Objective To summarize the best evidence concerning the prevention and management of indwelling line complications in patients with hepatocellular carcinoma(HCC)receiving hepatic artery infusion chemotherapy(HAIC),and to standardize the key contents of clinical observation of complications during HAIC treatment.Methods By using the"6S"pyramid model system,the relevant literature was searched in the order from high to low.Two professionals evaluated the quality of the literature,summarized the evidence and conducted the analysis and summarization.Results Ten literature articles were finally enrolled in this study,including one article of guideline,one article of systematic review,five articles of expert consensus,one article of meta-analysis,and two articles of randomized controlled trials.Six complications(catheter displacement or falling off,catheter obstruction,unplanned extubation,arterial spasm or occlusion,infection,puncture site bleeding/local hematoma)and 22 pieces of best evidence for prevention management were summarized.Conclusion This study systematically summarizes 6 complications and their prevention and treatment in patients with HCC receiving HAIC,providing a reliable basis for clinical practice.

Objective To analyze the impact of balloon post-dilation on cardiac conduction in patients undergoing transcatheter aortic valve replacement (TAVR). Methods From June 2021 to December 2022, patients with severe aortic valve stenosis or regurgitation who underwent TAVR surgery using domestically produced valves at Xijing Hospital, Air Force Military Medical University were selected. The occurrence of intraoperative and postoperative cardiac conduction block was recorded. According to whether balloon post-dilation was performed during the surgery, patients were divided into the post-dilation group and the non-post-dilation group. The baseline data, postoperative cardiac conduction block occurrence, and cardiac function of the two groups were analyzed. Results A total of 126 patients were included, including 52 males and 74 females, with an average age of (66.6±7.6) years. There were 30 patients in the post-dilation group and 96 patients in the non-post-dilation group. On the first day after TAVR, the average QRS intervals in the post-dilation group and the non-post-dilation group were (105.6±13.8) ms and (125.9±28.2) ms, respectively (P=0.017). At discharge, the average PR intervals in the two groups were (168.7±36.8) ms and (192.1±44.2) ms, respectively (P=0.024). At discharge, 9 (7.1%) patients developed new atrioventricular block, 5 (4.0%) patients developed new complete right bundle branch block, and 33 (26.2%) patients developed new complete left bundle branch block. During hospitalization, 2 (1.6%) patients received permanent cardiac pacemakers, both of whom were in the non-post-dilation group. There was no statistical difference in postoperative left ventricular structure and function between the two groups (P>0.05). Conclusion Postoperative expansion using domestically produced interventional valves for TAVR do not increase the incidence of early atrioventricular block and permanent cardiac pacemaker implantation after valve implantation, and there are no significant changes in cardiac structure and function in patients with conduction block in the short term after surgery.

Resistance to poly adenosine diphosphate (ADP)-ribose polymerase inhibitor (PARPi) presents a considerable obstacle in the treatment of ovarian cancer. F-box and tryptophan-aspartic (WD) repeat domain containing 11 (FBXW11) modulates the ubiquitination of growth-and invasion-related factors in lung cancer, colorectal cancer, and osteosarcoma. The function of FBXW11 in PARPi therapy is still ambiguous. In this study, RNA sequencing (RNA-seq) showed that FBXW11 expression was raised in ovarian cancer cells that had been treated with PARPi. FBXW11 was abnormally expressed at low levels in high-grade serous ovarian cancer (HGSOC) tissues, and low levels of FBXW11 were associated with shorter overall survival (OS) and progression-free survival (PFS) in HGSOC patients. Overexpressing FBXW11 made ovarian cancer more sensitive to PARPi, while knocking down FBXW11 made it less sensitive. The four-dimensional (4D) label-free quantitative proteomic analysis revealed that FBXW11 targeted S100 calcium binding protein A11 (S100A11) and promoted its degradation through ubiquitination. The increased degradation of S100A11 led to less efficient DNA damage repair, which in turn contributed to increased PARPi-induced DNA damage. The role of FBXW11 in promoting PARPi sensitivity was also confirmed in xenograft mouse models. In summary, our study confirms that FBXW11 promotes the susceptibility of ovarian cancer cells to PARPi via affecting S100A11-mediated DNA damage repair.

Objective To observe the value of quantitative CT(QCT)analysis of human body components for predicting microvascular invasion(MVI)status of hepatocellular carcinoma(HCC).Methods Totally 60 HCC patients were retrospectively enrolled and divided into positive group(n=15)and negative group(n=45)based on postoperative pathology findings of MVI or not.Human body composition parameters,including bone mineral density(BMD),subcutaneous fat area(SFA),visceral fat area(VFA),total fat area(TFA)and subcutaneous/visceral fat area ratio(SVR),as well as muscle fat area(MFA),muscle area(MA)and muscle fat infiltration(MFI)of posterior vertebral muscle group based on QCT were compared between groups,and the efficacy of the above parameters for predicting MVI status of HCC was observed.Results SFA,TFA,MFA and MFI were all higher,while MA was lower in positive group than those in negative group(all P＜0.05).The area under the curve(AUC)of SFA,VFA,TFA,MA,MFA and MFI for predicting MVI status of HCC ranged from 0.673 to 0.790(all P＜0.05).TFA and M FI were both independent risk factors of HCC MVI(both P＜0.05),with AUC of 0.790 and 0.759,respectively.Conclusion QCT analysis of human body components was helpful to predicting MVI status of HCC.

Objective To observe the difference of iron deposition in brain deep nuclei of systemic lupus erythematosus(SLE)patients with different disease activity levels using quantitative susceptibility mapping(QSM).Methods Fifty-four SLE patients were retrospectively enrolled and divided into moderate to severe activity group(score＞9,n=25)and mild activity group(score≤9,n=29)according to SLE disease activity index(SLEDAI)score.Patients' general clinical data,as well as the mean QSM of bilateral head of caudate nuclei,putamina,globi pallidi,red nuclei,substantiae nigrae,dentate nuclei and thalami were compared between groups.Pearson or Spearman coefficients were performed to analyze correlations of the mean QSM of nuclei being significant different between groups and conventional clinical indicators.Then receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of the mean QSM for distinguishing moderate to severe and mild activity SLE.Results Compared with mild activity group,moderate to severe activity group had higher serum ferritin,erythrocyte sedimentation rate(ESR),C reactive protein(CRP),anti-double stranded DNA(anti-dsDNA)antibody levels,also higher proportion of positive anti-ribosomal P protein(anti-P)antibodies,but lower complement C3 and C4 levels(all P＜0.05).The mean QSM of bilateral putamina and thalami were significantly higher in moderate to severe activity group than in mild activity group(both P＜0.05).The mean QSM of bilateral putamina was positively correlated with SLEDAI scores,ferritin levels and positivity of anti-P antibodies in SLE patients(with r or rs of 0.447,0.526 and 0.473,respectively,and all P＜0.05).The AUC for distinguishing moderate to severe SLE and mild activity SLE based on the mean bilateral putamina QSM was 0.810.Conclusion There were significant differences of iron deposition in deep brain nuclei of SLE patients with moderate to severe and mild activity.The mean QSM of bilateral putamina could be used to distinguish SLE with moderate to severe activity and mild activity.

Objective To analyze the application effect of blunt dissection for myotomy of incision in single-port thoracoscopic lung wedge resection.Methods Patients who underwent single-port thoracoscopic lung wedge resection in our hospital from January to June 2024 were selected and divided into the observation group(32 cases,received blunt dissection for myotomy of incision during the surgery)and the control group(35 cases,received electrosurgical knife for myotomy of incision during the surgery)according to random number table method.The anesthesia time,operation time,intraoperative blood loss,the earliest time to get out of bed after the operation,the dosage of dezocine,and the resting and cough visual analogue scale(VAS)scores in each postoperative period of patients in the two groups were compared.Results There was no significant difference in terms of anesthesia time,operation time,intraoperative blood loss,or dosage of dezocine of patients between the two groups(P>0.05).The earliest time to get out of bed after operation of patients in the observation group was shorter than that in the control group,with significant difference(P<0.05).No significant difference was observed in resting VAS scores 6 hours or 12 hours after operation of patients in both two groups(P>0.05),but significant differences were found in resting VAS scores 24 hours and 48 hours after operation between the two groups(P<0.05).No significant difference was found in cough VAS scores 6 hours after operation of patients between the two groups(P>0.05),but significant differences were observed in cough VAS scores 12 hours,24 hours,and 48 hours after operation between the two groups(P<0.05).Conclusion Compared with electrosurgical knife for myotomy of incision,blunt dissection for myotomy of incision in single-port thoracoscopic lung wedge resection can reduce postoperative pain,promote postoperative ambulation for patients,which is beneficial to postoperative recovery.

Objective To observe the value of machine learning(ML)model based on chest non-contrast CT(NCCT)radiomics for diagnosing metabolic syndrome(MetS)in males.Methods A total of 792 males who would undergo chest NCCT and bone density CT examination for physical check-up were prospectively enrolled and divided into training set(n=554,including 171 cases of MetS)and validation set(n=238,including 70 cases of MetS)at the ratio of 7∶3.Chest NCCT was performed,ROI of liver,intra-abdominal fat and skeletal muscle were delineated,and visceral fat area(VFA)at L2-3 intervertebral disc level was measured.Then radiomic signature(RS)of liver,intra-abdominal fat and skeletal muscle were established,and ML models were constructed using logistic regression(LR),random forests(RF)and extreme gradient boosting(XGBoost)algorithms,respectively,and their diagnostic performance were observed.Results Significant difference of age was found between MetS and non-MetS males in training set(P=0.010),while of RS scores were noticed in both training set and validation set(all P＜0.001).Combined ML models were constructed with age and RS.The area under the curve(AUC)of combined LR,RF and XGBoost models for diagnosing male MetS in training set was 0.899,0.996 and 0.943,while that in validation set was 0.861,0.860 and 0.876,respectively.Combined XGBoost model had the best performance.Conclusion XGBoost model based on chest NCCT radiomics was helpful for diagnosing male MetS.Combining with age could further improve its efficacy.

Objective To observe the value of subchondral bone(SB)intravoxel incoherent motion diffusion weighted imaging(IVIM-DWI)for quantitatively evaluating knee joint cartilage degeneration.Methods Totally 125 patients with knee cartilage degeneration were prospectively enrolled and divided into mild group(n=65,Outerbridge grades Ⅰ-Ⅱ)and moderate-severe group(n=60,Outerbridge grades Ⅲ-Ⅳ)based on arthroscopic findings.Additionally,30 healthy young subjects were recruited as control group.The apparent diffusion coefficient(ADC),true diffusion coefficient(D),pseudo diffusion coefficient(D*)and perfusion fraction(f)values of medial condyle of SB of femur,lateral condyle of femur,medial tibial plateau and lateral tibial plateau,as well as the mean values of each parameter of the above 4 regions were obtained based on knee joint IVIM-DWI and compared within and among groups.Spearman correlation analysis was used to observe the correlations between quantitative parameters and Outerbridge grading.The area under the receiver operating characteristic curve(AUC)was calculated to evaluate the efficacy of each quantitative parameter alone and their combination for assessing knee cartilage degeneration.Results Significant differences of D*values were found among different parts of knee joint SB in moderate-severe group,also of D value,D* value and f value among different parts of knee joint SB in mild group(all P＜0.05).Significant differences of IVIM-DWI parameter were found among different parts of knee joint SB in control group(all P＜0.05).ADC value of knee joint SB in moderate-severe group,mild group and control group decreased successively,while D value increased successively(all P＜0.001).D* values of knee joint SB in moderate-severe group was higher than that in mild group and control group(both P＜0.05).No significant difference of f value of knee joint SB was found between moderate-severe group and mild group(P＞0.05),while both the latter two were higher than that in control group(both P＜0.05).ADC value,D value and f value of knee joint SB were positively correlated(rs=0.671,0.634,0.416,all P＜0.01),while D* value of knee joint SB was negatively correlated with Outerbridge grading(rs=-0.729,P＜0.01).AUC of combination of parameters for distinguishing mild group from control group,and mild group from moderate-severe group was 0.859 and 0.808,respectively.Conclusion SB IVIM-DWI could be used for quantitatively evaluation of knee cartilage degeneration.

Resistance to poly adenosine diphosphate(ADP)-ribose polymerase inhibitor(PARPi)presents a considerable obstacle in the treatment of ovarian cancer.F-box and tryptophan-aspartic(WD)repeat domain containing 11(FBXW11)modulates the ubiquitination of growth-and invasion-related factors in lung cancer,colorectal cancer,and osteosarcoma.The function of FBXW11 in PARPi therapy is still ambiguous.In this study,RNA sequencing(RNA-seq)showed that FBXW11 expression was raised in ovarian cancer cells that had been treated with PARPi.FBXW11 was abnormally expressed at low levels in high-grade serous ovarian cancer(HGSOC)tissues,and low levels of FBXW11 were associated with shorter overall survival(OS)and progression-free survival(PFS)in HGSOC patients.Overexpressing FBXW11 made ovarian cancer more sensitive to PARPi,while knocking down FBXW11 made it less sensitive.The four-dimensional(4D)label-free quantitative proteomic analysis revealed that FBXW11 targeted S100 calcium binding protein A11(S100A11)and promoted its degradation through ubiquiti-nation.The increased degradation of S100A11 led to less efficient DNA damage repair,which in turn contributed to increased PARPi-induced DNA damage.The role of FBXW11 in promoting PARPi sensitivity was also confirmed in xenograft mouse models.In summary,our study confirms that FBXW11 promotes the susceptibility of ovarian cancer cells to PARPi via affecting S10OA11-mediated DNA damage repair.

Objective:To explore the value of the vesical imaging-reporting and data system (VI-RADS) score based on multiparametric MRI (mpMRI) combined with quantitative tumor MRI parameters in assessing the muscle invasion of bladder cancer.Methods:The study was a case-control study. The data of 87 bladder cancer patients confirmed by pathology who underwent mpMRI of the bladder were retrospectively collected from the First Medical Center of Chinese PLA General Hospital between January 2019 and April 2023 The pathological findings were used as the gold standard to categorize them into the muscle invasive bladder cancer (MIBC) group (29 cases) and non-muscle invasive bladder cancer (NMIBC) group (58 cases). Quantitative parameters were measured based on preoperative mpMRI images, including the length of tumor bladder wall contact, the perpendicular distance between the bladder tumor and the tangent of the bladder wall, the maximal diameter of the bladder tumor, and the volume of the bladder tumor. Bladder cancer was classified according to the VI-RADS scoring criteria. The Mann-Whitney U test was used for intergroup comparisons. Multivariate logistic regression analysis was performed to obtain the independent risk factors related to muscle invasion of bladder cancer and to establish the model. The receiver operating characteristic curves were analyzed for MRI quantitative parameters and logistic regression models, and area under the curve (AUC) comparisons were performed using the DeLong test. Results:The differences in tumor bladder wall contact length, perpendicular distance from the tumor to the tangent line of the bladder wall, maximum diameter, bladder tumor volume, and the VI-RADS scores were statistically significant between the MIBC group and the NMIBC group ( P<0.05). Multifactorial logistic regression analysis showed that tumor bladder wall contact length ( OR=21.07, 95% CI 3.56-124.89, P=0.001) and VI-RADS score ( OR=11.90, 95% CI 3.53-40.12, P<0.001) were the independent risk factors for evaluating the muscle invasion of bladder cancer. The difference between the VI-RADS score and the tumor bladder wall contact length for assessing muscular infiltration of bladder cancer had AUCs of 0.802 (95% CI 0.704-0.899) and 0.759 (95% CI 0.652-0.865). The combined model of VI-RADS score combined with tumor bladder wall contact length had an AUC of 0.891 (95% CI 0.812-0.970), which was higher than the diagnostic efficacy of applying tumor bladder wall contact length or VI-RADS score alone ( Z=3.05, 2.37, P=0.002, 0.018). Conclusion:Tumor contact length with the bladder wall is an independent risk factor for assessing muscle invasion of bladder cancer and the combination of VI-RADS score may enhances diagnostic accuracy.