Objective To construct an innovative CNN-Transformer dual-stream parallel network architecture integrating clinical data and imaging features for improving the predictive accuracy of pectoralis major myofascial metastasis in breast cancer,and to optimize the model performance by screening the optimal feature subset through genetic algorithm.Methods The proposed architecture concurrently processed clinical records and imaging data,including physical characteristics such as resolution,contrast,grayscale distribution,and texture features to identify their latent correlations.Meanwhile,genetic algorithms were employed to remove redundant features while retaining the most clinically and physically relevant features for pectoralis major myofascial metastasis prediction.Results The CNN-Transformer model that integrated imaging and clinical features showed superior performance across all evaluation metrics such as weighted F1 score and AUCROC,outperforming models relying only on imaging or clinical data.Conclusion The proposed dual-stream parallel network architecture combined with feature selection strategy significantly enhances the predictive accuracy of pectoralis major myofascial metastasis in breast cancer,and demonstrates the critical role of imaging features in improving model performance.

Cryoglobulinemia is a group of disorders characterized by the presence of temperature-dependent immunoglobulins in serum, exhibiting high heterogeneity in classification and clinical manifestations. Laboratory diagnosis serves as a crucial diagnostic tool for this condition. In recent years, the application of next-generation flow cytometry, mass spectrometry, and modified capillary immunotyping has significantly improved the sensitivity of cryoglobulin detection and the accuracy of subtyping. Moreover, this disease is frequently associated with infections, autoimmune disorders, and B-cell lymphoproliferative disorders, making dynamic monitoring of laboratory indicators essential for prognostic evaluation. This article systematically elaborates the pathogenesis of cryoglobulinemia and advances in laboratory diagnosis, aiming to enhance clinical and laboratory professionals′ understanding and comprehension of cryoglobulinemia.

Objective To construct an innovative CNN-Transformer dual-stream parallel network architecture integrating clinical data and imaging features for improving the predictive accuracy of pectoralis major myofascial metastasis in breast cancer,and to optimize the model performance by screening the optimal feature subset through genetic algorithm.Methods The proposed architecture concurrently processed clinical records and imaging data,including physical characteristics such as resolution,contrast,grayscale distribution,and texture features to identify their latent correlations.Meanwhile,genetic algorithms were employed to remove redundant features while retaining the most clinically and physically relevant features for pectoralis major myofascial metastasis prediction.Results The CNN-Transformer model that integrated imaging and clinical features showed superior performance across all evaluation metrics such as weighted F1 score and AUCROC,outperforming models relying only on imaging or clinical data.Conclusion The proposed dual-stream parallel network architecture combined with feature selection strategy significantly enhances the predictive accuracy of pectoralis major myofascial metastasis in breast cancer,and demonstrates the critical role of imaging features in improving model performance.

Cryoglobulinemia is a group of disorders characterized by the presence of temperature-dependent immunoglobulins in serum, exhibiting high heterogeneity in classification and clinical manifestations. Laboratory diagnosis serves as a crucial diagnostic tool for this condition. In recent years, the application of next-generation flow cytometry, mass spectrometry, and modified capillary immunotyping has significantly improved the sensitivity of cryoglobulin detection and the accuracy of subtyping. Moreover, this disease is frequently associated with infections, autoimmune disorders, and B-cell lymphoproliferative disorders, making dynamic monitoring of laboratory indicators essential for prognostic evaluation. This article systematically elaborates the pathogenesis of cryoglobulinemia and advances in laboratory diagnosis, aiming to enhance clinical and laboratory professionals′ understanding and comprehension of cryoglobulinemia.

Monopolar spindle 1, also known as threonine and tyrosine kinase (TTK), is a key component of spindle assembly checkpoint (SAC). It is considered to be a monitoring mechanism to ensure mitotic fidelity and genomic stability. TTK is overexpressed in a variety of malignant tumors, and patients with low expression of TTK tend to have a longer survival time, suggesting that it may be used as a biomarker for diagnosis and prognosis. Abnormal expression of TTK often impairs the function of SAC, resulting in irregular mitosis, increased aneuploidy and mitotic disaster, thus promoting the occurrence of tumors. Current studies have shown that TTK inhibitors can inhibit the proliferation of tumor cells and increase the sensitivity of tumor cells to therapy in combination with chemotherapy or radiotherapy to achieve sensitization and attenuated effects. This article will review the research and application of TTK and its inhibitors in malignant tumors.

Objective To study the changes in erythrocyte osmotic fragility(EOF)in patients with hypercythemia,pol-ycythemia and anemia under a high altitude environment.Methods A total of 174 outpatients,inpatients and people un-dergoing physical examination in Tibet Autonomous Region People′s Hospital in October 2020 were enrolled and divided into four groups according to hemoglobin levels:the polycythemia group(n=42),the physiologic increase group(n=48),the a-nemia group(n=29)and the healthy control group(n=55).They were compared with 67 anemia patients and 67 healthy people in the laboratory of Peking Union Medical College Hospital in the same period as the plain control group.The classic EOF test method was used to compare the results of each group′s EOF.The concentrations of NaCl solution for starting he-molysis(STH)and NaCl solution for complete hemolysis(CTH)were included,and the data were statistically analyzed by SPSS software.Results There was a significant difference in CTH between Zang and Han healthy people(P＜0.05).STH in high altitude polycythemia group(0.52)was higher than that in high altitude healthy control group(0.48)(P＜0.001).Compared with plain,the median CTH of plateau anemia group(0.36)and plateau health control group(0.36)was signifi-cantly higher than that of plain anemia group(0.28)and plain control group(0.28)(P＜0.001).Multivariate logistic regres-sion analysis showed that plateau region,female polycythemia and anemia were risk factors for STH elevation.Conclusion This study finds that the EOF increases in the plateau population and patients with polycythemia,which provides reference for studying red blood cell disorders and blood transfusion strategy in the plateau region.

OBJ ECTIVE To predict the quality marker （Q-Marker）of Forsythia suspensa . METHODS The fingerprints of 10 batches of F. suspensa were established by high performance liquid chromatography. The common peaks were confirmed. The candidate components of Q-Marker in F. suspensa were screened. The volatile oil of F. suspensa were analyzed by gas chromatography-mass spectrometry （GC-MS），and the candidate components of Q-Marker in volatile oil were screened. The network pharmacology analysis was performed for the candidate components of Q-Marker. The network diagram of the “candidate components of F. suspensa Q-Marker-target-pathway”was constructed to predict the Q-marker of F. suspensa . RESULTS & CONCLUSIONS Twenty-one common peaks were obtained for 10 batches of F. suspensa ，and four components were identified as phillyrin，forsythoside A ，pinoresinol-4-O-β-D-glucoside and rutin. Seven candidate components were obtained by GC-MS analysis，such as β-pinene，α-pinene，terpinen-4-ol，limonene，γ-terpinene，α-phellandrene，β-myrcene. By network pharmacology analysis， 16 key targets and 17 pathways were obtained. It was preliminarily predicted that phillyrin ， forsythoside A ， pinoresinol-4-O-β-D-glucoside，rutin，terpinen-4-ol，α-phellandrene，α-pinene and β-pinene were Q-marker of F. suspensa .

Objective:To provide normal reference thresholds for clinical dynamic monitoring of the risk of microthrombus during pregnancy, we aimed to establish reference intervals of D-dimer in healthy pregnant women during different periods of gestation in Xi′an.Method:From December 2020 to March 2022, a total of 1502 healthy pregnant women and healthy non-pregnant women (healthy non-pregnant control group) who received routine prenatal examination in Northwest Women and Children′s Hospital were recruited in the study by questionnaire, including 1236 healthy pregnant women and 266 healthy non-pregnant control group. Plasma D-dimer concentration was detected by STA-R Evolution automatic blood coagulation analyzer and the concentration levels of D-dimer in different pregnancies and age groups were calculated using Graph Prism 9.0 software. In addition, 20 samples were collected in each pregnancy to verify the established reference interval.Results:There was no significant difference in plasma D-dimer levels between<30 years old and ≥30 years old at different gestational weeks. Plasma D-dimer level in healthy pregnant women group was significantly higher than that in healthy non-pregnant women group of the same age (P<0.05). With the increase of gestational week, plasma D-dimer level in pregnant women increased significantly, and plasma D-dimer level at different gestational weeks ≤13 weeks, 13+ 1-20 weeks, 20+ 1-27 weeks, 27+ 1-35 weeks, ≥35 +1 week were 0.33 (0.26, 0.47) μg/ml, 0.41 (0.30, 0.51) μg/ml, 0.71 (0.48, 0.94) μg/ml, 0.91 (0.70, 1.27) μg/ml, 1.30 (0.96, 1.72) μg/mlrespectively. Unilateral reference interval acuities were≤0.89 μg/ml, ≤1.53 μg/ml, ≤2.44 μg/ml, ≤2.74 μg/ml, ≤3.82 μg/ml respectively. The reference range established in this study was verified by 20 independent samples from each of the 5 gestational age groups, and the results were acceptable. Conclusion:This study preliminarily established the reference interval of plasma D-dimer in healthy pregnant women at different gestational weeks in Xi ′an area, which is helpful for the auxiliary diagnosis of thrombotic diseases during pregnancy.

Objective:To understand the influencing factors of death of epidemic Japanese encephalitis (EJE) cases in Longnan City of Gansu Province.Methods:In the EJE Monitoring Information Report Management System of the Chinese Disease Prevention and Control Information System, data on EJE cases with onset from 2014 to 2018 and current address in Longnan City were derived. An "Individual Questionnaire of Epidemic Japanese Encephalitis in Longnan City" was designed, retrospective study was conducted on enrolled cases, their information on demographic data, consultation, onset, clinical classification, and chronic underlying diseases were collected, characteristics of EJE cases and death-related factors were analyzed.Results:From 2014 to 2018, a total of 260 EJE cases were reported in Longnan City, and 259 cases completed the questionnaire. Among them, 70 cases (27.0%) were aged ≥60 years old, 67 cases (25.9%) were severe and extremely severe, and 55 cases (21.2%) had chronic underlying diseases. Among 259 EJE cases, 46 cases died, with a fatality rate of 17.8%. After multivariate unconditional logistic regression analysis, age ≥60 years old [odds ratio ( OR)=2.667, 95% confidence interval ( CI): 1.140-6.237], severe and extremely severe ( OR = 2.762, 61.820, 95% CI: 1.053-7.091, 5.149-742.239), and chronic underlying diseases ( OR = 2.489, 95% CI: 1.038-5.964) were risk factors for death in EJE cases. Conclusions:The influencing factors of death of EJE cases in Longnan City are age, clinical classification and chronic underlying diseases. Therefore, we should focus on patients over 60 years old, clinically classified as severe or extremely severe, and suffering from chronic underlying diseases, and strengthen the immunization of EJE vaccine for key populations.

Objective To establish and evaluate the application of modified capillary immunotyping for cryoglobulin qualification .Methods Referred to literature and benchwork experience , a modified capillary immunotyping technique was set up for cryoglobulin identification . Seventy-eight cryoglobulin positive specimens were collected by a standard method in Peking Union Medical College Hospital from November 2016 to July 2017.Thirty-nine samples were identified the type of the cryoglobulin simultaneously by modified capillary immunotyping ( CI ) and immunofixation electrophoresis ( IFE ) .Results Using the modified capillary immunotyping method , the types of cryoglobulin in seventy-eight specimens were identified.The number of cases decreased in the order of Ⅲ, Ⅱ and Ⅰ type of cryoglobulin .The clinical characteristics coincidence with previous reports .The modified CI method had a dramatic advantage in the speed, clarity, and accuracy of results compared with IFE .The ratio of reportable cases between these two methods was 1:0.87.Conclusion The modified capillary immunotyping was an accurate and easy method for cryoglobulin qualification , and feasible for clinical application .