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.

To explore SMARCA4-deficient non-small cell lung cancer in the chest Clinical characteristics, imaging manifestations, histopathological features and treatment prognosis of patients with SMARCA4-dNSCLC and SMARCA4-deficient undifferentiated tumors (SMARCA4-UT) To enhance the understanding of the disease.

A retrospective analysis was conducted on 37 patients with SMARCA4-deficient tumors (SMARCA4-DT) in the chest admitted to the Second Affiliated Hospital of Army Medical University from November 2022 to April 2025. They were divided into 10 cases of SmarCA4-deletion non-small cell lung cancer (SMARCA4-dNSCLC) and 27 cases of SmarCA4-deletion undifferentiated tumor (SMARCA4-UT). The gender, age, smoking history, clinical symptoms, Eastern Cooperative Oncology Group (ECOG) performance status score, tumor CT location, tumor size, tumor density, uniformity of tumor enhancement, metastasis site, stage, histopathological characteristics and prognosis of the patients were compared.

Compared with SMARCA4-dNSCLC, SMARCA4-UT has a larger tumor diameter, extremely irregular tumor density and enhancement uniformity, a later clinical stage, more common mediastinal lymph node metastasis, and a higher Ki-67 index. The Overall Survival (OS) is short. The difference was statistically significant (P<0.05); There was no statistically significant difference in clinical manifestations, ECOG performance status score, and distant metastasis sites (P>0.05). The histological morphology of SMARCA4-dNSCLC presents various poorly differentiated NSCLC morphologies. The histological morphology of SMARCA4-UT is poorly differentiated and has lost the morphological characteristics of epithelial carcinoma, presenting as rhabdoid morphology. Surgery is the main treatment for early-stage tumors, while chemotherapy combined with immunotherapy is the core regimen for advanced-stage tumors. However, the Overall prognosis of both types of tumors is extremely poor, and the Median Overall Survival (mOS) is relatively short. The median survival period of SMARCA4-dNSCLC patients in this article was 14 months, while that of SMARCA4-UT was 5 months, and the difference was statistically significant (P<0.05).

Both SMARCA4-dNSCLC and SMARCA4-UT have the characteristics of high invasiveness, rapid disease progression and poor prognosis. However, SMARCA4-UT has a higher degree of malignancy, faster progression and worse prognosis. There are differences between the two in terms of imaging manifestations, histopathological features and prognosis. SMARCA4 can be routinely incorporated into the immunohistochemical detection of poorly differentiated and undifferentiated thoracic tumors in clinical practice. Early identification and accurate classification are of great clinical significance for evaluating the condition and guiding treatment.

To systematically dissect the molecular mechanisms underlying the transcriptional regulatory network governing malignant proliferation of lung adenocarcinoma cells through integrated analysis of multiple public human lung cancer single-cell transcriptomic datasets, and to identify core genes and transcription factors driving tumor proliferation, thereby providing a theoretical basis for early diagnosis and targeted therapy of lung cancer.

Four public lung cancer scRNA-seq datasets (GSE131907, GSE149655, GSE148071, and E-MTAB-6149) were integrated and processed. After quality control, normalization, and batch correction using Harmony, a total of 199 489 high-quality cells were retained. Cell clustering was performed using the Louvain algorithm, and cell types were annotated using canonical marker genes. InferCNV combined with Gaussian mixture modeling (GMM) was applied to accurately distinguish tumor epithelial cells from normal epithelial cells based on copy number variation (CNV) profiles. Differentially expressed genes (DEGs) were identified using the Wilcoxon rank-sum test. Weighted gene co-expression network analysis (WGCNA) was performed to identify key functional modules, and the GENIE3 algorithm was used to construct transcription factor regulatory networks. Finally, HMGB2 was knocked down in A549 cells via siRNA transfection, and the expression changes of core transcription factors and their downstream target genes were validated by qRT-PCR.

After batch correction, cells from different datasets were uniformly mixed. A total of 20 cell clusters were identified and classified into four major lineages: immune cells (65.18%), epithelial cells (27.43%), endothelial cells (4.60%), and fibroblasts (2.79%). Using CNV-based GMM analysis, 23 505 tumor cells were successfully identified (44.90% of all epithelial cells), among which 80.59% were classified as high-confidence malignant cells. WGCNA identified the blue module as the key module highly associated with the cell cycle, whose activity was markedly elevated in S and G2/M phases, with all hub genes being canonical cell cycle drivers. Transcriptional regulatory network analysis uncovered a tightly interacting regulatory circuit consisting of seven core transcription factors, including FOXM1, E2F7, and HMGB2. Functional cell experiments confirmed that knockdown of HMGB2 significantly downregulated the expression of key genes including FOXM1, E2F7, and TOP2A.

This study successfully integrated multiple lung cancer single-cell transcriptomic datasets and established a comprehensive single-cell atlas of lung cancer epithelial cell heterogeneity. We elucidated the molecular mechanism by which the core transcriptional regulatory axis centered on HMGB2-FOXM1/E2F7/HMGA1-cell cycle genes drives malignant proliferation of lung cancer epithelial cells. These findings provide a novel theoretical basis and potential molecular targets for the identification of early diagnostic biomarkers and the development of targeted therapeutic strategies for lung cancer.

To identify robust pulmonary arterial hypertension (PAH)-associated genes through multi-cohort transcriptomic integration and single-cell resolution analyses, and to elucidate their cellular origins and potential links to immune microenvironment remodeling.

Differential expression analysis of PAH and control was conducted on three independent transcriptome cohorts (GSE217438, GSE117261, GSE33463) respectively, and the intersection was taken to obtain consistent candidate genes across cohorts. Build a protein-protein interaction (PPI) network based on STRING to locate key nodes; The co-expression network was constructed using WGCNA and module-trait association and functional enrichment were carried out. Further analyze the single-cell transcriptome data of lung tissue to clarify the cellular origin of RGS1 and conduct quasi-temporal analysis in the mononuclear macrophage lineage. At the same time, compare the differences in cell communication between the control and PAH and screen the key ligand-receptor axes. Finally, a rat PAH model induced by MCT (60 mg/kg) was constructed. The expression changes of RGS1 were verified by RT-qPCR of alveolar macrophages, Western blot and immunohistochemistry of lung tissue.

The intersection of differentially expressed genes across three cohorts indicates candidate genes exhibit strong cross-cohort stability, with the immune-regulatory gene RGS1 further identified. In all three independent cohorts, RGS1 was significantly upregulated in the PAH group (P<0.05). Protein interaction network analysis revealed RGS1 occupies a central position within the network and interacts with multiple G protein signaling and immune-related molecules, suggesting its potential involvement in GPCR-mediated immune pathways. WGCNA analysis revealed that the dark gray module containing RGS1 was highly correlated with the PAH phenotype (cor=0.43, P=5e-5). Genes in this module were enriched in pathways including adaptive immune response, immunoglobulin-mediated response, and lymphocyte-mediated immunity. Single-cell analysis revealed that RGS1 is predominantly highly expressed in immune cells. The proportion of macrophages significantly increased in the PAH group, accompanied by enrichment of inflammation-related pathways (P<0.05). The results of pseudotime series showed that monocyte-macrophage migration occurred in a continuous state along the trajectory, and the expression of RGS1 changed dynamically with pseudotime. Cell communication analysis showed that the number and intensity of overall communication were increased in PAH group, and the probability of ligand-receptor pair PPIA-BSG communication was significantly increased in PAH group, suggesting that the signal network was remodled. The expressions of RGS1 mRNA and protein in alveolar macrophages in the experimental group were significantly up-regulated in the MCT animal model (P<0.01), and the positive signal of RGS1 in lung tissue was enhanced by IHC.

RGS1 may be involved in the remodeling of the immune microenvironment in PAH and serve as an immune-related biomarker and potential therapeutic target.

To investigate the predictive value of intratumoral heterogeneity (ITH) quantified by computed tomography (CT)-based habitat radiomic features for the response to immune checkpoint inhibitors (ICIs) in patients with non-small cell lung cancer (NSCLC).

A total of 148 NSCLC patients scheduled to receive pembrolizumab plus platinum-based doublet chemotherapy at our hospital from June 2022 to June 2025 were enrolled as the training cohort, and another 98 patients treated during the same period served as the validation cohort. Pre-treatment CT images were acquired and habitat radiomic features were extracted. LASSO regression was used to select core features for constructing the ITHscore model. After treatment completion, treatment response was assessed according to RECIST criteria. In the training cohort, patients with complete response or partial response were classified as the response group (n=79), while those with stable disease or progressive disease were classified as the nonresponse group (n=69). Clinical data were compared between the two groups. Univariate and multivariate logistic regression analyses were performed to identify independent factors associated with ICI response. Predictive performance was evaluated using receiver operating characteristic (ROC) curves and decision curve analysis (DCA).

In the training cohort, significant differences were observed between the response and nonresponse groups in age, sex, clinical stage, and programmed deathligand 1 (PDL1) expression level (all P<0.05). LASSO regression selected 8 core features with nonzero coefficients from 1, 524 radiomic features to construct the ITHscore. Multivariate logistic regression showed that age (OR=1.145, 95%CI: 1.031~1.272, P=0.011), sex (OR=2.447, 95%CI: 1.079~5.550, P=0.032), clinical stage (OR=3.555, 95%CI: 1.581~7.992, P=0.002), PDL1 expression (OR=0.887, 95%CI: 0.847~0.929, P=0.007), and ITHscore (OR=1.895, 95%CI: 1.261~2.848, P=0.002) were independent predictors of ICI response. ROC analysis showed that the AUC of the ITHscore model was 0.818 (95%CI: 0.737~0.882), and that of the clinical feature model was 0.793 (95%CI: 0.710~0.862) (P>0.05). The combined model achieved an AUC of 0.896 (95%CI: 0.827~0.944), with a sensitivity of 75.61% and specificity of 91.23%, outperforming either single model. In the validation cohort, the combined model yielded an AUC of 0.879(95%CI: 0.807~0.931), sensitivity of 70.73%, and specificity of 92.41%. DCA demonstrated that at a threshold probability of 0.25, the net benefit of the combined model (0.27) was higher than that of the ITHscore model (0.23) and the clinical feature model (0.11).

The ITHscore combined with clinical features, constructed from CTbased intratumoral heterogeneity radiomic features, demonstrates good discriminative ability and clinical net benefit for predicting ICI response in NSCLC patients, and may facilitate early identification of patients likely to benefit from immunotherapy.

The present study explores the incidence of treatment-related pneumonitis (TRP) in patients with locally advanced non-small cell lung cancer (NSCLC) undergoing radiotherapy combined with immunotherapy, and its association with systemic immune-inflammation index (SII).

A retrospective analysis of the clinical data of patients with unresectable locally advanced NSCLC patients who were treated at the hospital from January 2021 to December 2024 was conducted. The patients were divided into two groups according to whether they received immunotherapy: a combined group (radiotherapy + immunotherapy) and a radiotherapy group (radiotherapy only). The primary research objective was to make a comparison between the incidence and severity of TRP in the two groups, and the secondary research objective was to explore the relationship between pre-treatment SII and TRP in the combined group.

The study population comprised 89 patients, predominantly male 82 patients(92.13%), with 41 patients (46.07%) aged ≥65 years. The incidence of TRP in the combination group was 27 cases (61.36%), which was higher than that in the radiotherapy group 16 cases (35.56%)(P<0.05). The incidence of grade ≥3 TRP in the combination group was 7 cases (15.91%), higher than the radiotherapy group 2 cases(4.44%)(P>0.05). In the combined group, among the 27 patients with TRP, ground-glass opacities occurred in 23 cases (85.18%), consolidation in 15 cases (55.56%), reticular opacities in 10 cases (37.04%), and bilateral lung involvement in 10 cases (37.04%). In the radiotherapy group, among the 16 patients with TRP, ground-glass opacities occurred in 12 cases (75.00%), consolidation in 7 cases (43.75%), reticular opacities in 5 cases (31.25%), and bilateral lung involvement in 4 cases (25.00%). The incidence rates in the combination group were higher than those in the radiotherapy group, but the differences were not statistically significant (P>0.05). Higher pre-treatment SII values[1 035.1 (568.8, 1 727.5)] than those without TRP[472.0(336.4, 851.3)] (χ²=7.35, P=0.01). Multivariate logistic regression analysis confirmed that elevated SII was an independent risk factor for TRP in the combination group(OR=1.01, 95%CI: 1.01~1.01, P<0.05), with consistent results across different adjustment models.

In comparison with radiotherapy administered in isolation, the combination of radiotherapy and immunotherapy has been observed to result in an elevated probability of TRP. Consequently, it is imperative that caution is exercised when formulating combined treatment plans in clinical practice. The increase in SII prior to treatment may be associated with the occurrence of TRP, suggesting that SII may serve as a potential biomarker.

To compare the anesthetic effects of ciprofol and propofol in Da Vinci robotassisted lung cancer lobectomy.

A total of 113 patients who underwent Da Vinci robotassisted lung cancer lobectomy in our hospital from May 2022 to February 2025 were enrolled and randomly divided into a ciprofol group 57 cases and a propofol group 56 cases. The ciprofol group received a loading dose of 0.3~0.4 mg/kg ciprofol followed by continuous intravenous infusion at 0.8 mg/(kg·h) for maintenance, while the propofol group received a loading dose of 1.5~2.5 mg/kg propofol followed by continuous infusion at 5.0 mg/(kg·h). The two groups were compared in terms of intraoperative heart rate (HR), mean arterial pressure (MAP), systolic blood pressure (SBP), diastolic blood pressure (DBP), regional cerebral oxygen saturation (rSO₂), postoperative recovery time, orientation recovery time, MiniMental State Examination (MMSE) scores, and perioperative adverse reactions.

At 5 min after induction, MAP, SBP, and DBP in the ciprofol group were higher than those in the propofol group (P<0.05). At 15 min after anesthesia, there was no significant difference in rSO₂ between the two groups [(75.54±2.57)% vs. (75.84±2.62)%, P=0.565]; at 10, 30, and 60 min of onelung ventilation and at 20 min after resumption of twolung ventilation, rSO₂ in the ciprofol group was higher than that in the propofol group [(71.67±2.42)% vs. (69.54±2.37)%, (70.37±2.87)% vs. (68.29±4.35)%, (70.27±3.68)% vs. (66.31±2.13)%, (74.45±3.76)% vs. (71.21±2.71)%, all P<0.001]. The induction success time [(1.41±0.42) min vs. (1.59±0.58) min], spontaneous breathing recovery time [(10.96±1.57) min vs. (13.28±2.02) min], postoperative recovery time [(9.34±1.58) min vs. (11.57±1.82) min], and orientation recovery time [(16.35±2.53) min vs. (18.98±2.42) min] in the ciprofol group were shorter than those in the propofol group (all P<0.001). The MMSE scores at 3 h and 72 h after surgery in the ciprofol group were higher than those in the propofol group [(19.31±1.52) vs. (17.54±1.37), (25.90±1.04) vs. (23.31±1.13), P<0.001]; at 24 h after surgery, there was no significant difference between the two groups (P=0.711). There were no statistically significant differences between the two groups in the incidence of nausea and vomiting, intraoperative hypertension, hypotension, tachycardia, bradycardia, injection site pain, or postoperative delirium (POD) (P>0.05), POD 3 cases (5.36%) in the propofol group.

In Da Vinci robotassisted lung cancer lobectomy, ciprofol can better maintain intraoperative hemodynamic stability, increase cerebral oxygen saturation during onelung ventilation, shorten postoperative recovery and orientation recovery time, improve early cognitive function, and does not increase the risk of adverse reactions compared with propofol, demonstrating clinical significance.

To investigate the efficacy and safety of different doses of bevacizumab combined with pemetrexed and platinum-based chemotherapy as first-line treatment for advanced non-squamous non-small cell lung cancer (NSCLC).

Data from 76 patients with advanced non-squamous NSCLC treated with bevacizumab combined with pemetrexed and platinum-based regimens admitted to our hospital between September 2021 and December 2025 were selected. Among them, 45 patients received the low-dose group (7.5 mg/kg) and 31 patients received the high-dose group (15 mg/kg). Propensity score matching (PSM) was used to randomly assign 28 patients to each group at a 1︰1 ratio. Objective response rate (ORR), disease control rate (DCR), overall survival (OS), and adverse reactions were compared between the two groups. Survival curves were plotted using the Kaplan-Meier method, and survival differences were compared using the Log-rank test. Cox regression was used for subgroup analysis.

Baseline characteristics were balanced between the two groups after PSM (P>0.05). ORR was 53.57% vs. 35.71% in the low-dose group (P=0.179), and DCR was 78.57% vs. 60.71% (P=0.146) in the high-dose group. Median OS was 24.5 months (95%CI: 19.324~29.676) vs. 22.8 months (95%CI: 17.512~28.088) in the low-dose group (HR=1.167, 95%CI: 0.540~2.519, Log-rank P=0.695). Subgroup analysis showed no significant interaction between baseline characteristics such as age, sex, Eastern Cooperative Oncology Group Performance Status (ECOG PS), smoking history, pathological subtype, hypertension, chronic obstructive pulmonary disease (COPD), and KRAS mutation and dose-response relationship (P>0.05). Adverse reactions were predominantly grade 1~2 in both groups; there was no statistically significant difference in the incidence of grade ≥3 serious hematologic and non-hematologic toxicities between the groups (P>0.05). The incidence of grade 1~2 nausea/vomiting was higher in the low-dose group than in the high-dose group (42.86% vs. 17.86%, P=0.042), but no increase in grade ≥3 gastrointestinal toxicities (7.14% vs. 3.57%, P=0.553).

The efficacy of low-dose bevacizumab (7.5 mg/kg) combined with pemetrexed and platinum-based chemotherapy as first-line treatment for advanced non-squamous NSCLC is non-inferior to the standard dose (15 mg/kg), with similar adverse reaction risks and good safety profile.

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 clinical significance of pulmonary artery distensibility (PAD) monitored by electrocardiogram-gated computed tomography pulmonary angiography (CTPA) in the prognostic risk stratification of patients with acute pulmonary embolism (APE).

A total of 109 APE patients who underwent electrocardiogram-gated CTPA in our hospital from February 2021 to December 2025 were enrolled. According to the prognosis, 23 patients with poor prognosis were assigned to the observation group and 86 patients with good prognosis to the control group. Serum high-sensitivity cardiac troponin I (hs-cTnI), D-dimer, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were compared between the two groups. The simplified Pulmonary Embolism Severity Index (sPESI), simplified Wells score, and Pulmonary Embolism Rule-out Criteria (PERC) score were calculated. The right ventricle/left ventricle transverse diameter ratio (RV/LV), pulmonary artery obstruction index (PAOI), and PAD were measured by CTPA. The predictive value was assessed by receiver operating characteristic (ROC) curves. Multivariate logistic regression analysis was used to identify prognostic risk factors, and a nomogram model was constructed.

Compared with the control group, the observation group showed significantly higher serum hs-cTnI[96.50 (28.79, 269.32) pg/ml vs. 43.85 (24.22, 90.76) pg/ml], NT-proBNP [2 147.00 (422.05, 5 687.15) pg/ml vs. 140.60 (45.21, 614.20) pg/ml], sPESI [2.00(1.00, 3.00) points vs. 1.00(0.00, 1.00) points], and PERC score [2.00(2.00, 3.00) points vs. 1.00(1.00, 2.00) points], and lower systolic blood pressure [135.50 (119.75, 150.25) mmHg vs. 139.50 (124.50, 150.00) mmHg] (P<0.05). The observation group also had higher RV/LV [1.33 (1.08, 1.56) vs. 0.95 (0.90, 1.15)], a higher proportion of RV/LV>1.0 (89.66% vs. 49.65%), and higher PAOI [35.25% (31.03%, 40.73%) vs. 29.00% (25.93%, 34.23%)], while PAD was significantly lower [2.95 (2.22, 4.97)×10^-3/mmHg vs. 5.98(4.37, 7.31)×10^-3/mmHg] (P<0.05). ROC curve analysis showed that the area under the curve (AUC) of PAD for predicting poor short-term prognosis was 0.859 [95%CI: 0.803~0.904], with a sensitivity of 84.48% and a specificity of 80.14%. The AUC of RV/LV was 0.757 (95%CI: 0.691~0.815), with a sensitivity of 89.66% and a specificity of 54.61% at the cutoff value>1.0. The AUC of PAOI was 0.766 (95%CI: 0.700~0.823), with a sensitivity of 84.48% and a specificity of 70.21% at the cutoff value >30%. Multivariate logistic regression analysis revealed that NT-proBNP>125 pg/ml (OR=5.396, 95%CI: 1.822~15.978), RV/LV>1.0 (OR=7.562, 95%CI: 2.397~23.860), PAOI>30% (OR=13.784, 95%CI: 3.912~48.567), and PAD>4.28×10^-3/mmHg (OR=0.086, 95%CI: 0.028~0.270) were risk factors for the prognosis of APE (P<0.05). The AUC of the combined prediction was 0.94 (95%CI: 0.90~0.98), which was superior to that of any single indicator (P<0.05).

PAD measured by electrocardiogram-gated CTPA can reflect the mechanical changes of pulmonary vasculature in APE patients, and its predictive performance is superior to RV/LV and PAOI. The combination of PAD, RV/LV, PAOI, and NT-proBNP can improve the accuracy of risk stratification in APE patients, demonstrating clinical significance.

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 explore predictive biomarkers for the efficacy of firstline immune checkpoint inhibitors (ICIs) combined with chemotherapy in patients with advanced non-small cell lung cancer (NSCLC) and to construct a prognostic scoring model.

A total of 125 patients with advanced NSCLC who received firstline ICIs plus chemotherapy in our hospital from October 2023 to October 2025 were enrolled, and treatment responses were analyzed. Variables were screened by LASSO regression, and the NLAL scoring system was constructed based on neutrophiltolymphocyte ratio (NLR), lactate dehydrogenase (LDH), albumin (ALB), and liver metastasis. Patients were divided into a lowrisk group (0-1 point, 95 cases) and a highrisk group (2–5 points, 30 cases). Patients were divided into the observation group (NLR>3.25) and the control group (NLR<3.25). Progressionfree survival (PFS) was analyzed using receiver operating characteristic (ROC) curves, multivariate Cox proportional hazards regression, and KaplanMeier curves.

The disease control rate (DCR) in the lowrisk group was 84.21%, significantly higher than that in the highrisk group (60.00%) (χ²=7.892, P=0.005); the objective response rate (ORR) was also higher in the lowrisk group [40.00% (38/95) vs. 10.00% (3/30), χ²=9.310, P=0.002]. The area under the curve (AUC) of the NLAL score for predicting DCR was 0.797 (95%CI: 0.665~0.872), which was superior to single indicators including NLR (AUC=0.735), LDH (AUC=0.752), ALB (AUC=0.718), liver metastasis (AUC=0.689), and PDL1 expression (AUC=0.578) (all P<0.05). Multivariate Cox regression showed that liver metastasis (HR=1.524, 95%CI: 1.032~2.248, P=0.034), NLR>3.25 (HR=1.854, 95%CI: 1.247~2.766, P=0.003), LDH>225 U/L (HR=1.654, 95%CI: 1.114~2.452, P=0.013), and ALB<36.52 g/L(HR=1.416, 95%CI: 1.005~1.996, P=0.046) were risk factors for shorter PFS. The median PFS was longer in the lowrisk group than in the highrisk group (15.31 months vs. 6.78 months, logrank P<0.001). The AUC of the NLAL score for predicting PFS was 0.763 (95%CI: 0.689~0.821), superior to single indicators (P<0.05). With a median followup of 19 months, 72 patients (57.60%) survived and 53 (42.40%) died.

The NLAL score based on NLR, LDH, ALB, and liver metastasis can predict ORR, DCR, and PFS in advanced NSCLC patients receiving firstline ICIs combined with chemotherapy, and it is superior to single peripheral blood biomarkers and PDL1 expression, demonstrating clinical utility.

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.