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.

This study analyzes the pathologic complete response (pCR) in five patients with limited-stage small-cell lung cancer (LS-SCLC) following neoadjuvant therapy, presenting their clinical characteristics, treatment regimens, and prognoses.

This article reports a case of primary muscle-invasive urothelial carcinoma of the bladder diagnosed in a male patient 9 years after allogeneic kidney transplantation. The patient presented with a one-week history of painless gross hematuria. Computed tomography (CT) and magnetic resonance (MR) imaging revealed a space-occupying lesion at the bladder base and right wall. Pathological examination following transurethral resection of the bladder tumor (TURBT) indicated high-grade invasive urothelial carcinoma. Given the patient's long-term immunosuppressive therapy, multiple comorbidities (particularly severe cardiac dysfunction), and inability to tolerate radical cystectomy or standard chemotherapy, monotherapy with the antibody-drug conjugate (ADC) disitamab vedotin (RC48) was initiated. A multidisciplinary consultation organized by the Guangdong Urological Association concluded that the patient was not a surgical candidate and was unsuitable for combined immunotherapy. It was recommended to switch the immunosuppressive regimen to sirolimus, which has potential antitumor effects, and to perform genetic testing to guide further targeted therapy. After communication with the patient and family, treatment with disitamab vedotin was continued. After the 11th cycle, a second cystoscopy with pathological biopsy of the original tumor site and margins showed no residual carcinoma, indicating a pathological complete response. The treatment was well-tolerated with alopecia as the only notable adverse event. This case suggests that disitamab vedotin monotherapy is a promising and effective option for renal transplant recipients with muscle-invasive bladder cancer who are ineligible for standard treatments due to poor general condition.

房性心动过速（房速）是心脏外科术后常见并发症，目前治疗策略以抗心律失常药及射频消融为主。本文报道1例主动脉瓣及二尖瓣机械瓣置换术后反复发作阵发性心房颤动、房速，三维激动标测示先后存在2种房速，即围绕三尖瓣环及手术瘢痕的“8”字折返性房速及冠状静脉窦内局灶性房速。术中依次行三尖瓣环峡部线性消融、瘢痕-下腔静脉口连线消融、双肺静脉前庭隔离及冠状窦内局灶消融后，房速终止，术后随访6个月，无心动过速复发，给临床治疗提供新的诊疗思路。

全皮下植入型心律转复除颤器（S-ICD）是治疗心脏性猝死的重要手段，S-ICD术后出现不恰当放电发生率相对较低。本文报道1例S-ICD术后发生肌电干扰、P波/T波过感知且QRS波振幅较低三重计数致误放电。经重新调整除颤电极位置后未再出现肌电干扰，但左侧卧位时QRS波振幅低，仍有放电，再次调整参数，嘱患者避免左侧卧位，未再出现放电。亦在为S-ICD术后出现不恰当放电处理提供参考。

尖顶军盔征（SHS）由Littmann在2011年提出，因心电图特征与1842年普鲁士国王军盔形状相似而得名，表现为QRS波前基线向上偏移、R波尖锐及ST段抬高。本文报道1例冠心病介入治疗后脑出血患者心电图表现为SHS。

双左前降支（LAD）变异为少见的冠状动脉（冠脉）先天性变异，其特点为两根前降支同时位于前室间沟内，较短者结束于高位前室间隔沟内，较长者则进入远端前室间沟内供应心尖部。本次报道病例为典型稳定性心绞痛患者，冠脉造影示LAD近段闭塞，血管内超声检查始终未发现LAD闭塞开口，遂行冠脉CT血管造影证实为双前降支，短前降支自左主干发出，长前降支自右冠脉近段圆锥支发出，走行于主动脉和右心室流出道之间，最终诊断为Ⅵ型双LAD变异。

To explore the clinical characteristics and genetic variation features of children with Majeed syndrome (MS).

One child with MS (patient 1) diagnosed and treated in the First Affiliated Hospital of Xinjiang Medical University in July 2022 was selected as the study subject. A retrospective analysis of her clinical case data was conducted. Relevant research literature on MS patients in domestic and international databases was retrieved, and the clinical features, genetic characteristics, and treatment outcomes of these patients were analyzed. Patient 1 and her guardians were informed consent for the diagnosis and treatment.

① Patient 1 was a 14.7-year-old female with a history of recurrent multi-joint pain for over 12 years, accompanied by growth retardation, short stature (height 129 cm), and occasional fever. Laboratory findings indicated low red blood cell count and hemoglobin (Hb) level, high erythrocyte sedimentation rate, and elevated interleukin (IL)-6 levels. MRI of bilateral sacroiliac joints and knees showed inflammatory changes in the metaphyses of the large joints of the lower limbs. Patient 1 was initially diagnosed as ＂systemic juvenile idiopathic arthritis (JIA) to be ruled out＂, and was treated with glucocorticoids, later adjusted to glucocorticoids + methotrexate / methotrexate + adalimumab, all with poor efficacy. Whole-exome sequencing (WES) of patient 1 revealed a homozygous mutation in the LPIN2 gene [Exon20 c. 2585C>G (p.Pro862Arg)], and confirming the diagnosis of MS. Based on repeated cytokine tests showing high IL-6 levels, the IL-6 inhibitor tocilizumab was administered. After 6 months of follow-up, her joint pain significantly improved, and her height at the last follow-up was 140.0 cm. ② Literature review results: a total of 16 relevant research articles on MS patients were retrieved globally, including patient 1, encompassing 40 MS patients for analysis. Among them, 3 were adults and 37 were children; the ratio of males to females was 23∶13, with 4 cases of unknown gender; all cases were reported from 7 countries, mainly concentrated in Asia. Among the 30 cases reporting parental consanguinity, 23 had consanguineous parents, including 1 case from China (patient 1) and 22 cases (73.3%, 22/30) from other countries. The top four clinical manifestations of 40 patients were congenital dyserythropoietic anemia (CDA) accounted for 97.5% (39/40), chronic recurrent multifocal osteomyelitis (CRMO) accounted for 95.0% (38/40), recurrent fever accounted for 67.5% (27/40), and growth retardation accounted for 62.5% (25/40). At least 24 pathogenic LPIN2 gene mutations were identified. Biologics, such as IL-1 inhibitors, showed good efficacy.

MS is a rare autosomal recessive genetic disorder. Early genetic testing helps confirm the diagnosis of MS, reduce misdiagnosis, and enable timely personalized treatment to mitigate the impact on the child′s growth velocity and skeletal development.

To investigate the clinical characteristics and genetic variations of Gitelman syndrome (GS).

A case of GS diagnosed in November 2024 at Xi′an Children′s Hospital (patient 1) was included in the study. Clinical data, whole-exome sequencing (WES) results, and sanger sequencing validation results of patient 1 were retrospectively collected. Variants identified were classified for pathogenicity according to the Standards and Guidelines for the Interpretation of Sequence Variants by the American College of Medical Genetics and Genomics (ACMG). Literature on pediatric GS cases confirmed to be caused by SLC12A3 gene mutations was retrieved from the China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP Chinese Science and Technology Journal Database, and PubMed, using the Chinese and English keywords " Gitelman syndrome" and " SLC12A3". The literature search period was set from January 1, 2022, to March 31, 2025. The procedures of this study complied with the regulations of the Ethics Committee of Xi′an Children′s Hospital and were approved by the committee (Approval No.20240133). Informed consent was obtained from the guardian of patient 1.

①The patient is a 6-year-and-6-month-old boy who admitted to case collected hospital with " intermittent vomiting for two week." The results of relevant auxiliary examinations at admission showed low serum K⁺ concentration which was 1.64 mmol/L and low serum Cl^- concentration which was 89.7 mmol/L while serum Mg²⁺, Ca²⁺, and Na⁺ concentrations were normal. Despite repeated potassium supplementation, the therapeutic response was poor. The etiology of hypokalemia remained unclear, suggesting the possibility of an underlying genetic disorder. His result of genetic testing showed SLC12A3 gene compound heterozygous mutations: c. 1956delC(p.Asn653Thrfs*19) and c. 2029G>A(p.Val677Met), inherited from his father and mother, respectively. Based on his clinical manifestations and genetic testing results, he was diagnosed as GS. After oral treatment by potassium chloride and spironolactone, the patient 1 showed no recurrence of vomiting symptoms upon follow-up until May 2025, with serum electrolyte levels remaining within normal ranges. ②Literature review results: a total of 20 pieces of relevant research literature involving 24 cases of GS children caused by SLC12A3 gene mutations were retrieved. Among them, 7 cases exhibited growth retardation, and 3 cases primarily presented with vomiting symptoms at onset. All patients demonstrated hypokalemia. Six cases showed normal serum magnesium levels, while the remaining patients exhibited varying degrees of hypochloremic alkalosis, hypophosphatemia, hypocalciuria, and elevated renin-angiotensin-aldosterone system activity.

Childhood GS has an atypical clinical presentation in childhood. The presence of refractory hypokalemia and metabolic alkalosis warrants high clinical suspicion, and prompt genetic confirmation is critical for diagnosis and treatment.

To explore the clinical manifestations, diagnosis and treatment methods of patients with uterine cystic adenomyoma (UCA).

A patient with spontaneous rupture of UCA who was treated at the Chengdu First People′s Hospital in June 2023 (patient 1) was selected as the subject. A retrospective analysis method was used to collect the patient′s examination results after admission, main treatment process, pathological examination and follow-up results. Keywords such as " uterine cystic adenomyoma" " uterine adenomyosis cyst" " cystic adenomyoma" " adenomyotic cyst" " uterine adenomyoma" in both Chinese and English were used to retrieve literature related to UCA from CNKI, Wanfang Data Knowledge Service Platform, VIP Chinese Science and Technology Journal Database, and PubMed literature databases. The literature search time was set from the establishment of the above databases to August 31, 2024. The procedures followed in this study were in accordance with the requirements of Helsinki Declaration of the World Medical Association revised in 2013.

①Patient 1, a 38-year-old woman (G₁P₁), had a history of cesarean delivery. Her menstrual cycle was regular, without dysmenorrhea, and her last menstruation started on June 25, 2023. On June 28, 2023, she was admitted to emergency department of our hospital due to " sudden lower abdominal pain, continuous colic, with nausea and vomiting". And the pain was relieved after treatment. On June 30, 2023, follow-up at our hospital′s gynecology outpatient clinic showed significant pain relief, but transvaginal color Doppler ultrasound indicated abnormalities. She was hospitalized in our hospital on July 3, 2023. Enhanced abdominal CT after admission revealed abnormal uterine morphology, uneven enhancement, a 4.5 cm × 4.4 cm × 4.5 cm mass posterior to the uterus, poorly defined, suggesting a uterine tumor. The initial diagnosis upon admission was pelvic mass, suspected adnexal mass, intestinal tumor, or sacral tumor. On July 6, 2023, single-port laparoscopy and UCA resection were performed. Intraoperatively, old hemorrhage and a 5 cm × 5 cm × 4 cm uterine mass near the posterior cervix were found, containing a chocolate-like cystic lesion. Based on medical history, clinical presentation, auxiliary tests, surgery, and pathological examination results, patient 1 was diagnosed with ruptured UCA. After the operation, she was treated with leuprorelin and long-term oral administration of dienogest. The results of vaginal ultrasound about 2 years after the operation showed a uterus of 6.3 cm × 4.1 cm × 4.3 cm with multiple hypoechoic nodules, the largest (2.0 cm × 1.9 cm × 1.7 cm) in the posterior wall, with relatively clear borders but irregular shape. ②Literature review results: According to the literature search strategy set for this study, excluding cases of juvenile UCA in patients under 30 years of age, 25 articles related to adult UCA patient studies were retrieved, involving 54 UCA patients. Combining patient 1, a total of 55 UCA patients were studied. The median age of these 55 patients was 38.6 years; 14 patients (25.5%) had clinical symptoms of prolonged menstruation, increased menstrual flow with abdominal pain, 11 patients (20.0%) had progressively severe dysmenorrhea, 17 patients (30.9%) had irregular vaginal bleeding, 7 patients (12.7%) had acute abdominal pain or chronic pelvic pain, and 6 patients (10.9%) had pelvic or uterine cavity mass. Only 12 patients (21.8%) were preoperatively diagnosed with UCA, while the other 43 patients (78.2%) were misdiagnosed, and all 55 cases were diagnosed as UCA by histopathological examination. And 47 patients (85.5%) underwent surgical treatment, 7 patients underwent ultrasound-guided puncture, and 1 patient underwent conservative treatment. After treatment, the above clinical symptoms were relieved.

UCA is difficult to diagnose preoperatively and is easily misdiagnosed. It needs to be diagnosed based on the patient′s clinical manifestations, imaging examinations, and pathological examinations. Surgery is the main treatment method with a relatively good prognosis.

Primary peritoneal mesothelioma, especially malignant peritoneal mesothelioma (MPM), is clinically rare. It is characterized by insidious onset, lack of specific symptoms, and poor treatment effect. Rapid and definite diagnosis is of great significance for follow-up treatment of peritoneal mesothelioma. According to the pathogenesis characteristics of one MPM patient, this case report presents a rapid diagnosis method guided by strong logic, and in order to provide reference for the rapid diagnosis of similar clinical cases.