Objective To explore the expression of human epidermal growth factor receptor 2 (HER2) and its associations with clinical, pathological, and imaging characteristics in endometrial carcinoma (EC) patients. Methods A retrospective analysis was conducted on 214 patients with newly diagnosed EC treated at Zhongshan Hospital, Fudan University, from January 2022 to December 2024. HER2 expression was assessed using immunohistochemistry (IHC) staining, and its associations with clinical characteristics, histopathological and imaging features were analyzed. Results The HER2 expression rate (IHC score of 1＋/2＋/3＋) in EC was 37.4% (80/214). HER2 expression was significantly associated with older age, advanced International Federation of Gynecology and Obstetrics (FIGO) stage, aggressive histological types, P53abn and low apparent diffusion coefficient (ADC) of preoperative pelvic magnetic resonance imaging (MRI). Multivariate analysis indicated that aggressive histological types (P＝0.002) and low ADC of preoperative pelvic MRI (P＝0.047) were independent factors associated with HER2 expression. Conclusions ADC of EC lesions may serve as a non-invasive predictive marker for HER2 expression, while histological type provides a critical basis for precisely guiding HER2 testing.

Objective To evaluate the differential diagnostic value of synthetic magnetic resonance imaging(syMRI)and field of view optimized and constrained undistorted single shot diffusion weighted imaging(FOCUS DWI)in patient with breast imaging reporting and data system(BI-RADS)4 breast lesions.Methods A total of 68 patients who underwent breast MRI and were classified as BI-RADS category 4 were prospectively enrolled.Among them,there were 31 cases of benign lesions(benign group)and 37 cases of malignant lesions(malignant group).All patients underwent T1WI,T2WI,FOCUS DWI,dynamic contrast-enhanced magnetic resonance ima-ging(DCE-MRI)and syMRI.Two radiologists delineated the region of interest(ROI)on quantitative parameters images of syMRI and the apparent diffusion coefficient(ADC)images generated from FOCUS DWI and calculated T1,T2,proton density(PD)and ADC values,respectively.The thresholds and diagnostic efficacy of syMRI and FOCUS DWI parameters were evaluated by the receiver op-erating characteristic(ROC)curve.Logistic regression analysis was used to combine the parameters of the two sequences and evalu-ate the diagnostic efficacy.Results The T2,PD,and ADC values in the malignant group were significantly lower than those in the benign group(P＜0.05),but there were no statistically significant difference in T1 values between the groups(P＞0.05).T2 and ADC values could be used as important diagnostic indexes in patient with malignant lesions of BI-RADS 4 breast lesions,and the area under the curve(AUC)of T2 and ADC was 0.833 and 0.867,respec-tively.There was no significant difference in AUC of T2 and ADC between benign and malignant groups(Z=0.485,P=0.627).The AUC of T2 value combined with ADC value was 0.910,and the sensitivity and specificity was 90.3％and 89.2％,respectively.Conclusion T2 value of syMRI and ADC value of FOCUS DWI can be used as quantitative diagnostic indicators in patients with BI-RADS 4 breast lesions.The combination of T2 and ADC values can further improve the differential diagnosis efficiency.

Type B insulin resistance syndrome(TBIR)is a rare autoimmune disease caused by the presence of autoantibodies against insulin receptors in the human body,leading to severe refractory hyperglycemia or refractory hypoglycemia.This article reports a case of TBIR patient,summarizes and analyzes its epidemiological characteristics and diagnosis and treatment methods,providing a basis for clinical treatment.

Objective:To understand the current situations and existing problems of pediatric emergency in Shanghai city and provide a basis for the construction and management of pediatric emergency.Methods:The questionnaire survey was used to investigate the current situations of pediatric emergency department in secondary and tertiary public hospitals in Shanghai city.Results:A total of 28 questionnaires were delivered, and 28 were responded.Six of the 28 hospitals had no administratively independent pediatric emergency or no separate pediatric emergency area.Of the 22 hospitals, each had an average of 9.7 professional emergency pediatricians, with the exception of one secondary hospital that lacked professional emergency pediatricians.Professional emergency pediatricians accounted for an average of 70.0% of all pediatricians.Of the 22 hospitals, 18(81.8%) were open 24 hours a day.Fourteen(63.6%) had independent triage.Eight children′s emergency rooms(36.4%) were shared with adults.Among the 22 hospitals, 20 hospitals filled in the annual total number of pediatric emergency visits, and the total number of pediatric emergency visits ranged from 2 791 to 467 428, with an average of 93 966.65.Conclusion:There are still some problems in the development of pediatric emergency department in secondary and tertiary public hospitals in Shanghai city, such as insufficient human resources, substandard personnel training, incomplete equipment and lack of critical first-aid techniques.Therefore, the construction and management of pediatric emergency department still need to be improved.

Background: In China, secondary cytoreductive surgery (SCR) has been widely used in ovarian cancer (OC) over the past two decades. Although Gynecologic Oncology Group-0213 trial did not show its overall survival benefit in first relapsed patients, the questions on patient selection and effect of subsequent targeting therapy are still open. The preliminary data from our pre-SOC1 phase II study showed that selected patients with second relapse who never received SCR at recurrence may still benefit from surgery. Moreover, poly(ADP-ribose) polymerase inhibitors (PARPi) maintenance now has been a standard care for platinum sensitive relapsed OC. To our knowledge, no published or ongoing trial is trying to answer the question if patient can benefit from a potentially complete resection combined with PARPi maintenance in OC patients with secondary recurrence. Methods SOC-3 is a multi-center, open, randomized, controlled, phase II trial of SCR followed by chemotherapy and niraparib maintenance vs chemotherapy and niraparib maintenance in patients with platinum-sensitive second relapsed OC who never received SCR at recurrence. To guarantee surgical quality, if the sites had no experience of participating in any OC-related surgical trials, the number of recurrent lesions evaluated by central-reviewed positron emission tomography–computed tomography image shouldn't be more than 3. Eligible patients are randomly assigned in a 1:1 ratio to receive either SCR followed by 6 cyclesof platinum-based chemotherapy and niraparib maintenance or 6 cycles of platinum-based chemotherapy and niraparib maintenance alone. Patients who undergo at least 4 cycles of chemotherapy and must be, in the opinion of the investigator, without disease progression, will be assigned niraparib maintenance. Major inclusion criteria are secondary relapsed OC with a platinum-free interval of no less than 6 months and a possibly complete resection. Major exclusion criteria are borderline tumors and non-epithelial ovarian malignancies, received debulking surgery at recurrence and impossible to complete resection. The sample size is 96 patients. Primary endpoint is 12-month non-progression rate.

Background: Two randomized phase III trials (EORTC55971 and CHORUS) showed similar progression-free and overall survival in primary or interval debulking surgery in ovarian cancer, however both studies had limitations with lower rate of complete resection and lack of surgical qualifications for participating centers. There is no consensus on whether neoadjuvant chemotherapy followed by interval debulking surgery (NACT-IDS) could be a preferred approach in the management of advanced epithelial ovarian cancer (EOC) in the clinical practice. Methods The Asian SUNNY study is an open-label, multicenter, randomized controlled, phase III trial to compare the effect of primary debulking surgery (PDS) to NACT-IDS in stages IIIC and IV EOC, fallopian tube cancer (FTC) or primary peritoneal carcinoma (PPC).The hypothesis is that PDS enhances the survivorship when compared with NACT-IDS in advanced ovarian cancer. The primary objective is to clarify the role of PDS and NACT-IDS in the treatment of advanced ovarian cancer. Surgical quality assures include at least 50% of no gross residual (NGR) in PDS group in all centers and participating centers should be national cancer centers or designed ovarian cancer section or those with the experience participating surgical trials of ovarian cancer. Any participating center should be monitored evaluating the proportions of NGR by a training set. The aim of the surgery in both arms is maximal cytoreduction. Tumor burden of the disease is evaluated by diagnostic laparoscopy or positron emission tomography/computed tomography scan. Patients assigned to PDS group will undergo upfront maximal cytoreductive surgery within 3 weeks after biopsy, followed by 6 cycles of standard adjuvant chemotherapy. Patients assigned to NACT group will undergo 3 cycles of NACT-IDS, and subsequently 3 cycles of adjuvant chemotherapy. The maximal time interval between IDS and the initiation of adjuvant chemotherapy is 8 weeks. Major inclusion criteria are pathologic confirmed stage IIIC and IV EOC, FTC or PPC; ECOG performance status of 0 to 2; ASA score of 1 to 2. Major exclusion criteria are non-epithelial tumors as well as borderline tumors; low-grade carcinoma; mucinous ovarian cancer. The sample size is 456 subjects. Primary endpoint is overall survival.

Objective:To analyze the characteristics of the ocular vestibular evoked myogenic potential on three different eye positions and to explore the appropriate eye position for oVEMP.Methods:15 patients (30 ears) with vertigo who underwent oVEMP test from December 2017 to May 2018 were selected as the patient group, including seven males and eight females, with an average age of (51±13) years. Another 22 (44 ears) healthy young people were recruited into the control group, including 10 males and 12 females, with an average age of (23±5) years. oVEMPs were measured on the following three eye positions respectively: 30 degrees straight up(upper median position),45 degrees upper right(upper right position), and 45 degrees upper left(upper left position). oVEMP elicitation rate, oVEMP latencies, amplitudes and interaural amplitude asymmetry ratio were analyzed by SPSS 23.0 statistical software.Results:There was no statistical significance ( P>0.05) in the oVEMP elicitation rate, oVEMP latency, amplitude and asymmetry ratio on the three eye positions among the control group, the patient group and the overall subjects. Conclusions:The three eye positions can be used to detect oVEMP in clinic. There is no difference in the extraction rate and waveform characteristics. When one of the eye positions is difficult to gaze or not easy to obtain the coincidence curve, the other two can be used to obtain the ideal oVEMP curves as well.

Objective To investigate the differences in the gene expression profiles between SW480 and SW620 cell lines.Methods A dataset of GDS756 containing the gene expression profiles of SW480 and SW620 was downloaded from the GEO database in NCBI.The differential expression genes between SW480 and SW620 were analyzed with gene set enrichment analysis (GSEA) and leading edge subset analysis.The genes in leading edge subset were re-annotated by FunRich software.The core genes of leading edge subset closely relating to SW480 or SW620 were analyzed with the STRING on-line analytical system.The functional core genes closely relating to SW480 or SW620 were obtained by the combined analysis of the core genes and high frequency genes from leading edge subset.Results GSEA identified 12 significantly enriched gene sets,491 leading edge genes and 7 highly overlapping genes from SW480 and 80 significantly enriched gene sets,870 leading edge genes and 6 highly overlapping genes from SW620.The STRING system identified 5 core genes from SW480 and 8 from SW620.The combined analysis of GSEA and bionetwork obtained 2 functional core genes,TOP2A and CDK1,from SW620.Conclusion The SW480 and SW620 cells with identical genetic background have different functional gene expression profiles,and the functional core genes TOP2A and CDK1 in SW620 cells may be related to the signal pathways of colon cancer metastasis.

Objective: To investigate the clinical features and genetic characteristics of cases with NBAS gene defects. Method: Characteristics of clinical materials, immunological data and gene mutation of the first case in China with NBAS gene mutation were retrospectively analyzed. The related literature was searched by using search terms'NBAS’. Result: A 2-year-four-month old girl, was admitted due to 'fever and pallor for one day’. There was an intrauterine growth retardation at her fetal stage. Since her birth, she had suffered from recurrent infections and development delay was accompanied by persistent liver dysfunction. Her head circumference and height were 43.5 cm and 60 cm, respectively. She seemed pale. She had progeroid appearance with loose skin, sparse hair, proptosis and low-set ears. The cranial suture did no close and the anterior fontanel was about 6 cm×5 cm. Abdominal palpation showed that the liver was 2 cm below the right costal margin, and the spleen was 1.5 cm below the left rib. Both alanine aminotransferase(100-1 991 IU/L) and aspartate aminotransferase (191-1 367 IU/L) were persistently abnormal. Visual evoked potentials and fundus examination revealed optic nerve atrophy. Bone mineral density assessment showed osteoporosis. The IgG level was 2.0 g/L (3.41-19.6) and absolute count of CD19⁺B cells was 231.27/μl (608.8-2 167.7) . Her hemoglobin level was 53 g/L. Bone marrow smear showed serious hypoplasia in erythroid cell. The gene sequencing results showed NBAS gene c.5741C> T, pR1914H and c.6496-6497insA, p.S2166Ffs* 2 compound heterozygous mutations. A total of 8 literatures were collected including 57 cases with NBAS gene homozygous or compound heterozygous mutation. These 57 cases were characterized by short stature(88%, 50/57) , Pelger-Huët anomaly (75%, 43/57) , skeletal dysplasia (74%, 42/57), optic nerve atrophy (72%, 41/57), abnormality of liver enzymes or acute liver failure (42%,24/57), abnormalities of immune system(19%, 11/57), development delay of mental, language or sports(11%, 6/57). Other clinical manifestations such as progeroid appearance, proptosis and hypotonia were also common. NBAS gene c.5741G>A homozygous mutation accounted for 61% (35/57) cases. Conclusion Cases with NBAS gene defects often manifests as short stature, optic nerve atrophy, Pelger-Huët anomaly, skeletal dysplasia, recurrent infections, abnormality of liver enzymes, progeroid appearance, proptosis, hypotonia and immunodeficiency. Gene sequencing analysis showed NBAS gene homozygous or compound heterozygous mutations, and homozygous mutation of c.5741G>A was most common.