Acute kidney injury (AKI) is a common complication following laparoscopic radical nephrectomy (LRN). Emerging evidence implicates extracellular vesicles (EVs) as promising candidates for diagnostic biomarkers in disease surveillance, therapeutic efficacy evaluation, and prognostic stratification. Currently, there is a lack of research on preoperative plasma EVs protein markers for predicting AKI after LRN. Plasma samples were obtained prior to the induction of anesthesia. Plasma-derived EVs were isolated using combinatorial chromatography and analyzed proteomically through off-label quantification (4D-DIA) from 5 patients with postoperative AKI and 5 patients without. Subsequently, plasma samples from an additional cohort comprising 28 AKI patients and 24 no_AKI patients were collected to validate differential protein expression in EVs. A total of 43 differential proteins were identified in EVs extracted from plasma samples, including 1 up-regulated protein and 42 down-regulated proteins. Subsequent validation demonstrated that the mean levels of Poly(rC)-binding protein 2 (PCBP2) and Profilin 1 (Pfn1) were significantly lower in AKI patients compared to no_AKI patients, yielding an AUC of 0.893 and 0.923 (95% CI: 0.776 -0.962; 0.814 -0.978), a sensitivity of 92.9% and 89.3%, and a specificity of 83.3% and 87.5%, respectively. This study employed 4D-DIA proteomic analysis and identified 43 differentially expressed proteins, among which PCBP2 and Pfn1 in plasma EVs were significantly downregulated in AKI patients and demonstrated good predictive ability for AKI. Moreover, preoperative risk stratification based on their optimal cutoff values showed high consistency with the postoperative KDIGO clinical diagnostic criteria.

Postoperative blood pressure (BP) patterns may provide prognostic information in cardiac surgery patients, yet their clinical significance remains unclear. We investigated the association between early postoperative nocturnal BP rising and mortality in this population. This retrospective cohort study used the MIMIC-IV database (2008–2019) including adult patients undergoing coronary artery bypass grafting (CABG) or valvular surgery. Patients with an intensive care unit (ICU) stay less than 24 h, insufficient BP records, or indeterminate ICU admission were excluded. Nocturnal BP rising was defined as nocturnal mean arterial pressure (MAP) exceeding diurnal MAP within the first 24 h postoperatively. Outcomes included 30-day, 90-day, and 1-year mortality. Restricted cubic splines, Kaplan–Meier survival curves, and Cox proportional hazards models were used to assess associations between nocturnal BP rising and mortality, adjusting for confounders. Subgroup and sensitivity analyses were also conducted to confirm consistency and robustness. A total of 6139 patients were included in this study. Among them, 1997 (32.5

Objective To investigate the damaging effects of red blood cell supernatant(RBC-S)stored for different durations(7 d,14 d,and 28 d)on vascular endothelial cells,and to explore the underlying mechanisms using bioinformat-ics analysis,so as to provide references for optimizing red blood cell transfusion strategies.Methods Human umbilical vein endothelial cells(HUVECs)were co-cultured with RBC-S stored for 7,14 and 28 days,designated as the 7 d group,14 d group and 28 d group respectively,which were collectively defined as the experimental groups.Cell damage was evalu-ated by cell proliferation assay(Cell Counting Kit8,CCK8),lactate dehydrogenase(LDH)release assay,4',6diamidino2phenylindole(DAPI)staining,and flow cytometry for apoptosis and reactive oxygen species(ROS)levels.The damage degree of RBC-S on vascular endothelial cells was assessed by statistical analysis of damage data among different groups.Since the damage effect reached a plateau at all time points,the 28 d storage group was selected as the representa-tive for further mechanistic studies.Transcriptomic analysis was performed to explore the role of frizzled class receptor 1(FZD1)and Wnt signaling pathway in red blood cell storagerelated endothelial dysfunction.Results Compared with the control group,the storage groups treated with 7 d,14 d,and 28 d RBC-S showed significantly decreased cell proliferation rates[control group 100%,7 d group(69.51±2.30)%,14 d group(74.54±2.89)%,28 d group(73.59±2.36)%,P<0.05],significantly reduced numbers of DAPI-stained cell nuclei[control group(213±12.5)per field,7 d group(140.33±17.04)per field,14 d group(152.00±23.72)per field,28 d group(144.33±19.09)per field,P<0.05]and significantly increased LDH release[control group(1),7 d group(8.33±1.41),14 d group(9.23±0.83),28 d group(9.16±0.60),P<0.05].There was no significant difference in the degree of damage caused by RBC-S among dif-ferent storage groups(P>0.05).With the prolongation of storage time,free hemoglobin(FHb)gradually increased[con-trol group(not detected),7 d(16.57±6.38)mg/L,14 d(76.80±22.83)mg/L,28 d(286.97±29.02)mg/L,P<0.05].The apoptotic rate(20.53±2.94)%and ROS relative intensity(5.13±0.91)in the 28 d storage group were sig-nificantly higher than those in the control group(P<0.05).Transcriptomic analysis showed that FZD1 played a key role in vascular endothelial dysfunction induced by red blood cell storage and was closely related to the Wnt signaling regulatory net-work.Conclusion RBC-S stored for 7 d,14 d,or 28 d can all significantly damage vascular endothelial cells,and the damaging effect reaches a plateau at 7 d of storage.Mechanistic investigation of the 28 d group indicated that the downregu-lation of the FZD1/Wnt signaling pathway may play a critical role in vascular endothelial dysfunction induced by red blood cell storage,providing a theoretical basis for further optimizing red blood cell storage and transfusion strategies.

Objective This study compared the effects of norepinephrine or phenylephrine combined with restrictive infusion on the oxygenation during thoracoscopic one-lung ventilation (OLV).Methods Ninety patients were randomly divided into three groups: the norepinephrine group (Group N), the phenylephrine group (Group P), and the control group (Group C). Arterial partial pressure of oxygen (PaO2) and intrapulmonary shunt fraction (Qs/Qt) were measured with patients in lateral positions during two-lung ventilation (TLV) at 10 min (T1), and during OLV at 15 min (T2) and 45 min (T3). Lung tissue samples were analyzed for endothelin and COX-2 levels after surgery.Results At T3, Group P had significantly higher PaO2 and lower Qs/Qt than Groups N and C (all p < 0.05), with no significant differences between Groups N and C (all p > 0.05). Compared to T1, Groups N and C showed significantly lower PaO2 and higher Qs/Qt at T2 and T3 (all p < 0.05), with no significant differences in PaO2 and Qs/Qt at T3 compared with T2 (all p > 0.05). Group P patients had lower PaO2 and higher Qs/Qt at T2 and T3 compared to T1 (all p < 0.05), but at T3, PaO2 increased and Qs/Qt decreased compared to T2 (all p < 0.05). Lung tissue levels of endothelin and COX-2 were significantly elevated in group P compared to groups N and C (all p < 0.05).Conclusion Combining phenylephrine with restrictive infusion during OLV improved oxygenation by increasing PaO2, decreasing Qs/Qt, and raising endothelin and COX-2 levels in lung tissue, thereby enhancing the HPV effect.

Pulmonary hypertension (PH) is a lethal vascular disorder characterized by hypoxia-driven vascular remodeling, yet the molecular mechanisms underlying endothelial dysfunction remain poorly understood. Here, we identify peroxiredoxin-1 (PRDX1) as a critical mediator of PH pathogenesis through redox-independent regulation of mitochondrial dynamics. Hypoxia upregulated PRDX1 expression in human pulmonary artery endothelial cells (HPAECs) via HIF1α-dependent transcriptional activation, as demonstrated by chromatin immunoprecipitation and promoter-luciferase assays. PRDX1 silencing attenuated hypoxia-induced HPAEC proliferation and apoptosis resistance, while its overexpression mimicked hypoxic effects independently of its antioxidant activity. Mechanistically, PRDX1 directly interacted with Dynamin-related protein 1 (DRP1) and facilitated sentrin-specific protease 3 (SENP3) binding, suppressing DRP1 SUMO2/3 conjugation to promote mitochondrial fission. In vivo, endothelial-specific PRDX1 knockdown in a hypoxia/SU5416(SuHx)-induced PH rat model significantly reduced right ventricular systolic pressure, vascular wall thickening, and endothelial hyperproliferation, while improving exercise tolerance. These findings reveal a novel HIF1α-PRDX1-DRP1 axis driving mitochondrial fragmentation and vascular remodeling in PH, positioning PRDX1 as a promising therapeutic target for halting disease progression.

High-altitude hypoxia (HH) significantly affects mammalian physiological functions, especially sleep rhythms, anxiety-like behavior, and neuroinflammation. In this study, adult male Sprague-Dawley rats were randomly assigned to five groups: Control, HH, HH with low-dose dexmedetomidine (Dex), HH with high-dose Dex, and Control with Dex. Rats were exposed to a simulated 6000-meter altitude for 7 days. Behavioral tests, enzyme-linked immunosorbent assay (ELISA), reverse transcription quantitative PCR (RT-qPCR), and Western blotting were used to assess hormone levels, gene/protein expression, and inflammatory markers. HH exposure elevated hypothalamic serotonin (5-hydroxytryptamine, 5-HT) and reduced melatonin levels. The sleep rhythm-related gene Timeless was downregulated, while Homer1 was upregulated at both mRNA and protein levels. Knockdown of Timeless or overexpression of Homer1 resulted in a significant increase in hypothalamic 5-HT levels and a marked decrease in melatonin levels. HH induced enhanced anxiety-like behaviors and reduced spontaneous activity, accompanied by elevated levels of L-1β, IL-6, and TNF-α in both serum and hypothalamus. Inhibition of the TLR4-MyD88-NFκB pathway significantly alleviated both hormonal disturbances and anxiety-like behaviors in HH rats.Dex treatment, especially at high doses, suppressed inflammatory responses, normalized hormone levels, restored sleep gene expression, and improved behavioral outcomes. These results indicate that dex mitigates HH-induced sleep and inflammatory disturbances, highlighting its therapeutic potential for high-altitude neurological dysfunction.

Robot-assisted partial nephrectomy (RAPN) is an established, minimally invasive technique to treat patients with renal masses. The incidence of acute kidney injury (AKI) after RAPN is high and is associated with poor prognosis. This study aims to develop and validate an interpretable machine-learning model based on clinical features for individualized risk assessment of RAPN-AKI. We retrospectively reviewed 325 patients undergoing RAPN at the Third Medical Center of PLA General Hospital (May 2022–Oct 2023) as the training dataset, and 146 from the Fifth Medical Center of PLA General Hospital (Nov 2023–Dec 2024) for external validation. Models were constructed using Boruta-selected features and eight machine learning algorithms. Performance was assessed by the area under the receiver operating characteristic curve (AUC), F1-score, accuracy, precision, calibration, and decision curve analysis (DCA). Shapley additive explanations (SHAP) interpreted feature contributions. The incidence of AKI in internal training and external validation datasets was 24.6

Background:Non-small cell lung cancer (NSCLC) remains one of the leading causes of cancer-related mortality worldwide. While traditional prognostic factors have mainly focused on tumor characteristics, recent evidence underscores the importance of immune response, inflammation, and nutritional status in determining patient outcomes. This study assesses the prognostic value of prognostic immune-inflammatory-nutritional (PIIN) score in predicting overall survival (OS) of NSCLC patients. Methods:A retrospective analysis was conducted on the clinical data of 406 NSCLC patients who underwent surgical treatment. The optimal PIIN score cut-off value was established using receiver operating characteristic (ROC) curve analysis, dividing patients into high and low PIIN score groups. Both univariate and multivariate Cox regression analyses identified independent prognostic factors, which were used to construct a nomogram. Results:The ideal PIIN score cut-off value was 24.2. Multivariate Cox regression analysis demonstrated that PIIN score [hazard ratio (HR): 2.116, 95% confidence interval (CI): 1.305-3.430, P=0.002], tumor-node-metastasis (TNM) stage (stage II: HR: 2.437, 95% CI: 1.223-4.855, P=0.01; stage III: HR: 6.753, 95% CI: 3.779-12.065, P<0.001), and forced expiratory volume in the first second (FEV1) (HR: 2.335, 95% CI: 1.402-3.889, P=0.001) were independent prognostic factors. The concordance index (C-index) of the nomogram constructed based on independent risk factors was 0.838 (95% CI: 0.736-0.906). ROC analysis showed that the area under the curve (AUC) values for the nomogram's prediction of 1-, 3-, and 5-year OS were 0.843, 0.831, and 0.825, respectively. Conclusions:PIIN score was validated as an independent and reliable predictor of OS in stage I-III NSCLC patients after surgery. This score provides a valuable tool for individualized prognosis evaluation in clinical practice.

INTRODUCTION:This is a cross-sectional design to evaluate high-density lipoprotein cholesterol (HDL-C) and fasting blood glucose (FBG) as novel biomarkers for assessing the risk of geriatric comorbidities. Based on data from 316 patients with geriatric comorbidities, participants were selected through hospital records according to predefined inclusion and exclusion criteria. The primary outcome measures include the impact of HDL-C and FBG levels on the severity of comorbidities and the calibration and decision utility of the nomogram prediction model. The study also explores the clinical value of the nomogram model in managing the risk of geriatric comorbidities amidst the aging population. METHODS:Multiple statistical methods, including logistic regression, Lasso regression, and calibration analysis, were used to assess the associations of the above factors and evaluate the performance of the nomogram prediction model. The model demonstrated high predictive accuracy in internal and external validation, with nearly perfect calibration performance observed in the external validation. Decision curve analysis further confirmed the model's high clinical utility and benefit. RESULTS:HDL-C was significantly negatively associated with the risk of geriatric comorbidities (odds ratio [OR] = 0.387, 95% confidence interval [CI]: 0.286-0.547, p < 0.05), while FBG was positively associated with comorbidity risk (OR = 1.050, 95% CI: 1.129-2.136, p < 0.05). The nomogram model demonstrated high predictive accuracy in internal and external validation, with nearly perfect calibration performance observed in the external validation. Decision curve analysis further confirmed the model's high clinical utility and benefit. CONCLUSION:This study underscores the importance of HDL-C and FBG as critical biomarkers for assessing comorbidity risk in the elderly and reveals the potential application of the nomogram prediction model in the risk prediction and management of elderly comorbidities. These findings support using these indicators in predicting and intervening comorbidities in the elderly, providing substantial evidence for further research and clinical practice.

Background:Due to the poor prognosis of non-small cell lung cancer (NSCLC) patients, precise and reliable biomarkers are urgently needed to predict the prognosis in NSCLC patients after radical lung surgery. Hence, this study sought to investigate the correlation between the monocyte-to-high-density lipoprotein ratio (MHR) and overall survival (OS) in NSCLC patients after surgery. Methods:This retrospective study analyzed clinical data, including MHR, from NSCLC patients undergoing radical surgery. OS was calculated to evaluate the prognosis of the NSCLC patients. The association between the MHR and OS was analyzed. A receiver operating characteristic (ROC) curve analysis was conducted to evaluate the 3- and 5-year predictive value of the MHR for prognosis after surgery. Results:In total, 256 patients were enrolled in this study. All patients had a follow-up for more than 5 years. The prognosis of the patients with a higher MHR (>0.3) was worse than that of the patients with a lower MHR (≤0.3) (P<0.001). The univariate Cox survival analysis showed that the MHR, surgery time, tumor (pT) stage, lymph node (pN) stage, and sex were all significantly associated with the risk of death in patients with NSCLC. The multivariate Cox survival analysis showed that the MHR [hazard ratio (HR) =24.837, 95% confidence interval (CI): 7.265-84.911], T stage, N stage, and surgery time were prognostic factors for NSCLC patients after surgery. The stratified analysis, which excluded patients with tumors in situ, showed that the MHR (HR =27.097, 95% CI: 8.081-90.877), surgery time, and pN stage significantly increased the risk of death in NSCLC patients. The area under the ROC curve (AUCROC) values of the MHR in predicting the 3- and 5-year survival of the NSCLC patients after surgery were 0.758 and 0.760, respectively. Conclusions:The MHR was found to be an independent predictor of OS in NSCLC patients after radical surgery. Early monitoring and reducing the MHR may be of great significance in preventing disease recurrence and improving patient prognosis.

Background:Non-small cell lung cancer (NSCLC) diagnosed in younger patients represents a rare and distinct entity within lung cancer, yet prognostic indicators for younger patients surgically treated for NSCLC remain unclear. We aimed to analyze the long-term surgical outcomes in a large cohort and to identify predictors and to develop nomograms for effective survival prediction. Methods:The Surveillance, Epidemiology, and End Results (SEER) database [2010-2020] was queried for pathologically confirmed NSCLC cases who underwent cancer-directed surgery. We selected a cutoff age of 49 years or younger to define the younger cohort. The Kaplan-Meier method was used for survival analysis. Cox proportional hazards regression models were used to determine prognostic parameters associated with survival. Nomogram performance was assessed via receiver operating characteristic (ROC) curves and calibration curves in both the training and validation cohort. Results:Among the 2,584 younger patients surgically treated for NSCLC meeting the inclusion criteria, the 5-year overall survival (OS) and lung cancer-specific survival (LCSS) rates were 84.3% and 87.0%, respectively. Multivariate analysis identified age, gender, histology, T stage, tumor, node, metastasis (TNM) stage, and postoperative therapy as independent prognosticators. Nomograms exhibited robust predictive performance. The ROC areas for 5-year OS were 0.816 for the training cohort and 0.811 for the validation cohort, while for the 5-year LCSS, the areas were 0.845 and 0.848, respectively. Additionally, the calibration curves demonstrated a high degree of concordance between the actual and predicted values. Conclusions:We identified the independent survival factors among younger patients treated surgically for NSCLC and established nomograms for the prediction of the long-term survival, offering valuable insights into clinical decision-making for post-surgical treatment.

BACKGROUND:Crosstalk between endothelial cells (ECs) and smooth muscle cells (SMCs) contributes to the progression of hypoxia pulmonary hypertension (HPH). OBJECTIVE:In this study, we investigated whether the SP1/ADAM10/DRP1 and ADAM10-PI3K-AKT-mTOR axis mediate the crosstalk between ECs and SMCs. METHODS AND RESULTS:The expression of ADAM10 increased in hypoxia-treated rats and ECs. Furthermore, the knockdown of ADAM10 alleviated HPH in rats and the malignant phenotype of hypoxia ECs. ADAM10 expression upregulated in the conditioned medium of hypoxia ECs. Conditioned medium was separated and added to the SMC culture system. Adding SMCs to a conditioned medium containing hypoxia-induced ECs promoted proliferation and decreased the apoptosis of SMCs. When SMCs were treated with a conditioned medium from ECs in which ADAM10 expression was knocked down, we found that the effects of the conditioned medium on the proliferation and apoptosis of SMCs were reduced. The protein levels of DRP1, PI3K, AKT, and mTOR decreased in SMCs treated with a conditioned medium of ECs in which ADAM10 was knocked down. After overexpressing ADAM10 in ECs, the medium was collected and added into the SMC culture system containing Mdivi-1 (DRP1 inhibitor) or LY294002 (PI3K inhibitor), and the SMCs showed reduced proliferation and increased apoptosis. SP1 was predicted based on the promoter regions of ADAM10 using the JASPAR database. The downregulation of SP1 decreases ADAM10 expression. CONCLUSION:SP1 increases the secretion and levels of ADAM10 in hypoxia ECs. ADAM10 released by ECs regulates the hypoxia-induced malignant phenotype of SMCs via the DRP1 and PI3K/AKT/mTOR signaling pathways.

BackgroundPerioperative inflammatory indices reflect systemic inflammatory responses and have been linked to cancer progression and prognosis. This study aims to explore the differences in perioperative inflammatory indices between lung squamous cell carcinoma (LSCC) and adenocarcinoma (LUAD) and their association with long-term outcomes.MethodsThis study included 287 lung cancer patients who underwent curative resection between June 2016 and December 2017, comprising 61 cases of LSCC and 226 cases of LUAD. Perioperative baseline information and inflammatory cell counts were collected. Patients were followed up for a median duration of 76 months, during which disease-free survival (DFS) and overall survival (OS) were recorded. Cox regression analysis was used to evaluate the prognostic significance of inflammatory factor levels.ResultsSignificant differences were observed in white blood cell count and systemic inflammation response index (SIRI) between LSCC and LUAD (P < 0.05). Regression analysis identified age (OR=2.096, P=0.004), postoperative day 1 D-dimer level (OR=1.550, P<0.001), and Platelet-to-lymphocyte ratio (PLR) (OR=1.901, P=0.031) as independent risk factors for perioperative venous thromboembolism (VTE). Furthermore, open surgical approach (HR=2.437, P=0.016), tumor type (LSCC; HR=2.437, P=0.016), and PLR (HR=1.534, P=0.019) were independent risk factors for DFS.ConclusionInflammatory index is key predictors of perioperative VTE and DFS in lung cancer, emphasizing their critical role in prognosis.

Complex Regional Pain Syndrome Type I (CRPS-I) is a chronic neuropathic pain disorder characterized by peripheral nerve hyperexcitability and altered nociceptive signaling. Voltage-gated sodium channels (Nav1.7, Nav1.8, Nav1.9) in dorsal root ganglia (DRG) are key contributors to pain hypersensitivity. This study investigated the analgesic effects and underlying mechanisms of bone marrow mesenchymal stem cell (BMSC) transplantation in a CRPS-I rat model. The model was induced by hind limb ischemia-reperfusion, followed by intrathecal administration of BMSCs. Pain behaviors were assessed using thermal withdrawal latency (TWL), mechanical withdrawal latency (MWL), spontaneous pain scoring, and acetone-evoked cold allodynia. RT-PCR and Western blot analysis were used to evaluate Nav channel expression in DRG tissue, while electrophysiological properties were examined using whole-cell patch clamp to generate current-voltage (I-V) curves. CRPS-I rats exhibited decreased TWL and MWL, elevated expression of Nav1.7, Nav1.8, and Nav1.9, and enhanced sodium current density with delayed inactivation. BMSC transplantation significantly alleviated pain behaviors, downregulated sodium channel expression, and normalized I-V characteristics-marked by increased activation thresholds, reduced peak currents, and faster inactivation kinetics. These findings suggest that BMSCs mitigate neuronal hyperexcitability by modulating peripheral Nav channel activity. This study provides mechanistic evidence supporting the therapeutic potential of BMSC-based interventions for CRPS-I and related neuropathic pain conditions.

Background:The prognostic predictors of the synchronous multiple primary lung cancer (SMPLC) still remain unclear, and there is a lack of studies on the prognosis of SMPLC patients excluding those with multifocal ground-glass/lepidic (GG/L) nodules. The aim of this study is to develop an effective model for predicting survival of SMPLC patients. Methods:In this multicenter cohort study, a total of 831 SMPLC patients presenting for lung cancer resection from January 2004 to January 2018 at five institutions were included for developing and validating a nomogram model. Specifically, 499 patients from the Cancer Hospital, Chinese Academy of Medical Sciences, and Beijing Chao-Yang Hospital, Capital Medical University were served as the training cohort. A total of 332 patients from The Third Xiangya Hospital of Central South University, the First Affiliated Hospital of University of Science and Technology of China, and Beijing Liangxiang Hospital were served as the external validation cohort. The nomogram model was compared with the Tumor Node Metastasis (TNM) system for the overall survival. The C-index, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were used to evaluate the model performance. A user-friendly website for SMPLC survival probability calculation was also provided for a better understanding of prognosis of patients with resected SMPLC. Results:A total of seven independent risk factors were selected by conducting a multivariate analysis on the training set. Further, a nomogram model was developed with these factors. Both the internal and external validations exhibited good discrimination (C-index: internal, 0.827; external, 0.784). The NRI and IDI of this model were 0.33 and 0.21, respectively. The survival rates for 1-year, 3-year, and 5-year were consistent with the actual observed values. A set of cutoff values were determined by grouping the patients into three different groups. For each group, we should expect a significant distinction between survival curves. Conclusions:The novel nomogram model enables accurate survival risk stratification of patients with resected SMPLC and may assist in decision-making that is conducive to patients with SMPLC at high risk.

BackgroundThe preoperative inflammatory condition significantly influences the prognosis of malignancies. We aimed to investigate the potential significance of preoperative inflammatory biomarkers in forecasting the long-term results of lung carcinoma after microwave ablation (MWA).MethodThis study included patients who received MWA treatment for lung carcinoma from Jan. 2012 to Dec. 2020. We collected demographic, clinical, laboratory, and outcome information. To assess the predictive capacity of inflammatory biomarkers, we utilized the area under the receiver operating characteristic curve (AUC-ROC) and assessed the predictive potential of inflammatory biomarkers in forecasting outcomes through both univariate and multivariate Cox proportional hazard analyses.ResultsA total of 354 individuals underwent MWA treatment, of which 265 cases were included in this study, whose average age was 69.1 ± 9.7 years. The AUC values for the Systemic Inflammatory Response Index (SIRI) to overall survival (OS) and disease-free survival (DFS) were 0.796 and 0.716, respectively. The Cox proportional hazards model demonstrated a significant independent association between a high SIRI and a decreased overall survival (hazard ratio [HR]=2.583, P<0.001). Furthermore, a high SIRI independently correlated with a lower DFS (HR=2.391, P<0.001). We developed nomograms utilizing various independent factors to forecast the extended prognosis of patients. These nomograms exhibited AUC of 0.900, 0.849, and 0.862 for predicting 1-year, 3-year, and 5-year OS, respectively. Additionally, the AUC values for predicting 1-year, 3-year, and 5-year DFS were 0.851, 0.873, and 0.883, respectively.ConclusionSIRI has shown promise as a valuable long-term prognostic indicator for forecasting the outcomes of lung carcinoma patients following MWA.

Background:Postoperative cerebral infarction (PCI) is serious complication for thoracic surgery patients, however, the risk factors still unclear. This study sought to investigate the incidence risk factors of postoperative cerebral infarction after thoracic surgery.Methods:Patients who underwent thoracic surgery from 2011 to 2022 at Beijing Chaoyang Hospital were identified and followed-up for 30 days postoperatively to determine the primary outcome of PCI. Patients with PCI were identified as the PCI cohort, and those without PCI were identified as the non-PCI cohort. The clinical data of all the patients were collected. The Mann-Whitney U test and chi-square test were used to analyze the baseline differences. Propensity-score matching (PSM) at a ratio of 1:4 was used to match the variables between the 2 cohorts, and a stepwise univariate conditional logistic regression was used to analyze the risk factors of PCI.Results:We enrolled 8,448 consecutive patients who underwent thoracic surgeries, including 21 with PCI and 8,827 without PCI. Among the 21 PCI patients, 6 patients died. A history of cerebral infarction [odds ratio (OR) = 4.38, P=0.037], perioperative blood transfusion (OR =6.22, P=0.013), a history of deep vein thrombosis (DVT) (OR =5.25, P=0.022), and hyperlipidemia (OR =13.76, P<0.01) were identified as independent risk factors among all the factors by the univariate logistical analysis after the PSM of the other covariates at a ratio of 1:4.Conclusions:PCI patients who undergo thoracic surgery have a poor prognosis. A history of cerebral infarction, perioperative blood transfusion, a history of DVT, and hyperlipidemia are risk factors of PCI. Patients with risk factors may need prevention measure and assist clinician for early diagnosis of PCI.

e17500 Background: As an important tumor marker for follow-up and prognosis of ovarian cancer, CA125 is not suitable as a screening indicator due to its frequent elevation in many physiological or pathological condition, thus women are often puzzled by unaccountably elevated levels of CA125. While we have known that the CA125 level is differed by age and benign gynecological diseases, the specific trend of CA125 level changes is still not clear. We hope that this study will contribute to a more accurate and individual interpretation of CA125 by evaluating the baseline levels of CA125 in healthy women of different ages and analysis the association between benign gynecological diseases and CA125 level. Methods: This was a cross-sectional study enrolled 73390 women without ovarian cancer from January 2016 to December 2021 in three health examination centers. We have assessed the distribution of CA125 levels in different age groups and analyzed the variation trend of CA125 levels by age among women with normal ultrasonic results, as well as performed the correlation analysis between several benign gynecological diseases and CA125 levels. Results: 55422 women with normal ultrasonic results and CA125 level <200U/mL were included in the analysis of variations in CA125 depending on age. We observed CA125 levels were linearly associated with age (R 2 =0.0503, p<0.0001). Using the group <30 years as a baseline, average CA125 levels decreased by 3.4%, 10.1%, 42.6%, 40.5%, 31.8%, and 20.3% by every 10 years. With the increase of age, the downward trend of CA125 began to reverse at the age of 60, and it showed significantly difference between each adjacent subgroup (p<0.05). 8630 women were selected with abnormal ultrasonic results, we observed that CA125 was lower in women with uterine effusion, higher in endometrial hyperplasia, endometrial polyps, hydrosalpinx, ovarian cyst, adenomyosis and uterine fibroids. Age and all those diseases demonstrated possible associations (p<0.05) with CA125 levels ≥35U/ml in univariable logistic regressions. Multivariable analysis identified that ovarian cyst (p<0.001), adenomyosis (p<0.001) and uterine fibroids (p=0.018) were still significantly associated with abnormal CA125 level. Conclusions: With the increase of age, CA125 level generally showed a downward trend, but there is a slight increase in CA125 after age 60. Ovarian cyst, adenomyosis and uterine fibroids demonstrated significant associations with abnormal CA125 level. [Table: see text]