ObjectiveTo investigate the application value of a predictive model constructed based on quantitative imaging parameters and serum tumor markers in predicting the postoperative prognosis of patients with pancreatic ductal adenocarcinoma （PDAC）. MethodsA retrospective study was conducted among 146 patients with PDAC who underwent radical resection in Hebei Medical University Fourth Hospital from April 2020 to March 2023， and the patients were divided into a training set with 102 patients and a validation set of 44 patients at a ratio of 7∶3 using the completely randomized method. All patients underwent enhanced computed tomography （CT） and multi-parametric magnetic resonance imaging scans， and CT values in the arterial phase， the venous phase， and the delayed phase were recorded， as well as apparent diffusion coefficient （ADC） at b = 800 s/mm² and signal intensity （SI） of T₂ weighted imaging. The serum levels of carbohydrate antigen 19-9 （CA19-9） and carcinoembryonic antigen （CEA） were also measured. The independent-samples t test was used for comparison of continuous data between groups， and the chi-square test was used for comparison of categorical data between groups. Kaplan-Meier survival curves were plotted for survival analysis； the univariate and multivariate Logistic regression analysis was used to investigate the association of clinical and imaging indicators with prognosis； the least absolute shrinkage and selection operator （LASSO）-Cox regression model was used to identify the important influencing factors for prognosis， and a prognostic prediction model was constructed. The receiver operating characteristic （ROC） curve was used to analyze the predictive value of the model in predicting prognosis in both the training set and the validation set. ResultsThe Kaplan-Meier survival curve analysis showed a median survival time of 33.00 months in the training set and 32.00 months in the validation set， with no significant difference between the training set and the validation set （P>0.05）. The univariate analysis showed that patient age， degree of tumor differentiation， lymph node metastasis， tumor stage， vascular invasion， CA19-9， CEA， ADC value， and SI value were significantly associated with the survival prognosis of patients （χ²=5.906， 13.116， 12.807， 17.277， 14.611， 7.275， 14.339， 9.506， and 13.137， all P<0.05）. The LASSO-Cox multivariate regression analysis showed that six factors were incorporated into the regression model， i.e.， tumor stage （HR=8.934， 95%CI： 3.215 — 21.562， P<0.001）， lymph node metastasis （HR=2.971， 95%CI： 1.298 — 5.647， P=0.002）， CA19-9 （HR=3.948， 95%CI： 1.758 — 8.994， P<0.001）， CEA （HR=1.965， 95%CI： 1.083 — 3.664， P=0.039）， ADC value （HR=2.873， 95%CI： 1.307 — 6.037， P=0.003）， and SI value （HR=3.107， 95%CI： 1.264 — 7.339， P=0.001）. The nomogram model constructed based on these factors had an area under the ROC curve of 0.845 （95%CI： 0.774 — 0.915） in the training set and 0.919 （95%CI： 0.870 — 0.967） in the validation set. ConclusionThe combined model of quantitative imaging parameters and serum tumor markers constructed based on LASSO-Cox regression can effectively predict the postoperative prognosis of PDAC patients， thereby helping to identify high-risk patients and guide decision-making for adjuvant therapy.

Objective To investigate the epidemiology of elderly respiratory tract infection (RTI) cases in a hospital in Xuzhou region from 2020 to 2022. Methods The cases of RTI patients in a hospital were screened from May 2020 to December 2022, and 548 cases that met the criteria were included in the study. Patient case data were analyzed for symptoms, pathogen distribution, and differences in patient distribution under different screening conditions (age, disease, and season). Results More than 90.00% of the included RTI patients presented with symptoms of cough, sputum, wet rales and pleural effusion was less common. The top three comorbidities were cardiovascular disease (153 patients, 27.92%), cerebrovascular disease (133 patients, 24.27%), and gastrointestinal disease (105 patients, 19.16%).All 548 elderly patients tested positive for respiratory pathogens (100.00%). There were 540 cases of single pathogen infection (98.54%) and 8 cases of mixed infection (1.46%). The top five single pathogen infections were Pseudomonas aeruginosa (92 cases, 16.76%), Escherichia coli (78 cases, 14.21%), drug-resistant Staphylococcus aureus (69 cases, 12.57%), Klebsiella pneumoniae (65 cases, 11.84%), and Mycoplasma pneumoniae (46 cases, 8.38%). The highest detection rate of respiratory pathogens was found in patients >90 years old, whose main pathogens were Pseudomonas aeruginosa, Klebsiella pneumoniae and drug-resistant Staphylococcus aureus. The next highest rates of pathogen detection were found in patients aged 86-91 and 81-85 years, unlike patients >90 years, who had a higher rate of Escherichia coli detection. Unlike other age groups, patients <75 years old had a higher percentage of influenza B virus detection. The highest incidence of pneumonia was found in 45.62% (250 cases). Escherichia coli had the highest detection rate in acute bronchitis/episodes and pneumonia, respiratory syncytial virus had the highest detection rate in wheezing bronchitis, Klebsiella pneumoniae had the highest detection rate in bronchopneumonia, and Pseudomonas aeruginosa had the highest detection rate in fever. The highest detection rate of pathogens was found in fall (36.50%), followed by spring (27.01%). The distribution of pathogen infections in all seasons was matched with the results of pathogenicity testing. Streptococcus oxysporus had the highest number of infections in the fall (χ²=20.33, P<0.001). Conclusion Elderly respiratory tract infections in this region are most common in patients over 90 years old, with the highest incidence of pneumonia and high incidence in fall, and the pathogens are mainly Pseudomonas aeruginosa, Escherichia coli and drug-resistant Staphylococcus aureus. Attention to distinguish the above characteristics can provide some support for early diagnosis and treatment of respiratory infections in the elderly in this region.

Objective To investigate the serum interleukin-17A(IL-17A)and chemokine CXC motif ligand 13(CXCL13)levels in children with cough variant asthma and their clinical significance.Methods A total of 108 children with cough variant asthma admitted to Meihe Maternity Hospital from November 2021 to Febru-ary 2023 were selected as the study group,and 86 healthy children who underwent physical examinations dur-ing the same period were selected as the control group.The levels of serum IL-17A and CXCL13 in the two groups were detected by enzyme-linked immunosorbent assay.Multivariate Logistic regression was used to an-alyze the factors influencing the occurrence of cough variant asthma.Receiver operating characteristic(ROC)curve was plotted to analyze the diagnostic value of serum IL-17A and CXCL13 expressions for cough variant asthma.Results The levels of serum IL-17A and CXCL13 in the study group were both higher than those in the control group(P＜0.05).The levels of serum IL-17A and CXCL13 in children with cough variant asthma were negatively correlated with forced vital capacity(FVC),forced expiratory volume in one second(FEV1),maximal expiratory flow rate(PEF),and FEV1/FVC and basal respiratory conductivity(Grs cont),while positively correlated with initial resistance value(Rrs cont).Multivariate Logistic regression analysis indicated that FVC,FEV1,PEF,FEV1/FVC,and Grs cont were protective factors influencing the occurrence of cough variant asthma(P＜0.05).However,Rrs cont,IL-17A and CXCL13 were risk factors affecting the occurrence of cough variant asthma(P＜0.05).The area under the curve(AUC)of serum IL-17A and CXCL13 levels for diagnosing cough variant asthma were 0.920 and 0.867,respectively.The AUC of the combined diagnosis of the two was 0.937,which was significantly greater than that of the diagnosis of CXCL1 alone(Z=2.194,P=0.028).Conclusion The levels of serum IL-17A and CXCL13 in children with cough variant asthma are upreg-ulated,and both are related to the lung function and airway responsiveness of children with cough variant asthma.The combined detection of serum IL-17A and CXCL13 levels has a high diagnostic value for cough variant asthma.

Objective:To analyzed the chemical components of Black Tartary Buckwheat using Ultra-performance liquid chromatography coupled with quadrupole-electrostatic field orbitrap high-resolution mass spectrometry (UPLC-Q-Exactive Orbitrap MS); To further compared the compositional differences under various drying conditions.Methods:UPLC-Q-Exactive Orbitrap MS was employed to scan 14 samples of Black Tartary Buckwheat in 4 batches, aiming to identify the major chemical components. ACQUITY UPLC HSS T3 C18 column (2.1 mm×100 mm, 1.7 μm) was adopted; mobile phase was 0.1% formic acid aqueous solution-acetonitrile solution; flow rate was 0.3 ml/min for gradient elution; HESI-Ⅱ ion source was used to detect negative ions. According to general mass spectroscopy rules and literature, at the same time, Compound Discoverer 3.2 and MSConvert software were used to analyze the data, upload to GNPS network, and finally generate network diagram using Cytocape 3.6.1 software.Results:A total of 134 components were identified in Black Tartary Buckwheat, of which 76 compounds were identified in the negative ion mode, 79 compounds were identified in the positive ion mode, and 21 chemicals were simultaneously identified as positive and negative ions. Based on the similarity cluster analysis of UPLC-Q-Exactive Orbitrap MS secondary mass spectrometry fragment patterns, a molecular network was established, and the main compounds in Black Tartary Buckwheat were flavonoids, phenolic acids and amino acids, and the results showed that the positive and negative ion modes had similar clustering results. There were certain differences in the content of flavonoids, phenolic acids, and amino acids in Black Tartary Buckwheat under two different drying conditions.Conclusion:The established UPLC-Q-Exactive Orbitrap MS method enables rapid identification of the main chemical components in Black Tartary Buckwheat, while the constructed molecular network provides a reference framework for further research on its chemical composition. Additionally, the drying conditions are found to exert certain effects on the content of these chemical components.

Objective:To investigate the efficacy of radiotherapy in patients with advanced esophageal cancer receiving first-line chemoimmunotherapy.Methods:A retrospective analysis was conducted on the data of 137 patients with Stage Ⅳ esophageal squamous cell carcinoma (ESCC) treated at our hospital from January 2018 to May 2023. These patients were divided into two groups: a group treated with first-line chemoimmunotherapy combined with radiotherapy (chemoimmunotherapy + radiotherapy group, n = 43) and a group treated with only chemoimmunotherapy ( n = 94). Inverse probability of treatment weighting (IPTW) was applied to balance baseline characteristics between the groups. With overall survival (OS) and progression-free survival (PFS) as study endpoints, the survival data were analyzed using the Kaplan-Meier method, the log-rank test, and the Cox regression method. Results:Before calibration, the chemoimmunotherapy + radiotherapy group significantly outperformed the sole chemoimmunotherapy group in median PFS (13.6 months vs. 7.0 months; HR: 0.501, 95% CI: 0.309-0.811, P = 0.005). After calibration using the COX proportional-hazards model for age, gender, Eastern Cooperative Oncology Group (ECOG) performance status, smoking history, T/N/M stage, and tumor location, the chemoimmunotherapy + radiotherapy group still had significant advantages in PFS (14.7 months vs. 7.0 months; HR: 0.441, 95% CI: 0.261-0.745, P = 0.002). IPTW analysis further confirmed this trend (13.9 months vs. 7.0 months; HR: 0.492, 95% CI: 0.304-0.795, P < 0.001). Specifically, the median OS of the chemoimmunotherapy + radiotherapy group demonstrated significant improvement in all analyses: pre-calibration (29.5 months vs. 18.0 months; HR: 0.507, 95% CI: 0.297-0.867, P = 0.013), after calibration using the Cox model (27.5 months vs. 16.7 months; HR: 0.470, 95% CI: 0.266-0.830, P = 0.009), and after calibration using IPTW (29.5 months vs. 16.9 months; HR: 0.448, 95% CI: 0.262-0.764, P < 0.001). Conclusions:The combination of radiotherapy and first-line chemoimmunotherapy can significantly improve survival outcomes of patients with advanced ESCC, suggesting its potential as a standard treatment strategy.

Papillary cystadenocarcinoma of the prostate is a clinically rare condition, and we admitted one case in September 2022. The patient was an 82-year-old male presenting with asymptomatic gross hematuria for one week. Cystoscopy revealed a papillary lesion located anterior to the verumontanum. During surgery, resection of the urethral lesion and prostate tissue showed that the tumor base originated from the cystically dilated prostate gland with multiple papillary lesions. Postoperative pathological diagnosis confirmed papillary cystadenocarcinoma of the prostate. The patient was followed up for 18 months without recurrence of hematuria or other symptoms. Papillary cystadenocarcinoma of the prostate exhibits distinct aggressive and recurrent characteristics. For patients with a pathologically confirmed diagnosis, given the current unclear effectiveness of radiotherapy and chemotherapy, it is advisable to prioritize radical surgical treatment and/or lymph node dissection in patients with good general condition to achieve a better prognosis.

Protein arginine methyltransferase 5 (PRMT5) acts as an oncogene in liver cancer, yet its roles and in-depth molecular mechanisms within the liver cancer immune microenvironment remain mostly undefined. Here, we demonstrated that disruption of tumor-intrinsic PRMT5 enhances CD8⁺ T-cell-mediated antitumor immunity both in vivo and in vitro. Further experiments verified that this effect is achieved through downregulation of the inhibitory immune checkpoint molecule, fibrinogen-like protein 1 (FGL1). Mechanistically, PRMT5 catalyzed symmetric dimethylation of transcription factor 12 (TCF12) at arginine 554 (R554), prompting the binding of TCF12 to FGL1 promoter region, which transcriptionally activated FGL1 in tumor cells. Methylation deficiency at TCF12-R554 residue downregulated FGL1 expression, which promoted CD8⁺ T-cell-mediated antitumor immunity. Notably, combining the PRMT5 methyltransferase inhibitor GSK591 with PD-L1 blockade efficiently inhibited liver cancer growth and improved overall survival in mice. Collectively, our findings reveal the immunosuppressive role and mechanism of PRMT5 in liver cancer and highlight that targeting PRMT5 could boost checkpoint immunotherapy efficacy.

A 70-year-old male patient was treated with venetoclax 100 mg orally once daily for acute myeloid leukemia. Before treatment, laboratory tests showed serum potassium 3.61 mmol/L, serum calcium 1.88 mmol/L, inorganic phosphate 1.33 mmol/L, serum uric acid 276.3 μmol/L, aspartate aminotransferase (AST) 23 U/L, gamma-glutamyl transferase (GGT) 179 U/L, and lactate dehydrogenase (LDH) 797 U/L. Six hours later of medication, the patient experienced chest tightness, wheezing, fever with chills, and the highest body temperature was 38.3 ℃. Laboratory tests showed serum potassium 5.54 mmol/L, serum calcium 1.76 mmol/L, inorganic phosphate 3.41 mmol/L, serum uric acid 827.2 μmol/L, AST 205 U/L, GGT 157 U/L, LDH 4 789 U/L, and D-dimer 51.19 mg/L, respectively. It was considered that there was a high possibility of tumor lysis induced by venetoclax, and the drug was immediately stopped. Symptomatic treatments were given, including oxygen inhalation, electrocardiogram monitoring, fluid infusion, alkalinization of urine, and uric acid reduction. The fever of the patient was alleviated on the day of drug withdrawal, the symptoms of chest distress and asthma were improved the next day, and 3 days later, laboratory tests showed serum potassium 4.24 mmol/L, serum calcium 2.02 mmol/L, inorganic phosphate 1.76 mmol/L, serum uric acid 275.0 μmol/L, AST 37 U/L, GGT 80U/L, LDH 1 146 U/L, and D-dimer 7.97 mg/L; venetoclax treatment was resumed and the tumor lysis syndrome-related symptoms did not recur.

Objective:To create nodal integrated topological attributes (NITA) index and explore its application value in obsessive-compulsive disorder (OCD) identification by combining with machine learning model.Methods:Sixty-nine patients with OCD and 69 healthy volunteers matched with gender, age and years of education from the Second Affiliated Hospital of Xinxiang Medical University who met the enrollment criteria from January 2022 to September 2023 were included in the study.Their whole-brain functional magnetic resonance imaging (MRI) data were collected and preprocessed to construct the brain functional network, and the global and nodal topological attributes were extracted as the two sets of training features for the support vector machine (SVM), random forest and gradient boosting tree, and the better features were selected by comparing the classification results of the three machine learning models. The selected features were downgraded using principal component analysis algorithm, and the above models were trained again to filter out the models that were compatible with the new dimensional features. Finally, the new dimensional features with statistically significant differences in brain regions were screened and used to train the adapted model. SPSS 20.0 software was used to process relevant data, and independent sample t-test was used for inter group comparison. Results:Each machine learning model trained based on node topological attribute metrics was higher than the global metrics in terms of accuracy, recall, F1 value and AUC, and the average accuracy of the former was higher than that of the latter by about 10.00%. The node topology attribute metrics were downscaled and named NITA, which can synthesize about 95.00% of the feature information of node topology attribute metrics on average. SVM was finally chosen as the fitness model for NITA (accuracy of 86.00%, recall of 87.00%, F1 value of 0.86, AUC of 0.92). Compared with healthy controls, the differences in NITA in the medial superior frontal gyrus, middle frontal gyrus, ventral inferotemporal gyrus, caudal inferior parietal lobule, medial precuneus, insula hypergranular cellular area, caudal cuneus gyrus, inferior occipital gyrus, caudal hippocampus, dorsal caudate nucleus, and several subregions of the superior temporal gyrus and the thalamus were statistically significant in the OCD group (all P<0.05, FDR-corrected). Training the NITA of the above brain regions as features yielded the optimal model FDR-NITA-SVM, which had an accuracy of 91.38% in the training group and 90.00% in the test group. Conclusion:NITA can be used as a potential imaging marker for recognizing OCD.NITA abnormal brain regions are key nodes for information exchange and integration among brain networks in OCD patients.

Objective:To investigate the relationship between thoracic aortic calcification (TAC) and autonomic nervous system (ANS) function in patients receiving continuous ambulatory peritoneal dialysis (CAPD).Methods:It was a cross-sectional study. The CAPD patients with dialysis duration >6 months between January and December 2022 were retrospectively enrolled. The baseline clinical data, heart rate variability (HRV) data such as standard deviation of all normal to normal intervals (SDNN), root mean square of successive differences between adjacent normal-to-normal intervals (RMSSD), high frequency (HF), very low frequency (VLF), low frequency (LF), LF/HF, acceleration capacity (AC) and deceleration capacity (DC), and skin sympathetic nerve activity (SKNA) were collected. TAC was defined as TAC score (TACS) >100 AU. The patients were divided into TACS >100 AU group and TACS≤100 AU group based on whether the thoracic aorta was calcified. The differences of those data between the two groups were compared. Logistic regression model was used to analyze the related factors of TAC. Spearman correlation analysis method was used to analyze the correlation between peripheral blood neuropeptide Y, ANS parameters, average amplitude SKNA (aSKNA) and TACS.　Cox regression model was used to analyze the risk factors of all-cause mortality in patients with CAPD.Results:The study included 106 CAPD patients with 50 males (47.2%), age of (46.04±11.10) years and dialysis duration of (41.55±30.52) months. TACS>100 AU group exhibited significantly lower heart rate ( t=2.015, P=0.046), DC ( t=2.131, P=0.035), LF/HF ( Z=3.332, P<0.001) and ln(LF/HF) ( t=3.326, P=0.001), and higher AC ( t=-2.392, P=0.019) than TACS≤100 AU group. Multivariate logistic regression analysis results showed that after adjusting for age and eosinophil count, lnVLF ( OR=0.66, 95% CI 0.45-0.98, P=0.038), lnLF ( OR=0.69, 95% CI 0.49-0.97, P=0.032), DC ( OR=0.79, 95% CI 0.64-0.99, P=0.039) and AC ( OR=1.32, 95% CI 1.04-1.68, P=0.021) were independently correlated with the risk of TAC. Spearman correlation analysis showed that neuropeptide Y level in peripheral blood was correlated with aSKNA ( r=0.23, P=0.017), lnSDNN ( r=-0.20, P=0.036) and TACS ( r=0.19, P=0.048). During the follow-up period of (25.8±4.2) months, 5 patients (4.72%) died, including 1 patient in the TACS≤100 AU group and 4 patients in the TACS>100 AU group. Compared with the survival group, the death group had higher TACS ( Z=-2.262, P=0.024) and lower LF/HF ( Z=-2.750, P=0.006). Cox regression analysis results showed that increased ln(LF/HF) was an independent influencing factor for all-cause mortality in CAPD patients ( HR=0.22, 95% CI 0.05-0.83, P=0.026). Conclusions:HRV parameters (lnVLF, lnLF, AC and DC) of CAPD patients are independently associated with TAC. The dysfunction of ANS in CAPD patients (especially the decreased vagus nerve activity) may promote TAC.