Objective:To investigate the efficacy of radiotherapy in patients with advanced esophageal cancer receiving first-line chemoimmunotherapy.Methods:A retrospective analysis was conducted on the data of 137 patients with Stage Ⅳ esophageal squamous cell carcinoma (ESCC) treated at our hospital from January 2018 to May 2023. These patients were divided into two groups: a group treated with first-line chemoimmunotherapy combined with radiotherapy (chemoimmunotherapy + radiotherapy group, n = 43) and a group treated with only chemoimmunotherapy ( n = 94). Inverse probability of treatment weighting (IPTW) was applied to balance baseline characteristics between the groups. With overall survival (OS) and progression-free survival (PFS) as study endpoints, the survival data were analyzed using the Kaplan-Meier method, the log-rank test, and the Cox regression method. Results:Before calibration, the chemoimmunotherapy + radiotherapy group significantly outperformed the sole chemoimmunotherapy group in median PFS (13.6 months vs. 7.0 months; HR: 0.501, 95% CI: 0.309-0.811, P = 0.005). After calibration using the COX proportional-hazards model for age, gender, Eastern Cooperative Oncology Group (ECOG) performance status, smoking history, T/N/M stage, and tumor location, the chemoimmunotherapy + radiotherapy group still had significant advantages in PFS (14.7 months vs. 7.0 months; HR: 0.441, 95% CI: 0.261-0.745, P = 0.002). IPTW analysis further confirmed this trend (13.9 months vs. 7.0 months; HR: 0.492, 95% CI: 0.304-0.795, P < 0.001). Specifically, the median OS of the chemoimmunotherapy + radiotherapy group demonstrated significant improvement in all analyses: pre-calibration (29.5 months vs. 18.0 months; HR: 0.507, 95% CI: 0.297-0.867, P = 0.013), after calibration using the Cox model (27.5 months vs. 16.7 months; HR: 0.470, 95% CI: 0.266-0.830, P = 0.009), and after calibration using IPTW (29.5 months vs. 16.9 months; HR: 0.448, 95% CI: 0.262-0.764, P < 0.001). Conclusions:The combination of radiotherapy and first-line chemoimmunotherapy can significantly improve survival outcomes of patients with advanced ESCC, suggesting its potential as a standard treatment strategy.

Objective:To analyze the epidemiological and clinical features of infectious diseases of the central nervous system (CNS).Methods:A cross-sectional study and analysis were conducted to summarize the epidemiological and clinical characteristics of 9 918 patients with CNS infectious diseases, who were diagnosed and treated at 29 hospitals across China from January 1, 2001 to December 31, 2020. Data collected included demographic data, clinical manifestations, health economic indicators, and prognostic outcomes.Results:Among the 9 918 collected cases of CNS infectious diseases, 5 559 were male (56.0%) and 4 359 were female (44.0%), with an onset age of 38 (25, 53) years. Education level: slightly more junior high school education (2 651 cases, 26.7%), and less elementary school education and below (2 181 cases, 22.0%) were found. Occupational distribution: farmers were found predominant (3 215 cases, 32.4%), followed by workers (1 826 cases, 18.4%) and students (1 633 cases, 16.5%). Clinical manifestations: headache (6 074 cases, 61.2%), fever (5 869 cases, 59.2%) and positive meningeal irritation signs (2 273 cases, 22.9%) were the 3 most common clinical manifestations, followed by nausea and (or) vomiting (2 095 cases, 21.1%), impaired consciousness (2 077 cases, 20.9%), psychiatric symptom (1 866 cases, 18.8%) and epilepsy (1 627 cases, 16.4%), etc., and cranial nerve involvement was found in 669 cases (6.7%). Major pathogens included viruses in 6 814 cases (68.7%), Mycobacterium tuberculosis in 1 677 cases (16.9%), common bacteria in 864 cases (8.7%), fungi in 254 cases (2.6%), spirochetes of syphilis in 183 cases (1.8%), parasites in 121 cases (1.2%), and rickettsiae in 5 cases (0.1%). Urban-rural distribution: slightly more cases were found in the countryside (5 418 cases, 54.6%) than in the towns (4 500 cases, 45.4%). Distribution of onset by season: 2 412 cases (24.3%) fell ill in spring, 2 835 cases (28.6%) in summer, 2 187 cases (22.1%) in fall, and 2 484 cases (25.0%) in winter. Health economics: the duration of hospitalization was 15 (8, 27) days, and the cost of hospitalization was 1.53 (0.91, 3.02)×10 000 yuan. Prognosis: 9 531 cases (96.1%) were cured or improved, and 92 cases (0.9%) died. Conclusions:The pathogens responsible for CNS infectious diseases are predominantly viruses. Although the incidence is slightly higher during the summer months, the overall seasonal pattern is not particularly pronounced. These infections are more commonly observed in young and middle-aged males and present with a diverse range of clinical manifestations, contributing to a significant disease burden.

Objective:To observe the signal intensity and homogeneity of subretinal hyperreflective material (SHRM) in neovascular age-related macular degeneration (nAMD) and preliminarily analyze its relationship with macular neovascularization (MNV) morphology.Methods:A prospective cross-sectional observational study. Forty-six eyes of 46 nAMD patients with SHRM who initially visited Zhongshan Ophthalmic Center, Sun Yat-sen University from January 1, 2022 to March 31, 2023 were enrolled. Optical coherence tomography (OCT) examination was performed according to a standardized protocol, and 3D Slicer software was used for three-dimensional reconstruction of SHRM lesions. Signal intensity was represented by the mean gray value (mGV) of the three-dimensional lesion area, and homogeneity was represented by the standard deviation of gray values (GV-SD). OCT angiography (OCTA) was used to scan the 6 mm×6 mm area of the macula. FIJI and Angio Tool software were used to measure MNV vascular network total area, perimeter, maximum and minimum diameters, maximum vessel diameter, vascular component area, total number of vascular network junctions and endpoints, vessel dispersion, and mean lacunarity. The ratio of maximum to minimum diameter of the vascular network, average vessel length, vessel density, and vessel fractal index were calculated. Using the mean mGV of the total sample as the standard, the eyes were divided into low-density SHRM group (20 eyes) and high-density SHRM group (26 eyes); using the mean GV-SD of the total sample as the standard, the eyes were divided into homogeneous SHRM group (29 eyes) and non-homogeneous SHRM group (17 eyes). The morphological characteristics of MNV between groups were compared. Independent samples t-test or Mann-Whitney U test was used for between-group comparisons; a multivariate regression model was established to analyze independent factors affecting SHRM signal characteristics. Results:Among the 46 eyes of 46 patients, there were 26 eyes of 26 males (56.52%, 26/46) and 20 eyes of 20 females (43.48%, 20/26). The mean age was (65.61±7.50) years. The average vessel length and vessel dispersion in the high-density SHRM group and low-density SHRM group were (6.88±4.56), (11.30±6.31) mm ?1 and 41.30±67.26, 13.22±11.34, respectively. Compared with the low-density SHRM group, the high-density SHRM group had significantly lower average vessel length ( t=2.645) and higher vessel dispersion ( t=?2.090), with statistically significant differences ( P=0.012, 0.046). Compared with the homogeneous SHRM group, the non-homogeneous SHRM group had significantly higher total area ( t=?2.338), maximum diameter ( t=?3.137), and minimum diameter ( t=?2.173), with statistically significant differences ( P<0.05). The total number of vascular network junctions in the non-homogeneous SHRM group and homogeneous SHRM group were (90.71±67.34) and (49.34±41.91), respectively; the non-homogeneous SHRM group had significantly more junctions than the homogeneous SHRM group, with a statistically significant difference ( t=?2.286, P=0.032). Multivariate regression analysis showed that average vessel length was an independent factor affecting SHRM intensity (odds ratio=0.819, 95% confidence interval 0.705-0.951, P=0.009); there were no independent vascular indicators affecting SHRM reflectivity homogeneity ( P>0.05). Conclusion:In nAMD, compared with low-density SHRM, high-density SHRM has significantly lower average vessel length and higher vessel dispersion; compared with homogeneous SHRM, non-homogeneous SHRM has a larger spatial dimension of the vascular network.

Objective:To investigate the efficacy of radiotherapy in patients with advanced esophageal cancer receiving first-line chemoimmunotherapy.Methods:A retrospective analysis was conducted on the data of 137 patients with Stage Ⅳ esophageal squamous cell carcinoma (ESCC) treated at our hospital from January 2018 to May 2023. These patients were divided into two groups: a group treated with first-line chemoimmunotherapy combined with radiotherapy (chemoimmunotherapy + radiotherapy group, n = 43) and a group treated with only chemoimmunotherapy ( n = 94). Inverse probability of treatment weighting (IPTW) was applied to balance baseline characteristics between the groups. With overall survival (OS) and progression-free survival (PFS) as study endpoints, the survival data were analyzed using the Kaplan-Meier method, the log-rank test, and the Cox regression method. Results:Before calibration, the chemoimmunotherapy + radiotherapy group significantly outperformed the sole chemoimmunotherapy group in median PFS (13.6 months vs. 7.0 months; HR: 0.501, 95% CI: 0.309-0.811, P = 0.005). After calibration using the COX proportional-hazards model for age, gender, Eastern Cooperative Oncology Group (ECOG) performance status, smoking history, T/N/M stage, and tumor location, the chemoimmunotherapy + radiotherapy group still had significant advantages in PFS (14.7 months vs. 7.0 months; HR: 0.441, 95% CI: 0.261-0.745, P = 0.002). IPTW analysis further confirmed this trend (13.9 months vs. 7.0 months; HR: 0.492, 95% CI: 0.304-0.795, P < 0.001). Specifically, the median OS of the chemoimmunotherapy + radiotherapy group demonstrated significant improvement in all analyses: pre-calibration (29.5 months vs. 18.0 months; HR: 0.507, 95% CI: 0.297-0.867, P = 0.013), after calibration using the Cox model (27.5 months vs. 16.7 months; HR: 0.470, 95% CI: 0.266-0.830, P = 0.009), and after calibration using IPTW (29.5 months vs. 16.9 months; HR: 0.448, 95% CI: 0.262-0.764, P < 0.001). Conclusions:The combination of radiotherapy and first-line chemoimmunotherapy can significantly improve survival outcomes of patients with advanced ESCC, suggesting its potential as a standard treatment strategy.

Objective:To analyze the epidemiological and clinical features of infectious diseases of the central nervous system (CNS).Methods:A cross-sectional study and analysis were conducted to summarize the epidemiological and clinical characteristics of 9 918 patients with CNS infectious diseases, who were diagnosed and treated at 29 hospitals across China from January 1, 2001 to December 31, 2020. Data collected included demographic data, clinical manifestations, health economic indicators, and prognostic outcomes.Results:Among the 9 918 collected cases of CNS infectious diseases, 5 559 were male (56.0%) and 4 359 were female (44.0%), with an onset age of 38 (25, 53) years. Education level: slightly more junior high school education (2 651 cases, 26.7%), and less elementary school education and below (2 181 cases, 22.0%) were found. Occupational distribution: farmers were found predominant (3 215 cases, 32.4%), followed by workers (1 826 cases, 18.4%) and students (1 633 cases, 16.5%). Clinical manifestations: headache (6 074 cases, 61.2%), fever (5 869 cases, 59.2%) and positive meningeal irritation signs (2 273 cases, 22.9%) were the 3 most common clinical manifestations, followed by nausea and (or) vomiting (2 095 cases, 21.1%), impaired consciousness (2 077 cases, 20.9%), psychiatric symptom (1 866 cases, 18.8%) and epilepsy (1 627 cases, 16.4%), etc., and cranial nerve involvement was found in 669 cases (6.7%). Major pathogens included viruses in 6 814 cases (68.7%), Mycobacterium tuberculosis in 1 677 cases (16.9%), common bacteria in 864 cases (8.7%), fungi in 254 cases (2.6%), spirochetes of syphilis in 183 cases (1.8%), parasites in 121 cases (1.2%), and rickettsiae in 5 cases (0.1%). Urban-rural distribution: slightly more cases were found in the countryside (5 418 cases, 54.6%) than in the towns (4 500 cases, 45.4%). Distribution of onset by season: 2 412 cases (24.3%) fell ill in spring, 2 835 cases (28.6%) in summer, 2 187 cases (22.1%) in fall, and 2 484 cases (25.0%) in winter. Health economics: the duration of hospitalization was 15 (8, 27) days, and the cost of hospitalization was 1.53 (0.91, 3.02)×10 000 yuan. Prognosis: 9 531 cases (96.1%) were cured or improved, and 92 cases (0.9%) died. Conclusions:The pathogens responsible for CNS infectious diseases are predominantly viruses. Although the incidence is slightly higher during the summer months, the overall seasonal pattern is not particularly pronounced. These infections are more commonly observed in young and middle-aged males and present with a diverse range of clinical manifestations, contributing to a significant disease burden.

Objective:To observe the signal intensity and homogeneity of subretinal hyperreflective material (SHRM) in neovascular age-related macular degeneration (nAMD) and preliminarily analyze its relationship with macular neovascularization (MNV) morphology.Methods:A prospective cross-sectional observational study. Forty-six eyes of 46 nAMD patients with SHRM who initially visited Zhongshan Ophthalmic Center, Sun Yat-sen University from January 1, 2022 to March 31, 2023 were enrolled. Optical coherence tomography (OCT) examination was performed according to a standardized protocol, and 3D Slicer software was used for three-dimensional reconstruction of SHRM lesions. Signal intensity was represented by the mean gray value (mGV) of the three-dimensional lesion area, and homogeneity was represented by the standard deviation of gray values (GV-SD). OCT angiography (OCTA) was used to scan the 6 mm×6 mm area of the macula. FIJI and Angio Tool software were used to measure MNV vascular network total area, perimeter, maximum and minimum diameters, maximum vessel diameter, vascular component area, total number of vascular network junctions and endpoints, vessel dispersion, and mean lacunarity. The ratio of maximum to minimum diameter of the vascular network, average vessel length, vessel density, and vessel fractal index were calculated. Using the mean mGV of the total sample as the standard, the eyes were divided into low-density SHRM group (20 eyes) and high-density SHRM group (26 eyes); using the mean GV-SD of the total sample as the standard, the eyes were divided into homogeneous SHRM group (29 eyes) and non-homogeneous SHRM group (17 eyes). The morphological characteristics of MNV between groups were compared. Independent samples t-test or Mann-Whitney U test was used for between-group comparisons; a multivariate regression model was established to analyze independent factors affecting SHRM signal characteristics. Results:Among the 46 eyes of 46 patients, there were 26 eyes of 26 males (56.52%, 26/46) and 20 eyes of 20 females (43.48%, 20/26). The mean age was (65.61±7.50) years. The average vessel length and vessel dispersion in the high-density SHRM group and low-density SHRM group were (6.88±4.56), (11.30±6.31) mm ?1 and 41.30±67.26, 13.22±11.34, respectively. Compared with the low-density SHRM group, the high-density SHRM group had significantly lower average vessel length ( t=2.645) and higher vessel dispersion ( t=?2.090), with statistically significant differences ( P=0.012, 0.046). Compared with the homogeneous SHRM group, the non-homogeneous SHRM group had significantly higher total area ( t=?2.338), maximum diameter ( t=?3.137), and minimum diameter ( t=?2.173), with statistically significant differences ( P<0.05). The total number of vascular network junctions in the non-homogeneous SHRM group and homogeneous SHRM group were (90.71±67.34) and (49.34±41.91), respectively; the non-homogeneous SHRM group had significantly more junctions than the homogeneous SHRM group, with a statistically significant difference ( t=?2.286, P=0.032). Multivariate regression analysis showed that average vessel length was an independent factor affecting SHRM intensity (odds ratio=0.819, 95% confidence interval 0.705-0.951, P=0.009); there were no independent vascular indicators affecting SHRM reflectivity homogeneity ( P>0.05). Conclusion:In nAMD, compared with low-density SHRM, high-density SHRM has significantly lower average vessel length and higher vessel dispersion; compared with homogeneous SHRM, non-homogeneous SHRM has a larger spatial dimension of the vascular network.

The incidence of chronic fatigue syndrome(CFS)has gradually increased in recent years.Although CFS can severely affect patient quality of life,its clinical diagnosis is easily overlooked.Elucidating the pathogenesis of CFS and treating it from both etiological and symptomatological perspectives are crucial for patient recovery;however,its unclear pathogenesis means that etiological treatment options are limited,and current treatments mainly focus on improving clinical symptoms.In this context,there is a need to establish and evaluate a suitable animal model.This article comprehensively integrates the diagnostic criteria of CFS and progress in related basic research.We also summarize the behavioral experimental method used to evaluate CFS models in basic research in the past 5 years and discuss these evaluations from the perspectives of general condition,fatigue state,cognitive function,emotional state,and pain degree.This review aims to present the current situation,expose problems,trigger reflection,and promote improvements in the behavioral evaluation of animal models of CFS.

TCM functional exercises are the important means of TCM to prevent and cure diseases. By adjusting the bones and muscles externally, adjusting the heart and organs internally, promoting blood circulation, improving sleep disorders, enhancing metabolism and immune capacity, the aim of preventing and treating diseases, prolonging life span, and strengthening the body is achieved. TCM exercises have a significant effect on the treatment of various types of fatigue such as chronic fatigue syndrome, Exercise-induced fatigue, post-stroke fatigue, and cancer-related fatigue.

TCM believes that spleen deficiency is the root cause of emotional abnormalities in chronic fatigue syndrome (CFS), and clinical treatment often involves the heart, liver and kidney. TCM therapy has a significant efficacy in CFS emotional abnormalities. It is mostly treated with oral administration of TCM, acupuncture, moxibustion and massage therapy. It may play a therapeutic role by improving oxidative stress and immune inflammation, regulating nerve-endocrine, controlling energy metabolism and other ways. It is suggested to establish the syndrome differentiation standard of CFS emotional abnormality in the future, so as to improve the accuracy of syndrome differentiation and treatment; form a perfect treatment guide or expert consensus to guide the standardized application of various internal and external treatment methods; explore objective indicators based on the pathogenesis, and focus on the morphological and functional changes of disease target brain regions with the help of neuroimaging techniques, so as to improve the diagnosis and prognosis evaluation of CFS; based on the guidance of TCM theory, improve the CFS emotional abnormal animal modeling method.

Objective To analyze the relationship of the volume of 87 brain regions with postnatal age and neurobehavior in full-term neonates.Methods A total of 75 full-term newborns[gestational age(39.38±1.22)weeks;male/female(51/24);postnatal age(11.11±6.67)days]without abnormalities on brain MRI(three-dimensional T1-weighted imaging,3D T1WI)at our hospital between November 2010 and September 2017 were retrospectively included.Based on the template of 87 brain regions,the neonatal brains were divided into 87 brain regions and their volumes were calculated by using V-shape Bottleneck network(VB-Net)deep learning segmentation technique,Pearson partial correlation and regression analysis were used to explore the relationship of the volume of each brain region with postnatal age and neurobehavioral scores.Results After adjusting for gestational age,birth weight,head circumference,body length and sex,66.7％of the regional brain volumes(58/87 brain regions)significantly increased with the postnatal age(correlation coefficient r:0.2-0.7,P＜0.05).The volumes of gray matter in bilateral lentiform nucleus,left caudate nucleus,right occipital lobe,right inferior temporal lobe,and bilateral anterior temporal lobe strongly correlated with the postnatal age(r＞0.50,P＜0.05).The gray matter volume of the right occipital lobe linearly increased with age(slope:100.67),and was positively correlated with behavioral scores(r=0.324,P＜0.01).Conclusion Most of regional brain volumes increase with the postnatal age during the neonatal period,and the fastest growth occurs in primary sensorimotor-related brain regions,presenting the spatial heterogeneity.Partial brain region grows with the development of behavioral ability.