of lipid droplets. In vivo study showed that HA@PC@Pita NPs cleared necrotic core and enhanced plaque stability in the ApoE ^-/- mice model with advanced atherosclerosis. Taken together, this study demonstrated the potential of HA@PC@Pita NPs for the treatment of advanced atherosclerosis.

The diagnosis of hematological disorders is currently established from the combined results of different tests, including those assessing morphology (M), immunophenotype (I), cytogenetics (C), and molecular biology (M) (collectively known as the MICM classification). In this workflow, most of the results are interpreted manually (i.e., by a human, without automation), which is expertise-dependent, labor-intensive, time-consuming, and with inherent interobserver variability. Also, with advances in instruments and technologies, the data is gaining higher dimensionality and throughput, making additional challenges for manual analysis. Recently, artificial intelligence (AI) has emerged as a promising tool in clinical hematology to ensure timely diagnosis, precise risk stratification, and treatment success. In this review, we summarize the current advances, limitations, and challenges of AI models and raise potential strategies for improving their performance in each sector of the MICM pipeline. Finally, we share perspectives, highlight future directions, and call for extensive interdisciplinary cooperation to perfect AI with wise human-level strategies and promote its integration into the clinical workflow.

Objective To investigate the effects of long-term radiofrequency(RF)radiation at 2.65 GHz on behavior,inflammatory response,and intestinal microecology in mice in order to provide a basis for the safety assessment of long-term RF exposure.Methods One hundred and eight male C57BL/6N mice(17～21 g,6～8 weeks old)were randomly assigned to a control group(Con)and a RF exposure group.The mice of the RF exposure group were subjected to whole-body uniform exposure to 2.65 GHz RF radiation in an electromagnetic reverberation chamber for 3 h/day for 28 consecutive days.RF field distribution and changes in core body temperature were monitored using an electromagnetic radiation analyzer and a fiber-optic temperature probe,respectively.Cognitive function was assessed using the Y-maze and novel object recognition(NOR)test.Anxiety-like behaviors were evaluated through open field test(OFT)and elevated plus maze(EPM),while depressive-like behaviors were examined with sucrose preference test(SPT)and tail suspension test(TST).HE staining was used to observe the histopathological changes in mouse tissues.Radioimmunoassay(RIA)was employed to detect the expression of pro-inflammatory cytokines,TNF-α and IL-1 β,as well as anti-inflammatory cytokines,IL-4 and IL-10 in the serum,brain,jejunum,and spleen samples.Additionally,metagenomic sequencing was performed to assess alterations in the gut microbiota composition.Results Long-term RF radiation led to a maximal increase of 0.59℃in the core body temperature,but had no significant effects on cognitive function,anxiety-like behaviors,or depressive-like behaviors,or apparent damage of the hippocampal or jejunal tissues in the exposed mice.However,RF exposure significantly up-regulated the expression of the pro-inflammatory cytokine TNF-α in serum(P<0.05),and did not significantly alter the concentrations of other cytokines(IL-1β,IL-4,IL-10),caused significant decrease in α-diversity of the intestinal microbiota(P<0.01),with reduced relative abundances of Ligilactobacillus murinus and Acetatifactor muris(P<0.05),while elevated abundances of Lachnospiraceae bacterium(P<0.01).Conclusion Long-term exposure to 2.65 GHz RF radiation induces systemic inflammatory responses and disrupts gut microbiota homeostasis in mice.

The incidence of malignant tumors among elderly patients is increasing.Influenced by multiple factors such as aging,tumor,and drug,this population exhibits a high prevalence of renal insufficiency.However,there remains a scarcity of research data and significant challenges in clinical management.This article systematically an-alyzes the challenges faced in administering anti-tumor therapies to elderly patients with renal insufficiency and pro-poses management strategies.Optimization approaches include precise assessment of renal function,selection of nephrotoxicity-sparing medications,appropriate dose adjustments,implementation of preventive measures,and em-phasis on comprehensive geriatric assessment and multidisciplinary collaboration.Renal injury management should be individualized,with considerations for special populations such as renal transplant recipients and dialysis pa-tients.Future efforts should focus on biomarker discovery and the development of low-nephrotoxicity therapeutic agents to address these complex clinical challenges.

Objective To investigate the functional changes of oligodendrocytes in a mouse model of cognitive impairment induced by microwave radiation and the mechanism.Methods C57BL/6N male mice were exposed to S-band microwave at 2.856 GHz and 8 mW/cm2 for 15 min.The rectal temperature of mice was monitored by an optical fiber thermometer during microwave radiation.The changes of autonomous exploration behavior and learning and memory ability of mice on the 1st and 7th days after microwave radiation were detected via the open field test and novel object recognition test.Immunofluorescence was used to detect the expression and distribution of neuroglia-2 proteoglycan(NG2)and myelin basic protein(MBP)in the hippocampus of mice on the 1st and 7th days after radiation.Clemastine fumarate,a drug that promoted the maturation of oligodendrocyte precursor cells was administered by gavage,and the expression levels of brain-derived neurotrophic factor(BDNF)and fibroblast growth factor 2(FGF2)in hippocampal tissues were detected by radioimmunoassay at 1 and 7 days after radiation.The changes of myelin sheath structure an 1 and 7 days after radiation were observed by transmission electron microscopy.The effects of clemastine fumarate on learning and memory impairment induced by microwave exposure in mice were assessed via open field and new object recognition experiments.Results Under the experimental conditions,the rectal temperature in mice caused by microwave radiation increased by less than 1 ℃,which was within the thermal safety range of the body.The open field test showed that compared with the control group,the microwave radiation group didn't change significant in terms of movement speedon the 1st and 7th days,but the time spent exploring in the central area was significantly reducedon the 1st day after radiation(P＜0.05).In the novel object recognition test,the indexes of the mice on the 1st day were significantly reduced(P＜0.05),indicating that the anxiety like behavior and cognitive function of the mice were impaired after microwave radiation.Compared with the control group,the proportion of NG2+area in the hippocampus was significantly decreased(P＜0.05)in the microwave radiation group,while that of MBP+area hardly changed on the 1st day after microwave radiation(P＞0.05).The expression level of oligodendrocyte related BDNF in the hippocampus was significantly decreased(P＜0.05).The myelin of the corpus callosum was broken,and the myelin g ratio was significantly increased(P＜0.05),suggesting that micro wave radiation could reduce the number of oligodendrocyte precursors and damage the secretion and myelin function of oligodendrocyte.Compared with the radiation group,the expression levels of BNDF and FGF2 in the radiation combined with clemastine fumarate group were up-regulated,the myelin g ratio was significantly decreased on the 1st day after radiation(P＜0.05),and the novel object recognition index was significantly increased(P＜0.05).Conclusion Pulsed microwave radiation below the body's fever threshold can cause cognitive dysfunction and other brain damage in mice.The impaired secretion and myelin function of oligodendrocytes and the decreased self-repair ability are the important mechanisms of cognitive dysfunction induced by microwave radiation.

Transient perivascular inflammation of the carotid artery(TIPIC)syndrome is a relatively rare disease,and ultrasound is the first screening method for initial diagnosis of the disease.Contrast-enhanced ultrasound(CEUS)has unique advantages in the follow-up of patients with TIPIC syndrome.This paper reports a patient with TIPIC syndrome who was treated with acute left neck pain.The inflammation was significantly re-lieved and subsided after treatment with non-steroidal anti-inflammatory drugs.The ultrasound changes of carotid artery lesions in this patient during follow-up were analyzed,and the application value of CEUS in the follow-up diagnosis of this disease was summarized,in the hope of providing clinical reference.

Objective:To further improve the understanding of paroxysmal nocturnal hemoglobinuria (PNH), we retrospectively analyzed and summarized the clinical characteristics, treatment status, and survival status of patients with PNH in Zhejiang Province.Methods:This study included 289 patients with PNH who visited 20 hospitals in Zhejiang Province. Their clinical characteristics, comorbidity, laboratory test results, and medications were analyzed and summarized.Results:Among the 289 patients with PNH, 148 males and 141 females, with a median onset age of 45 (16-87) years and a peak onset age of 20-49 years (57.8% ). The median lactic dehydrogenase (LDH) level was 1 142 (604-1 925) U/L. Classified by type, 70.9% (166/234) were classical, 24.4% (57/234) were PNH/bone marrow failure (BMF), and 4.7% (11/234) were subclinical. The main clinical manifestations included fatigue or weakness (80.8%, 235/289), dizziness (73.4%, 212/289), darkened urine color (66.2%, 179/272), and jaundice (46.2%, 126/270). Common comorbidities were hemoglobinuria (58.7% ), renal dysfunction (17.6% ), and thrombosis (15.0% ). Moreover, 82.3% of the patients received glucocorticoid therapy, 70.9% required blood transfusion, 30.7% used immunosuppressive agents, 13.8% received anticoagulant therapy, and 6.3% received allogeneic hematopoietic stem cell transplantation. The 10-year overall survival (OS) rate was 84.4% (95% CI 78.0% -91.3% ) . Conclusion:Patients with PNH are more common in young and middle-aged people, with a similar incidence rate between men and women. Common clinical manifestations include fatigue, hemoglobinuria, jaundice, renal dysfunction, and recurrent thrombosis. The 10-year OS of this group is similar to reports from other centers in China.