Hyperthermic intrathoracic chemotherapy (HITHOC) is a localized treatment that combines hyperthermia with medications such as chemotherapy, anti-angiogenic agents, targeted therapy, or immunotherapeutic agents. It has advanced clinical progress for conditions such as malignant pleural mesothelioma, pleural metastasis of lung cancer, and pleural dissemination of thymic tumors. Systematic analyses indicate that as an adjuvant therapy to cytoreductive surgery, HITHOC improves patient survival and effectively controls pleural effusion and pleural metastasis. It exerts antitumor effects by enhancing drug penetration through thermal effects, inducing apoptosis, and modulating the immune microenvironment. HITHOC combined with systemic therapies (e.g., chemotherapy, targeted therapy, and immunotherapy) demonstrates synergistic potential, but its role as a local treatment should be clearly defined as adjunctive within the comprehensive management of advanced-stage patients. Further research is needed to clarify its indications, standardized protocols, and long-term efficacy and to explore optimized regimens and personalized combination treatment strategies. This review delves into the key bottlenecks hindering the development of hyperthermia therapy, such as the lack of high-level evidence-based medicine and the absence of standardized diagnostic and efficacy evaluation criteria, and proposes potential solutions.

Objective: The CT/MRI Liver Imaging Reporting and Data System (LI-RADS) demonstrates high specificity with relatively limited sensitivity for diagnosing hepatocellular carcinoma (HCC) in high-risk patients. This study aimed to explore the possibility of improving sensitivity by combining CT/MRI LI-RADS v2018 with second-line contrast-enhanced ultrasound (CEUS) LI-RADS v2017 using sulfur hexafluoride (SHF) or perfluorobutane (PFB). Materials and Methods: This retrospective analysis of prospectively collected multicenter data included high-risk patients with treatment-naive hepatic observations. The reference standard was pathological confirmation or a composite reference standard (only for benign lesions). Each participant underwent concurrent CT/MRI, SHF-enhanced US, and PFB-enhanced US examinations. The diagnostic performances for HCC of CT/MRI LI-RADS alone and three combination strategies (combining CT/ MRI LI-RADS with either LI-RADS SHF, LI-RADS PFB, or a modified algorithm incorporating the Kupffer-phase findings for PFB [modified PFB]) were evaluated. For the three combination strategies, apart from the CT/MRI LR-5 criteria, HCC was diagnosed if CT/MRI LR-3 or LR-4 observations met the LR-5 criteria using LI-RADS SHF, LI-RADS PFB, or modified PFB. Results: In total, 281 participants (237 males; mean age, 55 ± 11 years) with 306 observations (227 HCCs, 40 non-HCC malignancies, and 39 benign lesions) were included. Using LI-RADS SHF, LI-RADS PFB, and modified PFB, 20, 23, and 31 CT/MRI LR-3/4 observations, respectively, were reclassified as LR-5, and all were pathologically confirmed as HCCs. Compared to CT/MRI LI-RADS alone (74%, 95% confidence interval [CI]: 68%–79%), the three combination strategies combining CT/MRI LI-RADS with either LI-RADS SHF, LI-RADS PFB, or modified PFB increased sensitivity (83% [95% CI: 77%–87%], 84% [95% CI: 79%–89%], 88% [95% CI: 83%–92%], respectively; all P < 0.001), while maintaining the specificity at 92% (95% CI: 84%–97%). Conclusion The combination of CT/MRI LI-RADS with second-line CEUS using SHF or PFB improved the sensitivity of HCC diagnosis without compromising specificity.

Objective:To investigate the effects of short-peptide-based enteral nutrition on nutritional status, immune function, and chemotherapy-related adverse reactions in children with acute lymphoblastic leukemia (ALL).Methods:A total of 106 children with ALL receiving chemotherapy at the Affiliated Hospital of Jining Medical University between January 2021 and April 2022 were enrolled. According to the principle of between-group baseline data matching, the patients were divided into observation group and control group by random number table method, with 53 cases in each group. All patients received chemotherapy according to the CCCG-ALL-2020 protocol established by the Multi-center Cooperative Group of the Chinese Society of Pediatric Oncology (2020). The control group received a regular diet, while the observation group received a regular diet supplemented with short-peptide-based enteral nutrition. The incidence rates of malnutrition, hypoproteinemia, hypoalbuminemia, abnormal immunoglobulin levels (IgG, IgM, IgA), and adverse reactions (liver injury, infection) were compared between both groups before chemotherapy and at the end of each of the following seven chemotherapy phases: Induction remission therapy (PVDL), Induction remission therapy (CAT), Early intensification therapy (CAT+), Consolidation therapy (HDMTX), Interim maintenance therapy, Reinduction therapy, and prior to the end of Maintenance therapy. Normally or approximately normally distributed measurement data were expressed as xˉ± s and compared by independent samples t-test. Counting data were expressed as n (%) and compared by χ2 test. Results:During the CAT phase, the incidence of malnutrition was significantly lower in the observation group than in the control group [20.8% (11/53) vs. 39.6% (21/53), χ2=4.48, P=0.034]. The incidence of hypoproteinemia was significantly lower in the observation group during HDMTX, Reinduction, Interim maintenance, and prior to the end of Maintenance therapy [47.2% (25/53) vs. 69.8% (37/53), χ2=5.60, P=0.018; 45.3% (24/53) vs. 67.9% (36/53), χ2=5.53, P=0.019; 41.5% (24/53) vs. 64.2% (34/53), χ2=5.45, P=0.020; 28.3% (15/53) vs. 54.7% (29/53), χ2=7.62, P=0.006, respectively]. The incidence of hypoalbuminemia was significantly lower in the observation group during CAT+, HDMTX, Reinduction, Interim maintenance, and prior to the end of Maintenance therapy [5.7% (3/53) vs. 22.6% (12/53), χ2=6.29, P=0.012; 9.4% (5/53) vs. 26.4% (14/53), χ2=5.19, P=0.023; 9.4% (5/53) vs. 28.3% (15/53), χ2=6.16, P=0.013; 7.6% (4/53) vs. 24.5% (13/53), χ2=5.68, P=0.017; 3.8% (2/53) vs. 18.9% (10/53), χ2=6.01, P=0.014, respectively]. For IgG, incidence was significantly lower in the observation group during Interim maintenance, Reinduction, and prior to the end of Maintenance therapy [7.6% (4/53) vs. 22.6% (12/53), χ2=4.71, P=0.030; 20.8% (11/53) vs. 39.6% (21/53), χ2=4.48, P=0.034; 11.3% (6/53) vs. 26.4% (14/53), χ2=3.94, P=0.047, respectively]. For IgM, incidence was significantly lower in the observation group during the CAT and CAT+ phases [45.3% (24/53) vs. 66.0% (35/53), χ2=4.63, P=0.032; 58.5% (31/53) vs. 77.4% (41/53), χ2=4.33, P=0.037, respectively]. For IgA, incidence was significantly lower in the observation group during Reinduction therapy and Interim maintenance [22.6% (12/53) vs. 45.3% (24/53), χ2=6.06, P=0.014; 9.4% (5/53) vs. 24.5% (13/53), χ2=4.28, P=0.038, respectively]. For liver injury, incidence was significantly lower in the observation group during the CAT, CAT+, and prior to the end of Maintenance phases [22.6% (12/53) vs. 43.4% (23/53), χ2=5.16, P=0.023; 26.4% (14/53) vs. 50.9% (27/53), χ2=6.72, P=0.010, 11.3% (6/53) vs. 26.4%(14/53), χ2=3.94、 P=0.047,respectively]. For infection, incidence was significantly lower in the observation group during the CAT+ and HDMTX phases [35.9% (19/53) vs. 56.6% (30/53), χ2=4.59, P=0.032; 24.5% (13/53) vs. 43.4% (23/53), χ2=4.21, P=0.040, respectively]. Conclusions:Short-peptide-based enteral nutrition demonstrates significant advantages in the treatment of pediatric ALL. It provides substantial support for patient treatment and recovery by improving nutritional status, modulating immune function, and reducing chemotherapy-related adverse reactions.

Objective: The CT/MRI Liver Imaging Reporting and Data System (LI-RADS) demonstrates high specificity with relatively limited sensitivity for diagnosing hepatocellular carcinoma (HCC) in high-risk patients. This study aimed to explore the possibility of improving sensitivity by combining CT/MRI LI-RADS v2018 with second-line contrast-enhanced ultrasound (CEUS) LI-RADS v2017 using sulfur hexafluoride (SHF) or perfluorobutane (PFB). Materials and Methods: This retrospective analysis of prospectively collected multicenter data included high-risk patients with treatment-naive hepatic observations. The reference standard was pathological confirmation or a composite reference standard (only for benign lesions). Each participant underwent concurrent CT/MRI, SHF-enhanced US, and PFB-enhanced US examinations. The diagnostic performances for HCC of CT/MRI LI-RADS alone and three combination strategies (combining CT/ MRI LI-RADS with either LI-RADS SHF, LI-RADS PFB, or a modified algorithm incorporating the Kupffer-phase findings for PFB [modified PFB]) were evaluated. For the three combination strategies, apart from the CT/MRI LR-5 criteria, HCC was diagnosed if CT/MRI LR-3 or LR-4 observations met the LR-5 criteria using LI-RADS SHF, LI-RADS PFB, or modified PFB. Results: In total, 281 participants (237 males; mean age, 55 ± 11 years) with 306 observations (227 HCCs, 40 non-HCC malignancies, and 39 benign lesions) were included. Using LI-RADS SHF, LI-RADS PFB, and modified PFB, 20, 23, and 31 CT/MRI LR-3/4 observations, respectively, were reclassified as LR-5, and all were pathologically confirmed as HCCs. Compared to CT/MRI LI-RADS alone (74%, 95% confidence interval [CI]: 68%–79%), the three combination strategies combining CT/MRI LI-RADS with either LI-RADS SHF, LI-RADS PFB, or modified PFB increased sensitivity (83% [95% CI: 77%–87%], 84% [95% CI: 79%–89%], 88% [95% CI: 83%–92%], respectively; all P < 0.001), while maintaining the specificity at 92% (95% CI: 84%–97%). Conclusion The combination of CT/MRI LI-RADS with second-line CEUS using SHF or PFB improved the sensitivity of HCC diagnosis without compromising specificity.

Objective: The CT/MRI Liver Imaging Reporting and Data System (LI-RADS) demonstrates high specificity with relatively limited sensitivity for diagnosing hepatocellular carcinoma (HCC) in high-risk patients. This study aimed to explore the possibility of improving sensitivity by combining CT/MRI LI-RADS v2018 with second-line contrast-enhanced ultrasound (CEUS) LI-RADS v2017 using sulfur hexafluoride (SHF) or perfluorobutane (PFB). Materials and Methods: This retrospective analysis of prospectively collected multicenter data included high-risk patients with treatment-naive hepatic observations. The reference standard was pathological confirmation or a composite reference standard (only for benign lesions). Each participant underwent concurrent CT/MRI, SHF-enhanced US, and PFB-enhanced US examinations. The diagnostic performances for HCC of CT/MRI LI-RADS alone and three combination strategies (combining CT/ MRI LI-RADS with either LI-RADS SHF, LI-RADS PFB, or a modified algorithm incorporating the Kupffer-phase findings for PFB [modified PFB]) were evaluated. For the three combination strategies, apart from the CT/MRI LR-5 criteria, HCC was diagnosed if CT/MRI LR-3 or LR-4 observations met the LR-5 criteria using LI-RADS SHF, LI-RADS PFB, or modified PFB. Results: In total, 281 participants (237 males; mean age, 55 ± 11 years) with 306 observations (227 HCCs, 40 non-HCC malignancies, and 39 benign lesions) were included. Using LI-RADS SHF, LI-RADS PFB, and modified PFB, 20, 23, and 31 CT/MRI LR-3/4 observations, respectively, were reclassified as LR-5, and all were pathologically confirmed as HCCs. Compared to CT/MRI LI-RADS alone (74%, 95% confidence interval [CI]: 68%–79%), the three combination strategies combining CT/MRI LI-RADS with either LI-RADS SHF, LI-RADS PFB, or modified PFB increased sensitivity (83% [95% CI: 77%–87%], 84% [95% CI: 79%–89%], 88% [95% CI: 83%–92%], respectively; all P < 0.001), while maintaining the specificity at 92% (95% CI: 84%–97%). Conclusion The combination of CT/MRI LI-RADS with second-line CEUS using SHF or PFB improved the sensitivity of HCC diagnosis without compromising specificity.

Objective: The CT/MRI Liver Imaging Reporting and Data System (LI-RADS) demonstrates high specificity with relatively limited sensitivity for diagnosing hepatocellular carcinoma (HCC) in high-risk patients. This study aimed to explore the possibility of improving sensitivity by combining CT/MRI LI-RADS v2018 with second-line contrast-enhanced ultrasound (CEUS) LI-RADS v2017 using sulfur hexafluoride (SHF) or perfluorobutane (PFB). Materials and Methods: This retrospective analysis of prospectively collected multicenter data included high-risk patients with treatment-naive hepatic observations. The reference standard was pathological confirmation or a composite reference standard (only for benign lesions). Each participant underwent concurrent CT/MRI, SHF-enhanced US, and PFB-enhanced US examinations. The diagnostic performances for HCC of CT/MRI LI-RADS alone and three combination strategies (combining CT/ MRI LI-RADS with either LI-RADS SHF, LI-RADS PFB, or a modified algorithm incorporating the Kupffer-phase findings for PFB [modified PFB]) were evaluated. For the three combination strategies, apart from the CT/MRI LR-5 criteria, HCC was diagnosed if CT/MRI LR-3 or LR-4 observations met the LR-5 criteria using LI-RADS SHF, LI-RADS PFB, or modified PFB. Results: In total, 281 participants (237 males; mean age, 55 ± 11 years) with 306 observations (227 HCCs, 40 non-HCC malignancies, and 39 benign lesions) were included. Using LI-RADS SHF, LI-RADS PFB, and modified PFB, 20, 23, and 31 CT/MRI LR-3/4 observations, respectively, were reclassified as LR-5, and all were pathologically confirmed as HCCs. Compared to CT/MRI LI-RADS alone (74%, 95% confidence interval [CI]: 68%–79%), the three combination strategies combining CT/MRI LI-RADS with either LI-RADS SHF, LI-RADS PFB, or modified PFB increased sensitivity (83% [95% CI: 77%–87%], 84% [95% CI: 79%–89%], 88% [95% CI: 83%–92%], respectively; all P < 0.001), while maintaining the specificity at 92% (95% CI: 84%–97%). Conclusion The combination of CT/MRI LI-RADS with second-line CEUS using SHF or PFB improved the sensitivity of HCC diagnosis without compromising specificity.

Objective: The CT/MRI Liver Imaging Reporting and Data System (LI-RADS) demonstrates high specificity with relatively limited sensitivity for diagnosing hepatocellular carcinoma (HCC) in high-risk patients. This study aimed to explore the possibility of improving sensitivity by combining CT/MRI LI-RADS v2018 with second-line contrast-enhanced ultrasound (CEUS) LI-RADS v2017 using sulfur hexafluoride (SHF) or perfluorobutane (PFB). Materials and Methods: This retrospective analysis of prospectively collected multicenter data included high-risk patients with treatment-naive hepatic observations. The reference standard was pathological confirmation or a composite reference standard (only for benign lesions). Each participant underwent concurrent CT/MRI, SHF-enhanced US, and PFB-enhanced US examinations. The diagnostic performances for HCC of CT/MRI LI-RADS alone and three combination strategies (combining CT/ MRI LI-RADS with either LI-RADS SHF, LI-RADS PFB, or a modified algorithm incorporating the Kupffer-phase findings for PFB [modified PFB]) were evaluated. For the three combination strategies, apart from the CT/MRI LR-5 criteria, HCC was diagnosed if CT/MRI LR-3 or LR-4 observations met the LR-5 criteria using LI-RADS SHF, LI-RADS PFB, or modified PFB. Results: In total, 281 participants (237 males; mean age, 55 ± 11 years) with 306 observations (227 HCCs, 40 non-HCC malignancies, and 39 benign lesions) were included. Using LI-RADS SHF, LI-RADS PFB, and modified PFB, 20, 23, and 31 CT/MRI LR-3/4 observations, respectively, were reclassified as LR-5, and all were pathologically confirmed as HCCs. Compared to CT/MRI LI-RADS alone (74%, 95% confidence interval [CI]: 68%–79%), the three combination strategies combining CT/MRI LI-RADS with either LI-RADS SHF, LI-RADS PFB, or modified PFB increased sensitivity (83% [95% CI: 77%–87%], 84% [95% CI: 79%–89%], 88% [95% CI: 83%–92%], respectively; all P < 0.001), while maintaining the specificity at 92% (95% CI: 84%–97%). Conclusion The combination of CT/MRI LI-RADS with second-line CEUS using SHF or PFB improved the sensitivity of HCC diagnosis without compromising specificity.

Objective:To investigate the effects of short-peptide-based enteral nutrition on nutritional status, immune function, and chemotherapy-related adverse reactions in children with acute lymphoblastic leukemia (ALL).Methods:A total of 106 children with ALL receiving chemotherapy at the Affiliated Hospital of Jining Medical University between January 2021 and April 2022 were enrolled. According to the principle of between-group baseline data matching, the patients were divided into observation group and control group by random number table method, with 53 cases in each group. All patients received chemotherapy according to the CCCG-ALL-2020 protocol established by the Multi-center Cooperative Group of the Chinese Society of Pediatric Oncology (2020). The control group received a regular diet, while the observation group received a regular diet supplemented with short-peptide-based enteral nutrition. The incidence rates of malnutrition, hypoproteinemia, hypoalbuminemia, abnormal immunoglobulin levels (IgG, IgM, IgA), and adverse reactions (liver injury, infection) were compared between both groups before chemotherapy and at the end of each of the following seven chemotherapy phases: Induction remission therapy (PVDL), Induction remission therapy (CAT), Early intensification therapy (CAT+), Consolidation therapy (HDMTX), Interim maintenance therapy, Reinduction therapy, and prior to the end of Maintenance therapy. Normally or approximately normally distributed measurement data were expressed as xˉ± s and compared by independent samples t-test. Counting data were expressed as n (%) and compared by χ2 test. Results:During the CAT phase, the incidence of malnutrition was significantly lower in the observation group than in the control group [20.8% (11/53) vs. 39.6% (21/53), χ2=4.48, P=0.034]. The incidence of hypoproteinemia was significantly lower in the observation group during HDMTX, Reinduction, Interim maintenance, and prior to the end of Maintenance therapy [47.2% (25/53) vs. 69.8% (37/53), χ2=5.60, P=0.018; 45.3% (24/53) vs. 67.9% (36/53), χ2=5.53, P=0.019; 41.5% (24/53) vs. 64.2% (34/53), χ2=5.45, P=0.020; 28.3% (15/53) vs. 54.7% (29/53), χ2=7.62, P=0.006, respectively]. The incidence of hypoalbuminemia was significantly lower in the observation group during CAT+, HDMTX, Reinduction, Interim maintenance, and prior to the end of Maintenance therapy [5.7% (3/53) vs. 22.6% (12/53), χ2=6.29, P=0.012; 9.4% (5/53) vs. 26.4% (14/53), χ2=5.19, P=0.023; 9.4% (5/53) vs. 28.3% (15/53), χ2=6.16, P=0.013; 7.6% (4/53) vs. 24.5% (13/53), χ2=5.68, P=0.017; 3.8% (2/53) vs. 18.9% (10/53), χ2=6.01, P=0.014, respectively]. For IgG, incidence was significantly lower in the observation group during Interim maintenance, Reinduction, and prior to the end of Maintenance therapy [7.6% (4/53) vs. 22.6% (12/53), χ2=4.71, P=0.030; 20.8% (11/53) vs. 39.6% (21/53), χ2=4.48, P=0.034; 11.3% (6/53) vs. 26.4% (14/53), χ2=3.94, P=0.047, respectively]. For IgM, incidence was significantly lower in the observation group during the CAT and CAT+ phases [45.3% (24/53) vs. 66.0% (35/53), χ2=4.63, P=0.032; 58.5% (31/53) vs. 77.4% (41/53), χ2=4.33, P=0.037, respectively]. For IgA, incidence was significantly lower in the observation group during Reinduction therapy and Interim maintenance [22.6% (12/53) vs. 45.3% (24/53), χ2=6.06, P=0.014; 9.4% (5/53) vs. 24.5% (13/53), χ2=4.28, P=0.038, respectively]. For liver injury, incidence was significantly lower in the observation group during the CAT, CAT+, and prior to the end of Maintenance phases [22.6% (12/53) vs. 43.4% (23/53), χ2=5.16, P=0.023; 26.4% (14/53) vs. 50.9% (27/53), χ2=6.72, P=0.010, 11.3% (6/53) vs. 26.4%(14/53), χ2=3.94、 P=0.047,respectively]. For infection, incidence was significantly lower in the observation group during the CAT+ and HDMTX phases [35.9% (19/53) vs. 56.6% (30/53), χ2=4.59, P=0.032; 24.5% (13/53) vs. 43.4% (23/53), χ2=4.21, P=0.040, respectively]. Conclusions:Short-peptide-based enteral nutrition demonstrates significant advantages in the treatment of pediatric ALL. It provides substantial support for patient treatment and recovery by improving nutritional status, modulating immune function, and reducing chemotherapy-related adverse reactions.

AIM:To investigate whether crocin alleviates right ventricular injury induced by monocrotaline(MCT)in rats with pulmonary arterial hypertension(PAH),and to explore the underlying mechanisms.METHODS:Forty male SD rats were randomly divided into 4 groups:normal group,PAH group,crocin group and sildenafil group,with 10 rats in each group.The rats in PAH,crocin and sildenafil groups received subcutaneous injection of MCT(50 mg/kg)to establish the PAH model.Starting from the day of MCT injection,the rats in crocin group received crocin(200 mg/kg),the rats in sildenafil group received sildenafil(30 mg/kg),and those in PAH and normal groups were orally gavaged with an equal volume of saline once daily.After 4 weeks,measurements of right ventricular systolic pressure(RVSP),mean pulmonary artery pressure(mPAP),right ventricular hypertrophy index(RVHI)and right ventricular mass index(RVMI)were taken for the rats in each group.Tissue staining was conducted to observe pathological changes in the right ventricle,and the expression levels of inflammatory factors(IL-1β,IL-6 and TNF-α),the p38 MAPK/NF-κB inflammato-ry pathway,CCL2,CCR2,and the macrophage marker CD68 were assessed.RESULTS:Compared with PAH group,the rats in crocin and sildenafil groups exhibited significant reductions in RVSP,mPAP,RVHI and RVMI(P＜0.05).Right ventricular tissue displayed no evident infiltration of inflammatory cells or proliferation of collagen fibers.The down-regulation of the p38 MAPK/NF-κB pathway and inflammatory factors(IL-1β,IL-6 and TNF-α)was significant(P＜0.05).Additionally,the CCL2/CCR2 pathway and the infiltration of CD68+ macrophages were markedly decreased(P＜0.05).CONCLUSION:Crocin effectively mitigates right ventricular damage in MCT-induced PAH rats,with its effica-cy comparable to that of sildenafil at the dosage utilized in this experiment.Some protective mechanisms of crocin may be attributed to its regulatory effects on inflammation.

Objective:To investigate the current situation and characteristics of post-intensive care syndrome in elderly patients during the transitional period, and explore its influencing factors.Methods:From December 2022 to September 2023, convenience sampling was used to select 119 elderly patients in the Intensive Care Unit of China-Japan Friendship Hospital as the research subject. The General Information Questionnaire, Short Physical Performance Battery, Fatigue Scale-14, Barthel Index, Hospital Anxiety and Depression Scale, and Mini-mental State Examination were used to evaluate patients for post-intensive care syndrome from cognitive, psychological, and physiological aspects 7 days after their transfer from the Intensive Care Unit. Binomial Logistic regression was used to analyze the influencing factors of post-intensive care syndrome in elderly patients.Results:Among 119 elderly patients, 84 developed post-intensive care syndrome, with an incidence of 70.6%. The binomial Logistic regression showed that women and high nutritional risk were risk factors for the occurrence of post-intensive care syndrome in elderly patients ( P<0.05) . Conclusions:The incidence of post-intensive care syndrome is high in elderly patients during the transition period, with females and patients with high nutritional risk being prone to developing post-intensive care syndrome. Medical and nursing staff should pay attention to identifying gender differences, focus on high-risk populations, and dynamically evaluate different symptoms early on to provide precise interventions for elderly patients.