Objective To investigate the characteristics of peripheral blood in the treatment of aplastic anemia(AA)with Bushen Shengxue Method and Yiqi Yangxue Method combined with Western medicine.Methods Totally 492 AA patients who were treated in 19 centers including Xiyuan Hospital China Academy of Chinese Medical Sciences from September 2018 to March 2021 were selected,and were randomized into three groups:161 cases in the Bushen Shengxue group,164 cases in the Yiqi Yangxue group,and 167 cases in the control group.All three groups were orally administered cyclosporine and androgens.Bushen Shengxue group was given Bushen Shengxue Granules,Yiqi Yangxue group was given Yiqi Yangxue Granules,and the control group was given placebo(half dosage of Bushen Shengxue granules).The general data,overall efficacy,and peripheral blood at the 1st month,the 4th month,and 6th month after treatment were analyzed.Results The total effective rate of Bushen Shengxue group was 98.8％(159/161),which was significantly higher than that of Yiqi Yangxue group(79.9％)and the control group(61.7％),with statistical significance(P＜0.001);The total effective rate of Yiqi Yangxue group was significantly higher than that of the control group(P＜0.001).Compared with before treatment,the hemoglobin(HGB)levels of all three groups of patients significantly increased after treatment(P＜0.001,P＜0.01),and the platelet levels of Bushen Shengxue group and the control group significantly increased after treatment(P＜0.001);after treatment,the HGB levels in the three groups were ranked from high to low as the Bushen Shengxue group,Yiqi Yangxue group and the control group(P＜0.01).25％of patients had HGB levels exceeding 20％of baseline values,Bushen Shengxue group took 1 month,while Yiqi Yangxue group and control group took 4 months;25％of patients had an increase in HGB levels exceeding 50％of the baseline value,Bushen Shengxue group took 6 months,while Yiqi Yangxue group and control group took more than 6 months.At 6 months,the number of patients with HGB elevation exceeding 20％and 50％of baseline values in Bushen Shengxue group was higher than that in Yiqi Yangxue group and the control group(P＜0.05,P＜0.001).25％of patients had white blood cell elevation exceeding 50％of the baseline value,Bushen Shengxue group took 4 months,Yiqi Yangxue group took 6 months,and the control group took more than 6 months.25％of patients showed an increase in platelet levels exceeding 100％of the baseline value,Bushen Shengxue group took 4 months,while Yiqi Yangxue group and control group took 6 months;at 6 months,the number of patients in Bushen Shengxue group and Yiqi Yangxue group with platelet elevation exceeding 20％of the baseline value was significantly higher than that in the control group(P＜0.01,P＜0.05).Conclusion Bushen Shengxue method combined with Western medicine intreating AA is better than the method of Yiqi Yangxue method combined with Western medicine.In terms of improving HGB,it is reflected in shortening the recovery time and increasing the number of beneficiaries,and the dosage can affect the recovery time and the number of beneficiaries at the same time;in terms of improving white blood cell and platelet,it is reflected in shortening the recovery time,and the dosage can affect the recovery time.

Objective:To compare the safety and efficacy of novel en-bloc Holmium laser enucleation of the prostate（HoLEP）with complete membranous urethral mucosa sparing technique with traditional 2-lobe technique HoLEP in benign prostatic hyperplasia（BPH）treatment.Methods:The data of BPH patients treated with HoLEP from January 2023 to May 2024 in Xinhua Hospital，School of Medicine，Shanghai Jiaotong University were retrospectively reviewed. Seventy-two patients received novel en-bloc HoLEP with complete membranous urethral mucosa sparing technique（novel en-bloc group），while 79 patients received traditional 2-lobe technique HoLEP（traditional 2-lobe technique group）.There was no significant difference between novel en-bloc group and traditional 2-lobe technique group in the age［（71.0 ± 7.1）years vs.（69.8 ± 6.5）years］，body mass index［（24.5 ± 2.8）kg/m 2 vs.（23.9 ± 3.5）kg/m 2］，international prostate symptom score（IPSS）［26.0（22.0，28.0）vs. 25.0（22.0，28.0）］，quality of life（QOL）score［5.0（5.0，6.0）vs. 5.0（5.0，6.0）］，prostate sepcific antigen（PSA）［4.98（2.40，11.11）ng/ml vs. 4.38（1.62，7.54）ng/ml］and prostate volume［（74.06 ± 42.67）ml vs.（70.10 ± 33.94）ml］（all P > 0.05）. The incidence of acute urinary retention in novel en-bloc group was significantly higher than that in traditional 2-lobe technique group［31.94%（23/72）vs. 17.72%（14/79）， P = 0.042］.The procedure of novel en-bloc was shown as followed：expose the prostatic capsule near the verumontanum and expand the initial capsule plane on both sides. The prostatic urethral mucosa was cut off in a circular pattern medial to the external urethral sphincter，which could form a complete “circular mucosal pad”. Seperate the apical gland along the capsule plane at 12 o’clock and expand the capsule plane until the bladder neck was reached.The bladder neck was then used as a marker so as to separate the glands on both sides along the capsule plane and merge with the initial plane. The entire lobe of the prostate was finally removed along the surgical capsule of the prostate. The procedure of traditional two lobe method was shown as followed：expose the prostatic capsule near the verumontanum and then divide the prostate into two lobes by longitudinal incision at 6 and 12 o’clock. The mucosa was horizontally cut at 12 o’clock，medial to the external urethral sphincter in order to preserve the apical urethral mucosal flap. The twp lobes were then removedd respectively along the capsule layer. The surgery-related indicators，perioperative complications and other data were compared between the two groups，as well as IPSS，QOL score，lower urinary tract symptoms，and the incidence of stress urinary incontinence in the two groups 1 month after surgery. Results:Compared with the patients underwent 2-lobe technique HoLEP，the patients underwent novel en-bloc HoLEP had lower hemoglobin loss［0.50（-5.50，7.50）g/L vs. 7.00（1.00，13.25）g/L， P = 0.003］，lower operation time［（72.06 ± 34.37）min vs.（85.42 ± 40.35）min， P = 0.030］，higher surgical efficacy［（0.72 ± 0.31）g/min vs.（0.55 ± 0.29）g/min， P = 0.002］and lower incidence of stress urinary incontinence one month after operation［2.78%（2/72）vs. 10.13%（8/79）， P = 0.070］. There was no significant difference in the incidence of postoperative gross hematuria［0 vs. 2.53%（2/79）］，postoperative sepsis［1.39%（1/72）vs. 1.27%（1/79）］，postoperative dysuria［4.17%（3/72）vs. 5.06%（4/79）］，postoperative IPSS improvement［12.0（11.0，13.0）vs. 12.0（10.0，14.0）］and postoperative QOL improvement［3.0（2.0，3.0）vs. 3.0（2.0，3.0）］between the two groups（ P > 0.05）. The patients were further divided into 2 sub-groups according to whether prostate volume ≥ 60 ml or not. In the patients of prostate volume < 60 ml，surgical efficacy was significantly higher in novel en-bloc HoLEP group than that in traditional 2-lobe technique group［（0.55 ± 0.25）g/min vs.（0.41 ± 0.19）g/min， P = 0.028］. In the patients of prostate volume ≥ 60 ml，the surgical efficacy of novel en-bloc HoLEP was also higher［（0.88 ± 0.28）g/min vs.（0.66 ± 0.31）g/min， P = 0.006］. Conclusions:Novel en-bloc HoLEP with complete membranous urethral mucosa sparing technique was demonstrated to has lower blood loss，shorter operation time，higher surgical efficacy and lower incidence of stress urinary incontinence，which is suitable of all sizes of prostate.

Objective To observe the value of intratumoral and peritumoral CT radiomics combined with clinic for predicting cervical lymph node metastasis(CLNM)of papillary thyroid carcinoma(PTC).Methods Totally 338 patients with PTC were retrospectively enrolled and divided into training set(n=236)and validation set(n=102)at a ratio of 7∶3,also further assigned into subgroups according to CLNM or not within sets.The clinical independent risk factors for PTC CLNM were identified using multivariate logistic regression analysis,and a clinical model was then constructed.Intratumoral ROI were delineated on CT images including non-enhanced and three-phase enhancement images,which were then enlarged by 2 mm.Radiomics models of intratumoral,peritumoral and intratumoral+peritumoral ROI were established based on non-enhanced CT,as well as arterial phase,venous phase,delayed phase and multi-phase enhanced CT,respectively,the best one was selected and combined with clinical model to construct a combined model.Receiver operating characteristic curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of each model for predicting PTC CLNM.Results Male patient and aged＜45 years were both clinical independent risk factors for PTC CLNM(both P＜0.05).Multi-phase intratumoral+peritumoral radiomics model was the optimal radiomics model,which was used to construct the combined model combining with clinical model.The AUC of combined model for predicting PTC CLNM in training set was 0.859,superior to that of clinical model and multi-phase intratumoral+peritumoral radiomics model(0.684,0.831,both P＜0.05),which in validation set was 0.832,similar to that of multi-phase intratumoral+peritumoral radiomics model(0.819,P=0.368)but superior to that of clinical model(0.605,P＜0.001).Conclusion Multi-phase intratumoral and peritumoral CT radiomics could be used to predict PTC CLNM.Combining with clinic could further improve its efficacy.

Purpose To evaluate the value of arterial-phase CT-based radiomics and habitat imaging models in predicting programmed death ligand 1(PD-L1)expression levels in non-small cell lung cancer(NSCLC).Materials and Methods Clinical and imaging data from 258 pathologically confirmed NSCLC patients at Yijishan Hospital of Wannan Medical College from April 2022 to May 2024 were retrospectively analyzed.Patients were randomly divided into training(n=207)and validation(n=51)sets at a 4∶1 ratio.Whole-lesion radiomic features were extracted from arterial-phase CT images.Subregional habitats were generated using local feature clustering,and their radiomic features were fused to derive habitat analysis features.Dimensionality reduction identified features for constructing whole-lesion radiomic and habitat analysis models.Logistic regression algorithms were used to build models and develop nomograms.Model performance was evaluated using the area under the receiver operating characteristic curve(AUC),and clinical utility was assessed via decision curve analysis.Results Two independent clinical risk factors(tumor location and necrosis presence),14 whole-lesion radiomic features and 16 habitat analysis features were selected.The clinical model achieved AUCs of 0.685(training)and 0.682(validation).The habitat analysis model(AUC:0.776 training,0.761 validation)outperformed the whole-lesion radiomic model(AUC:0.701 training,0.647 validation).The combined model integrating clinical,whole-lesion and habitat analysis features demonstrated superior performance(AUC:0.838 training,0.826 validation)and the highest clinical net benefit on decision curve analysis.Conclusion Habitat imaging features derived from arterial-phase CT effectively predict PD-L1 expression in NSCLC.Combining clinical characteristics with whole-lesion and habitat analysis features further enhances predictive performance.

Purpose To evaluate the value of arterial-phase CT-based radiomics and habitat imaging models in predicting programmed death ligand 1(PD-L1)expression levels in non-small cell lung cancer(NSCLC).Materials and Methods Clinical and imaging data from 258 pathologically confirmed NSCLC patients at Yijishan Hospital of Wannan Medical College from April 2022 to May 2024 were retrospectively analyzed.Patients were randomly divided into training(n=207)and validation(n=51)sets at a 4∶1 ratio.Whole-lesion radiomic features were extracted from arterial-phase CT images.Subregional habitats were generated using local feature clustering,and their radiomic features were fused to derive habitat analysis features.Dimensionality reduction identified features for constructing whole-lesion radiomic and habitat analysis models.Logistic regression algorithms were used to build models and develop nomograms.Model performance was evaluated using the area under the receiver operating characteristic curve(AUC),and clinical utility was assessed via decision curve analysis.Results Two independent clinical risk factors(tumor location and necrosis presence),14 whole-lesion radiomic features and 16 habitat analysis features were selected.The clinical model achieved AUCs of 0.685(training)and 0.682(validation).The habitat analysis model(AUC:0.776 training,0.761 validation)outperformed the whole-lesion radiomic model(AUC:0.701 training,0.647 validation).The combined model integrating clinical,whole-lesion and habitat analysis features demonstrated superior performance(AUC:0.838 training,0.826 validation)and the highest clinical net benefit on decision curve analysis.Conclusion Habitat imaging features derived from arterial-phase CT effectively predict PD-L1 expression in NSCLC.Combining clinical characteristics with whole-lesion and habitat analysis features further enhances predictive performance.

Objective To observe the value of intratumoral and peritumoral CT radiomics combined with clinic for predicting cervical lymph node metastasis(CLNM)of papillary thyroid carcinoma(PTC).Methods Totally 338 patients with PTC were retrospectively enrolled and divided into training set(n=236)and validation set(n=102)at a ratio of 7∶3,also further assigned into subgroups according to CLNM or not within sets.The clinical independent risk factors for PTC CLNM were identified using multivariate logistic regression analysis,and a clinical model was then constructed.Intratumoral ROI were delineated on CT images including non-enhanced and three-phase enhancement images,which were then enlarged by 2 mm.Radiomics models of intratumoral,peritumoral and intratumoral+peritumoral ROI were established based on non-enhanced CT,as well as arterial phase,venous phase,delayed phase and multi-phase enhanced CT,respectively,the best one was selected and combined with clinical model to construct a combined model.Receiver operating characteristic curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of each model for predicting PTC CLNM.Results Male patient and aged＜45 years were both clinical independent risk factors for PTC CLNM(both P＜0.05).Multi-phase intratumoral+peritumoral radiomics model was the optimal radiomics model,which was used to construct the combined model combining with clinical model.The AUC of combined model for predicting PTC CLNM in training set was 0.859,superior to that of clinical model and multi-phase intratumoral+peritumoral radiomics model(0.684,0.831,both P＜0.05),which in validation set was 0.832,similar to that of multi-phase intratumoral+peritumoral radiomics model(0.819,P=0.368)but superior to that of clinical model(0.605,P＜0.001).Conclusion Multi-phase intratumoral and peritumoral CT radiomics could be used to predict PTC CLNM.Combining with clinic could further improve its efficacy.

Objective To investigate the characteristics of peripheral blood in the treatment of aplastic anemia(AA)with Bushen Shengxue Method and Yiqi Yangxue Method combined with Western medicine.Methods Totally 492 AA patients who were treated in 19 centers including Xiyuan Hospital China Academy of Chinese Medical Sciences from September 2018 to March 2021 were selected,and were randomized into three groups:161 cases in the Bushen Shengxue group,164 cases in the Yiqi Yangxue group,and 167 cases in the control group.All three groups were orally administered cyclosporine and androgens.Bushen Shengxue group was given Bushen Shengxue Granules,Yiqi Yangxue group was given Yiqi Yangxue Granules,and the control group was given placebo(half dosage of Bushen Shengxue granules).The general data,overall efficacy,and peripheral blood at the 1st month,the 4th month,and 6th month after treatment were analyzed.Results The total effective rate of Bushen Shengxue group was 98.8％(159/161),which was significantly higher than that of Yiqi Yangxue group(79.9％)and the control group(61.7％),with statistical significance(P＜0.001);The total effective rate of Yiqi Yangxue group was significantly higher than that of the control group(P＜0.001).Compared with before treatment,the hemoglobin(HGB)levels of all three groups of patients significantly increased after treatment(P＜0.001,P＜0.01),and the platelet levels of Bushen Shengxue group and the control group significantly increased after treatment(P＜0.001);after treatment,the HGB levels in the three groups were ranked from high to low as the Bushen Shengxue group,Yiqi Yangxue group and the control group(P＜0.01).25％of patients had HGB levels exceeding 20％of baseline values,Bushen Shengxue group took 1 month,while Yiqi Yangxue group and control group took 4 months;25％of patients had an increase in HGB levels exceeding 50％of the baseline value,Bushen Shengxue group took 6 months,while Yiqi Yangxue group and control group took more than 6 months.At 6 months,the number of patients with HGB elevation exceeding 20％and 50％of baseline values in Bushen Shengxue group was higher than that in Yiqi Yangxue group and the control group(P＜0.05,P＜0.001).25％of patients had white blood cell elevation exceeding 50％of the baseline value,Bushen Shengxue group took 4 months,Yiqi Yangxue group took 6 months,and the control group took more than 6 months.25％of patients showed an increase in platelet levels exceeding 100％of the baseline value,Bushen Shengxue group took 4 months,while Yiqi Yangxue group and control group took 6 months;at 6 months,the number of patients in Bushen Shengxue group and Yiqi Yangxue group with platelet elevation exceeding 20％of the baseline value was significantly higher than that in the control group(P＜0.01,P＜0.05).Conclusion Bushen Shengxue method combined with Western medicine intreating AA is better than the method of Yiqi Yangxue method combined with Western medicine.In terms of improving HGB,it is reflected in shortening the recovery time and increasing the number of beneficiaries,and the dosage can affect the recovery time and the number of beneficiaries at the same time;in terms of improving white blood cell and platelet,it is reflected in shortening the recovery time,and the dosage can affect the recovery time.

Objective:To compare the safety and efficacy of novel en-bloc Holmium laser enucleation of the prostate（HoLEP）with complete membranous urethral mucosa sparing technique with traditional 2-lobe technique HoLEP in benign prostatic hyperplasia（BPH）treatment.Methods:The data of BPH patients treated with HoLEP from January 2023 to May 2024 in Xinhua Hospital，School of Medicine，Shanghai Jiaotong University were retrospectively reviewed. Seventy-two patients received novel en-bloc HoLEP with complete membranous urethral mucosa sparing technique（novel en-bloc group），while 79 patients received traditional 2-lobe technique HoLEP（traditional 2-lobe technique group）.There was no significant difference between novel en-bloc group and traditional 2-lobe technique group in the age［（71.0 ± 7.1）years vs.（69.8 ± 6.5）years］，body mass index［（24.5 ± 2.8）kg/m 2 vs.（23.9 ± 3.5）kg/m 2］，international prostate symptom score（IPSS）［26.0（22.0，28.0）vs. 25.0（22.0，28.0）］，quality of life（QOL）score［5.0（5.0，6.0）vs. 5.0（5.0，6.0）］，prostate sepcific antigen（PSA）［4.98（2.40，11.11）ng/ml vs. 4.38（1.62，7.54）ng/ml］and prostate volume［（74.06 ± 42.67）ml vs.（70.10 ± 33.94）ml］（all P > 0.05）. The incidence of acute urinary retention in novel en-bloc group was significantly higher than that in traditional 2-lobe technique group［31.94%（23/72）vs. 17.72%（14/79）， P = 0.042］.The procedure of novel en-bloc was shown as followed：expose the prostatic capsule near the verumontanum and expand the initial capsule plane on both sides. The prostatic urethral mucosa was cut off in a circular pattern medial to the external urethral sphincter，which could form a complete “circular mucosal pad”. Seperate the apical gland along the capsule plane at 12 o’clock and expand the capsule plane until the bladder neck was reached.The bladder neck was then used as a marker so as to separate the glands on both sides along the capsule plane and merge with the initial plane. The entire lobe of the prostate was finally removed along the surgical capsule of the prostate. The procedure of traditional two lobe method was shown as followed：expose the prostatic capsule near the verumontanum and then divide the prostate into two lobes by longitudinal incision at 6 and 12 o’clock. The mucosa was horizontally cut at 12 o’clock，medial to the external urethral sphincter in order to preserve the apical urethral mucosal flap. The twp lobes were then removedd respectively along the capsule layer. The surgery-related indicators，perioperative complications and other data were compared between the two groups，as well as IPSS，QOL score，lower urinary tract symptoms，and the incidence of stress urinary incontinence in the two groups 1 month after surgery. Results:Compared with the patients underwent 2-lobe technique HoLEP，the patients underwent novel en-bloc HoLEP had lower hemoglobin loss［0.50（-5.50，7.50）g/L vs. 7.00（1.00，13.25）g/L， P = 0.003］，lower operation time［（72.06 ± 34.37）min vs.（85.42 ± 40.35）min， P = 0.030］，higher surgical efficacy［（0.72 ± 0.31）g/min vs.（0.55 ± 0.29）g/min， P = 0.002］and lower incidence of stress urinary incontinence one month after operation［2.78%（2/72）vs. 10.13%（8/79）， P = 0.070］. There was no significant difference in the incidence of postoperative gross hematuria［0 vs. 2.53%（2/79）］，postoperative sepsis［1.39%（1/72）vs. 1.27%（1/79）］，postoperative dysuria［4.17%（3/72）vs. 5.06%（4/79）］，postoperative IPSS improvement［12.0（11.0，13.0）vs. 12.0（10.0，14.0）］and postoperative QOL improvement［3.0（2.0，3.0）vs. 3.0（2.0，3.0）］between the two groups（ P > 0.05）. The patients were further divided into 2 sub-groups according to whether prostate volume ≥ 60 ml or not. In the patients of prostate volume < 60 ml，surgical efficacy was significantly higher in novel en-bloc HoLEP group than that in traditional 2-lobe technique group［（0.55 ± 0.25）g/min vs.（0.41 ± 0.19）g/min， P = 0.028］. In the patients of prostate volume ≥ 60 ml，the surgical efficacy of novel en-bloc HoLEP was also higher［（0.88 ± 0.28）g/min vs.（0.66 ± 0.31）g/min， P = 0.006］. Conclusions:Novel en-bloc HoLEP with complete membranous urethral mucosa sparing technique was demonstrated to has lower blood loss，shorter operation time，higher surgical efficacy and lower incidence of stress urinary incontinence，which is suitable of all sizes of prostate.

ObjectiveTo investigate the immunological characteristics of the patients with aplastic anemia （AA） and elevated hemogram parameters treated with Yiqi Yangxue prescription combined with Western medicine and the predictive effects of immunological indexes on elevated hemogram parameters， thus providing a reference for the prediction of the treatment efficacy and the adjustment of the treatment regimen. MethodA retrospective study was conducted， involving 77 AA patients treated with Yiqi Yangxue prescription combined with Western medicine for 6 months in 19 medical institutions including Xiyuan Hospital， China Academy of Chinese Medical Sciences from September 2018 to March 2021. The patients were assigned into two groups according to the elevations in hemogram parameters ［including hemoglobin （HGB）， white blood cell count （WBC）， platelet （PLT）， and absolute neutrophil count （ANC）］ after 6 months of treatment. One group had the elevation <50%， and the other group had the elevation ≥50% compared with the baseline. The clinical and immunological characteristics were compared between the two groups. Result① Compared with the group with HGB elevation<50%， the group with HGB elevation≥50% showed elevated level of CD3⁺ human leukocyte antigen-DR （HLA-DR）⁺ and increased proportion of patients with T-helper cell type 2 （Th2）<5%， CD8⁺≥50%， and CD3⁺HLA-DR⁺≥9% before treatment （P<0.05， P<0.01）. The multivariate Logistic regression analysis showed that CD8⁺≥50% before treatment was the independent influencing factor for HGB elevation ≥50% ［odds ratio （OR）=12.000， 95% confidence interval （CI） 2.218， 64.928， P<0.01］. ② Compared with the group with WBC elevation<50%， the group with WBC elevation≥50% showed increased proportion of patients with CD3⁺HLA-DR⁺<6% and T-box transcription factor （T-bet）≥200% before treatment （P<0.05）. The multivariate Logistic regression analysis showed that CD3⁺HLA-DR⁺<6% （OR=2.998， 95%CI 1.036， 8.680， P<0.05） and T-bet≥200% （OR=3.634， 95%CI 1.076， 12.273， P<0.05） before treatment were independent influencing factors for WBC elevation≥50%. ③ Compared with the group with PLT elevation<50%， the group with PLT elevation≥50% presented lowered Th1 and CD3⁺HLA-DR⁺ levels and increased proportion of patients with Th1<12%， CD4⁺≥6%， and CD3⁺HLA-DR⁺<5% before treatment （P<0.05， P<0.01）. The multivariate Logistic regression analysis showed that CD3⁺HLA-DR⁺<5% before treatment was the independent influencing factor for PLT elevation≥50% （OR=16.190， 95%CI of 3.430 to 76.434， P<0.01）. ④ Compared with the group with ANC elevation<50%， the group with ANC elevation≥50% showed no significant changes in the hemogram parameters before treatment. ConclusionAs for the AA patients with rapid elevation in HGB， Yiqi Yangxue prescription combined with Western medicine demonstrate significant effects in the patients with Th2<5% and CD3⁺HLA-DR⁺≥9%， especially those with CD8⁺≥50%. As for the AA patients with rapid elevation in WBC， the therapy was particularly effective in the patients with CD3⁺HLA-DR⁺<6% and T-bet≥200%. As for the AA patients with rapid growth in PLT， the therapy was particularly effective in the patients with Th1<12% and CD4⁺≥6%， especially those with CD3⁺HLA-DR⁺<5%.

Objective:To investigate the association between programmed cell death protein 1 (PD-1) and its ligand PD-L1 and cytokines in patients with polycystic ovary syndrome (PCOS).Methods:Using the GSE54248 dataset from the GEO database, differentially expressed PD1/PD-L1 pathway-related genes in PCOS were identified and subjected to GO and KEGG pathway enrichment analysis. In this case-control study, totally 105 patients with PCOS (named PCOS group) and 109 non-PCOS patients (named control group) who were treated at the Reproductive Assisted Reproduction Center of the First Affiliated Hospital of Xinjiang Medical University from January 2022 to June 2023 were recruited. The QBPlex flow cytometry high-throughput multiplex assay was utilized to assess the peripheral blood levels of PD-L1, PD-L2, PD-1, and cytokines in PCOS group and control group. Pearson's method was used for correlation analysis.Results:In PCOS group, the PD-1 level in peripheral blood [2.890 (0.020, 4.540) ng/L] was significantly lower than that of control group [3.370 (2.460, 4.360) ng/L, P=0.008], the PD-L1 level [9.820 (8.860, 10.880) ng/L] was lower than that in control group [10.410 (9.700, 11.160) ng/L, P=0.001]. There was no significant difference in the expression level of PD-L2 between the two groups ( P>0.05). From the GSE54248 dataset, 26 differentially expressed genes were identified, primarily enriched in the PD-1/PD-L1 pathway, Th1 and Th2 cell differentiation, and pathways associated with the production of cytokines involved in inflammatory responses. Compared with control group, PCOS group exhibited a significant decrease in the peripheral blood concentrations of interleukin (IL)-5, IL-9, IL-25, IL-10, growth stimulation expressed gene 2 (ST-2), and Granzyme B, and a significant increase in IL-8, IL-1RA, and tumor necrosis factor-α (TNF-α) levels, with all differences being statistically significant (all P<0.05). PD-1 exhibited positive correlations with the levels of IL-1RA, ST-2, and TNF-α ( r=0.270, P=0.005; r=0.213, P=0.029; r=0.291, P=0.003), while it exhibited negative correlations with the levels of IL-9, IL-25, and Granzyme B ( r=-0.322, P<0.001; r=-0.211, P=0.031; r=-0.369, P<0.001). PD-L1 demonstrated positive correlations with the levels of IL-9, IL-25, and Granzyme B ( r=0.254, P=0.009; r=0.330, P<0.001; r=0.340, P<0.001), and a negative correlation with IL-10 level ( r=-0.373, P=0.009). Conclusion:The expression of PD-1 and PD-L1 in the peripheral blood of PCOS patients is down-regulated, which may be associated with an imbalance in Th1/Th2 cytokines and serve as potential molecular biomarkers for the treatment of PCOS.