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 explore the early identification, clinical characteristics, diagnosis and treatment, and pregnancy outcomes of pregnancy-related fulminant type 1 diabetes mellitus (FT1DM), in order to improve clinicians' diagnostic and therapeutic approach and increase maternal and fetal survival rates.

A retrospective analysis was conducted on the clinical data of 4 patients with pregnancy-related FT1DM. Additionally, a literature search was performed using the keyword " fulminant type 1 diabetes" in the China National Knowledge Infrastructure (CNKI) and Chinese Journal Full-text Database from January 2000 to December 2024. A total of 222 relevant articles and case reports were retrieved, including 423 patients with FT1DM. Among these, 100 cases of pregnancy-related FT1DM were further screened and analyzed.

All four patients presented with a typical acute onset, rapidly progressing from markedly elevated blood glucose (random blood glucose 18.75-38.69 mmol/L) to diabetic ketosis or ketoacidosis within a short period (1-5 days). They exhibited a " dissociation" phenomenon between extremely high random blood glucose and relatively mildly elevated glycated hemoglobin (6.1%-6.9%), with a PG/HbA1c ratio ≥3.3. Fasting serum C-peptide levels were all <100 pmol/L; pancreatic autoantibodies were negative in 3 patients and not tested in 1. Literature analysis of 100 pregnancy-related FT1DM cases showed that the condition was more common during pregnancy (96%, 96 cases), with acute onset (mean time approximately 3 days). The four patients presented with non-specific prodromal symptoms: gastrointestinal symptoms in 2 cases, respiratory symptoms in 1 case, and neurological symptoms in 1 case.Literature analysis of 100 pregnancy-related FT1DM cases showed that The most common prodromal symptoms were gastrointestinal symptoms (24%, 24 cases), followed by respiratory symptoms (16%, 16 cases). After multidisciplinary treatment, 3 neonates survived and 1 was stillborn. Literature analysis showed that the overall pregnancy outcomes were extremely poor, with a fetal loss rate as high as 60% (mainly stillbirths, accounting for 54%).

Pregnancy-related FT1DM has an acute onset and insidious symptoms, and leads to an extremely high rate of fetal loss. Clinicians should enhance their awareness and remain highly vigilant for any non-specific gastrointestinal or respiratory symptoms in pregnant women without a history of diabetes, considering them as possible prodromal signs of FT1DM. Random blood glucose, urine ketone bodies, and pancreatic function (C-peptide) should be tested immediately, and the key feature of " dissociation between blood glucose and glycated hemoglobin" should be used for early differentiation. Emergency protocols should be initiated, and multidisciplinary collaboration should be implemented to improve maternal and fetal survival.

A 59-year-old man with a body mass index of 25.2 kg/m² was diagnosed with adenocarcinoma of the descending colon near the splenic flexure and a rectal tumor 5 cm from the anal verge. Totally laparoscopic left hemicolectomy with transrectal natural orifice specimen extraction surgery (NOSES) was performed together with transanal local excision of the rectal lesion. The inferior mesenteric vein was preserved, and the specimen was removed through an approximately 3 cm upper rectal incision using a double-bag technique. Operative time was 140 min and blood loss was 20 mL. Pathology showed moderately differentiated adenocarcinoma of the left colon (pT₃N_1b; 3/14 lymph nodes positive; perineural invasion present; no definite lymphovascular invasion), with an additional tubulovillous adenoma containing focal intramucosal carcinoma in the same specimen. The rectal lesion was a 0-Ip tubulovillous adenoma with focal moderately differentiated adenocarcinoma invading the head of the submucosa (pT₁), with negative margins and no lymphovascular or perineural invasion. The patient was discharged on postoperative day 6 without complications. This case suggests that an integrated transrectal NOSES and transanal local excision strategy may be technically feasible in carefully selected patients with synchronous left-sided colon and rectal cancer.

A case of severe immune-related colitis complicated by spontaneous transanal passage of necrotic intestinal mucosa following immune checkpoint inhibitor therapy is reported. The patient was diagnosed with stage IV thymic squamous cell carcinoma and was treated with albumin-bound paclitaxel and carboplatin in combination with tislelizumab. At 5.5 weeks after the last cycle of combined chemotherapy and immunotherapy, colonoscopy revealed scattered mucosal congestion, erosions, and superficial ulcers throughout the colorectum. Subsequently, an approximately 20-cm-long segment of dark-red necrotic intestinal mucosa was discharged through the anus. Histopathological examination of intestinal mucosal biopsy specimens supported the diagnosis of immune-related enterocolitis, which was classified as grade 3 according to the Common Terminology Criteria for Adverse Events. Conservative treatment, including bowel rest, nutritional support, mucosal protection, and symptomatic management, resulted in no significant clinical improvement. Following multidisciplinary consultation involving the departments of gastroenterology, colorectal surgery, and oncology, the necrotic intestinal tissue was surgically removed. The patient recovered uneventfully after the procedure. Histopathological examination of the resected tissue demonstrated ischemic necrosis of the intestinal mucosa accompanied by a severe inflammatory response. This case highlights the complexity and diversity of the clinical manifestations, diagnosis, and management of immune checkpoint inhibitor–related colitis. For patients receiving immune checkpoint inhibitors who develop hematochezia or diarrhea, early assessment and grading of colitis, repeated clinical evaluation, and prompt multidisciplinary consultation are recommended. When necrotic tissue is identified or conservative treatment is ineffective, timely surgical intervention should be considered to prevent serious adverse outcomes.

To investigate the correlation of pan-immune-inflammation value (PIV), platelet-to-lymphocyte ratio (PLR), D-dimer (D-D) and cardiac troponin I (cTnI), as well as their combined index, with the risk stratification of acute pulmonary embolism (APE).

A total of 123 APE patients admitted to Tongxiang Hospital of Traditional Chinese Medicine (Zhejiang Province) and Punan Hospital of Pudong New Area (Shanghai) from January 2021 to October 2025 were enrolled. According to pulmonary embolism severity index (PESI) scores, patients were divided into low-risk group (39 cases) and intermediate-high-risk group (84 cases). The influencing factors of APE risk stratification were analyzed, and the predictive value of single and combined indicators for APE severity was evaluated.

The neutrophil count in the intermediate-high risk group was 5.31(3.95, 7.95)×10⁹/L, monocyte count 0.64(0.47, 0.81)×10⁹/L, PIV 565.55 (373.41, 1030.36), D-dimer 7.62(4.08, 15.18)mg/L, cTnI 20.52(8.29, 36.91)ng/ml, SII 992.30(696.69, 1 828.96), NLR 4.46(3.10, 9.44), and PLR 181.56(131.90, 281.31), which were higher than those in the low-risk group [4.46 (3.12, 5.91)×10⁹/L, 0.44 (0.35, 0.51)×10⁹/L, 171.77(127.51, 333.45), 4.31(1.54, 6.89)mg/L, 5.35(2.88, 11.94)ng/ml, 494.21 (295.97, 840.78), 2.67(1.66, 4.39), and 109.03(91.24, 144.61), respectively]; while the lymphocyte count in the intermediate-high risk group was 1.14(0.76, 1.38), lower than that in the low-risk group [1.84 (1.27, 2.12)], and the differences between groups were statistically significant (P<0.05). Multivariate binary Logistic regression analysis confirmed that high levels of PIV, PLR, D-D and cTnI were independent risk factors for intermediate-high-risk APE. Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) of PIV, PLR, D-D and cTnI for predicting intermediate-high-risk APE was 0.827 (95%CI: 0.743~0.911), 0.769(95%CI: 0.681~0.857), 0.694 (95%CI: 0.598~0.790) and 0.735 (95%CI: 0.634~0.835), respectively, while the combined index had an AUC of 0.884 (95%CI: 0.817~0.951). At the optimal cut-off value of 0.560, the sensitivity, specificity and Youden index were 89.29%, 74.26% and 0.636, respectively.

PIV, PLR, D-D and cTnI are influencing factors for the occurrence of intermediate-high risk pulmonary embolism. Elevated levels of PIV, PLR combined with D-D and cTnI are closely correlated with the risk stratification of APE. Combined detection can effectively improve the early identification ability of intermediate-high risk APE and facilitate clinical evaluation.

To investigate the predictive value of peripheral blood inflammatory markers for major pathological response (MPR) in patients with locally advanced nonsmall cell lung cancer (NSCLC) receiving neoadjuvant immunochemotherapy.

A total of 104 patients with locally advanced NSCLC who received neoadjuvant immunochemotherapy at our hospital from February 2022 to January 2025 were retrospectively enrolled. Based on postoperative pathological findings, MPR were divided into the observation group (63 cases) and non MPR were the control group (41 cases). Clinical data, as well as pre and posttreatment neutrophiltolymphocyte ratio (NLR), platelettolymphocyte ratio (PLR), systemic immuneinflammation index (SII), and prognostic nutritional index (PNI), were collected. The change values (Δ=posttreatment-pretreatment) were calculated. LASSO regression was used for variable selection, and multivariate Logistic regression was performed to identify independent factors associated with MPR and to construct a nomogram. The association between dynamic inflammation score and eventfree survival (EFS) was analyzed using the KaplanMeier method with the Logrank test.

After treatment, the observation group showed significantly lower ΔNLR[-0.65(-1.71, -0.27) vs. 0.58 (0.22, 1.94), Z= -5.053, P<0.001], ΔPLR[-48.13 (-102.80, -12.83) vs. 26.22 (-16.87, 60.70), Z=-4.660, P<0.001], and ΔSII[-225.54 (-411.09, -83.77) vs. 380.83 (104.52, 538.33), Z=-5.768, P<0.001], and significantly higher ΔPNI[0.98(-1.80, 3.71) vs. -1.63 (-7.15, 0.79), Z=-5.236, P<0.001] than the control group. Multivariate Logistic regression revealed that pathological subtype (adenocarcinoma vs. squamous cell carcinoma: OR=0.127, 95%CI: 0.021~0.769, P=0.025), histological differentiation (poorly differentiated vs. moderately differentiated: OR=0.022, 95%CI: 0.002~0.294, P=0.004), ΔNLR(OR=0.518, 95%CI: 0.299~0.898, P=0.019), ΔSII (OR=0.996, 95%CI: 0.993~0.998, P=0.002), and ΔPNI (OR=1.514, 95%CI: 1.146~2.001, P=0.004) were independent factors for MPR. The nomogram model yielded an AUC of 0.95 (95%CI: 0.91~0.99) for predicting MPR. The HosmerLemeshow test indicated good model calibration (χ²=6.610, P=0.579), and the decision curve analysis demonstrated a high net clinical benefit within the risk threshold range of 0.10~0.92. Using the median dynamic inflammation score of 0.76 as the cutoff, the lowscore group (52 cases) had a significantly shorter median EFS of 22 months compared with 36 months in the highscore group (52 cases) (Logrank χ²= 30.989, P<0.001).

Dynamic changes in ΔNLR, ΔSII, and ΔPNI before and after neoadjuvant immunochemotherapy are predictive biomarkers for postoperative MPR in patients with locally advanced NSCLC. The nomogram combining these markers with pathological subtype and histological differentiation exhibits excellent discriminative ability, calibration, and clinical net benefit, which may help preoperatively predict pathological response to neoadjuvant immunochemotherapy and provide a reference for longterm recurrence risk stratification.

To analyze the clinical, radiological, laboratory, and histopathological characteristics of indeterminate pulmonary nodules that were highly suspected of malignancy preoperatively but were confirmed as benign by postoperative pathology, and to provide evidence for improving the accuracy of preoperative diagnosis and reducing unnecessary surgical intervention.

A total of 271 patients with pulmonary nodules who were preoperatively suspected of having malignant lesions, underwent surgical resection, and were pathologically confirmed to have benign pulmonary nodules after surgery at our hospital, between January 2020 and December 2024 were retrospectively included. Their clinical baseline characteristics, radiological findings, laboratory results, and pathological data were systematically analyzed.

During the 5-year study period, a total of 13, 201 surgical resections for pulmonary nodules were performed at our hospital, including 961 preoperatively indeterminate pulmonary nodules (7.28%). The 271 patients included in this study were pathologically confirmed to have benign lesions after surgery, accounting for 2.05% of all pulmonary nodule resections during the same period and 28.20% of all preoperatively indeterminate pulmonary nodules. Among the 271 patients, pulmonary nodules were mainly detected during routine health examinations in 166 patients (61.25%), followed by symptom-related detection in 58 patients (21.40%) and incidental detection during evaluation for other diseases in 47 patients (17.34%). Radiologically, multiple nodules were observed in 213 patients (78.60%) and solitary nodules in 58(21.40%); solid nodules were found in 240 patients (88.56%), whereas mixed ground-glass and pure ground-glass nodules were found in 31 patients (11.44%). Nodules were located in the right lung in 165 patients (60.89%) and in the left lung in 106(39.11%). The maximum nodule diameter was >1.0 cm in 162 patients (59.78%) and ≤1.0 cm in 109 patients (40.22%). Among radiological signs suggestive of malignancy, lobulation was the most common, occurring in 101 patients (37.27%), followed by spiculation in 86 patients (31.73%), pleural adhesion in 78 patients (28.78%), and the vascular penetration sign in 68 patients (25.09%). Lymphadenopathy was present in 87 patients (41.83%). PET/CT showed an increased SUVmax in 195 patients (71.96%); among them, 81 patients had an SUVmax ≥2.5 (41.54%), and 114 patients had an SUVmax <2.5 (58.46%). Postoperative pathology showed inflammatory lesions in 184 patients (67.89%), among which granulomatous inflammation accounted for 116 cases; confirmed tuberculosis and fungal infection accounted for 39 cases (33.62%)and 15 cases (12.93%), respectively. Among benign tumors, hamartoma was the most common type, with 36 cases (55.38%), followed by pulmonary sclerosing pneumocytoma in 18 cases (27.69%). Elevated fasting blood glucose was identified in 88 of the 271 patients, with an overall incidence of 32.47%. The incidence of elevated blood glucose was significantly higher in the inflammatory lesion group than in the non-inflammatory lesion group(38.59%比19.54%, P=0.002).Surgical procedures included thoracoscopic wedge resection in 151 patients (55.72%), segmentectomy in 70 patients (25.83%), and lobectomy in 50 patients (18.45%).

Benign pulmonary nodules surgically resected due to preoperative suspicion of malignancy were predominantly solid and multiple, and frequently exhibited imaging features suggestive of malignant nodules. Postoperative pathology most commonly revealed inflammatory lesions, particularly granulomatous inflammation. Abnormal glycemic status was not uncommon in this patient population, suggesting that, in addition to routine imaging assessment and follow-up, glycemic status should also be considered during the preoperative differential diagnosis. Comprehensive evaluation may help optimize clinical decision-making and reduce unnecessary surgical intervention.

To clarify the epidemiological characteristics, viral subtype distribution and population infection patterns of influenza in Ya′an City during surveillance years 2019-2024, so as to provide scientific evidence for targeted prevention and control strategies.

Influenza surveillance data from March 2019 to February 2025 were collected from two national sentinel hospitals in Ya′an City, with zero-positive data generated during epidemic prevention and control in 2020 excluded. Reverse transcription-polymerase chain reaction (RT-PCR) was performed for viral subtyping identification. The chi-square (χ²) test was adopted to compare differences in positive detection rates across different years, seasons and populations.

A total of 13, 454 samples were included, with 2, 535 positive cases (18.84%). The annual differences were significant (P<0.001), and 803 positive cases (29.82%) were detected in 2023. Virus typing was dominated by seasonal influenza A(H3N2) subtype (seasonal H3) with 1, 411 cases (55.66%), followed by influenza B virus Victoria lineage (BV lineage) with 1, 725 cases (28.60%) and 2009 pandemic influenza A(H1N1) virus (novel H1N1) with 399 cases (15.74%); influenza B virus Yamagata lineage (BY lineage) was not detected. The seasonal distribution showed a bimodal pattern, with 1, 020 cases (27.54%) in autumn and 792 cases (24.00%) in winter, and the lowest number of 255 cases (7.93%) in summer; the difference was statistically significant (P<0.001). The 5-14 years age group had 1, 303 positive cases (30.23%); the positive rates among 1, 207students(33.07%) and15 teachers (37.50%) were significantly higher than those in other occupations (P<0.001). The positive rate in the school setting 1, 711 cases( 25.76%) was significantly higher than that outside school 824 cases(12.09%) (P<0.001).

Influenza epidemics in Ya′an City prevail in autumn, winter and spring, with the most prominent peak occurring in autumn. Alternating circulation of seasonal H3, BV and pdm09 A/H1N1 strains is identified, and students and teachers constitute high-risk populations. It is recommended to prioritize influenza vaccination for school-aged children aged 5-14 years, teachers and preschool children, strengthen morning and afternoon temperature checks as well as absence tracking due to illness in key settings such as schools, and establish a two-dimensional early warning system covering viral subtype and seasonal dynamics.