Objective: This prospective study evaluated the feasibility of chemical exchange saturation transfer (CEST) MRI for assessing disease activity in thyroid-associated ophthalmopathy (TAO). Materials and Methods: A total of 88 patients with active TAO, 76 with inactive TAO, and 30 healthy controls were enrolled. CEST MRI-derived magnetization transfer ratio (MTR) and MTR asymmetry (MTRasym) at 1 ppm, 2 ppm, and 3.5 ppm were calculated. Clinical data, MTR, and MTRasym values for the extraocular muscles (one representative muscle per eye, yielding two measurements per participant) were compared among the groups. Spearman’s correlation was used to examine associations between imaging parameters and the clinical activity score (CAS) in patients with TAO. Logistic regression analysis was used to identify independent associations between imaging parameters and disease activity in patients with TAO (active vs. inactive). Receiver operating characteristic (ROC) analysis was conducted to evaluate the diagnostic performance for discriminating active from inactive TAO. Results: Patients with active TAO showed lower MTR values (P < 0.001) and higher MTRasym (1 ppm), MTRasym (2 ppm), and MTRasym (3.5 ppm) (all P < 0.001) compared with those with inactive TAO. MTR was negatively correlated with CAS (r = -0.402; P < 0.001), while MTRasym (1 ppm), MTRasym (2 ppm), and MTRasym (3.5 ppm) were positively correlated with CAS (r = 0.369, 0.350, and 0.349, respectively;all P < 0.001). MTR and MTRasym (1 ppm) were independently associated with TAO activity. The areas under the ROC curve (AUCs) for MTR and MTRasym (1 ppm) in discriminating active from inactive TAO were 0.772 and 0.730, respectively. Combining MTR with MTRasym (1 ppm) significantly improved diagnostic performance compared with either parameter alone, achieving an AUC of 0.805 (P = 0.029 and 0.001). Conclusion MTR and MTRasym (1 ppm) were independently associated with TAO activity. Their combination further enhanced diagnostic performance in distinguishing active from inactive TAO, suggesting their potential as quantitative imaging biomarkers to guide treatment in patients with TAO.

Addressing the enduring challenge of evaluating traditional Chinese medicines (TCMs), the integrated evidence chain-based effectiveness evaluation of TCMs (Eff-iEC) has emerged. This paper explored its capacity through a demonstration study that evaluated the effectiveness evidence of six commonly used anti-hepatic fibrosis Chinese patent medicines (CPMs), including Biejiajian Pill (BP), Dahuang Zhechong Pill (DZP), Biejia Ruangan Compound (BRC), Fuzheng Huayu Capsule (FHC), Anluo Huaxian Pill (AHP), and Heluo Shugan Capsule (HSC), using both Eff-iEC and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. The recognition of these CPMs within the TCM academic community was also assessed through their inclusion in relevant medical documents. Results showed that the evidence of BRC and FHC received higher assessments in both Eff-iEC and GRADE system, while the assessments for others varied. Analysis of community recognition revealed that Eff-iEC more accurately reflects the clinical value of these CPMs, exhibiting superior evaluative capabilities. By breaking through the conventional pattern of TCMs effectiveness evaluation, Eff-iEC offers a novel epistemology that better aligns with the clinical realities and reasoning of TCMs, providing a coherent methodology for clinical decision-making, new drug evaluations, and health policy formulation.

Reninoma is a rare renal secretory tumor，prevalent in the young population. This disease is mostly surgically resected，and the use of microwave ablation to treat reninoma in children is scarce. A case of reninoma in a child was reported in this paper. The patient presented with refractory hypertension，hypokalemia，hyperreninemia and hyperaldosteronemia. Enhanced CT and contrast-enhanced ultrasound showed mass in the lower pole of the right kidney，which was considered as reninoma and microwave ablation was performed. The renin concentration decreased to 68.42 pg/ml at 4 hours after surgery. After 1 year of postoperative follow-up，there was no recurrence of hypertension and hypokalemia，and no signs of tumor recurrence were seen on repeated ultrasound examinations.

Reninoma is a rare renal secretory tumor，prevalent in the young population. This disease is mostly surgically resected，and the use of microwave ablation to treat reninoma in children is scarce. A case of reninoma in a child was reported in this paper. The patient presented with refractory hypertension，hypokalemia，hyperreninemia and hyperaldosteronemia. Enhanced CT and contrast-enhanced ultrasound showed mass in the lower pole of the right kidney，which was considered as reninoma and microwave ablation was performed. The renin concentration decreased to 68.42 pg/ml at 4 hours after surgery. After 1 year of postoperative follow-up，there was no recurrence of hypertension and hypokalemia，and no signs of tumor recurrence were seen on repeated ultrasound examinations.

Objective:The pregnancy outcome,related influencing factors and genetic results of pregnant women with intracranial cysts were comparatively analyzed to provide evidence for prenatal consultation and clini-cal treatment of the fetus with intracranial cyst.Methods:A total of 92 pregnant women with fetal intracranial cysts were selected.The data of pregnancy and delivery were collected by electronic medical record system.The prog-nosis of newborn was recorded by telephone follow-up.According to the pregnancy outcome,they were divided into continued pregnancy group(80/92,87%)and induced labor group(12/92,13%).Analyze the factors that might influence the pregnancy outcome of intracranial cysts,as well as genetic outcomes.Results:Compared with the continued pregnancy group and the induced labor group,there were statistical differences between the gesta-tion age at diagnosis≤28 weeks and the presence of other abnormalities(P＜0.05),but there were no statistical differences in the age of pregnant women and the number of intracranial cysts(P＞0.05).The results of genetic examination were compared between normal and abnormal groups of 25 cases,and there were no statistical differences in the age of pregnant women,the gestation age at diagnosis,whether there was adverse pregnancy history,whether there was single cyst,and the presence of other abnormalities(P＞0.05).Conclusions:Diagno-sis of fetal intracranial cyst at≤28 weeks gestation and other systemic abnormalities are risk factors affecting pregnancy outcome.

Objective:This study aims to discuss the diagnosis and treatment of pediatric appendicovesical fistula (AVF).Methods:A retrospective analysis was conducted on the clinical data of a pediatric patient with AVF admitted to our hospital in March 2023. The patient was a 6-year and 11-month old male who was hospitalized on March 21, 2023, due to difficulty urinating accompanied by diarrhea for two weeks. Computed tomography (CT) revealed bladder stones. The preoperative diagnosis was bladder stones. Transurethral cystoscopic lithotripsy with laser was performed under general anesthesia. Two weeks postoperatively, the child presented with recurrent symptoms of frequent urination, urinary pain, and diarrhea. Urine routine examination indicated a urinary tract infection. Over a month of antibiotic treatment was ineffective, and symptoms such as pneumaturia and fecaluria emerged, with exacerbation of diarrhea, suggesting the possibility of a fistulous tract between the child's intestine and bladder. Further bladder ultrasonography with contrast showed microbubbles of contrast medium leaking from the right posterior bladder wall into the intestinal tract. Enhanced magnetic resonance imaging (MRI) demonstrated a small, sharp tube-like shadow at the upper edge of the right posterior bladder, with a strip-like, significantly enhanced shadow within the lumen. The preoperative diagnosis was revised to appendicovesical fistula. During cystoscopic examination, a papillary-like protrusion was identified on the right lateral wall of the bladder, with no evident orificium fistulae or foreign body discharge noted at the protrusion site. Consequently, robot-assisted laparoscopic partial cystectomy, appendectomy, and lysis of adhesions were performed.Results:The patient was administered antibiotic for a 10-day course of anti-infection and a urinary catheter was maintained for 13 days. The patient recovered entirely and had been discharged after the removal of the urinary catheter. At an 11-month follow-up, there were no reported specific discomforts.Conclusions:Pediatric AVF is rare, and bladder contrast-enhanced ultrasonography and MRI are preferred for initial diagnostic evaluation. The diagnosis can be confirmed by specific clinical presentations such as intermittent pneumaturia and fecaluria, diarrhea with bladder stones. Laparoscopic surgery or robot-assisted laparoscopic surgery could be a feasible treatment option.

Objective:The pregnancy outcome,related influencing factors and genetic results of pregnant women with intracranial cysts were comparatively analyzed to provide evidence for prenatal consultation and clini-cal treatment of the fetus with intracranial cyst.Methods:A total of 92 pregnant women with fetal intracranial cysts were selected.The data of pregnancy and delivery were collected by electronic medical record system.The prog-nosis of newborn was recorded by telephone follow-up.According to the pregnancy outcome,they were divided into continued pregnancy group(80/92,87%)and induced labor group(12/92,13%).Analyze the factors that might influence the pregnancy outcome of intracranial cysts,as well as genetic outcomes.Results:Compared with the continued pregnancy group and the induced labor group,there were statistical differences between the gesta-tion age at diagnosis≤28 weeks and the presence of other abnormalities(P＜0.05),but there were no statistical differences in the age of pregnant women and the number of intracranial cysts(P＞0.05).The results of genetic examination were compared between normal and abnormal groups of 25 cases,and there were no statistical differences in the age of pregnant women,the gestation age at diagnosis,whether there was adverse pregnancy history,whether there was single cyst,and the presence of other abnormalities(P＞0.05).Conclusions:Diagno-sis of fetal intracranial cyst at≤28 weeks gestation and other systemic abnormalities are risk factors affecting pregnancy outcome.

Objective:The pregnancy outcome,related influencing factors and genetic results of pregnant women with intracranial cysts were comparatively analyzed to provide evidence for prenatal consultation and clini-cal treatment of the fetus with intracranial cyst.Methods:A total of 92 pregnant women with fetal intracranial cysts were selected.The data of pregnancy and delivery were collected by electronic medical record system.The prog-nosis of newborn was recorded by telephone follow-up.According to the pregnancy outcome,they were divided into continued pregnancy group(80/92,87%)and induced labor group(12/92,13%).Analyze the factors that might influence the pregnancy outcome of intracranial cysts,as well as genetic outcomes.Results:Compared with the continued pregnancy group and the induced labor group,there were statistical differences between the gesta-tion age at diagnosis≤28 weeks and the presence of other abnormalities(P＜0.05),but there were no statistical differences in the age of pregnant women and the number of intracranial cysts(P＞0.05).The results of genetic examination were compared between normal and abnormal groups of 25 cases,and there were no statistical differences in the age of pregnant women,the gestation age at diagnosis,whether there was adverse pregnancy history,whether there was single cyst,and the presence of other abnormalities(P＞0.05).Conclusions:Diagno-sis of fetal intracranial cyst at≤28 weeks gestation and other systemic abnormalities are risk factors affecting pregnancy outcome.

Objective:The pregnancy outcome,related influencing factors and genetic results of pregnant women with intracranial cysts were comparatively analyzed to provide evidence for prenatal consultation and clini-cal treatment of the fetus with intracranial cyst.Methods:A total of 92 pregnant women with fetal intracranial cysts were selected.The data of pregnancy and delivery were collected by electronic medical record system.The prog-nosis of newborn was recorded by telephone follow-up.According to the pregnancy outcome,they were divided into continued pregnancy group(80/92,87%)and induced labor group(12/92,13%).Analyze the factors that might influence the pregnancy outcome of intracranial cysts,as well as genetic outcomes.Results:Compared with the continued pregnancy group and the induced labor group,there were statistical differences between the gesta-tion age at diagnosis≤28 weeks and the presence of other abnormalities(P＜0.05),but there were no statistical differences in the age of pregnant women and the number of intracranial cysts(P＞0.05).The results of genetic examination were compared between normal and abnormal groups of 25 cases,and there were no statistical differences in the age of pregnant women,the gestation age at diagnosis,whether there was adverse pregnancy history,whether there was single cyst,and the presence of other abnormalities(P＞0.05).Conclusions:Diagno-sis of fetal intracranial cyst at≤28 weeks gestation and other systemic abnormalities are risk factors affecting pregnancy outcome.

Objective:The pregnancy outcome,related influencing factors and genetic results of pregnant women with intracranial cysts were comparatively analyzed to provide evidence for prenatal consultation and clini-cal treatment of the fetus with intracranial cyst.Methods:A total of 92 pregnant women with fetal intracranial cysts were selected.The data of pregnancy and delivery were collected by electronic medical record system.The prog-nosis of newborn was recorded by telephone follow-up.According to the pregnancy outcome,they were divided into continued pregnancy group(80/92,87%)and induced labor group(12/92,13%).Analyze the factors that might influence the pregnancy outcome of intracranial cysts,as well as genetic outcomes.Results:Compared with the continued pregnancy group and the induced labor group,there were statistical differences between the gesta-tion age at diagnosis≤28 weeks and the presence of other abnormalities(P＜0.05),but there were no statistical differences in the age of pregnant women and the number of intracranial cysts(P＞0.05).The results of genetic examination were compared between normal and abnormal groups of 25 cases,and there were no statistical differences in the age of pregnant women,the gestation age at diagnosis,whether there was adverse pregnancy history,whether there was single cyst,and the presence of other abnormalities(P＞0.05).Conclusions:Diagno-sis of fetal intracranial cyst at≤28 weeks gestation and other systemic abnormalities are risk factors affecting pregnancy outcome.