Background and purpose:Patients with prostate cancer(PCa)have consistently shown suboptimal responses to immunotherapy,which may be closely related to the immunosuppressive state of the PCa tumor microenvironment.MYC,a key transcription factor in cancer cells,is involved in cell proliferation,differentiation,apoptosis and immune surveillance by regulating the expression of intracellular genes.This study aimed to elucidate the mechanisms through which MYC fosters an immunosuppressive state within the PCa tumor microenvironment and to delineate its functional impact on PCa cells.Methods:We performed clustering and annotation of single-cell RNA sequencing(scRNA-seq)data from PCa,and conducted subcluster analyses for tumor cells,T cells,and macrophages respectively.The expression changes of MYC and CD47 across tumor subtype were analyzed,and the expression variations of signal regulatory protein alpha(SIRPα)among macrophage subtype were assessed.Furthermore,we divided the PCa transcriptomic dataset samples into high-and low-MYC expression groups based on MYC expression levels,and performed differential expression analysis and enrichment analysis for each group.The functional role of MYC in PCa cells was validated using chromatin immunoprecipitation-quantitative polymerase chain reaction(ChIP-qPCR)and experimental analyses.Furthermore,animal experiments(reviewed and approved by the ethics committee of the First Affiliated Hospital of Henan University of Science and Technology,approval number:D-2025-B015)were conducted to further validate the relationship between MYC and CD47.Finally,we analyzed and validated the whey acidic protein four-disulfide core domain 2(WFDC2)+tumor subtype using transcriptomic data from PCa.Results:Through the analysis of scRNA-seq data from PCa,a total of 32,977 cells were identified,and 7 distinct cell types were annotated.The tumor cells were further divided into 10 tumor cell subtypes,among which the WFDC2+tumor cell subtype exhibited more intensive cellular communication with CD8+T cells and macrophages within the PCa tumor microenvironment.MYC and CD47 exhibited high expression levels during the middle-to-late stages of differentiation in PCa cells,whereas SIRPα maintained high expression throughout the macrophage differentiation trajectory.Enrichment analysis revealed that the WFDC2+tumor cell subtype was primarily enriched in signaling pathways such as transforming growth factor-β(TGF-β)and Wnt/β-catenin.ChIP-qPCR confirmed the regulatory relationship between MYC and CD47 expression.Additionally,it was found that MYC knockdown significantly inhibited the proliferation and invasion abilities of PCa cells,while overexpression of CD47 could reverse this effect.Animal experiment results confirmed an positive correlation between MYC and CD47 protein expression.Furthermore,Tumor Immune Dysfunction and Exclusion(TIDE)and Estimate analyses indicated that patients in the low-expression group of the WFDC2+tumor cell subtype exhibited a potentially better response to immunotherapy compared to those in the high-expression group.Conclusion:The findings of this study elucidate the role of MYC in the PCa tumor immune microenvironment.Specifically,MYC promotes the proliferation and migration of PCa cells by regulating the expression of CD47.These insights provide novel perspectives for the treatment of PCa patients.

Objective:To explore the CT manifestation characteristics of peripancreatic aneurysms related to pancreatitis (PRPA).Methods:A retrospective analysis was conducted on the clinical data of 15 patients with pancreatitis-related aneurysms collected in Deyang People's Hospital from June 2017 to February 2025. Among them, there were 11 males and 4 females, with an age of (56.5±16.9) years. Record the CT manifestations of the patients, and observe the PRPA tumor-carrying arteries, morphology, quantity, bleeding, calcification, dynamic changes, etc.Results:The CT results showed that there were a total of 26 PRPAs in 15 patients. The aneurysm walls of the PRPAs had no calcification, among which 12 cases were single and 1 case was double. Two cases were multiple. The patients were pancreatitis complicated with muscle fiber dysplasia. Among them, one case had 5 PRPAs and the other had 7 PRPAs. Of the 26 PRPAs, 12 were sac-like, 8 were beaded, 4 were fusiform, and 2 were columnar in shape. The numbers of aneurysm-carrying arteries and PRPA were as follows: 8 in the pancreaticoduodenal artery, 7 in the hepatic artery and its branches, 6 in the splenic artery and its branches, 2 in the left gastric artery, 1 in the gastroduodenal artery, 1 in the middle colonic artery, and 1 in the ileocolonic artery. The CT diagnosis report missed 16 PRPAs, with a missed diagnosis rate of 61.5% (16/26). Among the 11 ruptured PRPAs, 4 were missed, with a missed diagnosis rate of 36.4%. Three missed aneurysms were diagnosed by digital subtraction angiography, and one was retrospectively analyzed by CT. Among the 15 unruptured PRPAs, 12 were missed, with a missed diagnosis rate of 80.0%. All the missed aneurysms were detected by retrospective CT analysis. There were 2 images without re-examination and 24 images with re-examination. Among the PRPAs with re-examination images, 4 disappeared after interventional embolization on the same day, 1 relapsed after interventional embolization on the same day, with a reduction in volume and disappeared after 3 days. Three cases underwent elective interventional embolization, among which two shranked and one enlarged before interventional embolization. Among the 16 cases that did not receive interventional treatment, 7 disappeared on their own, 1 was completely liquefied, 5 shrank but did not disappear, 2 remained stable in size without any change, and 1 increased. Among the re-examined PRPA images, 7 showed signs of enlargement.Conclusion:The main characteristics of PRPA are high rupture rate, prone to missed diagnosis and dynamic changes in size.

ObjectiveTo elucidate the critical role of rehabilitation medical records (including electronic records) in rehabilitation medicine's clinical practice and management, comprehensively analyzed the structure, core content and data standards of rehabilitation medical records, to develop a standardized medical record data architecture and core dataset suitable for rehabilitation medicine and to explore the application of rehabilitation data in performance evaluation and payment. MethodsBased on the regulatory documents Basic Specifications for Medical Record Writing and Basic Specifications for Electronic Medical Records (Trial) issued by National Health Commission of China, and referencing the World Health Organization (WHO) Family of International Classifications (WHO-FICs) classifications, International Classification of Diseases (ICD-10/ICD-11), International Classification of Functioning, Disability and Health (ICF), and International Classification of Health Interventions (ICHI Beta-3), this study constructed the data architecture, core content and data standards for rehabilitation medical records. Furthermore, it explored the application of rehabilitation record summary sheets (home page) data in rehabilitation medical statistics and payment methods, including Diagnosis-related Groups (DRG), Diagnosis-Intervention Packet (DIP) and Case Mix Index. ResultsThis study proposed a systematic standard framework for rehabilitation medical records, covering key components such as patient demographics, rehabilitation diagnosis, functional assessment, rehabilitation treatment prescriptions, progress evaluations and discharge summaries. The research analyzed the systematic application methods and data standards of ICD-10/ICD-11, ICF and ICHI Beta-3 in the fields of medical record terminology, coding and assessment. Constructing a standardized data structure and data standards for rehabilitation medical records can significantly improve the quality of data reporting based on the medical record summary sheet, thereby enhancing the quality control of rehabilitation services, effectively supporting the optimization of rehabilitation medical insurance payment mechanisms, and contributing to the establishment of rehabilitation medical performance evaluation and payment based on DRG and DIP. ConclusionStructured rehabilitation records and data standardization are crucial tools for quality control in rehabilitation. Systematically applying the three reference classifications of the WHO-FICs, and aligning with national medical record and electronic health record specifications, facilitate the development of a standardized rehabilitation record architecture and core dataset. Standardizing rehabilitation care pathways based on the ICF methodology, and developing ICF- and ICD-11-based rehabilitation assessment tools, auxiliary diagnostic and therapeutic systems, and supporting terminology and coding systems, can effectively enhance the quality of rehabilitation records and enable interoperability and sharing of rehabilitation data with other medical data, ultimately improving the quality and safety of rehabilitation services.

Xeroderma pigmentosum(XP)is a rare autosomal recessive disorder related to XP gene variation,often causing secondary malignant tumors.This article reports a case of a young child with secondary squamous cell carcinoma of the lower lip caused by xero-derma pigmentosum.Through a review of relevant literature,the clinical characteristics,pathogenesis,clinical pathological manifesta-tions,and prognosis of XP are discussed.

Xeroderma pigmentosum(XP)is a rare autosomal recessive disorder related to XP gene variation,often causing secondary malignant tumors.This article reports a case of a young child with secondary squamous cell carcinoma of the lower lip caused by xero-derma pigmentosum.Through a review of relevant literature,the clinical characteristics,pathogenesis,clinical pathological manifesta-tions,and prognosis of XP are discussed.

Background and purpose:Patients with prostate cancer(PCa)have consistently shown suboptimal responses to immunotherapy,which may be closely related to the immunosuppressive state of the PCa tumor microenvironment.MYC,a key transcription factor in cancer cells,is involved in cell proliferation,differentiation,apoptosis and immune surveillance by regulating the expression of intracellular genes.This study aimed to elucidate the mechanisms through which MYC fosters an immunosuppressive state within the PCa tumor microenvironment and to delineate its functional impact on PCa cells.Methods:We performed clustering and annotation of single-cell RNA sequencing(scRNA-seq)data from PCa,and conducted subcluster analyses for tumor cells,T cells,and macrophages respectively.The expression changes of MYC and CD47 across tumor subtype were analyzed,and the expression variations of signal regulatory protein alpha(SIRPα)among macrophage subtype were assessed.Furthermore,we divided the PCa transcriptomic dataset samples into high-and low-MYC expression groups based on MYC expression levels,and performed differential expression analysis and enrichment analysis for each group.The functional role of MYC in PCa cells was validated using chromatin immunoprecipitation-quantitative polymerase chain reaction(ChIP-qPCR)and experimental analyses.Furthermore,animal experiments(reviewed and approved by the ethics committee of the First Affiliated Hospital of Henan University of Science and Technology,approval number:D-2025-B015)were conducted to further validate the relationship between MYC and CD47.Finally,we analyzed and validated the whey acidic protein four-disulfide core domain 2(WFDC2)+tumor subtype using transcriptomic data from PCa.Results:Through the analysis of scRNA-seq data from PCa,a total of 32,977 cells were identified,and 7 distinct cell types were annotated.The tumor cells were further divided into 10 tumor cell subtypes,among which the WFDC2+tumor cell subtype exhibited more intensive cellular communication with CD8+T cells and macrophages within the PCa tumor microenvironment.MYC and CD47 exhibited high expression levels during the middle-to-late stages of differentiation in PCa cells,whereas SIRPα maintained high expression throughout the macrophage differentiation trajectory.Enrichment analysis revealed that the WFDC2+tumor cell subtype was primarily enriched in signaling pathways such as transforming growth factor-β(TGF-β)and Wnt/β-catenin.ChIP-qPCR confirmed the regulatory relationship between MYC and CD47 expression.Additionally,it was found that MYC knockdown significantly inhibited the proliferation and invasion abilities of PCa cells,while overexpression of CD47 could reverse this effect.Animal experiment results confirmed an positive correlation between MYC and CD47 protein expression.Furthermore,Tumor Immune Dysfunction and Exclusion(TIDE)and Estimate analyses indicated that patients in the low-expression group of the WFDC2+tumor cell subtype exhibited a potentially better response to immunotherapy compared to those in the high-expression group.Conclusion:The findings of this study elucidate the role of MYC in the PCa tumor immune microenvironment.Specifically,MYC promotes the proliferation and migration of PCa cells by regulating the expression of CD47.These insights provide novel perspectives for the treatment of PCa patients.

Objective:To explore the CT manifestation characteristics of peripancreatic aneurysms related to pancreatitis (PRPA).Methods:A retrospective analysis was conducted on the clinical data of 15 patients with pancreatitis-related aneurysms collected in Deyang People's Hospital from June 2017 to February 2025. Among them, there were 11 males and 4 females, with an age of (56.5±16.9) years. Record the CT manifestations of the patients, and observe the PRPA tumor-carrying arteries, morphology, quantity, bleeding, calcification, dynamic changes, etc.Results:The CT results showed that there were a total of 26 PRPAs in 15 patients. The aneurysm walls of the PRPAs had no calcification, among which 12 cases were single and 1 case was double. Two cases were multiple. The patients were pancreatitis complicated with muscle fiber dysplasia. Among them, one case had 5 PRPAs and the other had 7 PRPAs. Of the 26 PRPAs, 12 were sac-like, 8 were beaded, 4 were fusiform, and 2 were columnar in shape. The numbers of aneurysm-carrying arteries and PRPA were as follows: 8 in the pancreaticoduodenal artery, 7 in the hepatic artery and its branches, 6 in the splenic artery and its branches, 2 in the left gastric artery, 1 in the gastroduodenal artery, 1 in the middle colonic artery, and 1 in the ileocolonic artery. The CT diagnosis report missed 16 PRPAs, with a missed diagnosis rate of 61.5% (16/26). Among the 11 ruptured PRPAs, 4 were missed, with a missed diagnosis rate of 36.4%. Three missed aneurysms were diagnosed by digital subtraction angiography, and one was retrospectively analyzed by CT. Among the 15 unruptured PRPAs, 12 were missed, with a missed diagnosis rate of 80.0%. All the missed aneurysms were detected by retrospective CT analysis. There were 2 images without re-examination and 24 images with re-examination. Among the PRPAs with re-examination images, 4 disappeared after interventional embolization on the same day, 1 relapsed after interventional embolization on the same day, with a reduction in volume and disappeared after 3 days. Three cases underwent elective interventional embolization, among which two shranked and one enlarged before interventional embolization. Among the 16 cases that did not receive interventional treatment, 7 disappeared on their own, 1 was completely liquefied, 5 shrank but did not disappear, 2 remained stable in size without any change, and 1 increased. Among the re-examined PRPA images, 7 showed signs of enlargement.Conclusion:The main characteristics of PRPA are high rupture rate, prone to missed diagnosis and dynamic changes in size.

Objective To evaluate the efficacy and safety of combined therapy with 89Sr for treating skeletal-related events of prostate cancer. Methods Databases including PubMed,MEDLINE,EMBASE,the Cochrane library,CNKI,CBM and Wanfang were systematically searched since 89Sr was first reported in 1976 to September 2015 to include the randomized controlled trials (RCTs) of the combined therapy with 89Sr for skeletal-related events of prostate cancer.The statistical analysis was performed using Review Manager Version 5.2. Results A total of 18 RCTs involving 1 280 patients were analyzed.The results of meta-analysis indicated:there were statistically significant differences in the pain relief rate [OR=4.71,95%CI(3.34, 6.62),P<0.000 1],decrement rate of bone metastasis[OR=3.63,95%CI(2.60,5.09),P<0.000 1] and improvement rate of life quality [OR=2.16,95%CI(1.16,4.02),P<0.05].Progression-free survival of patients in experimental group was significantly longer than that in control group [HR=0.84,95%CI(0.73,0.97),P=0.02].No significant difference was found in overall survival [HR=0.82,95%CI(0.65,1.02),P=0.07].There were no significant differences in the incidence of adverse events [OR=1.46,95%CI(0.98,2.17),P>0.05]. Conclusion Combined therapy with 89Sr has better efficacy and comparable safety profile compared with standard therapy.However,the quality and sample size of the included studies are limited,so more high-quality and large-sample RCTs are needed to verify the validity.

Objective To establish the new animal models of malformation of cortical development (MCD) induced by methylazoxymethanol acetate (MAM),and analyze the relationship between extent of histopathology and age,seizure susceptibility and effect of seizure on the histopathology.Methods Pregnant Sprague-Dawley rats were randomly divided into MAM group and control group;rats in the MAM group received twice intraperitoneal injection of MAM (15 mg/kg) to establish MCD models on embryonic day 15,while rats in the control group only given normal saline.Daily activities and EEG features of the next generation rats were observed;Thioine-Giemsa staining and immunofluorescence staining of NeuN were applied to observe the histological changes.Pilocarpine was administrated to investigate the effects of seizure susceptibility and epilepsy seizure on pathological morphology.Results The MAM rats were dull and curtail their activities,their seizure susceptibility elevated.The histopathological and immunofluorescence staining results revealed that the MAM rats' cerebral cortex decreased and the laminar organization was disrupted;there were heterotopic neuros,hypertrophic neurons and proliferation nodules in the hippocampal and cortex;the pathology changes exacerbated with age.The malformation of cortical development was more serious in the MAM rats which experienced seizure than the MAM rats.Conclusion The MCD rat models can be established by twice intraperitoneal injection of MAM,and their pathological features resemble the patient of MCD and their pathology exacerbate with age.Seizure can aggravate the pathology of MCD.Combining utilization MAM and pilocarine could be a good approach to establish animal models of epilepsy based on MCD.

Objective To investigate the protective effects of memantine on isofluane￣induced decrease of proliferation in neural stem cells ( NSCs) and the potential mechanisms in vitro. Methods Neural stem cells were isolated from rat hippocampi (postnatal day 1) and grew in culture. Cultured NSCs were randomly divided into the control ( Group Control), Vehicle (Group Vehicle), Isoflurane ( Group Iso), Isoflurane +Memantine ( Group Iso +Mem) and Isoflurane + Memantine +LY294002 groups (Group Iso+Mem+LY).Proliferation was assessed by cell counting and BrdU incorporation.Western blot was conducted to detect protein expression of phospho￣Akt. Results Compared with the control group,BrdU incorporation and phospho￣Akt expressions in neural stem cells significantly declined after 2.4% isoflurane exposure for 6 h (P<0.01).However, isofluane￣induced decrease of BrdU incorporation and phospho￣Akt expressions was attenuated by the treatments of memantine (P<0.01)). It was showed that Akt inhibitors LY294002 reversed the protective effects on neural stem cells proliferation by memantine(P<0.01). Conclusion The results suggest that memantine treatment might attenuate isofluane￣induced decrease of proliferation in neural stem cells via Akt signaling pathway.