Qujiang People's Hospital

Inverted colonic diverticulum (ICD) is a rare endoscopic finding that often mimics a sessile polyp or submucosal tumor, increasing the risk of misdiagnosis and inappropriate intervention. Accurate identification is crucial to avoid potential complications such as perforation. This case is notable for its unusual location in the cecum and its initial misdiagnosis as a gastrointestinal stromal tumor (GIST). A 66-year-old man with a 10-year history of chronic constipation underwent routine surveillance colonoscopy, which revealed a 30–40 mm sessile lesion in the cecum near the ileocecal valve with a central depression covered by adherent debris/impacted fecal material and peripheral hyperemia; water-jet irrigation was attempted but failed to adequately clear the adherent material. Biopsies obtained from the peripheral mucosa showed benign mucosal hyperplasia, and contrast-enhanced computed tomography (CT) demonstrated focal cecal wall thickening without definite radiologic evidence of malignancy; however, malignancy could not be confidently excluded given the lesion’s size and indeterminate preoperative assessment. After multidisciplinary team (MDT) discussion and shared decision-making with the patient and family, laparoscopic right hemicolectomy was performed. Gross examination showed a submucosal mass with a narrow-necked cavity connected to the bowel lumen. Histopathology confirmed inverted colonic diverticulum, with no evidence of dysplasia or malignancy. The patient recovered well without complications. This case highlights the diagnostic challenges of inverted colonic diverticulum, particularly when located in the cecum. Recognition of endoscopic features and cautious interpretation of imaging are essential to prevent unnecessary or harmful procedures. Surgical resection remains a definitive option when malignancy cannot be excluded or endoscopic diagnosis is inconclusive.

Subtropical forest ecosystems, especially evergreen broad-leaved forests in the East Asian monsoon region, are a crucial component of the global terrestrial carbon cycle and make a key contribution to the “missing carbon sequestration” in the Northern Hemisphere. This review systematically integrates recent research progress on the carbon pool patterns, aboveground-subsurface biogeochemical processes, and global change responses of subtropical forests, summarizing the potential mechanisms of their sustainable carbon sequestration capacity and identifying current cognitive bottlenecks. Studies have shown that subtropical mature forests have carbon sequestration potential that exceeds traditional theoretical expectations, but there are still significant shortcomings in terms of carbon stability in deep soil (>1 m), quantitative constraints on rhizosphere activating effects, and assessment of ecosystem resilience under extreme climate events. Furthermore, the nonlinear interactions between factors such as climate warming, precipitation changes, and nitrogen deposition may trigger a critical turning point in carbon sink functions, and the water-carbon-geological coupling processes in special habitats such as karst and mangrove forests are often underestimated. We further propose that future research should focus on developing coupled models of “plant–soil–microbe hydrology”, combining molecular and isotopic techniques to elucidate microbial carbon pump mechanisms and strengthening long-term in situ experiments under combined extreme events to provide scientific support for subtropical forest carbon sink management and prediction.

This case report describes a 75-year-old male patient who was admitted due to acute intestinal obstruction. The patient had a history of small cell lung cancer. Emergency surgery pathology confirmed the presence of primary composite small cell lung cancer with rare independent dual component metastasis: The colonic lesion was metastatic poorly differentiated adenocarcinoma, and the mesenteric lymph nodes were metastatic small cell carcinoma. Postoperatively, the patient rapidly progressed to septic shock and multiple organ failure, ultimately resulting in death. To our knowledge, this case is the first report of Combined Small Cell Lung Cancer (C-SCLC) presenting a rare pattern of independent dual-component metastasis (adenocarcinoma component metastasizing to the colonic mucosa and small cell carcinoma component metastasizing to the lymph nodes) leading to acute intestinal obstruction. This finding expands the understanding of the metastatic heterogeneity of C-SCLC, suggesting that its different cellular components may possess independent metastatic potential and target organ preferences, reflecting the molecular plasticity of tumors during evolution.

To reduce the production cost of Pleurotus giganteus and to valorize agricultural waste, this study investigated the effects of substituting cottonseed hull with corn cob (a major lignocellulosic by-product of maize production) on the mycelial growth, agronomic traits, nutrient composition, commercial quality, and economic benefits of P. giganteus ‘Shenxun No.1’. The aim was to verify the feasibility of this substitution and screen optimal substrate formulations for industrial cultivation. Four substrate formulations with corn cob substitution ratios of 0% (T1), 15% (T2, control), 30% (T3), and 45% (T4) were designed, while adjusting cottonseed hull proportions to 45%, 30%, 15%, and 0%, respectively. Mycelial colonization performance, fruiting body agronomic traits (yield and cap/stipe characteristics), nutrient contents (crude protein, crude fiber, etc.), and commercial traits (marketable yield and production cost) were systematically determined and analyzed. The results showed that corn cob content exceeding 15% prolonged the substrate bag colonization time by 5–7 days, but T4 (45% corn cob) resulted in the densest mycelia with excellent structural development. In terms of fruiting bodies, T4 exhibited the highest yield in the second harvest flush and the highest total yield across three flushes. Nutritionally, crude protein content of fruiting bodies decreased by 10.48% in T4 compared to T1, while crude fiber content increased with rising corn cob proportion; no significant difference in crude polysaccharide content was observed among formulations. Importantly, corn cob substitution did not impair the commercial traits of fruiting bodies, and T4 achieved the lowest material cost per bag (0.78 CNY) with an optimal cost–benefit ratio. In conclusion, corn cob is a viable and cost-effective substitute for cottonseed hull in P. giganteus cultivation, and the 45% substitution formulation (T4) is recommended for industrial production due to its superior yield performance and economic benefits. This study provides a theoretical basis for sustainable utilization of agricultural waste and optimization of P. giganteus cultivation systems.

Accurate metastasis prediction in lung adenocarcinoma is essential for effective treatment plans and improved prognosis. Current methods face challenges in accuracy and clinical application. We developed a binary classification model (XGBoost) and a multiclassification model (stacking) using SEER database data. The binary model predicts metastasis presence (M0 vs. non-M0), and the multiclassification model further refines the degree of metastasis (M1a, M1b, M1c). Model performance was assessed using ROC AUC, PR AUC, and KS curves. SHAP values were used to analyze important features and explain the decision-making process. The binary model achieved ROC AUC and PR AUC scores exceeding 0.77, with the KS curve showing high consistency in distinguishing between positive and negative samples. The multiclassification model also performed well, demonstrating stability and generalizability across different metastasis stages. Key predictive factors included AJCC stage, survival duration, tumor size, and treatment information. This study improves the accuracy and clinical application of metastasis prediction in lung adenocarcinoma through interpretable machine learning models. The combination of binary and multiclassification models not only predicts metastasis presence but also details its extent, providing valuable clinical decision support. Future research should integrate diverse data sources to enhance model robustness and better serve clinical practice. Not applicable.