Wuhan Sixth Hospital

Background: Hepatocellular carcinoma (HCC) is characterized by a chronic inflammatory and immunologically dysregulated microenvironment. Circulating immune-inflammatory biomarkers reflect systemic biochemical and immune alterations and may provide laboratory-accessible indicators for prognosis assessment. However, the prognostic value of interleukin-6 (IL-6) and the systemic immune-inflammation index (SII) in HCC patients receiving immune checkpoint inhibitors (ICIs) remains incompletely defined. Methods: A comprehensive literature search was conducted across PubMed, Embase, Web of Science, the Cochrane Library, CNKI, and Wanfang Data to identify cohort studies evaluating circulating IL-6 and/or SII in HCC patients treated with ICIs. Hazard ratios (HRs) with 95% confidence intervals (CIs) for progression-free survival (PFS) and overall survival (OS) were pooled using fixed- or random-effects models. Subgroup and sensitivity analyses were performed to explore sources of heterogeneity. Results: Twelve studies involving 1,508 patients were included. Elevated circulating IL-6 levels were significantly associated with poorer PFS (HR = 1.91, 95% CI 1.40–2.60) and OS (HR = 2.13, 95% CI 1.52–2.97), with robust results across sensitivity analyses. In contrast, the prognostic value of SII was context-dependent. Higher SII was significantly associated with shorter PFS in non-100% hepatitis B virus–related HCC populations and with poorer OS in patients receiving combined local treatment, while no significant associations were observed in other subgroups. Conclusions: Circulating IL-6 serves as a stable immune-biochemical prognostic biomarker in HCC patients treated with ICIs, whereas the prognostic relevance of SII is modulated by disease etiology and treatment modality. These findings provide laboratory-relevant biochemical evidence supporting the integration of circulating immune-inflammatory markers into prognostic evaluation frameworks for HCC.

Malignant brain tumors remain a major therapeutic challenge due to poor intracellular delivery of therapeutics. Radiopharmaceuticals such as Technetium-99m (^99mTc) are valuable for imaging and therapy but suffer from limited tumor uptake caused by cellular and membrane barriers. Focused ultrasound (FUS) offers a noninvasive strategy to transiently enhance membrane permeability through sonoporation. Unlike prior studies largely focused on blood-brain barrier disruption, this work specifically investigates direct tumor cell sonoporation as an independent uptake mechanism. This study evaluates FUS-mediated enhancement of ^99mTc radiopharmaceutical uptake in brain tumor cells and determines optimal acoustic parameters balancing efficacy and safety. Human glioblastoma (U87-MG) and astrocytoma (A172) cells were cultured and exposed to FUS at intensities of 0.3, 0.5, and 0.7 W/cm2 for 30-120 s. Radiopharmaceutical uptake was quantified using γ-scintillation counting. Membrane integrity was assessed by live/dead fluorescence microscopy and lactate dehydrogenase release, while cell viability was evaluated via medical training therapy (MTT) assays. U87-MG cells exhibited up to a 3.1-fold increase at 0.7 W/cm2 for 120 s, with a 2.3-fold enhancement at the clinically relevant 0.5 W/cm2 for 60 s while maintaining >92% viability. A172 cells showed similar trends with slightly lower magnitudes. Safety assays confirmed reversible membrane permeabilization at ≤0.5 W/cm2. The temporal uptake kinetics aligned with established membrane pore resealing dynamics, supporting reversible sonoporation as the uptake mechanism. Importantly, while ^99mTc complexes are primarily diagnostic, enhanced intracellular delivery achieved by optimized FUS may also support future theranostic strategies, including radionuclide therapy. These findings underscore the translational potential of FUS in neuro-oncology, where tumor heterogeneity necessitates parameter optimization to maximize radiopharmaceutical delivery, improve imaging contrast, and overcome therapeutic resistance.

Thymomas are well-established disruptors of central immune tolerance, yet their capacity to drive systemic autoimmunity via a single autoantigen remains incompletely characterized. We report a 59-year-old male who, following resection of a Masaoka stage IIb type B2 thymoma, developed sequential neurological, endocrine, and renal manifestations over 18 months. Clinical evaluation confirmed stiff-person syndrome (SPS) with axial muscle hypermetabolism on PET-CT, latent autoimmune diabetes (HbA1c 11%), subclinical hypothyroidism (TSH 15.28 μIU/mL), and distal renal tubular acidosis (dRTA) evidenced by severe hypokalemia (K+ 2.4 mmol/L) and inappropriately alkaline urine (pH 7.5). All three syndromes were associated with persistently high-titer glutamic acid decarboxylase 65 (GAD65) autoantibodies (>500 nmol/L in serum). Epitope mapping identified molecular mimicry between the GAD65 peptide ²60PEVKEK²65 and homologous sequences in renal H+-ATPase and thyroid peroxidase, providing a mechanistic basis for multi-organ cross-reactivity. Treatment with intravenous immunoglobulin (IVIG) led to a 53.6% reduction in serum and an 80% decline in cerebrospinal fluid GAD65 antibody levels, paralleling clinical improvement. This case illustrates how thymoma-induced loss of tolerance to GAD65 can trigger widespread autoimmune injury through conformational epitope spreading, positioning GAD65 as a paraneoplastic pan-autoantigen. High-titer GAD65 antibodies may serve as a biomarker for systemic involvement, supporting early multidisciplinary surveillance in thymoma patients.

This study retrospectively evaluates and compares the clinical effects of dapagliflozin and linagliptin on cardiac function and glycemic control in patients with type 2 diabetes mellitus (T2DM) complicated by heart failure (HF), thereby providing real-world evidence to support clinical decision-making. This retrospective study included 200 patients with both T2DM and HF, who were divided into 2 groups based on their treatment regimens: a control group and a treatment group (100 patients each). All patients received standard anti-HF therapy in combination with metformin. The control group was administered linagliptin (5 mg once daily before breakfast), while the treatment group received dapagliflozin (10 mg once daily) for a duration of 6 months. Relevant clinical data were collected and analyzed for both groups. Baseline characteristics were comparable between the 2 groups (P > .05). The total effective rate was significantly higher in the treatment group compared with the control group (97.5% vs 80.0%, P < .001), indicating a superior improvement in clinical symptoms with dapagliflozin. Both groups showed significant reductions in fasting blood glucose, 2-hour postprandial blood glucose, and HbA1c compared with baseline values (P < .001), with no statistically significant differences between groups (P > .05), suggesting that both drugs effectively improve glycemic control. The treatment group demonstrated greater improvements in NT-proBNP, fibroblast growth factor 23, central pulse pressure, left ventricular ejection fraction, left ventricular end-diastolic diameter, and left ventricular remodeling index compared with the control group (P < .05), indicating a more pronounced effect of dapagliflozin on cardiac function. The incidence of adverse drug reactions was low and not significantly different between groups (2.0% in the control group vs 4.0% in the treatment group, P > .05). Both dapagliflozin and linagliptin effectively improve glycemic control and cardiac function in patients with T2DM and HF, with favorable safety profiles. However, dapagliflozin appears to confer additional benefits in improving cardiac function, potentially due to its unique pharmacological mechanism.

ObjectiveIntegrin alpha-3 (ITGA3) has been implicated in tumor metastasis in various cancers, but its role in epithelial ovarian cancer (EOC)-associated liver metastasis (LM) remains unclear. This study aimed to investigate its role in LM in primary EOC patients.MethodsIt was a retrospective study with a sample size of n = 235 receiving surgical resection at Puren Hospital Affiliated to Wuhan University of Science and Technology between January 2020 and December 2021, including 98 LM (LM group) and 137 non-LM cases (N-LM group). ITGA3 expression was assessed by immunohistochemistry. ROC curves were used for predictive performance analysis, Kaplan-Meier curves for survival analysis, and Cox regression analysis for identification of risk factors.ResultsMarkedly elevated ITGA3 expression in tumor tissues was found in the LM group (P < 0.001), which demonstrated strong predictive value for LM in EOC patients (area under the curve (AUC) = 0.881, sensitivity = 70.41%, specificity = 87.59%, P < 0.001), and strongly correlated with tumor size and postoperative residual lesions (both P < 0.05). Compared with the L-ITGA3 group, the H-ITGA3 group had a higher incidence of postoperative LM (P < 0.001) and showed a left-shifted curve in Kaplan-Meier analysis (P < 0.001). ITGA3 expression in tumor tissues (HR = 5.977), tumor grade (HR = 1.441), and postoperative residual lesions (HR = 1.697) were identified as independent risk factors for postoperative LM.ConclusionsITGA3 expression in tumor tissue significantly aids in predicting LM in EOC patients and is independently and closely related to adverse clinicopathological outcomes.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12920-025-02268-4.

To compare the result of routine nursing with specialised nursing in patients undergoing ultrasound-guided interventional therapy for benign ovarian cyst. The study was conducted at the Wuhan Sixth Hospital, Wuhan, China, from June 2021 to June 2023, and comprised female patients having benign ovarian cysts who underwent ultrasound-guided interventional therapy. The patients were randomised into control group CG receiving routine nursing care, and study group SG receiving specialised nursing. The groups were compared with respect to outcome measures, including first time out of bed, length of hospital stay, degree of pain, anxiety and depression, complications, quality of life and nursing satisfaction. Data was analysed using SPSS 20. Of the 100 female patients, 50(50%) were in group CG with mean age 38.17±4.21 years, and 50(50%) were in group SG with mean age 38.21±4.25 years. Compared to the controls, those in group SG had shorter first time out of bed hours and length of hospital stay, lower pain scores at 24h and 48h post-therapy, lower anxiety and depression scores, lower incidence of complications, higher quality of life, and higher nursing satisfaction (p<0.05). Specialised nursing could accelerate postoperative recovery, relieve pain, decrease the incidence of complications, relieve negative emotions, promote quality of life, and promoted nursing satisfaction of patients having benign ovarian cyst who underwent ultrasound-guided interventional therapy.

ObjectiveTo investigate the relationship between cementum development and epithelial stem cells in rabbit molars, as well as the associated morphological characteristics.MethodsA total of 25 New Zealand white rabbits were selected and divided into five age groups (14 days, 21 days, 28 days, 50 days, and 8 months). The developmental process of cementum was examined using micro-computed tomography (micro-CT), scanning electron microscopy (SEM), and histological methods.ResultsCementum in rabbit molars was classified into three types: acellular extrinsic fiber cementum (AEFC), cellular intrinsic fiber cementum (CIFC), and cellular mixed stratified cementum (CMSC). With increasing age, both the bone volume fraction (BV/TV) and bone mineral density of the cementum significantly increased (P < 0.05). Following apoptosis of epithelial cells, mesenchymal stem cells (MSCs) differentiated into cementoblasts; however, the role of epithelial-mesenchymal transition (EMT) was found to be limited. The formation of functional cementum primarily depended on the insertion of periodontal ligament (PDL) fibers.ConclusionThe cementum of rabbit molars surrounds the enamel. With increasing age, both the volume and density of the cementum continue to increase, and its functions differ significantly based on its classification. EMT is not the principal mechanism involved.

ObjectiveTo explore the predictive value of peak systolic velocity (PSV) ratio, PSV1 and PSV2 of ophthalmic artery Doppler in pregnant women for small for gestational age (SGA) infants and to construct a nomogram prediction model.MethodsA total of 201 pregnant women who visited our hospital from March 2022 to June 2024 were selected as the research subjects, and their clinical data and ophthalmic artery Doppler parameters were collected. The data were randomly divided into a training set (n = 295) and a verification set (n = 126) in a 7:3 ratio. The independent risk factors for SGA were screened by univariate and multivariate Logistic regression analysis, and the nomogram model was constructed. The model calibration degree, prediction efficiency and clinical value were evaluated.ResultsThe incidence of SGA in the training and validation sets was 25.42 and 25.31%, respectively. Multivariate Logistic regression analysis showed that PSV ratio of ophthalmic artery, PSV1, PSV2, Pulse index 1 (PI1), PI2, and gestational week were the independent risk factors for SGA (all p < 0.05). The C-index of the nomogram model in the training set and the verification set was 0.858 and 0.835, respectively, the area under the ROC curve (AUC) was 0.858 (95% CI: 0.804–0.912) and 0.835 (95% CI: 0.734–0.936), and the sensitivity and specificity were 0.887, 0.747 and 0.636 and 0.833, respectively. The calibration curve showed good agreement between the predicted and actual values, respectively, which was good by the Hosmer-Lemeshow test. The analysis of decision curve showed that the model had high clinical application value in the range of threshold probability 0.10–0.80.ConclusionThe nomogram model based on PSV ratio of ophthalmic artery Doppler, PSV1, and PSV2 has good prediction performance for SGA, and provides a new tool for early clinical recognition of high-risk pregnant women with SGA. However, the accuracy and applicability of the model still need to be further verified in the multi-center large sample study.

To construct and validate a nomogram prediction model for the risk of cefoperazone sodium/sulbactam sodium (CPZ/SAM)-related coagulation disorders in hospitalized patients. Patients treated with CPZ/SAM from January 2022 to December 2024were enrolled and divided into a coagulation disorder group and a control group based on the occurrence of coagulation disorders. Clinical data were collected to identify risk factors and construct a nomogram model, which was validated using the Hosmer-Lemeshow goodness-of-fit test, receiver operating characteristic (ROC) curve, decision curve analysis (DCA), and clinical impact curve. A total of 439 patients were included, with 86 cases (19.59%) in the coagulation disorder group and 353 cases in the control group. Multivariate analysis identified malnutrition, recent bleeding history, prolonged treatment duration with CPZ/SAM, combination use with carbapenems, and elevated serum creatinine as independent risk factors. The constructed nomogram had an AUC of 0.845, demonstrating good calibration ability (χ²=2.312, P=0.891), providing moderate net benefit in predicting the incidence of coagulation disorders, with consistent agreement between predicted and actual probabilities. The nomogram model effectively identifies high-risk patients, indicating that attention should be paid to the risk of coagulation disorders in patients with the above risk factors during CPZ/SAM treatment.