To evaluate current evidence on machine learning (ML) for the diagnosis of Hirschsprung disease (HSCR) and summarize its diagnostic performance and potential clinical utility. PubMed, Web of Science, Cochrane Library, and Scopus were systematically searched (January 2016–November 2025) for studies applying ML to HSCR diagnosis. Study quality was assessed using QUADAS-2. Findings were narratively synthesized, with exploratory meta-analysis performed where feasible. Eleven studies were included, with substantial heterogeneity in design, data modalities, and outcomes. Three barium enema–based studies were eligible for meta-analysis, showing pooled sensitivity of 0.857 (95

BACKGROUND:This study evaluates age-specific patterns and factors influencing incomplete correction after the Nuss procedure, challenging the premise that younger age inherently increases recurrence. METHODS:A retrospective review was conducted on patients who underwent the Nuss procedure for pectus excavatum (2006-2021), with a minimum follow-up of 2 years after bar removal. Patients were stratified by operative age: Group A (3-6 years), Group B (7-10 years), Group C (11-14 years), and Group D (≥15 years). Perioperative parameters and outcomes were compared. RESULTS:Among 526 patients, the preoperative Haller index decreased with age (P < .001). Older groups demonstrated increased operative time, blood loss, bar use, and non-life-threatening complication rates (all P < .001). While the 6.3% (33/526) incomplete correction rate initially varied by age (P = .049), risk disparities became non-significant following adjustment for multiple comparisons. Presentation timing differed, with Group A showing delayed presentation within one year post-removal versus early detection within one month for Group D. Oblique bar placement, introduced in 2012, significantly reduced incomplete correction in the youngest group (12.2% to 3.3%, P = .020), without significant effect on other groups. CONCLUSIONS:No deterioration occurred in complete correction cases among all age groups. Younger age was associated with fewer postoperative complications. Incomplete correction rate was not age-dependent, but the underlying mechanisms varied among groups. Modifications in surgical technique and instrumentation significantly improved the complete correction rate.

This study applies Peplau’s interpersonal relations theory to investigate the interaction between clinical medical postgraduates and their supervisors at Tongji Medical College. Through surveys from both student and supervisor perspectives, it assesses the current interaction status and analyzes influencing factors, aiming to provide insights for improving this critical educational dynamic. Cross-sectional online survey was conducted among 78 postgraduates and 39 supervisors at Tongji Medical College from October 1, 2024, to October 1, 2025. Data from self-developed questionnaires based on Peplau’s theory in two versions were analyzed via descriptive statistics, chi-square tests, and multiple linear regression in SPSS 26. In this study, descriptive analysis revealed that students at Tongji Medical College generally expressed high satisfaction with their supervisor-postgraduate relationships, though supervisors demonstrated uneven performance across the stages of Peplau’s interpersonal theory. Differential and correlation analyses of the 5-point Likert scale questionnaire revealed that all 16 variables significantly influenced student satisfaction. Among these, four variables showed a significant positive correlation with satisfaction: the supervisor’s initiative in understanding students, the supervisor’s willingness to adjust teaching plans during the process, students’ ability to learn by analogy, and students’ development of independent clinical reasoning. Additionally, two variables showed negative correlations with student satisfaction: whether supervisors progressively increased students’ clinical autonomy and whether students developed the ability to supervise junior students. The current study applies Peplau’s interpersonal relations theory as an analytical framework. The findings suggest that incorporating this theory into the evaluation system can provide a valuable, structured perspective for assessing the relational and processual aspects of mentorship.

Introduction: Heart failure with preserved ejection fraction (HFpEF) is increasingly prevalent, accounting for nearly half of all heart failure cases, and is often complicated by atrial fibrillation (AF), which exacerbates symptoms and worsens prognosis. AF occurs in 40%-60% of HFpEF patients, contributing to structural remodeling, diastolic dysfunction, and elevated hospitalization rates. While pharmacological therapies including SGLT2 inhibitors, ACE inhibitors/ARBs/ARNI, beta-blockers, and mineralocorticoid receptor antagonists show broad benefits, rhythm control strategies such as radiofrequency ablation (RFA) remain underexplored in this population. Methods: This randomized, prospective, single-blinded trial enrolled 84 HFpEF patients with symptomatic AF. Participants were assigned to RFA (n = 39) or standard medical therapy (n = 45) and followed for 1 year. Key outcomes included changes in BNP levels, left atrial diameter (LAD), left ventricular ejection fraction (LVEF), AF recurrence, and quality of life (Minnesota Living with Heart Failure Questionnaire, MLHFQ). RFA involved pulmonary vein isolation (PVI) with irrigated catheters; patients with persistent AF also underwent posterior wall isolation (PWI). The medical group received optimized guideline-directed medical therapy (GDMT) including SGLT2 inhibitors, ACEi/ARB/ARNI, beta-blockers, and MRA as indicated. Results: RFA significantly reduced AF recurrence (p = 0.001) and attenuated left atrial enlargement (Delta LAD: -0.2 mm vs. +2.0 mm in the medical group, p < 0.001). While LVEF remained unchanged in both groups, RFA improved MLHFQ scores (p < 0.001), whereas medical therapy did not (p = 0.076). BNP levels declined in both groups (p < 0.001) but without intergroup differences. In patients with interpretable E/A ratio measurements, diastolic function appeared to improve in the ablation group compared to medical therapy (p < 0.001). Multivariate analysis identified PVI as an independent protective factor against AF recurrence (OR = 0.20) and a driver of MLHFQ improvement (beta = -16.28). Conclusions: In HFpEF patients with AF, RFA effectively suppresses atrial remodeling, reduces AF recurrence, and enhances the quality of life without altering LVEF. These benefits highlight the importance of targeting structural and symptomatic outcomes over traditional systolic function metrics. Future studies should validate long-term benefits on hard endpoints.

This study compared perioperative outcomes among robot-assisted thoracoscopic surgery (RATS), video-assisted thoracoscopic surgery (VATS), and open thoracotomy (OT) in pediatric patients with mediastinal tumors, and evaluated the technical advantages and economic implications of RATS. Clinical data of 184 children who underwent mediastinal tumor resection at our institution between December 2014 and January 2025 were retrospectively analyzed. Baseline characteristics, operative parameters, and perioperative outcomes were compared across the three surgical approaches. Multivariate regression was performed to identify independent predictors of postoperative hospital stay. All procedures were completed successfully, with no perioperative mortality. Baseline demographics were comparable among the groups. Both RATS and VATS resulted in significantly shorter chest drainage duration and hospital stay than OT. Intraoperative blood loss was lower in minimally invasive groups, with the least blood loss and postoperative analgesic requirement observed in the RATS. The RATS group, however, incurred the highest total hospitalization costs, reflecting robotic system and disposable instrument expenses. Multivariate analysis identified chest drainage duration and surgical approach as significant predictors of hospital stay. Longer operative duration was modestly associated with postoperative complications, while older age predicted ICU admission. RATS was associated with superior short‑term perioperative outcomes, including reduced blood loss, shorter drainage duration and hospitalization, and lower postoperative analgesic use, compared with VATS and OT in children with mediastinal tumors. Despite these advantages, the higher procedural costs remain a key limitation. RATS represents a promising minimally invasive alternative for appropriately selected pediatric patients, warranting further validation through multicenter prospective studies.

Background This study investigates the tutor-postgraduate interaction among clinical medical graduates at Tongji Medical College using Peplau's interpersonal relationship theory. Through surveys from both student and supervisor perspectives, it assesses the current interaction status and analyzes influencing factors, aiming to provide insights for improving this critical educational dynamic. Methods Cross-sectional online survey was conducted among 78 postgraduates and 39 tutors at Tongji Medical College from October 1, 2024, to October 1, 2025. Data from self-developed questionnaires based on Peplau's theory in two versions were analyzed via descriptive statistics, chi-square tests, and multiple linear regression in SPSS 26. Results In this study, descriptive analysis revealed that students at Tongji Medical College generally expressed high satisfaction with their mentor-mentee relationships, though mentors demonstrated uneven performance across the stages of Peplau's interpersonal theory. Differential and correlation analyses of the 5-point Likert scale questionnaire revealed that all 16 variables significantly influenced student satisfaction. Among these, four variables showed a significant positive correlation with satisfaction: the mentor's initiative in understanding students, the mentor's willingness to adjust teaching plans during the process, students' ability to learn by analogy, and students' development of independent clinical reasoning. Additionally, two variables showed negative correlations with student satisfaction: whether mentors progressively increased students' clinical autonomy and whether students developed the ability to mentor junior students. Conclusion The current study proposes that Peplau's interpersonal relationship theory provides guidance for improving mentor-student relationships, and incorporating Peplau's Interpersonal Relationship Theory into the evaluation system can more objectively assess the teaching outcome of mentors.

This study aims to compare the clinical outcomes of robot-assisted thoracoscopic surgery (RATS), traditional video-assisted thoracoscopic surgery (VATS), and open thoracotomy (OT) in children with mediastinal tumors, while also evaluating the technical advantages associated with RATS. This study conducted a retrospective analysis of clinical data from 184 pediatric patients who underwent surgery for mediastinal tumors at our center between December 2014 and January 2025. Baseline characteristics, surgical technical parameters and perioperative outcomes were compared among the three groups.184 patients were identified, all surgeries were completed successfully, with no recorded perioperative deaths. There were no significant differences in baseline characteristics. The length of hospital stay for minimally invasive group was significantly shorter than for OT group. The intraoperative blood loss in minimally invasive group was significantly less than in OT group. Total hospital charges for RATS were significantly higher than for VATS and OT groups. Mean usage of diclofenac sodium suppositories for postoperative analgesia was lowest in RATS group, significantly lower than that in other groups. Multivariate analysis indicated significant influences on hospital stay, including operative time, blood transfusion, chest tube duration, age, and surgical approach. RATS demonstrates superior perioperative outcomes compared to VATS and OT in the management of mediastinal tumors in pediatric patients. Key advantages include shorter chest drainage time and length of hospital stay, lower rates of postoperative complications and postoperative pain. However, RATS is associated with higher treatment costs.

Arrhythmia of the heart is a dangerous and potentially fatal condition. The current widely used treatment is the implantable cardioverter defibrillator (ICD), but it is invasive and affects the patient's quality of life. The sonogenetic mechanism proposed here focuses ultrasound on a cardiac tissue, controls endogenous stretch-activated Piezo1 ion channels on the focal region's cardiomyocyte sarcolemma, and restores normal heart rhythm. In contrast to anchoring the implanted ICD lead at a fixed position in the myocardium, the size and position of the ultrasound focal region can be selected dynamically by adjusting the signals of every piezoelectric chip on the ultrasonic phased array, and it allows novel and efficient defibrillations. Based on the developed interdisciplinary electro-mechanical model of sonogenetic treatment, our analysis shows that the proposed ultrasound intensity and frequency will be safe and painless for humans and well below the limits established by the U.S. Food and Drug Administration.

Tuberculosis (TB) remains a major public health challenge, with research on new anti-TB drugs crucial for global TB elimination efforts. Here, we report a novel class of anti-TB agents. Especially, compounds 5b and 5j exhibited the highest activity [minimum inhibitory concentration (MIC) H37Rv: 0.16 and 0.12 μg/mL]. Chiral resolution was performed on compounds 5b and 5j; the isomers were evaluated for their activity and safety, confirming that the R-isomer 5bb and 5jb displayed significant anti-TB activity (MIC H37Rv: 0.03–0.06 μg/mL; MDR-Mtb: 0.125–0.06 μg/mL) and low hERG toxicity. Further evaluations on 5bb and 5jb demonstrated good metabolic stability, favorable kinetic parameters and oral bioavailability (F: 56.7 and 63.8%, respectively). The results of in vivo activity assessment indicate that 5bb and 5jb exhibit protective and therapeutic effects on zebrafish larvae and adult zebrafish infected with Mycobacterium marinum. Based on these results, compounds 5bb and 5jb are considered promising candidates for further in-depth studies.

Hepatoblastoma, a common extracranial malignant solid tumor in childhood, is often detected at an advanced stage and is difficult to treat surgically. Despite the availability of multiple comprehensive treatments that can be combined with surgery, hepatoblastoma treatment outcomes remain poor. Surgery is the main treatment strategy for hepatoblastoma, but it faces many challenges, including tumor attachment to surrounding tissues, tumor wrapping or invading of vital organs and tissues, the presence of giant or multiple tumors, distant metastasis, the formation of a tumor thrombus, and significant surgical trauma. In this review, we discuss recent research advances and propose potential strategies for overcoming these challenges. Such strategies may improve the rate of hepatoblastoma resection and local control in children, as well as reduce complications and trauma.

[This retracts the article DOI: 10.3892/ol.2019.9901.].

Colorectal cancer (CRC) represents one of the most prevalent forms of malignant tumors, characterized by a notably high rate of mortality among affected individuals. The primary objective of this investigation is to delve into the functional role of Hsa_circ_0007718 in the context of colorectal cancer and to elucidate its impact on the progression of CRC by modulating the interaction between the miR-1299 microRNA and its target gene, PSMC2. To assess the expression levels of Hsa_circ_0007718, along with miR-1299 and PSMC2, real-time quantitative fluorescent PCR (qRT-PCR) assays were meticulously performed using both CRC cell lines and clinical samples derived from patients. A cellular model was established to investigate the interactions occurring between miR-1299 and Hsa_circ_0007718, as well as the connections to PSMC2, thereby providing a comprehensive understanding of these molecular interactions. The findings of this research revealed a significant upregulation of Hsa_circ_0007718 in both colorectal cancer cell lines and tissue samples. Importantly, the data indicated that the suppression of Hsa_circ_0007718 led to a marked decrease in the proliferation rates, migratory potential, and invasive capabilities of CRC cells. Furthermore, the study confirmed that Hsa_circ_0007718 acts as a downstream target of miR-1299, exerting its regulatory effects by inhibiting miR-1299 and thereby promoting the expression of PSMC2.

BACKGROUND:As reported, γ-tubulin (TuBG1) is related to the occurrence and development of various types of malignant tumors. However, its role in hepatocellular cancer (HCC) is not clear. The present study was to investigate the relationship between TuBG1 and clinical parameters and survival in HCC patients.METHODS:The correlation between TuBG1 and clinical parameters and survival in HCC patients was explored by bioinformatics analysis. Immunohistochemistry was used for the verification. The molecular function of TuBG1 was measured using colony formation, scratch assay, trans-well assay and flow cytometry. Gene set enrichment analysis (GSEA) was used to pick up the enriched pathways, followed by investigating the target pathways using Western blotting. The tumor-immune system interactions and drug bank database (TISIDB) was used to evaluate TuBG1 and immunity. Based on the TuBG1-related immune genes, a prognostic model was constructed and was further validated internally and externally.RESULTS:The bioinformatic analysis found high expressed TuBG1 in HCC tissue, which was confirmed using immunohistochemistry and Western blotting. After silencing the TuBG1 in HCC cell lines, more G1 arrested cells were found, cell proliferation and invasion were inhibited, and apoptosis was promoted. Furthermore, the silence of TuBG1 increased the expressions of Ataxia-Telangiectasia and Rad-3 (ATR), phospho-P38 mitogen-activated protein kinase (P-P38MAPK), phospho-P53 (P-P53), B-cell lymphoma-2 associated X protein (Bax), cleaved caspase 3 and P21; decreased the expressions of B-cell lymphoma-2 (Bcl-2), cyclin D1, cyclin E2, cyclin-dependent kinase 2 (CDK2) and CDK4. The correlation analysis of immunohistochemistry and clinical parameters and survival data revealed that TuBG1 was negatively correlated with the overall survival. The constructed immune prognosis model could effectively evaluate the prognosis.CONCLUSIONS:The increased expression of TuBG1 in HCC is associated with poor prognosis, which might be involved in the occurrence and development of HCC.

Liver fibrosis plays an important role in the progression of liver disease, but there is a severe shortage of direct and efficacious pharmaceutical clinical interventions. Literature research indicates that aspartic acid exhibits hepatoprotective properties. In this paper, 32 target compounds were designed and synthesized utilizing aspartic acid as the lead compound, of which 22 were new compounds not reported in the literature. These compounds were screened for their inhibitory effects on the COL1A1 promoter to assess in vitro anti-liver fibrosis activity and summarized structure–activity relationships. Four compounds exhibited superior potency with inhibition rates ranging from 66.72% to 97.44%, substantially higher than EGCG (36.46 ± 4.64%) and L-Asp (11.33 ± 0.35%). In an LPS-induced inflammation model of LX-2 cells, both 41 and 8a could inhibit the activation of LX-2 cells, reducing the expression of COL1A1, fibronectin, and α-SMA. Upon further investigation, 41 and 8a ameliorated liver fibrosis by inhibiting the IKKβ-NF-κB signaling pathway to alleviate inflammatory response. Overall, the study evaluated the anti-liver fibrosis effects of aspartic acid derivatives, identified the potency of 41, and conducted a preliminary exploration of mechanisms, laying the foundation for the discovery of novel anti-liver fibrosis agents.

Atherosclerosis (AS) is a long-standing cardiovascular and cerebrovascular disease. Its occurrence and development are related to the pathophysiology of lipids including cholesteryl ester (CE), cholesterol, triacylglycerol (TG), and phospholipid (PL). In this review, we focus on the roles and possible mechanisms of different lipid subcomponents in the process of AS, and provide new ideas for the prevention, diagnosis and treatment of AS.

Despite the significant progress that has been made in terms of understanding the pathophysiology and risk factors of Hirschsprung-associated enterocolitis (HAEC), the morbidity rate has remained unsatisfactorily stable, and clinical management of the condition continues to be challenging. Therefore, in the present literature review, we summarized the up-to-date advances that have been made regarding basic research on the pathogenesis of HAEC. Original articles published between August 2013 and October 2022 were searched in a number of databases, including PubMed, Web of Science, and Scopus. The keywords "Hirschsprung enterocolitis", "Hirschsprung's enterocolitis", "Hirschsprung's-associated enterocolitis", and "Hirschsprung-associated enterocolitis" were selected and reviewed. A total of 50 eligible articles were obtained. The latest findings of these research articles were grouped into gene, microbiome, barrier function, enteric nervous system, and immune state categories. The present review concludes that HAEC is shown to be a multifactorial clinical syndrome. Only deep insights into this syndrome, with an accrual of knowledge in terms of understanding its pathogenesis, will elicit the necessary changes that are required for managing this disease.

Nanomaterials have been extensively used for cancer therapy and diagnosis due to their designability, multifunctionality, and unique in vivo distribution. Metal ions are increasingly seen in cancer therapy and diagnostics as more and more biological effects of metal ions are revealed. Metal-ion-based antitumor strategies, as well as metal-ion-based designed nanomaterials, are continuously being developed with exciting and emerging impacts. Meanwhile, metal-ion-based nanomaterials are forming drug-free theranostic nanoplatforms, where metal ions, as part of building nanomaterials, replace conventional drugs. In this review, we discuss recent advances in multi-functional designed nanomaterials with the ability to deliver metal ions and focus on the role of metal ions in cancer therapy, including chemotherapy, chemodynamic therapy, immunotherapy, etc. The metal-ion-induced cell death, such as apoptosis, ferroptosis, and cuproptosis, is detailed in this review. Mono-/Multi-model imaging depending on metal ions for tumor diagnosis and guided tumor treatment is also the emphasis. By discussing the applications, challenges, and opportunities, we expect the metal-ions-based theranostic nanoplatforms have a far-reaching development in preclinic or clinics.

Purpose:To describe a new technique for repairing wide iridodialysis (>180°) with a double-armed flanged polypropylene suture.Setting:Private practice, Wuhan, China.Design:Case report.Methods:Adjacent to the iridodialysis side, the sclera was punctured 2 mm exterior to the corneal limbus into the anterior chamber with a 30-G needle, then the root of the de-inserted iris was punctured. A 7-0 polypropylene thread was placed into the anterior chamber through a corneal incision on the opposite side and inserted into the needle. The needle was withdrawn, leaving one side of the suture out of the eye. Then, the sclera was punctured by a new needle 2 mm from the first puncture site and passed through the iris root 2 mm from the original iris puncture point. The other end of the thread was inserted into the needle and taken out of the eye. The suture was tightened to make the iris root adhere to the corneal limbus. Finally, the suture is was cut, and the ends were cauterized and left inside the sclera. This procedure can be repeated until the iridodialysis is solved.Results:The abovementioned technique was applied in four cases. At the end of the operations, the pupils of all patients were nearly round, with a diameter of about 3 mm. No patient suffered from intraoperative and postoperative complications.Conclusions:The double-armed flanged polypropylene suture is a simple and safe operation method that can be applied to repair wide iridodialysis.

Supplementary Methods and Supplementary Figure Legends

The two most common inherited forms of colorectal cancer(CRC)are familial adenomatous polyposis and hereditary nonpolyposis colorectal cancer.They are caused by germline mutations in the APC and mismatch repair genes,respec-tively.1 The simultaneous inheritance of both an APC gene mutation and a mismatch repair gene mutation is very rare.