Real-time, noninvasive programmed death-ligand 1 (PD-L1) testing using molecular imaging has enhanced our understanding of the immune environments of neoplasms and has served as a guide for immunotherapy. However, the utilization of radiotracers in the imaging of human brain tumors using positron emission tomography/computed tomography (PET/CT) remains limited. This investigation involved the synthesis of [¹⁸F]AlF-NOTA-PCP2, which is a novel peptide-based radiolabeled tracer that targets PD-L1, and evaluated its imaging capabilities in orthotopic glioblastoma (GBM) models. Using this tracer, we could noninvasively monitor radiation-induced PD-L1 changes in GBM. [¹⁸F]AlF-NOTA-PCP2 exhibited high radiochemical purity (>95%) and stability up to 4 h after synthesis. It demonstrated specific, high-affinity binding to PD-L1 in vitro and in vivo, with a dissociation constant of 0.24 nM. PET/CT imaging, integrated with contrast-enhanced magnetic resonance imaging, revealed significant accumulation of [¹⁸F]AlF-NOTA-PCP2 in orthotopic tumors, correlating with blood-brain barrier disruption. After radiotherapy (15 Gy), [¹⁸F]AlF-NOTA-PCP2 uptake in tumors increased from 9.51% ± 0.73% to 12.04% ± 1.43%, indicating enhanced PD-L1 expression consistent with immunohistochemistry findings. Fractionated radiation (5 Gy × 3) further amplified PD-L1 upregulation (13.9% ± 1.54% ID/cc) compared with a single dose (11.48% ± 1.05% ID/cc). Taken together, [¹⁸F]AlF-NOTA-PCP2 may be a valuable tool for noninvasively monitoring PD-L1 expression in brain tumors after radiotherapy.

Objective:To investigate the effects of spinal cord injury(SCI)on neuropathic pain(NP)and cognitive dysfunction in mice,as well as the activation of neurons in the anterior cingulate cortex(ACC),in order to provide experimental evidence for the connection between NP and cognitive dysfunction following SCI.Methods:Ten 8-week-old male C57BL/6J mice were used to prepare a model of spinal cord hemisection(SCI).Pain behavior and cognitive function of mice after SCI were assessed using von Frey,thermal stimulation,and Morris water maze behavioral experi-ments.Immunofluorescence staining were used to analyze the expression of c-Fos and GAD67/VGLUT2 positive cells in the anterior cingulate cortex(ACC)of the SCI model mice.Results:Compared with the Sham group,the SCI group of mice showed a significant decrease in mechanical threshold and thermal pain threshold(P＜0.05).The Morris water maze results indicated a significantly prolonged escape latency(P＜0.05)and a significant reduction in the use of search strategies for locating the hidden platform.Immunofluorescence results showed a significant increase in the num-ber of c-Fos positive cells in the ACC(P＜0.05),which were mainly co-labeled with excitatory neuron marker VGLUT2 positive cells.Conclusion:SCI leads to abnormal pain behavior and cognitive dysfunction in mice,and it induces the activation of neurons in the ACC,with a predominant activation of excitatory neurons.This study provides morphological evidence for the involvement of excitatory neurons in the ACC in the comorbidity of NP and cognitive impairment following SCI.

Objective:To explore the predictive value of the combined application of total prostate-specific antigen (TPSA), vascular endothelial growth factor A (VEGF-A), and interleukin (IL) in predicting postoperative biochemical recurrence in patients with prostate cancer.Methods:This study adopted a retrospective cohort research method. 202 male prostate cancer patients who visited Xi′an Gaoxin Hospital from April 2021 to January 2024 were selected as the research subjects. The age of the patients was 68(64, 71) years, and their postoperative conditions were classified into the non-recurrence group ( n=144) and the biochemical recurrence group ( n=58). The general clinical data and serumological test indicators SA, free prostate-specific antigen (FPSA), VEGF-A, IL-6, IL-17] were detected and compared between the two groups. Quantitative data with normal distribution were expressed as mean±standard deviation, and the comparison between groups was performed using the independent sample t-test; non-normal distribution quantitative data were expressed as M( Q1, Q3), and the comparison between groups was performed using the Mann-Whitney U test. The comparison between groups of count data was performed using the chi-square test. Through Spearman correlation analysis and multivariate Logistic regression analysis, the risk factors for biochemical recurrence after surgery in prostate cancer patients were screened out, and the efficacy of the combined prediction model based on TPSA, VEGF-A, and IL-17 was evaluated by receiver operating characteristic (ROC) curve, decision curve (DCA), and calibration curve. Results:The average tumor diameter, proportion of positive surgical margins, proportion of seminal vesicle invasion, and proportion of patients with Gleason score 3-5 in the biochemical recurrence group were significantly higher than those in the non-recurrence group ( P<0.05). The serumological indicators TPSA, VEGF-A, IL-6, IL-17 in the biochemical recurrence group were 44.28 (42.37, 48.57) ng/mL, (28.24±3.99) ng/mL, (39.14±2.95) ng/L and (66.64±6.04) pg/mL; those in the non-recurrence group were 41.25 (36.61, 43.56) ng/mL, (23.52±3.75) ng/mL, (37.19±4.19) ng/L, and (57.31±6.63) pg/mL. The biochemical recurrence group was higher than the non-recurrence group, and the difference was statistically significant ( P<0.05). Spearman correlation analysis and Logistic regression analysis found that TPSA, VEGF-A, and IL-17 were risk factors for biochemical recurrence after surgery in prostate cancer patients ( P<0.05); the DCA curve and calibration curve indicated that the combined prediction model based on TPSA, VEGF-A, and IL-17 had good accuracy (Hosmer-Lemeshow P=0.421), and the ROC curve suggested that the efficacy of the above indicators combined for predicting biochemical recurrence after surgery in prostate cancer patients was higher [AUC (95% CI)=0.899 (0.832-0.966)], and higher than the independent predictive efficacy of each indicator. Conclusion:Continuous monitoring of serum TPSA, VEGF-A, and IL-17 levels can effectively predict the risk of postoperative recurrence in prostate cancer patients and also provide biological markers for preventing disease recurrence.

Real-time,noninvasive programmed death-ligand 1(PD-L1)testing using molecular imaging has enhanced our understanding of the immune environments of neoplasms and has served as a guide for immunotherapy.However,the utilization of radiotracers in the imaging of human brain tumors using positron emission tomography/computed tomography(PET/CT)remains limited.This investigation involved the synthesis of[18F]AlF-NOTA-PCP2,which is a novel peptide-based radiolabeled tracer that targets PD-L1,and evaluated its imaging capabilities in orthotopic glioblastoma(GBM)models.Using this tracer,we could noninvasively monitor radiation-induced PD-L1 changes in GBM.[18F]AlF-NOTA-PCP2 exhibited high radiochemical purity(＞95％)and stability up to 4 h after synthesis.It demonstrated specific,high-affinity binding to PD-L1 in vitro and in vivo,with a dissociation constant of 0.24 nM.PET/CT imaging,integrated with contrast-enhanced magnetic resonance imaging,revealed significant accumulation of[18F]AlF-NOTA-PCP2 in orthotopic tumors,correlating with blood-brain barrier disruption.After radiotherapy(15 Gy),[18F]AlF-NOTA-PCP2 uptake in tumors increased from 9.51％±0.73％to 12.04％±1.43％,indicating enhanced PD-L1 expression consistent with immunohisto-chemistry findings.Fractionated radiation(5 Gy × 3)further amplified PD-L1 upregulation(13.9％±1.54％ID/cc)compared with a single dose(11.48％±1.05％ID/cc).Taken together,[18F]AlF-NOTA-PCP2 may be a valuable tool for noninvasively monitoring PD-L1 expression in brain tumors after radiotherapy.

Objective This study aims to develop and evaluate an emergency medical information management system for the medical rescue of mass casualties in public health emergencies at civil airports,focusing on on-site triage and emergency treatment.Methods A retrospective analysis was conducted to compare the effects of on-site emergency drills for mass-casualty rescue in public health emergencies at the Guangzhou Baiyun International Airport Emergency Center in 2018 and 2024.The 2018 drills involving 21 casualties for which conventional emergency medical rescue equipment and procedures were utilized were set as a control group,while the 2024 drills involving 19 casualties for which an emergency medical information processing system were set as an experimental group.Data were analyzed using descriptive epidemiology,chi-square test,and t-test in terms of in-jury conditions,triage time,and total transfer and handover time.By integrating the entire process and all elements to achieve in-formation-based handling in the practical emergency medical rescue drills,the role and advantages of the emergency medical in-formation processing system in scientific command,rapid response,rapid triage,and emergency treatment for mass casualties in public health emergencies were examined.Results The two drills had no difference in the number of casualties(x2=0.054,P=0.973).The time spent on casualty triage and the total time for transfer and handover in 2024 were significantly reduced com-pared with those in 2018(t′=18.992,14.787,both P＜0.001).Conclusion The emergency medical information management system enhances the command,response capabilities and rescue efficiency and level of emergency medical rescue of mass casual-ties in public health emergencies at civil airports.It has promoted the informatization,digitalization and intelligence construction of emergency medical rescue for public health emergencies at civil airports in China,thereby offering a reference for optimizing the informatization model of emergency medical rescue at civil airports in China.

Objective:To investigate the effects of spinal cord injury(SCI)on neuropathic pain(NP)and cognitive dysfunction in mice,as well as the activation of neurons in the anterior cingulate cortex(ACC),in order to provide experimental evidence for the connection between NP and cognitive dysfunction following SCI.Methods:Ten 8-week-old male C57BL/6J mice were used to prepare a model of spinal cord hemisection(SCI).Pain behavior and cognitive function of mice after SCI were assessed using von Frey,thermal stimulation,and Morris water maze behavioral experi-ments.Immunofluorescence staining were used to analyze the expression of c-Fos and GAD67/VGLUT2 positive cells in the anterior cingulate cortex(ACC)of the SCI model mice.Results:Compared with the Sham group,the SCI group of mice showed a significant decrease in mechanical threshold and thermal pain threshold(P＜0.05).The Morris water maze results indicated a significantly prolonged escape latency(P＜0.05)and a significant reduction in the use of search strategies for locating the hidden platform.Immunofluorescence results showed a significant increase in the num-ber of c-Fos positive cells in the ACC(P＜0.05),which were mainly co-labeled with excitatory neuron marker VGLUT2 positive cells.Conclusion:SCI leads to abnormal pain behavior and cognitive dysfunction in mice,and it induces the activation of neurons in the ACC,with a predominant activation of excitatory neurons.This study provides morphological evidence for the involvement of excitatory neurons in the ACC in the comorbidity of NP and cognitive impairment following SCI.

Objective This study aims to develop and evaluate an emergency medical information management system for the medical rescue of mass casualties in public health emergencies at civil airports,focusing on on-site triage and emergency treatment.Methods A retrospective analysis was conducted to compare the effects of on-site emergency drills for mass-casualty rescue in public health emergencies at the Guangzhou Baiyun International Airport Emergency Center in 2018 and 2024.The 2018 drills involving 21 casualties for which conventional emergency medical rescue equipment and procedures were utilized were set as a control group,while the 2024 drills involving 19 casualties for which an emergency medical information processing system were set as an experimental group.Data were analyzed using descriptive epidemiology,chi-square test,and t-test in terms of in-jury conditions,triage time,and total transfer and handover time.By integrating the entire process and all elements to achieve in-formation-based handling in the practical emergency medical rescue drills,the role and advantages of the emergency medical in-formation processing system in scientific command,rapid response,rapid triage,and emergency treatment for mass casualties in public health emergencies were examined.Results The two drills had no difference in the number of casualties(x2=0.054,P=0.973).The time spent on casualty triage and the total time for transfer and handover in 2024 were significantly reduced com-pared with those in 2018(t′=18.992,14.787,both P＜0.001).Conclusion The emergency medical information management system enhances the command,response capabilities and rescue efficiency and level of emergency medical rescue of mass casual-ties in public health emergencies at civil airports.It has promoted the informatization,digitalization and intelligence construction of emergency medical rescue for public health emergencies at civil airports in China,thereby offering a reference for optimizing the informatization model of emergency medical rescue at civil airports in China.

[Objective] To analyze the influencing factors of postoperative patency of longitudinal single suture intussusception microsurgical vasoepididymostomy, to provide reference for improving the repetition rate. [Methods] The clinical data of 82 patients with epididymal obstructive azoospermia who underwent longitudinal single suture intussusception microsurgical vasoepididymostomy in our hospital during Sep.2020 and Jan.2023 were retrospectively analyzed.The postoperative patency and spouse pregnancy were followed up by face to face and / or telephone interview.The effects of age, course of disease, body mass index (BMI), previous medical history (epididymitis, operation history, none), preoperative seminal plasma elastase (SPE) level, anastomosis site, unilateral and bilateral lesion, sperm quality, operation time and hospital stay on the postoperative patency rate were analyzed. [Results] All operations were successful, the follow-up rate was 95.12% (78/82), 78 were married, and the postoperative patency was 78.21% (61/78). Of the 61 patients who achieved patency, 56 were married, and the natural pregnancy rate of spouse was 45.21% (33/73). Univariate analysis showed that patients with age <30 years, course of disease <2 years, preoperative SPE level <290 ng/mL, bilateral anastomosis, body or tail anastomosis and motile sperm had higher postoperative patency rate (P>0.05). BMI, previous history, the number of motile sperms examined by epididymal fluid, the length of operation and hospital stay had no significant effects on postoperative patency (P>0.05). The results of multivariate logistic regression analysis showed that preoperative SPE level (OR=0.998, 95%CI: 0.997-1.000, P=0.008) and (OR=10.724, 95%CI: 2.243-51.283, P=0.003) were significantly correlated with postoperative patency. [Conclusion] The preoperative SPE level and anastomosis site are significant influencing factors of postoperative patency, which is higher in patients with age <30 years, course of disease <2 years, preoperative SPE level <290 ng/mL, bilateral anastomosis, body or tail anastomosis and motile sperm.

Objective To explore the safety and efficacy of laparoscopic left renal vein stent implantation combined with microsurgical varicocelectomy in the treatment of nutcracker syndrome complicated with varicocele.Methods A retrospective analysis was conducted on the data of 50 patients with nutcracker syndrome complicated with varicocele admitted to our hospital during Nov.2018 and Jul.2023.All patients underwent laparoscopic left renal vein stent implantation combined with microsurgical varicocelectomy.Results Altogether 47 patients were followed up after operation,with a mean age of(21.45±3.84)years.All operations were successful,and gross hematuria,proteinuria,abdominal pain and other symptoms relieved within 3-7 days after surgery.Postoperative follow-up showed that no patients had serious complications or recurrence of clinical symptoms.Left renal vein ultrasound and CT showed that the blood flow of the left renal vein was restored,and the stent position was stable.Compared with those before surgery,the angle between the abdominal aorta and the superior mesenteric artery[(44.91±6.59)° vs.(22.58±6.61)°]and the diameter of the left renal vein at the angle[(6.03±0.99)mm vs.(1.87±0.46)mm]were significantly increased,and the blood flow velocity of the left renal vein at the angle[(48.77±14.79)cm/s vs.(102.53±41.15)cm/s]was significantly decreased,with statistically significant differences(P＜0.001).Scrotal ultrasound confirmed that there was no recurrence of varicocele 6 months after surgery,and the diameter of the spermatic vein was significantly reduced,with statistically significant differences(P＜0.001).Semen analysis showed that the sperm concentration[(60.27±48.45)×106/mL vs.(36.57±36.67)×106/mL,P=0.032]and percentage of rapid forward movement of sperm were significantly increased[(22.54±10.70)vs.(15.01±10.77),P=0.005],with statistically significant differences.The increase value of semen concentration[(23.7±41.48)×106/mL vs.(6.12±4.97)×106/mL,P=0.016)]increased after combined operation compared with left renal venous stenting alone,and there was no significant difference in the diameter of spermatic vein,inner diameter of renal vein and flow rate between the two surgical methods(P＞0.05).Conclusion Laparoscopic left renal vein stent implantation combined with microsurgical varicocelectomy is a minimally invasive,safe and effective method for the treatment of nutcracker syndrome complicated with varicocele.

【Objective】 To analyze the application value of penile vibrating perception threshold measurement in the diagnosis of erectile dysfunction (ED) and provide reference for the seversity of ED patients. 【Methods】 The clinical data, Erectile Hardness Scale (EHS) score, International Index of Erectile Function Questionnaire-5 (IIEF-5) score, and the vibrating perception threshold (VPT) of the penis of 257 patients with decreased erectile function as the main complaint or accompanying symptoms treated during Jan. and Dec.2021 were retrospectively collected and analyzed.Patients with EHS=4 and IIEF-5≥22 were classified into the normal group, and the rest into the ED group.The differences in VPT in patients with different EHS scores were compared, and the correlation between IIEF-5 and VPT was analyzed.The diagnostic value of VPT for ED was evaluated with receiver operating characteristic (ROC) curve. 【Results】 The difference in penile VPT among patients with different EHS scores was statistically significant (P<0.05).With the decrease of EHS score, VPT showed an increasing trend.Glans VPT was negatively correlated with IIEF-5 score (ρ=-0.22, P<0.001), and penile shaft VPT was also negatively correlated with IIEF-5 score (ρ=-0.26, P<0.001).The VPT of glans penis [(4.17±1.37) V vs.(3.47±1.24) V, P=0.009] and the VPT of penis body [(3.73±1.41) V vs.(2.99±1.14)V, P=0.003] in the ED group were both higher than those in the normal group.The area under the ROC curve (AUC) of the glans VPT was 0.642.When the cut-off value was 3.537 V, the sensitivity was 63.4%, and the specificity was 63.6%.The AUC of the penile shaft VPT was 0.659.When the cut-off value was 2.775 V, the sensitivity was 72.3%, with a specificity of 54.5%. 【Conclusion】 The penile VPT of ED patients is higher than that of normal ones, and there is a correlation between VPT and the severity of ED.Severe ED is associated with higher VPT.The measurement of penile VPT is helpful for the clinical diagnosis of ED patients.