The strategy of pelvic lymph node dissection in patients with localized intermediate- and high-risk prostate cancer（PCa）has been one of the research hotspots in recent years. This review synthesizes recent progress in clinical，diagnostic imaging and immunological aspects of pelvic lymph node dissection.It is found that the detection rate of metastatic lymph nodes in patients with localized intermediate-risk PCa is relatively low，and the survival benefit after dissection is not significant. PSMA PET/CT examination can be used instead of lymph node dissection for staging. Extended lymph node dissection in patients with localized high-risk PCa can achieve a higher detection rate of metastatic lymph nodes and possible survival benefits. However，excessive lymph node dissection can weaken the response ability to immunotherapy. The strategy for pelvic lymph node dissection in patients with localized intermediate-high-risk PCa needs further study.

Objective:To explore the value of multiparametric ultrasonography，including grayscale ultrasound（US），color Doppler flow imaging（CDFI），and real-time shear wave elastography（SWE）in diagnosing mucosal healing（MH）in pediatric patients with Crohn's disease.Methods:This prospective study consecutively enrolled pediatric CD patients who underwent endoscopic examinations at Hunan Children's Hospital from January 2024 to August 2024. Based on the Simplified Endoscopic Score for Crohn's Disease（SES-CD），all intestinal segments were divided into two groups：the MH group and the non-mucosal healing（NMH）group. Differences in bowel wall thickness（BWT），bowel wall stratification，color Doppler grading，SWE values，and increased thickness of mesenteric fat were compared between the two groups. ROC curves were plotted to evaluate the diagnostic performance of each ultrasound parameter. Multivariate Logistic regression analysis was used to identify independent predictors of MH，and a regression model was developed based on these factors.Results:A total of 234 intestinal segments from 60 pediatric CD patients were included in the analysis，divided into the MH group（101 segments）and the NMH group（133 segments）.There were significant differences between the MH and NMH groups in terms of BWT，bowel wall stratification，color Doppler grading，SWE values，and increased thickness of mesenteric fat（all P<0.05）. The multivariate Logistic regression analysis identified BWT，color Doppler grading，and SWE values as independent predictors associated with MH（all P<0.05）.The area under the ROC curve was 0.906（95% CI = 0.867 - 0.945， P＜0.05），with a sensitivity of 0.865 and specificity of 0.851. Conclusions:Multiparametric ultrasonography can effectively assess MH in pediatric CD patients，providing critical information for accurate clinical evaluation of disease status and treatment outcomes.

The strategy of pelvic lymph node dissection in patients with localized intermediate- and high-risk prostate cancer（PCa）has been one of the research hotspots in recent years. This review synthesizes recent progress in clinical，diagnostic imaging and immunological aspects of pelvic lymph node dissection.It is found that the detection rate of metastatic lymph nodes in patients with localized intermediate-risk PCa is relatively low，and the survival benefit after dissection is not significant. PSMA PET/CT examination can be used instead of lymph node dissection for staging. Extended lymph node dissection in patients with localized high-risk PCa can achieve a higher detection rate of metastatic lymph nodes and possible survival benefits. However，excessive lymph node dissection can weaken the response ability to immunotherapy. The strategy for pelvic lymph node dissection in patients with localized intermediate-high-risk PCa needs further study.

Objective:To explore the value of multiparametric ultrasonography，including grayscale ultrasound（US），color Doppler flow imaging（CDFI），and real-time shear wave elastography（SWE）in diagnosing mucosal healing（MH）in pediatric patients with Crohn's disease.Methods:This prospective study consecutively enrolled pediatric CD patients who underwent endoscopic examinations at Hunan Children's Hospital from January 2024 to August 2024. Based on the Simplified Endoscopic Score for Crohn's Disease（SES-CD），all intestinal segments were divided into two groups：the MH group and the non-mucosal healing（NMH）group. Differences in bowel wall thickness（BWT），bowel wall stratification，color Doppler grading，SWE values，and increased thickness of mesenteric fat were compared between the two groups. ROC curves were plotted to evaluate the diagnostic performance of each ultrasound parameter. Multivariate Logistic regression analysis was used to identify independent predictors of MH，and a regression model was developed based on these factors.Results:A total of 234 intestinal segments from 60 pediatric CD patients were included in the analysis，divided into the MH group（101 segments）and the NMH group（133 segments）.There were significant differences between the MH and NMH groups in terms of BWT，bowel wall stratification，color Doppler grading，SWE values，and increased thickness of mesenteric fat（all P<0.05）. The multivariate Logistic regression analysis identified BWT，color Doppler grading，and SWE values as independent predictors associated with MH（all P<0.05）.The area under the ROC curve was 0.906（95% CI = 0.867 - 0.945， P＜0.05），with a sensitivity of 0.865 and specificity of 0.851. Conclusions:Multiparametric ultrasonography can effectively assess MH in pediatric CD patients，providing critical information for accurate clinical evaluation of disease status and treatment outcomes.

Dilated cardiomyopathy is a heterogeneous myocardial disease, clinically characterized by progressive heart failure, arrhythmia, thromboembolism, and sudden death. Cardiomyopathy is mainly myocardial hypertrophy and myocardial fibrosis. The pathogenesis may be related to immune response, virus infection, and genetic factors. This article reviews the common causes and signaling pathways of dilated cardiomyopathy, providing theoretical basis for the treatment of dilated cardiomyopathy and also provide direction and perspective for the diagnosis and treatment of chronic Keshan disease.

Objective To investigate the predictive value of serum placental growth factor(PLGF)/soluble fms-like tyrosine kinase-1(sFlt-1),combined with the placental three-dimensional energy Doppler index(3D-PDI)in preeclampsia(PE).Methods From January 2021 to December 2022,120 pregnant women with PE risk factors were selected and followed up until 1 week after delivery.Serum PLGF and sFlt-1 levels were measured at routine prenatal check-ups at 14 to 20 weeks gestation.The PLGF/sFlt-1 ratio was calculated,and placental 3D-PDI was detected by ultrasound,including the vascularization index(VI),blood flow index(FI),and vascularization-blood flow index(VFI).Based on whether PE occurred after 20 weeks of pregnancy,cases were divided into PE(55 cases)and control groups(65 cases).The PE group was further divided into mild PE(35 cases)and severe PE groups(20 cases)based on the severity of the di-sease.The differences in PLGF/sFlt-1 and 3D-PDI between the groups were compared in terms of a statistical analysis of the correlation between PLGF,sFlt-1,and 3D-PDI.The receiver operating characteristic curve(ROC)was plotted,and the predictive value of each index on PE alone or in combination was analyzed.Results The systolic blood pressure(SBP),diastolic blood pressure(DBP),24 h protein-uria level,preterm birth rate,NICU admission rate,and preconception BMI in the PE group were higher than those in the control group(P＜0.05).The two groups had no differences in age,gestational age,pregnancy history,and fertility history(P＞0.05).The serum PLGF/sFlt-1 of the PE group was lower than that of the control group,and the serum PLGF/sFlt-1 of the severe group was lower than that of the mild group(P＜0.05).The 3D-PDI index of the PE group was lower than that of the control group,and the 3D-PDI index of the severe group was lower than that of the mild group(P＜0.05).Pearson's correlation analysis indicated that PLGF and VFI were signifi-cantly positively correlated(P＜0.01),and sFlt-1 was significantly negatively correlated with VFI(P＜0.01).ROC curve analysis showed that PLGF/sFlt-1,VI,FI,and VFI all had predictive value for PE and the value of VI,FI,and VFI jointly predicted PE,and was higher than that of various parameters(AUC = 0.951).Serum PLGF/sFlt-1,VI,FI,and VFI combined predicted the highest value(AUC=0.987).Conclusion In patients with PE,serum PLGF,sFlt-1,and placental VFI are significantly correlated.Serum PLGF/sFlt-1,placenta VI,FI,and VFI are reduced in early pregnancy,and the combined application of the four indicators has the highest efficacy in predicting PE,providing a possible reference for the early clinical screening or prediction of PE.

To have better clinical understanding of Schimke immuno-osseous dysplasia(SIOD) through analyzing the clinical features, treatment, and prognosis of four patients with SIOD.

Mutations in the SAMD9 and SAMD9L genes are associated with MIRAGE syndrome and ATXPC syndrome, respectively. This study reports the clinical characteristics and genetic analysis of one case with SAMD9 mutation (c.3809T > A, p.F1270Y) and two cases with SAMD9L mutations (c.2675T > G, p.M892R; c.1096T > G, p.F366V and c.4517T > C, p.L1506p), none of which have been previously reported. All patients presented with recurrent infections, growth retardation, and myelodys-plasia, with varying degrees of involvement of multiple systems, including respiratory, gastrointestinal, immune, endocrine, neurological, and reproductive systems. In terms of treatment, two patients underwent regular intravenous immunoglobulin and their clinical symptoms improved, while one patient had a favorable recovery following hematopoietic stem cell transplantation at the age of 1 year and 5 months of age. SAMD9/SAMD9L gene mutations, therefore, chould be considered in children with recurrent infections, myelodysplasia, pancytopenia, and growth retardation. Early genetic testing is crucial for timely diagnosis and treatment, which may improve patient outcomes.

H 1-antihistamines are widely used in the treatment of various allergic diseases, but there are still many challenges in the safe and rational use of H 1-antihistamines in pediatrics, and there is a lack of guidance on the prescription review of H 1-antihistamines for children.In this paper, suggestions are put forward from the indications, dosage, route of administration, pathophysiological characteristics of children with individual difference and drug interactions, so as to provide reference for clinicians and pharmacists.

Objective To understand the cognition，attitude and awareness on the prevention and control of COVID-19 among recent international travellers back to China（hereinafter referred to as the inbound group）and local residents（domestic group），and to provide scientific evidence for further prevention and control of the epidemic. Methods Using a questionnaire website，a questionnaire entitled “Investigation and analysis of residents’ knowledge，attitude，and practice on COVID-19”was prepared，with the targeted population of the survey being international travelers back to China and local residents who had been quarantined at home for 14 days in Jinqiao Town. Cluster sampling was used to conduct the survey through WeChat. The two groups were then compared using chi-square test by using SPSS 23.0. Results Between the two groups，the awareness on the respiratory droplet transmission and inactivation effectiveness by alcohol，peracetic acid and ultraviolet ray on the SARS-CoV-2 were statistically different（P < 0.05）. In the attitude towards prevention and control measures，there was significant difference between the two groups in selecting prevention and control plans for the whole population during the outbreak（P < 0.05）. In the comparison of behavior，there was a statistical difference between the two groups（P < 0.05）whether to maintain a distance of more than 1 meter in social communication. Regarding the choice of quarantine methods（stay-at-home，intensive quarantine and no quarantine），the difference between two groups was statistically significant（P < 0.05）. Conclusion In terms of the knowledge of COVID-19，attitude towards prevention and control measures，and their own behavior，there are some differences between the inbound group and domestic group.