Objective: To comprehensively evaluate the clinical efficacy of a single dose of tranexamic acid (TXA) in reducing perioperative blood loss in patients undergoing craniomaxillofacial plastic and cosmetic surgery through meta-regression analysis. Methods: Embase, PubMed, Wanfang Data, VIP database, China National Knowledge Infrastructure (CNKI), the Chinese Clinical Trial Registry (ChiCTR) and Cochrane Central Register of Controlled Trials (CENTRAL) were electronically retrieved to collect clinical studies evaluating efficacy of perioperative TXA administration in patients undergoing craniomaxillofacial plastic and cosmetic surgery, from inception to August 2024. Quality assessment of randomized controlled trials (RCTs) was performed using Cochrane Collaboration's Risk of Bias Tool. Based on the results of methodological heterogeneity, corresponding meta-analyses were conducted using either random-effects or fixed-effects models in R programming software. Results: Thirty-one articles were included, involving 2 072 patients who underwent craniomaxillofacial plastic and cosmetic surgeries. Among these patients, 1 051 were in the TXA treatment group, and 1 021 were in the control group. The paired meta-analysis showed that compared with the control group, the use of TXA significantly reduced bleeding volume in perioperative patients [standardized mean difference (SMD)=-1.13; 95%CI (-1.47, -0.80), P<0.001]. Subgroup analysis revealed that TXA significantly reduced intraoperative bleeding volume in patients across different surgeries, with the order of efficacy as follows: orthognathic surgery [SMD=-1.44; 95%CI (-2.07, -0.80), P<0.001], cleft palate repair [SMD=-1.32; 95%CI (-2.14, -0.50), P<0.001], rhinoplasty [SMD=-0.97; 95%CI (-1.63, -0.30), P<0.001], and craniosynostosis [SMD=-0.96; 95%CI (-1.40, -0.53), P=0.040]. The result of the meta regression showed there was no significant difference in the hemostatic effect of TXA on patients with increasing doses (5, 10, 15, 20, 25 mg/kg) (P=0.650). Sensitivity analysis verified that the pooled values were stable and reliable. The Egger's test indicated a certain degree of publication bias (Z=-3.40, P<0.001). Conclusion: Existing evidence suggests that TXA effectively reduces perioperative blood loss in patients undergoing craniofacial plastic surgery, regardless of its dosage administered.

Objective To summarize the clinicopathological characteristics,diagnostic and therapeutic process and aeromedical evaluation of 17 cases of thyroid cancer in Chinese military pilots in order to provide a reference for the diagnosis and treatment of disease and aeromedical evaluation of patients with thyroid cancer in military pilots in the future.Methods A retrospective analysis was conducted on the clinicopathological characteristics,treatment methods and aerospace medical evaluation conclusions of 17 military pilots with thyroid cancer who were hospitalized and underwent diagnosis,treatment and aeromedical evaluation at the Department of Aviation Medicine of Xijing Hospital from March 2021 to March 2025.Results All 17 pilots with thyroid cancer were male,and the age of onset ranged from 22 to 51 years old(with a median age of 40 years old).All patients underwent fine-needle aspiration biopsy of thyroid nodules or enlarged cervical lymph nodes before the operation.The postoperative pathological types were all papillary thyroid carcinoma.Among them,16 cases were papillary thyroid microcarcinoma,9 cases were combined with regional lymph node metastasis,and 1 case with postoperative complications of Horner's syndrome recovered after treatmentwas.14 patients underwent unilateral glandular lobe and isthectomy of the thyroid,3 patients underwent total/near-total thyroidectomy,2 patients received radioactive 131I treatment after the operation,and 17 patients received thyroid stimulating hormone(TSH)suppression therapy after the operation.After aerospace medical evaluation,15 cases were qualified for flight duties,the observation time was 3 to 6 months(with an average observation time of 4.2 months),1 case reached the age limit,and 1 case was temporarily unqualified for failure to achieve TSH suppression.After 0.5 to 4.0 years of follow-up,no patient showed signs of recurrence or metastasis.Conclusion For thyroid cancer in military pilots,universal screeningprotocols and earlydetection,as well as standardized therapeutic regimensshould be carried out.Evidence-based aeromedical evaluations and long-term monitoring should be conducted based on the aircraft type,jobs,and flight experience to preserve military combat effectiveness to the greatest extent.

Metastatic castration-resistant prostate cancer (mCRPC) is often resistant to conventional therapies, and prostate-specific membrane antigen (PSMA)-targeted radionuclide therapy has emerged as a promising therapeutic strategy. Ligands such as 177Lu-PSMA and 225Ac-PSMA have demonstrated clinical benefits in ongoing studies and show potential when combined with endocrine therapy, chemotherapy, immunotherapy, and radiotherapy. Additionally, novel therapeutic approaches, including PSMA-targeted antibody-drug conjugates (ADCs), chimeric antigen receptor T-cell (CAR-T) therapy, and bispecific T-cell engagers (BiTEs), are being actively explored. This review summarizes the recent advancements in PSMA-targeted treatment and their clinical applications.

Metastatic castration-resistant prostate cancer (mCRPC) is often resistant to conventional therapies, and prostate-specific membrane antigen (PSMA)-targeted radionuclide therapy has emerged as a promising therapeutic strategy. Ligands such as 177Lu-PSMA and 225Ac-PSMA have demonstrated clinical benefits in ongoing studies and show potential when combined with endocrine therapy, chemotherapy, immunotherapy, and radiotherapy. Additionally, novel therapeutic approaches, including PSMA-targeted antibody-drug conjugates (ADCs), chimeric antigen receptor T-cell (CAR-T) therapy, and bispecific T-cell engagers (BiTEs), are being actively explored. This review summarizes the recent advancements in PSMA-targeted treatment and their clinical applications.

Sphingomyelin phosphodiesterase 3 (SMPD3) encodes neutral sphingomyelinase 2 (nSMase2), which plays an important role in tumor development as a key enzyme regulating cell growth variation and inducing apoptosis with the important messenger molecule ceramide. On one hand, the common epigenetic alteration of SMPD3 methylation mediates carcinogenesis through the disruption of gene expression by regulating cell proliferation, differentiation, and apoptosis. Meanwhile, SMPD3 also induces apoptosis and cell cycle arrest in tumor cells through its hydrolysis products. On the other hand, SMPD3 is also closely related to pro-cancer processes such as exosome secretion, inflammatory response, and tumor cell proliferation. In this paper, the biological action of SMPD3 in tumor diseases was reviewed to enhance the understanding of the role of SMPD3 in the development of different tumors and provide broader ideas for basic research and clinical diagnosis and treatment of tumor diseases.

Clonorchis sinensis is considered a class I carcinogen for cholangiocarcinoma, but an increasing number of studies have found that it is also closely associated with hepatocellular carcinoma. This paper reviews the discovery and prevalence, historical studies, key regional studies, animal models and complications of Clonorchis sinensis, and summarizes the possible molecular mechanisms of Clonorchis sinensis contributing to hepatocellular carcinoma development, in order to gain insight into the correlation between Clonorchis sinensis and hepatocellular carcinoma, and thus to provide new ideas for the study of the effects of Clonorchis sinensis infection on hepatocellular carcinoma.

The onset of primary hepatic carcinoma (PHC) is usually occult, and early symptoms are not obvious. Most patients are at advanced stages of disease at diagnosis, and the prognosis is poor. Paraneoplastic syndrome (PNS) refers to the clinical manifestations indirectly caused by tumor metabolites or abnormal immune reactions that cannot be explained by the primary lesion, local tumor spread or distant metastasis. Hypercholesterolemia, hypercalcemia and hypoglycemia are the most commonly seen clinical presentations of PNS in PHC patients. Adequate understanding of PNS is of great importance in early diagnosis and treatment of PHC. In this review, we summarized the clinical manifestations and prognostic mechanisms of PNS in patients with PHC.

Objective:To study the relationship between preoperative serum carbohydrate antigen 19-9 (CA19-9) levels and long-term prognosis after partial hepatectomy in patients with hepatocellular carcinoma (HCC).Methods:The clinical data of 1102 patients with HCC who underwent partial hepatectomy at the Affiliated Tumor Hospital of Guangxi Medical University from January 2012 to December 2017 were retrospectively analyzed. There were 960 males and 142 females, with an average age of 51 years. The X-tile software determined the best cut-off value of CA19-9 to be 55U/ml. The enrolled patients were then divided into the low-level (CA19-9≤55 U/ml, n=956) and high-level (CA19-9 >55 U/ml, n=146) groups. The Kaplan-Meier method was used to analyze survival, and the log-rank test was performed to evaluate survival rates. The prognostic risk factors of HCC were calculated by the Cox proportional hazards model. Results:The 1, 3, and 5-year survival rates for the low-level group were 85.0%, 68.2%, and 60.9%, respectively, which were significantly higher than those of the high-level group of 80.1%, 58.2%, and 47.0%, respectively ( P<0.05) . The 1, 3, and 5-year recurrence-free survival rates of the low level group were 60.5%, 44.6%, and 37.9% respectively, which were significantly higher than those in the high-level group of 53.4%, 33.3%, and 25.1%, respectively ( P<0.05). Cox regression analysis showed that patients with CA19-9 >55 U/ml ( HR=1.323, 95% CI: 1.070-1.636, P=0.010) had a higher risk of recurrence after hepatectomy, while patients with CA19-9 >55 U/ml ( HR=1.511, 95% CI: 1.163-1.964, P=0.002) had a poor prognosis after hepatectomy. Conclusions:Preoperative serum level of CA19-9>55 U/ml was an independent risk factor for survival and recurrence of HCC patients after partial hepatectomy. CA19-9 had a significant predictive value for prognosis of HCC patients who underwent partial hepatectomy.

Objective To explore the effect of quality control circles (QCCs) in improving the delivery health checkup report.Methods QCC was founded with the theme of"improving the quality of health checkup report delivery."First,we planned an activity schedule and identified topics.We then set target focuses for service personnel,distribution modes,and operating environments;planned countermeasures;and selected optimal policies.Circle members implemented the optimal policies jointly.Reports of physical examinations by the Guoyu health management center were selected and analyzed.The total number of reports before improvement (January to December 2015) was 59 189 of which 34 549 (58.4％) were male patients and 24 640 (41.6％) were female patients;their average age was (37.7± 11.4) years.The total number of reports after improvement (December 2016 to January 2017) was 6 568,of which 3 881 (59.1％) were male patients and 2 687(40.9％) were female patients;their average age was (39.9± 11.7) years.We compared the quality indicators and evaluated the comprehensive quality of the patients before and after improvement.A total of 65 531 physical examination reports of subjects examined at the center between February and December 2017 were selected for effect tracking,including 39 230 (59.9％) men and 26 301(40.1％) women,aged (38.1±11.5).Results The on-time delivery rate of the health examination reports from rose from 51.4％ to 94.0％.The ratio of system leakage to sign for reports decreased from 14.5％ to 0.8％.The average time between the examination and when each report was handed over to for distribution decreased from 29.8 hours to 4.2 hours,and the average time between each report being distributed to the providers checking in dropped from 509.8 hours to 72.8 hours,while the average time for the preparation of each report for delivery decreased from 13.5 seconds to 3.1 seconds.The average time between delivery of a report and its being signed decreased from 4.3 seconds to 0.1 seconds.Before the improvement,the expected goals were not met.After improvement,the delivery rate of the health examination reports was 100.0％,the delivery intact rate of the group reports was 100.0％,and the satisfaction rate of the group reports was 99.4％.The comprehensive quality for the members was obviously higher after the improvement than before.After 11 months of tracking,the delivery accuracy rate of health examination report still failed to reach the target value of 100.0％,but all other indicators reached the target value,with good results.Conclusions Application of QCC not only improved the delivery the health checkup reports,but also promoted service quality after medical examinations and ended medical dispute caused by the loss of physical examination reports.

Objective To compare the efficacy of CO2 laser and conventional laryngeal microsurgery in the treatment of benign lesions of vocal cord (polyp of vocal cord) and precancerous lesions (leukoplakia of vocal cord) of patients. Methods A total of 60 patients with vocal cord polyps were selected, and randomly divided into two groups, each with 30 patients. Thirty patients with vocal cord leukoplakia were selected and randomly divided into two groups, each with 15 patients. One group was performed by cold instruments for lesion resection (conventional group), the other by CO2 laser for removal of diseased tissue or mucosal ablative surgery (laser group). Two groups of patients were examined by laryngostroboscope, electronic laryngoscopy, GRABS, VHI subjective ratings and objective voice analysis before operation and one week, one month and three months after operation. ResuIts The outcomes of those with vocal cord polyps in early recovery (1 week) laser group were slightly worse than the conventional group. In later recovery (1~3 months), with electronic laryngoscopy inspection, laryngostroboscope mucosal wave observation, the analysis of subjective and objective data from the two groups showed no significantly differences. For patients with vocal cord leukoplakia in early recovery (1 week), laser group slightly worse than the conventional group, in later recovery (1~3 months), there were no obvious difference between the two groups in electronic laryngoscopy inspection, laryngostroboscope mucosal wave observation, the analysis of subjective and ob_jective data. Follow -up operations, the recurrence rates in laser group was significantly lower than conventional group. ConcIusion The treatment by CO2 laser can significantly improve their pronunciation quality for vocal cord polyps and vocal cord leukoplakia patients, it has a good therapeutic effect, especially the long-term effective of vo_cal cord leukoplakia is better than conventional operation.