OBJECTIVE To systematically evaluate risk prediction models for chemotherapy-induced myelosuppression in pediatric patients with malignant tumors， evaluate their modeling strategies， key predictors， and predictive performance， and provide evidence-based references for clinical decision-making and research. METHODS A literature search was conducted across 11 databases， including CNKI， Wanfang Data， and PubMed， for relevant studies published before April 2025. Two reviewers independently performed literature screening and data extraction， and the risk of bias and applicability of the models were evaluated using the PROBAST tool. RESULTS Ultimately， seven studies were selected， of which four were English articles and three were Chinese articles， involving 12 risk prediction models. Although model discrimination was good （AUC 0.748-0.981）， only two models underwent external validation； furthermore， calibration was inadequately reported in three studies. PROBAST indicated that all models exhibited a high risk of bias， with major issues including a predominance of retrospective designs， inadequate sample representativeness， and lack of blinding. However， in terms of applicability， all models received favorable evaluations. In terms of modeling methods， most studies employed traditional logistic regression approaches to construct models， while only a minority introduced machine learning algorithms and conducted systematic comparisons among multiple algorithms. Models developed using machine learning methods significantly outperformed those constructed with traditional statistical methods. CONCLUSIONS The existing risk prediction models for myelosuppression after chemotherapy in children with malignant tumors demonstrate potential in clinical risk early warning. However， they generally suffer from design and methodological limitations， such as a predominance of retrospective single-center designs， few events per variable， opaque handling of missing data， and inconsistent reporting of model coefficients. Future studies should adopt prospective designs， incorporate machine learning with key clinical predictors， and follow TRIPOD reporting guidelines to enhance scientific rigor and clinical utility.

Background/Aims: Liver transplantation (LT) following total hepatectomy is a life-saving treatment for hepatocellular carcinoma (HCC). The HCC recurrence after LT hinders the effectiveness of the procedure. The objective of this study is to develop a pre-operative risk stratification model based on a liquid biopsy. Methods: We conducted a comprehensive multi-omics study of 260 HCC patients from three centers, including clinical data, low-coverage whole-genome sequencing of cell-free DNA (cfDNA) from plasma, as well as whole-exome, single-nucleus RNA, and spatial transcriptomics from matched tumor and non-tumor tissues. Results: We identified cfDNA-derived copy number alteration (CNA) signatures associated with post-transplant recurrence. By integrating cfDNA-derived CNA profiles with single-cell transcriptomic data, we traced recurrence-associated cfDNA to a distinct subpopulation of malignant cells within the primary tumor. These cells were embedded in a pro-metastatic microenvironment of specialized endothelial subtypes and cancer-associated fibroblasts. Notably, most recurrence-associated lesions were detectable in cfDNA prior to liver transplantation (LT). Building on these insights, we developed the ZJU Criteria based on CNA fragments and tumor markers, a pre-LT risk prediction tool that integrates conventional clinical factors with cfDNA-derived CNA signatures, and validated it using internal and independent external cohorts. Conclusion Our findings suggest that post-transplant recurrence commonly originates from advanced subclones that emerge late during tumor evolution. The ZJU Criteria provides an accurate, non-invasive strategy that significantly improves pre-LT risk stratification and clinical decision-making for patients with HCC.

Objective:To analyze the research status of family management for children with cancer, explore research hotspots and development trends, so as to provide reference for subsequent research and clinical practice in family management for children with cancer.Methods:Literature related to family management for children with cancer was retrieved from the Web of Science Core Collection Database. The search period was from January 31, 2014 to December 31, 2024. CiteSpace 6.4.R1 was employed for bibliometric analysis.Results:A total of 647 articles were included. The annual publication volume showed an overall trend of first decreasing, then increasing, and fluctuating upward. The authors conducting the study on family management for children with cancer formed a distinct core team. The United States and the University of Pennsylvania were the top countries and institutions in terms of publications, with close collaboration and exchange among institutions. Research focuses on recurrence treatment, social support systems, and deepening precision interventions for Ewing sarcoma. The development of technology driven management tools, cross-cultural research, and the integration of policy and ethical studies represent a future trend.Conclusions:Research focuses on key areas such as recurrence treatment, social support systems, and precision interventions for Ewing sarcoma, emphasizing family management practices, building social support networks, and identifying therapeutic targets. In the future, technology driven management tools should be developed to achieve intelligence, cross-cultural research should be deepened, and a humanized management model should be constructed by combining policy and ethical research, in order to improve the efficiency and effectiveness of subsequent related research and clinical practice for family management for children with cancer.

Objective:To analyze the research status of family management for children with cancer, explore research hotspots and development trends, so as to provide reference for subsequent research and clinical practice in family management for children with cancer.Methods:Literature related to family management for children with cancer was retrieved from the Web of Science Core Collection Database. The search period was from January 31, 2014 to December 31, 2024. CiteSpace 6.4.R1 was employed for bibliometric analysis.Results:A total of 647 articles were included. The annual publication volume showed an overall trend of first decreasing, then increasing, and fluctuating upward. The authors conducting the study on family management for children with cancer formed a distinct core team. The United States and the University of Pennsylvania were the top countries and institutions in terms of publications, with close collaboration and exchange among institutions. Research focuses on recurrence treatment, social support systems, and deepening precision interventions for Ewing sarcoma. The development of technology driven management tools, cross-cultural research, and the integration of policy and ethical studies represent a future trend.Conclusions:Research focuses on key areas such as recurrence treatment, social support systems, and precision interventions for Ewing sarcoma, emphasizing family management practices, building social support networks, and identifying therapeutic targets. In the future, technology driven management tools should be developed to achieve intelligence, cross-cultural research should be deepened, and a humanized management model should be constructed by combining policy and ethical research, in order to improve the efficiency and effectiveness of subsequent related research and clinical practice for family management for children with cancer.

Objective:To study the effect and mechanism of ganoderma lucidum polysaccharide peptide(GLPP)on renal anti oxidative stress and immune inflammation in diabetes nephropathy mice.Methods:The C57 male mice model of diabetes nephropathy was established by streptozotocin combined with high glucose and high-fat diet.Sixty diabetes nephropathy mice were divided into model group,losartan group,GLPP group(low,medium and high dose groups),GLPP high-dose+losartan group,with 10 mice in each group,10 mice fed with normal diet as the blank group.The losartan group was given 10 mg/kg losartan by gavage,and GLPP low,medium and high dose groups was given 50,100,and 200 mg/kg GLPP by gavage,while the GLPP high-dose+losartan group were given 200 mg/kg GLPP+10 mg/kg losartan by gavage.The blank group and model group were given physiological saline by gavage.After gastric lavage,observe the diet,water intake,renal pathology,structure,and apoptosis of renal tubular epithelial cells in mice,and analyze the levels of blood biochemical indicators,immune inflammation,oxidative stress indicators,and expression of apoptosis/cycle regulatory proteins in mice.Results:Compared with the blank group,the model group showed an increase in blood biochemical indicators such as Scr,BUN,TC,TG and GSP(P<0.05),as well as inflammation indicators such as level of IL-6 and TNF-α、MCP-1 were decreased(P<0.05),the oxidative stress indicator MDA was increased,T-AOC,GSH-PX,SOD were decreased(P<0.05),the apoptosis rate of renal tubular epithelial cells were increased(P<0.05),the expression levels of Bax,Caspase-3,P53,P21 were all increased,and the expression levels of Bcl-2 and Cyclin D1 were decreased(P<0.05).Compared with the model group,the losartan group,GLPP dose groups,GLPP high-dose+losartan group Scr,BUN,TC,TG,GSP,IL-6,TNF-α,MCP-1,MDA levels,apoptosis rate of renal tubular epithelial cells,Bax,Caspase-3,P53,P21 expression levels were all reduced,while T-AOC,SOD,GSH-PX levels,Bcl-2,and Cyclin D1 expression levels were all increased.Renal pathological changes were improved,and mitochondrial swelling was reduced.The GLPP high-dose+losartan group showed the most significant improvement(P<0.05).Conclusion:GLPP can reverse the renal injury in diabetes nephropathy mice,which may be related to the inhibition of apoptosis of renal tubular epithelial cells by alleviating renal oxidative stress and immune inflammatory damage.

Objective:To investigate the psychological adaptation level and influencing factors of primary caregivers of postoperative thyroid cancer patients at different time points, providing a basis for developing targeted interventions.Methods:Using convenience sampling, primary caregivers of patients who underwent thyroid cancer surgery at Taizhou First People's Hospital from January 2020 to February 2024 were selected. The study applied a general information questionnaire, Psychological Adaptation Scale, Caregiver Burden Scale for Cancer Patients, Family Caregiver Task Inventory, and Mutuality Scale at four time points: 1 day before discharge, and at 1, 3, and 6 months postoperatively.Results:A total of 335 questionnaires were distributed, and 325 valid responses were obtained after four rounds of follow-up surveys, with an effective recovery rate of 97.01%. Generalized estimating equation analysis showed that caregiver age, education level, caregiving experience, number of co-caregivers, caregiver burden, caregiving competence, and mutuality with the patient were significant influencing factors of psychological adaptation ( P<0.05) . Conclusions:Psychological assessment of primary caregivers should begin before patient discharge and continue with regular follow-up. Intervention measures should be developed based on identified influencing factors of psychological adaptation.

Objective:To investigate the value of tumor and adipose tissue metabolic parameters from baseline 18F-FDG PET/CT in predicting the efficacy and prognosis of immunotherapy in patients with advanced nasopharyngeal carcinoma (NPC). Methods:From February 2019 to February 2022, 112 patients (91 males, 21 females, age 21-73 years) with advanced NPC who were treated with programmed death-1 (PD-1) inhibitors at Sun Yat-Sen University Cancer Center were retrospectively included. All patients underwent baseline PET/CT examination. Tumor and adipose tissue metabolic parameters were measured and calculated. Patients were divided into clinical benefit and non-clinical benefit groups, and Mann-Whitney U test or χ2 test was used to assess the differences between groups. Prognostic analysis of progression-free survival (PFS) was performed using multivariate Cox proportional hazards regression model and a prognostic stratification system was constructed. Results:Of the 112 patients, 85 were in the clinical benefit group and 27 were in the non-clinical benefit group. In non-clinical benefit group and clinical benefit group, the metabolic tumor volume (MTV) of primary tumor (PT-MTV) were 47.7(7.7, 81.2) and 14.0(5.7, 27.1)cm 3, total lesion glycolysis (TLG) of primary tumor (PT-TLG) were 228.9(27.4, 492.8) and 72.7(20.4, 165.5)g, whole-body MTV (WB-MTV) were 94.2(45.9, 215.4) and 61.3(31.6, 104.3)cm 3, whole-body TLG (WB-TLG) were 605.5(214.1, 1 402.5) and 319.2(172.4, 632.8)g, SUV max of visceral adipose tissue (SUV max-VAT) were 0.77(0.55, 0.91) and 0.62(0.48, 0.76), respectively ( Z values: from -2.72 to -1.96, all P<0.05). The proportion of patients with lung metastasis in non-clinical benefit group was higher than that in clinical benefit group (44.4%(12/27) vs 23.5%(20/85); χ2=4.39, P=0.036). PT-MTV (hazard ratio ( HR)=2.807, 95% CI: 1.540-5.118, P=0.001) and the presence of lung metastases ( HR=1.691, 95% CI: 1.012-2.823, P=0.045) were independent predictive factors for PFS in multivariate analysis. The prognostic prediction model based on the two predictive factors was able to significantly differentiate the prognosis in patients. Conclusions:Baseline tumor metabolic parameters and SUV max-VAT are associated with the efficacy of immunotherapy in patients with advanced NPC. PT-MTV and lung metastasis can independently predict PFS. The constructed prediction model can stratify patients′ prognosis.

Objective:To assess the effectiveness of kinetic parameters of 18F-prostate specific membrane antigen (PSMA)-1007 PET/MR in distinguishing tumor recurrence (TR) from radiation necrosis (RN) in glioma patients. Methods:From January 2023 to June 2023, imaging data of 10 patients (6 males, 4 females; media age of 39.5 years) with gliomas who were suspected of recurrence and were referred for 18F-PSMA-1007 PET/MR scans at Sun Yat-Sen University Cancer Center were retrospectively analyzed. Static parameters from 18F-PSMA-1007 PET scans, including SUV max, SUV mean, metabolic tumor volume (MTV), and total lesion′s PSMA (TLP), as well as dynamic parameters including K 1, k 2, k 3, k 4, net influx rate (K i), and volume of distribution ( Vt) were obtained by using compartmental and multigraphical models. Additionally, parameters from dynamic contrast-enhanced MRI (DCE-MRI) were collected. Mann-Whitney U test was used to compare parameter differences between TR and RN groups. Spearman rank correlation analysis was used to explore the correlation between K i and DCE-MRI parameters. Results:Finally, 8 cases were diagnosed as TR and 2 cases were diagnosed as RN. The kinetic compartmental model-based evaluation determined that irreversible 2-tissue model (2T3K) provided the best-fitting results. The differences in SUV mean (median: 2.48 vs 0.89; Z=-2.09, P=0.044), SUV max (median: 4.04 vs 1.40; Z=-2.09, P=0.044), and K i (median: 1.33×10 -2vs 3.87×10 -3;Z=-2.10, P=0.044) between TR and RN groups were statistically significant. Some parameters of DCE-MRI also showed differences between the two groups ( Z=-2.09, P=0.044 for all). The K i yielded moderate correlation with DCE-MRI parameter Ve ( rs=0.650, P=0.042), while correlations between K i and other DCE-MRI parameters were not significant ( rs values: from -0.207 to 0.632, all P>0.05). Conclusion:Dynamic and multi-parametric 18F-PSMA-1007 PET/MR system holds promise for accurately distinguishing TR from RN in treated glioma patients.

Objective:To analyze the distribution and epidemiological characteristics of common non-bacterial pathogens in hospitalized children with acute respiratory tract infections(ARTI)from a multi-center study covering 4 regions in Fujian Province in 2023.Methods:A retrospective cohort study was conducted using medical record analysis.A total of 22 769 hospitalized children with ARTI were enrolled from January to December 2023 across seven regional pediatric medical centers in Fujian Province (covering four major geographical divisions of Fuzhou, Nanping, Sanming and Longyan; all selected hospitals were regional children′s medical centers).Using single-tube multiplex PCR with fragment analysis on a Sanger sequencing platform, the nucleic acids of 11 common non-bacterial respiratory pathogens were tested in nasopharyngeal swabs collected from 22 769 children. These pathogens included influenza A virus(FluA), influenza B virus(FluB), parainfluenza virus(PIV), respiratory syncytial virus (RSV), adenovirus (ADV), human rhinovirus (HRV), human bocavirus (HBoV), human coronavirus (HCoV), human metapneumovirus(HMPV), Mycoplasma pneumoniae(MP), and Chlamydia (Ch). Count data were described as [ n(%)], and the chi-square test/Fisher′s exact test was used to compare the differences in rates between groups. Epidemiological features, including positive detection rates, pathogen profiles, and correlations with region, sex, age and month, were analyzed. Results:Among 22 769 children with ARTI, pathogens were detected in 16 213 cases (71.21%), including 13 340 single infections (58.59%).The detection rates of single pathogens in descending order were human rhinovirus (HRV, 12.95%), Mycoplasma pneumoniae(MP, 12.27%), respiratory syncytial virus(RSV, 11.12%), influenza A virus (Flu-A, 7.98%), parainfluenza virus(PIV, 4.66%), human metapneumovirus(HMPV, 4.60%), adenovirus(ADV, 2.70%), human bocavirus(HBoV, 0.84%), human coronavirus(HCoV, 0.82%), influenza B virus(Flu-B, 0.47%) and Chlamydia(Ch, 0.18%).Mixed infections occurred in 2 873 cases(12.62%), primarily dual infections(2 679 cases).Regional analysis revealed significant disparities:Luoyuan County Hospital (Fuzhou) exhibited the highest total detection rate(86.59%, 1 414/1 633)and mixed infection rate(23.27%, 380/1 633)(both P<0.001), with notably elevated MP (26.39%, 431/1 633);Jian′ou City Hospital(Nanping) ranked second for Flu-A(14.21%, 409/2 879), RSV(13.20%, 380/2 879) and mixed infections(17.12%, 493/2 879);Lianjiang County Hospital(Fuzhou) showed distinct prevalence of Flu-A(10.68%, 130/1 217), PIV(6.00%, 73/1 217), and HBoV(1.73%, 21/1 217); Yong′an City Hospital (Sanming) reported high MP (26.07%, 238/913) and RSV(12.38%, 113/913);Shaowu City Hospital(Nanping) was dominated by MP (18.60%, 407/2 188) and HRV(13.39%, 293/2 188); Tingzhou Hospital(Longyan) had the highest HRV (17.88%, 407/2 276) and Flu-B (0.75%, 17/2 276); and Fuzhou Children′s Hospital showed elevated ADV(3.38%, 394/11 663) and HCoV(1.08%, 126/11 663). Except for Flu-B(0.47%, 108/22 769; P=0.054) and Ch(0.18%, 40/22769; P=0.900), all pathogens and mixed infections exhibited significant regional variations ( P<0.05).Gender analysis indicated higher detection rates of HRV, RSV, Flu-A, ADV, PIV, HBoV and mixed infections in males, while MP, HMPV, Flu-B, HCoV, and Ch were more prevalent in females, with statistically significant differences for HRV and MP (both P<0.001). Age stratification showed the highest overall detection rate in the 3-<6 years group (75.48%; P<0.001): RSV and Ch peaked in infants (<1 year), HRV, PIV, ADV and HBoV in toddlers (1-<3 years), HMPV, HCoV, and mixed infections in preschool children (3-<6 years), and MP, Flu-A and Flu-B in older children (6-<18 years).Analyzing the prevalent months, the monthly prevalence trends of pathogens in various regions are similar.Seasonal trends demonstrated year-round HRV activity (peaking in spring/autumn), MP prevalence in autumn/winter, RSV surges in spring-summer (April-June) and late summer-autumn (August-October), and Flu-A predominanced in winter-spring. Conclusion:Multiplex PCR with fragment analysis demonstrated high diagnostic efficacy. The top 4 non-bacterial pathogens in Fujian Province′s ARTI-hospitalized children in 2023 were HRV, MP, RSV and Flu-A. Pathogen distribution exhibited significant regional, age and seasonal variations, emphasizing the need for targeted prevention strategies.

Objective:To report the nationwide surveillance results of pathogenic profiles and antimicrobial resistance patterns of Gram-positive bloodstream infections in China in 2023.Methods:The clinical isolates of Gram-posttive bacteria from blood cultures were collected in member hospitals of National Bloodstream Infection Bacterial Resistant Investigation Collaborative System（BRICS）during January to December 2023. Antimicrobial susceptibility testing was performed using the dilution method recommended by the Clinical and Laboratory Standards Institute（CLSI）. Statistical analyses were conducted using WHONET 5.6 and SPSS 25.0 software.Results:A total of 4 385 Gram-positive bacterial isolates were obtained from 60 participating center. The top five pathogens were Staphylococcus aureus（ n=1 544，35.2%），coagulase-negative Staphylococci（ n=1 441，32.9%）， Enterococcus faecium（ n=574，13.1%）， Enterococcus faecalis（ n=385，8.8%），and α-hemolytic Streptococci（ n=187，4.3%）. The prevalence of methicillin-resistant Staphylococcus aureus（MRSA）and methicillin-resistant coagulase-negative Staphylococci（MRCNS）was 26.2%（405/1 544）and 69.8%（1 006/1 441），respectively. Notably，all Staphylococci remained susceptible to glycopeptide or daptomycin. Staphylococcus aureus demonstrated excellent susceptibility（>97.0%）to cephalobiol，rifampicin，trimethoprim-sulfamethoxazole，linezolid，minocycline，tigecycline，and eravacycline. No Enterococcus exhibiting resistance to linezolid were detected. Glycopeptide resistance was uncommon but more frequent in Enterococcus faecium（resistance to vancomycin and teicoplanin：both 1.7%）compared to Enterococcus faecalis（both 0.3%）. The detection rates of MRSA and MRCNS exhibited significant regional variations across the country（ χ2=17.674 and 148.650，respectively，both P<0.001）. No vancomycin-resistant Enterococci were detected in central China. Institutional comparison demonstrated higher prevalence of MRSA（ χ2=14.111， P<0.001）and MRCNS（ χ2=4.828， P=0.028）in provincial hospitals than that in municipal hospitals. Socioeconomic analysis identified elevated detection rates of both MRSA（ χ2=18.986， P<0.001）and MRCNS（ χ2=4.477， P=0.034）in less developed regions（per capita GDP