ObjectiveTo investigate the feasibility， safety， and efficacy of surgery-assisted transjugular intrahepatic portosystemic shunt （SA-TIPS） in the treatment of portal hypertension comorbid with complex portal vein thrombosis， including cavernous transformation of the portal vein （CTPV）. MethodsAn analysis was performed for the data of 36 patients with portal hypertension and complex portal vein thrombosis who underwent SA-TIPS in Beijing Shijitan Hospital， Capital Medical University， from November 2023 to January 2025， including general status， technical data of the surgical process （surgical success rate， puncture times， time of operation， the number of stents used， and the length of shunt）， perioperative complications， and surgical recovery. The change in portal pressure gradient （PPG） after shunt was compared， and the rate of reaching the standard for PPG reduction was calculated， as well as stent patency rate within 1 week after surgery. The paired samples t-test was used for comparison of continuous data between two groups. ResultsAmong the 36 patients， 34 （94.4%） underwent SA-TIPS successfully. The incidence rate of perioperative complications was 16.7% （6/36）， including 3 cases of thoraco-abdominal hemorrhage， 2 cases of intraoperative arrhythmia， and 1 case of incision infection. There was a significant reduction in PPG after SA-TIPS （t=19.85， P<0.01）， and the patients achieving a ≥50% reduction in PPG accounted for 76.5% （26/34）. Imaging reexamination within 1 week showed a shunt patency rate of 100%. ConclusionSA-TIPS has a high technical success rate， a favorable safety profile， and good efficacy in the treatment of portal hypertension comorbid with complex portal vein thrombosis （including CTPV）， and therefore， it holds promise for clinical application.

AIM:To investigate the synergistic efficacy of travoprost and betahistine mesylate in early open angle glaucoma.METHODS:This study is a prospective, randomized, controlled, open label single center clinical trial that enrolled 82 patients(82 eyes)with early primary open-angle glaucoma from January 2020 to January 2023(eligible eyes were included, and the right eye was selected if both eyes met the inclusion criteria). The patients were randomly divided into a monotherapy group(41 eyes)treated with only travoprost eye drops and a combination therapy group(41 eyes)treated with travoprost eye drops and oral betahistine mesylate according to a 1:1 ratio using a random number table method. Followed-up for 12 mo, the intraocular pressure(IOP), retinal nerve fiber layer(RNFL)thickness, ocular hemodynamics [peak systolic velocity(PSV), end diastolic velocity(EDV), resistance index(RI), pulsatility index(PI)], liver and kidney function, quality of life, and clinical symptom scores before and after treatment were compared between the two groups of patients.RESULTS:Totally 4 patients were unable to complete all follow-up visits due to various factors, including 2 cases in the monotherapy group and 2 cases in the combination therapy group, with a lost rate of follow-up of 5%. The IOP in the combination therapy group was significantly lower than that in the monotherapy group at all time points(all P<0.05). Additionally, the rate of reduction in RNFL thickness was significantly slower in the combination therapy group compared to the monotherapy group(all P<0.05). Hemodynamic parameters revealed that PSV and EDV were significantly higher in the combination therapy group at 12 mo, while RI and PI were significantly lower than those in the monotherapy group(all P<0.05). The quality of life scores and visual analog scale(VAS)scores were also significantly better in the combination therapy group compared to the monotherapy group(all P<0.05). There were no statistically significant differences in liver functions, including alanine aminotransferase(ALT), aspartate aminotransferase(AST), total bilirubin(TBIL), and kidney functions, including serum creatinine(Scr), blood urea nitrogen(BUN), and uric acid(UA)between the two groups at 6 and 12 mo after treatment, with no serious damage to liver and kidney or other systemic adverse reactions observed in either groups. Furthermore, the incidence of headache in the combination group was lower than that of the monotherapy group(P=0.042), and there were no statistical significance in the incidence of other adverse reactions(all P>0.05).CONCLUSION:The combination therapy of travoprost and betahistine mesylate exhibits significant synergistic effects in patients with early primary open angle glaucoma, offering better IOP control, neuroprotection of the optic nerve, and oxidative stress inhibition. This combination may provide a new clinical reference for comprehensive glaucoma treatment.

Temporomandibular joint osteoarthritis is a common chronic degenerative disease,in which joint pain is the most signif-icant symptom,but its pathogenesis is still unclear.Significant subchondral bone lesions can occur in the early stage of osteoarthritis progression,and more and more experimental evidence shows that subchondral bone lesions play an important role in the pain caused by osteoarthritis.Osteoclasts,osteocytes,osteoblasts,endothelial cells,new generating nerves and blood vessels in the sub-chondral bone matrix microenvironment interact with each other and participate in the process of osteoarthritis pain.Therefore,regu-lating the subchondral bone matrix microenvironment is expected to become a new strategy to control joint pain.

Objective:To investigate the relationship between nerve growth factor (NGF) concentration in follicular fluid and abnormal menstrual cycle in infertile patients with polycystic ovary syndrome (PCOS).Methods:A retrospective cohort study was conducted on 100 infertile patients with PCOS who underwent in vitro fertilization and embryo transfer (IVF-ET) at Department of Obstetrics and Gynecology, Peking University Third Hospital from March 2017 to June 2019. For comparison, the 100 patients with PCOS were divided into low NGF group ( n=50) and high NGF group ( n=50) based on the median NGF concentration (1 644.03 ng/L) in follicular fluid. Baseline characteristics, menstrual status and clinical outcomes of assisted reproductive technology were compared. We performed multiple linear regression analysis to examine the effect of NGF in follicular fluid on menstrual cycle length for multivariate analysis. Results:1) PCOS patients in the low NGF group had significantly higher body mass index [(27.24±5.17) kg/m 2] and white blood cell count [7.31(5.99, 8.43)×10 9/L ] than those in the high NGF group [(25.03±4.46) kg/m 2, P=0.024; 5.95(5.08,7.01)×10 9/L, P=0.001], while high-density lipoprotein cholesterol [1.15 (0.98, 1.36) mmol/L] and basic follicle-stimulating hormone level [6.51 (5.10,7.95) U/L] in the low NGF group were significantly lower than those in the high NGF group [1.36 (1.09,1.52) mmol/L, P=0.039;6.51 (5.10,7.95)U/L, P=0.040]. 2) PCOS patients in the low NGF group had significantly higher menstrual cycle length [60.00 (35.00, 180.00) d] than the high NGF group [32.50 (27.00,67.50) d, P=0.001]. 3) Multiple linear regression analysis revealed that after adjustment for body mass index, age, infertility duration, infertility type, and glucose and lipid metabolic parameters, the NGF concentration in the follicular fluid independently and negatively correlated with menstrual cycle length ( P<0.05). 4) The NGF concentration in follicular fluid was not correlated with assisted reproductive outcomes. Conclusion:NGF concentration in follicular fluid is closely related to the degree of menstrual cycle abnormalities in patients with PCOS.

Objective:To investigate the relationship between nerve growth factor (NGF) concentration in follicular fluid and abnormal menstrual cycle in infertile patients with polycystic ovary syndrome (PCOS).Methods:A retrospective cohort study was conducted on 100 infertile patients with PCOS who underwent in vitro fertilization and embryo transfer (IVF-ET) at Department of Obstetrics and Gynecology, Peking University Third Hospital from March 2017 to June 2019. For comparison, the 100 patients with PCOS were divided into low NGF group ( n=50) and high NGF group ( n=50) based on the median NGF concentration (1 644.03 ng/L) in follicular fluid. Baseline characteristics, menstrual status and clinical outcomes of assisted reproductive technology were compared. We performed multiple linear regression analysis to examine the effect of NGF in follicular fluid on menstrual cycle length for multivariate analysis. Results:1) PCOS patients in the low NGF group had significantly higher body mass index [(27.24±5.17) kg/m 2] and white blood cell count [7.31(5.99, 8.43)×10 9/L ] than those in the high NGF group [(25.03±4.46) kg/m 2, P=0.024; 5.95(5.08,7.01)×10 9/L, P=0.001], while high-density lipoprotein cholesterol [1.15 (0.98, 1.36) mmol/L] and basic follicle-stimulating hormone level [6.51 (5.10,7.95) U/L] in the low NGF group were significantly lower than those in the high NGF group [1.36 (1.09,1.52) mmol/L, P=0.039;6.51 (5.10,7.95)U/L, P=0.040]. 2) PCOS patients in the low NGF group had significantly higher menstrual cycle length [60.00 (35.00, 180.00) d] than the high NGF group [32.50 (27.00,67.50) d, P=0.001]. 3) Multiple linear regression analysis revealed that after adjustment for body mass index, age, infertility duration, infertility type, and glucose and lipid metabolic parameters, the NGF concentration in the follicular fluid independently and negatively correlated with menstrual cycle length ( P<0.05). 4) The NGF concentration in follicular fluid was not correlated with assisted reproductive outcomes. Conclusion:NGF concentration in follicular fluid is closely related to the degree of menstrual cycle abnormalities in patients with PCOS.

Renal cell carcinoma in a transplanted kidney is rare, and partial nephrectomy in transplanted kidney is even more uncommon. A patient with papillary transplanted renal cell carcinoma who underwent partial nephrectomy was reported. The patient was admitted to the hospital due to the discovery of transplanted kidney mass, and the enhanced examination of CTU found a lesion in the upper pole of the transplanted kidney in the right iliac fossa, which may be renal cancer, with a diameter of about 2 cm. After open partial nephrectomy of the transplanted kidney, the postoperative pathology showed that the tumor was papillary renal cell carcinoma. The antirejection drugs were used after surgery. During the follow-up period of 16 months, there was no recurrence of transplanted kidney tumor.

Objective To investigate the effectiveness and safety of drug-eluting beads bronchial arterial chemoembolization(DEB-BACE)versus BACE for the treatment of stage Ⅲ-Ⅳ lung squamous cell carcinoma.Methods A total of 104 patients with stage Ⅲ-Ⅳ lung squamous cell carcinoma,who were admitted to the Lishui Municipal Central Hospital of China between January 2013 and August 2021,were enrolled in this study.According to the therapeutic scheme,the patients were divided into DEB-BACE group(n=41)and BACE group(n=63).For patients of DEB-BACE group,Cisplatin at 75 mg/m2 dose and gemcitabine at 1 000 mg/m2 dose(400 mg was used as loaded-drug dose)were injected through a microcatheter,which was followed by embolization with CalliSpheres microspheres loaded with 400 mg of gemcitabine.For patients of BACE group,Cisplatin at 75 mg/m2 and gemcitabatin at 1 000 mg/m2 were injected through a microcatheter,which was followed by arterial embolization with blank microspheres.Three weeks after DEB-BACE or BACE,the patients of both groups were started on intravenous chemotherapy.The primary study endpoint was overall survival(OS).The secondary study endpoints included progression-free survival(PFS),objective response rate(ORR),disease control rate(DCR),adverse reactions,and the remission rate of dyspnea.Results Of the 104 patients,63 received BACE sequential intravenous chemotherapy and 41 received DEB-BACE sequential intravenous chemotherapy.The median OS in DEB-BACE group was 23.0 moths,which was obviously longer than 12.0 months in BACE group(P=0.009).Multivariate Cox regression analysis showed that DEB-BACE treatment was an independent risk factor for OS(HR=0.59,95％ CI:0.38-0.91,Log-rank test P=0.018).Meanwhile,the remission rate of dyspnea in DEB-BACE group was significantly higher than that in BACE group(57.1％ vs 30.6％,P＜0.043).Conclusion Compared with BACE sequential intravenous chemotherapy,DEB-BACE sequential intravenous chemotherapy can significantly prolong the survival time of patients with stage Ⅲ-Ⅳ lung squamous cell carcinoma and significantly improve the symptoms of dyspnea,which has important applications in the treatment of patients with advanced lung squamous cell carcinoma.

Temporomandibular joint osteoarthritis is a common chronic degenerative disease,in which joint pain is the most signif-icant symptom,but its pathogenesis is still unclear.Significant subchondral bone lesions can occur in the early stage of osteoarthritis progression,and more and more experimental evidence shows that subchondral bone lesions play an important role in the pain caused by osteoarthritis.Osteoclasts,osteocytes,osteoblasts,endothelial cells,new generating nerves and blood vessels in the sub-chondral bone matrix microenvironment interact with each other and participate in the process of osteoarthritis pain.Therefore,regu-lating the subchondral bone matrix microenvironment is expected to become a new strategy to control joint pain.

Renal cell carcinoma in a transplanted kidney is rare, and partial nephrectomy in transplanted kidney is even more uncommon. A patient with papillary transplanted renal cell carcinoma who underwent partial nephrectomy was reported. The patient was admitted to the hospital due to the discovery of transplanted kidney mass, and the enhanced examination of CTU found a lesion in the upper pole of the transplanted kidney in the right iliac fossa, which may be renal cancer, with a diameter of about 2 cm. After open partial nephrectomy of the transplanted kidney, the postoperative pathology showed that the tumor was papillary renal cell carcinoma. The antirejection drugs were used after surgery. During the follow-up period of 16 months, there was no recurrence of transplanted kidney tumor.

Objective:To investigate the driver gene mutation status and prognostic influencing factors in patients with operable lung adenosquamous carcinoma (LASC).Methods:A retrospective case series study was conducted. Clinical and pathologic data were retrospectively collected from patients with LASC who underwent surgical treatment at the Second Affiliated Hospital of Air Force Military Medical University from January 2008 to December 2018, and the patients' surgically resected specimens were sequenced for epidermal growth factor receptor (EGFR) and Kirsten rat sarcoma (KRAS) genes. The distribution of driver gene EGFR and KRAS mutations in patients was analyzed, and the differences in the distribution of mutations among patients stratified by clinical factors were compared; disease-free survival (DFS) of patients stratified by clinical factors was analyzed by the Kaplan-Meier method, and the comparison between groups was performed by the log-rank test.Results:A total of 106 patients were included, including 64 (60.4%) males and 42 (39.6%) females, aged (58±10) years old. Patients with EGFR and KRAS gene mutations accounted for 38.7% (41/106), of which 33.0% (35/106) were patients with EGFR mutations and 5.7% (6/106) were patients with KRAS mutations. The EGFR mutation loci included 19del, L858R, L861Q and 20in, and the KRAS mutation loci included G12A, G12D, G12C and G12V. Patients aged ≤65 years old, female, with lesions in the lower lobe of the left lung, non-squamous cell carcinoma as the main pathological component, and with a smoking index of <400 were more likely to have EGFR and KRAS gene mutations, but the differences were not statistically significant (all P>0.05), and there was no statistically significant difference in the proportions of patients with EGFR and KRAS gene mutations among patients with different TNM stages, T stages and N stages (all P > 0.05). The median follow-up time was 51 months (range: 14-96 months). The difference in DFS among patients with different N stages was statistically significant ( P= 0.002), and the DFS of N 0 stage was better than that of N 1, N 2 and N 3 stages, and the differences were statistically significant (all P < 0.05). The median DFS time of N 0, N 1 and N 2 stages was 44.4, 17.5 and 23.9 months, respectively, and the median DFS time of N 3 stage (1 case) was 8.7 months. Patients with different TNM stages had a tendency to have differences in DFS, but the difference was not statistically significant ( P = 0.060); the difference in DFS between patients with different pathological components was not statistically significant ( P = 0.177); patients without pleural invasion had a tendency to have better DFS than patients with pleural invasion, but the difference was not statistically significant ( P = 0.252). The difference in DFS between patients with and without driver gene EGFR and KRAS mutations was not statistically significant ( P = 0.809), and further subgroup analysis showed that the difference in DFS among mutated patients with different TNM stages was not statistically significant ( P = 0.684). Conclusions:The driver gene EGFR and KRAS mutations are more common in patients with early LASC; DFS may be related to TNM stage and N stage, but may not be related to the mutation status of EGFR and KRAS genes, the type of pathology, or whether or not the pleura is invaded.Objective To investigate the driver gene mutation status and prognostic influencing factors in patients with operable lung adenosquamous carcinoma (LASC). Methods A retrospective case series study was conducted. Clinical and pathologic data were retrospectively collected from patients with LASC who underwent surgical treatment at the Second Affiliated Hospital of Air Force Military Medical University from January 2008 to December 2018, and the patients' surgically resected specimens were sequenced for epidermal growth factor receptor (EGFR) and Kirsten rat sarcoma (KRAS) genes. The distribution of driver gene EGFR and KRAS mutations in patients was analyzed, and the differences in the distribution of mutations among patients stratified by clinical factors were compared; disease-free survival (DFS) of patients stratified by clinical factors was analyzed by the Kaplan-Meier method, and the comparison between groups was performed by the log-rank test. Results A total of 106 patients were included, including 64 (60.4%) males and 42 (39.6%) females, aged (58±10) years old. Patients with EGFR and KRAS gene mutations accounted for 38.7% (41/106), of which 33.0% (35/106) were patients with EGFR mutations and 5.7% (6/106) were patients with KRAS mutations. The EGFR mutation loci included 19del, L858R, L861Q and 20in, and the KRAS mutation loci included G12A, G12D, G12C and G12V. Patients aged ≤65 years old, female, with lesions in the lower lobe of the left lung, non-squamous cell carcinoma as the main pathological component, and with a smoking index of <400 were more likely to have EGFR and KRAS gene mutations, but the differences were not statistically significant (all P>0.05), and there was no statistically significant difference in the proportions of patients with EGFR and KRAS gene mutations among patients with different TNM stages, T stages and N stages (all P > 0.05). The median follow-up time was 51 months (range: 14-96 months). The difference in DFS among patients with different N stages was statistically significant ( P= 0.002), and the DFS of N 0 stage was better than that of N 1, N 2 and N 3 stages, and the differences were statistically significant (all P < 0.05). The median DFS time of N 0, N 1 and N 2 stages was 44.4, 17.5 and 23.9 months, respectively, and the median DFS time of N 3 stage (1 case) was 8.7 months. Patients with different TNM stages had a tendency to have differences in DFS, but the difference was not statistically significant ( P = 0.060); the difference in DFS between patients with different pathological components was not statistically significant ( P = 0.177); patients without pleural invasion had a tendency to have better DFS than patients with pleural invasion, but the difference was not statistically significant ( P = 0.252). The difference in DFS between patients with and without driver gene EGFR and KRAS mutations was not statistically significant ( P = 0.809), and further subgroup analysis showed that the difference in DFS among mutated patients with different TNM stages was not statistically significant ( P = 0.684). Conclusions The driver gene EGFR and KRAS mutations are more common in patients with early LASC; DFS may be related to TNM stage and N stage, but may not be related to the mutation status of EGFR and KRAS genes, the type of pathology, or whether or not the pleura is invaded.