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.

To evaluate the feasibility and clinical value of vital pulp therapy in the treatment of chronic hyperplastic pulpitis in young permanent teeth.

The pulpotomy was used in two cases of young permanent teeth with chronic hyperplastic pulpitis. Combined with literature review, the pathological basis, indications, key operational points, and restorative strategies were discussed.

After a follow-up of 12 to 30 months, the two teeth maintained favorable pulp vitality. Radiographic examination revealed no periapical abnormalities, and continued root development was observed in case 2.

Under strict indication control, vital pulp therapy provides a minimally invasive and effective treatment option for chronic hyperplastic pulpitis in young permanent teeth, which helps preserve pulp vitality and promote root development.

Root fracture represents a severe form of dental trauma, particularly in young permanent teeth. It often leads to displacement of the coronal fragment, compromising the blood supply of dental pulp. Improper management can readily result in complications such as pulp necrosis and inflammatory root resorption, ultimately affecting the long-term survival of the tooth. This article reports a complex case of an 8-year-old male patient with multiple horizontal root fractures accompanied by coronal displacement in the maxillary central incisors. Through a comprehensive conservative approach utilizing resin-reinforced fiber tape for flexible splinting, supplemented by occlusal adjustment and a protective splint, the affected teeth achieved favorable biological healing over a 2-year follow-up period. Although diffuse pulp canal obliteration occurred in the involved teeth, clinical examination revealed no abnormalities and their functional status was good.

This case report presents a successful case of autologous tooth transplantation assisted by three-dimensional (3D) printing technology combined with delayed partial pulpotomy. Preoperative cone-beam computed tomography (CBCT) data of the patient were collected, and Mimics software was used to design and construct a 3D template for the transplanted tooth. After disinfection, the template was used to guide the preparation of the alveolar socket at the recipient site. Following the extraction of the hopeless tooth, the recipient socket was prepared with the aid of the template. 3D printing-assisted digital surgery enabled accurate preparation of the recipient site, reduced the extraoral time of the transplanted tooth, and preserved the viability of the periodontal membrane. The physical dimension of the apical foramen is a critical determinant of revascularization of the transplanted dental pulp. In this case, the apical foramen diameters of the mesial and distal roots were 0.68 mm and 0.91 mm, respectively. Postoperatively, vital pulp preservation was achieved in the distal root with a larger apical foramen. This case provides a novel clinical reference for vital pulp preservation during mature autologous permanent tooth transplantation.

The displacement of a dental bur during impacted tooth extraction and migration to the duodenum is a rare clinical complication. This article reports a case of accidental swallowing and displacement of a dental bur to the duodenum during impacted tooth extraction, and reviews the risk factors, diagnosis, management strategies, and preventive measures based on literature analysis, providing reference for clinical prevention.

Informed by case reports and systematic analysis of the literature, this study aims to offer diagnostic and treatment insights for the early identification of nodule rupture.

This study reports on three cases of nodule rupture following thermal ablation at the First Affiliated Hospital of Dalian Medical University, along with a systematic review of 64 cases from the literature published from January 2019 to May 2025, encompassing an analysis of predisposing factors, time of occurrence, clinical manifestations, imaging features, and treatment strategies associated with nodule rupture.

Among the three cases of nodule rupture following thermal ablation reported at our center, two-dimensional ultrasound and contrast-enhanced ultrasound showed thyroid capsular discontinuity and an extrathyroidal mass with central non-enhancement and peripheral isoenhancement. Case 1 was complicated by abscess formation, with symptom relief achieved through aspiration and drainage; Case 2 experienced nodule rupture secondary to skin burns following ablation performed at an external institution; and Case 3 experienced rupture due to the premature timing of repeat ablation. Both Case 2 and Case 3 achieved complete symptom resolution with conservative management. A systematic review of 64 cases of nodule rupture following thermal ablation revealed that the median time to onset was 28 days postoperatively, 71.9% (46/64) of patients presented with neck pain and 28.1% (18/64) with neck swelling. Ultrasound imaging showed thyroid capsular discontinuity in 95.3% (61/64) of cases. Among the 40 cases with reported rupture type 90.0% (36/40) presented with anterior-type rupture. Additionally, among 58 cases reporting the correlation between initial nodule size and rupture, 86.2% (50/58) had an initial maximum diameter＞2.75 cm. Finally, 89.7% (52/58) of patients initially received conservative management, achieving a complete resolution rate of 50.0% (26/52), while 10.3% (6/58) underwent invasive treatment as the primary intervention.

Nodule rupture following thyroid thermal ablation most frequently occurs in larger nodules and is predominantly characterized by anterior type rupture, with a median time to onset of 28 days postoperatively. Neck pain is the most common clinical manifestation. Two-dimensional ultrasound, in combination with contrast-enhanced ultrasound, plays a critical role in the diagnosis. Conservative treatment is effective in some cases, while invasive treatments can improve overall treatment success.

To investigate the expression characteristics and clinical significance of STE20 family genes in lung squamous cell carcinoma (LUSC), and to explore their association with immune infiltration and their potential as prognostic biomarkers and therapeutic targets.

Transcriptomic data from TCGA, GTEx, and GEO databases (GSE229509, GSE268175) comprising 85 normal lung tissues and 559 LUSC tissues were integrated to analyze the differential expression of STE20 family members. ESTIMATE and TIMER databases were used to evaluate the correlation between STE20s and immune cell infiltration. LASSO regression was employed to construct a prognostic risk model, and random forest model was used to assess the prognostic value of MST4. GO and KEGG enrichment analyses were performed to explore the potential functions of MST4. qRT-PCR and Western blotting were used to validate the expression of key genes in LUSC cell lines (NCIH520, H-1703, SK MES 1).

Among STE20 family members, SPAK, PAK1, PAK6, and MST4 were significantly upregulated in LUSC tissues (P<0.05), while MST1, OSR1, TAO2, MINK, TNIK, and LOK were significantly downregulated (P<0.05). Immune infiltration analysis revealed that MST3, MYO3B, and TNIK were positively correlated with immune scores, whereas MST1, MST4, PAK1, and PAK6 were negatively correlated. TIMER analysis showed that MST4 expression was significantly negatively correlated with infiltration of CD8⁺ T cells (r=-0.23, P<0.001), CD4⁺ T cells (r=-0.19, P<0.01), and macrophages (r=-0.21, P<0.001). LASSO regression identified five prognosis-related genes (PAK1, PAK6, MST1, OSR1, MST4). The risk score model indicated that the high-risk group had significantly shorter overall survival than the low-risk group (HR=2.34, 95%CI: 1.78~3.08, P<0.001). The random forest model predicting 1-, 3-, and 5-year survival achieved AUC values of 0.71, 0.75, and 0.75, respectively. High MST4 expression was associated with poor prognosis (HR=1.89, 95%CI: 1.42~2.51, P<0.001). GO/KEGG enrichment analysis revealed that MST4 is involved in cell cycle, ECM-receptor interaction, and EMT-related pathways. qRT-PCR and Western blotting confirmed that mRNA and protein levels of PAK1, PAK6, and MST4 were significantly higher in LUSC cell lines than in normal lung epithelial cells (BEAS-2B) (P<0.01), while MST1 and OSR1 were significantly lower (P<0.01).

STE20 family genes are aberrantly expressed in LUSC and are closely associated with immune infiltration and prognosis. MST4, as a key member, may promote LUSC progression by regulating cell cycle and ECM remodeling, highlighting its potential as a prognostic biomarker and therapeutic target.

To analyze the clinical characteristics and prognosis of patients with acute respiratory distress syndrome (ARDS).

The clinical data of 75 patients with ARDS admitted to the Second Affiliated Hospital of Army Medical University from December 2020 to January 2024 were retrospectively collected. They were grouped according to prognosis. 41 cases survived as the control group and 34 cases died as the observation group. Compare the basic information, laboratory indicators, lung injury prediction score (LIPS) and acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)of the two groups. Logistic regression was used to analyze the prognostic risk factors of ARDS, and the prognosis of ARDS was predicted by the receiver operating characteristic (ROC) curve.

Among 75 patients with ARDS, severe pulmonary infection in 46 cases (61.33%), severe acute pancreatitis in 19 cases (25.33%), sepsis in 5 cases (6.67%), and severe trauma in 5 cases (6.67%). Forty-one cases (54.67%) survived and 34 cases (45.33%) died. The age of the observation group was (63.06±13.52) years old, and APACHE The Ⅱ score (14.82±5.83) points, LIPS score (6.28±1.72) points, and oxygenation index (145.76±72.24) were statistically different from those of the control group (54.20±13.59) years old, (7.22±3.24) points, (4.63±1.36)points, and (205.27±61.30) (P<,0.05). Logistic regression analysis showed that age (OR: 1.080, 95%CI: 1.011~1.153), LIPS score (OR: 2.245, 95%CI: 1.252~4.027), APACHE Ⅱ score (OR: 1.263, 95%CI: 1.067~1.496) and oxygenation index (OR: 0.988, 95%CI: 0.977~1.000) were risk factors for the prognosis of ARDS. the area under the ROC curve (AUC) showed that the AUC of the APACHE Ⅱ score combined with the oxygenation index was 0.888, the Youden index was 0.707, the sensitivity was 0.853, and the specificity was 0.854.

The APACHE Ⅱ score combined with the oxygenation index can predict the prognosis of ARDS patients, which is helpful for the early identification of high-risk patients and provides a basis for targeted intervention.

To investigate the relationship between the D-dimer to albumin ratio (DAR), chest computed tomography (CT) parameters, and pulmonary function in acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

A retrospective analysis was conducted on 83 patients with AECOPD (observation group) and 82 patients with COPD (control group) admitted to our hospital from March 2019 to December 2024. Pulmonary function, DAR, and CT parameters were compared between the two groups. Spearman′s rank correlation analysis was used to evaluate the relationships among DAR, chest CT parameters, and pulmonary function.

The DAR in the observation group was significantly higher than that in the control group [17.90 (12.17, 38.93) vs. 8.39 (6.27, 13.73), P<0.001]. The area under the receiver operating characteristic (ROC) curve (AUC) for DAR in diagnosing AECOPD was 0.827, which was higher than that of C-reactive protein (AUC 0.803), neutrophil count (AUC 0.647), lymphocyte count (AUC 0.639), and monocyte count (AUC 0.637). The lung volume in the observation group was significantly lower than that in the control group [(3.58±0.93)L vs. (4.77±1.14)L, t=7.351, P<0.001], while the emphysema index (EI) [19.36(10.62, 30.46)% vs. 6.03(3.83, 12.08)%, Z=-6.965, P<0.001] and air trapping index (ATI) [0.97±0.02 vs. 0.91±0.02, t=19.270, P<0.001] were significantly higher. The forced expiratory volume in one second (FEV₁) [53.00 (42.00, 69.00)% vs. 62.50 (50.00, 74.00)%, Z=-2.259, P=0.024], FEV₁/forced vital capacity (FVC) [58.22 (51.87, 65.48)% vs. 63.71 (55.23, 68.77)%, Z=-2.720, P=0.007], maximum mid-expiratory flow (MMEF) [25.00 (15.25, 34.50)% vs. 29.55 (21.05, 41.00)%, Z=-2.030, P=0.042], and carbon monoxide diffusing capacity (DL_CO) [63.00 (45.50, 77.50)% vs. 75.00 (55.25, 89.00)%, Z=-3.222, P=0.001] were significantly lower in the observation group compared to the control group (P<0.05). Spearman′s rank correlation and multiple linear regression analyses showed that DAR was negatively correlated with FEV₁ (Rho=-0.287, P<0.001), FEV₁/FVC (Rho=-0.264, P<0.001), and MMEF (Rho=-0.267, P<0.001). Lung volume was positively correlated with FEV₁(Rho=0.336, P<0.001), FEV₁/FVC (Rho=0.281, P<0.001), MMEF (Rho=0.215, P=0.001), and DL_CO (Rho=0.195, P=0.011). ATI was negatively correlated with FEV₁ (Rho=-0.311, P<0.001), FEV₁/FVC (Rho=-0.309, P<0.001), MMEF (Rho=-0.286, P<0.001), and DL_CO (Rho=-0.299, P<0.001). EI was negatively correlated with FEV₁ (Rho=-0.281, P<0.001), FEV₁/FVC (Rho=-0.289, P<0.001), and DL_CO (Rho=-0.162, P=0.038). The AUC of DAR for predicting readmission or death in AECOPD was 0.783 (95%CI: 0.575~0.992), with an optimal cutoff value of 16.448. Kaplan-Meier survival curve analysis showed that the event-free survival rate of AECOPD patients with DAR<16.448 (n=18) was significantly higher than that of patients with DAR ≥16.448(n=19) (88.89% vs. 47.37%, χ²=6.973, P=0.008).

DAR, lung volume, EI, and ATI in AECOPD patients are correlated with pulmonary function parameters.

To investigate the factors influencing the efficacy of non-invasive positive pressure ventilation (NIPPV) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) combined with obstructive sleep apnea (OSA), and to evaluate the clinical value of different nocturnal ventilation strategies.

A retrospective analysis was conducted on 138 patients with AECOPD complicated by OSA admitted to our hospital from April 2022 to December 2025. Based on the therapeutic effect of NIPPV during hospitalization, patients were divided into two groups: 93 cases in the observation group (effective treatment) and 45 cases in the control group (ineffective treatment). General data, arterial blood gas parameters, sleep monitoring data, and ventilation parameters were collected from both groups. Univariate and multivariate logistic regression analyses were used to identify factors influencing the therapeutic effect.

Univariate analysis showed that body mass index (BMI), arterial partial pressure of carbon dioxide (PaCO₂), positive end-expiratory pressure (PEEP), NIPPV initiation delay time, nocturnal ventilation strategy, apnea-hypopnea index (AHI), and minimum pulse oxygen saturation (miniSpO₂) were associated with the efficacy of NIPPV (P<0.05). Multivariate logistic regression analysis revealed that BMI (OR=0.87, P=0.024), PaCO₂ (OR=0.94, P=0.006), and AHI (OR=0.91, P=0.005) were negative predictors; whereas ΔPEEP increment (OR=1.88, P=0.004), shorter NIPPV delay time (OR=0.78, P=0.019), active nocturnal PEEP up-titration (OR=4.26, P=0.002), and higher miniSpO₂ (OR=1.12, P=0.009) were protective factors. The area under the receiver operating characteristic (ROC) curve (AUC) was 0.839.

High BMI, PaCO₂, and AHI, moderate nocturnal increase in PEEP, early initiation of NIPPV, and high oxygen saturation can improve the therapeutic effect of NIPPV in patients with AECOPD combined with OSA. Optimizing ventilation parameters and intervention timing has clinical significance for enhancing ventilation efficiency and sleep quality in these patients.

To analyze the relationship between serum levels of glycan antigen 6 (KL-6) and pulmonary surfactant protein D (SP-D) in patients with connective tissue disease-related interstitial lung disease (CTD-ILD) and the diagnosis and severity of chest high-resolution computed tomography (HRCT), in order to investigate their clinical significance.

A total of 221 patients with CTD admitted to our hospital from January 2022 to December 2025 were retrospectively enrolled, comprising 81 patients with CTD-ILD and 140 patients with CTD alone. Based on whether they had received anti-CTD medication within the preceding 3 months, the patients were stratified into the following subgroups: the untreated CTD-ILD group 39 cases and the treated CTD-ILD group 42 cases; the untreated CTD group 70 cases and the treated CTD group 70 cases. Enzyme linked immunosorbent assay was used to measure serum KL-6 and SP-D levels. The diagnostic efficacy of serum KL-6 and SP-D were evaluated to predict CTD-ILD using binary logistic regression and receiver operating characteristic (ROC) curves. Spearman correlation analysis was used to explore the relationship between KL-6, SP-D and pulmonary function and HRCT scores.

Compared with the CTD group, the serum levels of KL-6 [855.39 (419.03, 1 281.28) U/ml vs. 182.71 (138.83, 231.68)U/ml], SP-D[64.56(61.10, 68.36) ng/ml vs. 49.27 (46.94, 52.50)ng/ml], and red blood cell distribution width-standard deviation (RDW-SD) [48.30(45.00, 51.40) fL vs. 44.40 (42.00, 48.10) fL] were significantly higher in the CTD-ILD group (P<0.05). Multivariate logistic regression analysis demonstrated that SP-D (OR=1.085, P<0.001), KL-6 (OR=1.009, P<0.001), and RDW-SD (OR=1.061, P=0.014) were independent risk factors for the development of CTD-ILD. ROC curve analysis indicated that the combination of KL-6, SP-D, and RDW-SD yielded the optimal predictive performance for CTD-ILD. The areas under the curve in the untreated and treated groups were 0.975 and 0.951, respectively, with corresponding sensitivity and specificity reaching 100.00% and 94.31% in the untreated group, and 76.89% and 95.12% in the treated group. Spearman correlation analysis showed that in both treated and untreated CTD-ILD patients, KL-6 and SP-D were significantly negatively correlated with pulmonary function parameters (r=-0.618~-0.278, P<0.05), and positively correlated with HRCT scores (untreated group: r=0.356 and 0.478; treated group: r=0.331 and 0.412; all P<0.05).

KL-6 and SP-D could be more promising biomarkers for diagnosing CTD-ILD and assessing its severity, and their diagnostic value is not affected by CTD disease subtypes and drug interference.

To observe the clinical efficacy of tumor hyperthermia combined with Yiqi Fuzheng mixture in the treatment of lung cancer with malignant pleural effusion.

A total of 118 patients with lung cancer and malignant pleural effusion admitted to our hospital from January 2022 to January 2025 were selected and randomly divided into Group A 41 cases, Group B 40 cases, and Group C 37 cases. All patients underwent pleural puncture and catheter drainage. Group A received tumor hyperthermia alone, Group B received Yiqi Fuzheng mixture alone, and Group C received tumor hyperthermia combined with Yiqi Fuzheng mixture. The malignant pleural effusion remission rate, tumor marker parameters serum carbohydrate antigen 125 (CA125), carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA21-1), neuron-specific enolase (NSE), total scores of primary and secondary symptoms in the traditional Chinese medicine (TCM) syndrome score, and adverse reactions were compared among the groups.

After treatment, 37 cases (100.00%) in group C had remission of malignant pleural effusion, which was higher than 35 cases (85.37%) in group A and 32 cases (80.00%) in group B (P<0.05). After treatment, CA125, CEA, CYFRA21-1, and NSE in each group decreased compared with those before treatment. The levels of CA125 (19.97±5.13) U/ml, CEA (24.36±3.18) ng/ml, CYFRA21-1 (3.21±0.43) ng/ml, and NSE (21.23±3.84) ng/ml in group C were lower than those of group A[CA125(25.84±5.61) U/ml, CEA(28.12±4.39) ng/ml, CYFRA21-1(4.67±0.48)ng/ml, NSE(25.06±4.24) ng/ml] and group B[CA125(30.06±7.28) U/ml, CEA(32.11±4.96)ng/ml, CYFRA21-1(5.36±0.54) ng/ml, NSE(32.13±4.72)ng/ml] (P<0.05). The total main symptom score and secondary symptom total score of each group decreased after treatment, and the scores of main symptoms (5.27±1.02) and secondary symptom total score (2.01±0.76) in group C were lower than those of group A main symptoms(7.95±1.09), secondary symptom total score(2.97±0.82) and group B main symptoms(9.23±1.37), secondary symptom total score(3.74±0.91) (P<0.05). There were 13 cases (35.14%) of nausea, vomiting, and chest pain in group C, which were not statistically different from 16 cases (39.02%) in group A and 11 cases (27.50%) in group B (P>0.05). After one year follow up, 14 cases (34.15%) in group A survived, 27 cases (65.85%) died; 12 cases (30.00%) in group B survived, 28 cases (70.00%) died; 18 cases (48.65%) in group C survived, 19 cases (51.35%) died(χ²=3.124, P=0.210).

Tumor hyperthermia combined with Yiqi Fuzheng mixture in the treatment of lung cancer with malignant pleural effusion can effectively control fluid accumulation, reduce the levels of tumor markers CA125, CEA, CYFRA21-1, and NSE, and improve clinical symptoms, and has clinical significance.