Papillary thyroid carcinoma (PTC) can exhibit lateral neck lymph node metastasis at an early stage. Lateral neck lymph node metastasis is a crucial factor affecting the prognosis of PTC and is an absolute indication for neck lymph node dissection surgery. Additionally, it is a relative contraindication of endoscopic surgery for most medical centers. Therefore, the preoperative identification of lateral neck lymph node metastasis is vital for surgical decision-making and prognosis assessment. Ultrasound, CT, cytology, and clinical features can provide some information on lateral neck lymph node metastasis, but their accuracy does not fully meet clinical needs. Deep learning is a primary method for medical image recognition or feature extraction. In recent years, deep learning-based ultrasound, CT, cytology, conventional clinical parameters, or multimodal models combining these data have been developed and are expected to achieve routine clinical application. With the establishment and sharing of large datasets, automated annotation, algorithm optimization, and resolution of data security issues, deep learning is expected to accurately predict lateral neck lymph node metastasis in PTC. Furthermore, it can be integrated into electronic medical record systems for automated real-time analysis and assist clinical decision-making.

Background Work-related musculoskeletal disorders (WMSDs) are one of the major occupational health problems faced by bus drivers and should receive special attention. Objective To explore the associations of weekly working hours and sleep quality with neck and lower back WMSDs among bus drivers, as well as assess the potential mediating role of sleep quality. Methods From June to December 2022, we recruited bus drivers from 5 subsidiaries of the Shenzhen Bus Group by convenient sampling method. Demographic characteristics, lifestyles, and work-related features of the bus drivers were collected through a questionnaire survey. The Pittsburgh Sleep Quality Index (PSQI) scale and the Musculoskeletal Disorders Survey Questionnaire were used to assess sleep quality and WMSDs respectively. Logistic regression models were applied to analyze the associations of weekly working hours and sleep quality with WMSDs in neck and lower back. Furthermore, mediation analysis was performed to investigate the role of sleep quality in the associations between weekly work hours and neck and lower back WMSDs. Results A total of 1792 valid questionnaires were collected, with a response rate of 95.07%. Among these, 89.3% of the bus drivers worked more than 40 h per week, and the positive rate of poor sleep quality was 28.2%. The overall positive rate of WMSDs within one year before the survey was 69.12%. Among different body regions, the leading positive rates were identified in neck and lower back regions, at 55.92% and 53.68%, respectively. The logistic regression model showed that compared to the bus drivers with weekly work hours ≤40 h, those weekly worked (40~48] h (OR=1.43, 95%CI: 1.02, 2.01; OR=1.65, 95%CI: 1.17, 2.34), (48~56] h (OR=2.69, 95%CI: 1.89, 3.83; OR=2.30, 95%CI: 1.62, 3.29) and ＞56 h (OR=2.63, 95%CI: 1.86, 3.74; OR=3.23, 95%CI: 2.27, 4.62) had significantly increased risk of WMSDs in neck and lower back. Additionally, when compared to those with good sleep quality, bus drivers with poor sleep quality had higher risks of both neck and lower back WMSDs (OR=4.08, 95%CI: 3.20, 5.23; OR=4.15, 95%CI: 3.26, 5.30, respectively). Further mediation analysis indicated that sleep quality partially mediated the associations between weekly working hours and both neck and lower back WMSDs, with 36.15% and 33.68% as the respective proportion of mediation. Conclusion The positive rate of WMSDs is high among bus drivers, and the most common WMSDs occur in neck and lower back. Long working hours and poor sleep quality are significantly associated with increased risks of neck and lower back WMSDs. Sleep quality may mediate the associations of weekly working hours with neck and lower back WMSDs.

Interleukin-17 (IL-17) and its receptor family members are involved in a variety of pathophysiological processes.Studies have shown that the IL-17 family may be closely related to the occurrence and development of interstitial cystitis/ bladder pain syndrome (IC/BPS).This paper explores the relationship between the IL-17 family and IC/BPS, introduces the members and structures of the IL-17 family, their value in inflammatory diseases, and discusses in depth the IL-17 pathways in IC/BPS and the latest research progress.Research has found that the IL-17 family is upregulated in IC/BPS, related to the exacerbation of pathological inflammatory reactions, and responsible for maintaining the chronic inflammatory state of IC/BPS patients.In addition, IL-17 is also associated with neuroinflammation, pain, and other biological effects in IC/BPS.This review aims to deepen the understanding of the mechanisms underlying IC/BPS and to provide references for the development of new therapeutic strategies.

Objective To investigate the application value of multi slice spiral computed tomography(MSCT)in the diagnosis of bilateral Wilms tumor(BWT)in children.Methods The clinical and CT data of 7 children with BWT confirmed by clinical,imaging and pathology were analyzed retrospectively,and all cases underwent CT plain scanning and enhancement CT.Results Two cases were complicated with hypospadias,1 case with cryptorchidism,and 1 case with WAGR syndrome.There were 19 lesions in 14 kid-neys in 7 cases.The lesions were single in 10 kidneys and multiple in 4 kidneys on CT.CT flat scan showed that there were 3 solid lesions,16 cystic lesions,and there were different degrees of necrotic cystic changes inside,2 combined with bleeding,10 calcification,15 clear boundaries,and 4 exudation around.CT enhancement showed that the tumor body was unevenly strengthened,the necrotic cystic area was not strengthened,and the residual renal parenchyma was significantly strengthened.The typical signs were crescent signs and cuddle-ball signs,with 1 case of left renal venous thrombosis and 1 case of the invasion of renal pelvis.Conclusion MSCT can be used in the preoperative diagnosis of BWT in children,to evaluate the effect of chemotherapy and the postoperative evaluation,and to follow-up with and without recurrence and metastasis,so as to provide an important value for clinical diagnosis and treatment.

Objective To investigate the characteristics of CT findings in pediatric ovarian torsion and improve the understanding of pediatric ovarian torsion.Methods The clinical and CT data of 20 cases of ovarian torsion confirmed by pathology and/or surgery were analyzed retrospectively,based on the timing of ovarian torsion,they were divided into fetal and non-fetal groups.All 20 cases underwent plain CT scan and 11 cases underwent CT enhancement.Results All of the 20 cases were unilateral duplication,including 12 cases right and 8 cases left.There were 8 cases of ovarian torsion in the fetal group,all of them were visited with the finding of abdominal mass.The eggshell calcification on CT manifestations was found in 8 cases,and 2 cases of pelvic effusion.There were 12 cases of ovarian torsion in the non-fetal group,all of them presented with abdominal pain,CT showed the disc sign in 7 cases,peduncular protrusion sign in 6 cases,adnexal bleeding sign in 2 cases,subcapsular effusion sign in 2 cases,the uterus displaced to the ipsilateral ovary in 6 cases and pelvic effusion in 10 cases.The disc sign and peduncular protrusion sign were direct signs for the diagnosis of ovarian torsion,and the adnexal bleeding sign and subcapsular effusion sign suggested the possibility of necrosis.Conclusion Pediatric ovarian torsion CT findings with typical signs such as disc sign,peduncular protrusion sign,adnexal bleeding sign and subcapsular effusion sign,combined with clinical history,a more accurate diagnosis can be given,providing assistance in clinical treatment.

Objective:To investigate the effect of staged operations with oral mucosa preimplantation urethral plate in the treatment of crippled hypospadias.Methods:The clinical records of patients with crippled hypospadias which were treated in the First People’s Hospital of Zunyi from March 2019 to March 2023 were retrospectively reviewed. Staged operations with oral mucosa preimplantation urethral plate were applied to all patients. The survival condition of preimplantation urethral plate, urethrocutaneous fistula, urethral dehiscence, urethral diverticulum, urethrostenosis, residual chordee, the appearance of penis and urinating condition were observed.Results:Twelve male children were enrolled, ranging in age from 5 years and 1 month to 14 years, with a median age of 8 years and 2 months. All of these patients had 2 to 4 times of urethroplasty surgeries with an average time of 3.2. All patients suffered from moderate to severe chordee and lack of prepuce, including 5 patients with urethral dehiscence, 3 cases with multiple urethrocutaneous fistulas and 4 cases with urethrostenosis. All patients were followed 6 to 36 months after surgery with an average of 25 months. One patient suffered from infection of preimplantation urethral plate after the first stage operation was cured by hyperbaric oxygen therapy and local dressing. Two patients complained of urethrocutaneous fistula after the second stage operation were cured by fistulectomy. No urethral dehiscence, urethral diverticulum, urethrostenosis or residual chordee was observed in other patients. Penile appearance was not bloated and the longitudinal slit urethral orifice was located in the head of the penis. Urination was smooth and the urine line was continuous.Conclusion:Staged operation with oral mucosa preimplantation urethral plate is an effective and safe method for the treatment of crippled hypospadias.

Objective Based on DRG evaluation indicators,research an evaluation method that can comprehensive-ly evaluate the medical service capacity and efficiency of clinical departments in hospitals.Methods Using the front page of inpatient medical records from a tertiary hospital in Xuzhou in 2022 as a sample,obtaining DRG related indi-cators through the China Healthcare Security Diagnosis Related Groups 1.1 grouping system.Based on the number of DRG,CMI,TEI,and CEI indicators,use TOPSIS method to comprehensively evaluate the quality of medical ser-vices in clinical departments.Results The widest coverage of medical services is in General Surgery,with a DRG group of 325;The most difficult medical service is in the Emergency Department,with a CMI value of 1.45;The best time efficiency is in Ophthalmology,with a TEI of 0.56,The Dermatology has the best cost efficiency,with a CEI of 0.36;TOPSIS comprehensive evaluation shows that the top five are Pediatrics,General Medicine,Emergen-cy Department,General Surgery,and Gastroenterology,and the bottom five are Dentistry,Burn Unit,Orthope-dics,Neurosurgery,and CCU.Conclusion The TOPSIS method based on DRG integrates two dimensions of medical service capability and medical service efficiency,and horizontally compares clinical departments.The evaluation re-sults are more objective,reasonable,and accurate,which can provide a methodological basis for hospital refined management.