Objective To quantitatively assess the correlation between the skeletal muscle index(SMI)of patients and the occur-rence of anastomotic leakage(AL)in rectal cancer patients after surgery,and to analyze the risk factors for AL in rectal cancer patients and the influencing factors of sarcopenia.Methods The clinical,pathological,and related imaging data of 362 patients who under-went radical surgery for rectal cancer were retrospectively analyzed.All patients underwent pelvic MRI and abdominal CT scans(plain/enhanced)within one month before surgery,and the third lumbar vertebra skeletal muscle area(L3-SMA)was measured from the images.All patients were divided into AL group(56 cases)and control group(306 cases)based on the presence or absence of postoperative complications.The differences in clinical characteristics and imaging parameters between the two groups were analyzed.A logistic risk prediction model was established.Results Significant differences were observed between the two groups in sarcopenia,type of surgery,surgical approach,serum albumin level,operation duration,stoma type,and extramural vascular invasion(EMVI)(P＜0.05).These factors were incorporated in a multivariate logistic regression analysis model,the area under the curve(AUC)of receiver operating characteristic(ROC)curve of the model was 0.810[95％confidence interval(CI)0.743-0.876,P＜0.001],with a sensitivity of 0.865 and specificity of 0.669.Conclusion Sar-copenia is a significant risk factor for AL after rectal cancer surgery.It enhances the predictive efficacy for postoperative AL and serves as a basis for identifying high-risk populations for AL in clinical practice.

Objective:To investigate the expression,function,and clinical significance of CD24 in testicular germ cell tumors(TGCT).Methods:This study included 204 testicular germ cell tumor(TGCT)patients from the TCGA database and the TGCT-Changhai testicular germ cell tumor cohort(Changhai Hospital cohort).Prognostic analysis and multivariate analysis were employed to evaluate the association between CD24 expression and clinical characteristics.Immunohistochemistry(IHC)staining of tumor tissues was used to elucidate the mechanism by which CD24 regulated the tumor immune microenvironment(TIME)in TGCT.Finally,by analyzing the diffrences in PD-L1 expression levels and tumor-associated macrophage(TAM)M2-type cell infiltration rates between CD24 high-expression and low-expression groups,and employing the TIDE algorithm,we investigated the correlation between CD24 expression levels and immune escape scores as well as immunotherapy response rates.Results:Analysis of the TCGA database revealed that CD24 expression was significantly upregulated in TGCT with high clinical staging and M-stage(P<0.05).Compared to adjacent normal tissues,CD24 expression was significantly elevated in both primary and metastatic TGCT tissues(P<0.05).Significant differences in CD24 expression levels were observed across TNM stages and tumor progression statuses(all P<0.05).Univariate logistic regression analysis identified CD24 as a predictive factor for clinical outcomes in TGCT patients(OR=0.135,95%CI[0.035,0.516],P=0.003),and multivariate analysis further confirmed its role as an independent predictor(OR=0.057,95%CI[0.005,0.624],P=0.019).In TGCT tissues,CD24 mRNA levels correlated with immune cell markers CD206 and CD70(all P<0.05).Additionally,CD24 expression levels demonstrated significant predictive value in immune escape scoring and immunotherapy response rate assessments.Conclusions:CD24 is highly expressed in TGCT tissues and its expression is significantly correlated with the prognosis of TGCT patients,which makes it a potential new target point of biotherapy for testicular germ cell tumor patients.

Objective To investigate shared mechanisms and therapeutic targets between heart failure(HF)and vascular de-mentia(VaD),and identify natural compounds for dual-organ protection.Methods Single-cell data(8 samples)from GEO were processed via Seurat for clustering.Through CellChat,inter-organ communication was constructed,and top 95%ligand-receptor pairs were analyzed by KEGG enrichment.Bulk RNA-seq(70 samples)underwent differential gene(limma)and immune infiltra-tion(CIBERSORT)analyses.31186 compounds from TCMbank werescreened by AutoDock Vina,followed by molecular dynam-ics validation.Results HF fibroblasts(43.75%,7 subclusters)and VaD oligodendrocytes(76.57%,6 subclusters)dominated re-spective tissues.Cross-disease integration revealed HF-driven fibrosis(COLLAGEN)and VaD-associated neuroinflammation(SPP1),converging on PI3K-Akt and ECM pathways.HF-specific markers(TNXB/THBS4/COL1 A2)and VaD signatures(SPP1/PDGFC/TGFA)were identified,with FOXC1 identified as a shared transcriptional regulator.B cell activation character-ized immune dysregulation.Among 8 FOXC1 inhibitors,Qingdainone showed optimal binding[affinity:-9.0 kcal/mol;RMSD:(0.2±0.06)nm].Conclusion This study uncovers fibrosis-neuroinflammation crosstalk in HF-VaD comorbidity and proposes Qingdainone as a FOXC1-targeting therapeutic candidate.

Objective To investigate shared mechanisms and therapeutic targets between heart failure(HF)and vascular de-mentia(VaD),and identify natural compounds for dual-organ protection.Methods Single-cell data(8 samples)from GEO were processed via Seurat for clustering.Through CellChat,inter-organ communication was constructed,and top 95%ligand-receptor pairs were analyzed by KEGG enrichment.Bulk RNA-seq(70 samples)underwent differential gene(limma)and immune infiltra-tion(CIBERSORT)analyses.31186 compounds from TCMbank werescreened by AutoDock Vina,followed by molecular dynam-ics validation.Results HF fibroblasts(43.75%,7 subclusters)and VaD oligodendrocytes(76.57%,6 subclusters)dominated re-spective tissues.Cross-disease integration revealed HF-driven fibrosis(COLLAGEN)and VaD-associated neuroinflammation(SPP1),converging on PI3K-Akt and ECM pathways.HF-specific markers(TNXB/THBS4/COL1 A2)and VaD signatures(SPP1/PDGFC/TGFA)were identified,with FOXC1 identified as a shared transcriptional regulator.B cell activation character-ized immune dysregulation.Among 8 FOXC1 inhibitors,Qingdainone showed optimal binding[affinity:-9.0 kcal/mol;RMSD:(0.2±0.06)nm].Conclusion This study uncovers fibrosis-neuroinflammation crosstalk in HF-VaD comorbidity and proposes Qingdainone as a FOXC1-targeting therapeutic candidate.

Lung cancer is one of the most prevalent malignant tumors,which incidence and mortality rates increasing annually.Development of drug resistance is a primary factor contributing to treatment failure.Tumor-associated macrophages(TAMs),as key immune cells within tumor microenvironment(TME),play a significant role in the emergence and progression of drug resistance in tu-mors.TAMs can polarize into two distinct subtypes,M1 and M2,in response to diverse signaling stimuli.Research indicates that M2 TAMs are closely associated with poor prognoses in lung cancer,facilitating drug resistance through mechanisms such as promoting angiogenesis,enabling immune evasion,inducing stem cell-like characteristics in tumors,modulating relevant signaling pathways,and secreting cytokines.Traditional Chinese medicine(TCM)is characterized by its multi-target approach and minimal toxic side effects,it has been shown to enhance tumor sensitivity to drugs,slow malignant progression,and extend patient survival.This paper reviews the relationship between TAMs and lung cancer drug resistance while summarizing current research on TCM and their active components that regulate TAM activity to mitigate drug resistance in lung cancer,aiming to provide new insights for targeting TAMs in this context.

Objective To quantitatively assess the correlation between the skeletal muscle index(SMI)of patients and the occur-rence of anastomotic leakage(AL)in rectal cancer patients after surgery,and to analyze the risk factors for AL in rectal cancer patients and the influencing factors of sarcopenia.Methods The clinical,pathological,and related imaging data of 362 patients who under-went radical surgery for rectal cancer were retrospectively analyzed.All patients underwent pelvic MRI and abdominal CT scans(plain/enhanced)within one month before surgery,and the third lumbar vertebra skeletal muscle area(L3-SMA)was measured from the images.All patients were divided into AL group(56 cases)and control group(306 cases)based on the presence or absence of postoperative complications.The differences in clinical characteristics and imaging parameters between the two groups were analyzed.A logistic risk prediction model was established.Results Significant differences were observed between the two groups in sarcopenia,type of surgery,surgical approach,serum albumin level,operation duration,stoma type,and extramural vascular invasion(EMVI)(P＜0.05).These factors were incorporated in a multivariate logistic regression analysis model,the area under the curve(AUC)of receiver operating characteristic(ROC)curve of the model was 0.810[95％confidence interval(CI)0.743-0.876,P＜0.001],with a sensitivity of 0.865 and specificity of 0.669.Conclusion Sar-copenia is a significant risk factor for AL after rectal cancer surgery.It enhances the predictive efficacy for postoperative AL and serves as a basis for identifying high-risk populations for AL in clinical practice.

Purpose To develop and validate a nomogram incorporating high-resolution MRI and clinicopathological indicators for predicting distant metastasis after curative resection of mid-low rectal cancer.Materials and Methods This retrospective study analyzed 219 patients with pathologically confirmed mid-low rectal cancer from Tianjin Union Medical Center(December 2016 to December 2021).Patients were categorized into metastasis(n=46)and non-metastasis(n=173)groups based on postoperative distant metastasis occurrence.All patients underwent preoperative pelvic MRI with measurement of posterior mesangial thickness(PMT),mesentery fat area(MFA)and mesenteric fascia envelopment volume(MFEV)on high-resolution T2WI.Clinicopathological and imaging data were collected.Cox proportional hazards model identified predictive factors for distant metastasis,and a risk probability nomogram was constructed.Predictive performance,goodness-of-fit and clinical applicability were evaluated.Results Kaplan-Meier analysis demonstrated significantly higher distant metastasis risk in patients with PMT≤1.43 cm,MFA≤19.31 cm2 and MFEV≤137.46 cm3 compared to those with higher values(χ2=29.07,8.71,19.05;all P<0.05).Cox regression identified tumor differentiation(HR=0.536,95％CI 0.290-0.990),pathological N stage(HR=0.397,95％CI 0.210-0.747),perirectal structure invasion(HR=0.242,95％CI 0.068-0.865)and PMT(HR=0.334,95％CI 0.168-0.664)as independent predictors.The nomogram achieved a concordance index of 0.775 with good calibration.Decision curve analysis demonstrated substantial net benefit across wide probability thresholds,indicating excellent clinical applicability.Conclusion Patients with PMT≤1.43 cm,MFA≤19.31 cm2 and MFEV≤137.46 cm3 exhibit elevated distant metastasis risk.The nomogram incorporating tumor differentiation,pathological N stage,perirectal structure invasion and PMT effectively predicts distant metastasis after curative resection of mid-low rectal cancer.

Objective To investigate the differences of condylar position in patients with temporomandibular disorders(TMD),and to further explore the effects of condylar position displacement and malocclusion factors on TMD.Methods According to the inclusion criteria,normal occlusion subjects without TMD(group A,n=10),normal occlusion subjects with TMD(group B,n=8),malocclu-sion subjects without TMD(group C,n=9)and malocclusion subjects with TMD(group D,n=20)were collected.Condylar position measurement(CPM)and Cadiax Ⅳ were used to locate the position of condyle in RP and ICP,and the displacement and direction of condyle in three-dimensional direction from RP to ICP were measured by vernier caliper.All the data were averaged three times and an-alyzed by SPSS26.0 statistical software.Results In the sagittal direction,the condylar displacement of group A and group B,group C and group D,and group A and group D had statistical differences(P＜0.01).The displacement of the right condyle in the vertical direc-tion of group D was greater than that of group A,and the difference was statistically significant(P＜0.05).The difference among other groups was not statistically significant.There was no significant difference in the lateral displacement of condyle between the four groups.In group A and group D,the largest proportion of condyle deviation was anterior up,while in group B and group C,the largest proportion of condyle deviation was posterior up.Conclusion RP-ICP condylar sagittal displacement is common in people with TMD.The condyle displacement of RP-ICP in malocclusion patients without TMD is not significantly different from that in normal occlusion patients without TMD.Patients with TMD malocclusion are more likely to have condylar displacement in sagittal direction and vertical direction than normal occlusion without TMD.

Objective:To evaluate the clinical significance of morular metaplasia (MM) in fertility-preserving treatment for young patients with endometrial hyperplasia and grade 1 endometrial endometrioid carcinoma.Methods:Clinical data was retrospectively collected from patients diagnosed with endometrial hyperplasia or grade 1 endometrial endometrioid carcinoma under 40 years old who underwent progestin-based fertility-sparing treatmentat in Tianjin Medical University General Hospital between January 2018 and November 2022.Patients were divided into the MM group (37 cases) and the non-MM group (63 cases) based on pathological findings. Clinical characteristics, hysteroscopic features, treatment efficacy and fertility outcomes were compared between the two groups. The MM group was further stratified into three subgroups based on the timing of MM occurrence:(1) MM-Bef group ( n=10): MM was present in the initial endometrial curettage or hysteroscopic biopsy pathology before fertility-sparing treatment and disappeared after treatment; (2) MM-Sus group ( n=14): MM persisted consistently before and after therapy;(3) MM-Aft group ( n=13): MM was absent before therapy but appeared after treatment. The risk factors which had impact on the treatment outcomes of the patients were analyzed using univariate and multivariate Cox regression analysis. Results:The rate of polycystic ovary syndrome were higher in the MM group than the non-MM group [51% (19/37) vs 27% (17/63), P=0.014]. The complete response (CR) rate was significantly lower in the MM group than in the non-MM group [73% (27/37) vs 95% (60/63), P=0.006], and the median time to CR was significantly longer in the MM group (6.0 vs 5.0 months, P=0.005).Multivariate analysis identified that MM-Sus ( HR=0.355, 95% CI:0.174-0.723; P=0.004) and MM-Aft ( HR=0.314, 95% CI:0.145-0.681; P=0.003) were independent risk factors for delayed CR in fertility-sparing treatment. The patients in the MM group and non-MM group underwent hysteroscopic biopsy for 76 and 131 times. "Gravel-like change" was a more frequent hysteroscopic manifestation in the MM group than that in the non-MM group [18% (14/76) vs 2% (2/131), P<0.001]. Conclusions:Patients in the MM group have poorer treatment outcomes than patients in the non-MM group. MM-Sus and MM-Aft are risk factors for fertility-preserving treatment in young patients with endometrial hyperplasia or grade 1 endometrial endometrioid carcinoma. "Gravel-like change" is the characteristic hysteroscopic manifestations of MM.

Purpose To develop and validate a nomogram incorporating high-resolution MRI and clinicopathological indicators for predicting distant metastasis after curative resection of mid-low rectal cancer.Materials and Methods This retrospective study analyzed 219 patients with pathologically confirmed mid-low rectal cancer from Tianjin Union Medical Center(December 2016 to December 2021).Patients were categorized into metastasis(n=46)and non-metastasis(n=173)groups based on postoperative distant metastasis occurrence.All patients underwent preoperative pelvic MRI with measurement of posterior mesangial thickness(PMT),mesentery fat area(MFA)and mesenteric fascia envelopment volume(MFEV)on high-resolution T2WI.Clinicopathological and imaging data were collected.Cox proportional hazards model identified predictive factors for distant metastasis,and a risk probability nomogram was constructed.Predictive performance,goodness-of-fit and clinical applicability were evaluated.Results Kaplan-Meier analysis demonstrated significantly higher distant metastasis risk in patients with PMT≤1.43 cm,MFA≤19.31 cm2 and MFEV≤137.46 cm3 compared to those with higher values(χ2=29.07,8.71,19.05;all P<0.05).Cox regression identified tumor differentiation(HR=0.536,95％CI 0.290-0.990),pathological N stage(HR=0.397,95％CI 0.210-0.747),perirectal structure invasion(HR=0.242,95％CI 0.068-0.865)and PMT(HR=0.334,95％CI 0.168-0.664)as independent predictors.The nomogram achieved a concordance index of 0.775 with good calibration.Decision curve analysis demonstrated substantial net benefit across wide probability thresholds,indicating excellent clinical applicability.Conclusion Patients with PMT≤1.43 cm,MFA≤19.31 cm2 and MFEV≤137.46 cm3 exhibit elevated distant metastasis risk.The nomogram incorporating tumor differentiation,pathological N stage,perirectal structure invasion and PMT effectively predicts distant metastasis after curative resection of mid-low rectal cancer.