The research aims to study the application effect of personalized 3D printed side hernia fixation plates in the care of patients with permanent colostomy for colorectal cancer. A total of 110 patients with permanent colostomy of colorectal cancer are selected from the Wound Ostomy Nursing Clinic of the First People's Hospital of Huai'an City from December 2018 to January 2023. They are randomly divided into the research group and the control group, with 55 cases in each group. The control group uses a stoma pocket and wears an abdominal band to fix the tissue around the stoma, while the research group uses a 3D printed side hernia fixator to fix the tissue around the stoma with the abdominal band. At 1, 3, and 6 months after surgery, the inflammatory factors C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-1β (IL-1β), and skin condition around the stoma scores are observed in both groups of patients. The incidence of stoma complications, pocket replacement frequency, abdominal belt wearing frequency, and abdominal belt displacement within 6 months are also analyzed. The time effect and grouping exchange effect of changes in CRP, IL-6, IL-1β in both groups of patients were statistically significant (P < 0.05). At 1 month after surgery, there was no statistically significant difference in the expression levels of CRP, IL-6, and IL-1β between the two groups of patients (P > 0.05). At 3 and 6 months after surgery, the expression levels of CRP, IL-6, and IL-1β in the research group were significantly lower than those in the control group (P < 0.05). Patients with permanent colostomy for colorectal cancer can effectively reduce inflammatory reactions by wearing an abdominal strap on the basis of personalized 3D printed side hernia fixators.

To summarize and analyze the computed tomography (CT) and magnetic resonance imaging (MRI) features of uterine sarcoma. This retrospective study reviewed the clinical data and CT/MRI findings of 15 patients with uterine sarcomas confirmed by surgery and pathology, focusing on their characteristic imaging manifestations. Among the 15 patients, eight had uterine smooth muscle sarcoma (four with lesions confined to the uterine cavity and four presenting as large pelvic masses; all were cystic); one had undifferentiated uterine sarcoma [low signal on TI-weighted imaging (T1WI), high signal on T2-weighted imaging (T2WI) with the clear border, and marginal ring-shaped high signals on diffusion-weighted image (DWI)]; two had uterine adenosarcoma (mixed-density nodular and mass-like lesions with marked heterogeneous enhancement); three had low-grade endometrial stromal sarcoma (iso- or hypointense on T1WI, hyper- or slightly hyperintense on T2WI, and markedly hyperintense on DWI); and one had high-grade endometrial stromal sarcoma (a large cystic-solid pelvic mass). Pathology confirmed that this last lesion invaded the plasma membrane and involved local sub-plasma tissue of the intestinal wall. Uterine sarcoma commonly presents as the large cystic pelvic mass with indistinct margins, irregular shape, and possible invasion of adjacent structures. MRI typically shows iso- or slightly low T1WI signals, mixed high T2WI signals, high or slightly high DWI signals, and heterogeneous enhancement. These findings may aid in improving diagnostic accuracy and guiding clinical management of uterine sarcoma.

This study developed a nomogram using computed tomography (CT)-based delta-radiomics features and clinicopathological factors to predict lymph node metastasis (LNM) in patients with esophageal squamous cell carcinoma (ESCC) receiving neoadjuvant chemoradiotherapy (nCRT). This study retrospectively enrolled 170 patients with ESCC receiving nCRT. The delta-radiomics signature model was constructed utilizing least absolute shrinkage and selection operator regression, and the radiomics score (radScore) was determined for each patient. A combined nomogram was established using the radScore and independent influencing factors obtained through univariate and multivariate analyses. The consistency and predictive ability of the nomogram were assessed using the calibration curve and the area under the receiver operating factor curve (AUC). The clinical benefits were assessed using decision curve analysis (DCA). Two predictive models were constructed. The AUC values for the delta-radiomics signature model were 0.881 [95% confidence interval (CI): 0.827-0.935]. According to the univariate and multivariate analyses, the tumor length, tumor differentiation, and radScore were independent factors influencing LNM (P < 0.05). A combined nomogram was constructed from these factors, and the AUC reached 0.938 (95% CI: 0.898-0.979). DCA demonstrated that the clinical benefits of the nomogram for patients across an extensive range were more significant than the radiomics model alone. This CT-based delta-radiomics nomogram model could benefit LNM in patients with ESCC following nCRT.

The prognosis for patients with small cell lung cancer (SCLC), who develop liver metastases (LM) is extremely poor, and treatment options are limited. This study aimed to evaluate the efficacy and safety of hepatic arterial infusion (HAI) chemotherapy combined with systemic chemotherapy for patients diagnosed with LM-SCLC. From January 2019 to December 2023, HAI catheter systems were implanted in 15 patients with LM-SCLC, guided by digital subtraction angiography. All patients received systemic chemotherapy in combination with HAI using gemcitabine and floxuridine (FUDR). The overall response rate for intrahepatic lesions was 66.7%, including one patient (6.7%) with a complete response and nine (60.0%) with a partial response. Additionally, the median overall survival (mOS) was 13 months (95% confidence interval, 11.4-14.6 months). Notably, none of the patients experienced grade 4 adverse effects. However, the grade 3 adverse effects included leukopenia and neutropenia, which were well tolerated by all the patients. HAI of gemcitabine and FUDR, alongside systemic chemotherapy, may serve as an effective treatment strategy for achieving a high local response and prolonging mOS in patients with LM-SCLC, while also being associated with a relatively low incidence of adverse effects.

MDM2 inhibition restores p53 function, and even mutant p53 can induce cancer cell apoptosis. Notably, apoptosis and pyroptosis may interconvert during chemotherapy. This study aimed to explore the role of the MDM2-p53 pathway in the regulation of GSDME-mediated pyroptosis in lung adenocarcinoma. Immunohistochemistry and Western blotting were employed to measure the expression levels of GSDMD, GSDME, cleaved PARP, and MDM2. Nutlin-3, an MDM2 inhibitor, was administered to 5-FU-treated wild-type A549 cells, wild-type HBE cells, GSDME-overexpressing HBE cells, and A549 cells overexpressing p53 codon 72 mutation. GSDMD and GSDME were expressed in lung adenocarcinoma tissues, adjacent nontumor tissues, and noncancerous lung tissues, whereas only GSDME was expressed in A549 and HBE cells. After chemotherapy, the N-terminal fragment of GSDME was expressed in HBE and A549 cells. GSDME had a significantly lower protein level in HBE cells than in A549 cells ( P = 0.0092). GSDME overexpression markedly increased pyroptosis in A549 ( P = 0.01) and HBE cells ( P = 1.72 × 10 -6 ). Nutlin-3 significantly reduced cell viability and pyroptosis while increasing apoptosis in 5-FU-treated wild-type A549 cells, A549 cells with the p53 codon 72 mutation, and GSDME-overexpressing HBE cells. However, it exerted no significant effects on wild-type HBE cells. GSDME-mediated pyroptosis plays a pivotal role in chemotherapy-induced cell death in lung adenocarcinoma. MDM2 inhibition, which switches pyroptosis to apoptosis, can be employed to regulate chemotherapy-induced pyroptosis in lung cancer cells and normal tissue cells.

The purpose of this study is to retrospectively compare the therapeutic efficacy and safety of single session microwave ablation (MWA) and multiple session MWA for multiple malignant lung tumors. Retrospective analysis was conducted on clinical and pathological data of 103 patients with such malignancies treated from January 2020 to December 2022. Patients were categorized based on the number of MWA sessions required. Patients who had received only one MWA treatment were included in the single session MWA group, and patients, who had received two or more MWA treatments were included in the multiple session MWA group. Chest-enhanced CT scans were performed at 1, 3, 6, and 12 months post-MWA to assess ablation outcomes. The primary focus was the median overall survival (mOS), while secondary endpoints encompassed median local progression-free survival (PFS), technical success rates, safety, and complication rate. Analysis was performed by log-rank test and Cox proportional hazard regression model, using the Common Terminology Standard for Adverse Events (version 5.0) to assess safety within 28 days after MWA. Of 103 patients with multiple malignant lung tumors, each undergoing at least two tumor treatments during 168 MWA sessions. The median OS for the entire cohort stood at 27 months, with a corresponding median local PFS of 26 months. Patients in the single session MWA group had a median OS of 33 months compared with 13.1 months for those in the multiple session group (P = 0.001). Notably, adverse factors affecting survival after adjusting for confounding variables included T stage (P = 0.002), comorbidity (P = 0.018), solid tumor interior environment (P = 0.043), and multiple session MWA sessions (P = 0.035). No produce-related deaths or grade 3 or 4 adverse events occurred, with pneumothorax being the most common complication (13.1%). There is no significant difference in the occurrence of complications between the two groups (P > 0.05). Additionally, single session MWA exhibited superior OS and local PFS compared to multiple session MWA sessions, with statistically significant differences. For multiple session lung malignant tumors, the single session MWA group is superior to MWA in terms of survival and local tumor control, with no statistically significant difference in the incidence of complications between the two groups. The findings suggest that single session MWA procedures might be advantageous over multiple session MWAs.

Managing intestinal fistulas is complex and challenging due to the development of postoperative complications. It is essential to evaluate the effects of computed tomography (CT) body composition imaging biomarkers on major postoperative complications in these patients following definitive surgery. A total of 88 patients with intestinal fistula, who underwent definitive surgery were retrospectively reviewed. Each body composition index was calculated by dividing the cross-sectional area of the adipose or muscle tissue at the level of the third lumbar vertebra, as identified on a preoperative CT scan, by the square of the height. Postoperative complications were scored according to the Clavien-Dindo classification. Sixteen out of the 88 patients (18.08%) had major postoperative complications. In the univariate analysis, lower quadratus lumborum index (QLI; P = 0.047) and quadratus lumborum areas ([QLA]/body mass index [BMI]; P = 0.023), higher C-reactive protein (CRP; P = 0.036), longer length of stay (LOS; P = 0.002), and fewer preoperative admission histories (P = 0.049), were identified as risk factors. In the multivariable regression analysis, QLI (P = 0.011; odds ratio [OR] = 0.383) and LOS (P = 0.012; OR = 1.006) were identified as independent risk factors for major postoperative complications. Furthermore, QLI, QLA/BMI, CRP, LOS, sex, and age showed the highest area under the curve of 0.815, with a specificity and sensitivity of 64.8% and 93.8%, respectively (P < 0.001). Patients with lower QLI and QLA/BMI, longer LOS, and higher CRP were prone to have major postoperative complications.

No report is available on the treatment of primary colorectal cancer (CRC) by transarterial chemotherapy combined with lipiodol chemoembolization in tumor-feeding arteries. To determine the safety and efficacy of transarterial infusion chemotherapy (TAI) and lipiodol chemoembolization for the treatment of primary CRC. Thirty-seven patients with advanced CRC received TAI and lipiodol chemoembolization once a month, 1-3 times in all. Clinical efficacy, complications, and effectiveness were evaluated 1 month after each session. All 37 patients were successfully treated. The most common complications were abdominal discomfort, nausea, tenesmus, and myelosuppression. The overall disease control and objective response rates were 97.3% and 67.6%, respectively. Twenty-four patients survived and 13 died; the median survival duration was 21.1 months. Age was a significant influencing factor of overall survival. Transarterial chemotherapy combined with lipiodol chemoembolization appears to be safe and effective for treating advanced CRC.

To evaluate diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC) for the prenatal differentiation of fetal adrenal neuroblastoma (NB) from benign masses. This retrospective study analyzed prenatal magnetic resonance imaging/DWI data from 54 pregnant women (59 adrenal masses) with a suspected solid adrenal mass on ultrasound. Cases with severe malformations or poor image quality were excluded. The minimum ADC (ADC min ), mean ADC (ADC mean ), and relative ADC (rADC) values within the tumor solid components were measured. Group comparisons and receiver operating characteristic (ROC) curve analysis were performed to assess the diagnostic performance. Eighteen masses (30.5%) were classified as NB, while the remaining 41 (69.5%) were benign, including sequestration, hematoma, and teratoma. The NB group showed significantly greater gestational age at detection (mean age, 35 weeks), higher right adrenal prevalence (66.7%), and larger maximum diameters (3.6 cm vs. 2.4 cm; P < 0.01) compared to the non-NB group. The ADC min , ADC mean , and rADC were significantly lower in the NB group ( P < 0.001). ROC analysis identified ADC min as the optimal diagnostic parameter (area under the curve = 0.981). An ADC min threshold of 1382 μm²/s yielded 97.56% sensitivity and 100% specificity. These findings indicate that the quantitative DWI parameter ADC min can reliably differentiate fetal adrenal NB from benign lesions prenatally. Its high sensitivity and specificity may provide an objective basis for clinical decisions and optimized perinatal management.

Prophylactic hyperthermic intraperitoneal chemotherapy (HIPEC) remains controversial in locally advanced colorectal cancer (CRC). This study aimed to evaluate its survival benefits and safety. A retrospective cohort of 3008 CRC patients undergoing resection (2014-2019) was analyzed. Propensity score matching (PSM) generated 188 HIPEC and 188 control patients. Outcomes included operative metrics, complications (Clavien-Dindo ≥III), and 3-year overall survival (OS)/disease-free survival (DFS). Multivariable Cox regression identified prognostic factors. Post-PSM, HIPEC required longer operative time (215 vs 185 minutes) and hospital stay (9.2 vs 7.5 days), with comparable major complications (12.8% vs 10.6%, P > 0.05). HIPEC showed superior 3-year OS (87.2% vs 80.5%, HR = 0.54, P = 0.029) and DFS (81.7% vs 75.2%, HR = 0.59, P = 0.037). Multivariable analysis confirmed HIPEC (OS: HR = 0.54, 95% CI: 0.31-0.94; DFS: HR = 0.59, 95% CI: 0.37-0.93) and laparoscopic approach as independent survival predictors. Prophylactic HIPEC (43°C, 60-90 minutes) may improve survival in locally advanced CRC without increasing major complications, supporting its integration into surgical practice. Further validation through multicenter trials is warranted.