Objective To systematically analyze and identify key risk factors for postoperative pulmonary hemorrhage u-sing a combination of the random forest(RF)model and traditional logistic regression analysis,so as to provide data support for clinical practice.Methods This study included patients who underwent needle biopsy of lung masses from January 2020 to December 2023 in the Department of Interventional Therapy,Cancer Hospital,Tianjin Medical University.There were 844 cases,including 387 males and 457 females,ranging in age from 39 to 82 years.Clinical data and puncture-related characteristics were collected,including tumor size,puncture depth,puncture angle,presence of emphysema,lesion loca-tion in the lung,body position during puncture,whether the puncture passed through the interlobar fissure,and the number of punctures.The RF model was used to rank the importance of all variables,identifying those with the highest predictive value.Subsequently,a multivariate logistic regression model was applied to the top-ranked important variables to further e-valuate their independent impact on postoperative pulmonary hemorrhage.Results The RF model results showed that tumor size and puncture depth had the highest importance in predicting the risk of postoperative pulmonary hemorrhage.Multivari-ate logistic regression analysis further confirmed that smaller tumor size(HR:0.980,95％CI:0.971-0.989,P＜0.05)was significantly associated with a lower risk of hemorrhage,while greater puncture depth(HR:1.146,95％CI:1.063-1.235,P＜0.05)was closely related to a higher risk of hemorrhage.Additionally,other factors such as puncture angle,age,lesion location in the lung and presence of emphysema showed some influence but did not reach statistical significance in the multi-variate analysis.Conclusion This study successfully identified tumor size and puncture depth as independent risk factors for postoperative pulmonary hemorrhage by combining the RF model with multivariate logistic regression analysis.The appli-cation of the RF model improved the accuracy of feature selection,allowing us to focus on the most contributory predictive variables.These findings provide important support for preoperative risk assessment,suggesting that clinicians should priori-tize these key factors in preoperative evaluations to develop safer and more effective surgical plans,thereby reducing the risk of postoperative hemorrhage and other complications.

Inguinal hernia is a common surgical disease, and most patients need surgical treatment. In recent years, minimally invasive surgery based on laparoscopy has been popularized in hernia surgery. With the release of clinical guidelines, the progress of instruments and materials, the update of treatment concepts and anatomical knowledge, laparoscopic inguinal hernia repair, especially laparoscopic total extraperitoneal hernia repair (TEP), is developing towards a more accurate and minimally invasive direction. Based on literatures in recent years and combined with clinical practice, the authors explore the advances in clinical application of laparoscopic TEP.

Laparoscopic radical resection of transverse colon cancer is a difficult operation, which is featured by large operation area, multiple steps, and many clinical anatomical variations. It requires the concept of complete mesocolic excision. Because of its absolute high-definition picture restoration, the 4K laparoscope can effectively assist in the identification, protection and severance of blood vessels during the operation, and assist in judging the fascia space of the operation. After entering Toldt fascial space through the intermediate approach guided by the superior mesenteric vein, the left, right transverse colon and lower area of mesangium are completely dissected, the upper area of colon, hepatic and splenic flexure are sepearted. The authors summarize practical experiences, investigate the extent of lymph node dissection in 4K laparoscopic radical resection of transverse colon cancer and share surgical experience.

On January 22, 2020, China National Center for Bioinformation (CNCB) released the 2019 Novel Coronavirus Resource (2019nCoVR), an open-access information resource for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). 2019nCoVR features a comprehensive integra-tion of sequence and clinical information for all publicly available SARS-CoV-2 isolates, which are manually curated with value-added annotations and quality evaluated by an automated in-house pipeline. Of particular note, 2019nCoVR offers systematic analyses to generate a dynamic landscape of SARS-CoV-2 genomic variations at a global scale. It provides all identified variants and their detailed statistics for each virus isolate, and congregates the quality score, functional annotation,and population frequency for each variant. Spatiotemporal change for each variant can be visualized and historical viral haplotype network maps for the course of the outbreak are also generated based on all complete and high-quality genomes available. Moreover, 2019nCoVR provides a full collection of SARS-CoV-2 relevant literature on the coronavirus disease 2019 (COVID-19), including published papers from PubMed as well as preprints from services such as bioRxiv and medRxiv through Europe PMC. Furthermore, by linking with relevant databases in CNCB, 2019nCoVR offers data submission services for raw sequence reads and assembled genomes, and data sharing with NCBI. Collectively, SARS-CoV-2 is updated daily to collect the latest information on genome sequences, variants, hap-lotypes, and literature for a timely reflection, making 2019nCoVR a valuable resource for the global research community. 2019nCoVR is accessible at https://bigd.big.ac.cn/ncov/.

Objective: Investigate the clinicopathological features for secretory carcinoma of breast (SCB). Methods: The clinical data of 3 SCB cases were collected, immunohistochemical staining was performed by the streptavidin-peroxidase (SP) method to test the expression of the antibodies: ER, PR, HER-2, Ki-67, S100, CK5/6, p63, SMA, calponin, GCDFP-15, and EGFR. Fluorescence in situ hybridization (FISH) was used to detect the ETV6-NTRK3 gene fusion. Results: ER was focal weakly positive in case 1 and case 2 (about 5%) , and negative in case 3. PR was focal weakly positive in case 1 (about 5%) and completely negative in case 2 and case 3. Three cases showed that HER-2, SMA, calponin, GCDFP-15 were negative, while S100, CK5/6, EGFR were diffuse strongly positive. The proliferation index was nearly 15% in case 1 and case 2, and 10% in case 3. p63 was negative in mostly tumor cells of case 1, and focal positive expression in the nucleus and cytoplasm. In case 2, p63 was completely negative. However, p63 was observed positive in the cytoplasm as well as some secretory material in case 3. ETV6-NTRK3 gene fusion detection by FISH was positive in all cases. Conclusions SCB is a rare low grade triple-negative breast cancer with the unique pathomorphologic features, while its recurrent t (12; 15) (p13; q25) translocation resulting in ETV6 -NTRK3 gene fusion. It has the indolent clinical behavior and good prognosis.

Objective Investigate the clinicopathological features for secretory carcinoma of breast (SCB). Methods The clinical data of 3 SCB cases were collected, immunohistochemical staining was performed by the streptavidin?peroxidase ( SP) method to test the expression of the antibodies: ER, PR, HER?2, Ki?67, S100, CK5／6, p63, SMA, calponin, GCDFP?15, and EGFR. Fluorescence in situ hybridization ( FISH) was used to detect the ETV6?NTRK3 gene fusion. Results ER was focal weakly positive in case 1 and case 2 (about 5%) , and negative in case 3. PR was focal weakly positive in case 1 (about 5%) and completely negative in case 2 and case 3. Three cases showed that HER?2, SMA, calponin, GCDFP?15 were negative, while S100, CK5／6, EGFR were diffuse strongly positive. The proliferation index was nearly 15% in case 1 and case 2, and 10% in case 3. p63 was negative in mostly tumor cells of case 1, and focal positive expression in the nucleus and cytoplasm. In case 2, p63 was completely negative. However, p63 was observed positive in the cytoplasm as well as some secretory material in case 3. ETV6?NTRK3 gene fusion detection by FISH was positive in all cases. Conclusions SCB is a rare low grade triple?negative breast cancer with the unique pathomorphologic features, while its recurrent t (12; 15) ( p13; q25) translocation resulting in ETV6 ?NTRK3 gene fusion. It has the indolent clinical behavior and good prognosis.

Objective Investigate the clinicopathological features for secretory carcinoma of breast (SCB). Methods The clinical data of 3 SCB cases were collected, immunohistochemical staining was performed by the streptavidin?peroxidase ( SP) method to test the expression of the antibodies: ER, PR, HER?2, Ki?67, S100, CK5／6, p63, SMA, calponin, GCDFP?15, and EGFR. Fluorescence in situ hybridization ( FISH) was used to detect the ETV6?NTRK3 gene fusion. Results ER was focal weakly positive in case 1 and case 2 (about 5%) , and negative in case 3. PR was focal weakly positive in case 1 (about 5%) and completely negative in case 2 and case 3. Three cases showed that HER?2, SMA, calponin, GCDFP?15 were negative, while S100, CK5／6, EGFR were diffuse strongly positive. The proliferation index was nearly 15% in case 1 and case 2, and 10% in case 3. p63 was negative in mostly tumor cells of case 1, and focal positive expression in the nucleus and cytoplasm. In case 2, p63 was completely negative. However, p63 was observed positive in the cytoplasm as well as some secretory material in case 3. ETV6?NTRK3 gene fusion detection by FISH was positive in all cases. Conclusions SCB is a rare low grade triple?negative breast cancer with the unique pathomorphologic features, while its recurrent t (12; 15) ( p13; q25) translocation resulting in ETV6 ?NTRK3 gene fusion. It has the indolent clinical behavior and good prognosis.

Objective:To investigate the diagnosis and prognosis of one patient with carcinoma ex pleomorphic adenoma (CXPA)composed of three malignant components in parotid gland,and to raise the clinicians'awareness of the disease.Methods:A patient was presented to hospital because of the mass in left parotid gland region for more than 30 years and the accompanied pain lasted for one month.After color ultrasonography,the left parotid gland tumor resection was performed. Results: The operation was successful. The postoperative pathological diagnosis results comfirmed as CXPA,it was composed of three malignant components,including non-specific adenocarcinoma,ductal carcinoma,and myoepithelial carcinoma.Conclusion:CXPA composed of three malignant components at the same time are extremely rare.CXPA is difficult to diagnose and its prognosis is poor.The clinicians are supposed to improve the understanding of CXPA.

Objective ERP research has always been the hot spot of the n~ve electrophysiology research.A gTowing body of research suggests that ERP can effectively reflect the cognitive function in patients with depression,evaluate the risk of suicide.This paper reviews the ERP related components with depression and related research.On the basis of the application of ERP in the depression research discusses limitations and prospects on the later development.Methods The articles were retrievaled from databases,such as P UBMED,Foreign medical information resources retrieval platform,CNKI,Wanfang database,ect,from 2013-06 to 2015-01.Index strategy TI:TI:[depression OR affective disorder] AND [suicide OR suicidal] All field:event related potential.Reading and narrowing the scope of the articles,we should understand the experimental design,such as Sample company have suicidal ideation and (or) behavior of patients with depression.Potential induced way,ERP related component detection method,etc.The articles included 43 in English and 15 in Chinese.Read the full text and retain nearly five years about depression and related literature.Results Eventually,the article includes 34 articles and 3 of in Chinese.Conclusion Associated with suicidal ideation and (or) behavior of the existing cognitive dysfunction in patients with depression,ERP related components such as:abnormal P300 and CNV,MMN.N400 have not found abnormal.This article only from the Angle of depression and related research are reviewed in this paper the characteristics of ERP,ERP of other mental illnesses among related research,and to be perfect in the future.

Objective Recent years,epigenetics research mainly focused on DNA methylation.A growing body of research indicated that DNA methylation may play vital role in etiology of affective disorder.With brief introduction of DNA methylation molecular mechanisms and relevance of DNA methylation to affective disorder,this review focuses on some supporting evidence which are recently emerged in major depressive disorder (MDD) and bipolar disorder related gene DNA methylation.Methods We retrievaled related articles from databases,such as PUBMED,Foreign medical information resources retrieval platform,CNKI,Wanfang database,ect,from 2013-06 to 2015-01.Index strategy TI:[depression OR bipolar disorder OR affective disorder] AND All field:DNA methylation.Reading and narrowing the scope of the articles,the experimental design was understanded,such as DNA from either blood cell or brain parenchyma of sample,methods of methylation detection,gene detected and methylation position,etc.The articles included 168 in English and 32 in Chinese.The whole and retained the articles were red about MDD and bipolar disorder related gene DNA methylation in recent five years.Results Eventually,the article includes 29 articles and two of in Chinese.Most of them are receptor gene epigenetics research associated with disease.Conclusion MDD and bipolar disorder are associated with the higher of DNA methylation levels in multiple gene promoter region,such as GR,BDNF,5-HTR,SLC6A4 and the lower of COMT.This article only from the perspective of affective disorder reviewed the relationship between DNA methylation and diseases.None of other diseases epigenetics research,there is to be perfected in future.