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.

Sepsis is a common and critical illness in the intensive care unit (ICU) with high mortality, and remains a major challenge in clinical practice. Hemoperfusion, a blood purification method based on adsorption that removes either endogenous or exogenous toxins and pathogens, has attracted more and more interest for its therapeutic possibilities in the management of sepsis. This paper summarizes the mechanism and current application of hemoperfusion in sepsis treatment, with a particular focus on the timing of treatment. Early initiation and relatively prolonged continuous hemoperfusion may be quite helpful for individuals with moderate to severe sepsis requiring vasopressors.

Sepsis is a life-threatening clinical syndrome characterized by dysregulated host responses to infection, resulting in severe organ dysfunction. Although early and appropriate antimicrobial therapy remains the cornerstone of sepsis management, conventional diagnostic methods often fail to meet the clinical requirements for accuracy and timeliness in pathogen identification. Recent breakthroughs in pathogen identification through differential host immune responses offer a promising framework for a new diagnostic and therapeutic paradigm. This review summarizes progress in host-response-oriented pathogen identification, aiming to provide clinicians with innovative strategies for early, precise formulation of anti-infective regimens.

Acute respiratory distress syndrome (ARDS) is a severe clinical syndrome characterized by dysregulated inflammatory response caused by intrapulmonary and extrapulmonary injuries, and remains associated with high morbidity and mortality worldwide. Despite substantial advances in supportive care, the underlying pathogenesis of ARDS has not yet been fully elucidated. Emerging evidence suggests that epigenetic regulation plays a pivotal role in the development and progression of ARDS by modulating gene expression in response to environmental and inflammatory stimuli. Major epigenetic mechanisms include DNA methylation, histone modification and non-coding RNA-mediated regulation. As epigenetic alterations represent the interface between genetic susceptibility and environmental exposure, they may provide important insights into the heterogeneity and dynamic progression of ARDS. In this review, we summarize findings from in vitro studies, animal studies, and clinical studies to elucidate the role of epigenetic modifications in ARDS pathogenesis. Furthermore, we discuss the potential of epigenetic mechanisms as novel therapeutic targets and future directions for precision treatment strategies in ARDS.

Perioperative refractory ventricular fibrillation (RVF) refers to ventricular fibrillation that persists after standard cardiopulmonary resuscitation and multiple defibrillations, occurring within the high-risk window from the start of surgery to 24 hours postoperatively. The mortality rate is extremely high (85%-97%) and the rate of survival with intact neurological function is very low (only 5.6%). Currently, the specific epidemiological data for this condition is still lacking. As a manifestation of perioperative cardiac arrest, its incidence is (4.3-5.8) per 10, 000 cases, with significantly increased risk in emergency surgeries, infants, and elderly patients. The main risk factors include coronary artery abnormalities, concomitant heart failure or respiratory failure, and reperfusion injury related to cardiac surgery. The pathophysiological mechanism involves the synergistic effects of myocardial electrophysiological disorders, metabolic imbalance, and sympathetic storm. The key to prevention and treatment lies in implementing a stepwise intervention approach and initiating a rapid multidisciplinary collaboration process, including: promptly initiating high-quality mechanical CPR combined with dual sequential defibrillation (DSED), early identification of pulseless electrical activity (PEA) as a critical decision-making node for resuscitation; rational use of anti-arrhythmic drugs; early initiation of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support, and transfer to the hybrid operating room for coronary angiography/percutaneous coronary intervention (PCI), etc. This review systematically elaborates on the definition, epidemiological characteristics, risk factors, pathophysiological mechanism, current treatment principles, and research progress of perioperative RVF, aiming to provide a theoretical references for clinical practice.

Constipation-predominant irritable bowel syndrome (IBS-C), as a common functional gastrointestinal disorder, has a significant negative impact on the quality of life of patients. Currently, drug treatment faces many limitations, and non-pharmaceutical rehabilitation intervention based on the brain-gut axis theory has become a research hotspot. This article systematically reviews and compares the application evidence, mechanism of action and scope of application of non-pharmaceutical intervention strategies based on the brain-gut axis (including central nervous system regulation, peripheral orientation intervention, diet and cognitive behavioral intervention, traditional medicine and complementary and alternative therapies) in IBS-C. Analysis shows that individualized and multimodal intervention targeting specific pathophysiological subtypes (such as central sensitization and pelvic floor dysregulation) is the future trend. This article aims to provide evidence-based basis for the formulation of precise rehabilitation plans in clinical practice and clarify future research directions.

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.