OBJECTIVE To evaluate the cost-utility of disitamab vedotin （DV） combined with toripalimab versus platinum-containing chemotherapy as first-line therapy for locally advanced or metastatic urothelial carcinoma（UC） with human epidermal growth factor receptor 2 （HER2） expression from the perspective of China’s health-care system.METHODS A cost-utility analysis was performed. A three-state partitioned survival model was constructed based on the RC48-C016 trial with a 1-week cycle length. The long-term health benefits [quality-adjusted life years（QALYs）] and costs of disitamab vedotin combined with toripalimab versus platinum-containing chemotherapy as first-line therapy for locally advanced or metastatic UC with HER2 expression were simulated. The simulation time horizon was set to 15 years， and the discount rate was 4.5%. The willingness-to-pay （WTP） threshold was defined as twice China’s per capita gross domestic product（GDP） in 2025 （199 330 yuan/QALY）. The incremental cost-effectiveness ratio （ICER） between the two groups was compared， and one-way sensitivity analysis and probabilistic sensitivity analysis were conducted.RESULTS Compared with platinum-containing chemotherapy regimen， the DV plus toripalimab regimen yielded an additional 1.01 QALYs with an incremental cost of 183 224.45 yuan， and the ICER was 181 728.15 yuan/QALY， which was below the WTP threshold. At the current threshold， the probability that the DV combination regimen had a cost-utility advantage was 79.9%.CONCLUSIONS Taking twice China’s per capita GDP in 2025 as the WTP threshold， DV combined with toripalimab exhibits a cost-utility advantage over platinum-containing chemotherapy as first-line treatment for HER2-expressing locally advanced or metastatic urothelial carcinoma.

Objective To investigate the application value of full-length lower extremity CT scans performed at different noise index(NI)in terms of image quality and radiation dose for robot-assisted total knee arthroplasty(RTKA).Methods Eighty patients who underwent RTKA were selected and randomly divided into four groups based on different NI:NI=8,NI=18,NI=28,and NI=38.Subjective scores were assigned to the full-length lower extremity CT images and the three-dimensional skeletal models generated by volume rendering(VR)post-processing.Objective evaluations were performed using three indicators:dose length product(DLP),volume CT dose index(CTDIvol),and hip-knee-ankle angle(HKA).The application value of full-length lower extremity CT scans in RTKA was analyzed.Results(1)As the NI value increased,the subjective scores of thin-slice images decreased.Images with NI between 8 and 18 met the imaging diagnostic standards,while those with NI higher than 18 were unacceptable.(2)As the NI value increased,all VR skeletal models met the acceptance criteria for RTKA.(3)As the NI value increased,DLP and CTDIvol gradually decreased,with statistically significant differences(P<0.05),However,in the comparison between the NI=28 and NI=38 groups,the difference was not statistically significant(P>0.05).Conclusion Performing full-length lower extremity CT scans with an NI of 28 not only meets the preoperative planning requirements for RTKA but also minimizes the radiation dose.

Objective To investigate the application value of full-length lower extremity CT scans performed at different noise index(NI)in terms of image quality and radiation dose for robot-assisted total knee arthroplasty(RTKA).Methods Eighty patients who underwent RTKA were selected and randomly divided into four groups based on different NI:NI=8,NI=18,NI=28,and NI=38.Subjective scores were assigned to the full-length lower extremity CT images and the three-dimensional skeletal models generated by volume rendering(VR)post-processing.Objective evaluations were performed using three indicators:dose length product(DLP),volume CT dose index(CTDIvol),and hip-knee-ankle angle(HKA).The application value of full-length lower extremity CT scans in RTKA was analyzed.Results(1)As the NI value increased,the subjective scores of thin-slice images decreased.Images with NI between 8 and 18 met the imaging diagnostic standards,while those with NI higher than 18 were unacceptable.(2)As the NI value increased,all VR skeletal models met the acceptance criteria for RTKA.(3)As the NI value increased,DLP and CTDIvol gradually decreased,with statistically significant differences(P<0.05),However,in the comparison between the NI=28 and NI=38 groups,the difference was not statistically significant(P>0.05).Conclusion Performing full-length lower extremity CT scans with an NI of 28 not only meets the preoperative planning requirements for RTKA but also minimizes the radiation dose.

Objective To investigate alterations in plasma complement levels and white matter imaging characteristics,along with their relationship in patients with first-episode schizophrenia(SCZ).Methods Thirty-eight patients with first-episode schizophrenia and 42 healthy controls were enrolled.Whole-brain diffusion tensor imaging(DTI)was performed using a Philips 3.0 T MRI scanner.Tract-based spatial statistics(TBSS)combined with the Johns Hopkins University(JHU)white matter labels atlas was used to extract and compare white matter characteristics between the two groups.Plasma levels of complement components(C1q,C3,C4,factor B,factor H,and factor P)were measured using the MILLIPLEX? human complement assay kit via multiplex analysis.Spearman correlation analysis was conducted to examine the association between plasma complement levels and white matter features.Results The radial diffusivity(RD)of the left fornix/stria terminalis was significantly higher in the patient group compared to the control group[(0.62±0.04)×10-3mm2/s vs.(0.60±0.03)×10-3mm2/s,PFDR=0.048)].Factor H[677.71(551.58,846.21)ng/mL vs.582.76(513.93,729.71)ng/mL,P=0.041]and factor P[71.36(57.30,95.99)ng/mL vs.60.08(46.67,80.03)ng/mL,P=0.011]were both significantly elevated compared to the control group.Moreover,RD values in the left fornix/stria terminalis were negatively correlated with plasma C3 levels in the patient group(r=-0.362,P=0.025).Conclusion Patients with first-episode schizophrenia exhibit white matter microstructural abnormalities in left fornix/stria terminalis,which are significantly associated with plasma complement levels.

Objective To investigate alterations in plasma complement levels and white matter imaging characteristics,along with their relationship in patients with first-episode schizophrenia(SCZ).Methods Thirty-eight patients with first-episode schizophrenia and 42 healthy controls were enrolled.Whole-brain diffusion tensor imaging(DTI)was performed using a Philips 3.0 T MRI scanner.Tract-based spatial statistics(TBSS)combined with the Johns Hopkins University(JHU)white matter labels atlas was used to extract and compare white matter characteristics between the two groups.Plasma levels of complement components(C1q,C3,C4,factor B,factor H,and factor P)were measured using the MILLIPLEX? human complement assay kit via multiplex analysis.Spearman correlation analysis was conducted to examine the association between plasma complement levels and white matter features.Results The radial diffusivity(RD)of the left fornix/stria terminalis was significantly higher in the patient group compared to the control group[(0.62±0.04)×10-3mm2/s vs.(0.60±0.03)×10-3mm2/s,PFDR=0.048)].Factor H[677.71(551.58,846.21)ng/mL vs.582.76(513.93,729.71)ng/mL,P=0.041]and factor P[71.36(57.30,95.99)ng/mL vs.60.08(46.67,80.03)ng/mL,P=0.011]were both significantly elevated compared to the control group.Moreover,RD values in the left fornix/stria terminalis were negatively correlated with plasma C3 levels in the patient group(r=-0.362,P=0.025).Conclusion Patients with first-episode schizophrenia exhibit white matter microstructural abnormalities in left fornix/stria terminalis,which are significantly associated with plasma complement levels.

The human body, as a highly complex ecosystem, harbors diverse microbial communities, with major factors triggering allergic reactions encompassing the skin microbiome and fungi. The global diversity of fungi is estimated to range from approximately 600 000 to 1 million species, and theoretically, IgE-mediated sensitization may occur to any fungal species. As of now, the World Health Organization/IUIS official database records 113 fungal allergens originating from 30 different fungi species, covering 42 allergen families. Regarding the skin microbiome, 14 distinct Malassezia allergens have been identified, all derived from three different Malassezia fungi species-- M. furfur, M. sympodialis, and M. globosa. The conditions of patients with these allergies are exceptionally complex. This article extensively discusses the latest research advancements and clinical applications related to skin microbiome and fungal allergies from the European Academy of Allergy and Clinical Immunology (EAACI) publication, "Molecular Allergology User′s Guide 2.0". Additionally, it compiles information on the sources of fungal allergens, characteristics of allergen component protein families, clinical relevance, and management strategies, both domestically and internationally. The aim is to enhance the profound understanding of allergen components among relevant professionals. Through the application of advanced allergen component diagnostic techniques, the goal is to achieve precise diagnosis and treatment of fungal allergy patients and explore the mechanisms underlying fungal sensitization and pathogenesis, laying the foundation for studying the fungal allergen protein sensitization spectrum in the Chinese population.

The human body, as a highly complex ecosystem, harbors diverse microbial communities, with major factors triggering allergic reactions encompassing the skin microbiome and fungi. The global diversity of fungi is estimated to range from approximately 600 000 to 1 million species, and theoretically, IgE-mediated sensitization may occur to any fungal species. As of now, the World Health Organization/IUIS official database records 113 fungal allergens originating from 30 different fungi species, covering 42 allergen families. Regarding the skin microbiome, 14 distinct Malassezia allergens have been identified, all derived from three different Malassezia fungi species-- M. furfur, M. sympodialis, and M. globosa. The conditions of patients with these allergies are exceptionally complex. This article extensively discusses the latest research advancements and clinical applications related to skin microbiome and fungal allergies from the European Academy of Allergy and Clinical Immunology (EAACI) publication, "Molecular Allergology User′s Guide 2.0". Additionally, it compiles information on the sources of fungal allergens, characteristics of allergen component protein families, clinical relevance, and management strategies, both domestically and internationally. The aim is to enhance the profound understanding of allergen components among relevant professionals. Through the application of advanced allergen component diagnostic techniques, the goal is to achieve precise diagnosis and treatment of fungal allergy patients and explore the mechanisms underlying fungal sensitization and pathogenesis, laying the foundation for studying the fungal allergen protein sensitization spectrum in the Chinese population.

Objective:To investigate the early- and mid-term clinical, functional and radiographic outcomes of patellofemoral arthroplasty (PFA).Methods:A retrospective analysis was conducted in 64 patients (80 knees) who suffered from severe patellofemoral osteoarthritis (PFOA) and underwent PFA from January 2013 to December 2020. These patients were aged 60.50±8.82 (range from 27 to 82) years, including 9 males (12 knees) and 55 females (68 knees). All enrolled individuals presented typical PFOA. Unilateral PFA was performed in 48 cases, bilateral PFA in 16 cases, including one-stage PFA in 9 cases and two-stage PFA in 7 cases. The visual analogue scale (VAS), Hospital for Special Surgery (HSS) knee score and Oxford knee score (OKS) of patients with more than 5 years' follow-up were assessed to evaluate the clinical effects of PFA at the time before surgery, 1 year and 5 years after surgery. In addition, the patellar tilt angle (PTA) and hip-knee-ankle (HKA) angle were measured and analyzed to evaluate the improvement of patellar tracking and progression of tibiofemoral osteoarthritis, based on axial X-ray imaging (skyline view) of knee and the full length standing X-ray imaging of the lower limbs at before surgery and 5 years after surgery. Meanwhile, the complications of all patients that related to the operation were recorded.Results:A total of 64 patients were followed up for 4.31±1.79 (range, 1.5 to 8.2) years. Twenty-five patients (32 knees) who followed up more than 5 years were analyzed. The VAS, HSS and OKS improved from 5.91±0.82, 68.06±6.03 and 21.22±3.46 preoperatively to 0.88±1.01, 90.09±3.30 and 39.06±3.37 at 1 year after surgery, and to 0.41±0.76, 94.53±2.99 and 42.13±3.17 at 5 years after surgery, respectively ( F=89.38, 81.47, 56.73, P<0.001). Additionally, comparing to the preoperative radiological data, the patellar tract was improved with the PTA decreased from 8.21°±3.14° preoperatively to 3.58°±4.48°at 5 years after surgery ( t=4.96, P<0.001). The HKA angle changed from 179.01°±1.43° preoperatively to 178.77°±1.67° at 5 years follow up ( t=1.71, P=0.096). There was no case of prosthesis loosening or wear and no case of obvious progression of tibiofemoral osteoarthritis that needed revision in all patients. Conclusion:Satisfied early- and mid-term clinical outcomes could be achieved by PFA in treating severe PFOA patients. PFA could relieve pain and improve function of knee joint.

[Objective]To investigate the prognostic value of 18F-FDG PET/CT with different metabolic parameters in newly diagnosed limited-disease(LD)small cell lung cancer(SCLC).[Methods]Retrospective analysis was carried out in the patients between June 2005 to December 2016 in our hospital confirmed of LD SCLC by pathology or cytology and comprehensive imaging. Fifty-four patients were recruited. Record the general characteristics of patients,pre-treatment KPS score,smoking status,weight loss,serum LDH,NSE,OS,PFS. All lesions(primary lesions + metastases)were sketched out within one VOI,and the SUVmax, SUVmean and SUVpeak in the VOI were automatically measured and recorded. The automatic measurement was performed by the fixed threshold method. The thresholds of tumor of MTV and TLG were 40% and 50% of SUVmax. The TLG and MTV were identified as TLG40%,TLG50%,MTV40% and MTV50% respectively. Kaplan-Meier method was used for survival analysis. All the prognostic factors were analyzed by Cox model.[Result]The median SUVmax was 13.92(2.61~43.28),the median of SUVmean was 8.31(1.71~26.85) and the median of SUVpeak was 10.51(1.49 ~ 27.48). The median of TLG40% was 340.22(16.58 ~ 2827.26),the median of TLG50%was 215.645(1.70 ~ 2270.36),the median of MTV40% was 36.71(1.15 ~ 259.47 cm3),the median of MTV50% was 19.65(0.93 ~1900.00)cm3. Univariate and multivariate analysis of metabolic index and prognosis showed that TLG50% was the prognostic factor of OS(P = 0.013),but not of PFS(P > 0.05). The SUVmax,SUVmean and SUVpeak were not the prognostic factors of OS and PFS(P >0.05).[Conclusion]The volume metabolic parameters TLG50%was the independent prognostic factor of the overall survival time of the LD SCLC. The volume metabolic parameters (TLG and MTV) of 18F-FDG PET/CT were related to the prognosis of SCLC ,which could provide the basis for individual chemotherapy.