Objective To explore the correlation of MET status in patients with advanced prostatic acinar adenocarcinoma with the clinical pathological parameters and prognosis. Methods The specimen from 135 patients with advanced prostatic acinar adenocarcinoma was included. The expression of c-MET protein was detected via immunohistochemistry, and MET gene amplification was assessed by fluorescence in situ hybridization. The relationships of c-MET expression and gene amplification with clinicopathological features and prognosis were analyzed. Results The positive expression rate of c-MET was 52.60% (71/135). Compared with the c-MET expression in adjacent tissues, that in tumor tissues showed lower heterogeneous expression. Among the cases, 1.71% (2/117) exhibited MET gene polyploidy, but no gene amplification was detected. Positive c-MET expression was significantly correlated with high Gleason scores and grade groups (P=0.0073). However, no significant relationship was found between c-MET expression and progression-free survival or post-treatment t-PSA levels. Conclusion c-MET protein is expressed at a relatively low level in advanced prostatic acinar adenocarcinoma, suggesting that c-MET may not be a viable target for ADC drug development in prostatic acinar adenocarcinoma.

Objective: To systematically evaluate the influencing factors for repeated implantation failure (RIF) after in vitro fertilization-embryo transfer (IVF-ET) in China, so as to provide the evidence for prevention of RIF. Methods: Literature on influencing factors for RIF in China were retrieved from CNKI, Wanfang Data, VIP, China Medical Literature Service System, PubMed, Web of Science, Cochrane Library and Embase from inception to September, 2024. A meta-analysis was performed using RevMan 5.3 and Stata 14.0 softwares. Literature were excluded one by one for sensitivity analysis. Publication bias was evaluated using Egger's test. Results: Initially 4 836 relevant articles were retrieved, and 12 of them were finally included, with a total sample size of 11 554 individuals. There were 10 case-control studies, 1 cohort study, and 1 cross-sectional study; and 10 high-quality studies and 2 medium-quality studies. The meta-analysis showed that factors including advanced age (OR=1.121, 95%CI: 1.035-1.215), prolonged infertility duration (OR=1.237, 95%CI: 1.091-1.403), abnormal hysteroscopy findings (OR=2.205, 95%CI: 1.119-4.348), positive anti-nuclear antibody (ANA) (OR=2.393, 95%CI: 1.473-3.886), and positive anti-beta2 glycoprotein Ⅰ antibody (β2-GPⅠ-Ab) (OR=2.824, 95%CI: 1.987-4.013) were associated with an increased risk of RIF; while factors including the large number of embryos transferred (OR=0.309, 95%CI: 0.098-0.973), thicker endometrium (OR=0.601, 95%CI: 0.556-0.650), and higher granulocyte colony-stimulating factor (G-CSF) levels (OR=0.657, 95%CI: 0.511-0.845) were associated with a reduced risk of RIF. Conclusion IVF-ET RIF is associated with age, infertility duration, number of embryos transferred, endometrial thickness, hysteroscopy findings, G-CSF levels, ANA and β2-GPⅠ-Ab.

This article reports a rare case of thrombotic microangiopathy (TMA) with renal involvement complicated by allogeneic hematopoietic stem cell transplantation (allo-HSCT). The patient appeared increased serum creatinine 20 d after allo-HSCT, and gradually appeared hypertension, oliguria and edema. Despite discontinuing suspected medications, serum creatinine level did not decrease. Treatment with basiliximab and mycophenolate mofetil was initiated to prevent rejection, leading to gradual normalization of urine output and serum creatinine level. However, after stopping mycophenolate mofetil, the patient experienced recurrent increased blood pressure and decreased pulse oximetry, responding well to prednisone but recurring upon cessation, with gradually increased serum creatinine level. Renal pathology indicated that chronic TMA after allo-HSCT caused renal injury, primarily affecting the glomeruli. The renal function achieved long-term stability through low-dose prednisone and symptomatic treatment. By reviewing relevant literature, we discussed the clinical manifestations, laboratory tests, pathological features and treatment strategies of TMA with renal involvement complicated by allo-HSCT.

Objective:To summarize the clinical characteristics of elderly patients with stage Ⅰ diffuse large B-cell lymphoma (DLBCL) and analyze the factors associated with prognosis.Methods:A case series study was conducted by retrospectively collecting clinical data from patients aged over 60 years with newly diagnosed stage Ⅰ DLBCL across 20 medical centers in Jiangsu Province, China, between June 2010 and April 2023. The involved site, classification and treatment plan were summarized. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Statistical analyses were performed using the Kaplan-Meier method, and Cox regression model.Results:The study included 255 patients with a median age of 69 years, of whom 130 (51.0%) were male, 66 (25.9%) were aged ≥75 years and 26 (10.1%) had a high Charlson Comorbidity Index (CCI) score of ≥2. Extranodal involvement was observed in 163 (63.9%) patients, with the stomach (37.4%, 61/163), intestine (19.0%, 31/163), testes (11.0%, 18/163), and breast (7.4%, 12/163) being the most frequently affected sites. The non-germinal center B-cell (non-GCB) subtype was prevalent in 63.7% of patients (142/223), with no significant difference between the nodal and extranodal groups ( P=0.681). Furthermore, 73.9% (184/249) and 11.7% (29/249) of patients received the R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) and R-miniCHOP regimen, respectively. The overall 3-year PFS rate was 81.5%, and the 3-year OS rate was 85.6%. Patients aged ≥75 years ( HR=2.910, 95% CI 1.565-5.408, P=0.001) and/or with a CCI score ≥2 ( HR=2.324, 95% CI 1.141-4.732, P=0.020) had a significantly poorer PFS. Incorporating age ≥75 years and CCI score ≥2 into the stage-modified international prognostic index (sm-IPI) can better stratify the prognosis of elderly patients with stage Ⅰ DLBCL. The 3-year PFS rate was 48.7% in the high-risk group versus 85.7% in the low-risk group ( P<0.001). Conclusions:Our findings show that the elderly patients with stage Ⅰ DLBCL were predominantly characterized by extranodal involvement (particularly in the stomach and intestinal tract) and non-GCB subtype. Age ≥75 years and CCI ≥2 were identified as independent prognostic factors. The newly established sm-IPI-75-CCI incorporating these factors demonstrated superior prognostic discrimination compared to conventional risk assessment systems.

The core aberrant behaviors of attention deficit hyperactivity disorder (ADHD) are primarily manifested as inattention, hyperactivity, and impulsivity, which are closely associated with specific neuropathological features.Virtual reality (VR) technology, leveraging its immersive, interactive, and customizable properties, demonstrates potential in ameliorating the abnormal behavioral manifestations of individuals with ADHD. This article aims to synthesize existing evidence from neurobiological mechanism research and explore the therapeutic efficacy of VR interventions in improving abnormal behavioral presentations in ADHD patients. An evidence-integrated framework posits that: (1) VR enhances inhibitory control and working memory by promoting neural plasticity remodeling within key brain regions through highly contextualized simulation tasks, thereby optimizing functional connectivity.(2) VR reduces attentional lapses and impulsive behaviors by regulating the dynamic interplay efficiency among the default mode network, executive control network, and salience network.(3) VR elevates motivational levels and cognitive flexibility by dynamically modulating dopaminergic-noradrenergic system homeostasis, synergizing with brain-derived neurotrophic factor mediated synaptic plasticity. Delving deeper into these underlying mechanisms will facilitate the optimization of multi-target VR intervention design and provide novel insights for personalized behavioral therapy in ADHD.

The core aberrant behaviors of attention deficit hyperactivity disorder (ADHD) are primarily manifested as inattention, hyperactivity, and impulsivity, which are closely associated with specific neuropathological features.Virtual reality (VR) technology, leveraging its immersive, interactive, and customizable properties, demonstrates potential in ameliorating the abnormal behavioral manifestations of individuals with ADHD. This article aims to synthesize existing evidence from neurobiological mechanism research and explore the therapeutic efficacy of VR interventions in improving abnormal behavioral presentations in ADHD patients. An evidence-integrated framework posits that: (1) VR enhances inhibitory control and working memory by promoting neural plasticity remodeling within key brain regions through highly contextualized simulation tasks, thereby optimizing functional connectivity.(2) VR reduces attentional lapses and impulsive behaviors by regulating the dynamic interplay efficiency among the default mode network, executive control network, and salience network.(3) VR elevates motivational levels and cognitive flexibility by dynamically modulating dopaminergic-noradrenergic system homeostasis, synergizing with brain-derived neurotrophic factor mediated synaptic plasticity. Delving deeper into these underlying mechanisms will facilitate the optimization of multi-target VR intervention design and provide novel insights for personalized behavioral therapy in ADHD.

This article reports a rare case of thrombotic microangiopathy (TMA) with renal involvement complicated by allogeneic hematopoietic stem cell transplantation (allo-HSCT). The patient appeared increased serum creatinine 20 d after allo-HSCT, and gradually appeared hypertension, oliguria and edema. Despite discontinuing suspected medications, serum creatinine level did not decrease. Treatment with basiliximab and mycophenolate mofetil was initiated to prevent rejection, leading to gradual normalization of urine output and serum creatinine level. However, after stopping mycophenolate mofetil, the patient experienced recurrent increased blood pressure and decreased pulse oximetry, responding well to prednisone but recurring upon cessation, with gradually increased serum creatinine level. Renal pathology indicated that chronic TMA after allo-HSCT caused renal injury, primarily affecting the glomeruli. The renal function achieved long-term stability through low-dose prednisone and symptomatic treatment. By reviewing relevant literature, we discussed the clinical manifestations, laboratory tests, pathological features and treatment strategies of TMA with renal involvement complicated by allo-HSCT.

Objective:To summarize the clinical characteristics of elderly patients with stage Ⅰ diffuse large B-cell lymphoma (DLBCL) and analyze the factors associated with prognosis.Methods:A case series study was conducted by retrospectively collecting clinical data from patients aged over 60 years with newly diagnosed stage Ⅰ DLBCL across 20 medical centers in Jiangsu Province, China, between June 2010 and April 2023. The involved site, classification and treatment plan were summarized. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Statistical analyses were performed using the Kaplan-Meier method, and Cox regression model.Results:The study included 255 patients with a median age of 69 years, of whom 130 (51.0%) were male, 66 (25.9%) were aged ≥75 years and 26 (10.1%) had a high Charlson Comorbidity Index (CCI) score of ≥2. Extranodal involvement was observed in 163 (63.9%) patients, with the stomach (37.4%, 61/163), intestine (19.0%, 31/163), testes (11.0%, 18/163), and breast (7.4%, 12/163) being the most frequently affected sites. The non-germinal center B-cell (non-GCB) subtype was prevalent in 63.7% of patients (142/223), with no significant difference between the nodal and extranodal groups ( P=0.681). Furthermore, 73.9% (184/249) and 11.7% (29/249) of patients received the R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) and R-miniCHOP regimen, respectively. The overall 3-year PFS rate was 81.5%, and the 3-year OS rate was 85.6%. Patients aged ≥75 years ( HR=2.910, 95% CI 1.565-5.408, P=0.001) and/or with a CCI score ≥2 ( HR=2.324, 95% CI 1.141-4.732, P=0.020) had a significantly poorer PFS. Incorporating age ≥75 years and CCI score ≥2 into the stage-modified international prognostic index (sm-IPI) can better stratify the prognosis of elderly patients with stage Ⅰ DLBCL. The 3-year PFS rate was 48.7% in the high-risk group versus 85.7% in the low-risk group ( P<0.001). Conclusions:Our findings show that the elderly patients with stage Ⅰ DLBCL were predominantly characterized by extranodal involvement (particularly in the stomach and intestinal tract) and non-GCB subtype. Age ≥75 years and CCI ≥2 were identified as independent prognostic factors. The newly established sm-IPI-75-CCI incorporating these factors demonstrated superior prognostic discrimination compared to conventional risk assessment systems.

Abstract: Objective　To understand the behavioral characteristics of men who have sex with men (MSM) in different sexual roles and the current status of syphilis-HIV co-infection and mono-infection in Shenzhen, and to analyze the relationship between sexual roles and syphilis-HIV status. Methods　The snowball and respondent-driven sampling (RDS) were used to recruit MSM in Shenzhen for questionnaire surveys and serological testing of syphilis and HIV. Chi-square test, Wilcoxon two-sample test, Kruskal-Wallis test, and multivariate logistic regression model were used to analyze the factors associated with the sexual roles and syphilis-HIV co-infection and mono-infection. Results　A total of 839 MSM were recruited from 2019 to 2021. Of all, 289(34.45%) were receptive group, 270(32.18%) were insertive group, and 280(33.37%) were versatile group. Statistically significant differences were found among the three groups in age, household registration, educational background, first sexual partner, age of having anal sex for the first time, number of sexual partners in the last 6 months, having heterosexual sex in the last 6 months, and drug abuse (rush) in the last 6 months (χ2=34.980, 9.570, 7.621, 7.924, 23.229, 11.991, 37.717, 10.678, P<0.05). Among 839 MSM, the prevalence of syphilis-HIV co-infection, mono-HIV infection, and mono-syphilis infection were 4.17%, 5.13%, and 9.54%, respectively; the infection rates of the receptive group were 5.54%, 6.92%, and 10.03%, respectively; the infection rates of the versatile group were 4.29%, 6.43%, and 9.64%, respectively; the infection rates of insertive group were 2.59%, 1.85%, and 8.89%, respectively; there were statistical differences in infection rates of syphilis-HIV co-infection and mono-infection among different sexual roles (χ2=14.520, P=0.024 3). Ordinal logistic regression indicated that playing exclusively receptive and versatile roles in anal sexual intercourse in the last 6 months, the older MSM (≥30), senior high school and below, the younger age at the first anal, having 6 or more anal sexual partners, and not insist on using condoms in anal sexual intercourse were associated risk factors for syphilis-HIV co-infection and mono-infection. Compared with MSM in the insertive group, receptive MSM had 2.21 times the risk of syphilis-HIV co-infection and mono-infection (aOR=2.21, 95%CI:1.39-3.51), and versatile MSM had 1.26 times the risk (aOR=1.26, 95%CI:1.07-2.18). Conclusion　MSM with different sexual roles exhibit distinct demographic and sexual behavior characteristics, as well as varying risks for syphilis and HIV infections. Individualized and different corresponding preventive measures should be taken for MSM towards different sex roles and sexual behaviors.