To explore the feasibility of using indocyanine green(ICG) visualizing the deep infiltrating endometriosis (DIE) during robotic surgery.

A patient with DIE in Department of Genecology and Obstetrics, Chinese PLA General Hospital was selected and underwent total hysterectomy with bilateral adnexectomy and endometriosis lesion excision with perfect preoperative examination and no surgical contraindication. Near-infrared fluorescence imaging with indocyanine green was used in the operation to visualize the endometriosis lesions.

The location of the lesions were accurate and the patient discharged from hospital successfully.

Near-infrared fluorescence imaging system with indocyanine green may clearly visualize the deep infiltrating endometriosis during robotic surgery. It is characterized by brief operation, accuracy and real time. With this technique, we can comprehensively evaluate the scope of our surgery.

Carbapenem-resistant Acinetobacter baumannii (CRAB) infection is associated with reduced early postoperative survival among liver transplant recipients with acute-on-chronic liver failure (ACLF). We report the first case at our center in which Sulbactam-Durlobactam (SUL-DUR) was successfully used to treat a CRAB pulmonary infection patient with ACLF following liver transplantation. After initiating SUL-DUR therapy, next-generation sequencing (NGS) demonstrated a progressive decline in CRAB sequence counts. By day 4, CRAB-specific PCR of bronchoalveolar lavage fluid (BALF) returned negative, and CRAB was undetectable in subsequent BALF cultures. The treatment demonstrated favorable clinical efficacy, with notable radiological improvement and rapid microbial eradication. SUL-DUR not only rapidly controlled the progression of CRAB-induced pulmonary infection, but also facilitated the early initiation of immunosuppressive therapy. Subsequent in vitro antimicrobial susceptibility testing revealed synergy between SUL-DUR and cefepime, though no such synergy was observed with imipenem. This case underscores the promising role of SUL-DUR in managing post-transplant CRAB pneumonia, especially in high-risk patients with acute-on-chronic liver failure. Our findings may provide a valuable reference for optimizing therapeutic strategies in similar clinical cases.

To explore the clinical characteristics and management strategies of Graves disease (GD) complicated with concurrent Hashimoto′s thyroiditis, and the occurrence of agranulocytosis, thyroid storm, and drug-induced lupus erythematosus (DILE) during the course of treatment with methimazole.

A retrospective analysis was conducted on a 33-year-old woman admitted to the Department of Endocrinology, the Fifth Affiliated Hospital of Zhengzhou University with a thyroid storm complicated by severe granulocytopenia and DILE. Her comprehensive clinical presentation, laboratory evaluations, and therapeutic management were reviewed.

The patient, a 33-year-old woman, presented with significant hyperthyroidism at initial diagnosis, characterized by elevated levels of free triiodothyronine (FT3) (16.23 pmol/L) and free thyroxine (FT4) (45.38 pmol/L), decreased thyroid-stimulating hormone (TSH) levels (0.006 U/L), positive thyrotropin receptor antibody (TRAb) and thyroid peroxidase antibody (TPOAb), and increased thyroid iodine uptake (2 h 49.40%, 6 h 80.90%, 24 h 94.10%). Ultrasonography revealed a mildly enlarged thyroid with diffuse heterogeneous hypoechogenicity and slightly increased vascularity, consistent with the clinical presentation of GD complicated by HT, accompanied by granulocytopenia. Methimazole therapy induced myelosuppression (characterized by agranulocytosis, anemia, and thrombocytopenia), leading to secondary acute suppurative tonsillitis and triggering a thyroid storm (BWPS score 45). A bone marrow biopsy revealed hypoplasia of hematopoietic tissue. Key immunological tests were positive for antinuclear antibodies (≥1∶160) and anti-Sm antibodies, suggesting hematologic damage caused by DILE. After discontinuation of methimazole, aggressive antimicrobial therapy, administration of recombinant human granulocyte colony-stimulating factor (G-CSF), glucocorticoids, immunosuppressants, and subsequent I¹³¹ therapy, the patient′s infection was controlled. Complete blood count parameters gradually normalized. Thyroid function converted to subclinical hypothyroidism after I¹³¹ therapy and normalized with levothyroxine supplementation. DILE-related markers (antinuclear antibody titers) decreased, allowing for a reduction in glucocorticoid and immunosuppressive doses, and the patient′s condition remained stable.

Antithyroid drugs (e.g., methimazole) may trigger autoimmune responses, including DILE. In clinical practice, secondary immune abnormalities should be promptly screened during the diagnosis and treatment of hyperthyroidism with hematologic abnormalities to achieve early identification and intervention.

To explore the effects of synchronous intensity-modulated radiotherapy (SIB-IMRT) with different segmentation modes on intracranial progression, cognitive function, immune function, and quality of life in patients with lung cancer brain metastases (BM).

A prospective study was conducted on 92 patients with brain metastases (BM) admitted to Cangzhou Central Hospital from November 2021 to December 2024. They were randomly divided into Group A 49 cases (40Gy/20Fx whole brain+ local addition of 60Gy/20Fx) and Group B 43 cases (37.5Gy/15Fx whole brain+ local addition of 52.5Gy/15Fx). The intracranial progression free survival time (iPFS) was recorded. The flow cytometry was performed to detect blood lymphocyte subsets before and after radiotherapy. Kaplan-Meier curves was used to analyze the impact of different segmentation modes on iPFS. The effects of different segmentation modes on cognitive function, quality of life, and cellular immune function (CD3⁺, CD4⁺, CD8⁺ %) were analyzed by repeated measures method of variance.

During a median follow-up of 9.93 months, there were 21 deaths and 71 survivors. In addition, 59 patients (64.13%) experienced intracranial progression/recurrence, while the duration of iPFS 4.90 months (95%CI: 3.42-6.38 months) in Group A was less than the duration of iPFS 12.60 months (95%CI: 10.28~14.92 months) in Group B, Log-Rank=12.621, P=0.000. 44 treatment-related adverse events occurred, and there was no statistically significant difference in the incidence of adverse events between the two groups (P>0.05). At 4 and 6 months after radiotherapy, the Montreal cognitive scores of Group B (23.13±1.45) and (23.09±2.00) were higher than that of Group A (20.97±2.35) and (18.35±2.41), P=0.000; the Barthel index of daily living activities in group B (8.74±2.47) was higher than that in group A (6.95±0.39) at 6 months after radiotherapy (P=0.001). After radiotherapy for 2 months, CD8⁺ % 32.50(23.90, 41.10) in group B was higher than that in group A 27.10(17.65, 36.03)(P=0.001). Repeated analysis of variance showed that CD8⁺ % (Fgroup×time=6.966, P=0.012) had inter group interactions.

The whole brain 37.5Gy/15Fx+ local dose 52.5Gy/15Fx regimen can prolong iPFS in patients with multiple BM of lung cancer and help to maintain their immune function, cognitive ability, and quality of life after radiotherapy.

Nontuberculous Mycobacteria pulmonary disease (NTM-PD) is a chronic infectious lung disease caused by these bacteria, which has seen a significant rise in cases lately. This study aims to reveal the demographic characteristics, imaging findings, and pathogen distribution patterns of NTM-PD patients by looking back at clinical data.

It was selected that 205 patients diagnosed with NTM-PD at Xi′an Chest Hospital between June 2023 and May 2025. All participants met the diagnostic criteria from the Tuberculosis Branch of the Chinese Medical Association. It was extracted that data from the hospital′s electronic medical record system. This included patients′age, gender, medical history, comorbidities, clinical symptoms, imaging findings, and microbiological results.

Among the 205 patients, male 121 cases (59.02%) and female 84 cases (40.98%); 153 cases were aged ≥50 years (74.63%). Among the patients, 27 cases (13.17%) had a history of tuberculosis, 36 cases (17.56%) had concurrent bronchiectasis, and 25 cases (12.20%) had chronic obstructive pulmonary disease (COPD). Other comorbidities included abnormal blood glucose (including diabetes, impaired glucose tolerance, and hyperglycemia), hepatitis, pneumoconiosis, and tumors. Among males, 22 cases (18.18%)with COPD higher than 3 cases (3.57%) in females. Females also had 20 cases (23.81%) of bronchiectasis higher than 16 cases (13.22%) in males (P<0.05). The main symptoms were cough in 169 cases (82.44%), expectoration in 151 cases (73.66%), dyspnea in 79 cases (38.54%), chest tightness in 54 cases (26.34%), fever in 39 cases (19.02%), chest pain in 22 cases (10.73%), and hemoptysis in 32 cases (15.61%). The incidence of fever was higher in males 30 cases(24.79%) than in females 9 cases(10.71%) (P<0.05). The imaging features of thorax were nodular 124 cases(60.49%) and cavity (74 cases, 36.10%), and other common features were bronchiectasis, lymphadenopathy, pleural effusion, pneumothorax, etc.The number of lung cavities was 62 cases in males (51.24%) and 12 cases in females (14.29%). The number of bronchiectasis was 31cases in females (36.90%) and 29 cases in males (23.97%)(P<0.05). The etiology was mainly intracellular mycobacteria 79 cases(38.54%), followed by Mycobacterium abscessus 38 cases(18.54%), Mycobacterium kansasii 30 cases(14.63%) and Mycobacterium avium 14 cases(6.83%).The proportions of Mycobacterium abscessus, Mycobacterium kansasii, and Mycobacterium avium were significantly different between males and females (P<0.05).

There are gender differences in the clinical characteristics and pathogen distribution of NTM-PD patients, emphasizing the need for early identification, which can help tailor treatments, and suggesting that more research is needed on its epidemiological features and treatment strategies.

Analyze the therapeutic effect of bedaquiline combined with enteral nutrition support on multi-drug-resistant pulmonary tuberculosis (MDR-PTB).

The clinical data of 57 MDR-PTB patients admitted to our hospital were collected and divided into an observation group with 26 cases and a control group with 31 cases according to the treatment methods. Patients in the control group received conventional anti-tuberculosis treatment (levofloxacin, linezolid, clofazimine, cycloserine, and pyrazinamide) combined with enteral nutrition support (oral enteral nutrition powder 500~1 000 ml/d, with appropriate supplementary homogenate meals such as milk and vegetable puree, for 24 consecutive weeks). Patients in the observation group, on the basis of the control group′s regimen, took bedaquiline fumarate tablets orally, with an initial dose of 400 mg/d for 2 consecutive weeks, then reduced to 200 mg per dose, 3 times a week, for 22 consecutive weeks. The clinical efficacy, sputum smear conversion of Mycobacterium tuberculosis, serum immune function indexes [immunoglobulin (Ig) A, IgG, IgM, the ratio of CD4⁺ /CD8⁺ T lymphocytes], pulmonary function indexes [forced expiratory volume in the first second (FEV₁), peak expiratory flow (PEF), percentage of FEV₁ to predicted value (FEV₁%)], computed tomography (CT) signs [thick-walled cavity, calcification shadow, pulmonary consolidation and pleural thickening], nutritional status [hemoglobin (Hb), total lymphocyte count (TLC), albumin (ALB) level and Short Form 36 Health Survey Questionnaire (SF-36) score] and the occurrence of adverse reactions were compared between the two groups.

The clinical efficacy of the observation group was 23 cases (88.46%), which was higher than 19 cases (61.29%) in the control group. The sputum smear negative conversion rate, sputum culture negative conversion rate, IgA, IgG, IgM, the CD4⁺ /CD8⁺ ratio, PEF, FEV₁, FEV₁%, TLC, Hb, ALB levels and SF-36 scores of the observation group were (84.62%), (80.77%), (3.91±0.82) g/L, (20.18±3.97) g/L, (2.57±0.34) g/L, (1.41±0.16), (6.91±1.23) L/s, (1.41±0.22) L, (80.83±9.58)%, (1.94±0.47)×10⁹/L, (117.52±19.68) g/L, (40.14±8.75) g/L, (78.15±12.29) points respectively, all of which were higher than those of the control group [(67.74%), (61.29%), (3.32±0.79) g/L, (17.94±2.68) g/L, (2.31±0.48) g/L, (1.29±0.14), (6.28±1.07) L/s, (1.28±0.19) L, (75.19±9.64)%, (1.68±0.42)×10⁹/L, (105.73±21.56) g/L, (35.29±7.63) g/L, (71.03±13.48) points]. The incidences of thick-walled cavity, calcification shadow, pulmonary consolidation and pleural thickening in the observation group were 23.08%, 15.38%, 11.54%, 15.38% respectively, which were lower than those in the control group 48.39%, 45.16%, 38.71%, 41.94%, (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).

Bedaquiline combined with enteral nutrition support therapy has an obvious efficacy in the treatment of MDR-PTB, which can improve the nutritional status of patients, regulate the immune function, promote the recovery of the pulmonary structure and function of patients, and the safety feature is of significant importance.

To investigate the factors influencing postoperative pain in patients with nonsmall cell lung cancer (NSCLC) after thoracoscopic surgery.

Eightyseven non-small cell lung cancer patients who underwent thoracoscopic lobectomy in our hospital from April 2023 to May 2025 were selected. They were followed up for 3 months after surgery and divided into groups according to the numeric rating scale (NRS) score: 40 patients with postoperative pain (NRS>3) were assigned to the observation group, and 47 patients without pain (NRS≤3) were assigned to the control group. Clinical data and perioperative indicators were compared between the two groups.

Among the 87 patients, 40 cases(45.98%) experienced pain at 3 months after surgery. The observation group had a higher proportion of preoperative chestback pain 15 cases (37.50%), higher postoperative analgesic dosage (28.58±3.88)mg, and longer hospital stay (13.18±2.48)d compared with the control group [preoperative chestback pain 5 cases (10.64%), postoperative analgesic dosage (22.75±4.02) mg, hospital stay(9.91±1.80)d (P<0.05). Logistic regression analysis showed that preoperative chestback pain (OR=6.620, 95%CI: 1.511~28.992), postoperative analgesic dosage (OR=1.269, 95%CI: 1.055~1.526), and hospital stay (OR=1.716, 95%CI: 1.222~2.409) were influencing factors for postoperative pain in non-small cell lung cancer patients after thoracoscopic surgery (P<0.05). Preoperative chest and back pain, postoperative analgesic dosage, and hospital stay predicted the area under the receiver operating characteristic (ROC) curve for postoperative pain in patients with non-small cell lung cancer undergoing thoracoscopic surgery, with values of 0.634, 0.855, and 0.853, respectively. The combined prediction of the three factors yielded an AUC of 0.918 (95%CI: 0.853~0.983), which was superior to the individual prediction of preoperative chestback pain (Z=5.926, P=0.000), postoperative analgesic dosage (Z=2.188, P=0.029), or hospital stay (Z=2.107, P=0.035).

Preoperative chestback pain, postoperative analgesic dosage, and hospital stay are influencing factors for pain at 3 months after thoracoscopic surgery in non-small cell lung cancer patients, and their combined prediction has clinical significance.

To analyze the current status and epidemiological characteristics of different pathogen infections in the respiratory tract of children, providing reference for clinical diagnosis and treatment, as well as for the prevention and control of respiratory infectious diseases in children.

A total of 39, 025 children diagnosed with respiratory tract infections in our hospital from March 2024 to February 2025 were selected. Pharyngeal swab specimens were collected from these children, and nucleic acid testing for six respiratory pathogens was performed using the Natch 48 nucleic acid extraction method. The pathogens tested were Mycoplasma pneumoniae(MP), Influenza B virus (FluB), Influenza A virus (FluA), Respiratory syncytial virus (RSV), Adenovirus (ADV), and Human rhinovirus (HRV).

Among the 39 025 children tested, pathogens were detected in 22 867 cases (58.5%). Among these, single pathogen infections were found in 19 523 cases (85.38%), and mixed pathogen infections were found in 3 344 cases (14.62%). The distribution of the six pathogens among positive cases was as follows: ADV in 6 373 cases (32.64%), HRV in 4 745 cases (24.30%), MP in 4 050 cases (20.75%), FluA in 2 293 cases (11.75%), RSV in 1 346 cases (6.89%), and FluB in 716 cases (3.67%). Among children aged one month to one year, 1 528 pharyngeal swabs were tested, with 730 positive cases (47.77%). Among children aged >1 to 3 years, 5 224 were tested, with 3 950 positive cases (75.61%). Among children aged >3 to 6 years, 17 887 were tested, with 7 372 positive cases (41.21%). Among 7-year-old children, 14 386 were tested, with 7 471 cases (51.93%). Among children living in home-based care settings, 6 752 were tested, with 4 963 positive cases (73.50%). Among children attending kindergarten, 32 273 were tested, with 14 827 positive cases (45.94%). The difference in positive detection rates among children of different age groups was statistically significant (P<0.001). By season, 8 406 tests were performed in spring, with 4 032 positive cases (47.97%); 10 756 tests in summer, with 5 818 positive cases (54.09%); 9 714 tests in autumn, with 4 934 positive cases (50.79%); and 10 149 tests in winter, with 4 739 positive cases (46.69%). The difference in positive detection rates among children across different seasons was statistically significant (P<0.001).

The most common single pathogens causing respiratory infections in children are ADV, HRV, and MP. Mixed respiratory pathogen infections frequently involve combinations of HRV and ADV, as well as HRV and MP, which should receive clinical attention. Prevention and control measures should be formulated based on epidemiological characteristics to reduce the incidence of respiratory pathogen infections in children.

To analyze the value of mean platelet volume/platelet count ratio (MPR) and lactate/albumin ratio (LAR) combined for predicting the prognosis of patients with severe pneumonia.

A total of 119 patients with severe pneumonia admitted to our hospital from January 2020 to December 2024 were retrospectively selected as study subjects. According to the survival status of patients, they were divided into good prognosis group (survival) and poor prognosis group (death). Clinical data and MPR and LAR values of the two groups were collected and compared. Pearson correlation analysis was used to explore the correlation between MPR, LAR and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) scores in patients with severe pneumonia. Multivariate logistic regression analysis was used to identify the influencing factors for poor prognosis in patients with severe pneumonia. Receiver operating characteristic (ROC) curves and decision curve analysis were drawn to evaluate the value and clinical net benefit of MPR, LAR, and their combined application for predicting poor prognosis in patients with severe pneumonia.

Among 119 patients with severe pneumonia, 88 cases survived and 31 cases died after treatment. The APACHE Ⅱscore[(19.76±4.01)vs.(25.59±3.38)], D-D[(3.89±1.06)μg/ml vs.(4.35±1.19)μg/ml], CRP[(102.75±26.15)mg/L vs.(114.56±30.12)mg/L], PCT[(7.23±1.56)ng/ml vs.(8.91±2.64)ng/ml], MPR[(4.58±0.90)vs.(5.73±1.15)], LAR[(0.05±0.01)vs.(0.09±0.03)] of survivors and the dead, with statistically significant differences were found in comparison(P<0.05). Pearson correlation analysis showed that MPR and LAR were both positively correlated with APACHE Ⅱ scores in patients with severe pneumonia (P<0.05). Logistic regression analysis showed that after adjusting for other confounding factors, MPR (OR=2.962, 95%CI: 1.674~5.242) and LAR (OR=13.045, 95%CI: 3.899~43.649) were still independent risk factors for poor prognosis in patients with severe pneumonia (P<0.05). ROC curves showed that MPR and LAR had clinical significance in predicting the prognosis of patients with severe pneumonia, and the AUC of combined prediction was higher than that of single indicator prediction (P<0.05). Decision curve analysis results showed that MPR combined with LAR prediction could obtain maximum clinical benefit when the threshold probability was 0.30~0.65.

MPR and LAR are closely related to the condition and prognosis of patients with severe pneumonia, and their combined detection has higher efficacy in predicting poor prognosis of patients.

To investigate the clinical manifestations and diagnosis of Epstein-Barr virus (EBV)-associated pulmonary lymphomatoid granulomatosis (PLG) complicated with hemophagocytic syndrome (HPS).

We retrospectively analyzed the clinical features, laboratory findings, and treatment course of a patient with EBV-associated PLG and HPS, along with a literature review.

A 66-year-old female presented with fever, cough, and cutaneous nodular ecchymosis. The comprehensive examination revealed multiple nodules in both lungs, mediastinal lymphadenopathy, and splenomegaly; blood routine test: white blood cell count 2.15×10⁹/L, hemoglobin 77 g/L, platelet count 67×10⁹/L; C-reactive protein (CRP) 24.98 mg/L, erythrocyte sedimentation rate 35mm/1 h, ferritin>2 000.00μg/L, interleukin-2 receptor 7 500.00 U/ml, Epstein-Barr virus quantification positive, hepatitis B surface antigen, hepatitis B e antibody, and hepatitis B core antibody positive; bronchoalveolar lavage fluid next-generation sequencing(NGS) indicated Epstein-Barr virus positivity; bone marrow aspiration showed decreased platelet count and a bone marrow picture. Lung tissue biopsy immunohistochemistry (IHC) shows CD20(+ ) and Ki-67(+ ). Special stains: PAS (-) and PASM (-). In situ hybridization: EBER (+ ). The final pathological diagnosis suggests lymphomatoid granulomatosis cannot be excluded. The final diagnosis included HPS, PLG, EBV infection, chronic hepatitis B, and pulmonary infection. Initial treatment with anti-infectives, anti-inflammatory agents, and antivirals led to symptomatic improvement. However, the patient experienced recurrent pulmonary infections post-discharge. Ten months after onset, she was readmitted for fever and cough, and repeat lung biopsy confirmed B-cell lymphoma, prompting referral to hematology.

This report describes a rare case of EBV-associated PLG progressing to B-cell lymphoma with concurrent HPS. The findings aim to enhance clinicians′awareness of this disease entity.

To analyze the clinical manifestations, diagnostic strategies, and treatment options for eosinophilic granulomatosis with polyangiitis (EGPA), and to improve the early recognition and diagnostic capability of eosinophilic granulomatosis with polyangiitis. Additionally, to explore the efficacy of Mepolizumab monotherapy in patients with antineutrophil cytoplasmic antibody (ANCA)-negative eosinophilic granulomatosis with polyangiitis.

A case of antineutrophil cytoplasmic antibody-negative eosinophilic granulomatosis with polyangiitis admitted to our department on July 26, 2024, was selected. The symptoms, signs, laboratory tests, imaging findings, and treatment process were analyzed, and a literature review was conducted.

The patient was a 43-year-old female admitted due to recurrent wheezing and shortness of breath for over 30 years, along with the discovery of a pulmonary shadow for more than one month. She had a medical history of bronchial asthma, chronic sinusitis, and nasal polyps. Auxiliary examinations showed a peripheral white blood cell count of 8.74×10⁹/L, an absolute eosinophil count of 0.90×10⁹/L, an erythrocyte sedimentation rate of 31 mm/1h, and an elevated eosinophil proportion in bronchoalveolar lavage fluid to 76%. Total cholesterol 6.70 mmol/L, LDL cholesterol 3.98 mmol/L, Lipoprotein (a) 344.0 mg/L, Triglycerides 2.64 mmol/L. IgM positive (1.00 COI), IgG significantly elevated (>300.00 AU/ml). Antineutrophil cytoplasmic antibody testing was negative. Pathological biopsy of the right middle lung lobe revealed eosinophil infiltration in the lung tissue. A diagnosis of antineutrophil cytoplasmic antibody-negative eosinophilic granulomatosis with polyangiitis was considered. The patient was treated with Mepolizumab monotherapy for maintenance. Follow-up outpatient examinations showed a decrease in eosinophil count, and chest CT revealed significant absorption of the pulmonary lesions.

Patients with a long-term history of asthma and persistently elevated peripheral blood eosinophil levels should be alert to the possibility of eosinophilic granulomatosis with polyangiitis. Mepolizumab can serve as an effective maintenance treatment for antineutrophil cytoplasmic antibody-negative eosinophilic granulomatosis with polyangiitis.