Objective To longitudinally investigate the characteristics of postoperative weight changes in patients with esophageal cancer and analyze its influencing factors, which can provide certain guidance for nutritional intervention in patients with esophageal cancer. Methods Patients with esophageal cancer who underwent surgical treatment at the Sichuan Cancer Hospital from December 2020 to February 2022 were prospectively included. The general information questionnaire and body composition analyzer were used to longitudinally investigate the patients’ weight and body composition before surgery (T0), 1 month after surgery (T1), 3 months after surgery (T2) and 6 months after surgery (T3), and the change characteristics were analyzed. The generalized estimating equation was used to analyze the influencing factors for postoperative weight changes in patients with esophageal cancer. Results A total of 130 patients were enrolled, including 110 males and 20 females, aged 42-79 (63.33±8.16) years. The weight and body composition of patients with esophageal cancer showed a continuous slow downward trend within 6 months after surgery. The weight loss rate of patients at 1, 3, and 6 months after surgery was 5.10%, 7.76%, and 9.86%, respectively. The analysis results of the influencing factors for postoperative weight showed that patients with the following characteristics had more weight loss: female (β=−7.703, P=0.001), ≥60 years (β=−3.657, P=0.010), smoking (β=4.622, P=0.010), low tumor differentiation degree (β=4.314, P=0.039), and high frequency of eating (β=−3.400, P=0.008). Conclusion Weight loss is an important health problem for patients with esophageal cancer after surgery, and patients have a continuous downward trend in weight within 6 months after surgery. Medical staff should pay special attention to the patients who are female, ≥60 years, having smoking history and low tumor differentiation degree.

Chronic obstructive pulmonary disease (COPD) is the most common chronic respiratory disease around the world, and pharmacotherapy is the foremost treatment method currently. In recent decades, with the rapid development of bronchoscopic interventional therapy, endoscopic physical ablation technology presents a therapeutic effect in treating COPD, with few treatment-related side effects, showing excellent application prospects in treating COPD. Since ablation techniques in this field are emerging technologies with low patient acceptance, they are not widely used in the clinical treatment of COPD. This article reviews the development process of physical ablation techniques. Moreover, their current application status and the prospects in the field of COPD treatment are also summarized and analyzed. We hope to promote the application of physical ablation in the clinical treatment of COPD and provide practical references and a theoretical basis for the clinical treatment of COPD.

Based on advancements in modern medical research regarding the intricate connection between the endocrine and exocrine functions of the pancreas， as well as the relationship between pancreatic functions and traditional Chinese medicine （TCM） spleen system， this paper discussed the categorization of the pancreas. It is proposed that the pancreas is neither a true zang organ nor a fu organ， but possessed the attributes of an extraordinary fu-organ and can be classified under the spleen. The spleen governs transportation and transformation， ascent of the clear and dispersion of essence， which encompasses the endocrine and exocrine functions， and pancreatic enzymes and glucose-regulating hormones form the material basis for the spleen's function of dispersing essence. Diseases of the pancreas exhibit characteristics of both zang-organ deficiency and fu-organ excess， so treatment should simultaneously supplement zang-organ disease and regulate fu-organ disease when pancreas showing endocrine and exocrine co-morbidities， with focus on restoring the pancreas （spleen）'s dispersing essence function. Therapeutic strategies include supplementing spleen qi， nourishing spleen yin to strengthen spleen earth， unblocking spleen collaterals， raising spleen yang， and removing spleen turbidity to support the spleen's dispersing essence function， so as to replenish the essential qi of zang-fu organs， ensure their distribution throughout the body， and improve the endocrine and exocrine functions of the pancreas.

Objective To establish a chronic rejection (CR) model of mouse heart transplantation and analyze its characteristics. Methods Allogeneic BALB/c and C57BL/6 mice were used as donor and recipient for heart transplantation, and intraperitoneal injection of cytotoxic T lymphocyte-associated antigen 4-immunoglobulin (CTLA4-Ig) was given 1 and 2 days after surgery. Graft survival time, donor specific antibody (DSA) level, graft pathology and inflammatory cell infiltration were observed. Results In allogeneic transplantation model, graft survival time was prolonged after CTLA4-Ig treatment [(28.2±4.1) d vs. (7.0±0.7) d, P < 0.01]. The level of serum DSA-IgG increased at 2, 3 and 4 weeks after surgery, while the level of DSA-IgM remained unchanged. Myocardial cell injury, inflammatory cell infiltration, interstitial fibrosis and C4d deposition in capillaries were aggravated 3 weeks after operation and worsened 4 weeks after operation. The infiltrated immune cells were mainly macrophages, T cells and plasma cells. Conclusions Mouse allogeneic heart transplantation combined with CTLA4-Ig successfully establishes a CR model, which provides a basis for subsequent studies on the pathogenesis and intervention of CR.

BACKGROUND: Macrophage polarization anomalies and dysfunction play a crucial role in the pathogenesis of immune thrombocytopenia (ITP). Itaconate is a Krebs cycle-derived immunometabolite synthesized by myeloid cells to modulate cellular metabolism and inflammatory responses. This study aimed to evaluate the immunoregulatory effects of an itaconate derivative on macrophages in patients with ITP. METHODS: Peripheral blood-derived macrophages from patients with ITP and healthy controls were treated with 4-octyl itaconate (4-OI), a derivative of itaconate that can penetrate the cell membrane. Macrophage polarization, antigen-presenting functions, and phagocytic capability were measured via flow cytometry and enzyme-linked immunosorbent assay (ELISA). Macrophage glycolysis in patients with ITP and the metabolic regulatory effect of 4-OI were detected using a Seahorse XFe96 Analyzer. An active murine model of ITP was used to evaluate the therapeutic effects of 4-OI in vivo . RESULTS: 4-OI reduced the levels of CD80 and CD86 in M1 macrophages and suppressed the release of tumor necrosis factor-α (TNF-α) and interleukin (IL)-6 pro-inflammatory cytokines, suggesting that 4-OI could hinder the polarization of macrophages toward an M1 phenotype. We found that 4-OI pretreated M1 macrophages reduced the proliferation of CD4 + T cells and promoted the differentiation of regulatory T cells. In addition, after 4-OI treatment, the phagocytic capacity of M1 macrophages toward antibody-coated platelets decreased significantly in patients with ITP. In addition, the glycolytic function of M1 macrophages was elevated in individuals with ITP compared to those in healthy controls. 4-OI treatment downregulated glycolysis in M1 macrophages. The glycolysis inhibitor 2-deoxy-d-glucose (2-DG) also inhibited the polarization of M1 macrophages and restored their functions. In vivo , 4-OI treatment significantly increased platelet counts in the active ITP murine model. CONCLUSIONS Itaconate derivative 4-OI inhibited M1 macrophage polarization and restored impaired functions through metabolic reprogramming. This study provides a novel therapeutic option for ITP.
Macrophages/metabolism* ; Humans ; Animals ; Succinates/pharmacology* ; Mice ; Male ; Female ; Adult ; Middle Aged ; Flow Cytometry ; Tumor Necrosis Factor-alpha/metabolism* ; Enzyme-Linked Immunosorbent Assay ; Purpura, Thrombocytopenic, Idiopathic/metabolism* ; Glycolysis/drug effects* ; Metabolic Reprogramming

OBJECTIVE T o analyze the current situation and characteristics of hospital-associated infection in a psy-chiatric hospital,providing references for formulation of control measures for hospital-associated infection.METHODS A retrospective analysis was conducted on hospital-associated infection data from Shanghai Mental Health Center between Jan.1,2019,and Oct.31,2024.The infection rates and infection sites across different years,patient populations,and departments were analyzed.RESULTS A total of 47 051 inpatients were investiga-ted,with 1 798 cases of hospital-associated infections,resulting in an infection rate of 3.82％.The highest inci-dence rate was observed in 2020(4.13％).The top three departments with the highest incidence rates were the in-fectious disease department(12.13％),geriatric psychiatry(7.67％),and the Traditional Chinese Medicine De-partment department(4.90％).The primary infection sites were the lower respiratory tract(57.06％),urinary tract(18.24％),skin and soft tissue(14.29％).The incidence rate was higher in males(5.32％)than in females(2.72％)(P＜0.001).Statistically significant differences were found in the incidence rates among different age groups(P＜0.001),with the highest rate observed in patients aged over 90 years(17.11％).The lowest infection rate was found in patients hospitalized for less than 60 days(0.69％),while the highest was in those hospitalized for more than 1 000 days(49.94％).CONCLUSIONS The patients in psychiatric hospitals are susceptible to infec-tions in the respiratory tract,urinary tract,skin and soft tissue.Targeted prevention and control measures can be implemented based on high-risk factors such as age,length of stay,and gender to reduce the occurrence of in-fections.

Objective:To investigate the diagnostic value of different conventional ultrasound-based radiomics models and their combination with clinical ultrasound features in the pathological subtyping of renal cell carcinoma.Methods:Retrospective data from 286 patients diagnosed with renal cell carcinoma by pathology at the Tenth Affiliated Hospital of Southern Medical University between May 1，2017 and June 7，2024 were collected. Among the 286 patients，203 were clear cell carcinoma，44 were papillary renal cell carcinoma，and 39 were chromophobe renal cell carcinoma. The patients were randomly divided into a training group（201 cases）and a validation group（85 cases）in a ratio of 7 to 3. Regions of interest（ROI）were delineated on conventional ultrasound images，and the radiomics features were extracted. Feature selection was performed using Student's t-test，Pearson correlation，and the least absolute shrinkage and selection operator（LASSO）. Six different machine learning methods included category gradient boosting（CatBoost），light gradient boosting machine（LightGBM），Logistic regression（LR），random forest（RF），support vector machine（SVM）and extreme gradient boosting（XGBoost）were used to establish radiomics models. Weight balancing was applied to correct for sample imbalance，and an imaging genomics model was constructed after balancing the samples. Independent predictors of renal cell carcinoma subtyping were selected from clinical ultrasound features using univariate and multivariate logistic regression analyses，and a clinical imaging model was constructed. The best-performing radiomics model was combined with the clinical independent predictors to construct a combined model. Receiver operating characteristic curves and the obuchowski index were plotted to evaluate model performance. Results:Among the radiomics models，the model constructed using Random Forest（RS RF）after balancing the samples exhibited the best predictive performance，with area under the curve（AUCs）of 0.918（micro-average ROC）and 0.903（macro-average ROC），and the obuchowski index was 0.885 in the validation group. The long and short axes of ultrasound image tumor masses were used as imaging independent predictors to construct a clinical imaging model. In the validation group，the AUCs of the clinical model were 0.886（micro-average ROC）and 0.606（macro-average ROC），and the obuchowski index was 0.569. The combined model achieved AUCs of 0.888（micro-average ROC）and 0.967（macro-average ROC），with an obuchowski index of 0.933，outperforming any single model. Conclusions:The combination of conventional ultrasound-based radiomics models with clinical ultrasound features demonstrates high diagnostic value in differentiating clear cell carcinoma，papillary renal cell carcinoma，and chromophobe renal cell carcinoma. It may serve as an auxiliary tool for providing timely and effective clinical guidance.

Objective:To observe the high-risk histopathological feature (HRF) and their correlation with prognosis in children with intraocular retinoblastoma (RB) in the intraocular stage after failed eyepreserving treatment and enucleation surgery.Methods:A single-center retrospective case study. From August 2018 to January 2023, 64 children (64 eyes) with advanced intraocular RB who were diagnosed in Department of Ophthalmology of Beijing Children's Hospital and underwent enucleation surgery after failed eye-preserving treatment were included in the study. The median follow-up time was 51 months. The gender of the children patients, the age of visit and enucleation, International Intraocular Retinoblastoma Classification (IIRC), the initial chemotherapy regimen (hereinafter referred to as "chemotherapy"), the time of enucleation surgery, pathological results, post-enucleation treatment methods and prognosis were collected. The Mann-Whitney U test was used for comparison between groups. Survival analysis was performed using the Kaplan-Meier method, and the log-rank test was used for comparison between groups. Results:Among 64 cases and 64 eyes, 37 were male and 27 were female. The age of seeking medical treatment was 20 (11-31) months. The age at which the surgery was performed was 29 (16-40) months. The number of eyes in IIRC stage D and E was 16 and 48 respectively. The initial chemotherapy regimens simply applied (hereinafter referred to as "alone") intravenous systemic chemotherapy (IVC) and ophthalmic artery infusion chemotherapy (IAC) in 40 cases and 11 cases, 13 cases of IVC+IAC. All patients with positive HRF received systemic adjuvant chemotherapy after surgery. There were 37 eyes (57.8%, 37/64) positive for HRF. There was no statistically significant difference in the positive rate of HRF between children in IIRC stage D and stage E ( χ2=0.021, P=0.884). Among the 37 eyes with HRF, the numbers of eyes with extensive choroidal invasion, posterior lamina cribrosa optic nerve invasion, scleral invasion and optic nerve stump involvement were 17 (45.9%, 17/37), 16 (43.2%, 16/37), 3 (8.1%, 3/37) and 3 (8.1%, 3/37), respectively. During the follow-up period, there were 5 cases (7.8%, 5/64) of extraocular metastasis of the tumor and death, all of which were stage E and had HRF. Among them, the initial treatment plan was IAC for 4 cases, one case of IVC. The survival rates of children among the IVC, IAC or IVC+IAC regimens were 97.5% (39/40), 63.6% (7/11), and 100.0% (13/13), respectively. The comparison of survival rates among different chemotherapy regimens showed statistically significant differences ( χ2=14.233, P<0.001). The results of survival analysis showed that the cumulative survival rate of those with extensive choroidal invasion, posterior lamina cribrosa optic nerve infiltration, and those who received IAC was significantly lower than that of those without extensive choroidal invasion, posterior lamina cribrosa optic nerve infiltration, and those who received IVC+IAC and IVC ( P<0.05). Conclusions:Eye-preserving treatment for children with advanced intraocular RB may increase the positive rate of HRF and the risk of extraocular metastasis. The IVC+IAC eye-protecting treatment plan can improve the survival rate of children.

Spectral computed tomography (CT) has triggered a technological revolution in radiodiagnosis while demonstrating its increasing application value in radiotherapy. Employing dual-energy techniques for material decomposition, spectral CT provides optimized solutions for several critical aspects of radiotherapy. Based on a review of the application situation of spectral CT in radiotherapy, this study delved into spectral CT′s significant advantages in image quality improvement, precise dose calculation, and comprehensive quantitative assessment. Furthermore, this study envisioned the development orientations and application prospects of spectral CT.