Spatial transcriptomics is an innovative technology that enables high-throughput, genome-wide analysis of transcript expression and spatial localization within tissues. By preserving structural organization, it provides critical insights into tumor sub-regions, substructures, and the heterogeneity and plasticity of cancer, stromal, and immune cells, as well as cell-cell interactions. Spatial transcriptomics also offers an unprecedented understanding of the tumor microenvironment, including immune cell infiltration, activation and repression, and immune suppression mediated by stromal cells. Importantly, it deepens our understanding of malignant transformation from precancerous lesions, tumorigenesis, and immune escape. Furthermore, spatial transcriptomics is reshaping cancer subtype diagnosis and risk stratification, uncovering factors associated with drug resistance, predicting therapy responses, and informing the development of personalized cancer treatments and potentially prevention. In summary, spatial transcriptomics serves as a cornerstone of cancer research, transforming the research landscape and unlocking groundbreaking opportunities for precision cancer diagnosis, risk stratification, targeted therapy, and prevention.

Skin cutaneous melanoma (SKCM),a highly invasive malignant tumor originating from skin melanocytes,poses a significant threat to public health[1,2]. Its development is closely associated with multiple factors,such as ultraviolet radiation,gene mutations,and immune escape. Among these,imbalance in the immune surveillance and clearance of tumor cells is a crucial link to disease progression[3,4]. Tripartite motif-containing 27,which belongs to the TRIM protein family and is encoded by the TRIM27 gene,contains the RING,B-box,and coiled-coil domains. It participates in biological processes such as cell-cycle regulation,signal transduction,and immune response mainly by modifying target proteins through ubiquitination.Notably,increasing evidence indicates that TRIM27 is closely associated with the tumor immune microenvironment and contributes to cancer immune escape via multiple mechanisms,thereby promoting tumor development[5]. However,the role of TRIM27 in SKCM remains unclear,thus prompting our investigation to elucidate this.

The objective of this study was to compare the safety and efficacy of laparoscopic-assisted surgery and traditional open surgery for pediatric incarcerated inguinal hernia. A total of 58 pediatric patients with indirect incarcerated inguinal hernia between January 2014 and January 2020 were included in this study. The patients were divided into 2 groups; observational group who underwent laparoscopic-assisted surgery (n = 36), and a control group who underwent traditional open surgery (n = 22). The overall operation time, intraoperative blood loss, postoperative recovery time, length of hospital stay, occurrence of postoperative scrotal or vulvar hematomas, incidence of postoperative surgical site infection, and hernia recurrence were analyzed and compared between the 2 groups. Compared with the control group, the operation time (38.28 ± 5.90) minutes, intraoperative blood loss (1.15 ± 0.54 mL), postoperative recovery time (8.39 ± 1.42 h), and length of hospital stay (1.64 ± 0.59) were significantly lower in the observational group (P < .05). There was no incidence of scrotal or vulvar hematoma or surgical site infection in the observation group, which was significantly lower than that in the control group (P < .05). However, no statistically significant difference was found in the rate of postoperative hernia recurrence between the 2 groups (P > .05). In conclusion, laparoscopic-assisted surgery appears to be a safe and effective alternative approach to traditional open surgery for the treatment of pediatric incarcerated inguinal hernia. Its advantages include reduced trauma, faster recovery, shorter hospital stays, and fewer complications.

目的 探讨幽门前瓣膜症(PM)的临床特点和诊治方式,提高幽门前瓣膜症的诊治水平.方法 回顾性分析郑州大学第一附属医院小儿外科2012-01-2022-09 诊断为PM患儿的临床资料.结果 共选入7 例患儿,平均初次出现症状年龄为9.7 个月,病程 1 个月～8a.行非手术治疗后5 例行手术治疗,其中4 例行开腹下瓣膜切除及幽门成形术,1 例行内镜下幽门切除术.随访期间7 例患儿均未再出现间断呕吐症状.结论 PM极易误诊、漏诊,消化道造影、腹部超声及胃镜的联合应用对PM有重要诊断价值.对婴幼儿反复非胆汁性呕吐,经腹部超声发现幽门无肥厚者可考虑PM.内镜不仅能帮助诊断,也可直接行手术治疗,可极大减少手术损伤.

目的:探讨女童阑尾炎术后发生输卵管脓肿的病因、诊断及治疗.方法:回顾性分析郑州大学第一附属医院2017年1月至2020年1月收治的3例阑尾炎术后并发输卵管脓肿女童的临床资料,3例女童明确诊断后均行彩超引导下穿刺置管术,给予脓腔冲洗引流,同时静脉输注三代头孢类抗生素和奥硝唑针.文献检索女童阑尾炎术后并发输卵管脓肿的诊治病例.结果:3例女童经治疗后均痊愈出院,出院时血常规正常,有1例CRP稍高,出院后随访12个月,无腹痛、发热症状,无脓肿复发.文献检索共发现5例女童,年龄14～17岁,化脓性阑尾炎4例,坏疽性阑尾炎1例,均有穿孔;阑尾炎术后时间2个月～3a;入院均有腹痛,伴发热2例,伴排尿困难2例;右侧输卵管脓肿3例,右侧输卵管积脓并输卵管炎2例.5例均手术治疗;2例术后病理分别示化脓性输卵管炎及输卵管内部分钙化的粪石、慢性滤泡性输卵管炎.结论:女童阑尾炎术后,出现腹痛、发热,要警惕输卵管脓肿发生可能,尤其是青春期的女孩.超声结合盆腔CT或MRI可以明确诊断,彩超引导下脓肿穿刺置管外引流可以取得满意的疗效,避免盲目二次手术.

患儿男，1岁，因“间断发热半个月”入院。查体：腹部膨隆，肝左叶可扪及，剑突下5 cm。实验室检查：ALT 50 U/L，AST 89 U/L，乳酸脱氢酶1 004 U/L，羟丁酸脱氢酶722 U/L；EB病毒IgG阳性，巨细胞病毒IgG阳性，EB病毒核抗原IgG抗体阳性。血液病原微生物监测：洋葱伯克霍尔德菌复合群、EB病毒序列数增加。肿瘤标志物：甲胎蛋白1.22 ng/ml，癌胚抗原0.93 ng/ml。彩超：肝左叶非均质回声，见一大小约56 mm×43 mm低回声区。CT：肝左叶可见稍低密度肿块影，右侧边界欠清，左侧边界清，约38 mm× 42 mm× 51 mm，增强扫描可见轻度不均匀强化（图1）。胸部CT平扫未见异常。超声科会诊后，不建议行“超声引导下肝脏肿物穿刺引流术”，患者反复发热、肝脏占位较前增大，抗感染治疗疗效欠佳。遂行肝左叶肿瘤切除术+肝门淋巴结切除术。术后短期恢复可。病理：EB病毒阳性NK/T细胞增殖性疾病，结合免疫表型及EBER 原位杂交考虑为：（1）结外NK/T 细胞淋巴瘤，鼻型；（2）EB病毒阳性NK/T细胞增殖性疾病肿瘤期（图2）。免疫组化：CD3（+），CD20（-），PAX-5（-），CD5（-），CD2（+），CD7（-），CD56（-），TIA-1（+），GrB（+），Ki-67（约70%+），CD4（±），CD8（+），EBNA-2（-）。原位杂交：EBER（+）。术后淋巴瘤基因重排检测：TCRB Dβ-Jβ 位点存在单克隆重排（+++），提示淋巴瘤可能。患儿病理诊断明确，告知家属NK/T细胞淋巴瘤易并发嗜血细胞综合征，进展快，预后欠佳，建议尽早化疗，家属拒绝继续治疗，术后11 d 出院后失访。

本研究收集3例小儿肠道血管瘤患者的临床资料，生长方式为小肠单发包块型、小肠结肠多发型、直肠肛管弥漫型，分别接受手术治疗、手术联合内镜治疗、介入治疗，取得良好效果。小儿肠道血管瘤表现多样，应采取个体化治疗。

A 7-year-old girl presented with a 2-day history of abdominal pain and vomiting. After admission, blood tests revealed a white blood cell count of 11.15 (cid:1) 10 9 /L (reference range, 3.5 – 9.5 (cid:1) 10 12 /L), alanine transaminase level of 75 U/L (0 – 40 U/L), aspartate transaminase level of 56 U/L (0 – 40 U/L)

回顾性分析2016年1月至2020年1月郑州大学第一附属医院灌肠复位治疗的436例原发性肠套叠患儿的临床资料，其中彩超引导水压灌肠组180例，X线下空气灌肠组256例。结果显示水压灌肠组的复位成功率为95%，高于空气灌肠组的84%，差异有统计学意义( P<0.05)；水压灌肠组肠套叠时间>48 h的复位率为92%，高于空气灌肠组的89%，差异有统计学意义( P<0.05)。两组均无肠穿孔发生。水压灌肠对原发性肠套叠患儿的复位率高、安全性强，并且可以避免X线辐射。

Background: Although previous studies have shown that childhood sexual abuse (CSA) experiences might be related to suicide-related thoughts and behaviours in later life, the effects of alexithymia and experiential avoidance (EA) on this relationship have remained unclear. The present study aimed to expand prior findings among Chinese college students with a history of CSA in order to further test the effects of alexithymia on the relationship between CSA and non-suicidal self-injury (NSSI) and suicidal ideation (SI), and its indirect effects on NSSI and SI through EA. Methods: The Childhood Sexual Abuse Questionnaire, the Toronto Alexithymia Scale-20, the Acceptance and Action Questionnaire-II, the Non-Suicidal Self-Injury Questionnaire, and the Symptom Checklist were completed by 6,834 college students (3,829 female). Results: Overall, 1404 (20.76%) Chinese college students reported experiences of CSA; students with CSA experiences reported higher rates of SI and NSSI than those without CSA (12.82% vs. 4.50%, 35.11% vs. 20.82%). CSA, alexithymia, and EA were positively related to NSSI and SI. The effect of alexithymia on the relationship between CSA and NSSI and SI were significant. The effects of EA on the relationship between alexithymia and NSSI and SI were significant, too. Limitations: The major limitations of this study are its cross-sectional design and the use of self-report scales, especially retrospective self-reports (e.g., the Childhood Sexual Abuse Questionnaire). Conclusions: This study cast light on the effects of alexithymia, EA, and CSA on NSSI and SI in Chinese college students with a history of CSA. These findings can contribute to the prevention and treatment of suicide-related thoughts and behaviours.

Background Our previous study identified a Wilms tumor-suppressing peptide (WTSP) that was upregulated in healthy children, but downregulated in children with Wilms tumor (WT). This study aimed to investigate the effect of WTSP on WT growth in vivo and in vitro. Methods WTSP was synthesized by solid-phase synthesis of FOMC-protected amino acids. Cell growth curve, cytotoxicity, and apoptosis of WTSP-treated human WT cell line (SK-NEP-1) were determined by cell count, Cell Counting Kit-8 assay, and flow cytometry. The expression of key proteins of four WT-associated signaling pathways was determined by real-time PCR and western blotting. The WT xenograft mouse model was established by the armpit injection of SK-NEP-1 cells. The TUNEL assay was used to detect apoptosis in mouse tumor cells. Results WTSP inhibited the proliferation of SK-NEP-1 cells in a dose- and time-dependent manner, and it arrested SK-NEP-1 cells in G2/M phase. WTSP-treated cells exhibited a low expression of PCNA and Bcl-2 and high expression of Bax. The expression of β-catenin was markedly changed after WTSP treatment. WTSP-treated mice had significantly smaller tumors than untreated mice. Conclusion Our findings indicated an anti-tumor effect of WTSP, which is correlated with Wnt/β-catenin pathway. This newly identified peptide may exert a therapeutic effect of WT in the future.

We used blood serum samples collected from 31 lung cancer (LC) patients and 29 healthy volunteers in this study. Levels of serum metabolites were qualitative quantified with gas chromatography-mass spectrometry (GC-MS), and the data were analyzed by partial least-squares discrimination analysis (PLS-DA). Based on the Kyoto Encyclopedia of Genes and Genomes database, we performed pathway-based analysis utilizing metabolites presented at differential abundance between the LC serum samples and the normal healthy serum samples for systematical investigation on the metabolic alterations associated with LC pathogenesis. Finally, we analyzed the significantly enriched pathways as well as their relevant differentially expressed messenger RNAs, and drawn a correlation network plot to identify the serum metabolic biomarkers and the significantly altered metabolic pathways for LC. GC-MS analysis showed that 23 of the 169 metabolites identified were significantly different. PLS-DA model revealed that 13 of these metabolites were with variable importance > 1, and particularly five were with area under curve > 0.9. Pathway-based analysis demonstrated that five of eight enriched metabolic pathways were statistically significant with false discovery rate < 0.05. Lastly, the correlation networks between these pathways and their related genes suggested that 29 genes had correlation degree > 10, which were mainly engaged in the purine metabolism. In conclusion, we identified indole-3-lactate, erythritol, adenosine-5-phosphate, paracetamol and threitol as serum metabolic biomarkers for LC through metabolomics analysis. Besides, we identified the purine metabolism as the significantly altered metabolic pathway in LC with the help of transcriptomics analysis.

目的 总结儿童及青少年炎性肌纤维母细胞瘤(IMT)的诊断及治疗经验.方法 回顾性分析2013年11月至2018年6月郑州大学第一附属医院15例病理确诊为IMT的患儿(≤18岁)临床资料.结果 15例患儿中,男8例,女7例;入院年龄11个月～18岁;随访时间1个月～4.7年.6例腹腔IMT表现为腹胀、腹痛、腹部包块、血便、皮肤黏膜黄染等症状,2例膀胱IMT表现为血尿,4例肺部IMT表现为咳嗽、咳痰、呼吸困难、胸部疼痛,3例颌面颈部IMT表现为肿胀、触及包块.15例患儿入院查血常规:6例(40.0％)患儿白细胞计数升高,10例(66.7％)患儿贫血.3例患儿行红细胞沉降率检测均升高.9例患儿行C反应蛋白检测,4例(44.4％)升高.11例患儿肿瘤标志物检测未见特异性.15例患儿均行抗炎治疗.11例患儿CT显示瘤体边界清楚,手术完整切除;3例患儿CT显示瘤体边界不清,侵袭周围组织器官,姑息切除;1例穿刺活检后家属放弃治疗.免疫组织化学间变性淋巴瘤激酶(ALK)阳性患儿8例(67％),2例应用荧光原位杂交技术行基因检测显示ALK基因激活,服用克唑替尼.11例手术完整切除患儿中1例术后规律化疗:9例患儿术后无复发,1例术后因胸腔重度感染死亡,1例失访.3例瘤体姑息切除患儿:1例术后规律化疗,未见复发;1例术后7个月复发再次手术并规律化疗,现无复发;1例术后1年内2次复发均手术姑息切除,现带瘤生存.结论 IMT较为罕见,临床表现及辅助检查缺乏特异性.完全切除是治疗的关键,必要时行抗炎、放化疗、靶向治疗等综合治疗.完整切除预后良好,术后应定期复查.

Objective Enhanced recovery after surgery (ERAS) protocols help optimize inpatient care and minimize discomfort. This study was performed to explore the safety, feasibility, and clinical and social value of ERAS in pediatric gastrointestinal surgery. Methods This study included all children (n = 125) who underwent appendectomy, pyloromyotomy, transabdominal Soave's procedure, Meckel's diverticulum resection, or reduction of intussusception in our institution from January to September 2018. We compared surgical outcomes between children who underwent surgery under conventional perioperative regimens (control group, n = 57) and those who were treated with ERAS protocols (ERAS group, n = 68). Results There were no significant intergroup differences in demographic or surgical data. However, the bowel function recovery time, postoperative intravenous nutrition time, duration of postoperative hospital stay, and hospital costs were significantly lower in the ERAS group than control group. There was no significant intergroup difference in the complication rate. Conclusions Our results indicate that implementation of ERAS protocols is safe and feasible in pediatric gastrointestinal surgery. They can improve patient comfort, shorten the duration of the postoperative hospital stay, reduce hospital costs, and accelerate postoperative rehabilitation without increasing the risk of postoperative complications. Therefore, ERAS protocols deserve wider implementation and promotion.