Objective To observe the correlations of lumbar bone mineral density(BMD)with serum uric acid(SUA),hepatic fat and abdominal fat based on quantitative CT(QCT).Methods A total of 522 subjects who underwent lumbar QCT were retrospectively enrolled.Subjects with different genders were divided into hyperuricemia(HUA)group and normal SUA group according to SUA levels,and QCT parameters were compared between groups.Meanwhile,subjects with different genders were also divided into normal bone mass group(normal group),osteopenia group and osteoporosis(OP)group,and SUA and QCT parameters were compared among groups.Pearson correlation analyses were performed to explore the correlations of lumbar BMD with age,SUA,visceral adipose tissue(VAT),subcutaneous adipose tissue(SAT)and liver fat content.Results There were 325 males,with 105 ones in HUA group and 220 ones in normal SUA group.There were 197 females,with 26 ones in HUA group and 171 ones in normal SUA group.VAT,SAT and percentage of liver fat content in HUA group of different genders were all higher than those in normal SUA group(all P＜0.05).Among 325 males,there were 196 ones in normal group,105 ones in osteopenia group and 24 ones in OP group among males,and VAT increased successively in the above groups(all P＜0.05).Among 197 females,there were 147 ones in normal group,30 ones in osteopenia group and 20 ones in OP group,and VAT and SAT increased successively in the above groups(all P＜0.05).Lumbar BMD was moderately and weakly negatively correlated with age and VAT in males(r=-0.618,-0.286,both P＜0.001),which was moderately,lowly and weakly negatively correlated with age,VAT and SAT in females,respectively(r=-0.772,-0.451,-0.273,all P＜0.001).Conclusion Increased SUA levels resulted in increased abdominal and liver fat content,and the latter was negatively correlated with lumbar BMD.

Purpose To investigate the consistency and reliability of immunohistochemistry(IHC)staining and polymerase chain reaction-capillary electrophoresis(PCR-CE)in the detection of microsatellite instability.Methods The clinical data of 735 patients with solid tumors who underwent biopsy or surgical resection were collected,and the microsatellite status of tissue samples was detected by IHC and PCR-CE.Results Among the 344 cases of colorectal cancer(CRC),IHC results showed that 290 cases(84.3％)had proficient mismatch repair(pMMR),and 54 cases(15.7％)had deficient mismatch repair(dMMR).The results of PCR-CE showed that 53 patients(15.4％)had high microsatellite instability(MSI-H),and 291 patients(84.6％)had microsatellite stable(MSS).The consistency analysis of IHC and PCR-CE results showed that the Kappa value was 0.923(P＜0.001).Among the 168 cases of en-dometrial cancer(EC),IHC results showed that 42 cases(25.0％)had dMMR and 126 cases(75.0％)had pMMR;The results of PCR-CE showed that 39 cases(23.2％)had MSI-H and 129 cases(76.8％)had MSS.The consisten-cy analysis of the two methods showed that the Kappa value was 0.854(P＜0.001).Among the 165 cases of gastric cancer,IHC results showed that 22(13.3％)had dMMR and 143(86.7％)had pMMR;The results of PCR-CE showed that 22 cases(13.3％)had MSI-H and 143 cases(86.7％)had MSS/low microsatellite instability(MSI-L).The consistency analysis of IHC and PCR-CE results showed that the Kappa value was 0.843(P＜0.001).Among the 58 cases of head and neck squamous cell carcinoma(HNSCC),IHC results showed that 3 cases(5.2％)had dMMR and 55 cases(94.8％)had pMMR;The results of PCR-CE showed that 3 cases(5.2％)had MSI-H and 55 cases(94.8％)had MSS.The consistency analysis of the two methods showed that the Kappa value was 1.000(P＜0.001).Conclusion IHC and PCR-CE have high consistency and reliability in detecting MSI status in patients with CRC,EC,gastric cancer and HNSCC,and their combined application is helpful to improve the accuracy of MSI detec-tion in patients with solid tumors.

Head and neck squamous cell carcinoma(HNSCC)is the most common pathological subtype of head and neck malignancies.The majority of patients are diagnosed at an advanced stage,losing the opportunity for curative surgery,and overall prognosis remains poor.With its exceptional capabilities in image analysis and powerful data pro-cessing,artificial intelligence(AI)has the potential to become a valuable tool in precision pathology,offering new op-portunities to improve the diagnosis and treatment of head and neck cancer.This article provides a systematic review of the current research status on AI-assisted pathological image analysis in the diagnosis,treatment strategy selection,and prognosis prediction of HNSCC,while also discussing future research directions.

Head and neck squamous cell carcinoma(HNSCC)is the most common pathological subtype of head and neck malignancies.The majority of patients are diagnosed at an advanced stage,losing the opportunity for curative surgery,and overall prognosis remains poor.With its exceptional capabilities in image analysis and powerful data pro-cessing,artificial intelligence(AI)has the potential to become a valuable tool in precision pathology,offering new op-portunities to improve the diagnosis and treatment of head and neck cancer.This article provides a systematic review of the current research status on AI-assisted pathological image analysis in the diagnosis,treatment strategy selection,and prognosis prediction of HNSCC,while also discussing future research directions.

Purpose To investigate the consistency and reliability of immunohistochemistry(IHC)staining and polymerase chain reaction-capillary electrophoresis(PCR-CE)in the detection of microsatellite instability.Methods The clinical data of 735 patients with solid tumors who underwent biopsy or surgical resection were collected,and the microsatellite status of tissue samples was detected by IHC and PCR-CE.Results Among the 344 cases of colorectal cancer(CRC),IHC results showed that 290 cases(84.3％)had proficient mismatch repair(pMMR),and 54 cases(15.7％)had deficient mismatch repair(dMMR).The results of PCR-CE showed that 53 patients(15.4％)had high microsatellite instability(MSI-H),and 291 patients(84.6％)had microsatellite stable(MSS).The consistency analysis of IHC and PCR-CE results showed that the Kappa value was 0.923(P＜0.001).Among the 168 cases of en-dometrial cancer(EC),IHC results showed that 42 cases(25.0％)had dMMR and 126 cases(75.0％)had pMMR;The results of PCR-CE showed that 39 cases(23.2％)had MSI-H and 129 cases(76.8％)had MSS.The consisten-cy analysis of the two methods showed that the Kappa value was 0.854(P＜0.001).Among the 165 cases of gastric cancer,IHC results showed that 22(13.3％)had dMMR and 143(86.7％)had pMMR;The results of PCR-CE showed that 22 cases(13.3％)had MSI-H and 143 cases(86.7％)had MSS/low microsatellite instability(MSI-L).The consistency analysis of IHC and PCR-CE results showed that the Kappa value was 0.843(P＜0.001).Among the 58 cases of head and neck squamous cell carcinoma(HNSCC),IHC results showed that 3 cases(5.2％)had dMMR and 55 cases(94.8％)had pMMR;The results of PCR-CE showed that 3 cases(5.2％)had MSI-H and 55 cases(94.8％)had MSS.The consistency analysis of the two methods showed that the Kappa value was 1.000(P＜0.001).Conclusion IHC and PCR-CE have high consistency and reliability in detecting MSI status in patients with CRC,EC,gastric cancer and HNSCC,and their combined application is helpful to improve the accuracy of MSI detec-tion in patients with solid tumors.

Objective To observe the correlations of lumbar bone mineral density(BMD)with serum uric acid(SUA),hepatic fat and abdominal fat based on quantitative CT(QCT).Methods A total of 522 subjects who underwent lumbar QCT were retrospectively enrolled.Subjects with different genders were divided into hyperuricemia(HUA)group and normal SUA group according to SUA levels,and QCT parameters were compared between groups.Meanwhile,subjects with different genders were also divided into normal bone mass group(normal group),osteopenia group and osteoporosis(OP)group,and SUA and QCT parameters were compared among groups.Pearson correlation analyses were performed to explore the correlations of lumbar BMD with age,SUA,visceral adipose tissue(VAT),subcutaneous adipose tissue(SAT)and liver fat content.Results There were 325 males,with 105 ones in HUA group and 220 ones in normal SUA group.There were 197 females,with 26 ones in HUA group and 171 ones in normal SUA group.VAT,SAT and percentage of liver fat content in HUA group of different genders were all higher than those in normal SUA group(all P＜0.05).Among 325 males,there were 196 ones in normal group,105 ones in osteopenia group and 24 ones in OP group among males,and VAT increased successively in the above groups(all P＜0.05).Among 197 females,there were 147 ones in normal group,30 ones in osteopenia group and 20 ones in OP group,and VAT and SAT increased successively in the above groups(all P＜0.05).Lumbar BMD was moderately and weakly negatively correlated with age and VAT in males(r=-0.618,-0.286,both P＜0.001),which was moderately,lowly and weakly negatively correlated with age,VAT and SAT in females,respectively(r=-0.772,-0.451,-0.273,all P＜0.001).Conclusion Increased SUA levels resulted in increased abdominal and liver fat content,and the latter was negatively correlated with lumbar BMD.

Objective To explore the prognostic value of serum neutrophils/lymphocytes(NLR)for first-line treatment of patients with advanced gastric cancer using programmed cell death receptor 1(PD-1)inhibitors.Methods A total of 168 patients with advanced gastric cancer who were treated with immunotherapy combined with chemotherapy in the Fourth Hospital of Qinhuangdao from January 2018 to January 2021 were selected as study subjects,and the follow-up period was terminated at January 2023.The patients'data were collected,hematological and tumor markers before the combined treatment were analyzed,and the optimal cut-off value of NLR was calculated using X-tile software.The effect of NLR expression on the survival rate of patients with advanced gastric cancer was analysed by the Kaplan-Meier survival curve.Receiver operating curve(ROC)was used to analyze the predictive value of NLR in patients with advanced gastric cancer.The related factors affecting the disease progression of patients with advanced gastric cancer were screened combined with Cox proportional risk model.Results Among 168 patients,the optimal cut-off value of serum NLR before treatment was 2.41.Patients were divided into high NLR group(NLR＞2.41,n=93)and low NLR group(NLR＜2.41,n=75).NLR was related to tumor differentiation,distant metastasis,composite positive scores of PD-L1,carcinoembryonic antigen and cancer antigen 125(P＜0.05);the effective rate in the low NLR group was significantly higher than that in the high NLR group(P＜0.05);the median progression free survival(PFS)and the overall survival(OS)of patients in the low NLR group were both longer than those in the high NLR group(PFS:P=0.006;OS:P=0.023);ROC analysis showed that the area under the curve of NLR for the prognosis of advanced gastric cancer patients was 0.740,sensitivity was 81.50％,and specificity was 69.70％;in multivariate analysis,except initial NLR value,tumor differentiation degree and distant metastasis were also independent predictors of poor prognosis in patients with advanced gastric cancer(P＜0.05).Conclusion Among patients with advanced gastric cancer who received first-line immunotherapy combined with chemotherapy,pretreatment NLR is correlated with efficacy and PFS/OS,and has high value in predicting the prognosis of immunotherapy for advanced gastric cancer.

OBJECTIVE To explore the effects of letrozole combined with methylprednisolone on clinical outcomes， ovarian reserve function， serum sex hormones， and safety in infertile patients with polycystic ovary syndrome resistant to clomiphene. METHODS The clinical data of 78 infertile patients with polycystic ovary syndrome resistant to clomiphene in the Department of Gynecology of Qingdao Central Hospital from February 2021 to January 2022 was analyzed retrospectively， and all patients were divided into control group （42 cases） and observation group （36 cases） based on the treatment methods. The control group took letrozole 5 mg/d orally on the 5th to 9th day of the menstrual cycle. Vaginal ultrasound was used to monitor the development of the endometrium and follicles； estradiol valerate was used to correct endometrial thickness， and measures such as inducing ovulation with follicle-stimulating hormone were taken to promote pregnancy. On the basis of treatment in the control group， the observation group began taking methylprednisolone orally at a dose of 4 mg/d starting from the third day of natural menstruation or withdrawal bleeding. Both groups were treated for 6 menstrual cycles. The ovulation and pregnancy within one year， serum levels of sex hormones [estradiol （E2）， luteinizing hormone （LH）， follicle-stimulating hormone （FSH）， testosterone] and anti-Müllerian hormone （AMH）， ovulation indicators （follicle growth time， the number of ovulations， and the number of dominant follicles）， and the occurrence of adverse drug reactions were compared between the two groups. RESULTS After treatment， the biochemical pregnancy rate （72.22%） and clinical pregnancy rate （47.22%） of the observation group were significantly higher than those of control group （47.62%， 19.05%）； the serum levels of E2， LH， FSH， testosterone and AMH were significantly lower than the control group； the follicle growth time was significantly shorter than the control group； the number of ovulation and dominant follicles were significantly higher than the control group （P＜0.05）. There was no statistically significant difference in ovulation rate （94.44% vs. 83.33%） and total incidence of adverse drug reactions （8.33% vs. 9.52%） between the observation group and the control group （P＞0.05）. CONCLUSIONS Compared with letrozole alone， the combination of letrozole and methylprednisolone can significantly improve the pregnancy rate， the sex hormone levels and ovarian reserve function in infertile patients with polycystic ovary syndrome resistant to clomiphene， with high safety profiles.

Objective:To explore the prognostic value of baseline 18F-FDG PET/CT metabolic parameters in locally advanced cervical cancer (LACC) after concurrent chemoradiotherapy (CCRT). Methods:From September 2015 to October 2021, the clinical data of 180 LACC patients (age: 22-76 years) who underwent 18F-FDG PET/CT before CCRT at Affiliated Cancer Hospital of Shandong First Medical University were analyzed retrospectively. The metabolic tumor volume (MTV), total lesion glycolysis (TLG), SUV max, and SUV mean were computed by using the margin threshold of 42%SUV max. The optimal threshold for predicting progression-free survival (PFS) was obtained by ROC curve analysis. The Kaplan-Meier method was applied for survival analysis, and the log-rank test was applied to compare the survival rate between groups. Multivariate Cox proportional hazard regression was used to analyze progression for PFS. Results:The median follow-up was 19.1 months, and 54 patients (30.0%, 54/180) suffered from disease progression. ROC curve analysis showed that the optimal cut-off value of MTV was 31.145 ml, with the AUC of 0.641. Para-aortic lymph node (PALN) metastasis had the highest AUC value (0.589) among the clinical factors, followed by International Federation of Gynecology and Obstetrics (FIGO) stage (0.581). The 1-year PFS rates of patients with MTV<31.145 ml ( n=88) and MTV≥31.145 ml ( n=92) were 80.68% and 59.78%, respectively ( χ2=13.72, P<0.001). Multivariate Cox analysis demonstrated that pathological type (hazard ratio ( HR)=3.075, 95% CI: 1.370-6.901, P=0.006), FIGO stage ( HR=1.955, 95% CI: 1.031-3.707, P=0.040), PALN metastasis ( HR=2.136, 95% CI: 1.202-3.796, P=0.010) and MTV ( HR=2.449, 95% CI: 1.341-4.471, P=0.004) were the significant predictors for PFS. Conclusions:Pathological type, FIGO stage, PALN metastasis and MTV are independent prognostic risk factors for PFS. MTV as the baseline 18F-FDG PET/CT metabolic parameter, can realize prognostic stratification analysis.

Objective:To investigate the effect and molecular mechanism of tumor necrosis factor-α-inducible protein 8-like 2(TIPE2)on lipopolysaccharide(LPS)or interleukin-4(IL-4)-induced phenotypic switch of adipose tissue macrophages(ATM).Methods:The expression levels of TIPE2, inducible nitric oxide synthase(iNOS), monocyte chemoattractant protein 1(MCP-1), CD206, and arginase 1(Arg-1)in the visceral adipose tissue of obese mice, TIPE2-knockout(KO)mice, and control mice were detected by immunohistochemistry, Western blotting, and real-time PCR(RT-qPCR). Peritoneal macrophages isolated from KO and wild-type mice and RAW 264.7 mouse macrophage cell line were cultured, and then stimulated with LPS(100 ng/mL)or IL-4(20 ng/mL)for 6 hours. The expression levels of TIPE2, iNOS, MCP-1, CD206, and Arg-1 were detected by Western blotting and RT-qPCR.Results:Obese mice showed down-regulated TIPE2 expression, up-regulated pro-inflammatory markers iNOS and MCP-1 expressions, and down-regulated anti-inflammatory markers CD206 and Arg-1 expressions. LPS decreased the expression of TIPE2 in RAW 264.7 cells and peritoneal macrophages from mice, increased the expression of the classically activated macrophages(M1 phenotype)markers iNOS and MCP-1, and decreased the expression of the substituting activated macrophages(M2 phenotype)markers CD206 and Arg-1. IL-4 increased the expression of TIPE2 in RAW 264.7 cells and peritoneal macrophages, decreased the expression of iNOS and MCP-1, and increased the expression of CD206 and Arg-1. During the M1 polarization of macrophages, LPS increased toll-like receptor(TLR4)expression as well as nuclear transcription factor κBα suppressor protein(IκBα) and NF-κB phosphorylations in macrophages. Knockout of TIPE2 further increased the expression of the TLR4/IκBα/NF-κB signaling pathway and M1 macrophage markers, and further reduced the expression of the M2 macrophage markers.Conclusion:TIPE2 regulates ATM phenotypic transformation through inhibition of the TLR4/IκBα/NF-κB signaling pathway, which ameliorates adipose tissue inflammation in obese states.