Isocitrate dehydrogenase(IDH)wild-type glioma is a type of highly invasive brain tumor with poor prognosis and a high recur-rence rate.The recurrence process is driven by multiple complex and interwoven factors.Although the current standard treatment regi-mens can temporarily alleviate patients'symptoms,they still face significant challenges in effectively preventing tumor recurrence.The re-currence mechanism of this tumor is intricate and covers multiple aspects such as genomic instability,maintenance of stem cell characterist-ics and mesenchymal transformation,as well as dynamic changes in the tumor microenvironment.This article aims to comprehensively sum-marize the recurrence mechanism of glioblastoma and deeply explore potential countermeasures targeting these mechanisms,hoping to open up new perspectives and approaches for the treatment of recurrent tumors.

Objective To identify potential subtypes of demoralization syndrome among stroke patients undergoing neuroendovascular procedures using latent profile analysis,and to examine differences in death anxiety among these subtypes.Method This cross-sectional study used convenience sampling to recruit 202 stroke patients undergoing neuroendovascular procedures at a hospital from November 2024 to March 2025.Participants completed the General Information Questionnaire,Despair Scale(DS),and the Chinese version of the Templer's Death Anxiety Scale(CT-DAS).Using R software,we estimated a series of latent profile models(ranging from 2 to 6 profiles)based on four manifestations of demoralization syndrome:loss of meaning and purpose,dysphoria,helplessness and hopelessness,and sense of failure.Starting from the 2-profile model,we incrementally increased the number of profiles and compared model fit indices to identify the optimal solution.Subsequently,logistic regression analysis was conducted to identify the factors influencing DS scores according to the latent profile classifications.We compared DS scores across subgroups and performed bivariate correlation analysis between DS and CT-DAS subdimensions(Affective,Stress&Pain,Time Awareness,and Cognitive).Results The DS scores classified stroke patients into two distinct subtypes of demoralization syndrome:A Meaninglessness-Dysphoria Group(51.00%,103/202)and a Helplessness-Hopelessness Group(49.00%,99/202).The HHG demonstrated significantly higher proportions(P<0.05)of female patients,those hospitalized for 6～10 days,recipients of arterial stenosis/occlusion surgery,individuals with junior high school or higher education,employed subjects,and rural residents compared to the MDG.Binary logistic regression analysis revealed:Lower probability of HHG membership for urban(OR=0.159,P<0.001)and city(OR=0.224,P=0.007)residents versus rural counterparts;Higher HHG probability in patients hospitalized 6-10 days versus 1～5 days(OR=2.311,P=0.017);Elevated HHG risk among junior high school(OR=4.956,P<0.001)and high school or above graduates(OR=5.102,P=0.001)relative to those with primary education or less;Increased HHG probability in aneurysm embolization(OR=2.419,P=0.040)and arterial stenosis/occlusion surgery(OR=2.733,P=0.014)recipients compared to cerebrovascular angiography patients.The HHG scored significantly lower on the cognitive dimension of death anxiety than the MDG(t=2.421,P=0.016),while showing no differences in affective,stress&pain,or time awareness dimensions(P>0.05).Bivariate Pearson correlations indicated dysphoria(DS)positively correlated with Affective(r=0.192,P=0.006),Time Awareness(r=0.172,P=0.015),and Cognitive(r=0.139,P=0.049)of death anxiety.Conclusions Stroke patients undergoing neuroendovascular procedures exhibit elevated levels of death anxiety,with significant varia-tions observed across different subtypes of demoralization syndrome.Residential location,hospitalization duration,anxiety severity,and surgical type constitute significant determinants of demoralization syndrome.Targeted clinical interventions should be implemented to alleviate demoralization severity and mitigate death anxiety.

Objective To identify potential subtypes of demoralization syndrome among stroke patients undergoing neuroendovascular procedures using latent profile analysis,and to examine differences in death anxiety among these subtypes.Method This cross-sectional study used convenience sampling to recruit 202 stroke patients undergoing neuroendovascular procedures at a hospital from November 2024 to March 2025.Participants completed the General Information Questionnaire,Despair Scale(DS),and the Chinese version of the Templer's Death Anxiety Scale(CT-DAS).Using R software,we estimated a series of latent profile models(ranging from 2 to 6 profiles)based on four manifestations of demoralization syndrome:loss of meaning and purpose,dysphoria,helplessness and hopelessness,and sense of failure.Starting from the 2-profile model,we incrementally increased the number of profiles and compared model fit indices to identify the optimal solution.Subsequently,logistic regression analysis was conducted to identify the factors influencing DS scores according to the latent profile classifications.We compared DS scores across subgroups and performed bivariate correlation analysis between DS and CT-DAS subdimensions(Affective,Stress&Pain,Time Awareness,and Cognitive).Results The DS scores classified stroke patients into two distinct subtypes of demoralization syndrome:A Meaninglessness-Dysphoria Group(51.00%,103/202)and a Helplessness-Hopelessness Group(49.00%,99/202).The HHG demonstrated significantly higher proportions(P<0.05)of female patients,those hospitalized for 6～10 days,recipients of arterial stenosis/occlusion surgery,individuals with junior high school or higher education,employed subjects,and rural residents compared to the MDG.Binary logistic regression analysis revealed:Lower probability of HHG membership for urban(OR=0.159,P<0.001)and city(OR=0.224,P=0.007)residents versus rural counterparts;Higher HHG probability in patients hospitalized 6-10 days versus 1～5 days(OR=2.311,P=0.017);Elevated HHG risk among junior high school(OR=4.956,P<0.001)and high school or above graduates(OR=5.102,P=0.001)relative to those with primary education or less;Increased HHG probability in aneurysm embolization(OR=2.419,P=0.040)and arterial stenosis/occlusion surgery(OR=2.733,P=0.014)recipients compared to cerebrovascular angiography patients.The HHG scored significantly lower on the cognitive dimension of death anxiety than the MDG(t=2.421,P=0.016),while showing no differences in affective,stress&pain,or time awareness dimensions(P>0.05).Bivariate Pearson correlations indicated dysphoria(DS)positively correlated with Affective(r=0.192,P=0.006),Time Awareness(r=0.172,P=0.015),and Cognitive(r=0.139,P=0.049)of death anxiety.Conclusions Stroke patients undergoing neuroendovascular procedures exhibit elevated levels of death anxiety,with significant varia-tions observed across different subtypes of demoralization syndrome.Residential location,hospitalization duration,anxiety severity,and surgical type constitute significant determinants of demoralization syndrome.Targeted clinical interventions should be implemented to alleviate demoralization severity and mitigate death anxiety.

Isocitrate dehydrogenase(IDH)wild-type glioma is a type of highly invasive brain tumor with poor prognosis and a high recur-rence rate.The recurrence process is driven by multiple complex and interwoven factors.Although the current standard treatment regi-mens can temporarily alleviate patients'symptoms,they still face significant challenges in effectively preventing tumor recurrence.The re-currence mechanism of this tumor is intricate and covers multiple aspects such as genomic instability,maintenance of stem cell characterist-ics and mesenchymal transformation,as well as dynamic changes in the tumor microenvironment.This article aims to comprehensively sum-marize the recurrence mechanism of glioblastoma and deeply explore potential countermeasures targeting these mechanisms,hoping to open up new perspectives and approaches for the treatment of recurrent tumors.

Isocitrate dehydrogenase(IDH)mutation occurs frequently in glioma,cholangiocarcinoma,acute myeloid leukemia,chondro sar-coma and other tumors,and it's a potential target for cancer treatment.The novel cancer metabolite 2-hydroxyglutaric acid(2-HG)pro-duced after mutation has become an important marker for cancer treatment and prognosis evaluation.IDH mutation accurately down-regu-lates various biological processes such as glucose metabolism,lipid metabolism and amino acid metabolism in tumors.In addition,IDH mutation also affects the balance of immune microenvironment and epigenetic regulation,and its mechanism of action in the occurrence and development of cancer needs to be further explored and studied.This article reviews the mechanism of action and potential therapeut-ic strategies of IDH mutation in the development of tumors,aiming to provide novel therapeutic options for patients with IDH mutation.

Isocitrate dehydrogenase(IDH)mutation occurs frequently in glioma,cholangiocarcinoma,acute myeloid leukemia,chondro sar-coma and other tumors,and it's a potential target for cancer treatment.The novel cancer metabolite 2-hydroxyglutaric acid(2-HG)pro-duced after mutation has become an important marker for cancer treatment and prognosis evaluation.IDH mutation accurately down-regu-lates various biological processes such as glucose metabolism,lipid metabolism and amino acid metabolism in tumors.In addition,IDH mutation also affects the balance of immune microenvironment and epigenetic regulation,and its mechanism of action in the occurrence and development of cancer needs to be further explored and studied.This article reviews the mechanism of action and potential therapeut-ic strategies of IDH mutation in the development of tumors,aiming to provide novel therapeutic options for patients with IDH mutation.

Objective:To improve the understanding of indolent mantle cell lymphoma (MCL).Methods:The data of a patient with indolent leukemic MCL in the Second Affiliated Hospital of Nanjing Medical University in May 2013 were collected. The cell morphology was analyzed by using cell smear, the flow cytometry was used to make immunophenotype analysis, the karyotype analysis was performed by usig cytogenetic technique, and polymerase chain reaction (PCR) was used to make the immunoglobulin gene analysis. At the same time, lymph node pathology and immunohistochemistry were also analyzed. The related articles published were reviewed to sum up the characteristics and the treatment of indolent MCL.Results:The male patient aged 60 years was obviously asymptomatic accompanied with slow disease progression, leukemic manifestation and without lymphadenopathy. He received pathological biopsy because of located lymphadenopathy in 2008. Small cell morphology, Kappa light chain immunophenotype, t(11;14) translocation showed after the cytogenetic examination, clonal immune globulin gene rearrangement and low Ki-67 positive index were identified. In situ MCL was diagnosed by retrospective pathology.Conclusions:Indolent MCL is extremely rare. It is typically asymptomatic with none or minimal nodal involvement, indolent disease course, leukemic phase with mild lymphocytosis, Kappa light chain expression, simple karyotype, classical or small cell morphology of tumor cells and the positive index of Ki-67 <10%. In situ MCL can be seen in pathology examination. IgVH gene mutation positive and SOX11 negative expression are notable in indolent MCL. International prognostic index of MCL is probably not appropriate in the prognostic analysis of leukemic indolent MCL. It is emphasized that initial observation and having therapies only after the disease progression can be suited for indolent MCL.