ObjectiveTo describe the prevalence and dynamic pain characteristics of dysmenorrhea among female medical students through a menstrual diary-based observational study. MethodsFrom April to June 2021, female students were recruited from a medical college in Shanghai to complete menstrual diaries and record dysmenorrhea-related characteristics for two menstrual cycles. Dysmenorrhea severity was assessed using the visual analogue scale (VAS) (no pain: 0; mild: 1‒3; moderate: 4‒6; severe: 7‒10). A total of 323 diaries were collected, of which 303 were 93.81% valid (valid response rate: 93.81%), covering 596 complete menstrual cycles. Among them, 293 participants completed diaries for two cycles and were included in the analysis of persistent dysmenorrhea. Period, point, and persistent prevalence of dysmenorrhea were calculated using the number of participants as the denominator. Paired comparisons were performed using Cochran’s Q test and Bonferroni-adjusted McNemar tests. Using menstrual cycles with dysmenorrhea as the unit of analysis, the distributions of pain onset, peak timing, and pain duration across different severities were compared using the χ² tests or Fisher’s precision probability tests. ResultsAmong 303 female college students, 269 experienced dysmenorrhea during the first recorded cycle, and 288 had dysmenorrhea in any cycle. Among 596 complete menstrual cycles recorded, 527 were associated with dysmenorrhea (88.42%), and among 293 students who completed 2 complete recorded cycles, 239 had persistent dysmenorrhea. The period, point, and persistent prevalence of dysmenorrhea among female college students were 95.05% (288/303), 88.78% (269/303), and 81.57% (239/293), respectively (Q=61.61, P<0.001). The prevalence of persistently severe dysmenorrhea was 5.12% (15/293). Among the 527 dysmenorrheic cycles, there were statistically significant differences in the distribution of pain onset time (P=0.003) and pain duration (P<0.001) among different degrees of dysmenorrhea; mild dysmenorrhea mostly started on the first day of menstruation (52.83%), and moderate dysmenorrhea mostly started before menstruation (50.19%). Pain duration increased with severity; the proportions of cycles with pain lasting ≥4 days were 13.20%, 43.03%, and 51.56% for mild, moderate, and severe dysmenorrhea cycles, respectively. For all severity groups, mean pain scores peaked on the first day of menstruation and then decreased day by day to a stable level. ConclusionDysmenorrhea is highly prevalent among female medical students, and differences exist across pain severity levels in onset time, duration, and dynamic changes in pain. Identification and health guidance for those with persistently moderate-to-severe dysmenorrhea should be strengthened, and medical evaluation should be conducted when necessary.

Objective:To evaluate the accuracy and feasibility of an automated scanning and uptake system to assist pathologists with hu-man epidermal growth factor receptor 2(HER2)FISH interpretation.Methods:HER2 gene amplification is detected using FISH,and"result interpretation by independent pathologists"is regarded as the"gold standard."The consistency of"human-machine dialogue results"(use of a CytoVision* system combined with manual interpretation)and"CytoVision*-based automated interpretation"with the"gold standard"was assessed.Results:Consistency between"human-machine dialogue results"and the"gold standard"can surpass 91%,with the former method saving up to 50%of the manual operation time.The tendency of each cell nucleus's HER2 copy number to be"underestimated"is the main reason for the low sensitivity observed in cases with low copy number amplification and HER2 heterogeneous expression cases in"human-machine dialogue interpretation."Conclusions:Automatic FISH image analysis and uptake systems simulate the process of manu-ally interpreted cell selection,ensure random cell selection,and improve work efficiency.With its accurate selection of the hybridization re-gion and"human-computer dialogue,"the system is expected to"replace"interpretation by independent pathologists.

Objective:To investigate the clinical and pathological characteristics of primary thoracic synovial sarcoma (PTSS).Methods:Forty-two PTSS cases diagnosed at the Department of Pathology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China from October 2011 to April 2024 were analyzed. All cases were retrospectively studied using hematoxylin-eosin staining and immunohistochemistry. Their clinicopathological features were also reviewed. SS18 rearrangement was assessed in 28 cases using fluorescence in situ hybridization (FISH). Next generation sequencing (NGS) was performed on 8 cases.Results:Among the 42 cases, there were 23 biopsies and 19 surgically-removed specimens. One case was a specimen resected after neoadjuvant chemotherapy. There were 22 males and 20 females, with an age ranging from 6 to 68 years. Twenty-nine cases occured in the lung, 6 in mediastinum, 4 in pericardium, 1 in visceral pleura, and 1 in right atrium. One case did not show any unequivocal primary site. Computed tomography showed the tumors were manifested as a cystic mass, a solid mass, or thickening of the pleura and pericardium. Thirty-two cases had respiratory symptoms, while 19 had pleural effusion. One case had a history of radiotherapy for papillary thyroid carcinoma. Nineteen patients were treated with surgery, while 19 were treated with chemotherapy without surgery. Four patients were diagnosed and discharged, without specific treatment on the record. Morphologically, 1 case was biphasic type, 39 cases were monophasic type, and 2 cases were poorly differentiated type. In addition to the typical morphology of synovial sarcoma, tumors also showed pulmonary bullous changes, stromal collagen hyalinization, hemangiopericytoma-like vasculature, stromal edematous myxoid changes, and microcystic structure. Immunohistochemically, all cases were diffusely positive for TRPS1 (22/22), TLE1 (21/22), CD99 (26/26), SS18-SSX (25/25) and INI1 (12/12), including 3 cases with decreased expression of INI1. Twenty-one cases were focally positive for EMA (21/30), 4 cases for SMA (4/23), 2 cases for S-100 (2/28), and 2 cases (2/35) for CKpan. Twenty-eight cases (28/28) had SS18 rearrangement displaying a split signal on FISH analysis. Eight cases were found to have mutations in SMC1A, NOTCH2, CDK12, SPRY4, BRCA1, STK11, NF2, and PDGFRα genes using NGS. Eighteen of the 29 patients survived and 16 showed disease progression.Conclusions:PTSS is more commonly found in the lungs than other sites and has non-classical morphological features of various types, which need to be differentiated from other tumors. TRPS1 is highly expressed in PTSS and has certain diagnostic values. The diagnosis of PTSS also requires combination of patient′s medical history with thorough imaging studies.

Background:To compare the efficacy and safety of monthly administrations of gonadotropin releasing hormone (GnRH) agonists LY01005 and Zoladex ? in Chinese patients with premenopausal breast cancer. Methods:From October 2020 to November 2021, 188 premenopausal breast cancer patients were enrolled in 34 hospitals and randomized 1:1 to receive either LY01005 or Zoladex ? every 28 days for a total of three injections. All patients concomitantly received oral tamoxifen (TAM). The primary efficacy endpoint was cumulative probability of maintaining menopausal level [oestradiol (E2) ≤30 pg/ml] from day 29 to day 85. The second efficacy endpoint included changes in E2, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) compared with the baseline. Pharmacokinetics (PK), pharmacodynamics (PD), and safety were analyzed. The study also evaluated the pharmacokinetic and pharmacodynamic characteristics of LY01005. Results:A total of 188 patients were randomised and 187 patients received either LY01005 or Zoladex ?. Cumulative probabilities of maintaining menopausal level (E2≤30 pg/ml) from day 29 to day 85 were 93.1% for LY01005 and 86.3% for Zoladex ?. The between-group difference was 6.8% (95% CI: -2.3%, 15.9%) and primary efficacy in the LY01005 group was not inferior to that in the Zoladex ? group. Changes in E2, LH, and FSH levels compared with the baseline were equivalent between the two groups (E2: 89.34% to 90.23% vs. 82.11% to 85.02%; LH: 88.89% to 95.52% vs. 89.70% to 97.02%; FSH: 75.36% to 80.85% vs.73.07% to 80.24%, respectively). After three consecutive doses of LY01005, the LH and FSH levels of the subjects showed a transient increase after the first dose, reached a peak on the second day and then started to decrease. The LH and FSH reached a lower level and remained at or below that level until the 85th day. Both treatments were well-tolerated. Conclusion:LY01005 is as effective as Zoladex ? in suppressing E2 to menopausal levels in Chinese patients with premenopausal breast cancer, with a similar safety profile.

In view of the characteristics of H5N6 subtype avian influenza virus(AIV)that it has both high pathogenicity and the risk of cross-species transmission,posing a serious threat to the poultry farming industry and public health security,in order to effectively prevent and control the spread of H5N6 avian influenza,a rapid,sensitive and specific detection technolo-gy was established in this study.The specific monoclonal antibodies against the neuraminidase N6 protein of avian influenza A virus subtype H5N6 were obtained through hybridoma and monoclonal antibody technology.These antibodies were coupled and labeled with carboxyl-functionalized fluorescent quantum dots,along with previously prepared specific antibodies against the hemagglutinin H5 protein.A rapid fluorescence immunochromatographic detection method for the H5N6 subtype of avian influ-enza virus was established according to the principle of double-antibody sandwich immunochromatography.This method a-chieved a detection sensitivity of 1 ng/mL for recombinant hemagglutinin H5 subtype protein and 0.1 ng/mL for recombinant neuraminidase N6 subtype protein.Moreover,the method exhibited no cross-reactivity with other influenza subtypes or patho-gens,such as Newcastle disease(ND),infectious bronchitis(IB),and infectious laryngotracheitis(ILT),thus demonstrating good specificity.The method effectively identified the highly pathogenic avian influenza virus H5 subtype and directly distin-guished the H5N6 subtype with good accuracy.The fluorescent quantum dot immunochromatographic typing detection method established herein met the sensitivity,specificity,and accuracy requirements for H5N6 subtype detection,and can be further used for rapid detection of the H5 and H5N6 subtypes of avian influenza virus.

Thyroid cancer is the most prevalent malignant tumor of the endocrine system,and its incidence has shown a significant upward trend in recent years.Acetylation,an important post-translational protein modification,is involved in regulating gene transcription,cell cycle progression,and invasion ability in various types of thyroid cancers.Additionally,histone deacetylase(HDAC)inhibitors have shown potential in the treatment of thyroid cancer.This article systematically reviews the biological functions and regulatory mechanisms of acetylation in the development and progression of thyroid cancer based on recent literature.Furthermore,it discusses the clinical application prospects of HDAC inhibitors,providing a solid theoretical basis and feasible therapeutic strategies for targeted therapy of thyroid cancer.

Follicular variant of papillary thyroid carcinoma(FVPTC)is commonly found in young and middle-aged women,and cases in children and adolescents are relatively rare.The main driving genes of FVPTC are the RAS oncogene family or B-Raf proto-oncogene serine/threonine protein kinase(BRAF),and DICER1 gene mutation is rarely reported in this subtype.This article reports a case of recurrent FVPTC with positive DICER1 mutation in an adolescent,aiming to provide reference for the clinical diagnosis and treatment of FVPTC.The patient,a 19-year-old female,underwent total thyroidectomy and central lymph node dissection due to thyroid nodules 5 years ago,and was pathologically diagnosed with follicular tumor of uncertain malignant potential(FT-UMP);after surgery,the patients did not regularly undergo thyroid-stimulating hormone(TSH)suppression therapy and follow-up as instructed.Two months ago,the patient visited the hospital due to enlarged cervical lymph nodes,imaging suggested tumor recurrence with metastases to both lungs and vertebrae,and multigene testing indicated a DICER1 gene mutation.After comprehensive multidisciplinary consultation,bilateral cervical lymph node dissection was performed,and postoperative pathology confirmed the diagnosis of metastatic FVPTC.Te clinicans should focus on rare gene mutations such as DICER1 in the FVPTC patients,and for adolescent patients,follow-up and formulation of individualized treatment plans should be emphasized to achieve early tumor identification and precise intervention,and improve the long-term prognosis of patients.

OBJECTIVE To investigate the ultrasound characteristics of category 4 thyroid nodules in the Chinese version of the Thyroid Imaging Reporting and Data System(C-TI-RADS),and to analyze the value of ultrasonography combined with elastography scoring in the correction of nodule properties.METHODS Data from 80 patients with 105 nodules from April 2020 to December 2023 were retrospectively analyzed.Fine-needle aspiration biopsy or surgical pathology was used as the gold standard.The Kappa test was employed to evaluate diagnostic consistency,while the receiver operating characteristic(ROC)curve was utilized to assess the differentiation and accuracy of the diagnostic methods.RESULTS Sixty-eight malignant nodules and 37 benign nodules were confirmed by surgical pathology or puncture biopsy.After enhancement by ultrasonography,the percentage of malignant nodules with low intensity,centripetal enhancement,inhomogeneous enhancement,blurred boundary of enhanced nodules,enlarged enhanced nodules,and irregular enhanced nodules was significantly higher than that of the benign group,while the percentage of circumferential enhancement was lower than that of the benign group(P<0.05).The overall compliance rate of ultrasonography scoring in diagnosing C-TI-RADS category 4 thyroid nodules was 83.81%(88/105),and when compared with the pathological gold standard,the Kappa value was 0.644.The ROC curve analysis showed that the sensitivity of ultrasonography scoring in diagnosing benign and malignant nodules was 84.51%,the specificity was 82.35%,the correctness index was 0.669,the negative likelihood ratio was 0.188,and the positive likelihood ratio was 4.789.The overall compliance rate of elastography score in diagnosing C-TI-RADS category 4 thyroid nodules was 85.71%(90/105),and when compared with the pathological gold standard,the Kappa value was 0.689.The ROC curve analysis revealed that the sensitivity of elastography score in diagnosing benign and malignant nodules was 88.24%,the specificity was 81.08%,the correctness index was 0.693,the negative likelihood ratio was 0.145,and the positive likelihood ratio was 4.664.Ultrasonography enhancement features,along with the combination of ultrasonography score and elastography score,had an AUC=0.922(0.876-0.968),with an accuracy of 92.91%,demonstrating a strong ability to identify truly malignant nodules versus benign nodules.CONCLUSION Ultrasonography combined with elastography scoring is valuable in the correction of C-TI-RADS category 4 nodules in the thyroid gland and helps to improve diagnostic accuracy.

Objective: To analyze the association of eating dining locations and their association with nutritional status among Chinese children aged 6-17 years,so as to provide reference for guiding children s reasonable diet. Methods: Stratified random cluster sampling was used to select children aged 6 to 17 years from 28 cities and rural areas of 14 provinces in East, North, Central, South, Southwest, Northwest, Northeast of China, and a total of 52 535 children were included in the study from 2019 to 2021. Information including dining locations, demographic characteristics, dietary intakes and physical activity were collected through a questionnaire survey. Fasting body height and weight were measured in the morning. Unordered multiclass Logistic regression analysis was conducted to assess the relationship between dining locations and nutritional status in children. Results: Regarding children s dining locations, 66.3% ate breakfast at home,25.8% ate breakfast at school,7.9% ate breakfast outside (small dining tables, restaurants, stalls, etc.); 67.7% ate dinner at home,29.0% ate dinner at school,3.3% ate dinner outside; and 63.6% ate lunch at school,30.8% ate lunch at home,5.7% ate lunch outside. The prevalence rates of overweight/obesity and undernutrition were 28.6% and 9.3%, respectively. The adjusted multiclass Logistic regression analysis (controlling for age, region, parental education, household income, total energy intake, and moderate-to-vigorous physical activity) demonstrated that, compared to eating at home, school based breakfast and dinner consumption was associated with significantly lower overweight/obesity risks for both genders (boys: breakfast OR =0.70, 95% CI =0.65-0.75; dinner OR =0.80, 95% CI = 0.74- 0.86; girls: breakfast OR = 0.89 , 95% CI = 0.82-0.96; dinner OR =0.88, 95% CI =0.81-0.95), whereas eating lunch away from home significantly increased overweight/obesity risks (boys: OR =1.32, 95% CI =1.17-1.48; girls: OR =1.43, 95% CI =1.26- 1.62 ), with all associations being statistically significant ( P <0.05). After adjusting for confounding factors, boys who ate breakfast away from home showed a significantly reduced risk of undernutrition ( OR =0.80,95% CI =0.66-0.97), while those consuming lunch away from home had an increased risk ( OR =1.26, 95% CI =1.01-1.57) ( P <0.05). Conclusions The choice of dining locations for children is becoming more diverse, and a relatively high proportion of children eat meals outside the home and at school. Eating out have a higher risk of malnutrition for children. School feeding may be beneficial to children s physical health.

Debates persist regarding the efficacy and safety of azvudine, particularly its real-world outcomes. This study involved patients aged ≥60 years who were admitted to 25 hospitals in mainland China with confirmed SARS-CoV-2 infection between December 1, 2022, and February 28, 2023. Efficacy outcomes were all-cause mortality during hospitalization, the proportion of patients discharged with recovery, time to nucleic acid-negative conversion (T _NANC), time to symptom improvement (T _SI), and time of hospital stay (T _HS). Safety was also assessed. Among the 5884 participants identified, 1999 received azvudine, and 1999 matched controls were included after exclusion and propensity score matching. Azvudine recipients exhibited lower all-cause mortality compared with controls in the overall population (13.3% vs. 17.1%, RR, 0.78; 95% CI, 0.67-0.90; P = 0.001) and in the severe subgroup (25.7% vs. 33.7%; RR, 0.76; 95% CI, 0.66-0.88; P < 0.001). A higher proportion of patients discharged with recovery, and a shorter T _NANC were associated with azvudine recipients, especially in the severe subgroup. The incidence of adverse events in azvudine recipients was comparable to that in the control group (2.3% vs. 1.7%, P = 0.170). In conclusion, azvudine showed efficacy and safety in older patients hospitalized with COVID-19 during the SARS-CoV-2 omicron wave in China.