ObjectiveTo develop a community-family management model for older adults with mild cognitive impairment (MCI) and to formulate detailed application specifications, and to fully leverage the initiative of communities and families under limited resource conditions, for achieving community-based early detection and early intervention for older adults with MCI. MethodsA systematic literature review was conducted to identify pertinent publications. Corpus-based research methodologies were employed to extract, refine, integrate and synthesize management elements, thereby establishing the specific content and service processes for each stage of the management model. Utilizing the 5W2H analytical framework, essential elements such as management stakeholders, target populations, content and methods for each stage were delineated. The model and its application guidelines were finalized through expert consultation and demonstration. ResultsAn expert evaluation of the management model yielded mean scores of 4.84, 4.32 and 4.84 for acceptability, feasibility and systematicity, respectively. By integrating the identified core elements with expert ratings and feedback, the final iteration of the community-family management model for older adults with MCI was formulated. This model comprised of five stages: screening and identification, comprehensive assessment, intervention planning, monitoring and referral pathways to ensure implementation, and enhanced support for communities, family members and caregivers. Additionally, it included 18 specific application guidelines. ConclusionThe proposed management model may theoretically help delay cognitive decline, improve cognitive function and potentially promote reversal from MCI to normal cognition. It may also enhance the awareness and coping capacity of older adults and their families, strengthen community healthcare professionals' ability to early identify and manage MCI.

In recent years,artificial intelligence(AI)technologies,particularly those represented by deep learn-ing,have demonstrated tremendous potential in the advancement of medical applications.This article reviews recent re-search progress in AI applications for the diagnosis and treatment of triple-negative breast cancer,aiming to inform the development of clinically relevant AI algorithms that align with real-world practice scenarios.The ultimate objectives in-clude enhancing diagnostic accuracy through efficient computational approaches,reducing manual labor burdens,im-proving patient prognosis,and facilitating the identification of therapeutic targets in oncology through AI-driven predic-tive modeling.

Objective:To explore the relapse-related genes and their clinicopathological connections of diffuse large B cell lymphoma (DLBCL).Methods:Targeted panel sequencing was conducted on 32 eligible DLBCL samples; the patients were diagnosed, treated, and went into complete remission at the First Affiliated Hospital of Nanjing Medical University from January 2015 to December 2019, including 14 cases with recurrence (relapsed group) and 18 cases with long-term complete remission of over five years (remission group). Clinical and pathological data were further reviewed. Fisher′s exact test was employed to compare the differences in clinicopathological characteristics and mutation patterns between the two groups.Results:Among the 32 patients, there were 18 males and 14 females, with a male to female ratio of 1.3∶1.0 and a median age of 53 (45.5, 67.0) years. In the relapsed group, PIM1 (11/14), KMT2D (7/14), PRDM1 (6/14), MYD88 (6/14), DTX1 (6/14) emerged as the most frequently mutated genes. In the remission group, while recurrent PIM1, KMT2D and MYD88 mutations were also observed, the TP53 gene exhibited the highest mutation frequency (6/18). Compared to the remission group, relapsed group showed elevated mutation frequencies of PIM1 ( P=0.013) and FAT4 ( P=0.010), alongside a reduced incidence of TP53 mutations. In all 32 patients, DLBCL with CD79B, CCND3, DTX1, KMT2D and PRDM1 mutations demonstrated a propensity towards advanced clinicopathologic stage. Conclusions:Relapsed DLBCL has distinctive clinicopathological and genetic features. PIM1 and FAT4 may be served as potential biomarkers for screening relapsed DLBCL-NOS and as targets for novel therapeutic strategies.

Objective:To explore the clinical and pathological features of EBV-positive diffuse large B cell lymphoma (EBV +DLBCL) and to analyze the prognostic significance of CD30 expression in this entity. Methods:A retrospective analysis was conducted from 34 cases of EBV +DLBCL and 198 cases of EBV -DLBCL diagnosed and treated at the First Affiliated Hospital of Nanjing Medical University, from January 2017 to June 2023. Based on CD30 expression, 34 patients with EBV +DLBCL were categorized into CD30-positive and CD30-negative groups. Fisher exact test and Kaplan-Meier survival curves were employed to analyze the relationship between CD30 expression and clinicopathological parameters as well as its prognostic implications. Chi-square tests were used to compare the clinicopathological features between EBV +DLBCL and EBV -DLBCL. Results:There were 19 males and 15 females with a median age of 69.5 (15-83) years in the EBV +DLBCL group. Compared with EBV -DLBCL, EBV +DLBCL was more likely to present with clinical features such as B symptoms ( χ2=23.818, P<0.001), Ann Arbor stage Ⅲ-Ⅳ ( χ2=8.540, P=0.003), ECOG (Eastern Cooperative Oncology Group Performance Status) score 2-4 ( χ2=6.722, P=0.010), IPI score 3-5 ( χ2=9.953, P=0.002), and involvement of more than one extranodal site ( χ2=6.825, P=0.009). Additionally, EBV +DLBCL exhibited higher frequencies of elevated LDH ( χ2=4.307, P=0.038), CRP ( χ2=5.596, P=0.018), and β2-MG ( χ2=7.008, P=0.008) levels. Histopathologically, EBV +DLBCL was more commonly of the non-GCB subtype ( χ2=12.421, P<0.001), with higher frequencies of CD30-positive ( χ2=62.706, P<0.001),CD10-negative ( χ2=8.687, P=0.003),bcl-6-negative ( χ2=11.123, P<0.001), and bcl-2-negative ( χ2=22.779, P=0.003) expression. Using 20% as the positive threshold for CD30, the CD30-positive group had a higher proliferation index ( P=0.045). No significant differences were observed in overall survival between the two groups. Conclusions:EBV +DLBCL is more prevalent in the elderly and often exhibits aggressive clinical features. The expression of CD30 is not associated with the overall prognosis of EBV +DLBCL.

In recent years,artificial intelligence(AI)technologies,particularly those represented by deep learn-ing,have demonstrated tremendous potential in the advancement of medical applications.This article reviews recent re-search progress in AI applications for the diagnosis and treatment of triple-negative breast cancer,aiming to inform the development of clinically relevant AI algorithms that align with real-world practice scenarios.The ultimate objectives in-clude enhancing diagnostic accuracy through efficient computational approaches,reducing manual labor burdens,im-proving patient prognosis,and facilitating the identification of therapeutic targets in oncology through AI-driven predic-tive modeling.

Objective:To explore the relapse-related genes and their clinicopathological connections of diffuse large B cell lymphoma (DLBCL).Methods:Targeted panel sequencing was conducted on 32 eligible DLBCL samples; the patients were diagnosed, treated, and went into complete remission at the First Affiliated Hospital of Nanjing Medical University from January 2015 to December 2019, including 14 cases with recurrence (relapsed group) and 18 cases with long-term complete remission of over five years (remission group). Clinical and pathological data were further reviewed. Fisher′s exact test was employed to compare the differences in clinicopathological characteristics and mutation patterns between the two groups.Results:Among the 32 patients, there were 18 males and 14 females, with a male to female ratio of 1.3∶1.0 and a median age of 53 (45.5, 67.0) years. In the relapsed group, PIM1 (11/14), KMT2D (7/14), PRDM1 (6/14), MYD88 (6/14), DTX1 (6/14) emerged as the most frequently mutated genes. In the remission group, while recurrent PIM1, KMT2D and MYD88 mutations were also observed, the TP53 gene exhibited the highest mutation frequency (6/18). Compared to the remission group, relapsed group showed elevated mutation frequencies of PIM1 ( P=0.013) and FAT4 ( P=0.010), alongside a reduced incidence of TP53 mutations. In all 32 patients, DLBCL with CD79B, CCND3, DTX1, KMT2D and PRDM1 mutations demonstrated a propensity towards advanced clinicopathologic stage. Conclusions:Relapsed DLBCL has distinctive clinicopathological and genetic features. PIM1 and FAT4 may be served as potential biomarkers for screening relapsed DLBCL-NOS and as targets for novel therapeutic strategies.

Objective:To explore the clinical and pathological features of EBV-positive diffuse large B cell lymphoma (EBV +DLBCL) and to analyze the prognostic significance of CD30 expression in this entity. Methods:A retrospective analysis was conducted from 34 cases of EBV +DLBCL and 198 cases of EBV -DLBCL diagnosed and treated at the First Affiliated Hospital of Nanjing Medical University, from January 2017 to June 2023. Based on CD30 expression, 34 patients with EBV +DLBCL were categorized into CD30-positive and CD30-negative groups. Fisher exact test and Kaplan-Meier survival curves were employed to analyze the relationship between CD30 expression and clinicopathological parameters as well as its prognostic implications. Chi-square tests were used to compare the clinicopathological features between EBV +DLBCL and EBV -DLBCL. Results:There were 19 males and 15 females with a median age of 69.5 (15-83) years in the EBV +DLBCL group. Compared with EBV -DLBCL, EBV +DLBCL was more likely to present with clinical features such as B symptoms ( χ2=23.818, P<0.001), Ann Arbor stage Ⅲ-Ⅳ ( χ2=8.540, P=0.003), ECOG (Eastern Cooperative Oncology Group Performance Status) score 2-4 ( χ2=6.722, P=0.010), IPI score 3-5 ( χ2=9.953, P=0.002), and involvement of more than one extranodal site ( χ2=6.825, P=0.009). Additionally, EBV +DLBCL exhibited higher frequencies of elevated LDH ( χ2=4.307, P=0.038), CRP ( χ2=5.596, P=0.018), and β2-MG ( χ2=7.008, P=0.008) levels. Histopathologically, EBV +DLBCL was more commonly of the non-GCB subtype ( χ2=12.421, P<0.001), with higher frequencies of CD30-positive ( χ2=62.706, P<0.001),CD10-negative ( χ2=8.687, P=0.003),bcl-6-negative ( χ2=11.123, P<0.001), and bcl-2-negative ( χ2=22.779, P=0.003) expression. Using 20% as the positive threshold for CD30, the CD30-positive group had a higher proliferation index ( P=0.045). No significant differences were observed in overall survival between the two groups. Conclusions:EBV +DLBCL is more prevalent in the elderly and often exhibits aggressive clinical features. The expression of CD30 is not associated with the overall prognosis of EBV +DLBCL.

Objective:To investigate the clinicopathological and molecular genetic characteristics of Crohn′s disease (CD).Methods:A retrospective analysis was conducted on 52 CD patients who underwent surgical resection at the First Affiliated Hospital of Nanjing Medical University between January 2014 and June 2023. Clinical presentations and histopathological features were assessed. Whole-genome sequencing was performed on 17 of the samples, followed by sequencing and pathway enrichment analyses. Immunohistochemistry was used to assess the expression of frequently mutated genes.Results:Among the 52 patients, 34 were males and 18 were females, male-to-female ratio was 1.9∶1.0, with a median age of 45 years at surgery and 35 years at diagnosis. According to the Montreal classification, A3 (51.9%,27/52), B2 (61.5%, 32/52), and L3 (50.0%,26/52) subtypes were the most predominant. Abdominal pain and diarrhea were the common symptoms. Histopathological features seen in all 52 patients included transmural inflammation, disruption of cryptal architecture, lymphoplasmacytic infiltration, varying degrees of submucosal fibrosis and thickening, increased enteric nerve fibers and neuronal proliferation. Mucosal defects, fissure ulcers, abscesses, pseudopolyps, and adenomatous proliferation were also observed in 51 (98.1%), 38 (73.1%), 28 (53.8%), 45 (86.5%), and 28 (53.8%) cases, respectively. Thirty-one (59.6%) cases had non-caseating granulomas, and 3 (5.8%) cases had intestinal mucosal glandular epithelial dysplasia. Molecular analysis showed that 12/17 CD patients exhibited mutations in at least one mucin family gene (MUC2, MUC3A, MUC4, MUC6, MUC12, MUC17), and MUC4 was the most frequently mutated in 7/17 of cases. Immunohistochemical stains showed reduced MUC4 expression in epithelial cells, with increased MUC4 expression in the epithelial surface, particularly around areas of inflammatory cell aggregation; and minimal expression in the lower half of the epithelium.Conclusions:CD exhibits diverse clinical and pathological features, necessitating a comprehensive multidimensional analysis for diagnosis. Mutations and expression alterations in mucin family genes, particularly MUC4, may play crucial roles in the pathogenesis of CD.

Humans ; Consensus ; Liver Neoplasms/therapy* ; China