Objective To explore the feasibility of using the left inferior phrenic vein as an anatomical landmark and prioritizing the dissection of the central adrenal vein in retroperitoneal laparoscopic left adrenalectomy(RLLA).Methods 116 patients who had RLLA carried out in our hospital between January 2021 and December 2023 were chosen.They were separated into the experimental group(RLLA with the left inferior phrenic vein as an anatomical landmark and prioritizing the dissection of the central adrenal vein)and the control group[conventional three-layer method anatomic retroperitoneal laparoscopic adrenalectomy(RLA)],with 58 cases in each group.The clinical data of the two groups were compared,and the intraoperative and postoperative 24 h clinical indicators,stress indicators,immune function,and complications were evaluated.Results RLLA was successfully completed in two groups,and no cases were converted to open surgery.The operation time,time for searching the central vein,retention time of the drainage tube and postoperative hospital stay in the experimental group were significantly shorter than those in the control group.The intraoperative blood loss and postoperative drainage volume were significantly less than those in the control group,the differences were all statistically significant(P<0.05);There was no statistically significant difference in the recovery time of gastrointestinal function between the two groups of patients after surgery(P>0.05).There were no statistically significant differences in preoperative inflammatory factors,stress indicators and immune function indicators between the two groups of patients(P>0.05).The white blood cell(WBC),C-reaction protein(CRP)and interleukin-6(IL-6)of the two groups of patients 24 hours after the operation were significantly higher than those before the operation,but the experimental group was significantly lower than the control group,the differences were statistically significant(P<0.05).The malondialdehyde(MDA)of the two groups of patients 24 hours after the operation was significantly higher than that before the operation,while the superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)were significantly lower than those before the operation,and the MDA in the experimental group was significantly lower than that in the control group,and the SOD and GSH-Px were significantly higher than those in the control group(P<0.05).The levels of CD4+and CD4+/CD8+in experimental groups of patients 24 hours after the operation were significantly decreased than those before the operation,and the levels of CD3+,CD4+and CD4+/CD8+in the experimental group were significantly higher than those in the control group.The differences were statistically significant(P<0.05).There was no statistically significant difference in CD8+between the two groups of patients 24 hours after surgery(P>0.05).The number of cases with intraoperative blood pressure fluctuations in the experimental group was significantly lower than that in the control group,the difference was statistically significant(P<0.05).Neither peritoneal injury,renal pedicle vascular injury or retroperitoneal hematoma occurred during or after the operation in the two groups of patients.Conclusion In RLLA,using the left inferior phrenic vein as an anatomical landmark and prioritizing the dissection of the central adrenal vein is feasible,which can improve surgical indicators,reduce stress response and immune response,and have clinical application value.

N7-methylguanosine(m7G)modification occurs at the 5'cap of mRNA in eukaryotes,and is also found at specific sites on tRNA and rRNA,showing wide conservation across various biological organisms.Aberrant m7G modification is involved in the dysregulation of gene expression and serves as a biomarker for multiple cancers,with significant potential for applications in tumor diagnosis and therapy.This review summarizes the biological functions and regulatory mechanisms of m7G modification,and outlines its potential clinical applications.It also highlights the oncogenic roles of aberrant m7G modification and its association with prognosis,providing a detailed discussion of the role and molecular mechanisms of abnormal m7G modification in regulating drug resistance in various cancers.

As a major category of occupational hazards in China, physical factors are widely distributed in various industries and affect a large number of workers. The list and diagnostic criteria of occupational diseases caused by physical factors are important basis for occupational disease diagnosis and protection of occupational health rights and interests for occupational populations. This article compares the differences in the list of occupational diseases caused by physical factors at home and abroad, analyzes the problems in the current list of occupational diseases caused by physical factors and related diagnostic standards in China, and puts forward relevant suggestions for further adjusting the list of occupational diseases caused by physical factors, formulating and revising relevant diagnostic standards for occupational diseases, providing reference for improving the classification and catalogue of occupational diseases in China in the future.

As a major category of occupational hazards in China, physical factors are widely distributed in various industries and affect a large number of workers. The list and diagnostic criteria of occupational diseases caused by physical factors are important basis for occupational disease diagnosis and protection of occupational health rights and interests for occupational populations. This article compares the differences in the list of occupational diseases caused by physical factors at home and abroad, analyzes the problems in the current list of occupational diseases caused by physical factors and related diagnostic standards in China, and puts forward relevant suggestions for further adjusting the list of occupational diseases caused by physical factors, formulating and revising relevant diagnostic standards for occupational diseases, providing reference for improving the classification and catalogue of occupational diseases in China in the future.

Renal cancer is a common and increasingly prevalent malignancy with a complex pathogenesis influenced by genetics,smoking,and obesity.Current treatment mainly involves surgery with adjunctive chemotherapy,radiation,and immunotherapy,but high rates of recurrence and metastasis indicate its limited effectiveness,emphasizing the need for better therapeutic targets.Growing evidence indicates that epigenetic modifications,particularly RNA modifications,play a critical role in renal cancer development and progression.This review highlights recent advances in renal cancer epigenetics,focusing on RNA modifications such as N6-methyladenosine(m6 A),N7-methylguanosine(m7G),5-methylcytosine(m5C),N1-methyladenosine(m1A),adenosine-to-inosine(A-to-I),N6,2'-O-dimethyladenosine(m6Am),and N4-acetylcytidine(ac4C),along with their regulatory factors.It also explores the diagnostic and therapeutic potential of targeting RNA modifications and associated proteins.

N7-methylguanosine(m7G)modification occurs at the 5'cap of mRNA in eukaryotes,and is also found at specific sites on tRNA and rRNA,showing wide conservation across various biological organisms.Aberrant m7G modification is involved in the dysregulation of gene expression and serves as a biomarker for multiple cancers,with significant potential for applications in tumor diagnosis and therapy.This review summarizes the biological functions and regulatory mechanisms of m7G modification,and outlines its potential clinical applications.It also highlights the oncogenic roles of aberrant m7G modification and its association with prognosis,providing a detailed discussion of the role and molecular mechanisms of abnormal m7G modification in regulating drug resistance in various cancers.

Renal cancer is a common and increasingly prevalent malignancy with a complex pathogenesis influenced by genetics,smoking,and obesity.Current treatment mainly involves surgery with adjunctive chemotherapy,radiation,and immunotherapy,but high rates of recurrence and metastasis indicate its limited effectiveness,emphasizing the need for better therapeutic targets.Growing evidence indicates that epigenetic modifications,particularly RNA modifications,play a critical role in renal cancer development and progression.This review highlights recent advances in renal cancer epigenetics,focusing on RNA modifications such as N6-methyladenosine(m6 A),N7-methylguanosine(m7G),5-methylcytosine(m5C),N1-methyladenosine(m1A),adenosine-to-inosine(A-to-I),N6,2'-O-dimethyladenosine(m6Am),and N4-acetylcytidine(ac4C),along with their regulatory factors.It also explores the diagnostic and therapeutic potential of targeting RNA modifications and associated proteins.

Objective To explore the feasibility of using the left inferior phrenic vein as an anatomical landmark and prioritizing the dissection of the central adrenal vein in retroperitoneal laparoscopic left adrenalectomy(RLLA).Methods 116 patients who had RLLA carried out in our hospital between January 2021 and December 2023 were chosen.They were separated into the experimental group(RLLA with the left inferior phrenic vein as an anatomical landmark and prioritizing the dissection of the central adrenal vein)and the control group[conventional three-layer method anatomic retroperitoneal laparoscopic adrenalectomy(RLA)],with 58 cases in each group.The clinical data of the two groups were compared,and the intraoperative and postoperative 24 h clinical indicators,stress indicators,immune function,and complications were evaluated.Results RLLA was successfully completed in two groups,and no cases were converted to open surgery.The operation time,time for searching the central vein,retention time of the drainage tube and postoperative hospital stay in the experimental group were significantly shorter than those in the control group.The intraoperative blood loss and postoperative drainage volume were significantly less than those in the control group,the differences were all statistically significant(P<0.05);There was no statistically significant difference in the recovery time of gastrointestinal function between the two groups of patients after surgery(P>0.05).There were no statistically significant differences in preoperative inflammatory factors,stress indicators and immune function indicators between the two groups of patients(P>0.05).The white blood cell(WBC),C-reaction protein(CRP)and interleukin-6(IL-6)of the two groups of patients 24 hours after the operation were significantly higher than those before the operation,but the experimental group was significantly lower than the control group,the differences were statistically significant(P<0.05).The malondialdehyde(MDA)of the two groups of patients 24 hours after the operation was significantly higher than that before the operation,while the superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)were significantly lower than those before the operation,and the MDA in the experimental group was significantly lower than that in the control group,and the SOD and GSH-Px were significantly higher than those in the control group(P<0.05).The levels of CD4+and CD4+/CD8+in experimental groups of patients 24 hours after the operation were significantly decreased than those before the operation,and the levels of CD3+,CD4+and CD4+/CD8+in the experimental group were significantly higher than those in the control group.The differences were statistically significant(P<0.05).There was no statistically significant difference in CD8+between the two groups of patients 24 hours after surgery(P>0.05).The number of cases with intraoperative blood pressure fluctuations in the experimental group was significantly lower than that in the control group,the difference was statistically significant(P<0.05).Neither peritoneal injury,renal pedicle vascular injury or retroperitoneal hematoma occurred during or after the operation in the two groups of patients.Conclusion In RLLA,using the left inferior phrenic vein as an anatomical landmark and prioritizing the dissection of the central adrenal vein is feasible,which can improve surgical indicators,reduce stress response and immune response,and have clinical application value.

OBJECTIVE: To explore the application value of computer-aided diagnosis technology based on deep residual network in the diagnosis of occupational pneumoconiosis(hereinafter referred to as pneumoconiosis). METHODS: A total of 5 424 digital radiography chest images were collected from occupational health examiners using a convenient sampling method.These images were used to establish a data set. After training with the data set, the pneumoconiosis computer-aided diagnosis system was used to independently diagnose the test set images(50 positive and negative cases each) and output a positive probability value. Six diagnostic physicians with varied ages and different experiences performed independent diagnosis on the test set and assisted diagnosis with reference to computer results. The diagnostic accuracy was evaluated using the area under the receiver operating characteristic curve(AUC) value, sensitivity, and specificity.The Kappa consistency test was used to evaluate the diagnostic consistency. RESULTS: The AUC value, sensitivity, specificity, and Kappa value of pneumoconiosis diagnosis increased after using computer-aided diagnosis. The sensitivity increased from 0.74 to 0.85(P<0.05)and the Kappa value increased from 0.64 to 0.79(P<0.05). The AUC value increased from 0.90 to 0.95, and the specificity increased from 0.89 to 0.94, but there were no statistical difference(P<0.05). CONCLUSION: Computer-aided diagnosis can improve the sensitivity and consistency of pneumoconiosis screening and reduce the differences in diagnosis among physicians.

Objective:To discuss the clinical features and treatment of 19 patients with granulomatosis with polyangiitis (GPA) complicated with hypertrophic cranial pachymeningitis (HCP).Methods:The clinical features of 19 patients diagnosed with GPA complicated with HCP in Peking Union Medical College Hospital were retrospectively analyzed.Results:Among the 315 patients with GPA, 19 (12 males, 7 females, with) were diagnosed with HCP at Peking Union Medical College Hospital. The median age was 57 (19-64) years. In the neurological manifestations per se, all patients had headache, 16 patients had cerebral involvement, which included 8 cases at the frontal area, 8 cases at the temporal area, 8 cases at the skull base area (4 cases with parasellar involvements including 3 cases with cavernous sinus involvement and 2 cases with orbital involvement), 6 cases of tentorium involvement, 2 cases of cerebral palsy, 1 case of calvarium, 1 case of occipital, and 1 case with combined spinal pachymeningitis, respectively. In systemic manifestations, 10 patients had fever, 8 patients had weight lose, 4 patients had lung involvement, 3 patients had kidney involvement, 16 patients had nasosinusitis, 10 patients had tympanitis, and 16 patients had localized GPA. The laboratory tests showed that 15 patients had positive anti-neutrophil cytoplasmic antibodies (ANCA), including 8 cases with positive proteinase 3 (PR3)-ANCA and 6 cases with positive myeloperoxidase (MPO)-ANCA. Sixteen patients had lumbar puncture examination, 9 cases had elevated cerebrospinal pressure, 10 cases had elevated level of protein in cerebrospinal fluid. Nineteen patients were treated with glucocorticoids (12 patients accepted pulse therapy) and immunosuppressive agents. Twelve patients were treated with intrathecal injections of dexamethasone combined with or without Methotrexate (MTX). All 19 patients were improved.Conclusion:HCP, as a rare but serious manifestation of GPA, is not rare in active cases and should be intensively treated.