Objective: To explore the diagnosis, treatment and prognosis of primary prostatic signet ring cell carcinoma (SRCC), so as to provide reference for the clinical diagnosis and treatment. Methods: A retrospective analysis was conducted on the clinical data of 6 patients with primary prostatic SRCC treated in Nanjing Drum Tower Hospital during Nov.2020 and Sep.2024.The clinical manifestations, imaging features, treatment methods, histological characteristics and prognosis were summarized. Results: The average age of the patients was (72.00±4.28) years.Varying degrees of dysuria occurred in 4 patients. All patients underwent multi-parametric magnetic resonance imaging (mpMRI) examination before surgery, and the results indicated typical prostate cancer.Preoperative biopsies showed high-grade (Gleason 8-10) prostate acinar adenocarcinoma.Postoperative pathological diagnoses were mixed types of prostate acinar adenocarcinoma and SRCC, and no metastasis was found in the pelvic lymph nodes.All patients were followed up for 1 to 46 months after surgery and are currently alive.Robot-assisted laparoscopic radical prostatectomy only was performed in 3 cases; apalutamide and leuprolide/triptorelin was administered after surgery in 2 cases; bicalutamide + goserelin was administered after surgery in 1 case, who developed bladder metastasis of prostate cancer 24 months later, and the serum prostate-specific antigen (PSA) concentration decreased to a safe level (<0.2 ng/mL) after the use of darolutamide with radiotherapy.No recurrence or metastasis was found in the remaining patients. Conclusion: Primary prostatic SRCC is a rare and highly aggressive malignant tumor of the prostate.The diagnosis depends on pathological examinations due to lack of specific imaging features and clinical manifestations.The prognosis is poor, and there is currently no standardized treatment.The combined use of surgery, hormonotherapy and radiotherapy can help improve the survival rate of patients.

[Objective] To investigate the clinical utility of ATP-binding cassette transporter family in immunotherapy for bladder cancer based on IMvigor210 and UNC-108 (GSE176307) datasets. [Methods] Gene expression data of 348 patients with bladder urothelial carcinoma were downloaded from the IMvigor210 database.Firstly, consensus clustering was performed to the gene expression levels of the ATP-binding cassette transporter family, resulting in two clusters: Cluster 1 and Cluster 2.Survival analysis was conducted between the two clusters.Next, univariate Cox regression was employed to identify ATP-binding cassette transporter family genes significantly affecting prognosis.A predictive model was constructed using the random survival forest algorithm to predict treatment response and survival outcomes in patients with bladder cancer receiving immunotherapy.The model's accuracy was validated with UNC-108 dataset.Then, ESTIMATE and ssGSEA were applied to analyze differences in the tumor microenvironment.Furthermore, oncoPredict algorithm was used to predict the sensitivity of patients to cisplatin. [Results] A total of 9 ATP-binding cassette transporter family genes were selected to construct the ABC score predictive model.In the IMvigor210 datasets, the Kaplan-Meier analysis revealed that patients with low ABC score had significantly longer overall survival compared to those with high ABC score (P<0.001). The ABC score model demonstrated good performance with area under the ROC curve (AUC) of 0.80, 0.87, and 0.88 for predicting 0.5-year, 1-year, and 1.5-year survival, respectively.The predictive ability of the ABC score for immunotherapy response, with an AUC of 0.78, outperformed that of TMB (AUC: 0.72) and PD-L1 (AUC: 0.58). The ABC score also exhibited favorable predictive performance in the UNC-108 validation cohort.ABC score was also significantly correlated with tumor microenvironment immune scores, various immune cells, and the expression of immune checkpoint genes. [Conclusion] ATP-binding cassette transporter family is closely associated with the tumor microenvironment and the efficacy of immunotherapy for bladder cancer, making it a potential novel biomarker for immunotherapy.

Objective To study the microanatomic structure of the subtemporal transtentorial approach to the lateral side of the brainstem,and to provide anatomical information that will assist clinicians to perform surgeries on the lateral,circumferential,and petroclival regions of the brainstem.Methods Anatomical investigations were conducted on 8 cadaveric head specimens(16 sides)using the infratemporal transtentorial approach.The heads were tilted to one side,with the zygomatic arch at its highest point.Then,a horseshoe incision was made above the auricle.The incision extended from the midpoint of the zygomatic arch to one third of the mesolateral length of the transverse sinus,with the flap turned towards the temporal part.After removing the bone,the arachnoid and the soft meninges were carefully stripped under the microscope.The exposure range of the surgical approach was observed and the positional relationships of relevant nerves and blood vessels in the approach were clarified.Important structures were photographed and the relevant parameters were measured.Results The upper edge of the zygomatic arch root could be used to accurately locate the base of the middle cranial fossa.The average distances of the star point to the apex of mastoid,the star point to the superior ridge of external auditory canal,the anterior angle of parietomastoid suture to the superior ridge of external auditory canal,and the anterior angle of parietomastoid suture to the star point of the 10 adult skull specimens were 47.23 mm,45.27 mm,26.16 mm,and 23.08 mm,respectively.The subtemporal approach could fully expose the area from as high as the posterior clinoid process to as low as the petrous ridge and the arcuate protuberance after cutting through the cerebellar tentorium.The approach makes it possible to handle lesions on the ventral or lateral sides of the middle clivus,the cistern ambiens,the midbrain,midbrain,and pons.In addition,the approach can significantly expand the exposure area of the upper part of the tentorium cerebelli through cheekbone excision and expand the exposure range of the lower part of the tentorium cerebelli through rock bone grinding technology.The total length of the trochlear nerve,distance of the trochlear nerve to the tentorial edge of cerebellum,length of its shape in the tentorial mezzanine,and its lower part of entering into the tentorium cerebelli to the petrosal ridge were(16.95±4.74)mm,(1.27±0.73)mm,(5.72±1.37)mm,and(4.51±0.39)mm,respectively.The cerebellar tentorium could be safely opened through the posterior clinoid process or arcuate protrusion for localization.The oculomotor nerve could serve as an anatomical landmark to locate the posterior cerebral artery and superior cerebellar artery.Conclusion Through microanatomic investigation,the exposure range and intraoperative difficulties of the infratemporal transtentorial approach can be clarified,which facilitates clinicians to accurately and safely plan surgical methods and reduce surgical complications.

Objective To investigate the risk factors of common cold in the naval afloat unit.Methods A retrospective survey was made on the 694 naval afloat personnel and the case-control study was performed.The subjects were divided into the more liable to common cold group (common cold per year ≥ 2 twice) (totaling 365 cases) and the less liable to common cold group (common cold per year ＜ 2 twice) (totaling 329 cases),by depending on their liability to cold.Multivariate risk factors of common cold were analyzed by using logistic regression method.Results Single factor or univariate analysis showed that there was statistical significance in educational background,active smoking and passive smoking,vegetable consumption,fruit consumption,sleep quality,exercise,application of antibiotics per year,when comparisons were made between two groups (P ＜ 0.05).Multivariate analysis showed that related factors of common cold were educational background,active smoking and passive smoking,fruit consumption (＜ 3 times per week),sleep quality,exercise(＜ 3 times per week) and application of antibiotics per year(＞ 3 times) after adjustment of the influential factors,with odds ratio and 95％ confidence interval being respectively 0.681 (0.470-0.986),1.812 (1.046-3.138),2.160 (1.337-3.490),2.109 (1.495-3.205),4.204 (2.927-6.038),2.440 (1.584-3.758)and 5.178 (3.486-7.691).The factor of vegetable consumption (＜ 3 times per week) was positively correlated with common cold.Conclusions The study demonstrated that educational background was an independent protective factor of common cold,while active smoking,passive smoking,fruit consumption (＜ 3 times per week),sleep quality and exercise (＜ 3 times per week) were independent risk factors of common cold.

Objective To analyze the respiratory disease spectrum among the ship crews of naval afloat units from 2005 to 2014 and features of diseases in the last dozen of years,so as to provide evidence for future medical support of our naval afloat units.Methods Statistical analyses were made on the medical data of all the "Military Health Statistical Reports" from the Naval Logistics Command from January 2005 to November 2014,features of the disease were summarized,and finally a comparative study was performed on the respiratory system disorders encountered by naval afloat units in the past years.Results (1) The top 5 diseases that occurred among the naval afloat units from 2005 to 2014 were:upper respiratory tract infection,tonsillitis,trauma,ringworm,simple diarrhea,accounting for 61.7％ of all the diseases,with the incidence of upper respiratory tract infection (39.0％) being the first of all the disorders.(2) The top five system diseases among the naval afloat units from 2005 to 2014 were:respiratory system,digestive system,trauma,musculoskeletal system,skin and subcutaneous tissue disorders,accounting for 93％ of all the diseases,with the incidence of upper respiratory tract infection (53％) being the first of all system disorders.(3) The top five respiratory disorders that occurred among the naval afloat units during the same time span were:upper respiratory tract infection,tonsillitis,rhinitis,bronchitis and pneumonia,with the incidence of upper respiratory tract infection being the first,accounting for 74％ of all the respiratory system disorders.(4) During the time span of 2005 to 2013,the incidence of upper respiratory tract infection among the naval afloat units fluctuated between 93％ and 110％.Conclusions The respiratory system disorders were the most common diseases that occurred among the naval afloat units.With this reason,it was of positive significance to pay special emphasis on the prevention and treatment of respiratory diseases,the upper respiratory tract infection in particular.

Objective To investigate the risk factors of common cold in the naval afloat unit.Methods A retrospective survey was made on the 694 naval afloat personnel and the case-control study was performed.The subjects were divided into the more liable to common cold group (common cold per year ≥ 2 twice) (totaling 365 cases) and the less liable to common cold group (common cold per year ＜ 2 twice) (totaling 329 cases),by depending on their liability to cold.Multivariate risk factors of common cold were analyzed by using logistic regression method.Results Single factor or univariate analysis showed that there was statistical significance in educational background,active smoking and passive smoking,vegetable consumption,fruit consumption,sleep quality,exercise,application of antibiotics per year,when comparisons were made between two groups (P ＜ 0.05).Multivariate analysis showed that related factors of common cold were educational background,active smoking and passive smoking,fruit consumption (＜ 3 times per week),sleep quality,exercise(＜ 3 times per week) and application of antibiotics per year(＞ 3 times) after adjustment of the influential factors,with odds ratio and 95％ confidence interval being respectively 0.681 (0.470-0.986),1.812 (1.046-3.138),2.160 (1.337-3.490),2.109 (1.495-3.205),4.204 (2.927-6.038),2.440 (1.584-3.758)and 5.178 (3.486-7.691).The factor of vegetable consumption (＜ 3 times per week) was positively correlated with common cold.Conclusions The study demonstrated that educational background was an independent protective factor of common cold,while active smoking,passive smoking,fruit consumption (＜ 3 times per week),sleep quality and exercise (＜ 3 times per week) were independent risk factors of common cold.

Objective To analyze the respiratory disease spectrum among the ship crews of naval afloat units from 2005 to 2014 and features of diseases in the last dozen of years,so as to provide evidence for future medical support of our naval afloat units.Methods Statistical analyses were made on the medical data of all the "Military Health Statistical Reports" from the Naval Logistics Command from January 2005 to November 2014,features of the disease were summarized,and finally a comparative study was performed on the respiratory system disorders encountered by naval afloat units in the past years.Results (1) The top 5 diseases that occurred among the naval afloat units from 2005 to 2014 were:upper respiratory tract infection,tonsillitis,trauma,ringworm,simple diarrhea,accounting for 61.7％ of all the diseases,with the incidence of upper respiratory tract infection (39.0％) being the first of all the disorders.(2) The top five system diseases among the naval afloat units from 2005 to 2014 were:respiratory system,digestive system,trauma,musculoskeletal system,skin and subcutaneous tissue disorders,accounting for 93％ of all the diseases,with the incidence of upper respiratory tract infection (53％) being the first of all system disorders.(3) The top five respiratory disorders that occurred among the naval afloat units during the same time span were:upper respiratory tract infection,tonsillitis,rhinitis,bronchitis and pneumonia,with the incidence of upper respiratory tract infection being the first,accounting for 74％ of all the respiratory system disorders.(4) During the time span of 2005 to 2013,the incidence of upper respiratory tract infection among the naval afloat units fluctuated between 93％ and 110％.Conclusions The respiratory system disorders were the most common diseases that occurred among the naval afloat units.With this reason,it was of positive significance to pay special emphasis on the prevention and treatment of respiratory diseases,the upper respiratory tract infection in particular.