To evaluate the features of carotid web (CW) by ultrasonography.

A total of 66 patients with CW were retrospectively enrolled from January 2018 to June 2019 at Xuanwu Hospital, Capital Medical University. All patients were examined by both ultrasonography and CTA, and were divided into either a<50% stenosis group (54 cases) or a ≥50% stenosis group (12 cases). The ultrasonographic characteristics of CW, including the length, thickness, direction (forward or backward to the flow), acute angle between the web and carotid wall, and thrombus between the web and carotid wall were compared between the two groups. The stenosis degrees of carotid artery were compared between patients with and without ischemic stroke.

Forty-two (42/66, 63.6%) patients were diagnosed with CW by initial CDFI examination, of whom 21 (21/66, 31.8%) were diagnosed with ulcerative plaque and 3 (3/66, 4.5%) were diagnosed with carotid dissection at first but confirmed by second examination. There were no differences in the web length, thickness, direction, or thrombus detected between the two groups (P>0.05). The angle between the web and carotid wall in the<50% stenosis group was significantly smaller than that of the ≥50% stenosis group (median angel 39o vs 73o, P=0.002), and the percentage of patients with an angle≤ 60o in the<50% stenosis group was significantly higher than that of the ≥50% stenosis group (74.1% vs 41.7%, P=0.042). The diameter of the residual carotid artery at CW location in the<50% stenosis group was significantly larger and peak systolic velocity was significantly higher in the<50% stenosis group than in the≥50% stenosis group (P<0.001). The stenosis degrees of carotid artery were not statistically different between patients with and without ischemic stroke (P=0.321).

Ultrasonography can be used to evaluate the characteristics of carotid web in 2D and color mode. When the angle between the CW and carotid wall is large, the carotid artery stenosis ≥ 50% is more likely to happen, but carotid artery stenosis is not the main cause of ischemic stroke.

The aim of the present study was to evaluate the efficiency of sling exercise, therapeuticultrasound, therapeuticultrasound and sling exercise in patients to alleviate pain and improve lumbar function with lumbar disc herniation.

Individuals were selected from a list of patients being followed at the department of Rehabilitation in the third hospital of Hebei Medical University. 30 patients who were diagnosed with lumbar disc herniation were collected, the diagnoses were established upon medical history, physical examination, and results of imaging studies. The patients were randomly divided into three groups: therapeuticultrasound group received 14 sessions of ultrasonic therapy to the lumbar region, Sling exercise group received 14 sessions of sling exercise, and therapeuticultrasound and sling exercise group received therapeuticultrasound and sling exercise therapy 14 sessions of therapeuticultrasound to the lumbar region,7 sessions per week, 2 weeks. The VAS and ODI were compared with the assessment of the patients before and at the end of the therapy.

At the end of treatment, three groups VAS scores (F=3.069, P=0.043) and ODI scores (t=12.676, P<0.001) was lower than that at the beginning of treatment (P<0.05), at the end of treatment the VAS scores (F=59.400, P<0.001) and of the ODI scores (t=12.737, P<0.001) of ultrasonic and sling exercise therapy group was lower than the other group, the difference is significantly.

All three groups could reduce pain and improve lumbar function, and the ultrasonic and sling exercise therapy was most effective for lumbar disc herniation treatment in the three groups.

To analyze the treatment of different types of traumatic cerebral infarction in children, and explore its pathogenesis in combination with literature so as to improve the cure rate and reduce disability rate.

The clinical data of 42 cases of traumatic cerebral infarction in children were retrospectively analyzed in The Hospital of 81^st Group Army PLA from January 2015 to December 2019. The diagnosis of traumatic cerebral infarction in children was made by CT scan and MRI scan. According to different conditions, children with traumatic cerebral infarction were classified, and different treatment strategies were selected. Children with lacunar infarction were treated with calcium antagonists and neurotrophic drugs, supplemented by hyperbaric oxygen and exercise rehabilitation. The children of focal cerebral infarction and complex cerebral infarction treated by junior dehydrant and hormone also included the calcium antagonist and nutritional nerve drugs. The therapeutic regimen perhaps adjusted by the evolution of the disease. The children of extensive cerebral infarction underwent emergency cranial decompression, and was treated by reducing intracranial pressure and preventing complications after operation. The treatment results and recovery were observed.

In 42 cases of traumatic cerebral infarction in children, 35 cases (83.3%) were good recovery, 4 cases (9.5%) were moderate disability, 2 cases (4.8%) were severe disability, 1 case (2.4%) died, and no vegetative state. The good recovery rate of lacunar infarction was 100%, that of focal cerebral infarction was 62.5%, that of mixed cerebral infarction was 60%, and that of extensive cerebral infarction was 50%.

It is of great significance to improve the therapeutic effect and prognosis of children with traumatic cerebral infarction to adopt different treatment schemes for different types of cerebral infarction.

To characterize the patients with supratentorial hypertensive intracerebral hemorrhage (ICH) in the Tibetan Plateau over an altitude of 4000 meters.

A total of 68 cases with supratentorial hypertensive ICH were retrospectively included in Ali Regional People’s Hospital from January 2017 to September 2018. The clinical and laboratory data were collected. A simple linear correlation analysis was applied to analyze the correlation between the amount of bleeding and sex, age, nationality, time from onset , systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), serum triglyceride (TG), and cholesterol. According to computed tomography (CT) findings, 68 cases were divided into the basal ganglia ICH group (33 cases) and the lobar ICH group (35 cases). The characteristics between two groups were analyzed using t-test or χ² test.

The data of sex, age, nationality, time from onset, SBP, DBP, Hb, TG, and cholesterol of 68 cases on admission did not show any definitive correlation with the hematoma volumes (P＞0.05). The SBP and DBP of patients in the basal ganglia ICH group were significantly higher than that in the lobar ICH group, respectively [(184.9±28.5) mmHg vs (164.6±24.4) mmHg; (113.0±18.1) mmHg vs (103.0±18.4) mmHg] (t=0.499, 0.486; P=0.002, 0.033).

The relevant factors of hematoma volumes in patients with ICH in plateau area were not yet clear. Diastolic and systolic blood pressure of patients in the basal ganglia ICH group was higher than that in those in lobar ICH group.

To compare the efficacy evaluation of electrospun composite biomaterials and a porcine small intestine submucosa mesh for hernia repair.

A randomized, single-blind, controlled multicenter trial was performed in 3 hospitals in Shanghai. Eligible adult patients with primary unilateral reducible groin hernias were randomly assigned (1∶1) to electrospun composite biomaterials (experimental group) or porcine small intestine submucosa (control group) mesh groups. Patients were treated with the tARB technique and assessed at 1,3 and 6 months after the surgery. The primary endpoint was hernia recurrence. The secondary endpoints were postoperative complications including groin pain and operative site infections.

172 patients were assigned to experimental (n=86) and control (n=86) groups. At 6 months follow-up, postoperative complications occurred in 5 patients (5/86, 5.95%) and 2 (2/86, 2.35%) patients in the control and experimental groups, respectively (P>0.05). There was no significant difference in VAS or SVS score between the two groups.

We demonstrate that electrospun composite biomaterial mesh can be used as a ideal choice for inguinal hernia repair. Electrospun composite biomaterial has the characteristics of low recurrence rate, absorbability and long-term comfort.It can be further applied in clinical practice in the future.

Pancreaticoduodenectomy(PD)remains one of the most complicated hepatobiliary operations. The development of minimally invasive surgery for PD has always been an hot spot. Laparoscopic pancreaticoduodenectomy(LPD) has not been widespread carried out due to its difficulty and long learning curve. LPD accounts for 9% of all PD, according to the National Cancer Data base. Compared with laparoscopic surgery, robotic surgery system has significant advantages in the field of minimally invasive PD, including stereotactic amplified vision, filtering hand tremor and simulating the wrist. The article would review the surgical techniques and notes, which could provide clinical reference for other surgeons.

Percutaneous coronary intervention (PCI) significantly improves the prognosis of patients with coronary artery disease. However, the long-term presence of permanent metallic stents may lead to adverse events, including late in-stent thrombosis, neoatherosclerosis, and impaired vasomotor function. Drug-coated balloons (DCBs) effectively relases the antiproliferative drugs to the vascular wall during balloon inflation. Since no permanent implant remains after balloon withdrawal, DCBs embody the " intervention without implantation" concept, and significantly reducing complications associated with long-term implant retention. Sirolimus-coated balloons (SCBs), as a next-generation of DCBs, exert both antiproliferative and anti-inflammatory effects. In recent years, SCBs have been increasingly used for the treatment of in-stent restenosis, in situ small-vessel coronary lesions, and certain complex coronary lesions, with accumulating evidence suggesting favorable safety and efficacy. Intravascular imaging facilitates precise evaluation of reference vessel diameter, plaque morphology, calcification severity, and effect of lesion pretreatment, whereas coronary functional assessment helps determine the ischemic relevance of target lesions and evaluate post-operative hemodynamic improvement. The integrated application of intravascular imaging and functional assessment may facilitate more precise lesion screening, operational strategy formulation, and treatment response evaluation in SCB-based interventions. This review summarizes the mechanisms of action, technical characteristics, and clinical applications advancements of SCBs guided by intravascular imaging and functional assessment. Furthermore, it also discusses the limitations of current evidence and unresolved clinical issues, aiming to provide a reference for individualized interventional decision-making in coronary artery disease.

Autosomal dominant polycystic kidney disease (ADPKD) is a common inherited kidney disorder. Its core pathogenesis involves PKD1/PKD2 gene mutations leading to polycystin dysfunction, which subsequently results in cyst formation and kidney injury. Based on the 2025 KDIGO guidelines, renal ultrasound is the preferred screening modality, combined with the Mayo imaging classification (MIC) and predicting renal outcome in polycystic kidney disease (PROPKD) score for precise risk stratification. Magnetic resonance imaging (MRI) is utilized for kidney volume analysis to monitor disease progression, complemented by genetic testing to identify pathogenic variants. Therapeutically, tolvaptan serves as the pivotal agent that can significantly delay cyst growth and kidney failure. This review systematically outlines the background and pathogenesis of ADPKD, with a focus in the latest standards for imaging and genetic diagnosis, as well as cutting-edge advances such as gene and cell therapies, aiming to provide a reference for the precise clinical diagnosis and management of ADPKD.

Owing to their insidious onset and atypical early symptoms, ureteral tumors are prone to missed diagnoses and misdiagnoses. Accurate diagnosis is crucial for improving patient prognosis. Multimodal imaging techniques provide comprehensive diagnostic evidence through their complementary advantages. Among them, computed tomography urography (CTU) has become the core method for lesion detection and staging due to its high spatial resolution; multi-parametric magnetic resonance urography (MRU) has unique advantages in soft tissue evaluation; ultrasonography and positron emission tomography-computed tomography (PET/CT) play important roles in preliminary screening and metastatic lesion detection, respectively. AI-based radiomics enhances diagnostic accuracy and efficiency by extracting quantitative features from images and integrating machine learning algorithms to facilitate the differentiation of benign and malignant tumors, tumor grading and staging, as well as prognostic evaluation. This review summarizes the application status of multimodal imaging techniques and the technical progress of AI-based radiomics, analyzes the clinical value and existing challenges of their combined application, and provides a reference for the accurate diagnosis of ureteral tumors.

Osteoporosis(OP)is a chronic metabolic bone disease that has become increasingly prevalent due to the global aging population, imposing a significant burden on public health worldwide. Insulin resistance(IR), a major systemic metabolic abnormality, disrupts bone remodeling homeostasis and impairs bone quality, serving as a key pathophysiological mechanism for the onset and progression of OP. The triglyceride-glucose(TyG) index, an convenient alternative marker for IR, is increasingly utilized to evaluate bone health; however, its association with bone mineral density, bone turnover markers, and fracture risk remains controversial. Therefore, this review elucidates the relationship between the TyG index and bone health, aiming to provide a new perspective for risk assessment and early intervention of OP in clinical practice.

To evaluate the efficacy of postoperative hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with early-stage [International Federation of Gynecology and Obstetrics (FIGO) stage Ⅰ-Ⅱ] epithelial ovarian cancer, fallopian tube cancer, and primary peritoneal cancer.

A total of 243 patients with pathologically confirmed FIGO stage Ⅰ-Ⅱ epithelial ovarian, fallopian tube, or primary peritoneal cancer who underwent surgery at West China Second University Hospital, Sichuan University, between July 2022 and April 2025 were retrospectively enrolled. Patients were divided into study group (n=105, who received postoperative HIPEC treatment) and control group (n=138, who did not receive postoperative HIPEC treatment) based on whether they received HIPEC after surgery. Due to the similar biological behaviors and essentially identical treatment principles of ovarian cancer, fallopian tube cancer, and primary peritoneal cancer, and given that epithelial ovarian cancer accounts for >90% of ovarian cancer cases, these three malignancies were studied as a whole in this research. Hereinafter, epithelial ovarian cancer, fallopian tube cancer, and primary peritoneal cancer were collectively referred to as epithelial ovarian cancer. Clinical data and progression-free survival (PFS) of patients in two groups were collected by retrospective method. Propensity score matching (PSM) was performed at a 1∶1 ratio between the two groups to balance baseline characteristics (including age, FIGO stage, and histologic type, etc.), with a caliper width set at 0.1 times the standard deviation of the propensity score. After PSM, Kaplan-Meier method was used to plot the PFS curves of the two groups of patients, and the PFS period of two groups of patients was compared by the Log-rank test. Univariate Cox regression subgroup analyses were further constructed for subgroup analyses to explore the efficacy of HIPEC across different subgroups. Additionally, a separate PSM was conducted in patients with ovarian clear cell carcinoma, and the effect of HIPEC on PFS in patients with ovarian clear cell carcinoma was evaluated. This study was conducted in accordance with the requirements of the Helsinki Declaration of the World Medical Association revised in 2013.

①After PSM, 158 patients (79 in each group) were included in the final analysis. Post-matching, there were no statistically significant differences between two groups in age, histologic type, FIGO stage, or other clinical characteristics (all P>0.05). With a median follow-up of 19.2 months (0.2-41.8 months), disease progression occurred in 6 patients (7.6%) in study group and 10 patients (12.7%) in control group after PSM. Log-rank test showed no significant difference in PFS between two groups after PSM (χ²=1.11, P=0.291). Univariate Cox regression subgroup analysis showed that there were no statistically significant differences in the proportion of disease progression between the study group and the control group in different clinical subgroups after PSM (P>0.05). ②In the separate PSM analysis of 62 patients with ovarian clear cell carcinoma (31 cases in each group), with a median follow-up of 16.2 months (0.6-39.8 months), disease progression occurred in 3 patients (9.7%) in study group and 8 patients (25.8%) in control group. However, Log-rank test revealed no statistically significant difference in PFS between two groups of patients with ovarian clear cell carcinoma after PSM(χ²=2.77, P=0.096).

In this study, postoperative HIPEC does not demonstrate a significant benefit in improving PFS for patients with FIGO stage Ⅰ-Ⅱ epithelial ovarian, fallopian tube, or primary peritoneal cancer. In patients with FIGO stage Ⅰ-Ⅱ ovarian clear cell carcinoma, HIPEC shows a potential trend toward benefit, although the difference did not reach statistical significance. Larger-scale prospective randomized controlled trials are warranted to further validate these findings.

To explore the clinical and pathological characteristics, immunophenotypes, treatment responses and prognostic factors in patients with specific types of cervical adenocarcinoma.

A total of 79 patients with special type of cervical adenocarcinoma who were treated at the Second Affiliated Hospital of Chongqing Medical University, the First Affiliated Hospital of Chongqing Medical University, Chongqing Maternal and Child Health Hospital, Sichuan Provincial Maternity and Child Health Care Hospital, and Suining Central Hospital in Sichuan Province from 2019 to 2024 were selected as research subjects. General clinical data, clinical manifestations, auxiliary examination results, treatment strategies, and prognostic outcomes of all patients were collected by retrospective study method. Univariate and multivariate Cox proportional hazards regression analyses were performed to identify independent prognostic factors for patients with special type of cervical adenocarcinoma based on multicenter clinical data. This study adhered to procedures established by the Ethics Committee of the Second Affiliated Hospital of Chongqing Medical University and received its approval (Ethics Approval No. 2025-350). Informed consent forms for clinical research were obtained from all patients.

①Clinical characteristics: the median age at onset among the 79 patients in this study was 53 years (range: 31-78 years). The most common initial symptoms were abnormal vaginal bleeding (43 cases, 54.4%) and increased vaginal discharge (17 cases, 21.5%). ②Pathological characteristics: 12 pathological subtypes were identified, with gastric-type adenocarcinoma (GAS) (18 cases, 22.8%) and invasive stratified mucin-producing carcinoma (iSMC) (11 cases, 13.9%) and adenosquamous carcinoma (11 cases, 13.9%) being relatively prevalent. According to the 2018 International Federation of Gynecology and Obstetrics (FIGO) staging criteria for cervical cancer, 51 cases (64.6%) were stage Ⅰ, 15 cases (19.0%) were stage Ⅱ, 12 cases (15.2%) were stage Ⅲ, and only 1 case (1.3%) was stage Ⅳ. Preoperative examination results showed a human papillomavirus (HPV) infection rate of 68.8% (44/64), abnormal ThinPrep liquid-based cytology test (TCT) results in 62.3% (33/53) cases, and abnormal tumor marker levels in 46.4% (26/56) patients. ③Immunophenotypes: pathological examination results indicated that the immunophenotypes of the 79 patients were quite complex, with significant differences among various subtypes. For example, among the 17 GAS patients, the majority were positive for mucin 6 (MUC6) (11 cases) and mucin 5AC (MUC5AC) (9 cases), while only 5 cases were positive for P16, and 15 cases were negative for estrogen receptor (ER)/progesterone receptor (PR). Among the 11 iSMC patients, there was diffuse strong positivity for P16 (11 cases) and high expression of carcinoembryonic antigen (CEA) (9 cases). Among the 11 adenosquamous carcinoma patients, immunohistochemical results in 10 cases showed that P16 (8 cases) and CEA (8 cases) were generally positive. ④Treatment responses: 76 patients (96.2%) underwent radical surgery, of which 21 underwent surgery alone, and the remaining patients underwent combined preoperative induction chemotherapy alone (2 cases), postoperative adjuvant chemotherapy (18 cases), or postoperative adjuvant chemoradiotherapy (35 cases); 8 high-risk patients received immunotherapy at the same time after surgery, and 6 patients received targeted therapy; 3 patients did not undergo surgery due to late FIGO stage or personal wishes and received concurrent chemoradiotherapy or chemotherapy alone. Follow-up results showed that by the last follow-up, 12 cases (15.2%) had recurred and 4 cases (5.1%) were died, with a 1-year disease free survival (DFS) rate of 88.2%. ⑤Prognostic factors: univariate Cox proportional hazards regression analysis indicated that FIGO clinical stage, histological subtype, primary clinical presentation, and treatment modality were potential risk factors for mortality in patients with special type cervical adenocarcinoma (P<0.05). Inclusion of these four factors and patient age in a multivariate Cox proportional hazards regression analysis revealed that FIGO clinical stage Ⅲ-Ⅳ (HR=25.965, 95%CI: 2.260-298.000, P=0.009), and pathological subtype mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) (HR=2 033.598, 95%CI: 22.100-1.870×10^5, P=0.001), endometrioid adenocarcinoma (EAC) (HR=493.705, 95%CI: 17.300-1.410×10^4, P<0.001), and signet-ring cell carcinoma (SRCC) (HR=373.255, 95%CI: 2.010-6.930×10^4, P=0.026) were all independent risk factors for mortality in patients with special type of cervical adenocarcinoma (P<0.05).

Special type of cervical adenocarcinoma exhibits high heterogeneity, with a low incidence rate and nonspecific clinical manifestations, often leading to diagnostic challenges. This multicenter data analysis confirms that pathological subtypes and FIGO clinical staging serve as important prognostic indicators for evaluating outcomes in such patients.

To investigate the expression levels of circular RNA (circRNA) ATRNL1 and follistatin (FST) in peripheral blood of patients with endometrial polyp (EP), and to evaluate their ability to predict recurrence within 6 months after hysteroscopic electrosurgical resection.

A total of 85 patients with EP who underwent hysteroscopic resection at the People′s Hospital of Danyang from January to April in 2024 were enrolled and followed up for 6 months postoperatively. A retrospective analysis was conducted. According to whether the patients experienced a recurrence of EP within 6 months after surgery, they were divided into recurrence group (n=12) and non-recurrence group (n=73). The t test and chi-square test were applied to compare the general clinical data and serum levels of circATRNL1 and FST between two groups. Additionally, serum follicle-stimulating hormone (FSH), estradiol, luteinizing hormone (LH), relative expression levels of transforming growth factor (TGF)-β and vascular endothelial growth factor (VEGF) in endometrial tissue, as well as endometrial thickness before and 6 months after surgery, were compared inter-group and intra-group. Multivariate unconditional logistic regression analysis was conducted to identify independent risk factors for postoperative recurrence. Receiver operating characteristic (ROC) curves were constructed to assess the predictive value of serum circATRNL1 and FST individually and in combination. This study was approved by the Ethics Committee of the People′s Hospital of Danyang (Approval No. 20250430), and informed consent was obtained from all participants.

① Serum circATRNL1 and FST levels of EP patients in recurrence group were higher than those in non-recurrence group, and the differences were statistically significant (P<0.05). ② Inter-group comparison showed that at 6 months after surgery, the serum levels of FSH, estradiol, and LH, relative expression level of TGF-β in endometrial tissue, and endometrial thickness of EP patients in recurrence group were higher or thicker than those in non-recurrence group, and the differences were statistically significant (P<0.05). Intra-group comparison showed that, in both groups, these 5 parameters above as well as relative expression level of VEGF in endometrial tissue at 6 months after surgery were lower than those before surgery, and the differences were statistically significant (P<0.05). ③ Multivariate unconditional logistic regression analysis demonstrated that elevated serum circATRNL1 level (OR=4.080, 95%CI: 1.745-9.539, P=0.005), elevated serum FST level (OR=4.536, 95%CI: 1.939-10.605, P=0.004), elevated serum FSH level (OR=4.563, 95%CI: 1.952-10.669, P=0.006), elevated serum estradiol level (OR=5.028, 95%CI: 2.150-11.756, P=0.006), elevated serum LH level (OR=4.604, 95%CI: 1.969-10.765, P=0.003), higher expression level of TGF-β in endometrial tissue (OR=4.865, 95%CI: 2.081-11.374, P=0.002), and greater endometrial thickness (OR=4.914, 95%CI: 2.101-11.488, P=0.007) were all independent risk factors for EP recurrence within 6 months after surgery. ④ ROC curve analysis showed that the sensitivity of serum circATRNL1 level, serum FST level, and their combination in predicting EP recurrence within 6 months after hysteroscopic resection were 75.0%, 72.2%, and 75.0%, respectively, while the specificity values were 76.7%, 64.4%, and 84.9%, respectively. The corresponding area under the curve (AUC) were 0.819 (95%CI: 0.738-0.899), 0.724 (95%CI: 0.615-0.833), and 0.842 (95%CI: 0.759-0.925), respectively.

Abnormally elevated levels of circATRNL1 and FST in peripheral blood are associated with the progression of EP, and demonstrate potential value in predicting EP recurrence within 6 months after hysteroscopic resection.

To investigate the value of transvaginal color Doppler ultrasound combined with E-cervix elastography parameters in predicting the mode of delivery of pregnant women in the third trimester.

A total of 300 pregnant women who underwent late-pregnancy ultrasound examination at Xi′an Daxing Hospital from January 2022 to December 2024 were retrospectively enrolled. According to the mode of delivery, they were divided into a vaginal delivery group (n=201) and a cesarean delivery group (n=99). Cervical parameters including cervical length (CL), uterocervical angle (UCA), elasticity contrast index (ECI), hardness ratio, internal os strain (IOS), external os strain (EOS), and IOS/EOS were analyzed. Multivariate unconditional logistic regression analysis was performed to identify factors associated with the mode of delivery. Receiver operating characteristic (ROC) curves were constructed to evaluate the predictive performance of individual parameters and the combined model. This study was approved by the Medical Ethics Committee of Xi′an Daxing Hospital (Approval No. KY2024-002).

① Compared with the cesarean delivery group, the vaginal delivery group showed significantly lower CL and hardness ratio, and significantly higher UCA, ECI, IOS, and EOS (all P<0.05). ② Multivariate logistic regression analysis demonstrated that CL (OR=4.408, 95%CI: 2.486-7.817, P<0.001) and hardness ratio (OR=1.024, 95%CI: 1.005-1.043, P=0.012) were independent risk factors for cesarean delivery of pregnant women in the third trimester, whereas UCA (OR=0.934, 95%CI: 0.911-0.957, P<0.001) was an independent protective factor. ③ROC curve analysis showed that the area under the curve (AUC) for predicting vaginal delivery was 0.750 for UCA, 0.706 for CL, 0.652 for hardness ratio, 0.617 for IOS, 0.602 for EOS, and 0.596 for ECI. The combined model (UCA, CL, hardness ratio, IOS, EOS, and ECI) achieved an AUC of 0.841 (95%CI: 0.792-0.890), with a sensitivity of 86.1% and a specificity of 73.7%.

Transvaginal color Doppler ultrasound combined with E-cervix elastography can comprehensively evaluate cervical maturity from both anatomical and biomechanical perspectives. A multiparametric combined model demonstrates superior predictive performance compared with single parameters and may provide an objective basis for individualized assessment of delivery mode of pregnant women in the third trimester.

To explore the safety and efficacy of esketamine combined with ciprofol in induced abortion.

A total of 100 patients who underwent induced abortion in the Civil Aviation General Hospital from January to March 2024 were selected as the research subjects, and the patients were randomly divided into two groups according to the random number table: study group (n=50, anesthetized with esketamine 0.25 mg/kg + ciprofol 0.5 mg/kg) and control group (n=50, anesthetized with sufentanil 0.1 μg/kg + ciprofol 0.5 mg/kg). The general information, anesthesia onset time, intraoperative medication, related hemodynamic indexes [mean arterial pressure (MAP) and heart rate when the patient was calm upon entering the operating room (T0), when the speculum was inserted (T1), when the cervix was dilated (T2), at the end of the surgery (T3), and upon entering the recovery room (T4)], postoperative conditions, anesthesia satisfaction and occurrence of anesthesia-related adverse reactions were recorded, and statistical comparisons were performed using independent-samples t test, repeated measures ANOVA, or chi-square tests. This study was approved by the Medical Ethics Committee of the Civil Aviation General Hospital (Approval No. 2023-L-K-04). All patients provided fully informed consent and signed the clinical research informed consent form.

①There were no statistically significant differences in general clinical data between two groups of patients, such as age, height, weight, days of amenorrhea, and operation time (P>0.05). ②The onset time of anesthesia in study group was (27.7±6.0) s, which was significantly shorter than that in control group (31.0±5.9) s, and the difference was statistically significant (t=-3.65, P<0.001). There were no significant differences in the number of intraoperative body movements, the number and dosage of intraoperative additional ciprofol, and the total dose of ciprofol (P>0.05). ③Repeated measures ANOVA of MAP and heart rate at time points T0-T4 in the two groups of patients showed that the interaction effects of different treatments and time factors were statistically significant (F_{treatment×time}=3.11, 6.17; P_{treatment×time}=0.015, 0.001), and the effects of treatments and time factors were also statistically significant (F_treatment=17.39, 11.30; F_time=64.97, 15.20; all P<0.001). Further analysis of the individual effects of treatments revealed that MAP and heart rate at time points T1-T4 in study group were significantly higher than those in control group, and the differences were statistically significant (P<0.05). ④There were no significant differences in the modified observer′s assessment of alertness/sedation scale (MOAA/S) score at the end of surgery, postoperative recovery room stay time, and the visual analogue scale (VAS) score of uterine contraction pain during the recovery period between two groups (P>0.05). There were also no statistically significant differences between two groups in anesthesia satisfaction scores and the incidence of anesthesia-related adverse reactions (P>0.05).

In induced abortion, compared with sufentanil 0.1 μg/kg combined with ciprofol, esketamine 0.25 mg/kg combined with ciprofol had a faster onset of anesthesia, comparable analgesic effect, and more stable intraoperative hemodynamics.

To explore the clinical manifestations, complications, diagnosis, treatment and prognosis in neonatal Ureaplasma parvum (Up) meningitis.

A preterm infant with early-onset Up meningitis (infant 1), who was admitted to Xuzhou Central Hospital on October 31, 2023 was included into this study. A retrospective analysis was conducted on the clinical data of infant 1, including medical history, physical examination findings at admission, relevant auxiliary examination results, and the diagnosis and treatment process. Using the search terms " Ureaplasma parvum" " meningitis" " neonate/newborn" " preterm/premature" both in Chinese and English, literature related to neonatal Up meningitis indexed in domestic databases (Wanfang Data Knowledge Service Platform, CNKI, and VIP Database) and international databases (PubMed, Embase, and Web of Science) from the inception of each database to April 2025 was searched. A comprehensive analysis of the clinical manifestations, complications, diagnosis, treatment, and prognosis of Up meningitis in newborns was conducted on the related literature. This study was in line with World Medical Association Declaration of Helsinki revised in 2013.

①Infant 1: a female preterm infant with early-onset Up meningitis born at a gestational age of 34^{+ 1} weeks, was admitted to our hospital on the day of birth due to " moaning and frothing for 30 minutes" after delivery. Antenatal vaginal swab from the mother and a postnatal nasal swab from the infant 1 both tested positive for Ureaplasma Urealyticum (UU) nucleic acid. On day 6 after admission, the infant 1 began to experience recurrent low-grade fevers accompanied by apnea. Combined with a cerebrospinal fluid white blood cell count (WBC) of 62×10⁶/L, a glucose concentration of 0.55 mmol/L, and a protein level of 1.29 g/L, metagenomic next-generation sequencing (mNGS) detected Up in the cerebrospinal fluid, with a sequence count of 154 and a relative abundance of 32.25%, Up meningitis was diagnosed. On day 7 after admission, high-dose intravenous azithromycin was initiated at 20 mg/(kg·d) once daily. The dose was reduced to 5 mg/(kg·d) once daily on day 10 after admission. From day 18 to 27 after admission, due to " intraventricular hemorrhage and severe obstructive supratentorial hydrocephalus", daily therapeutic cerebrospinal fluid aspiration (10 mL/kg) was performed. The cerebrospinal fluid parameters gradually normalized, and azithromycin was discontinued on day 27 after admission. However, the hydrocephalus did not significantly improve. On day 29 after admission, the infant 1 was transferred to another hospital for Ommaya reservoir placement. From 3 to 6 months after birth, there was no longer any need to withdraw hydrocephalus fluid, and the symptoms of hydrocephalus improved. At a corrected age of 6 months, the development of infant 1 was assessed as essentially normal. ②Literature review results: A literature search identified 15 relevant articles on neonatal Up meningitis, reporting on 16 affected neonates (infants 2-17). Including infant 1, a total of 17 neonates with Up meningitis were analyzed. Among these 17 cases, excluding one case whose gender was not reported, there were 6 males and 10 females; gestational age was not reported in one case, but the median gestational age of the remaining 16 cases was 31.5 weeks (27.3, 39.8 weeks), with 10 cases being preterm (gestational age at birth < 37 weeks); birth weight was not reported in one case, but the median birth weight of the remaining 16 cases was 1 860 g (997, 3 355 g), with 9 cases having low birth weight (birth weight < 2 500 g); the median age at onset was 7 days after birth (3.0, 10.5 days), and 9 cases were classified as early-onset (within 7 days after birth) Up meningitis. Clinically, 12 cases presented with fever, 6 with neurological abnormalities, and 4 with respiratory abnormalities. Complications included hydrocephalus in 10 cases and intracranial hemorrhage in 3 cases. The cerebrospinal fluid examination results showed an elevated WBC count (median: 608×10⁶/L), a significantly increased protein level (3.7±2.0) g/L, and a significantly decreased glucose concentration (median: 0.5 mmol/L). In 10 cases, mNGS was the sole method used to detect Up in the cerebrospinal fluid. Commonly used antibiotics for Up meningitis included erythromycin, azithromycin [often at a dose of 20 mg/(kg·d)], and quinolones, with treatment courses ranging from 3 to 10 weeks. Hydrocephalus was managed with Ommaya reservoir insertion alone in 4 cases. Regarding outcomes, follow-up information was unavailable for one infant. Of the remaining 16 cases, follow-up assessments indicated normal intellectual and motor development in 14 infants.

Neonatal Up meningitis predominantly occurs in preterm infants, with early-onset cases being the most common. The primary clinical manifestation is fever, while the incidence of neurological abnormalities is relatively low. Some infants may present with respiratory abnormalities, and the condition is frequently associated with complications such as hydrocephalus and intracranial hemorrhage. Cerebrospinal fluid analysis typically reveals an elevated WBC count, significantly increased protein levels, and markedly decreased glucose concentrations. mNGS is commonly used for the detection of Up. Macrolides and quinolones are the antibiotics of choice for treatment, while Ommaya reservoir implantation alone is the preferred approach for managing hydrocephalus. The prognosis is favorable for the vast majority of infants following treatment.

To investigate the clinical characteristics, genetic features, and diagnostic and therapeutic strategies of deficiency in ELF4, X-linked (DEX).

A child with DEX who was hospitalized at the Children′s Hospital of Soochow University in September 2022 was enrolled as the proband. Clinical data, including clinical manifestations, laboratory findings, imaging features, genetic testing results, treatment, and follow-up outcomes, were retrospectively analyzed. Whole-exome sequencing (WES) was performed to identify ELF4 gene variants, which were subsequently confirmed by Sanger sequencing, and their pathogenicity was evaluated according to the guidelines of the American College of Medical Genetics and Genomics (ACMG). A literature search was conducted using the keywords " " ELF4 deficiency" and " ELF4 mutation" in Chinese and English across the Wanfang Data, China National Knowledge Infrastructure (CNKI), Chinese Medical Journal Network, and PubMed databases. The search period ranged from inception to December 30, 2025. This study was approved by the Medical Ethics Committee of the Children′s Hospital of Soochow University (Approval No. 2024CS087), and written informed consent was obtained from the patient′s guardian.

①The proband was a 4-year-10-month-old boy, the second-born of a twin pregnancy. His main clinical manifestations included perianal abscess, recurrent fever, abdominal pain, and oral ulcers. Colonoscopy revealed a large ulcer in the ileocecal region. WES identified a missense variant in the ELF4 gene (NM_001421.3), c.799C>T (p.R267W), located within the ETS domain. Sanger sequencing confirmed that the variant was maternally inherited, and it was classified as likely pathogenic according to the ACMG guidelines. Immunological evaluation indicated abnormalities in certain T- and B-lymphocyte subsets. The patient′s condition gradually improved following combined treatment with glucocorticoids, immunosuppressants, and biologic agents. His monozygotic twin brother presented only with recurrent oral ulcers and had milder symptoms. ②Literature review: A total of 29 pediatric patients with DEX were included. Among them, 89.7% (26/29) were male, and 64.3% (18/28) had disease onset at ≤6 years of age. The main clinical manifestations included oral ulcers (86.2%, 25/29), gastrointestinal symptoms (69.0%, 20/29), and fever (58.6%, 17/29). Glucocorticoids and biologic agents were the main therapeutic options. Overall, 72.4% (21/29) of patients achieved clinical remission after treatment, of whom 76.2% (16/21) required combination therapy. One patient maintained remission without medication, and one patient died due to multiple lymphomas. A total of 23 distinct ELF4 gene variants were identified in the 29 patients, with missense and frameshift variants being the most common, each accounting for 39.1% (9/23). Notably, 87.0% (20/23) of the variants involved the ETS domain, and variants affecting this domain were more likely to be associated with an autoinflammatory phenotype.

DEX exhibits marked clinical heterogeneity, and most patients require combination therapy for disease control. The disease predominantly presents with autoinflammatory features and may manifest as inflammatory bowel disease-like or Behçet′s disease-like phenotypes. ELF4 variants are mainly clustered in the ETS domain and variants involving the ETS domain of ELF4 may be associated with an autoinflammatory phenotype. Given that effective disease control often requires multi-drug therapy, early genetic testing should be considered in patients with early onset, atypical clinical manifestations, or poor response to treatment to establish a definitive diagnosis and guide individualized therapy.

To screen for differentially expressed RNA-binding protein genes (RBPs), construct a prognostic prediction model combined with risk score and clinicopathological characteristics of patients, validate it, and analyze the immunophenoscore (IPS) and drug sensitivity in different risk groups.

Transcriptomic and clinical data from The Cancer Genome Atlas (TCGA) breast cancer cohort (1 106 breast cancer tumor samples and 137 adjacent normal samples) were collected as the training set, and the GSE86166 dataset (containing 330 breast cancer samples) was used as the validation set. Differentially expressed RBPs between tumor samples and adjacent normal samples were screened in the training set. Univariate Cox proportional hazards regression and least absolute shrinkage and selection operator (LASSO) regression analyses were performed to select core RBPs and construct a prognostic risk score model. Breast cancer patients were divided into high-risk group (649 cases) and low-risk group (457 cases) based on the risk score cut-off value. Kaplan-Meier survival analysis and receiver operating characteristic (ROC) curves were used to evaluate model performance. External validation was conducted in the validation set samples (high-risk group 161 cases and low-risk group 169 cases) using the same risk score formula and cut-off value. In the TCGA training set, univariate and multivariate Cox proportional hazards regression analyses combined with patients clinicopathological characteristics were used to evaluate the independent prognostic value of the risk score. A prognostic model was constructed based on clinicopathological characteristics and the risk score, with calibration curves used to assess its accuracy and decision curve analysis (DCA) used to evaluate its clinical utility. IPS was used to assess the tumor immunophenotype characteristics of the high and low risk groups. The half maximal inhibitory concentration (IC₅₀) was used to evaluate the drug sensitivity of 296 commonly used clinical chemotherapeutic and targeted therapeutic drugs in the high and low risk groups. Using convenience sampling, 10 pairs of breast cancer tissue samples and corresponding adjacent normal tissue samples from Harbin Medical University Cancer Hospital collected between January 2023 and December 2025 were used to validate the expression differences of the 5 core genes at the protein level using histochemistry score(H-score).

A total of 126 differentially expressed RBPs were identified from 1 106 breast cancer tumor samples and 137 adjacent normal samples. Univariate Cox proportional hazards regression analysis and LASSO regression analysis ultimately identified 5 core RBPs (NUAK2, ACSL1, MAP1LC3C, WT1, and MYOCD), based on which a prognostic risk score model was established. Kaplan-Meier survival analysis showed that the median overall survival (OS) of patients in the high-risk group and low-risk group in the training set was 97.5 months (95%CI: 90.2-104.8) and 216.6 months (95%CI: 198.3-234.9), indicating a statistically significant difference (χ²=13.20, P<0.001) ; The median OS of patients in the high-risk group and low-risk group in the validation set was 76.8 months (95%CI: 70.5-83.1) and 182.4 months (95%CI: 165.7-199.2), indicating a statistically significant difference (χ²=4.14, P=0.042). ROC curve analysis showed that the area under the curve at 3, 5, and 7 years OS for the training and validation sets were 0.60 (95% CI: 0.54-0.66), 0.60 (95%CI: 0.53-0.67), 0.65 (95%CI: 0.59-0.71), and 0.64 (95%CI: 0.58-0.70), 0.60 (95%CI: 0.54-0.66), 0.62 (95%CI: 0.56-0.68), respectively, indicating that the model has prognostic predictive value in both the training and external validation sets. Multivariate Cox proportional hazards regression analysis showed that the risk score was an independent factor predicting overall survival (HR=6.807, 95%CI: 3.940-11.715, P<0.001). Calibration curves showed that the concordance index (c-index) of predicting prognostic model at 3, 5, and 7 years OS in breast cancer patients were 0.782, 0.765, and 0.748, respectively (χ²=8.62, 9.15, 7.89, all P>0.05), confirming the stable predictive performance of the model. DCA results showed that, within the clinical decision threshold interval of 0.153-0.604, the prognostic model provided a better net clinical benefit than both the treat-all and treat-none strategies.Tumor immunogenicity and immunotherapy response analysis showed that the IPS of the low-risk group was significantly higher than that of the high-risk group (all P<0.05). Drug sensitivity analysis showed that 146 drugs had lower IC₅₀ values in the low-risk group than in the high-risk group (all P<0.05), while 20 drugs had lower IC₅₀ values in the high-risk group than in the low-risk group (all P<0.05). The IC₅₀ values of seven classical chemotherapeutic drugs (paclitaxel, doxorubicin, carboplatin, oxaliplatin, cyclophosphamide, docetaxel and topotecan) were significantly lower in the low-risk group than in the high-risk group (all P<0.001). Protein validation results showed that the expression of NUAK2 (152.00±17.51 vs 16.00±13.08, t=16.60, P<0.001) and WT1 [35.00 (15.00, 72.50) vs 7.50 (1.75, 30.00), Z=−2.80, P=0.005] were higher in tumor tissues than in adjacent normal tissues, whereas the expression of MAP1LC3C (49.20±44.90 vs 128.00±37.06, t=-4.61, P=0.001), ACSL1 [145.00 (75.00, 187.50) vs 270.00 (247.50, 273.75), Z=−2.81, P=0.005], and MYOCD [100.00 (47.50, 140.00) vs 160.00 (150.00, 165.00), Z=−2.82, P=0.005] were lower in tumor tissues than in adjacent normal tissues.

In this study, the prognostic prediction model for breast cancer constructed based on 5 core RBPs has good predictive efficacy, and accordingly different risk groups show significant difference in IPS and drug sensitivity.