Objective:To explore the clinicopathological features of rectal neuroendocrine tumor (R-NET) G2, identify prognostic factors, and summarize treatment experience.Methods:The clinical data of patients diagnosed with R-NET G2 by pathological diagnosis admitted to Cancer Hospital of the Chinese Academy of Medical Sciences from January 2003 to September 2023 were retrospectively analyzed. The Fisher's exact test and Kaplan-Meier curves were performed to analyze the association between pathological features and prognosis.Results:A total of 22 patients were enrolled in this study and 21 patients were followed up for a period of 6-98 months with a median follow-up time of 42 months. 5 patients died due to tumor progression during the follow-up period. The 1-, 3-, and 5-year cancer-specific survival (CSS) of the whole group were 100.0%, 92.9%, and 69.6%, respectively. Of the 22 patients, 20 underwent surgical treatment, of which 15 underwent postoperative adjuvant therapy; 2 underwent medical treatment for liver and bone multiple metastases. The 5-year survival rates of patients with tumours ≥2 cm in length, T2-3 stage, lymph node metastasis, and distant metastasis (57.1%, 68.8%, 66.7%, and 63.6%, respectively) were shorter than those of patients with tumours <2 cm in length, T1 stage, no lymph node metastasis, and no distant metastasis (all 100.0%, P＜0.001). In addition, patients with liver metastases had larger primary tumor diameters and higher T-stages compared with those without distant metastasis ( P＜0.05). Conclusions:R-NET G2 has a high degree of malignancy compared with G1 and a high propensity for metastasis. Clinicians should formulate appropriate diagnostic and treatment strategies based on factors such as tumor size, depth of invasion, lymph node status, presence of distant metastasis, and the location and extent of distant metastasis.

Objective:To explore the clinicopathological features of rectal neuroendocrine tumor (R-NET) G2, identify prognostic factors, and summarize treatment experience.Methods:The clinical data of patients diagnosed with R-NET G2 by pathological diagnosis admitted to Cancer Hospital of the Chinese Academy of Medical Sciences from January 2003 to September 2023 were retrospectively analyzed. The Fisher's exact test and Kaplan-Meier curves were performed to analyze the association between pathological features and prognosis.Results:A total of 22 patients were enrolled in this study and 21 patients were followed up for a period of 6-98 months with a median follow-up time of 42 months. 5 patients died due to tumor progression during the follow-up period. The 1-, 3-, and 5-year cancer-specific survival (CSS) of the whole group were 100.0%, 92.9%, and 69.6%, respectively. Of the 22 patients, 20 underwent surgical treatment, of which 15 underwent postoperative adjuvant therapy; 2 underwent medical treatment for liver and bone multiple metastases. The 5-year survival rates of patients with tumours ≥2 cm in length, T2-3 stage, lymph node metastasis, and distant metastasis (57.1%, 68.8%, 66.7%, and 63.6%, respectively) were shorter than those of patients with tumours <2 cm in length, T1 stage, no lymph node metastasis, and no distant metastasis (all 100.0%, P＜0.001). In addition, patients with liver metastases had larger primary tumor diameters and higher T-stages compared with those without distant metastasis ( P＜0.05). Conclusions:R-NET G2 has a high degree of malignancy compared with G1 and a high propensity for metastasis. Clinicians should formulate appropriate diagnostic and treatment strategies based on factors such as tumor size, depth of invasion, lymph node status, presence of distant metastasis, and the location and extent of distant metastasis.

Objective To analyze the influencing factors of oral frailty in elderly patients with type 2 diabetes and construct a nomogram prediction model. Methods A total of 370 elderly patients with type 2 diabetes were selected as the research subjects, including 284 patients in the modeling group and 86 patients in the validation group. The Oral Frailty Index-8 (OF-8) Scale was used for oral frailty screening, and a score of ≥4 was considered positive for oral frailty. General information of the two groups was collected through a self-made questionnaire. Multivariate Logistic regression analysis was used to analyze the influencing factors of oral frailty in patients with type 2 diabetes, and nomogram model was constructed. The goodness-of-fit and predictive performance of the model were verified using the Hosmer-Lemeshow goodness-of-fit test and the receiver operating characteristic curve (ROC). Results The incidence of oral frailty among elderly patients with type 2 diabetes was 45.4% (129/284). Age, body mass index (BMI), appendicular skeletal muscle mass index (ASMI), smoking, monthly income and subjective chewing difficulty were identified as influencing factors for oral frailty in elderly diabetic patients (P < 0.05). The areas under the ROC for internal and external validation were 0.887 (95%CI, 0.847 to 0.925) and 0.839 (95%CI, 0.755 to 0.923), respectively. The Hosmer-Lemeshow test showed that χ²=4.852, P=0.773, indicating good goodness-of-fit for the nomogram model. Conclusion Age, ASMI, BMI, smoking, monthly income and subjective chewing difficulty are influencing factors for oral frailty in elderly diabetic patients. The nomogram prediction model constructed based on these influencing factors demonstrates good performance.

The patient was a 29-year-old male with a history of hemophilia for more than 10 years. After 6 hours of botulinum toxin injection into the masseter muscle, the redness and swelling of the right face gradually worsened, accompanied by local pain, and restricted mouth opening, etc. The hematoma was absorbed and the swelling subsided significantly after the infusion of coagulation factor Ⅸ. Such cases of large-scale hematomas after botulinum toxin injection in hemophiliacs is rarely reported. This article summarized the diagnosis and treatment process of this case and combines with literature review to provide clinical experience for diagnosis, treatment and prevention of similar complications.

Objective A high sodium(HS)diet is believed to affect bone metabolism processes.Clarifying its impact on osseointegration of titanium(Ti)implants holds significant implications for postoperative dietary management of implanted patients. Methods This investigation probed the impact of sodium ions(Na+)on neovascularization and osteogenesis around Ti implants in vivo,utilizing micro-computed tomography,hematoxylin and eosin staining,and immunohistochemical analyses.Concurrently,in vitro experiments assessed the effects of varied Na+concentrations and exposure durations on human umbilical vein endothelial cells(HUVECs)and MC3T3-E1 cells. Results In vivo,increased dietary sodium(0.8%-6.0%)led to a substantial decline in CD34 positive HUVECs and new bone formation around Ti implants,alongside an increase in inflammatory cells.In vitro,an increase in Na+concentration(140-150 mmol/L)adversely affected the proliferation,angiogenesis,and migration of HUVECs,especially with prolonged exposure.While MC3T3-E1 cells initially exhibited less susceptibility to high Na+concentrations compared to HUVECs during short-term exposure,prolonged exposure to a HS environment progressively diminished their proliferation,differentiation,and osteogenic capabilities. Conclusion These findings suggest that HS diet had a negative effect on the early osseointegration of Ti implants by interfering with the process of postoperative vascularized bone regeneration.

Objective:To identify the types of fear of progression in patients after percutaneous coronary intervention (PCI) based on latent profile analysis, and to explore the influencing factors of different types.Methods:Cross-sectional survey method was used to select the patients with coronary heart disease and underwent PCI in Anhui Public Health Clinical Center from April to December 2023 as the research object. The general information questionnaire, Fear of Progression Questionnaire-Short Form, Ruminative Response Scale and Brief Illness Perception Questionnaire were used to investigate them. Mplus8.3 software was used to construct the latent profile model.Results:A total of 240 patients with complete data were enrolled, including 176 males and 64 females, aged 28-84 (62.94 ± 11.20) years. The results of latent profile analysis showed that the fear of progression of patients after PCI could be divided into three latent categories: There were 59 cases (24.6%) in the low fear group, 111 cases (46.3%) in the medium fear group, and 70 cases (29.1%) in the high fear-worried family group. The results of multiple logistic regression analysis showed that compared with the low fear group, the probability of having primary school education or below was higher in the medium fear group ( OR=4.054, 95% CI 1.370-11.996) and the high fear-worry family group ( OR=5.996, 95% CI 1.562-23.014), secondary school was more likely in the moderate fear group ( OR=3.096, 95% CI 1.104-8.682, all P<0.05);Living in rural areas were more likely to be in the moderate fear group ( OR=2.587, 95% CI 1.187-5.637) and the high few-worry family group ( OR=6.958, 95% CI 2.567-18.856, all P<0.05); The probability of the first interventional therapy was higher in the moderate fear group ( OR=2.496, 95% CI 1.107-5.630) and the high fear-worry family group ( OR=4.924, 95% CI=1.809-13.402, all P<0.05). In addition, compared with the low fear group, patients with higher rumination were more likely to belong to the high few-worry family working group ( OR=1.130, 95% CI 1.055-1.210, P<0.05);Moderate fear group ( OR=1.181, 95% CI 1.046-1.334) and high fear family working group ( OR=1.349, 95% CI 1.164-1.562, all P<0.05) had a higher level of illness perception. Conclusions:There is significant heterogeneity in the fear of progression among patients after PCI. Medical staff can implement precise intervention according to the potential category characteristics of patients′ fear of progression, so as to reduce the level of fear of disease progression.

Hereditary hemochromatosis is a rare autosomal genetic disorder that can cause multi-organ dysfunction in the liver,pancreas,spleen,heart and pituitary gland,with diverse clinical manifestations,make the diagnosis difficult.In recent years,with the deepening of clinical understanding and the development of genetic diagnosis tools,the diagnostic rate of this disease has increased significantly.In this paper,we report a case of hereditary hemochromatosis type 3 involving multiple organs and complicated by severe heart failure,aiming to improve the clinicians'understanding of this disease and reduce the leakage and misdiagnosis.

The patient was a 29-year-old male with a history of hemophilia for more than 10 years. After 6 hours of botulinum toxin injection into the masseter muscle, the redness and swelling of the right face gradually worsened, accompanied by local pain, and restricted mouth opening, etc. The hematoma was absorbed and the swelling subsided significantly after the infusion of coagulation factor Ⅸ. Such cases of large-scale hematomas after botulinum toxin injection in hemophiliacs is rarely reported. This article summarized the diagnosis and treatment process of this case and combines with literature review to provide clinical experience for diagnosis, treatment and prevention of similar complications.

Objective:To investigate the potential effects of melatonin on improving mitochondrial function and reducing oxidative stress in granulosa cells in aged women with ovarian insufficiency in vitro, as well as explore the underlying mechanisms. Methods:Granulosa cells were extracted from waste follicular fluid obtained from patients undergoing assisted reproductive technology at the Reproductive Medicine Center of the Second Affiliated Hospital of Zhengzhou University from March to June 2022. According to the age of the patients, they were divided into two groups: the aged group (age ≥38 years old, 6 cases) and the young control group (age <35 years old, 6 cases). The mitochondrial ultrastructure of the granulosa cells was examined using transmission electron microscopy. Intracellular ATP levels were measured using an ATP detection kit, while mitochondrial DNA (mtDNA) copy number was assessed using real-time fluorescence quantitative PCR. Mitochondrial membrane potential was evaluated using the JC-1 fluorescent probe, reactive oxygen species (ROS) content was measured using the MitoSOX? Red mitochondrial oxide indicator, and protein expressions of SIRT3 and SOD2 were determined using Western blotting. According to the random number table method, samples from the aged group were randomly allocated to either the melatonin treatment group or blank control group (5 cases in each group) to assess the impact of in vitro melatonin treatment on the aforementioned mitochondrial parameters. SIRT3 in granular cells was down-regulated by transfection of siRNA, and the above indexes were detected before and after melatonin addition and compared with the negative control group. Results:In comparison to the young group, the aged group exhibited distinct differences in the ultrastructure of granulosa cell mitochondria. Specifically, the mitochondrial structure appeared unclear, with sparse and irregularly arranged ridges. Furthermore, significant reductions were observed in ATP levels ( P=0.012), mtDNA copy number ( P=0.005), and mitochondrial membrane potential ( P=0.009) in the aged group, while ROS content was increased ( P=0.003). Additionally, the levels of SIRT3 and SOD2 were significantly decreased ( P<0.001 and P=0.002, respectively). These differences were statistically significant. Following in vitro melatonin culture, improvements were observed in the mitochondrial ultrastructure, as well as increases in ATP levels ( P<0.001), mtDNA copy number ( P=0.038), and mitochondrial membrane potential ( P=0.002). Correspondingly, SIRT3 and SOD2 levels increased ( P=0.011 and P=0.031, respectively), while ROS content decreased ( P<0.001). These changes were statistically significant. After siRNA transfection, the expression of SIRT3 in the granulosa cells was significantly down-regulated ( P<0.001). After melatonin treatment, the ATP levels ( P<0.001), the mtDNA copy number ( P=0.001), and the mitochondrial membrane potential ( P<0.001) were all lower than those in the negative control group without SIRT3 downregulation, and the ROS content was higher than that in the negative control group ( P<0.001), with statistical differences. Similarly, the effects of melatonin on reducing ROS were also significantly diminished. Conclusion:In vitro melatonin culture has the potential to enhance mitochondrial function and alleviate oxidative stress in granulosa cells from aged women with ovarian insufficiency. Furthermore, in addition to its direct antioxidative properties, melatonin may regulate the levels of SIRT3 and SOD2 to reduce ROS.

Objective:To investigate the potential effects of melatonin on improving mitochondrial function and reducing oxidative stress in granulosa cells in aged women with ovarian insufficiency in vitro, as well as explore the underlying mechanisms. Methods:Granulosa cells were extracted from waste follicular fluid obtained from patients undergoing assisted reproductive technology at the Reproductive Medicine Center of the Second Affiliated Hospital of Zhengzhou University from March to June 2022. According to the age of the patients, they were divided into two groups: the aged group (age ≥38 years old, 6 cases) and the young control group (age <35 years old, 6 cases). The mitochondrial ultrastructure of the granulosa cells was examined using transmission electron microscopy. Intracellular ATP levels were measured using an ATP detection kit, while mitochondrial DNA (mtDNA) copy number was assessed using real-time fluorescence quantitative PCR. Mitochondrial membrane potential was evaluated using the JC-1 fluorescent probe, reactive oxygen species (ROS) content was measured using the MitoSOX? Red mitochondrial oxide indicator, and protein expressions of SIRT3 and SOD2 were determined using Western blotting. According to the random number table method, samples from the aged group were randomly allocated to either the melatonin treatment group or blank control group (5 cases in each group) to assess the impact of in vitro melatonin treatment on the aforementioned mitochondrial parameters. SIRT3 in granular cells was down-regulated by transfection of siRNA, and the above indexes were detected before and after melatonin addition and compared with the negative control group. Results:In comparison to the young group, the aged group exhibited distinct differences in the ultrastructure of granulosa cell mitochondria. Specifically, the mitochondrial structure appeared unclear, with sparse and irregularly arranged ridges. Furthermore, significant reductions were observed in ATP levels ( P=0.012), mtDNA copy number ( P=0.005), and mitochondrial membrane potential ( P=0.009) in the aged group, while ROS content was increased ( P=0.003). Additionally, the levels of SIRT3 and SOD2 were significantly decreased ( P<0.001 and P=0.002, respectively). These differences were statistically significant. Following in vitro melatonin culture, improvements were observed in the mitochondrial ultrastructure, as well as increases in ATP levels ( P<0.001), mtDNA copy number ( P=0.038), and mitochondrial membrane potential ( P=0.002). Correspondingly, SIRT3 and SOD2 levels increased ( P=0.011 and P=0.031, respectively), while ROS content decreased ( P<0.001). These changes were statistically significant. After siRNA transfection, the expression of SIRT3 in the granulosa cells was significantly down-regulated ( P<0.001). After melatonin treatment, the ATP levels ( P<0.001), the mtDNA copy number ( P=0.001), and the mitochondrial membrane potential ( P<0.001) were all lower than those in the negative control group without SIRT3 downregulation, and the ROS content was higher than that in the negative control group ( P<0.001), with statistical differences. Similarly, the effects of melatonin on reducing ROS were also significantly diminished. Conclusion:In vitro melatonin culture has the potential to enhance mitochondrial function and alleviate oxidative stress in granulosa cells from aged women with ovarian insufficiency. Furthermore, in addition to its direct antioxidative properties, melatonin may regulate the levels of SIRT3 and SOD2 to reduce ROS.