In recent years, the application of minimal residual disease (MRD) in solid tumors has gained widespread attention. MRD typically refers to the presence of residual cancer cells that remain undetectable by imaging after curative treatments, such as surgical resection. The presence of MRD post-surgery is significantly associated with an increased risk of tumor recurrence. In colorectal cancer, circulating tumor DNA (ctDNA) serves as an effective marker for assessing MRD, particularly in non-metastatic (stages I-III) colorectal cancer. As a real-time, accurate, and convenient biomarker, ctDNA can effectively predict tumor recurrence, guide postoperative adjuvant chemotherapy decisions, and provide crucial information for recurrence monitoring. The application prospects of ctDNA detection technology are vast, promising more precise and individualized treatment plans for colorectal cancer patients. This article comprehensively analyzes the progress in the application of ctDNA for detecting MRD in non-metastatic colorectal cancer patients, elaborates on its guiding role in clinical treatment decisions, and envisions the future development directions in this field.

In recent years, the application of minimal residual disease (MRD) in solid tumors has gained widespread attention. MRD typically refers to the presence of residual cancer cells that remain undetectable by imaging after curative treatments, such as surgical resection. The presence of MRD post-surgery is significantly associated with an increased risk of tumor recurrence. In colorectal cancer, circulating tumor DNA (ctDNA) serves as an effective marker for assessing MRD, particularly in non-metastatic (stages I-III) colorectal cancer. As a real-time, accurate, and convenient biomarker, ctDNA can effectively predict tumor recurrence, guide postoperative adjuvant chemotherapy decisions, and provide crucial information for recurrence monitoring. The application prospects of ctDNA detection technology are vast, promising more precise and individualized treatment plans for colorectal cancer patients. This article comprehensively analyzes the progress in the application of ctDNA for detecting MRD in non-metastatic colorectal cancer patients, elaborates on its guiding role in clinical treatment decisions, and envisions the future development directions in this field.

Objective:To summarize the distributional characteristics of postoperative occurrence of multi-drug resistant organism (MDRO) infections and their risk factors in simultaneous pancreas-kidney transplantation (SPK) recipients and examine the impact of MDRO infections on the survival of SPK recipients.Method:From January 2016 to December 2022, the relevant clinical data were retrospectively reviewed for 218 SPK recipients. The source of donor-recipient specimens and the composition percentage of MDRO pathogens were examined. According to whether or not MDRO infection occurred post-transplantation, they were assigned into two groups of MDRO (98 cases) and non-MDRO (120 cases). The clinical data of two groups of donors and recipients were analyzed. And the risk factors for an onset of MDRO infection were examined by binary Logistic regression. The survival rate of two recipient groups was compared by Kaplan-Meier method.Result:A total of 98/218 recipients (45%) developed MDRO infections. And 46 (46.9%) of sputum and 34 (34.7%) of urine were cultured positively and 49 (50%) pathogens expressed extended spectrum beta-lactamase. There were pneumonia (46 cases, 46.9%), urinary tract infections (34 cases, 34.7%), abdominal infections (16 cases, 16.3%) and bloodstream infections (2 cases, 2.0%). Univariate regression analysis revealed that length of renal failure ( P=0.037), length of hospitalization ( P<0.001), length of antibiotic use ( P<0.001), novel antibiotics ( P=0.014), albumin ( P<0.001) and leukocyte count ( P<0.001) were risk factors for an onset of MDRO infections. The results of multifactorial regression indicated that low albumin ( OR=0.855, 95% CI: 0.790~0.925, P<0.001) and leukopenia ( OR=0.656, 95% CI: 0.550~0.783, P<0.001) were independent risk factors for an onset of MDRO infections. The survival rates of recipients in MDRO group at Year 1/3 post-operation were 92.9% (91/98) and 89.8% (88/98). And the survival rate of recipients in non-MDRO group was 96.7% (116/120) at Year 1/3 post-operation. Inter-group difference was not statistically significant in 1-year survival rate of two recipient groups ( P=0.201); statistically significant inter-group difference in 3-year survival rate between two recipient groups ( P=0.041) . Conclusion:Low albumin and leukopenia are risk factors for MDRO infection. Infection with MDRO has some impact on the survival of recipients.

Objective:To explore the speech features of female patients with anhedonic depression and their recognition of pleasure deficient symptoms.Methods:A total of 102 female depression patients who were hospitalized at Nanjing Brain Hospital from September 2020 to October 2021 were selected, including 62 anhedonic depression patients (anhedonic group) and 40 non-anhedonic depression patients (non-anhedonic group). A total of 50 female healthy controls were recruited during the same period.All participants were evaluated by the 17-item Hamilton depression scale (HAMD-17), Snaith-Hamilton pleasure scale (SHAPS), and the temporal experience of pleasure scale (TEPS), as well as voice acquisition.SPSS 23.0 software was used for data processing.Statistical analysis was conducted using one-way ANOVA, non-parametric tests, Logistic regression, and receiver operating characteristic curve.Results:Compared with the non-anhedonic group, the anhedonic group showed significant changes in 15 voice features(all P<0.05), including Mel-frequency cepstral coefficients, formant frequencies, intensity, and energy features.Among these features, Mel-frequency cepstral coefficients exhibited the highest accuracy in identifying anhedonic depression, with sensitivity of 47.5%, specificity of 91.9%, area under curve (AUC) of 0.751, 95% CI=0.686-0.866.Formant frequencies could identify female anhedonic depression, with a sensitivity of 90.0%, a specificity of 40.3%, an AUC of 0.647, and 95% CI=0.605-0.824.Energy features could identify anhedonic deficient depression, with a sensitivity of 60.0%, a specificity of 74.2%, an AUC of 0.679, and 95% CI=0.587-0.804.Intensity features could identify female anhedonic depression, with a sensitivity of 70.0%, a specificity of 58.1%, an AUC of 0.640, and 95% CI=0.554-0.769. Conclusion:Mel-frequency cepstral coefficients, formant frequencies, intensity features, and energy features may have specific changes in female patients with anhedonic depression.The Mel-frequency cepstral coefficients has the highest recognition accuracy for anhedonic symptoms in female depression patients, and is expected to become an objective evaluation index for female anhedonic depression.

Objective:To explore the clinical efficacy of aspirin plus low molecule heparin for pancreatic thrombosis during simultaneous pancreas and kidney transplantation (SPK).Methods:A total of 129 patients aged 18 years or higher underwent SPK between September 2016 and March 2020.They were divided retrospectively into two groups of aspirin ( n=60) and heparin ( n=69) according to different anticoagulant regimens.The aspirin group received only aspirin 100 mg/d at Day 1 post-operation.The heparin group received subcutaneous injection of enoxaparin 2 000 AxaIU daily for 7 days and followed by aspirin and clopidogrel.Outcomes and complication rates were compared between two groups. Results:All operations were successful without any mortality.In aspirin group, there were 5 cases of pancreatic thrombosis and one patient underwent pancreatectomy.There was no pancreatic thrombosis in heparin group ( P=0.014). There were 8 cases of intestinal anastomotic bleeding in aspirin group and 19 cases in heparin group.Statistically significant inter-group difference existed ( P=0.048). However, no significant inter-group difference existed in delayed recovery or rejection. Conclusions:Heparin anticoagulation can significantly lower the incidence of pancreatic thrombosis after SPK.Despite a higher incidence of intestinal anastomotic bleeding, no serious complication occurs after conservative meaures.

Objective:To analyze the association of pre-transplant risk factors with diabetes mellitus after renal transplantation and examine the significance of preventing the occurrence in kidney transplantation recipients.Methods:A total of 290 kidney transplantation recipients were retrospectively reviewed at our transplantation center from August 2018 to May 2020.Diabetes mellitus after renal transplantation was employed as a primary outcome index.Multivariate Logistic regression model was utilized for constructing A (without adjusting for covariates)、B(covariates include: gender, dialysis mode, type of donation)and C(covariates include: gender, dialysis mode, type of donation, calcineurin inhibitor, antiproliferative drugs, primary disease, fasting blood glucose, 1 h postprandial blood glucose, fasting C peptide, 1 h and 2 h postprandial C peptide, fasting C-peptide index, 1 h postprandial C-peptide index, albumin, triglycerides, total cholesterol)to evaluate the relationship between diabetes mellitus after transplantation and age, body mass index, 2 h postprandial blood glucose(2 h-PG), HbA1c, and 2 h postprandial C-peptide index(2 h-CPI).Results:In model A, age [odds ratio(OR)1.1, 95% confidence interval( CI)1.0~1.1], BMI(OR 1.2, 95% CI 1.0~1.3), 2 h PG(OR 1.2, 95% CI 1.1~1.4), HbA1c(OR 2.7, 95% CI 1.5~4.9), 2 h-CPI(OR 0.7, 95% CI 0.5~1.0), model B/C had similar results with A. Age, BMI, 2 h PG and HbA1c were all risk factors for diabetes mellitus after transplantation while 2 h-CPI was a protective factor.Quartile stratification was analyzed by regression model.And trend test was significant( P<0.05). Conclusions:Age, BMI, 2 h PG, HbA1c and 2 h-CPI are correlated with diabetes mellitus after kidney transplantation.

ObjectiveTo investigate the prevalence of nonalcoholic fatty liver disease (NAFLD) and related abnormal indicators among taxi drivers in Shenzhen, China, and to provide a basis for scientific prevention and treatment of fatty liver disease. MethodsA total of 1752 taxi drivers who underwent physical examination in Shenzhen Longhua District People’s Hospital from May 2018 to June 2019 were selected, and related indicators were measured, including body mass index (BMI), blood pressure, fasting plasma glucose (FPG), total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and uric acid (UA). Liver ultrasound examination was also performed. The association between the prevalence rate of NAFLD and various biochemical parameters was analyzed. The t-test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. ResultsThe prevalence rate of NAFLD among the taxi drivers was 51.66% (905/1752), and male drivers had a significantly higher prevalence rate than female drivers［57.94% (770/1329) vs 31.91% (135/423), χ2=9.209, P=0.027］. The taxi drivers with NAFLD had significantly higher abnormal rates of BMI, blood lipids, blood pressure, FPG, and UA than those without NAFLD (χ2=5.894, 7.126, 8.045, 8.909, and 10.373, P=0.047, 0.035, 0.030, 0.028, and 0.018). The taxi drivers with a BMI of ≥28 kg/m2 had a significantly higher prevalence rate of NAFLD than those with a BMI of 24.0-27.9 kg/m2 or a BMI of ＜24 kg/m2 (male: χ2=7.904 and 18.624, P=0.035 and 0.008; female: χ2=8.613 and 31.635, P=0.029 and 0.006). The taxi drivers with working years of ＞15 years had a significantly higher prevalence rate of NAFLD than those with working years of 11-15 years, 5-10 years, and ＜5 years (male: χ2=9.781, 13.546, and 18.052, P=0.024, 0.012, and 0.008; female: χ2=7.052, 9.847, and 12.157, P=0.036, 0.023, and 0.016). ConclusionThere is a high prevalence rate of NAFLD among taxi drivers in Shenzhen, and male drivers have a higher prevalence rate than female drivers. The prevalence rate of NAFLD is associated with the abnormal rates of hyperlipidemia, obesity, hyperglycemia, and hyperuricemia and the working years in driving.

Objective To preliminarily explore the clinical efficacy of ipsilateral simultaneous pancreas and kidney transplantation (SPK) .Methods Ipsilateral SPK was performed in 40 patients from September 2016 to August 2018 .During a follow-up period of 6 to 29 months ,we summarized the efficacy and complications of the technique .Results Up to now ,38 patients achieved an exceelent clinical efficacy with no major surgical complications .However ,two patients died of severe pneumonia .The postoperative serum levels of creatinine at 3 ,6 ,12 ,24 months were 107 ,102 ,107 ,110 umol/L ;creatinine clearance rate 64 ,67 ,64 ,63 ml/min;fasting glucose 4 .6 ,5 .1 ,4 .6 ,5 .2 mmol/L ;glycated hemoglobin 4 .8％ , 5 .4％ ,4 .9％ ,5 .2％ respectively .And 1/2-year pancrea and kidney graft survival rates both were 92％ . Complications included kidney graft rejection (n= 11) ,pancreas graft rejection (n= 12) ,simultaneous renal & pancreas graft rejection (n=6) ,renal graft DGF (n=1) ,pulmonary infection (n=14) ,urinary tract infections (n=18) ,gastrointestinal bleeding (n=10) diarrhea (n=6) ,splenic venous thrombosis (n=2) ,incomplete ureteric obstruction of renal allograft (n=3) ,urine leakage (n=1) and pancreas allograft dysfunction (n= 2) .There were no severe surgical complications .After aggressive interventions ,all postoperative complications were cured and none required excision of kidney or pancreas .Conclusions Ipsilateral SPK has definite therapeutic efficacy and it is worth wider popularization .

Objective To determine the effects of resecting the lower half of left stellate ganglion (LSG) on fast ventricular rate (VR) in persistent atrial fibrillation (AF) and its mechanism. Methods Twelve mature healthy male beagle dogs (15–25 kg) were studied. They were randomly divided into two groups (an experimental group and a control group, 6 dogs in each group). The control group were merely performed with rapid left atrial pacing to induce persistent AF. The experimental group were disposed with rapid left atrial pacing and received resection of the lower half of LSG after the persistent AF was documented. Simultaneously the ventricular rates were monitored separately before anesthesia, after anesthesia, 30 minutes and one month after LSG resection. The forward passing effective refractory period (ERP) of the canine atrioventricular node (AVN) was also measured. Results Each dog was documented with persistent AF after 3–6 weeks’ left atrial pacing. After resecting the lower half of LSG for 30 minutes (the control group was only observed for 30 minutes without LSG resection), the average VR of the control group attained 144.5±4.2 beats/min, while that of the experimental group was 121.5±8.7 beats/min (P<0.001). After resecting the lower half of LSG for one month (the control group was observed for one month without LSG resection), the average VR of the control group was 139.2±5.6 beats/min, while that of the experimental group was 106.5±4.9 beats/min (P<0.001). Meantime, the forward passing ERP of AVN of the experimental group was significantly prolonged than that of the control group (265.6±7.8 msvs.251.1±4.6 ms, P=0.003). Conclusion Resection of the lower half of LSG is efficient in reducing VR in canines with persistent AF, one of the mechanisms of which may be prolonging the forward passing ERP of AVN.

Objective: To investigate the pathologic features of gonadal tissues of disorders of sexual development (DSD) in children. Methods: Fifty-three cases of gonadal developmental disorders were collected from July 2015 to August 2017 at Guangzhou Women and Children′s Medical Center. Clinical manifestations, karyotypes, sex hormone levels, ultrasound imaging, histology and immunophenotype of gonadal tissues were analyzed. Results: The age of patients ranged from 7 months to 17 years with an average of (50.7 ± 47.1) months. Social genders of the patients included 32 males and 21 females. Forty-eight patients had abnormal sex hormone levels. Clinical presentations included: toward female genitalia in 25 cases, male genitalia tendency in 17 cases and ambiguous external genitalia in 11 cases. Hypospadias was seen in 31 cases and short stature was seen in 8 cases. Chromosomal karyotyping of peripheral blood revealed 23 cases of sex chromosome disorders, 22 cases of 46 XY disorders, of which 3 cases were 5α-reductase deficiency and 8 cases of 46 XX disorders. Ultrasound examination showed cryptorchidism in 30 cases, including 16 cases of unilateral, 14 cases of bilateral and 1 case presenting a huge pelvic tumor. A total of 97 gonadal tissues from 53 cases of DSD were examined, including 9 cases of unilateral and 44 cases of bilateral gonads. Microscopically, 55 gonads (56.7%) showed dysplastic testes including 17 unilateral and 19 bilateral gonads. Fourteen were streak gonads (14.4%) including 8 unilateral and 3 bilateral gonadal tissues. Nine streak gonad with epithelial cord-like structures (9.3%) were found, of which 5 were unilateral and 2 were bilateral lesions. Seven gonads were ovotestis (7.2%), unilateral in 5 cases (the other side of the gonads of ovary in 4 cases, 1 case of dysplastic testes) and bilateral in 1 case. Seven gonads showed follicular-rich ovarian tissue (7.2%). One case showed bilateral dysplastic testes with gonadoblastoma and ectopic adrenal cortex. One case of streak gonad showed epithelial cord-like structures and undifferentiated glandular tissue embedded in malignant mixed germ cell tumors (mixed gonadoblastoma, dysgerminoma, mature teratoma and yolk sac tumor). One case had testicular microlithiasis. Uterus and fallopian tube structures were found in 11 cases. Immunohistochemical stains were performed in 15 cases. D2-40, PLAP and CKIT were expressed in germ cells and Calretinin, WT1 and inhibin were positive in Setoli cells. SALL4 and OCT3/4 were positive in 3 cases. Inhibin highlighted interstitial Leydig cells in 2 cases. GPC3 was positive in yolk sac tumor component. Conclusions Gonadal dysgenesis presents a broad spectrum of gonadal phenotypes with variable degrees of differentiation. The development of bilateral gonadal tissues has certain variability. Chromosomal karyotypes have no correlation with gonadal phenotypes. Accurate histopathologic diagnosis of gonadal dysgenesis plays an important role in the treatment and prognosis of the patient.