Objective To explore the clinical value of red blood cell volume distribution width coefficient of variation (RDW-CV), serum interleukin-11 (IL-11) and interleukin-31 (IL-31) in the diagnosis of interstitial lung disease (ILD). Methods Prospectively selected 46 ILD patients admitted to the Department of Respiratory and Critical Care Medicine, the Affiliated Hospital of Chengde Medical University from November 2022 to October 2023 were set as ILD group, 40 patients with community-acquired pneumonia (CAP) as CAP group, and 35 healthy examiners as control group. The ILD group was further divided into idiopathic interstitial pneumonia (IIP) subgroup (n=30) and connective tissue disease-related ILD (CTD-ILD) subgroup (n=16) based on clinical diagnosis. General and clinical data of each group were recorded, and RDW-CV and serum IL-11 and IL-31 levels were detected in each group. The ILD group was tested for alveolar arterial oxygen pressure difference (AaDO₂) and arterial blood oxygen pressure (PaO₂), and calculated the oxygenation index (OI). The correlation between the levels of RDW-CV, IL-11 and IL-31 and the severity of ILD were analyzed to explore the value of the above indicators in the clinical diagnosis of ILD and the differential diagnosis of different types of ILD. Results Compared with control group, there was no statistically significant difference in general information such as age, gender, smoking history, and complications between the ILD and CAP groups (P<0.05); RDW-CV, absolute values of neutrophil count (NEUT), and serum IL-11 and IL-31 levels in ILD group were significantly increased (P>0.05). Compared with CAP group, the levels of RDW-CV and serum IL-11, IL-31 in ILD group were increased, while the level of serum C-reactive protein (CRP) was decreased, with statistically significant differences (P<0.05). Correlation analysis results showed that RDW-CV and serum IL-31 in ILD patients were negatively correlated with OI (P<0.05), and positively correlated with AaDO₂ (P<0.05). The area under the ROC curves (AUC) of RDW-CV and serum IL-11, IL-31 single and combined applications for diagnosing ILD were 0.770, 0.666, 0.646, and 0.854, respectively (P<0.05). The AUC of serum IL-11 for differential diagnosis of CTD-ILD and IIP was 0.727(95%CI 0.580-0.874), with sensitivity of 62.5% and specificity of 73.3% (P<0.05). Conclusions RDW-CV and serum IL-31 have certain value in assessing the severity of ILD. RDW-CV and serum IL-11 and IL-31 have certain value in the diagnosis of ILD. Serum IL-11 has certain value in the differential diagnosis between CTD-ILD and IIP.

Cushing's disease is a severe endocrine disorder caused by excess secretion of adrenocorticotropic hormone from pituitary. Due to its subtle early clinical manifestations , the diagnosis of Cushing's disease is often delayed, and differentiating it from ectopic adrenocorticotropic hormone syndrome is a challenge. Combined functional tests can improve the diagnostic accuracy of Cushing's disease. The primary treatment for Cushing's disease is surgical removal of pituitary adenoma. However, about 1/3 of patients do not respond or experience recurrence after surgery, necessitating second-line treatments including medication. The development of novel drugs has enhanced the role of pharmacotherapy in the management of Cushing's disease. The review discusses the classic and emerging diagnostic methods and treatment strategies of Cushing's disease to deepen clinicians' understanding of its current treatment status and prospects.

Refractory prolactinoma is the most common pituitary neuroendocrine tumor. Dopamine receptor agonists (DA) are the primary choice for drug treatment. Most patients with prolactinomas respond well to DA. However, a minority of prolactinomas patients still show resistance to DA. Although drug-resistant and refractory prolactinomas are rare in clinical practice, their treatment is extremely challenging. Even a combination of drug therapy, multiple surgeries, and radiotherapy may not yield satisfactory outcomes. Therefore, standardizing the diagnosis and treatment process and pathway for refractory prolactionmas and exploring more effective multidisciplinary collaborative treatment strategies are urgent problems to be solved. In the clinical management of refractory prolactinomas, it is often necessary to consider the patient's condition comprehensively, replace other types of DA, or consider surgery, radiotherapy, and immunotherapy, which requires multidisciplinary diagnosis and treatment. This review synthesizes the latest literature at home and abroad to systematically discuss the latest advances in drug therapy, surgery, and radiotherapy treatments for refractory prolactionmas, aiming to provide new ideas for basic research, clinical diagnosis and treatment.

Sepsis-induced coagulopathy (SIC), a critical and potentially lethal condition arising from sepsis, results in endothelial damage and significant coagulation dysregulation, making it a major factor contributing to mortality among sepsis patients. Early diagnosis and treatment of SIC are expected to improve the prognosis of sepsis patients. In 2019, the International Society on Thrombosis and Hemostasis (ISTH) issued the first guidelines for the diagnosis and treatment of SIC, but there are no corresponding protocols in China. Therefore, Chinese Society of Thrombosis, Hemostasis and Critical Care, Chinese Medicine Education Association, and Chinese People's Liberation Army Professional Committee of Critical Care Medicine jointly formulated the "Chinese Expert Consensus on the Diagnosis and Treatment of Sepsis-induced Coagulopathy (2024 edition)." This consensus includes 5 parts: pathogenesis, classification, laboratory approaches, diagnosis and treatment, with a total of 14 evidence-based recommendations to guide clinical practice.

Objective To compare and explore the impact of radical prostatectomy, external beam radiation therapy, and prostate brachytherapy on sexual function of patients with prostate cancer. Methods A total of 80 prostate cancer patients admitted to the Urology Department of Ji'an Central People's Hospital from January 2020 to December 2022 were retrospectively analyzed. According to the treatment plan, they were divided into a surgical resection group (n=26, underwent radical prostatectomy), an external beam irradiation group (n=28, treated with high-energy X-rays or particle beams directed at irradiate tumor cells from outside the body), and a brachytherapy group (n=26, radioactive material placed directly into the prostate to act on cancer cells). General data such as age, body mass index (BMI) and Gleason score were collected for all patients. Patients were assessed for erectile dysfunction using international index of erectile function (IIEF) scale, for sexual desire using sexual dysfunction index (SDI) scale, and for sexual function using male sexual health questionnaire (MSHQ) scale. Six months after the end of treatment, the patients' anxiety and depression were assessed using self-rating anxiety scale (SAS) and self-rating depression scale (SDS). Results There were no statistically significant differences in age, BMI and Gleason score among patients in each group (P>0.05). The brachytherapy group demonstrated a higher rate of no erectile dysfunction compared to surgical resection group and external beam radiation group (P<0.05), and lower rates of mild and moderate to severe erectile dysfunction compared to surgical resection group (P<0.05). The external beam irradiation group showed a higher rate of no erectile dysfunction and lower rates of moderate to severe erectile dysfunction compared to surgical resection group (P<0.05). The brachytherapy group showed higher scores in sexual fantasy, sexual desire, sexual frequency and total SDI score than those in surgical resection group and external beam radiation group (P<0.05). The external beam radiation group also had higher scores in these areas compared to surgical resection group (P<0.05). The total sexual function score was higher in brachytherapy group compared to the other two groups (P<0.05), and the external beam irradiation group had a higher sexual function score than surgical resection group (P<0.05). The SAS and SDS scores in brachytherapy group were lower than those in surgical resection group and external beam radiation group (P<0.05). Conclusion Among the treatment methods for prostate cancer, prostate brachytherapy is relatively more effective in maintaining sexual function, especially in terms of erectile function and sexual desire, outperforming radical prostatectomy and external beam therapy.

Acromegaly can cause chronic complications in multiple systems such as the cardiovascular, respiratory, digestive, and endocrine systems, increasing the risk of death and significantly shortening the patient's life expectancy. Timely screening and early diagnosis and treatment can significantly improve the prognosis of patients and indirectly reflect the level of diagnosis and treatment of hospitals or teams. Clinical communication and research have revealed that physicians, in the course of clinical practice, are frequently constrained by factors such as time, economic considerations, and patient compliance, which hinder their ability to perform comprehensive screening for acromegaly-related complications. This review draws on expert consensuses and guidelines from both domestic and international sources, integrating them with the specific realities of China, to provide a comprehensive summary of the key aspects of screening and management for acromegaly-related complications. These aspects include the incidence of complications, optimal timing for screening, treatment approaches, long-term monitoring, and strict management protocols. It emphasizes standardization, precision, and personalization in clinical diagnosis and treatment work, aiming to comprehensively improve the diagnosis and treatment level of acromegaly in China, enhance the survival rate of patients, and improve their quality of life.

Pituitary thyroid-stimulating hormone (TSH) adenomas is a rare pituitary disorder, accounting for less than 2% of pituitary adenomas. The clinical manifestations primarily include mild to moderate symptoms of hyperthyroidism, corresponding symptoms caused by other anterior pituitary hormone secretion disorders, and symptoms resulting from the mass effect of pituitary tumors. Pituitary TSH adenomas need to be differentiated from primary hyperthyroidism (Graves' disease) and resistance to thyroid hormone (RTH), as misdiagnosis can lead to tumor growth and aggravation of the condition. Currently, with the help of sensitive laboratory tests, imaging examinations, and targeted functional tests, pituitary TSH adenomas can be diagnosed relatively accurately. The preferred treatment is surgical resection. In cases where surgery is not feasible or unsuccessful, radiotherapy or medical therapy can be considered. Long-acting somatostatin analogs can effectively reduce tumor volume and decrease TSH secretion, thereby normalizing free 3,5,3',5'-tetraiodothyronine (FT₄) and free 3,5,3'-triiodothyronine (FT₃). Early identification and effective treatment are significant for patients with pituitary TSH adenomas. This review summarizes the epidemiology, pathological characteristics, screening objects, clinical manifestations, auxiliary examinations, diagnosis and treatment, follow-up and evaluation of pituitary TSH adenoma, aiming to provide guidance for the clinical diagnosis and treatment of this condition.

Aneurysmal subarachnoid hemorrhage (aSAH), primarily caused by the rupture of intracranial aneurysms with bleeding into the subarachnoid space, is an acute neurological disease associated with high disability and mortality. Brain injury after aSAH results from a combination of injury mechanisms, with early brain injury (EBI) occurring within 72 hours post-onset, laying the foundation for subsequent pathophysiological changes in the brain and poor prognosis of patients. Among them, the brain immunoinflammatory response, involving the interaction of various immune cells and active substances, plays a significant role in post-aSAH EBI, and is related to delayed brain injury and long-term prognosis. Systemic inflammatory response following aSAH can also affect the prognosis and outcome of patients. This review summarizes the role of local and systemic immune inflammatory responses in the occurrence and progression of aSAH, as well as the research progress on related inflammatory biomarkers and therapeutic prospects, aiming to provide a theoretical reference for new treatment for aSAH.

Tumor neoantigens are antigens encoded by tumor-specific mutated genes, characterized by high specificity, significant exogenous origin, mutation randomness, clonal distribution and correlation with gene mutation. Because these antigens are not negatively screened by the thymus and recognized by T cells as "heterogeneous". They are less easily affected by the immune tolerance mechanism and exhibit strong immunogenicity, making them excellent targets for immunotherapy. Tumor neoantigens can be used to develop therapeutic vaccines, induce and cultivate T cells with stronger targeting capabilities, and are promising for predicting tumor survival prognosis and responses to immune checkpoint blockade therapies. This review summarizes the recent advances in clinical application of tumor neoantigen-based immunotherapy, and prospects for future research directions.

Objective To investigate incidence and modifiable risk factors of postoperative delirium (POD) in patients undergoing cardiac surgery. Methods A prospective observational research method was conducted on 880 cardiac surgery patients admitted to the Department of Cardiovascular Surgery, at the First Affiliated Hospital of Chongqing Medical University from January 2022 to June 2023. Patients' general and clinical data were collected. POD was assessed twice daily from the second day in the ICU using the Confusion Assessment Method of Intensive Care Unit(CAM-ICU) until discharge or transfer from ICU. The patients were divided into two groups based on the presence of POD, and the incidence rate was calculated. Subsequently, a 1:1 propensity score matching (PSM) was applied between the two groups. The differences in general information and clinical characteristics between the two groups of patients before and after PSM were compared. Logistic regression analysis was used to evaluate the modifiable risk factors for POD in patients undergoing cardiac surgery after PSM. Results Of the 880 patients, 278 experienced POD during their stay in the ICU, with an incidence rate of 31.6%. POD occurred between the 2nd and 12th day following ICU admission, with 91.4%(254 patients) experiencing it between the 2nd and 6th day. Univariate analysis identified preoperative factors of POD including gender, age, history of hypertension, history of diabetes, and smoking history; Intraoperative factors were ASA anesthesia grade, operation duration, extracorporeal circulation time, and aortic occlusion time; Postoperative factors included ICU length of stay, mechanical ventilation duration, and VAS score, all of which were statistically significant (P<0.05). After PSM, the distribution of three immutable demographic factors including gender, age, and blood type tended to be consistent among groups (P>0.05). Further multivariate logistic regression analysis showed that surgical time, ICU stay time, mechanical ventilation time, and VAS score were independent modifiable risk factors for POD in cardiac surgery patients (P<0.05), with corresponding OR values of 1.003, 3.117, 1.385, and 1.590, respectively. Conclusions Surgical time, ICU stay time, mechanical ventilation time, and VAS score are independent modifiable risk factors for the occurrence of POD in patients undergoing cardiac surgery. In clinical work, early intervention should be carried out based on the characteristics of the patient's condition and risk factors to further reduce the occurrence of POD.