Objective:To explore the application value of dynamic monitoring of serum thyroid hormone(THs)levels in assessing the condition changes and prognosis of elderly patients with sepsis.Methods:Using a retrospective cohort study,a total of 120 elderly critically ill patients hospitalized in the Department of Critical Care Medicine from April 2020 to April 2023 were selected as research subjects,divided into a sepsis group(60 cases)and a non-sepsis group(60 cases).Sepsis patients were further divided into a survival group(43 cases)and a death group(17 cases)based on 28-day survival status.Serum THs,PCT,IL-6,and Lac were measured on the 1st,5th,and 10th days of hospitalization(d1,d5,dl0)for sepsis patients,and the Sequential Organ Failure Assessment(SOFA)score and Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score were recorded.The datas of non-sepsis patients were sampled on d1.The incidence of non-thyroidal illness syndrome(NTIS)was statistically analyzed,and the dynamic changes of serum THs among different groups were compared.The correlation between THs and disease severity,as well as the predictive value of THs for 28-day mortality in sepsis,was analyzed.Results:①The incidence of NTIS was 78.33％(94/120),with a significantly higher incidence in sepsis patients(96.67％,58/60)compared to non-sepsis patients(60.00％),with statistical significance(P＜0.05).②Compared to non-sepsis patients,sepsis patients had significantly lower levels of TSH,T3,FT3,and T4 on d1,while rT3 was significantly elevated,with statistical significance(P＜0.05);the difference in FT4 levels was not statistically significant(P＞0.05).Pearson correlation analysis showed that T3 and T4 were negatively correlated with SOFA and APACHE Ⅱ scores(P＜0.05),while other THs indicators showed no correlation with SOFA and APACHE Ⅱ scores(P＞0.05).ANOVA results indicated that there was no statistically significant difference in T4 levels at the three time points,and its changes showed no obvious linear trend over time(P＞0.05);T3 was significantly lower on d1 than on d5 and d10,and showed an increasing trend with longer hospitalization,while SOFA and APACHE Ⅱ scores were significantly higher on d1 than on d5 and d10,showing a decreasing trend with longer hospitalization(all P＜0.05).③Compared to the survival group of sepsis patients,the death group had significantly higher levels of PCT on d10,IL-6 on d5 and d10,and Lac on d1,d5,and d10(P＜0.05).The death group had significantly lower levels of T3 and T4 on d1,significantly lower levels of TSH,T3,T4,and FT4 on d5,and significantly lower levels of TSH,T3,FT3,T4,and FT4 on d10,with statistical significance(P＜0.05).④Logistic regression analysis showed that independent risk factors for 28-day mortality in sepsis patients included T3 on d1 and T3,FT3,T4,FT4,and IL-6 on d10,with statistical significance(P＜0.05).ROC curve analysis indicated that serum levels of T3,FT3,T4,and FT4 on d10 had certain predictive value for 28-day mortality in sepsis patients(all P＜0.05),with T3,FT3,and FT4 showing good predictive value,and their AUCs were 0.875,0.872,and 0.861,respectively.The combined AUC for predicting 28-day mortality in sepsis patients using T3,FT3,and FT4 on d10 increased to 0.902.Conclusion:The incidence of NTIS was high in elderly sepsis patients,and the serum THs levels and their dynamic changes were closely related to the patients'condition changes.Continuous dynamic monitoring of serum THs levels could help to assess the progression of sepsis,and T3 may serve as an indicator for evaluating the progression and prognosis of sepsis.

Immune checkpoint inhibitor-related pneumonitis(CIP)is a relatively common immune-related adverse event.The current treatment for CIP mainly relies on glucocorticoids,with 70％～80％of patients being controlled by conventional glucocorticoid therapy.However,steroid-unresponsive CIP is often se-vere and can be life-threatening.There is no standard treatment protocol for steroid-unresponsive CIP,highlighting a significant unmet clinical need.This paper reviews the diagnosis,treatment progress,and exploratory research of steroid-unresponsive CIP to provide evidence-based guidelines and directions for clinical and translational research.

Objective:To explore the application value of dynamic monitoring of serum thyroid hormone(THs)levels in assessing the condition changes and prognosis of elderly patients with sepsis.Methods:Using a retrospective cohort study,a total of 120 elderly critically ill patients hospitalized in the Department of Critical Care Medicine from April 2020 to April 2023 were selected as research subjects,divided into a sepsis group(60 cases)and a non-sepsis group(60 cases).Sepsis patients were further divided into a survival group(43 cases)and a death group(17 cases)based on 28-day survival status.Serum THs,PCT,IL-6,and Lac were measured on the 1st,5th,and 10th days of hospitalization(d1,d5,dl0)for sepsis patients,and the Sequential Organ Failure Assessment(SOFA)score and Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score were recorded.The datas of non-sepsis patients were sampled on d1.The incidence of non-thyroidal illness syndrome(NTIS)was statistically analyzed,and the dynamic changes of serum THs among different groups were compared.The correlation between THs and disease severity,as well as the predictive value of THs for 28-day mortality in sepsis,was analyzed.Results:①The incidence of NTIS was 78.33％(94/120),with a significantly higher incidence in sepsis patients(96.67％,58/60)compared to non-sepsis patients(60.00％),with statistical significance(P＜0.05).②Compared to non-sepsis patients,sepsis patients had significantly lower levels of TSH,T3,FT3,and T4 on d1,while rT3 was significantly elevated,with statistical significance(P＜0.05);the difference in FT4 levels was not statistically significant(P＞0.05).Pearson correlation analysis showed that T3 and T4 were negatively correlated with SOFA and APACHE Ⅱ scores(P＜0.05),while other THs indicators showed no correlation with SOFA and APACHE Ⅱ scores(P＞0.05).ANOVA results indicated that there was no statistically significant difference in T4 levels at the three time points,and its changes showed no obvious linear trend over time(P＞0.05);T3 was significantly lower on d1 than on d5 and d10,and showed an increasing trend with longer hospitalization,while SOFA and APACHE Ⅱ scores were significantly higher on d1 than on d5 and d10,showing a decreasing trend with longer hospitalization(all P＜0.05).③Compared to the survival group of sepsis patients,the death group had significantly higher levels of PCT on d10,IL-6 on d5 and d10,and Lac on d1,d5,and d10(P＜0.05).The death group had significantly lower levels of T3 and T4 on d1,significantly lower levels of TSH,T3,T4,and FT4 on d5,and significantly lower levels of TSH,T3,FT3,T4,and FT4 on d10,with statistical significance(P＜0.05).④Logistic regression analysis showed that independent risk factors for 28-day mortality in sepsis patients included T3 on d1 and T3,FT3,T4,FT4,and IL-6 on d10,with statistical significance(P＜0.05).ROC curve analysis indicated that serum levels of T3,FT3,T4,and FT4 on d10 had certain predictive value for 28-day mortality in sepsis patients(all P＜0.05),with T3,FT3,and FT4 showing good predictive value,and their AUCs were 0.875,0.872,and 0.861,respectively.The combined AUC for predicting 28-day mortality in sepsis patients using T3,FT3,and FT4 on d10 increased to 0.902.Conclusion:The incidence of NTIS was high in elderly sepsis patients,and the serum THs levels and their dynamic changes were closely related to the patients'condition changes.Continuous dynamic monitoring of serum THs levels could help to assess the progression of sepsis,and T3 may serve as an indicator for evaluating the progression and prognosis of sepsis.

Objective To explore the relationship between dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)and clinical pathological features of invasive breast cancer and lymphovascular invasion(LVI).Methods Imaging and clinical pathological data were retrospectively collected from 508 patients with invasive breast cancer who underwent breast DCE-MRI at the First Medical Center of Chinese PLA General Hospital from January 2019 to August 2021.Patients were divided into the LVI-positive(LVI+)group(n=79)and LVI-negative(LVI-)group(n=429)based on postoperative pathological results.Univariate and multivariate logistic regression analyses were used to identify risk factors for LVI.Results Compared with LVI-group,LVI+group had a higher proportion of patients aged<45 years(44.3%vs.27.0%,P=0.002),non-mass-like enhancement(NME)(31.7%vs.17.7%,P=0.004),Ki-67 expression rate(40.0%vs.30.0%,P<0.001),high Ki-67 expression(94.9%vs.78.1%,P=0.001),Luminal B subtype(76.0%vs.60.1%,P=0.008),and positive axillary lymph nodes rate(72.2%vs.31.5%,P<0.001),while the proportion of Luminal A subtype was lower(2.5%vs.21.5%,P<0.001).Univariate and multivariate logistic regression analyses showed that age≥45 years(OR=0.468,95%CI 0.280-0.783,P=0.004)was an independent protective factor for LVI,while NME(OR=1.987,95%CI 1.126-3.444,P=0.016)was an independent risk factor.Compared with Luminal A subtype,patients with Luminal B subtype(OR=10.482,95%CI 3.164-64.923,P=0.001),HER-2 overexpression subtype(OR=11.571,95%CI 2.755-79.341,P=0.003)and triple-negative subtypes(OR=8.433,95%CI 1.985-57.908,P=0.009)had a higher risk of LVI.Conclusions Age≥45 years is an independent protective factor for LVI,while NME is an independent risk factor.Among molecular subtypes,patients with Luminal B,HER-2 overexpression and triple-negative subtypes have a higher risk of LVI compared with the Luminal A subtype.

With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.

Objective:To explore the correlation between serum ferritin(SF)levels and the efficacy of platelet transfusion in patients with malignant hematological diseases.Methods:Patients with malignant hematological diseases who received repeated transfusions of apheresis platelets in Department of Hematology of Aerospace Center Hospital in 2023 were selected.The platelet corrected count increment(CCI)was used to evaluate the efficacy of platelet transfusion.The correlations between sex,age,disease type,transplantation history,red blood cell transfusion history,and SF level and the efficacy of platelet transfusion were analyzed.Results:A total of 87 patients were included,with a cumulative 326 person-times platelet transfusions.As suggested by one-way analysis of variance,compared with the patients in the age groups of 24-45 years old and 46-66 years old,the patients in the age group of 2-23 years old had a better efficacy of platelet transfusion(P=0.004,P=0.004).There was no significant difference in the efficacy of platelet transfusion between the patients in the age group of 24-45 years old and those in the age group of 46-66 years old(P=0.876).Compared with the patients who had a history of red blood cell transfusion within 3 days,the patients without a history of red blood cell transfusion within 3 days had a better efficacy of platelet transfusion(P＜0.001).Compared with the groups with SF levels of 1.44-2.78 ng/L and＞2.78 ng/L,the group with SF levels＜1.44 ng/L had a better efficacy of platelet transfusion(P=0.028,P＜0.001).Compared with the group with SF levels＞2.78 ng/L,the group with SF levels of 1.44-2.78 ng/L had a better efficacy of platelet transfusion(P=0.001).After adjusting for age and the history of red blood cell transfusion,the transfusion efficacy of the group with SF levels＜1.44 ng/L was better than that of the groups with SF levels of 1.44-2.78 ng/L and＞2.78 ng/L(P=0.021,P＜0.001);Compared with the group with SF levels＞2.78 ng/L,the group with SF levels of 1.44-2.78 ng/L had a better efficacy of platelet transfusion(P=0.001).Both univariate and multivariate linear regression models showed that SF levels were negatively correlated with the efficacy of platelet transfusion(P＜0.001).Conclusion:There is a negative correlation between SF levels and the efficacy of platelet transfusion in patients with malignant hematological diseases.Detection of SF levels may provide guidance for predicting the efficacy of platelet transfusion.

Objective:To investigate the predictive value of endothelial activation and stress index(EASIX)for the prognosis of patients with mantle cell lymphoma(MCL).Methods:A retrospective analysis was conducted to assess prognosis and compare the clinical features of patients diagnosed with MCL who were admitted to the Affiliated Hospital of Xuzhou Medical University from January 2010 to June 2023,had therapeutic indications and received standard treatment.Results:A total of 66 patients were included and divided into high EASIX group and low EASIX group,according to a cutoff value of 0.97 determined by the receiver operating characteristic(ROC)curve.Multivariate Cox regression analysis showed that prealbumin＜0.2 g/L,high EASIX,and ECOG PS score ≥2 were independent risk factors influencing overall survival(OS)in MCL patients.The median OS of patients in the high and low EASIX group was 13.0 and 37.5 months,and the median progression-free survival was 8.8 and 26.0 months,respectively.The proportions of patients with ECOG PS score ≥2 and prealbumin＜0.2 g/L at onset significantly increased in the high EASIX group compared to those in the low EASIX group.Conclusion:At the time of initial diagnosis,EASIX can serve as an independent prognostic indicator impacting OS in patients with MCL.Furthermore,patients in the high EASIX group experience a poorer prognosis and shorter survival duration compared with those in the low EASIX group.

Immune checkpoint inhibitor-related pneumonitis(CIP)is a relatively common immune-related adverse event.The current treatment for CIP mainly relies on glucocorticoids,with 70％～80％of patients being controlled by conventional glucocorticoid therapy.However,steroid-unresponsive CIP is often se-vere and can be life-threatening.There is no standard treatment protocol for steroid-unresponsive CIP,highlighting a significant unmet clinical need.This paper reviews the diagnosis,treatment progress,and exploratory research of steroid-unresponsive CIP to provide evidence-based guidelines and directions for clinical and translational research.

Objective:To explore the correlation between serum ferritin(SF)levels and the efficacy of platelet transfusion in patients with malignant hematological diseases.Methods:Patients with malignant hematological diseases who received repeated transfusions of apheresis platelets in Department of Hematology of Aerospace Center Hospital in 2023 were selected.The platelet corrected count increment(CCI)was used to evaluate the efficacy of platelet transfusion.The correlations between sex,age,disease type,transplantation history,red blood cell transfusion history,and SF level and the efficacy of platelet transfusion were analyzed.Results:A total of 87 patients were included,with a cumulative 326 person-times platelet transfusions.As suggested by one-way analysis of variance,compared with the patients in the age groups of 24-45 years old and 46-66 years old,the patients in the age group of 2-23 years old had a better efficacy of platelet transfusion(P=0.004,P=0.004).There was no significant difference in the efficacy of platelet transfusion between the patients in the age group of 24-45 years old and those in the age group of 46-66 years old(P=0.876).Compared with the patients who had a history of red blood cell transfusion within 3 days,the patients without a history of red blood cell transfusion within 3 days had a better efficacy of platelet transfusion(P＜0.001).Compared with the groups with SF levels of 1.44-2.78 ng/L and＞2.78 ng/L,the group with SF levels＜1.44 ng/L had a better efficacy of platelet transfusion(P=0.028,P＜0.001).Compared with the group with SF levels＞2.78 ng/L,the group with SF levels of 1.44-2.78 ng/L had a better efficacy of platelet transfusion(P=0.001).After adjusting for age and the history of red blood cell transfusion,the transfusion efficacy of the group with SF levels＜1.44 ng/L was better than that of the groups with SF levels of 1.44-2.78 ng/L and＞2.78 ng/L(P=0.021,P＜0.001);Compared with the group with SF levels＞2.78 ng/L,the group with SF levels of 1.44-2.78 ng/L had a better efficacy of platelet transfusion(P=0.001).Both univariate and multivariate linear regression models showed that SF levels were negatively correlated with the efficacy of platelet transfusion(P＜0.001).Conclusion:There is a negative correlation between SF levels and the efficacy of platelet transfusion in patients with malignant hematological diseases.Detection of SF levels may provide guidance for predicting the efficacy of platelet transfusion.

Fecal microbiota transplantation (FMT) technology originated in China during the Eastern Jin Dynasty and has rapidly developed over the past two decades, becoming a primary method for studying the causal relationship between gut microbiota and the occurrence and progression of diseases. At the same time, the therapeutic effects of FMT in the field of gastrointestinal diseases have gained widespread recognition and are gradually expanding into other disease areas. The FMT procedure is relatively complex, and there is currently no standardized method; its success is influenced by various factors, including the donor, recipient, processing of the fecal material, and the method of implantation. Given the increasingly recognized relationship between gut microbiota and various diseases, FMT has become a research hotspot in both scientific studies and clinical applications, achieving a series of significant advancements. To help researchers better understand this technology, this paper will outline the development history of FMT, summarize common operational methods in research and clinical settings, review its application progress, and look forward to future development directions.