Objective The application of 18F-PSMA-1007 PET/CT in the precise diagnosis and treatment of prostate cancer(PCa)is gradually increasing.This study aimed to explore the predictive value of 18F-PSMA-1007 PET/CT for positive surgical margins after radical prostatectomy(RP).Methods A total of 173 PCa patients who were pathologically confirmed and underwent RP in our hospital from July 2020 to August 2023 were retrospectively recruited.All patients underwent 18F-PSMA-1007 PET/CT whole-body imaging before surgery.According to the postoperative pathological results,they were divided into a negative surgical margin group with 83 cases and a positive surgical margin group with 90 cases.The differences in age,SUVmax,SUVmean,preoperative total prostate specific antigen(tPSA),prostate specific antigen density(PSAD),prostate volume,Gleason score,and clinical T staging between the groups were compared,and the risk factors were further analyzed by Logistic regression.Results The preoperative tPSA(Z=-3.252,P=0.001),SUVmax(Z=2.531,P=0.011),and clinical T staging(P=0.018)were all lower in the negative surgical margin group than in the positive surgical margin group.PSAD(OR=3.492,95％CI:1.095-11.133,P=0.035),SUVmax(OR=1.036,95％CI:1.003-1.070,P=0.034),and clinical T staging(OR=3.364,95％CI:1.117-10.133,P=0.045)were independent risk factors for positive surgical margins.Conclusion 18F-PSMA-1007 PET/CT has certain predictive value for positive surgical margins after RP in PCa patients.High PSAD,high SUVmax and high clinical T stage were independent risk factors for predicting positive margin after PR surgery,thus providing some reference for the clinical treatment strategy of PCa patients.

Objective:To investigate the relationship between dynamic alterations in serum albumin (ALB) concentrations and clinical outcomes in hospitalized surgical patients, thus providing a basis for optimizing clinical management strategies.Methods:This study utilized data from a prospective observational cohort study on nutritional status among 7 122 elderly hospitalized patients across 34 tertiary hospitals in 18 Chinese cities. A total of 1 714 surgical patients hospitalized for 7-30 days with complete data were included. Standardized protocols were used to collect demographic data, clinical outcomes, and a range of laboratory results, including nutritional and hematological parameters. Heterogeneous effects of ALB on clinical outcomes were explored. Receiver operating characteristic (ROC) curves were used to determine cutoff values for infection-related complications. Correlation analyses and multiple linear regression models were used to identify independent predictors of the absolute change in ALB (?ALB).Results:Among the surgical patients, 69.7% (1 195/1 714) experienced a decline in ALB levels during their hospital stay, which was significantly associated with the occurrence of both infection- and non-infection-related complications. Simultaneously, a marked decrease in ALB was also significantly correlated with changes in nutritional and inflammatory status during hospitalization, worsening of gastrointestinal symptoms at discharge, and functional activity abnormalities (all P<0.05). ?ALB exhibited a close association with outcome variables such as infection-related complications. Based on the incidence of infection-related complications, a cutoff value for ALB was calculated, dividing patients into a high-risk group ( n=179) and a low-risk group ( n=1 535), and a statistically significant difference in the incidence of infection-related complications was found between these two groups ( P<0.05). Correlation analysis and multiple linear regression modeling revealed that female gender, a higher baseline ALB level, a poorer baseline inflammatory status, an exacerbation of inflammatory status, larger alterations in platelet-to-lymphocyte ratio, and the presence of infection-related complications were predictive factors for a decline in ALB levels among surgical patients during their hospital stay. Conclusions:?ALB serves as a critical indicator of the inflammatory-nutritional interplay, with its magnitude of decline effectively predicting clinical outcomes and nutritional status changes and guiding multidisciplinary interventions in surgical patients.

Objective To include patients with clinical data matched by propensity scores and to explore the value of 18F-fluorode-oxyglucose(18F-FDG)PET/CT metabolic parameters and radiomics in differentiating benign and malignant solitary pulmonary nod-ule(SPN).Methods A total of 54 patients with SPN(27 benign and 27 malignant)were retrospectively selected,all of them under-went 18F-FDG PET/CT scans.Then the metabolic parameters were analyzed,and the metabolic parameters model was established.After delineating the lesion,imaging features were selected through variance and correlation analysis.The logistic regression was used to build the model,and balance accuracy(bACC)was used to compare the performance of the models.The correlation between meta-bolic parameters and radiomics features was analyzed.Results The maximum standardized uptake value(SUVmax),total lesion uptake(TLU),and coefficient of variation(COV)of malignant were higher than those of benign(P＜0.05).SUVmax and COV had positive predictive value for malignant lesions[odds ratio(OR)＞1,P＜0.05].There was no statistical difference between the performance of the metabolic parameters model and the radiomics model(P＞0.05).There was a strong correlation between radiomics features and metabolic parameters.Conclusion After propensity score matching,metabolic parameters and radiomics show no statistical difference in differentiating benign from malignant SPN.

DNA methylation is the first epigenetic modification found in humans.Abnormal changes in DNA methylation are closely associated with the development and progression of diseases.Acupuncture,an important component of traditional Chinese medicine,has been shown to have significant therapeutic efficacy.The mechanisms underlying acupuncture are complex,involving physiological and pathological processes of integrated interactions across multiple targets.However,current research mostly focuses on a single target,highlighting the need for a more upstream approach to the investigation of the mechanisms.Herein,we reviewed studies on the direct or indirect regulation of DNA methylation via acupuncture.We also discussed its mechanisms of action in pain,obesity,depression,and Alzheimer disease,in order to provide a new perspective on the therapeutic mechanisms of acupuncture and the role of DNA methylation in the field of acupuncture research.Future research should concentrate on the effect of acupuncture on the DNA methylation of specific genes,the quantification of changes in DNA methylation at different acupoints,the development of individualized acupuncture prescriptions,further investigation of the specificity of the effects at different acupoint,and the expansion of the research to integrate epigenetics and genomics.This will provide a theoretical basis for the internationalization and the promotion of clinical application of acupuncture.

Objective The application of 18F-PSMA-1007 PET/CT in the precise diagnosis and treatment of prostate cancer(PCa)is gradually increasing.This study aimed to explore the predictive value of 18F-PSMA-1007 PET/CT for positive surgical margins after radical prostatectomy(RP).Methods A total of 173 PCa patients who were pathologically confirmed and underwent RP in our hospital from July 2020 to August 2023 were retrospectively recruited.All patients underwent 18F-PSMA-1007 PET/CT whole-body imaging before surgery.According to the postoperative pathological results,they were divided into a negative surgical margin group with 83 cases and a positive surgical margin group with 90 cases.The differences in age,SUVmax,SUVmean,preoperative total prostate specific antigen(tPSA),prostate specific antigen density(PSAD),prostate volume,Gleason score,and clinical T staging between the groups were compared,and the risk factors were further analyzed by Logistic regression.Results The preoperative tPSA(Z=-3.252,P=0.001),SUVmax(Z=2.531,P=0.011),and clinical T staging(P=0.018)were all lower in the negative surgical margin group than in the positive surgical margin group.PSAD(OR=3.492,95％CI:1.095-11.133,P=0.035),SUVmax(OR=1.036,95％CI:1.003-1.070,P=0.034),and clinical T staging(OR=3.364,95％CI:1.117-10.133,P=0.045)were independent risk factors for positive surgical margins.Conclusion 18F-PSMA-1007 PET/CT has certain predictive value for positive surgical margins after RP in PCa patients.High PSAD,high SUVmax and high clinical T stage were independent risk factors for predicting positive margin after PR surgery,thus providing some reference for the clinical treatment strategy of PCa patients.

Objective To include patients with clinical data matched by propensity scores and to explore the value of 18F-fluorode-oxyglucose(18F-FDG)PET/CT metabolic parameters and radiomics in differentiating benign and malignant solitary pulmonary nod-ule(SPN).Methods A total of 54 patients with SPN(27 benign and 27 malignant)were retrospectively selected,all of them under-went 18F-FDG PET/CT scans.Then the metabolic parameters were analyzed,and the metabolic parameters model was established.After delineating the lesion,imaging features were selected through variance and correlation analysis.The logistic regression was used to build the model,and balance accuracy(bACC)was used to compare the performance of the models.The correlation between meta-bolic parameters and radiomics features was analyzed.Results The maximum standardized uptake value(SUVmax),total lesion uptake(TLU),and coefficient of variation(COV)of malignant were higher than those of benign(P＜0.05).SUVmax and COV had positive predictive value for malignant lesions[odds ratio(OR)＞1,P＜0.05].There was no statistical difference between the performance of the metabolic parameters model and the radiomics model(P＞0.05).There was a strong correlation between radiomics features and metabolic parameters.Conclusion After propensity score matching,metabolic parameters and radiomics show no statistical difference in differentiating benign from malignant SPN.

Objective:To investigate the relationship between dynamic alterations in serum albumin (ALB) concentrations and clinical outcomes in hospitalized surgical patients, thus providing a basis for optimizing clinical management strategies.Methods:This study utilized data from a prospective observational cohort study on nutritional status among 7 122 elderly hospitalized patients across 34 tertiary hospitals in 18 Chinese cities. A total of 1 714 surgical patients hospitalized for 7-30 days with complete data were included. Standardized protocols were used to collect demographic data, clinical outcomes, and a range of laboratory results, including nutritional and hematological parameters. Heterogeneous effects of ALB on clinical outcomes were explored. Receiver operating characteristic (ROC) curves were used to determine cutoff values for infection-related complications. Correlation analyses and multiple linear regression models were used to identify independent predictors of the absolute change in ALB (?ALB).Results:Among the surgical patients, 69.7% (1 195/1 714) experienced a decline in ALB levels during their hospital stay, which was significantly associated with the occurrence of both infection- and non-infection-related complications. Simultaneously, a marked decrease in ALB was also significantly correlated with changes in nutritional and inflammatory status during hospitalization, worsening of gastrointestinal symptoms at discharge, and functional activity abnormalities (all P<0.05). ?ALB exhibited a close association with outcome variables such as infection-related complications. Based on the incidence of infection-related complications, a cutoff value for ALB was calculated, dividing patients into a high-risk group ( n=179) and a low-risk group ( n=1 535), and a statistically significant difference in the incidence of infection-related complications was found between these two groups ( P<0.05). Correlation analysis and multiple linear regression modeling revealed that female gender, a higher baseline ALB level, a poorer baseline inflammatory status, an exacerbation of inflammatory status, larger alterations in platelet-to-lymphocyte ratio, and the presence of infection-related complications were predictive factors for a decline in ALB levels among surgical patients during their hospital stay. Conclusions:?ALB serves as a critical indicator of the inflammatory-nutritional interplay, with its magnitude of decline effectively predicting clinical outcomes and nutritional status changes and guiding multidisciplinary interventions in surgical patients.

Objective:To evaluate the diagnostic efficacy of 18F-prostate specific membrane antigen (PSMA)-1007 PET/CT in patients with prostate imaging reporting and data system (PI-RADS) 1-3 lesions on multi-parametric MRI (mpMRI) and pathologically confirmed prostate cancer. Methods:Clinical, pathological, and imaging data of 59 patients (age (67.8±7.6) years) with PI-RADS 1-3 lesions on mpMRI in the First Affiliated Hospital of Xi′an Jiaotong University between December 2021 and March 2024 were retrospectively collected. Those patients also underwent 18F-PSMA-1007 PET/CT and prostate biopsy during the same period due to an elevated prostate specific antigen (PSA) level. The diagnostic performances of 18F-PSMA-1007 PET/CT for PI-RADS 1-3 prostate cancer and clinically significant prostate cancer were evaluated by using pathological results as the standard. Mann-Whitney U test was used to compare differences in clinical characteristics and PET parameters between PET-positive and PET-negative groups, and logistic regression analysis was performed to select independent influencing factors for the PET/CT diagnosis of prostate cancer. Results:Of the included 59 patients, 7, 27, and 25 had PI-RADS scores of 1, 2, and 3 respectively. Benign prostate hyperplasia was pathologically confirmed in 8 patients, and prostate cancer was confirmed in 51 patients, of which 37 had clinically significant prostate cancer. The sensitivity of 18F-PSMA-1007 PET/CT in diagnosing prostate cancer was 86.3%(44/51), the specificity was 2/8, the accuracy was 78.0%(46/59), the positive predictive value was 88.0%(44/50), and the negative predictive value was 2/9. For patients with clinically significant prostate cancer, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 91.9%(34/37), 27.3%(6/22), 67.8%(40/59), 68.0%(34/50), and 6/9, respectively. SUV max was significantly higher in the PET-positive group ( n=44) than that in the PET-negative group ( n=7; 12.8(9.1, 23.5) vs 5.1(5.0, 6.2); Z=-4.16, P=0.001). Logistic regression analysis showed that SUV max was an independent influencing factor for the diagnosis of prostate cancer by 18F-PSMA-1007 PET/CT (odds ratio ( OR)=6.01, 95% CI: 1.57-23.00, P=0.009). Conclusions:18F-PSMA-1007 PET/CT has a high sensitivity and positive predictive value in prostate cancer patients with PI-RADS 1-3 on mpMRI. It can be used as a supplementary modality to mpMRI to guide clinical decision for patients with PI-RADS 1-3 and clinically suspected prostate cancer lesions.

Objective:To evaluate the diagnostic efficacy of 18F-prostate specific membrane antigen (PSMA)-1007 PET/CT in patients with prostate imaging reporting and data system (PI-RADS) 1-3 lesions on multi-parametric MRI (mpMRI) and pathologically confirmed prostate cancer. Methods:Clinical, pathological, and imaging data of 59 patients (age (67.8±7.6) years) with PI-RADS 1-3 lesions on mpMRI in the First Affiliated Hospital of Xi′an Jiaotong University between December 2021 and March 2024 were retrospectively collected. Those patients also underwent 18F-PSMA-1007 PET/CT and prostate biopsy during the same period due to an elevated prostate specific antigen (PSA) level. The diagnostic performances of 18F-PSMA-1007 PET/CT for PI-RADS 1-3 prostate cancer and clinically significant prostate cancer were evaluated by using pathological results as the standard. Mann-Whitney U test was used to compare differences in clinical characteristics and PET parameters between PET-positive and PET-negative groups, and logistic regression analysis was performed to select independent influencing factors for the PET/CT diagnosis of prostate cancer. Results:Of the included 59 patients, 7, 27, and 25 had PI-RADS scores of 1, 2, and 3 respectively. Benign prostate hyperplasia was pathologically confirmed in 8 patients, and prostate cancer was confirmed in 51 patients, of which 37 had clinically significant prostate cancer. The sensitivity of 18F-PSMA-1007 PET/CT in diagnosing prostate cancer was 86.3%(44/51), the specificity was 2/8, the accuracy was 78.0%(46/59), the positive predictive value was 88.0%(44/50), and the negative predictive value was 2/9. For patients with clinically significant prostate cancer, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 91.9%(34/37), 27.3%(6/22), 67.8%(40/59), 68.0%(34/50), and 6/9, respectively. SUV max was significantly higher in the PET-positive group ( n=44) than that in the PET-negative group ( n=7; 12.8(9.1, 23.5) vs 5.1(5.0, 6.2); Z=-4.16, P=0.001). Logistic regression analysis showed that SUV max was an independent influencing factor for the diagnosis of prostate cancer by 18F-PSMA-1007 PET/CT (odds ratio ( OR)=6.01, 95% CI: 1.57-23.00, P=0.009). Conclusions:18F-PSMA-1007 PET/CT has a high sensitivity and positive predictive value in prostate cancer patients with PI-RADS 1-3 on mpMRI. It can be used as a supplementary modality to mpMRI to guide clinical decision for patients with PI-RADS 1-3 and clinically suspected prostate cancer lesions.

Objective:To investigate and compare the clinical outcomes of the arterial pre-occlusion technique(APOT) and the traditional technique in the surgery of locally advanced pancreatic cancer with arterial involvement after conversion therapy.Methods:This is a retrospective cohort study. The clinical data of 145 patients with locally advanced pancreatic cancer with arterial involvement admitted to the Department of Hepato-Biliary-Pancreatic Surgery of the First Hospital Affiliated to Naval Medical University,from January 2020 to December 2022 were retrospectively analyzed. All patients completed neoadjuvant therapy for tumors, and the feasibility of radical surgical treatment was determined by a multidisciplinary collaborative team evaluation before surgery. According to whether the intraoperative artery was pre-occluded, 145 patients were divided into two groups, including 28 cases in the APOT group(16 males, 12 females, aged (59.0±9.4) years), and 117 cases in the routine surgery group(76 males, 41 females, aged (55.1±8.2) years). To ensure comparability of baseline data between the APOT group and the routine surgery group, a 1∶2 match was performed using the propensity score matching method, and the caliper value was 0.006 45. The t-test,the Mann-Whitney U test, χ2 test or Fisher′s exact test were used to compare the data between the two groups,respectively. Results:After matching the propensity score,there were 28 cases in the APOT group and 56 cases in the routine surgery group. There were no significant differences in gender,age,preoperative comorbidities,preoperative body mass index,surgical approaches,chemotherapy regimen,stereotactic body radiation therapy ratio,tumor markers,and type of invaded artery between the two groups (all P>0.05).The arterial occlusion time M(IQR) in the APOT group was 7.0(3.8)minutes(range:3 to 15 minutes),and no ischemic manifestations were observed in the distal target organs that blocked blood vessels after surgery. The operation time was (170.3±57.7)minutes in the APOT group and (235.0±80.2)minutes in the routine surgery group,and the difference was statistically significant ( t=-3.800, P<0.01). The APOT group also experienced less intraoperative blood loss(650(588)ml vs. 800(600)ml; U=1 026.500, P=0.021). No significant differences were found between the groups in combined vein resection and reconstruction,celiac trunk resection,early postoperative complications, readmission rates at 30 days,and postoperative length of stay(all P>0.05). Extra-arterial dissection was performed in all patients,with arterial resection and reconstruction in 3 cases: 2 cases in the APOT group(1 case involving the superior mesenteric artery and 1 case involving the common hepatic artery) and 1 case in the routine group(involving the common hepatic artery). Postoperative abdominal bleeding occurred in 4 cases,with 3 cases in the routine group,1 case in the routine group. The R0 resection rate was 85.7%(24/28) in the APOT group and 80.4%(45/56) in the routine group,without significant differences between the groups( P=0.763). The median overall survival time was 27.6 months for the APOT group and 22.5 months for the routine group,while the median disease-free survival was 11.7 months and 16.8 months,respectively,with no significant differences between the two groups( P=0.532, P=0.927). Conclusion:The arterial pre-occlusion technique can be used for extra-arterial dissection in patients with locally advanced pancreatic cancer involving the arteries,reducing surgery time and intraoperative blood loss.