The clinical diagnosis and treatment of urinary tract infection has long faced the challenges of insufficient standardization of diagnosis and treatment pathways， irrational use of antimicrobial drugs and high recurrence rate. How to optimize the hierarchical diagnosis and treatment pathway of urinary tract infection， standardize the use of antimicrobial drugs， and reduce the recurrence rate have always been the focus of clinical attention. There is significant heterogeneity in the existing diagnostic criteria for urinary tract infection， which seriously affects the comparability and evidence integration of clinical and research studies. In order to solve the above problems， a consensus on global multidisciplinary diagnostic criteria for urinary tract infection has been formed by international multidisciplinary experts after three rounds of Delphi method. Breaking through the traditional classification framework， the consensus innovatively established a four-dimensional quantitative scoring system including local symptoms and signs， systemic inflammatory response， quantitative analysis of pyuria and urine culture results， and established a hierarchical standard for stepwise urinary tract diagnosis according to the scoring threshold. Based on the key citations related to the consensus， this paper interprets in detail the basis for the selection of core indicators and the establishment of thresholds for the diagnosis of urinary tract infection in the consensus， and focuses on the key issues and implementation paths of the consensus in localization practice. This consensus provides a unified standard for standardizing the clinical diagnosis and treatment of urinary tract infection， improving the homogeneity of clinical research through standardized diagnostic processes， and promoting the standardization of UTI drug research and development and the rational use of antibiotics and precision.

Objective To investigate the underlying mechanisms contributing to the limited therapeutic efficacy of endocrine therapy combined with CDK4/6 inhibitors in HR⁺/HER2-low breast cancer， and to develop a breast cancer organoid model as a tool for the precise identification of HR⁺/HER2-low patients who are responsive to pan-TKI treatment. Methods Transcriptomics was employed to identify differentially expressed genes in HR⁺/HER2-0 and HR⁺/HER2-low breast cancer samples and to perform functional enrichment analysis. Tumor organoid models were established using breast cancer tissues obtained from clinical sources， and the differential sensitivity of these samples to therapeutic agents was assessed using Calcein-AM/PI cell viability staining and EdU-based cell proliferation assays. Results The results of transcriptomic enrichment analysis indicated that EGFR was significantly activated in HR⁺/HER2-low breast cancer and exhibited characteristics of resistance to TKIs. Breast cancer organoids were successfully established. Drug sensitivity testing revealed that the therapeutic efficacy of ET combined with CDK4/6 inhibitors was suboptimal in certain cases of HR⁺/HER2-low breast cancer， while the addition of TKIs effectively restored sensitivity to the ET+CDK4/6 inhibitor regimen （P < 0.05）. Conclusions TKI can restore the reduced sensitivity of HR⁺/HER2-low breast cancer to endocrine therapy combined with CDK4/6 inhibitors. Breast cancer organoids hold promise as screening tools for assessing drug sensitivity in clinical settings for patients with HR⁺/HER2-low breast cancer.

Objective To investigate the molecular mechanism by which super enhancers （SEs） regulate the expression of the genetic suppressor element 1 （GSE1） and influence the proliferation of breast cancer cell line MCF-7. Methods The oncogene GSE1， driven by SEs， was identified through analysis of the ChIP-seq dataset of MCF-7 cells obtained from the GEO database. The protein expression level of GSE1 was assessed via Western blot following treatment with the bromodomain-containing protein 4 （BRD4） inhibitor JQ1. The expression of GSE1 across various cancers and different breast cancer subtypes was analyzed using the Human Protein Atlas （HPA） and The Cancer Genome Atlas （TCGA） databases， respectively. Overall survival （OS） of breast cancer patients was compared between the GSE1 high-expression and low-expression groups using the GEPIA database. Immunohistochemistry （IHC） was performed to evaluate GSE1 expression in breast cancer tissue samples. The mRNA expression levels of GSE1 in different breast cancer cell lines were validated by RT-qPCR. A GSE1 interference vector was constructed and transfected into MCF-7 cells， and the knockdown efficiency was assessed using Western blot. Cell proliferation and migration were evaluated using CCK-8 assay， colony formation assay， wound healing assay， and Transwell migration assay. Potential GSE1-interacting proteins were predicted using the STRING database. Finally， Western blot analysis was conducted to assess changes in epithelial-mesenchymal transition （EMT）-related proteins and key components of the Wnt/β-catenin signaling pathway. Results The integrative genomics viewer （IGV） was used to visualize ChIP-seq data from MCF-7 cells， and the rank ordering of super enhancers （ROSE） algorithm was applied to predict the SE region of GSE1 in the MCF-7 genome. GSE1 and BRD4 expression levels were significantly reduced following JQ1 treatment （P < 0.05）. High expression levels of GSE1 in breast cancer were confirmed through analyses using the HPA， TCGA， and GEPIA databases， as well as IHC， and these findings were associated with poor prognostic outcomes in breast cancer patients （P < 0.05）. RT-qPCR results further demonstrated that GSE1 is significantly upregulated in breast cancer cells （P < 0.05）. Analysis of the STRING database revealed a strong correlation between GSE1 and Snail （Snai1）. Transfection of a GSE1-specific interference vector significantly inhibited the proliferation and migration of MCF-7 cells compared to the control group， upregulated E-cadherin and Occludin expression， and downregulated N-cadherin and Snail expression （P < 0.05）. Additionally， knockdown of GSE1 resulted in decreased expression of Wnt/β-catenin signaling pathway-related proteins， including β-catenin， Wnt-5a， and Cyclin-D1， along with increased Axin1 expression （P < 0.05）. Conclusion SE driven GSE1 promotes the proliferation， migration and EMT of MCF-7 cells via the Wnt/β-catenin signaling pathway.

Objective To evaluate the diagnostic efficacy of sound touch viscoelastography （STVi） and shear wave elastography （SWE） in distinguishing between benign and malignant breast nodules. Methods A total of 104 breast nodules （52 benign and 52 malignant） from 102 patients scheduled for surgical treatment at Binzhou Medical University Hospital between October 2024 and February 2025 were prospectively enrolled. All nodules were pathologically confirmed through surgical excision or core needle biopsy. The viscosity coefficient and Young′s modulus of both intranodular and perinodular tissues within a 2-mm range were measured using the Mindray Resona A20S ultrasound system. The diagnostic performance of each parameter， the correlation between elastic parameter values and the maximum nodule diameter， as well as the inter-correlation between the two parameters were systematically analyzed. Results The elasticity parameters were significantly higher in malignant nodules ［maximum intranodular Viscosity coefficient （Vi_max）： 5.93 （4.33， 8.47） Pa·s， maximum Young′s modulus （E_max）： 81.18 （58.31， 120.33） kPa； maximum Viscosity coefficient of the surrounding 2-mm tissue （Vi2_max）： 7.57 （5.40， 10.16） Pa·s， maximum Young's modulus （E2_max）： 117.21 （65.66， 170.66） kPa］ compared to benign nodules ［Vi_max： 3.70 （2.69， 5.32） Pa·s， E_max： 41.42 （28.29， 64.25） kPa； Vi2_max： 4.30 （3.63， 5.65） Pa·s， E2_max： 47.23 （36.42， 74.67） kPa］ （P < 0.05）. The diagnostic performance of the 2-mm perinodular tissue （Vi2_max： 0.78， E2_max： 0.81） surpassed that of intranodular tissue （Vi_max： 0.72， E_max： 0.77） （P < 0.05）. The combined diagnostic model （Vi2+E2，Vi+E） achieved AUC values of 0.82 and 0.77， respectively， which outperformed STVi alone （P < 0.05） and showed marginally better performance than SWE alone， although the difference was not statistically significant （P > 0.05）. The maximum nodule diameter showed a moderate correlation with the elasticity parameters， with E2_max exhibiting the strongest correlation （r = 0.510，P < 0.05）. Conclusions Both STVi and SWE show clinical value in distinguishing between benign and malignant breast nodules. Particularly， elasticity parameters obtained from the 2-mm perinodular tissue demonstrate better diagnostic performance than those measured within the nodule itself， and combining these parameters enhances the overall diagnostic accuracy of STVi.

Objective To evaluate the predictive value of a nomogram model developed by integrating clinical and ultrasound multiparameters for HER-2-positive breast cancer. Methods This study retrospectively enrolled 343 patients with pathologically confirmed breast cancer from three medical centers and randomly divided them into training and validation cohorts. Univariate analysis， LASSO regression， and multivariate logistic regression were conducted on the training set to identify independent prognostic factors and construct a nomogram model. Bootstrap resampling with 1000 iterations was performed to evaluate the model′s robustness. Model calibration was assessed using calibration curves and the Hosmer-Lemeshow goodness-of-fit test. Receiver operating characteristic （ROC） curves were generated to evaluate model discrimination， and the area under the curve （AUC） along with other performance metrics were calculated. Decision curve analysis was employed to assess the clinical utility of the model， and the validation cohort was used for external validation. Results Univariate， LASSO， and multivariate regression analyses demonstrated that age， TTP （time to peak）， and the presence of a filling defect sign were independent predictors of HER-2-positive breast cancer （all P < 0.05）. Based on these independent predictors， a nomogram model was constructed. Bootstrap validation with 1，000 resamples indicated that the model′s predictive performance was stable. The Hosmer-Lemeshow test confirmed satisfactory model calibration， while the calibration curve illustrated accurate prediction probabilities. The area under the curve （AUC） for the training set was 0.863 （95%CI： 0.806 ~ 0.920）， and for the validation set， it was 0.846 （95%CI： 0.764 ~ 0.929）， indicating strong discriminative and generalization capabilities. Additionally， the clinical decision curve analysis demonstrated favorable clinical utility. Conclusion A nomogram model integrating clinical and multimodal ultrasound parameters demonstrates potential utility in predicting HER-2-positive breast cancer.

Autism spectrum disorder （ASD） is a severe neurodevelopmental disorder with onset in childhood， characterized by persistent social communication deficits and restricted， repetitive patterns of behavior. In recent years， its global prevalence has shown a continuous upward trend. However， there remains a lack of effective treatments capable of improving brain function in ASD.This article systematically reviews the mechanisms， clinical efficacy， and safety of HBOT in ASD， while exploring its potential therapeutic value. Research indicates that HBOT exerts its effects through the following mechanisms： enhancing plasma oxygen saturation， thereby improving oxygen supply to ischemic brain regions； inhibiting microglial activation， reducing pro-inflammatory cytokine levels； modulating gut microbiota homeostasis， restoring brain-gut axis dysfunction. Clinical studies demonstrate that when HBOT is combined with Applied Behavior Analysis （ABA）， it significantly reduces behavioral scale scores in children with ASD while improving their social interaction， self-care abilities， and verbal communication. Additionally， HBOT positively regulates oxidative stress markers and enhances perfusion in specific brain regions. Regarding safety， strict adherence to operational protocols minimizes the risk of adverse effects （e.g.， barotrauma）. This review provides evidence-based support for the standardized application of HBOT in ASD. Future research should focus on optimizing treatment protocols （e.g.， pressure and oxygen concentration parameters） and evaluating long-term efficacy.

The coagulopathy convergence model， by integrating the complex interplay among coagulation， inflammation， and innate immunity， offers novel insights into the intricate pathophysiology of heparin-induced thrombocytopenia （HIT） and vaccine-induced immune thrombotic thrombocytopenia （VITT）， thereby facilitating their differential diagnosis and clinical management. This review systematically outlines the core pathophysiological differences between these two conditions within the framework of the model. Although both disorders involve a platelet factor 4 （PF4）-dependent thrombotic pathway， they demonstrate notable differences in antibody profiles and mechanisms of immune amplification. Recent advances in diagnosis include the rapid diagnostic algorithm TORADI-HIT for HIT and the emerging clinical utility of neutrophil extracellular traps （NETs） as biomarkers for VITT. For refractory and severe cases， in addition to conventional anticoagulant and immunomodulatory therapies， model-guided targeted therapeutic strategies have become a focal point of research， including inhibition of NET formation （NETosis）， blockade of the complement cascade， and modulation of FcγRⅡa signaling. The translational potential of these strategies merits further investigation. Moreover， monitoring NET degradation products and complement activation fragments may aid in optimizing treatment and stratifying prognoses. This review proposes and visually illustrates an integrated "diagnosis-treatment-monitoring" clinical pathway for HIT and VITT， providing a standardized approach for clinical application. The model highlights a key damage-associated molecular patterns （DAMPs）-NETs-immunothrombosis axis， which serves as a crucial framework for understanding and implementing stratified， precision-based interventions in these complex immune-mediated thrombotic disorders.

Objective To investigate the efficacy of discontinuous density gradient combined with swim-up method for bacterial removal in frozen semen， and to provide experimental evidence for the safe application of frozen semen in assisted reproductive technology. Methods A total of 208 frozen semen samples containing non-pathogenic bacteria， cryopreserved in our human sperm bank from January 2019 to December 2023， were selected. The thawed semen samples were processed using discontinuous density gradient combined with swim-up method. To simulate in vitro fertilization procedures， the processed sperm suspensions were subjected to 5-day in vitro culture for bacterial residue monitoring. Prior to cryopreservation， all semen samples underwent routine bacterial culture to exclude pathogenic microorganisms. Post-thaw semen samples， processed sperm suspensions， and 5-day culture media were sent to an independent third-party laboratory for comprehensive bacterial identification. Results Among the 208 frozen semen samples containing non-pathogenic bacteria， 41 bacterial species were identified， with 1 ~ 4 species per sample. After processing with discontinuous density gradient combined with swim-up method， the sterility rate of the sperm suspension reached 89.42% （186/208）， with residual bacteria including Enterococcus faecalis， Corynebacterium glucuronolyticum， Group B Streptococcus， and Corynebacterium glycinophilum. After 5-day in vitro culture， the sterility rate increased to 93.75% （195/208）， with residual bacteria limited to Enterococcus faecalis and Group B Streptococcus. Conclusions The combined method of discontinuous density gradient and swim-up technique effectively eliminates most bacteria in frozen semen. However， the clearance rate for Enterococcus faecalis and Group B Streptococcus remains below 90%. Optimization of pre-freezing bacterial screening and post-thaw processing techniques is necessary to enhance the safety of frozen semen in assisted reproductive technology.

Objective To investigate the expression level of the protein inhibitor of the activated STAT2 （PIAS2） gene in prostate cancer and its relationship with clinicopathological features， and the potential role of PIAS2 in reprogramming lipid metabolism in prostate cancer. Methods The Cancer Genome Atlas Program （TCGA） database and HPA immunohistochemical analysis were used to show the expression of PIAS2 protein； qRT-PCR， Western bolt and immunohistochemistry were used to detect PIAS2 in prostate cancer tissues and their paracancerous tissues. PIAS2 expression in prostate cancer tissues and its paracancerous tissues and analyzed its relationship with clinicopathological features of patients； lentivirus infected prostate cancer cell line PC-3M， which stably knocked down PIAS2， was analyzed by ultra performance liquid chromatography mass spectrometry （UPLC-MS） for lipidomics. Results TCGA analysis showed that the expression of PIAS2 in prostate cancer tissues was higher than that in paracancerous tissues， and HPA immunohistochemistry analysis showed that PIAS2 protein was highly expressed in prostate cancer tissues； the expression of PIAS2 mRNA and protein was significantly elevated in prostate cancer compared with that in paracancerous tissues， and the difference was statistically significant （P < 0.05）； immunohistochemistry showed that PIAS2 protein Expression of PIAS2 protein was mainly localized in the nucleus of prostate， and the AOD value of prostate cancer tissues was significantly higher than that of paraneoplastic tissues： the results of clinicopathological parameters showed that PIAS2 had correlation with Gleason score and TNM stage （P < 0.05）， while there was no statistically significant correlation with the age of the patients， PSA and lymph node metastasis； UPLC-MS analysis suggested that the knockdown of PIAS2 affected 10 lipid changes， with down-regulation of phosphatidylcholine and phosphatidylethanolamine and up-regulation of phosphatidylinositol， phosphatidylserine， diacylglycerol， and triacylglycerol in the shPIAS2 group compared with the shNC group. Conclusions The expression of PIAS2 protein was significantly elevated in prostate cancer tissues， suggesting that PIAS2 is associated with the development of prostate cancer， and its pathogenesis may be related to the abnormal lipid metabolism of prostate cancer.

Objective To analyze the clinical characteristics and risk factors of children with B-cell acute lymphoblastic leukemia （B-ALL） who developed acute pancreatitis （AP） after treatment with pegaspargase （PEG-ASP）. Methods A retrospective analysis was conducted on the general data， clinical data， blood routine data， albumin concentration， and cumulative dose of PEG-ASP of 272 children with ALL complicated with AP who received PEG-ASP treatment in the hospital from January 2021 to February 2023. The correlations between gender， age， risk stratification， cumulative dose of pegaspargase， blood routine indicators， albumin concentration and the progression of pancreatitis were analyzed. Results Among the 272 children， the incidence of AP was 8.5% （23/272）. There was no statistically significant correlation between AP and gender， age， body mass index （BMI）， risk stratification， cumulative dose of pegaspargase， hemoglobin concentration， platelet count and monocyte count （P > 0.05）， but there was a significant correlation with white blood cell count， neutrophil count， lymphocyte count， neutrophil/lymphocyte ratio， platelet/lymphocyte ratio and albumin concentration （P < 0.05）. Logistic regression analysis further showed that white blood cell count， neutrophil count， lymphocyte count and albumin concentration were related to the occurrence of PEG-ASP-related AP （P < 0.05）. ROC analysis found that white blood cell count， lymphocyte count and albumin concentration could predict the occurrence of PEG-ASP-related AP. Conclusions White blood cell count， neutrophil count， lymphocyte count and albumin concentration are risk factors for PEG-ASP-related AP in children with B-ALL. Especially， abnormal white blood cell count， lymphocyte count and albumin concentration in blood routine examination can help identify high-risk children with B-ALL complicated with PEG-ASP-related AP at an early stage.

Objective To investigate the predictive value of preoperative ultrasound in combination with neutrophil-to-lymphocyte ratio （NLR）， calcitonin （Ctn）， and carcinoembryonic antigen （CEA） for cervical lymph node metastasis in patients with papillary thyroid carcinoma. Methods A total of 103 patients diagnosed with papillary thyroid carcinoma （PTC） who were admitted to the hospital between October 2021 and October 2024 were selected as the case group. Among them， 34 patients with cervical lymph node metastasis confirmed by surgical and pathological examination were assigned to the metastatic group， and 69 patients without cervical lymph node metastasis were assigned to the non-metastatic group. Additionally， 103 patients with benign thyroid nodules admitted during the same period were enrolled as the control group. Clinical data， ultrasonographic features， and serum levels of NLR， Ctn， and CEA were compared between the metastatic and non-metastatic groups. The predictive value of ultrasonographic features and the combined detection of NLR， Ctn， and CEA levels for cervical lymph node metastasis in PTC was evaluated using receiver operating characteristic （ROC） curve analysis. Results Compared to the control group， the case group exhibited a higher proportion of patients with microcalcification and grade 3 blood flow， as well as elevated levels of NLR， Ctn， and CEA （P < 0.05）. Similarly， compared to the non-metastatic group， the metastatic group showed a higher proportion of patients with microcalcification and grade 3 blood flow， along with increased levels of NLR， Ctn， and CEA （P < 0.05）. The metastatic group tested positive， whereas the non-metastatic group tested negative. The area under the curve （AUC） for ultrasound features （microcalcification， blood flow classification） combined with NLR， Ctn， and CEA levels in diagnosing cervical lymph node metastasis in papillary thyroid carcinoma was higher than that of individual indicators （P < 0.05）. Conclusions Preoperative ultrasound combined with the assessment of NLR， Ctn， and CEA levels demonstrates significant predictive value for cervical lymph node metastasis in papillary thyroid carcinoma.

Objective To compare the clinical outcomes of two internal fixation methods for the treatment of lateral column injuries following Schatzker type Ⅳ tibial plateau fractures with posterior lateral displacement of bone fragments. Methods A retrospective analysis was performed on the clinical data of 61 patients who underwent surgical treatment for lateral column injuries associated with Schatzker type Ⅳ tibial plateau fractures at the institution between March 2019 and August 2024. Of these patients， 34 who were treated with isolated lateral plating were allocated to the experimental group， and 27 who received combined fixation using a posterior T-plate and lateral plate were assigned to the control group. Results Both groups showed no incidence of grade C wound healing following surgery. The experimental group demonstrated a grade A wound healing rate of 94.1%， which was significantly higher than that of the control group （70.4%）. The surgical duration in the experimental group was significantly shorter ［（83.8 ± 8.5） minutes］ compared to the control group ［（115.7 ± 11.2） minutes］. Additionally， the postoperative hospital stay was shorter in the experimental group ［（12.5 ± 3.1） d］ than in the control group ［（14.9 ± 3.2） d］. The intraoperative blood loss in the experimental group ［（271.0 ± 51.3） mL］ was also significantly lower than that in the control group ［（308.5 ± 60.1） mL］， and the difference was statistically significant （P < 0.05）. No statistically significant difference was observed in fracture healing time between the two groups （P > 0.05）. At the final follow-up， no statistically significant differences were found in KSS or VAS scores between the two groups （P > 0.05）. Conclusions Both the simple lateral plate fixation method and the posterior T-shaped plate combined with lateral plate fixation method are applicable for the treatment of Schatzker type Ⅳ tibial plateau fractures involving posterior-lateral column injuries. However， the simple lateral plate fixation method is associated with shorter surgical duration， reduced hospitalization， less intraoperative blood loss， and a higher rate of incision healing.

Objective To investigate the therapeutic efficacy of the combination of upper limb rehabilitation robots （ULRR） and ultrasound-guided extracorporeal shock wave （ESW） in the treatment of mild to moderate rotator cuff injuries. Methods A total of 90 patients with mild to moderate rotator cuff injuries， who were admitted to the Second Affiliated Hospital of Anhui Medical University between January 2023 and March 2024， were selected and randomly assigned to three groups： Group A （basic rehabilitation）， Group B （basic rehabilitation + ESW）， and Group C （basic rehabilitation + ESW + ULRR）， with 30 patients in each group. Before and after treatment， shoulder pain was assessed using the visual analogue scale （VAS）. Proprioception was evaluated based on shoulder joint position reproduction error. The integral electromyography （iEMG） and root mean square （RMS） values of the median tract， supraspinatus， infraspinatus， and deltoid muscles on the affected side were measured using surface electromyography （sEMG）. The active range of motion （AROM） for external rotation， abduction， and forward flexion of the affected shoulder was measured using a standard goniometer. Overall shoulder function was evaluated using the Constant-Murley Shoulder Score （CMS）. The clinical efficacy rate and patient satisfaction levels were compared among the three groups. Results After treatment， the VAS score and shoulder position reproduction deviation angle in all three groups significantly decreased. Additionally， the iEMG and RMS values of the middle deltoid， supraspinatus， and infraspinatus muscles； the AROM of shoulder external rotation， abduction， and forward flexion； and the CMS scores （including pain， activities of daily living， active range of motion， and muscle strength） all showed significant improvement. Furthermore， the degree of improvement in all evaluated parameters in Group C was significantly greater than that observed in Groups A and B （P < 0.05）. Moreover， Group C demonstrated a significantly higher clinical response rate and greater patient satisfaction compared to Groups A and B （P < 0.05）. Conclusion For patients with mild to moderate rotator cuff injuries， the integration of an upper limb rehabilitation robot with extracorporeal shock wave therapy demonstrates superior therapeutic outcomes， effectively alleviating pain， enhancing motor function and proprioception， and increasing overall patient satisfaction.

Objective To investigate the potential association between XRCC1 and XRCC3 gene polymorphisms and susceptibility to cervical cancer within populations infected with high-risk human papillomavirus （HPV）. Methods A cohort of 176 cervical cancer patients with high-risk HPV infection， diagnosed at the First People's Hospital of Kashgar Region between January 2021 and January 2023， were enrolled as the study group. Concurrently， 177 women infected with high-risk HPV but without cervical cancer were enrolled as the control group. All participants were followed up， and genotyping along with HPV subtyping was conducted for subsequent analysis. Results The XRCC1 Arg399Gln genotype showed a significant association with cervical cancer risk among individuals infected with specific HPV subtypes （e.g.， HPV-16， -18， -52， and -58）， but no significant correlation was observed with the number of concurrent HPV infections. Compared to non-carriers， individuals carrying the XRCC1 Arg399Gln genotype exhibited an increased risk of cervical cancer， particularly among those infected with HPV-16， -18， -52， or -58. Statistically significant differences were found between the control group and the cervical cancer group for the XRCC1 Arg280His （P < 0.001） and XRCC3 Thr241Met （P < 0.05） genotypes； however， no significant differences were observed for XRCC1 Arg194Trp and XRCC1 Arg399Gln polymorphisms （P > 0.05）. Further analysis revealed that the XRCC1 Arg280His polymorphism was associated with a 3.57-fold higher risk of cervical cancer （OR = 3.57， 95%CI： 1.99 ~ 6.43）， while XRCC1 Arg194Trp showed no significant association （P > 0.05）. Additionally， XRCC1 Arg399Gln was associated with a reduced risk （OR = 0.57， 95%CI： 0.34 ~ 0.96）， and XRCC3 Thr241Met was linked to a decreased risk of cervical cancer （OR = 0.22， 95%CI： 0.06 ~ 0.84）. Conclusions In the HPV-infected population of Kashgar， the XRCC1 Arg280His polymorphism is significantly associated with an increased risk of cervical cancer （OR = 3.57）， whereas the XRCC3 Thr241Met （GG） genotype exhibits a protective effect （OR = 0.16）. The XRCC1 Arg399Gln variant demonstrates a protective association specifically among TT homozygotes （OR = 0.57）. In contrast， the XRCC1 Arg194Trp polymorphism does not show a statistically significant association with cervical cancer risk.

Objective To investigate the factors influencing the persistence of residual low back pain following percutaneous vertebroplasty （PVP） in patients with osteoporotic vertebral fractures （OVF）， in order to provide a scientific basis for clinical intervention strategies. Methods A retrospective analysis was conducted on data from 1 120 patients diagnosed with OVF who received PVP treatment between July 2020 and June 2025. Among them， 61 patients who experienced residual low back pain in the early postoperative period （defined as 2 days to 1 month after surgery） with a postoperative visual analog scale （VAS） score greater than 3 points were selected as the observation group. An additional 61 control subjects were matched to the observation group at a 1∶1 ratio based on age （± 5 years）， gender， and preoperative bone mineral density （± 0.5 standard deviation）. Univariate and logistic regression analyses were subsequently performed to evaluate potential influencing factors. Results Univariate analysis revealed statistically significant differences between the two groups with respect to preoperative thoracolumbar fascia injury （TFI）， MRI-detected liquefaction signals in the affected vertebrae， the number of involved vertebrae （≥ 2）， and suboptimal bone cement distribution （P < 0.05）. Multivariate regression analysis confirmed that these factors were independent risk factors， with corresponding odds ratios （ORs） of 5.378， 6.111， 3.245， and 2.890 （all P < 0.05）. The area under the curve （AUC） of the predictive model was 0.929， indicating a high level of predictive accuracy. Conclusion Preoperative TFI， MRI-demonstrated liquefaction signals in the affected vertebrae， the presence of multiple responsible vertebrae， and suboptimal bone cement distribution may contribute to an increased risk of early residual low back pain following PVP.

Objective To investigate the association between Helicobacter pylori （Hp） infection and the expression levels of p27， CyclinD1， matrix metalloproteinase 9 （MMP-9）， and related microRNAs， as well as their correlations with clinicopathological characteristics in gastric cancer （GC） tissues. Methods A total of 116 GC patients who underwent surgical resection were enrolled and classified into Hp-positive and Hp-negative groups based on Hp infection status， consisting of 76 and 40 cases， respectively. Among the Hp-positive group， patients were further categorized into good prognosis and poor prognosis subgroups according to their clinical outcomes， with 56 and 20 cases， respectively. The expression levels of p27， CyclinD1， MMP-9 proteins， as well as miR-490-3p and miR-146a in both cancerous and paracancerous tissues across the groups were compared. Additionally， the associations between the expression of these biomarkers in cancer tissues and the clinicopathological features and prognosis of Hp-positive GC patients were analyzed. Furthermore， potential risk factors contributing to poor prognosis in Hp-positive GC patients were identified， and a predictive model was constructed to evaluate its prognostic value. Results The expression levels of p27 protein and miR-490-3p in GC tissues were significantly lower compared to those in adjacent non-cancerous tissues， whereas the expression levels of CyclinD1， MMP-9 protein， and miR-146a were significantly higher （P < 0.05）. In cancer tissues from the Helicobacter pylori （Hp）-positive group， the expression of p27 protein and miR-490-3p was lower than that in the Hp-negative group， while the expression of CyclinD1， MMP-9 protein， and miR-146a was higher （P < 0.05）. Moreover， in Hp-positive GC patients， the expression levels of p27 protein and miR-490-3p in cancer tissues were lower in those with advanced stages （Ⅲ ~ Ⅳ） and lymph node metastasis compared to those with early stages （Ⅰ ~ Ⅱ） and no lymph node metastasis （P < 0.05）. Conversely， the expression levels of CyclinD1， MMP-9 protein， and miR-146a were higher in patients with advanced stages and lymph node metastasis （P < 0.05）. Compared with the good prognosis group， the poor prognosis group exhibited a higher proportion of advanced stages， lymph node metastasis， and elevated expression levels of CyclinD1， MMP-9 protein， and miR-146a， while the expression levels of p27 protein and miR-490-3p were reduced （P < 0.05）. Multivariate analysis indicated that advanced stage （Ⅲ ~ Ⅳ）， low expression of p27 protein， high expression of MMP-9 protein， and low expression of miR-490-3p were independent risk factors for poor prognosis in Hp-positive GC patients （P < 0.05）. The predictive model constructed for assessing the likelihood of poor prognosis in Hp-positive GC demonstrated an area under the curve （AUC） of 0.774， with a sensitivity of 80.00% and a specificity of 76.79%. Conclusions p27， CyclinD1， MMP-9 protein， miR-146a， and miR-490-3p were found to be abnormally expressed in patients with Hp-positive GC. Their expression levels were significantly associated with TNM stage and the presence of lymph node metastasis. Specifically， Stage Ⅲ ~ Ⅳ disease， low expression of p27 protein and miR-490-3p， and high expression of MMP-9 protein were identified as independent risk factors for poor prognosis in patients with Hp-positive GC. A predictive model based on these risk factors demonstrated favorable performance in forecasting poor clinical outcomes in this patient population.

Objective To explore the optimal warning threshold of motor evoked potentials （MEP） in decompression surgery for ossification of the posterior longitudinal ligament （OPLL） at cervical and thoracic segments， and the predictive role of different MEP parameters on postoperative lower extremity motor function. Methods A retrospective analysis was conducted on the clinical data of 227 patients diagnosed with cervical or thoracic OPLL and underwent decompression surgery from January 2022 to January 2024 in the hospital. There were 131 males and 96 females， with an average age of （60 ± 10） years. All patients underwent continuous neurophysiological monitoring during the operation， and the minimum ratio of MEP amplitude change to the baseline at the beginning of the operation （D_max） and the ratio of MEP terminal amplitude change to the baseline at the end of the operation （D_end） were recorded. The correlations between these two ratios and the lower extremity motor function immediately after the operation and at 1 year were compared. According to the Medical Research Council muscle strength score （MRC） standard， a postoperative score increase of ≥1 point compared to preoperative was defined as postoperative motor dysfunction. Pearson correlation coefficients were used to evaluate the correlations between D_max and D_end and the lower extremity motor function immediately after the operation and at 1 year. Receiver operating characteristic （ROC） curves were drawn to predict postoperative lower extremity motor dysfunction using D_max and D_end. Results Among the 227 patients， 186 had cervical OPLL and 41 had thoracic OPLL. The incidence of lower extremity motor dysfunction immediately after the operation and at 1 year was 7 cases （3.76%） and 2 cases （1.08%） in the cervical group， and 9 cases （21.95%） and 3 cases （7.32%） in the thoracic group， respectively. The incidence of lower extremity motor dysfunction in the thoracic group was higher than that in the cervical group （P < 0.001）. The baseline induction rate of bilateral lower extremity MEPs was 98.92% （368/372） in the cervical group and 96.34% （79/82） in the thoracic group. The Pearson correlation coefficients of D_end with the bilateral lower extremity motor function immediately after the operation in the cervical and thoracic groups were both greater than those of D_max， and the differences were statistically significant （cervical group： r = 0.669， 0.517， P = 0.001 2； thoracic group： r = 0.882， 0.727， P = 0.003 6）， while the differences in the Pearson correlation coefficients of D_end and D_max with the bilateral lower extremity motor function at 1 year were not statistically significant （cervical group： r = 0.457， 0.352， P = 0.088； thoracic group： r = 0.760， 0.625， P = 0.098）. The cut-off values of D_end for the cervical group were 0.853 immediately after the operation and at 1 year， and the cut-off values of D_max were 0.881 and 0.978， respectively. For the thoracic group， the cut-off values of D_end were 0.532 immediately after the operation and 0.639 at 1 year， and the cut-off values of D_max were 0.532 and 0.640， respectively. Conclusions In OPLL surgery， the MEP monitoring strategy should be adjusted according to the surgical segment. For the cervical segment， D_max should be emphasized to balance high sensitivity and specificity， while for the thoracic segment， D_max or D_end can be flexibly selected. Higher MEP warning thresholds are required for cervical OPLL surgery （D_max： 0.881 immediately after the operation and 0.978 at 1 year； D_end： 0.853）， while significantly lower thresholds are needed for thoracic OPLL （D_max/D_end： 0.532 immediately after the operation and 0.640 at 1 year）.

Objective To investigate the impact of sintilimab combined with TP chemotherapy regimen on immune function and prognostic survival in patients with advanced esophageal cancer. Methods A total of 82 patients with advanced esophageal cancer who received treatment in the hospital from January 2022 to October 2023 were enrolled. They were divided into two groups with 41 cases in each group using the random number table method. The control group was given the TP chemotherapy regimen， while the observation group was treated with sintilimab in addition to the TP chemotherapy regimen used in the control group. The treatment cycle was 21 days， and both groups received 4 cycles of treatment. After that， the observation group received sintilimab monotherapy for maintenance treatment for at least 1 year. The disease control rate （DCR） and objective response rate （ORR） of the patients were recorded. The immune function， levels of inflammatory factors and tumor markers before and after treatment were compared between the two groups. The swallowing function and quality of life of the patients before and after treatment were evaluated using the Swallowing Safety Assessment （SSA） and the Quality of Life Instruments for Cancer Patients - Esophageal Cancer （QLICP-ES）. The occurrence of adverse reactions was also recorded. After the start of treatment， the patients were followed up for 18 months， and the overall survival （OS） and survival rate were recorded. Results In the observation group， the partial remission rate and disease control rate were 53.66% and 87.80% respectively， both higher than those in the control group. After treatment， the levels of CD3⁺ and CD4⁺ in the observation group were （50.48 ± 5.61）% and （37.96 ± 4.69）% respectively， which were higher than （44.73 ± 5.12）% and （33.15 ± 4.21）% in the control group. The immune function of the observation group was improved compared with the control group， while the levels of inflammatory factors and tumor markers were lower than those in the control group. The swallowing function and quality of life were significantly improved compared with the control group （P < 0.05）.The 18-month follow-up results showed that the median overall survival （OS） in the observation group was 16 （9， 17） months， and that in the control group was 9 （7， 14） months. The OS in the observation group was longer than that in the control group （χ2 = 13.394， P < 0.001）. The 18months survival rates in the observation group and the control group were 60.98% （25/41） and 36.59% （15/41） respectively， with the observation group being higher than the control group （χ2 = 4.881， P = 0.027）. Conclusion The sintilimab combined with TP chemotherapy regimen is beneficial for improving immune function and enhancing the survival status of patients with advanced esophageal cancer.

Objective To evaluate the clinical efficacy and safety of the daratumumab-based regimens， including daratumumab， dexamethasone， and lenalidomide （DRd）， as well as daratumumab， dexamethasone， and bortezomib （DVd）， in the treatment of patients with relapsed or refractory multiple myeloma （RRMM） at our center. Methods Eighty patients with RRMM were assigned to either the DRd group （42 cases） or the DVd group （38 cases） based on their treatment regimens. Both groups received a baseline treatment of daratumumab combined with dexamethasone （Dd regimen）. In the DVd group， 1.3 mg/m² of bortezomib was administered subcutaneously on days 1， 4， 8， and 11 of each cycle， followed by a 10 day drug-free interval （days 12 ~ 21）， repeated every 3 weeks until disease progression. In the DRd group， 25 mg of lenalidomide was orally administered daily from day 1 to day 21 of each cycle， in addition to the Dd regimen， continuing until disease progression. The two groups were compared in terms of laboratory parameters， tumor markers， clinical efficacy， safety profiles， and long-term prognostic outcomes. Results After treatment， the overall response rate （ORR） of the DRd group and the DVd group was 78.57% （33 out of 42 cases） and 52.63% （20 out of 38 cases）， respectively. The serum creatinine （SCr） levels were （92.54 ± 14.33） and （102.07 ± 15.41） μmol/L， respectively； the M protein contents were （19.62 ± 2.04） and （21.08 ± 2.23） g/L， respectively； the β2-microglobulin （β2-MG） levels were （3.49 ± 1.12） and （4.16 ± 1.25） mg/L， respectively； and the progression-free survival rates were 42.86% （18 out of 42 cases） and 26.32% （10 out of 38 cases）， respectively. All these indicators showed statistically significant differences between the DRd group and the DVd group （all P < 0.05）. The incidence rates of adverse reactions in the observation group and the control group were 14.29% （6 out of 42 cases） and 13.16% （5 out of 38 cases）， respectively， and the difference was not statistically significant （P > 0.05）. Conclusion The DRd regimen demonstrates superior efficacy compared to the DVd regimen in treating patients with RRMM， leading to improved patient prognosis with a favorable safety profile.

Objective To evaluate an ultrasound-based deep learning radiomics nomogram （DLR_Nomogram） for non-invasively differentiating between type Ⅰ and type Ⅱ epithelial ovarian cancer （EOC） before surgery. Methods In this study， a cohort of 195 patients diagnosed with EOC was analyzed. Participants were randomly divided into a training set and a testing set at an 8∶2 ratio. Following data preprocessing， region of interest （ROI） delineation， feature extraction and selection， as well as the clipping and extraction of the maximum section sonogram for each sample， three initial models were developed： the radiomics signature （Rad_Sig）， the deep transfer learning signature （DTL_Sig）， and the clinical signature （Clinic_Sig）. Subsequently， an integrated model—referred to as the DLR_Nomogram—was constructed by combining Rad_Sig， DTL_Sig， and Clinic_Sig， and was presented in the form of a nomogram. The performance of the model was evaluated using the receiver operating characteristic （ROC） curve and the corresponding area under the curve （AUC）. Results In the testing set， the DLR_Nomogram demonstrated superior predictive performance （AUC： 0.951， 95%CI： 0.876 ~ 1.000） compared to Rad_Sig （AUC： 0.709， 95%CI： 0.539 ~ 0.880）， DTL_Sig （AUC： 0.842， 95%CI： 0.712 ~ 0.972）， and Clinic_Sig （AUC： 0.916， 95%CI： 0.827 ~ 1.000）. The Hosmer?Lemeshow goodness-of-fit test for the DLR_Nomogram resulted in a p-value exceeding 0.05， indicating adequate model calibration. Moreover， decision curve analysis revealed that the DLR_Nomogram offers a higher net clinical benefit across a defined range of threshold probabilities. Conclusions The ultrasound-based DLR_Nomogram exhibits a robust ability to differentiate between Type Ⅰ and Type Ⅱ EOC， and may serve as a valuable clinical tool for guiding individualized preoperative diagnostic and therapeutic decision-making.

Objective To analyze the risk factors for postoperative recurrence in patients with chronic sinusitis and nasal polyps （CRSwNP） treated by endoscopic sinus surgery （ESS）， and to construct a predictive model. Methods A retrospective study was conducted on 203 patients with CRSwNP who underwent ESS in the hospital from March 2022 to February 2023. These patients were divided into a recurrence group （n = 43） and an non-recurrence group （n = 160） based on whether they experienced recurrence after surgery. Clinical data were collected and analyzed using univariate analysis to identify significant differences. Lasso regression was used to screen potential influencing factors. Multivariate logistic regression was employed to analyze the risk factors. A nomogram was constructed for postoperative recurrence model， and the receiver operating characteristic （ROC） curve and calibration curve were used to evaluate the model. Results Single-factor analysis showed that disease duration， Lund-Mackay CT score， SNOT-22 score， EOS， ECP， total IgE， CRP， IL-5， and IL-1β in the recurrence group after ESS were higher than those in the non-recurrence group （P < 0.05）， while the UPSIT score， CD3⁺， CD4⁺， CD8⁺， and CD4⁺/CD8⁺ were lower （P < 0.05）； the proportion of patients with allergic rhinitis， asthma， no preoperative glucocorticoid treatment， and surgery time ≥ 2 hours in the recurrence group after ESS was higher than that in the non-recurrence group （P < 0.05）. Multivariate logistic regression analysis model showed that disease duration （OR = 1.389， 95% CI： 1.094 ~ 1.763， P = 0.007）， combined asthma （OR = 2.997， 95% CI： 1.065 ~ 8.432， P = 0.038）， Lund-Mackay CT score （OR = 1.156， 95% CI： 1.027 ~ 1.301， P = 0.016）， EOS （OR = 1.540， 95% CI： 1.249 ~ 1.898， P < 0.001）， total IgE （OR = 1.005， 95% CI： 1.000 ~ 1.009， P = 0.041）， and IL-5 （OR = 1.165， 95% CI： 1.078 ~ 1.260， P < 0.001） were risk factors for ESS recurrence. Based on multivariate logistic regression analysis nomogram， the area under the ROC curve （AUC） was 0.9057； the sensitivity 76.74%； the specificity 87.5%； the average absolute error （MAE） of the calibration curve 0.03； the mean square error （MSE） 0.00157， and the absolute error at the 0.9 percentile 0.065. Conclusions Disease course， the presence of asthma， Lund-Mackay CT score， EOS， total IgE， and IL-5 are all risk factors for postoperative recurrence in patients with CRSwNP. Moreover， the relevant nomogram model can be used as a reliable tool for assessing the risk of postoperative recurrence in CRSwNP.

Objective To observe the dynamic changes in serum levels of IL-6， IL-8， TREM-1， uPAR， and presepsin in patients with septic shock and to analyze the diagnostic significance of these biomarkers. Methods A total of 150 sepsis patients admitted to the hospital between February 2023 and February 2025 were prospectively enrolled as study subjects. According to their clinical conditions， the participants were categorized into a sepsis group （non-shock， n = 44） and a septic shock group （n = 106）. Additionally， 30 healthy individuals with normal clinical indicators during the same period were selected as the control group. The serum levels of IL-6， IL-8， TREM-1， uPAR， and presepsin were measured and compared across the different groups. Spearman correlation analysis and logistic regression analysis were conducted to assess the association between these biomarkers and the severity of sepsis. The diagnostic performance of these biomarkers for septic shock was evaluated using receiver operating characteristic （ROC） curve analysis. Results There were statistically significant differences in serum levels of IL-6， IL-8， TREM1， uPAR， and presepsin among the different groups （P < 0.05）， with the highest values observed in the septic shock group， followed by the sepsis group and the control group （P < 0.05）. The APACHE Ⅱ and SOFA scores of patients with septic shock were significantly higher than those of patients with sepsis （P < 0.05）. Spearman correlation analysis revealed that serum concentrations of IL-6， IL-8， TREM1， uPAR， and presepsin were positively correlated with both APACHE Ⅱ and SOFA scores， with correlation coefficients （rs） of 0.758， 0.880， 0.837， 0.832， and 0.846 for APACHE Ⅱ score， and 0.487， 0.549， 0.557， 0.626， and 0.664 for SOFA score， respectively （P < 0.05）. Logistic regression analysis indicated that serum levels of IL-6 （OR = 1.055）， IL-8 （OR = 1.054）， TREM1 （OR = 1.038）， uPAR （OR = 1.010）， and presepsin （OR = 2.103） were significantly associated with the development of septic shock （P < 0.05）. ROC curve analysis demonstrated that the AUC values for serum IL-6， IL-8， TREM1， uPAR， and presepsin in diagnosing septic shock were 0.608， 0.724， 0.887， 0.848， and 0.885， with corresponding sensitivities of 0.432， 0.909， 0.795， 0.909， and 0.591， and specificities of 0.880， 0.481， 0.915， 0.736， and 0.977， respectively. When these biomarkers were combined， the AUC increased to 0.973， with a sensitivity of 0.943 and a specificity of 0.953. Furthermore， the AUC for presepsin alone was significantly higher than that for IL-6 and IL-8 alone （P < 0.05）. Additionally， the AUC for the combined biomarkers was significantly greater than that for each biomarker individually （P < 0.05）. Conclusions Serum levels of IL-6， IL-8， TREM1， uPAR， and presepsin are significantly elevated in patients with septic shock， which may aid in the clinical diagnosis of the condition. The combined use of these five biomarkers enhances the accuracy of diagnosing septic shock.

Post-stroke depression （PSD）， a common stroke complication characterized by depressed mood and diminished interest， severely affects patients' recovery and quality of life. Microglial abnormal activation and polarization play key roles in PSD pathogenesis， closely associated with neuroinflammation and imbalance in neurotransmitter metabolism. In contrast， traditional Chinese medicine （TCM） demonstrates unique multi-target and multi-level mechanisms： regulating microglial function， ameliorating post-stroke neuroinflammatory environments， and promoting neuroplasticity， thereby potentially alleviating PSD symptoms. This review summarizes TCM's effects on microglial activation/polarization states and its therapeutic advances in PSD， providing novel perspectives and strategies for clinical management.

Ankylosing spondylitis （AS） is a chronic autoimmune disease characterized by inflammatory involvement of the axial skeleton and pathological bone formation. The T helper 17 cell （Th17 cell） subset of lymphocytes plays a central role in mediating the inflammatory processes associated with AS. This review summarizes recent advances in the regulation of Th17 cell differentiation in AS， with a focus on the complex mechanisms governed by cytokine microenvironments， transcription factor networks， and metabolic and epigenetic regulatory pathways. Key regulatory components discussed include the IL-23/STAT3 signaling axis， the CCL20/CCR6 chemotactic axis， and the master transcription factor RORγt. Additionally， this review critically evaluates emerging therapeutic strategies targeting metabolic reprogramming （e.g.， PKM2）， epigenetic regulators （e.g.， JMJD3， EZH2）， engineered exosome delivery systems， and modulators of metabolic enzymes. By analyzing the limitations of current treatment approaches， the review proposes future research directions emphasizing multi-target therapeutic strategies and highlights the importance of personalized medicine in achieving precise and effective treatment for AS. These developments reveal promising new avenues for modulating Th17-mediated immunity， offering transformative potential for the clinical management of AS.