Background The global number of type 2 diabetes (T2D) cases has been steadily increasing over the past few decades, becoming a major public health issue. Available toxicological research has indicated that ozone (O₃) can lead to oxidative stress and inflammatory responses, thereby causing metabolic changes and the development of T2D. Existing cohort studies on the impact of long-term O₃ exposure on the risk of developing T2D have reached contradictory conclusions, and the results have shown significant heterogeneity. Objective To summarize cohort studies on long-term O₃ exposure and T2D risk, and investigate heterogeneity sources in the association between O₃ and T2D. Methods Cohort studies on O₃ and T2D were searched through PubMed, Embase, and the Web of Science, with the search deadline set for 25 April, 2025. After two researchers independently screened the literature, extracted data, and evaluated the quality of the included studies, meta-analysis was conducted using Stata 18.0 software. We used a random effects model to calculate the overall relative risk (RR) of the standardized risk estimates and its 95% confidence interval (CI). Additionally, sensitivity analysis, subgroup analysis, meta-regression, and publication bias testing were performed to explore the sources of heterogeneity in the association between O₃ and T2D. Results In the 8 articles meeting predetermined inclusion criteria, a total of 11 cohort studies involving 54887070 participants were finally included. The results of the meta-analysis indicated that long-term exposure to O₃ was associated with a higher incidence of type 2 diabetes [standardized RR=1.04 (95%CI: 1.01, 1.07), P<0.001, I²=97.3%], and significant heterogeneity existed. The subgroup analysis showed that females (standardized RR=1.08, 95%CI: 1.03, 1.13) and the Asian population (standardized RR=1.09, 95%CI: 1.06, 1.11) were are more susceptible to O₃. The meta-regression model that included study region and average O₃ concentration variables explained 60.33% of the heterogeneity between studies. No significant evidence of publication bias was observed after the funnel plot test, Egger's test (P=0.437), Begg's test (P=0.640), and the trim-and-fill method. Conclusion Long-term exposure to O₃ could increase the risk of developing T2D, with females and Asian populations being particularly sensitive. The heterogeneity in the association between O₃ and T2D can be partly explained by factors such as average O₃ concentration and geographic location.

Primary liver cancer is one of the most common causes of cancer-related deaths in China,with hepatocellular carcinoma(HCC)accounting for 75%-85%.Approximately 70%of HCC patients are in the advanced stage at the time of diagnosis and miss the opportunity for radical surgery,leading to a poor prognosis.Yttrium-90 microsphere selective internal radiation therapy(90Y-SIRT),an emerging therapeutic modality,delivers radioactive microspheres via the hepatic artery to target tumors and uses beta radiation for localized tumor ablation.Compared to conventional transarterial chemoembolization and pharmacotherapy,90Y-SIRT shows the advan-tages of significant clinical benefits,good safety profiles,and broad applicability across diverse patient populations.This article re-views the advances in the application of 90Y-SIRT in HCC treatment.

Primary liver cancer is a malignant tumor with high incidence and mortality rates worldwide,and the early diagnosis of pri-mary liver cancer and the optimization of precise treatment strategies have become critical issues in the healthcare field.Due to the in-sufficient capabilities for molecular characterization,it is increasingly difficult for traditional imaging techniques to meet clinical needs in the era of precision medicine.Multimodal molecular imaging technology integrates the advantages of imaging modalities such as ul-trasound imaging,magnetic resonance imaging,and optical imaging,thereby achieving synergistic enhancement between molecular bio-logical information of liver cancer and precise anatomical localization and demonstrating a significant value in the diagnosis and treat-ment of liver cancer.This article reviews the advances in the application of multimodal molecular imaging in the early diagnosis,pre-cise treatment,and therapeutic efficacy monitoring of liver cancer.

Objective:To summarize the clinical characteristics of elderly patients with stage Ⅰ diffuse large B-cell lymphoma (DLBCL) and analyze the factors associated with prognosis.Methods:A case series study was conducted by retrospectively collecting clinical data from patients aged over 60 years with newly diagnosed stage Ⅰ DLBCL across 20 medical centers in Jiangsu Province, China, between June 2010 and April 2023. The involved site, classification and treatment plan were summarized. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Statistical analyses were performed using the Kaplan-Meier method, and Cox regression model.Results:The study included 255 patients with a median age of 69 years, of whom 130 (51.0%) were male, 66 (25.9%) were aged ≥75 years and 26 (10.1%) had a high Charlson Comorbidity Index (CCI) score of ≥2. Extranodal involvement was observed in 163 (63.9%) patients, with the stomach (37.4%, 61/163), intestine (19.0%, 31/163), testes (11.0%, 18/163), and breast (7.4%, 12/163) being the most frequently affected sites. The non-germinal center B-cell (non-GCB) subtype was prevalent in 63.7% of patients (142/223), with no significant difference between the nodal and extranodal groups ( P=0.681). Furthermore, 73.9% (184/249) and 11.7% (29/249) of patients received the R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) and R-miniCHOP regimen, respectively. The overall 3-year PFS rate was 81.5%, and the 3-year OS rate was 85.6%. Patients aged ≥75 years ( HR=2.910, 95% CI 1.565-5.408, P=0.001) and/or with a CCI score ≥2 ( HR=2.324, 95% CI 1.141-4.732, P=0.020) had a significantly poorer PFS. Incorporating age ≥75 years and CCI score ≥2 into the stage-modified international prognostic index (sm-IPI) can better stratify the prognosis of elderly patients with stage Ⅰ DLBCL. The 3-year PFS rate was 48.7% in the high-risk group versus 85.7% in the low-risk group ( P<0.001). Conclusions:Our findings show that the elderly patients with stage Ⅰ DLBCL were predominantly characterized by extranodal involvement (particularly in the stomach and intestinal tract) and non-GCB subtype. Age ≥75 years and CCI ≥2 were identified as independent prognostic factors. The newly established sm-IPI-75-CCI incorporating these factors demonstrated superior prognostic discrimination compared to conventional risk assessment systems.

Objective: To analyze the trends, gender, and age differences in the incidence of lip and oral cavity cancer in Chinese population from 1990 to 2021 and predict future incidence trends, providing a scientific basis for disease prevention and public health policy. Methods: Incidence data of lip and oral cavity cancer in Chinese population from the Global Burden of Disease (GBD) database from 1990 to 2021 were analyzed. The Joinpoint regression model was used to assess temporal trends, the age-period-cohort model was used to evaluate the independent effects of age, period, and cohort, and the Bayesian age-period-cohort model (BAPC) model was used to predict incidence trends from 2022 to 2044. Results: From 1990 to 2021, the age-standardized incidence rate of lip and oral cavity cancer in Chinese population increased from 2.39/100 000 to 3.76/100 000, and the crude incidence rate rose from 1.71/100 000 to 4.85/100 000. The incidence rate in males was higher and increased more rapidly than in females. Higher incidence rates were prevalent among older populations, a rapid increase in incidence rates occurred during 2003 to 2012, and earlier birth cohorts showed overall higher risks. BAPC predictions indicated a continued rise in incidence from 2022 to 2044. During this period, male incidence stabilized while female incidence increased at a relatively faster rate. Conclusion The incidence of lip and oral cavity cancer in Chinese population has revealed a continuous upward trend, particularly among males and older populations. Future prevention strategies should focus on these high-risk populations.

Objective:To summarize the clinical characteristics of elderly patients with stage Ⅰ diffuse large B-cell lymphoma (DLBCL) and analyze the factors associated with prognosis.Methods:A case series study was conducted by retrospectively collecting clinical data from patients aged over 60 years with newly diagnosed stage Ⅰ DLBCL across 20 medical centers in Jiangsu Province, China, between June 2010 and April 2023. The involved site, classification and treatment plan were summarized. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Statistical analyses were performed using the Kaplan-Meier method, and Cox regression model.Results:The study included 255 patients with a median age of 69 years, of whom 130 (51.0%) were male, 66 (25.9%) were aged ≥75 years and 26 (10.1%) had a high Charlson Comorbidity Index (CCI) score of ≥2. Extranodal involvement was observed in 163 (63.9%) patients, with the stomach (37.4%, 61/163), intestine (19.0%, 31/163), testes (11.0%, 18/163), and breast (7.4%, 12/163) being the most frequently affected sites. The non-germinal center B-cell (non-GCB) subtype was prevalent in 63.7% of patients (142/223), with no significant difference between the nodal and extranodal groups ( P=0.681). Furthermore, 73.9% (184/249) and 11.7% (29/249) of patients received the R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) and R-miniCHOP regimen, respectively. The overall 3-year PFS rate was 81.5%, and the 3-year OS rate was 85.6%. Patients aged ≥75 years ( HR=2.910, 95% CI 1.565-5.408, P=0.001) and/or with a CCI score ≥2 ( HR=2.324, 95% CI 1.141-4.732, P=0.020) had a significantly poorer PFS. Incorporating age ≥75 years and CCI score ≥2 into the stage-modified international prognostic index (sm-IPI) can better stratify the prognosis of elderly patients with stage Ⅰ DLBCL. The 3-year PFS rate was 48.7% in the high-risk group versus 85.7% in the low-risk group ( P<0.001). Conclusions:Our findings show that the elderly patients with stage Ⅰ DLBCL were predominantly characterized by extranodal involvement (particularly in the stomach and intestinal tract) and non-GCB subtype. Age ≥75 years and CCI ≥2 were identified as independent prognostic factors. The newly established sm-IPI-75-CCI incorporating these factors demonstrated superior prognostic discrimination compared to conventional risk assessment systems.

Objective To evaluate the safety and efficacy of transcatheter arterial chemoembolization(TACE)combined with lenvatinib and camrelizumab in the treatment of advanced hepatocellular carcinoma(HCC).Methods The clinical data of a total of 63 patients with advanced HCC,who received TACE combined with lenvatinib and camrelizumab(triple therapy)or TACE combined with lenvatinib(dual therapy)at the Jingmen Municipal People's Hospital of China between April 2020 and December 2021,were retrospectively analyzed.Triple therapy group had 30 patients,and dual therapy group had 33 patients.The post-treatment tumor response,disease progression-free survival(PFS),overall survival(OS),and the incidence of adverse drug reactions were recorded.Results The median follow-up period of the two groups was 14 months(range of 4-26 months).Compared with the dual therapy group,in the triple therapy group the objective response rate(ORR)was remarkably higher(83.3%vs.57.6%,P=0.026),the disease control rate(DCR)was obviously higher(93.3%vs.69.7%,P=0.039),the median PFS was significantly longer(8.0 months vs.5.0 months,P＜0.01),and the median OS was strikingly longer(24.0 months vs.12.0 months,P=0.004).No statistically significant difference in the incidence of adverse drug reactions existed between the two groups(P＞0.05).Conclusion For the treatment of advanced HCC,TACE combined with lenvatinib and camrelizumab is clinically safe and effective.(J Intervent Radiol,2024,32:57-62)

Objective To explore the predictive value of transvaginal ultrasound blood flow parameters combined with serum anti mullerian hormone (AMH) for in vitro fertilization embryo transfer (IVF-ET) pregnancy failure in infertility with polycystic ovary syndrome (PCOS). Methods A total of 173 infertile PCOS patients who underwent IVF-ET were selected as the study objects, of which 12 cases fell off. According to the results of vaginal Bultrasound on the 28th day after embryo transfer, 161 patients were divided into failed pregnancy group (n=96) and successful pregnancy group (n=65). The levels of resistance index (RI), pulsatile index (PI), ratio of maximum systolic to diastolic blood flow velocity (S/D), and serum AMH were compared between the two groups. Multivariate Logistic regression analysis was used to analyze the influencing factors of pregnancy failure in IVF-ET with PCOS infertility. Receiver operating characteristic (ROC) curves were drawn to analyze RI, PI, S/D and serum AMH levels alone and their combination to evaluate the predictive valueof IVF-ET pregnancy failure in PCOS infertility patients. Results The serum AMH level in the failed pregnancy group was significantly lower than that in the successful pregnancy group, and the blood flow RI, PI and S/D were higher than those in the successful pregnancy group (P < 0.001). RI (OR=4.688, 95%CI, 2.878 to 6.498), PI (OR=4.332, 95%CI, 2.277 to 6.387), S/D (OR=3.773, 95%CI, 1.856 to 5.691) and luteinizing hormone (LH)/follicle stimulating hormone (FSH) values on the third day of menstrual cycle (OR=2.998, 95%CI, 1.236 to 4.760) were the risk factors for pregnancy failure in PCOS infertility IVF-ET (P < 0.05); high FSH level on the third day of menstruation (OR=0.579, 95%CI, 0.416 to 0.806), high serum AMH level (OR=0.722, 95%CI, 0.533 to 0.911) and endometrial thickness on human chorionic gonadotropin (hCG)day (OR=0.632, 95%CI, 0.421 to 0.843) were protective factors for pregnancy failure in IVF-ET in PCOS infertility (P < 0.05). The sensitivity, specificity and area under the curve (AUC) of RI, PI and S/D combined with serum AMH levels in predicting pregnancy failure in IVF-ET of PCOS infertility were 95.83%, 80.00% and 0.933, respectively. Conclusion The combination of ultrasonic blood flow parameters and AMH has a good value in predicting pregnancy failure in IVF-ET of PCOS infertility.

Abstract Genetic diagnosis and etiological analysis were performed on a patient with hypoxic-ischemic encephalopathy at birth. MRI technology was used to examine the brain of the child. G-band karyotype analysis technology was used to analyze the karyotype of the child and her parents. Chromosomal microarray analysis(CMA) was used to analyze the entire genome of the child and her parents for chromosomal copy number variation(CNV) and to identify the small supernumerary marker chromosomes. The results of MRI supported the diagnosis of hypoxic-ischemic encephalopathy of the child and found the appearance of Dandy-Walker malformation. Karyotype analysis showed that the mother's karyotype was 46, XX, t(10; 13)(p11. 1; q11)[11]/46, XX[19]. The karyotype of the father was normal. The karyotype of the child was 47, XX, + mar. The CMA results showed that there was no CNVs above 200 kb in the parents. The CMA results of the child showed that the chromosome 10 was repeated in p15. 3 p11. 1, and the fragment size was 38. 39 Mb. In conclusion, this study found a rare small supernumerary marker chromosome(sSMC) on chromosome 10. Its genetic pattern and pathogenicity were analyzed. It is considered that sSMC(10) is the cause of the patient.

Objective:To understand the research progress and quality of lung cancer screening guidelines and consensus in China and abroad, and to provide reference for the formulation of high-quality lung cancer screening guidelines in China.Methods:Databases including PubMed, Medline, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, SinoMed, VIP and Wanfang Data were searched, websites and important references were also searched by hand retrieval. The Appraisal of Guidelines for Research & Evaluation Ⅱ(AGREE Ⅱ) and Reporting Items for Practice Guidelines in Healthcare (RIGHT) were used to assess the quality of newly published or updated guidelines and consensus.Results:A total of 9 guidelines and consensus published between 2015 and 2020 were included in this study, with countries including the United States, China, Canada, Saudi Arabia and South Africa. The field of scope and purpose and clarity of presentation scored relatively high but the rigor of development and applicability scored low. Five guidelines were judged to be A-level, all of which were published abroad, and the remaining four were B-level, including three guidelines and consensus issued by China and 1 guideline issued by South Africa. The report rate of RIGHT were higher in basic information and background, lower in review and quality assurance, funding and declaration and management of interests. There were 5 guidelines with a good level and 4 guidelines and consensus with a moderate level. The best overall quality guidelines were those published by the American College of Chest Physicians in 2018 and by the Canadian Task Force on Preventive Health Care in 2016.Conclusions:The number of countries and institutions that issue lung cancer screening guidelines and consensus had been increasing gradually, but the quality in China remained low. It is necessary to develop high-quality lung cancer screening guidelines suitable for China's national conditions in combination with evidence-based methods to guide practice.