Neurofibromatosis type 1 (NF1) presents with a diverse range of symptoms that can affect the skin, bones, eyes, central nervous system, and other organs. This article reports the diagnosis and treatment process of a patient with NF1 complicated by bilateral severe-to-profound sensorineural hearing loss. Genetic testing revealed a heterozygous variant of NF1 NM_ 000267.3: c.4054_ 4058del(p.Ser1352LeufsTer20, supporting the diagnosis of NF1. After thorough evaluation, a right cochlear implantation was performed, yielding satisfactory postoperative results. This case suggests that NF1 patients may exhibit phenotypic heterogeneity and atypicality, providing a reference for clinicians in the diagnosis and treatment of such patients.

An increasing number of studies have demonstrated that lactic acid,a key signaling molecule,plays a critical role in tumorigenes-is,immunotherapy response,and cellular metabolism regulation.Immunotherapy has become a mainstay of cancer treatment;however,most patients fail to respond,which may stem from the tumor immune microenvironment(TIME).Lactic acid,a central metabolic modulat-or of the tumor immune response,accumulates in the TIME and suppresses immune cell activity,thereby promoting tumor growth and im-mune escape.Targeting lactate metabolism and its associated pathways presents a novel strategy to overcome immunotherapy resistance.This article reviews current research on the regulatory mechanism of lactic acid in the TIME and immunotherapy,providing new ideas for combating tumor immunotherapy resistance.

Objective To explore the efficacy of extracting biopsy needle pose in chest CT images based on point cloud processing.Methods Three-dimensional point clouds were generated through segmentation of chest CT images and surface reconstruction.Spatial point cloud clustering and geometric constraints were applied to filter regions contained the puncture needle in space.The principal direction of the needle was judged using principal component analysis,and a cylindrical model was constructed to enclose the needle data.Then random sample consensus algorithm was used for needle trajectory fitting to accurately extract the spatial position and orientation of the puncture needle.The efficacy of the above method was evaluated using a 3D-printed anatomical model based on common clinical combinations of puncture depths and angles.Results The anatomical model experiments showed a 100％success rate in puncture needle identification,with angular error of(1.013±0.424)° and positional error of(2.023±1.553)mm,indicating that this method had good accuracy and stability.Conclusion The puncture needle's position in chest CT images could be extracted with high precision based on point cloud processing.

Objective To observe the impact factors of vascular heat sink effect during in vitro microwave ablation(MWA)of porcine lung.Methods Simulation models were established using in vitro porcine lung tissue blocks based on isobaric inflation with an air pump and cyclic perfusion of duck blood with a glass tube and peristaltic pump,etc.MWA was performed under 8 different combining conditions(vessel diameter of 3 or 5 mm,blood perfusion of 30 or 50 cm/s,as well as distance between vessel and ablation antenna of 5 or 10 mm)each for 3 times.The highest temperature TV on vessel side and TC on control side during MWA,and ablation depth DV on vessel side and DC on control side after MWA were recorded.Multi-factor linear regression equations were constructed based on simulated vessel diameters,blood perfusion and distance between vessel and ablation antenna,and the impact factors of|TC-TV|and|DC-DV|were screened,respectively.Results Simulated vessel diameter showed linear positive correlation with both|TC-TV|and|DC-DV|(both P＜0.001).Simulated distance between vessel and ablation antenna showed linear negative correlation with both|TC-TV|and|DC-DV|(both P＜0.001),and the latter had more obvious impact on vascular heat sink effect than the former.Meanwhile,no significant linear relationship was found between simulated blood perfusion and|TC-TV|nor|DC-DV|(both P＞0.05).Conclusion Simulated vessel diameter and distance between vessel and ablation antenna were both impact factors of vascular heat sink effect during in vitro MWA of porcine lung,and the latter was more influential,whereas simulated blood perfusion showed no significant impact on it.

CT-guided thermal ablation is a critical modality for treating lung cancer.Invasive thermometry techniques demonstrated sufficient accuracy for monitoring temperature of the target area during ablation,but their clinical application were limited since procedural invasiveness and relatively high risk of complications.Being non-invasive,safe and capable of global monitoring,non-invasive thermometry techniques have broad application prospects.The status of non-invasive thermometry techniques for CT-guided thermal ablation for lung cancer were reviewed in this article.

CT-guided thermal ablation is a critical modality for treating lung cancer.Invasive thermometry techniques demonstrated sufficient accuracy for monitoring temperature of the target area during ablation,but their clinical application were limited since procedural invasiveness and relatively high risk of complications.Being non-invasive,safe and capable of global monitoring,non-invasive thermometry techniques have broad application prospects.The status of non-invasive thermometry techniques for CT-guided thermal ablation for lung cancer were reviewed in this article.

Objective To observe the impact factors of vascular heat sink effect during in vitro microwave ablation(MWA)of porcine lung.Methods Simulation models were established using in vitro porcine lung tissue blocks based on isobaric inflation with an air pump and cyclic perfusion of duck blood with a glass tube and peristaltic pump,etc.MWA was performed under 8 different combining conditions(vessel diameter of 3 or 5 mm,blood perfusion of 30 or 50 cm/s,as well as distance between vessel and ablation antenna of 5 or 10 mm)each for 3 times.The highest temperature TV on vessel side and TC on control side during MWA,and ablation depth DV on vessel side and DC on control side after MWA were recorded.Multi-factor linear regression equations were constructed based on simulated vessel diameters,blood perfusion and distance between vessel and ablation antenna,and the impact factors of|TC-TV|and|DC-DV|were screened,respectively.Results Simulated vessel diameter showed linear positive correlation with both|TC-TV|and|DC-DV|(both P＜0.001).Simulated distance between vessel and ablation antenna showed linear negative correlation with both|TC-TV|and|DC-DV|(both P＜0.001),and the latter had more obvious impact on vascular heat sink effect than the former.Meanwhile,no significant linear relationship was found between simulated blood perfusion and|TC-TV|nor|DC-DV|(both P＞0.05).Conclusion Simulated vessel diameter and distance between vessel and ablation antenna were both impact factors of vascular heat sink effect during in vitro MWA of porcine lung,and the latter was more influential,whereas simulated blood perfusion showed no significant impact on it.

An increasing number of studies have demonstrated that lactic acid,a key signaling molecule,plays a critical role in tumorigenes-is,immunotherapy response,and cellular metabolism regulation.Immunotherapy has become a mainstay of cancer treatment;however,most patients fail to respond,which may stem from the tumor immune microenvironment(TIME).Lactic acid,a central metabolic modulat-or of the tumor immune response,accumulates in the TIME and suppresses immune cell activity,thereby promoting tumor growth and im-mune escape.Targeting lactate metabolism and its associated pathways presents a novel strategy to overcome immunotherapy resistance.This article reviews current research on the regulatory mechanism of lactic acid in the TIME and immunotherapy,providing new ideas for combating tumor immunotherapy resistance.

Objective To explore the efficacy of extracting biopsy needle pose in chest CT images based on point cloud processing.Methods Three-dimensional point clouds were generated through segmentation of chest CT images and surface reconstruction.Spatial point cloud clustering and geometric constraints were applied to filter regions contained the puncture needle in space.The principal direction of the needle was judged using principal component analysis,and a cylindrical model was constructed to enclose the needle data.Then random sample consensus algorithm was used for needle trajectory fitting to accurately extract the spatial position and orientation of the puncture needle.The efficacy of the above method was evaluated using a 3D-printed anatomical model based on common clinical combinations of puncture depths and angles.Results The anatomical model experiments showed a 100％success rate in puncture needle identification,with angular error of(1.013±0.424)° and positional error of(2.023±1.553)mm,indicating that this method had good accuracy and stability.Conclusion The puncture needle's position in chest CT images could be extracted with high precision based on point cloud processing.

ObjectiveTo investigate the trends in diabetes mortality rate and the characteristics of decreased population in Fengxian District, Shanghai from 2012 to 2021. MethodsData from the death registration records of the residents in Fengxian District between 2012 and 2021, sourced from the Shanghai Death Surveillance System, were analyzed. Indicators such as the crude mortality rate due to diabetes, the standardized mortality rate, years of life lost (YLL), and the probability of premature death were estimated. Annual percentage change (APC) was used to analyze the temporal trends of mortality and the probability of premature death due to diabetes. Rate decomposition analysis was used to assess the contributions of demographic and non-demographic factors to diabetes mortality. ResultsFrom 2012 to 2021, there were 1 471 deaths due to diabetes in Fengxian District, with a crude mortality rate of 27.51/100 000 and a standardized mortality rate of 17.58/100 000. The crude mortality rate showed an overall increasing trend (APC=4.58%, Z=3.49, P<0.05). The potential years of life lost (PYLL) due to diabetes over this period amounted to 9 715 person-years, with a PYLL rate of 1.82 ‰, and the average years of life lost (AYLL) was 11.94 years. The probability of premature death was 0.41% (APC=3.36%, t=2.33, P<0.05). Both population aging and non-aging factors contributed to the increase in diabetes mortality, with overall contribution rates of 67.99% and 32.01%, respectively. Among men, the contribution rates were 60.57% and 39.43%, while among women, they were 79.43% and 20.57%, respectively. ConclusionFrom 2012 to 2021, both the crude mortality rate and the probability of premature death due to diabetes showed an upward trend among the residents in Fengxian District, with a higher YLL. Population aging was the main factor causing the increase in mortality rate, while non-demographic factors had a greater impact on the rise in diabetes mortality among men than that in women. Therefore, the management on male diabetes patients should be strengthened.