Objective To analyze the clinical, imaging, pathological characteristics and prognosis of renal mucinous tubular and spindle cell carcinoma (MTSCC), so as to provide preference for the differential diagnosis and clinical management of this disease.Methods A retrospective analysis was conducted on the clinical and follow-up data of 14 patients diagnosed with renal MTSCC at the Eastern Theater Command General Hospital during June 2021 and Aug.2025.Relevant literature was reviewed.Results Of the 14 patients, 10 were female (71.4%) and 4 were male (28.6%), with a mean age of 56.9 years. Pathological staging included pT1a in 6 cases, pT1b in 7 cases, and pT2b in 1 case.The median tumor diameter was 4.5 (range 2.0-11.0) cm.Twelve cases (85.7%) were asymptomatic and detected incidentally.On ultrasonography, most tumors exhibited well-defined margins and regular morphology (9/10, 90%) and appeared as homogeneous hypoechoic masses (7/10, 70%).All lesions demonstrated hypovascular features on imaging studies.Ten patients (71.4%) underwent laparoscopic radical nephrectomy, and 4(28.6%) received partial nephrectomy.Histologically, a distinctive architecture composed of tubular structures, spindle-shaped cells, and mucinous stroma was exhibited.Immunohistochemically, the positive rates of PAX-8, VIMENTIN and CK7 in tumor cells were 100% (13/13), 91.7% (11/12) and 84.6% (11/13), respectively.The Ki-67 proliferation index ranged from 2.0% to 40.0%.During a median follow-up of 25.0 (range4.9-0.0) months, no local recurrence or distant metastasis was observed.Conclusion Renal MTSCC is a rare subtype of renal cell carcinoma, typically lacking specific clinical symptoms and characterized by hypovascular imaging features.The tumor generally follows an indolent course with a favorable prognosis.For localized tumors, partial nephrectomy should be the primary consideration.For cases with high-risk pathological features such as sarcomatoid changes, due attention should be paid to the potential invasiveness and follow-up should be closely conducted.

Objective The aim of this study is to discuss the causal relationship between periodontal disease(PD)and prostate cancer(PCa).Methods A two-sample bidirectional Mendelian randomization(MR)analysis based on publicly statistical data from genome-wide association studies(GWAS)was conducted.MR Egger,weighted medium,simple mode and weighted mode were supplemented,while inverse variance weighted analysis(IVW)was the main method of analysis.Heterogeneity testing,pleiotropy testing and leave-one-out testing were used to assess the sensitivity and stabili-ty.Results The results of MR analysis showed that PD had no significant impact on the occurrence of PCa:East Asian(IVW,PD:OR=1.07,P=0.48);European(IVW,PD:OR=1.00,P=0.37,periodontitis:OR=1.03,P=0.14,chronic gingivitis:OR=0.99,P=0.37,chronic periodontitis:OR=1.03,P=0.22).The reverse MR analysis also did not show a causal relationship between PCa and PD:East Asian(IVW,PD:OR=0.97,P=0.22);European(IVW,PD:OR=0.84,P=0.44,periodontitis:OR=1.01,P=0.75,chronic gingivitis:OR=0.93,P=0.23,chronic periodontitis:OR=0.99,P=0.80).The results of other analysis were consistent with those of IVW analysis.Conclusions The results of our two-sample bidirectional MR analysis do not support a causal relationship between PD and PCa.

Objective The aim of this study is to discuss the causal relationship between periodontal disease(PD)and prostate cancer(PCa).Methods A two-sample bidirectional Mendelian randomization(MR)analysis based on publicly statistical data from genome-wide association studies(GWAS)was conducted.MR Egger,weighted medium,simple mode and weighted mode were supplemented,while inverse variance weighted analysis(IVW)was the main method of analysis.Heterogeneity testing,pleiotropy testing and leave-one-out testing were used to assess the sensitivity and stabili-ty.Results The results of MR analysis showed that PD had no significant impact on the occurrence of PCa:East Asian(IVW,PD:OR=1.07,P=0.48);European(IVW,PD:OR=1.00,P=0.37,periodontitis:OR=1.03,P=0.14,chronic gingivitis:OR=0.99,P=0.37,chronic periodontitis:OR=1.03,P=0.22).The reverse MR analysis also did not show a causal relationship between PCa and PD:East Asian(IVW,PD:OR=0.97,P=0.22);European(IVW,PD:OR=0.84,P=0.44,periodontitis:OR=1.01,P=0.75,chronic gingivitis:OR=0.93,P=0.23,chronic periodontitis:OR=0.99,P=0.80).The results of other analysis were consistent with those of IVW analysis.Conclusions The results of our two-sample bidirectional MR analysis do not support a causal relationship between PD and PCa.

Objective:To investigate the causes and management strategies of anesthetic complications during percutaneous spinal endoscopic surgery under local anesthesia.Methods:A total of 16 800 patients (8 625 males and 8 175 females) who underwent percutaneous spinal endoscopic surgery under local anesthesia (including intravenous basic anesthesia) in Tianjin Hospital, Shandong Public Health Clinical Center and Hebei General Hospital from February 2012 to February 2023 were retrospectively analyzed. The average age was 45.3±21.6 years (range, 12-84 years). There were 220 cases of posterior cervical keyhole endoscopic surgery, 50 cases of thoracic transforaminal endoscopic surgery, 70 cases of thoracic posterior interlaminar endoscopic surgery, 11 670 cases of lumbar transforaminal endoscopic surgery, and 4 790 cases of lumbar posterior interlaminar endoscopic surgery. The occurrence time, clinical manifestations, management of intraoperative anesthesia complications were recorded, as well as surgical segments, puncture sites, complication symptoms, signs, outcome and prognosis.Results:All patients received percutaneous water-mediated uniaxial spinal endoscopic surgery under local anesthesia. There were 9 patients experienced anesthesia complications, including 6 cases of epidural diffusion of anesthetics and 3 cases of anesthetics mistakenly entering the subarachnoid space. There were 4 males and 5 females, aged 48.4±18.2 years (range, 28-84 years). There were 1 case of T 12L 1 disc herniation, 1 case of C 5-6 disc herniation, 3 cases of L 4-5 disc herniation and 4 cases of L 5S 1 disc herniation. Surgical segments and procedures: 1 case of C 5-6 posterior Keyhole endoscopic surgery, 1 case of T 12L 1 transforaminal endoscopic surgery, 2 cases of L 4-5 transforaminal endoscopic surgery, 1 case of L 4-5 interlaminar endoscopic surgery, and 4 cases of L 5S 1 interlaminar endoscopic surgery. Anesthesia complications all appeared 5-10 min after injection of local anesthetics, with symptoms of decreased oxygen saturation, decreased blood pressure, altered consciousness, and sensory and motor dysfunction of limbs. 6 patients with epidural diffusion of anesthetics recovered completely after symptomatic treatment in 5 cases, and 1 case was left with foot drop. Three patients with anesthetics mistakenly entering the subarachnoid space were immediately converted to the supine position, of which one recovered by mask oxygenation; 1 patient improved after emergency tracheal intubation, rehydration, and application of vasoconstrictive medications; and 1 patient developed multiple complications such as multiorgan failure, rhabdomyolysis, and sepsis after tracheal intubation, and recovered at 3 months after surgery with symptomatic treatment. Conclusions:Epidural diffusion and entering into subarachnoid space of anesthetics are serious complications of local anesthesia in percutaneous spinal endoscopic surgery. In addition to sensory and motor dysfunction of the limbs, the functions of the respiratory and circulatory systems can also be affected. It is necessary to be alert to the occurrence of anesthesia-related complications during operation and early identification and treatment.

Chronic rhinosinusitis(CRS)is a common chronic inflammation of nasal cavity and sinus mucosa,involving multiple pathogenesis mechanisms such as infection,allergic reactions,and immune abnormalities.Its main symptoms include nasal obstruction,rhinorrhea,and hyposmia,sig-nificantly affecting patients' quality of life.Seeking safe and effective long-term treatment methods is crucial for managing CRS.Traditional Chinese medicine(TCM)has a long history of treating CRS and has gained attention due to its profound theoretical basis,high safety,and low recurrence rate.According to TCM,CRS is mostly caused by the invasion of wind-cold-damp pathogens,heat accumu-lation in the Lung meridian,or spleen-stomach weakness.Various therapies such as oral administra-tion of Chinese herbal medicines,nasal drops,acupuncture,and moxibustion are employed to adjust the body's balance and achieve therapeutic goals.This article comprehensively analyzed recent do-mestic and international literature and reviewed the research progress on pathogenesis of CRS and its treatment with TCM,with particular emphasis on roles and mechanisms of active ingredients in Chi-nese herbal medicines.The aim of the study is to provide scientific evidence and technical support for prevention and treatment of CRS.

Objective:To identify the key epithelial cell characteristics that can accurately diagnose eosinophilic chronic sinusitis with nasal polyps（ECRSwNP） through nasal brush sampling and comparing with the pathological results of nasal polyp tissue sections. Methods:Ninety-one patients underwent surgery in the Ophthalmology and ENT Department of the Second People's Hospital of Longgang District, Shenzhen, from January 2022 to July 2024 were selected. The cohort comprised 58 males and 33 females（mean age: 41.4 years; range: 12.0-71.0）. The clinical characteristics of the patients, including gender, age, disease duration, smoking and drinking history, asthma history, subjective symptoms, sinus CT, and nasal endoscopy scores, were recorded. Nasal brush sampling of nasal polyps and inferior turbinate mucosa was performed before surgery to obtain cytological specimens, and nasal polyp tissues were collected during surgery. The demographic and clinical characteristics of patients with eosinophilic and non-eosinophilic nasal polyps were compared, as well as the relationship between nasal brush cytology of nasal polyps and inferior turbinate and nasal polyp histopathology. Statistical analysis was performed using SPSS 23.0 software. Results:Among the 91 patients, no significant differences were observed between ECRSwNP and NECRSwNP patients in terms of age, gender, smoking status, alcohol consumption, and disease duration. The nasal brush cell population in ECRSwNP patients was more likely to contain eosinophils（P<0.001） and less likely to contain lymphocytes and plasma cells（P<0.001）. Additionally, the ciliated cells in ECRSwNP patients exhibited larger widths（P=0.036）, shorter cilium lengths（P<0.001）, and more disordered arrangements（P<0.001） compared to NECRSwNP patients. In nasal brush cells from the inferior turbinate, ECRSwNP patients also showed shorter cilium lengths（P<0.001） and shorter cilia（P=0.024） compared to NECRSwNP patients. Conclusion:There are significant differences in obtaining epithelial cytological information from nasal polyps or inferior turbinates through nasal brush sampling between ECRSwNP and NECRSwNP patients.
Humans ; Male ; Female ; Middle Aged ; Adult ; Nasal Polyps/complications* ; Sinusitis/complications* ; Aged ; Chronic Disease ; Adolescent ; Nasal Mucosa/pathology* ; Young Adult ; Rhinitis/complications* ; Eosinophilia/pathology* ; Child ; Eosinophils/pathology* ; Rhinosinusitis

Objective:To investigate the causes and management strategies of anesthetic complications during percutaneous spinal endoscopic surgery under local anesthesia.Methods:A total of 16 800 patients (8 625 males and 8 175 females) who underwent percutaneous spinal endoscopic surgery under local anesthesia (including intravenous basic anesthesia) in Tianjin Hospital, Shandong Public Health Clinical Center and Hebei General Hospital from February 2012 to February 2023 were retrospectively analyzed. The average age was 45.3±21.6 years (range, 12-84 years). There were 220 cases of posterior cervical keyhole endoscopic surgery, 50 cases of thoracic transforaminal endoscopic surgery, 70 cases of thoracic posterior interlaminar endoscopic surgery, 11 670 cases of lumbar transforaminal endoscopic surgery, and 4 790 cases of lumbar posterior interlaminar endoscopic surgery. The occurrence time, clinical manifestations, management of intraoperative anesthesia complications were recorded, as well as surgical segments, puncture sites, complication symptoms, signs, outcome and prognosis.Results:All patients received percutaneous water-mediated uniaxial spinal endoscopic surgery under local anesthesia. There were 9 patients experienced anesthesia complications, including 6 cases of epidural diffusion of anesthetics and 3 cases of anesthetics mistakenly entering the subarachnoid space. There were 4 males and 5 females, aged 48.4±18.2 years (range, 28-84 years). There were 1 case of T 12L 1 disc herniation, 1 case of C 5-6 disc herniation, 3 cases of L 4-5 disc herniation and 4 cases of L 5S 1 disc herniation. Surgical segments and procedures: 1 case of C 5-6 posterior Keyhole endoscopic surgery, 1 case of T 12L 1 transforaminal endoscopic surgery, 2 cases of L 4-5 transforaminal endoscopic surgery, 1 case of L 4-5 interlaminar endoscopic surgery, and 4 cases of L 5S 1 interlaminar endoscopic surgery. Anesthesia complications all appeared 5-10 min after injection of local anesthetics, with symptoms of decreased oxygen saturation, decreased blood pressure, altered consciousness, and sensory and motor dysfunction of limbs. 6 patients with epidural diffusion of anesthetics recovered completely after symptomatic treatment in 5 cases, and 1 case was left with foot drop. Three patients with anesthetics mistakenly entering the subarachnoid space were immediately converted to the supine position, of which one recovered by mask oxygenation; 1 patient improved after emergency tracheal intubation, rehydration, and application of vasoconstrictive medications; and 1 patient developed multiple complications such as multiorgan failure, rhabdomyolysis, and sepsis after tracheal intubation, and recovered at 3 months after surgery with symptomatic treatment. Conclusions:Epidural diffusion and entering into subarachnoid space of anesthetics are serious complications of local anesthesia in percutaneous spinal endoscopic surgery. In addition to sensory and motor dysfunction of the limbs, the functions of the respiratory and circulatory systems can also be affected. It is necessary to be alert to the occurrence of anesthesia-related complications during operation and early identification and treatment.

OBJECTIVE To investigate the damage effect and potential toxic mechanism of SARS-CoV-2 spike protein(S protein)on human neuroblastomacells(SH-SY5Y).METHODS SH-SY5Y were treated with S protein at concentrations of 25,50,75,and 100 mg·L-1 for 24 h.Cell viability of SH-SY5Y was detected using the CCK-8 assay.The cytotoxic lactate dehydrogenase(LDH)detection kit was used to measure the release rate of LDH,and the 5-ethynyl-2′-deoxyuridine(EdU)-488 cell prolifera-tion kit was used to assess cell proliferation.The ATP detection kit was used to measure intracellular ATP content.The JC-1 fluorescent probe method was employed to detect the mitochondrial membrane potential(MMP)of cells.Seahorse XF was used to measure mitochondrial respiratory and glycolytic capacity.RESULTS Compared with the cell control group,cell viability was significantly reduced in S protein 25,50,75 and 100 mg·L-1 groups(P<0.01),and the half-inhibition concentration(IC50)was 65.05 mg·L-1.The LDH release rate wassignificantly increased(P<0.01)and the proportion of EdU positive cellswas significantly reduced(P<0.01)in S protein 25,50,75 and 100 mg·L-1 groups.S protein signifi-cantly reduced intracellular ATP content(P<0.01)at the concentrations of 75 and 100 mg·L-1,while significantly reduced intracellular MMP(P<0.05,P<0.01)at the concentrations of 50 and 75 mg·L-1.S protein 50 mg·L-1 increased the maximum value of basal glycolysis levels and glycolytic capacity(P<0.05,P<0.01),and S protein 25 and 50 mg·L-1 increased the maximum value of respiration capacity(P<0.05,P<0.01).SH-SY5Y cell viability was positively correlated with the intracellular ATP content and the MMP level(r2=0.9209,P=0.001;r2=0.6170,P=0.0025),and negatively correlated with the maximum level of basal glycolysis and glycolytic capacity(r2=0.5194,P=0.0285;r2=0.6664,P=0.0073),and nega-tively correlated with ATP production capacity(r2=0.8204,P=0.0008).CONCLUSIONS protein decreases the viability of SH-SY5Y cells and inhibited cell proliferation.The mechanism may be closely related to the disorder of energy metabolism.

OBJECTIVE To investigate the damage effect and mechanisms of cyclophosphamide(CTX)and its active metabolite derivative 4-hydroperoxycyclophosphamide(4-HC)to human neuroblas-toma SH-SY5Y cells.METHODS SH-SY5Y cells were treated with CTX[0(cell control),0.01,0.1,1,5,10,20,40 and 80 mmol·L-1]and 4-HC[0(cell control),0.01,0.1,1,5,10,20,40 and 80 μmol·L-1]for 48 h.Cell confluence and morphology were observed by the IncuCyte ZOOM system.Cell viability was assessed by CCK-8 assay.Lactate dehydrogenase(LDH)release was measured by LDH assay kit.SH-SY5Y cells were treated with CTX(0,1,5,10 and 20 mmol·L-1)and 4-HC(0,1,5,10 and 20 μmol·L-1)for 48 h before cell proliferation was analyzed by 5-ethynyl-2′-deoxyuridine(EdU)staining assay.Immunofluorescence was employed to assess the levels of the DNA double-strand break marker γ-H2AX and to evaluate changes in mitochondrial membrane potential.SH-SY5Y cells were treated with CTX(0,1,5 and 10 mmol·L-1)and 4-HC(0,1,5 and 10 μmol·L-1)for 48 h,and the alterations in glycolysis and oxidative phosphorylation levels were analyzed using the Seahorse XFe96 Analyzer.RESULTS Compared with the cell control group,cell confluence and cell viability were significantly reduced in the CTX and 4-HC groups(P<0.01),and the half-maximal inhibitory concentrations(IC50)for CTX and 4-HC were 4.44 mmol·L-1 and 4.78 μmol·L-1,respectively.The release rate of LDH was signif-icantly increased while the percentage of EdU+cells was significantly reduced in the CTX and 4-HC groups(P<0.01).The percentage of γ-H2AX+cells was significantly increased and mitochondrial membrane potential significantly decreased in the CTX and 4-HC group(P<0.05).Treatment with CTX and 4-HC resulted in reduced levels of maximum glycolytic capacity,glycolytic reserve,maximal respi-ration,and ATP production(P<0.05).CONCLUSION CTX and 4-HC exert significant cytotoxic effects on SH-SY5Y cells by disrupting cell membrane structure,impeding cell proliferation,and reducing cell viability.The mechanisms underlying these effects may involve intracellular DNA damage,disturbance of energy metabolism and mitochondrial dysfunction.

Objective To explore the biological function and downstream mechanism of ETS1 in glioma.Methods Bioinformatics and immunohistochemistry were used to analyze the differential expression characteristics of ETS1 in gliomas;qRT-PCR was employed to detect the expression level of ETS1 mRNA and lncRNA X-inactive specific transcript(XIST).CCK-8 and 5-ethyl-2′-deoxyuridine experiments were conducted to detect cell growth.Western blot was used to detect the expression of apoptosis-related proteins(Bax,Bak,Bcl-2).PROMO database was utilized to predict the binding sites between ETS1 and XIST promoter.Dual-luciferase reporter gene assay and chromatin immunoprecipitation-quantitative polymerase chain reaction assays were performed to verify the binding relationship between ETS1 and the XIST promoter region.cBioPortal database was used to analyze the correlation between the expression of ETS1 mRNA and XIST in glioma tissues.Results The expression levels of ETS1 mRNA and protein were significantly upregulated in glioma(P<0.05).The depletion of ETS1 significantly inhibited the proliferation of glioma cells and promoted cell apoptosis(P<0.05).ETS1 could target and bind with the XIST promoter and promote the expression of XIST(P<0.05).The overexpression of XIST reversed the effects of ETS1 on the proliferation of glioma cells and the promotion of cell apoptosis(P<0.05).Conclusion ETS1 is highly expressed in glioma tissues.It could promote the expression of lncRNA XIST,boost the proliferation of glioma cells,and inhibit cell apoptosis.