Volume 104 · Issue 36 · 2024

The effects of tinnitus on human health are receiving increasing attention, and it is currently believed that the central compensatory response caused by peripheral hearing loss is the main pathogenesis of chronic tinnitus. Tinnitus, psychological problems and sleep disorders affect and worsen each other, and should be taken seriously in treatment strategies. Chronic tinnitus treatment strategy advocates comprehensive treatment based on sound therapy, including reducing tinnitus sound perception and improving patients′ negative mood and poor sleep. Whether treating tinnitus alone or treating relevant psychological problems and sleep disorders can break the vicious circle of tinnitus, psychological problems and sleep disorders. Therefore, balancing both psychological and sleep problems, is the direction of tinnitus treatment and research. The clinical study of the treatment of tinnitus should shift from the previous single tinnitus treatment mode and a single tinnitus evaluation index to the comprehensive treatment and comprehensive evaluation indicators that balance both psychotherapy and sleep improvement.

In recent years, the treatment of malignant tumors has continually advanced, significantly extending the survival period of cancer patients. Tumors are increasingly present as chronic diseases over the long term, and the cardiovascular toxicity associated with cancer treatment has become increasingly prominent, severely affecting the effective treatment and survival of cancer patients. As a result, cardio-oncology has gained considerable attention as an emerging discipline. However, cardiovascular diseases in cancer patients often have an insidious onset, and early identification and treatment are frequently overlooked. Throughout the course of cancer treatment, it is crucial to reasonably apply cardiac biomarkers for risk stratification, early identification, and screening of cardiovascular diseases in patients, as well as to improve the early diagnosis and treatment levels of cardiovascular diseases in cancer patients. To this end, Cardio-Oncology Group, Chinese Society of Cardiology in conjunction with Cardiovascular Expert Committee, China Medical Doctor Association of Laboratory Medicine, organized experts in relevant fields to compile this consensus. It aims to provide a basis for clinicians to standardize the screening and management of cardiovascular toxicity related to cancer treatment through the reasonable application of cardiac biomarkers.

To verify the consistency between changes in Mandarin Tinnitus Questionnaire (MTQ) scores and tinnitus treatment outcomes.

Tinnitus patients attending the Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital of Sichuan University from September 2020 to September 2021were prospectively enrolled. The tinnitus severity was evaluated by the doctor′s assessment, the patient′s self-assessment, the MTQ, and the Visual Analogue Scale (VAS). Follow-up assessments were conducted 3 to 6 months later to evaluate the severity of tinnitus post-treatment, and information on the interventions received (pharmacologic/non-pharmacologic) and patients′ self-reported clinical impressions of their treatment outcomes (tinnitus cured/improved/no change/exacerbated) was collected.

A total of 54 tinnitus patients aged (43.5±12.7) years were included, consisting of 16 males and 38 females. There were 38 cases in the medication group and 16 cases in the non-medication group. No statistically significant differences in baseline clinical data were observed (all P>0.05). The proportion of primary tinnitus in the medication group was higher than that in the non-medication group [97.4% (37/38) vs 75.0% (12/16), P=0.023]. The correlation coefficients of MTQ scores at the initial and follow-up visits with doctor′s assessment, patient′s self-assessment, and VAS scores were 0.679, 0.483, 0.606, 0.774, 0.779, and 0.756, respectively (all P<0.001). The ΔMTQ correlation coefficient with ΔVAS was 0.694 (P<0.001), with a mean difference of 3.704×10^-7 and 95% limits of agreement ranging from -1.534 to 1.534 in Bland-Altman analysis. There were no statistically significant differences of ΔVAS and ΔMTQ between two groups (both P>0.05).

MTQ correlates well with the doctor′s assessment, the patient′s self-assessment, and VAS. Changes in MTQ scores associate well with changes in VAS scores. Additionally, changes in MTQ scores are consistent with the effect of tinnitus treatment.

To explore the related factors of anxiety and anxiety tendency in patients with tinnitus.

A cross-sectional study was carried out. Basic information, tinnitus characteristics, and psychological status of patients who complained of tinnitus in the Outpatient Department of Eye & ENT Hospital, Fudan University between January 2020 and December 2023 were collected. All patients filled out the self-rating anxiety scale (SAS) and underwent pure tone audiometry testing. According to the SAS scores, patients were divided into three groups: non-anxiety group (SAS<40), anxiety tendency group (40≤SAS<50), and anxiety group (SAS≥50). The related factors of anxiety and anxiety tendency were analyzed using multivariate ordered logistic regression analysis.

A total of 176 patients (57 males and 119 females) aged (49.4±10.7) years (range: 13-76 years)were included, with the onset time of 3 days-37 years. There were 78 cases (44.3%), 65 cases (36.9%) and 33 cases (18.8%) in the non-anxiety group, the anxiety tendency group and the anxiety group, respectively. The duration of disease in the anxiety group [(43.4±15.1) months] was significantly longer than that in the anxiety tendency group [(27.2±5.3) months] and the non-anxiety group [(19.6±3.5) months], with statistically significant differences (both P<0.05). The proportion of female patients in the anxiety group [81.8% (27/33)] and anxiety tendency group [75.4% (47/65)] was significantly higher than that in the non-anxiety group [57.7% (45/78)], and the differences were statistically significant (both P<0.05). The proportion of patients with emotional disorders [12.1% (4/33) vs 2.6% (2/78)], stress [15.1% (5/33) vs 3.9% (3/78)], and sleep disorders [48.5% (16/33) vs 23.1% (18/78)] in the anxiety group was significantly higher than that in the non-anxiety group (all P<0.05). The proportion of patients only had sleep disorders in the anxiety tendency group [38.5% (25/65) vs 23.1% (18/78)] was higher than that in the non-anxiety group, with a statistically significant difference (P<0.05). The results of multivariate ordered logistic regression analysis showed that sleep disorders werethe most significant factor affecting anxiety and anxiety tendency in tinnitus patients (OR=2.667, 95%CI: 1.451-4.909, P=0.002).

A significant proportion of tinnitus patients exhibit anxiety and anxiety tendency, and sleep disorders play a major role in the development of anxiety and anxiety tendencies in tinnitus patients.

To explore the validity of the Chinese version of tinnitus handicap inventory (THI-CM) using confirmatory factor analysis.

A cross-sectional study was carried out. The patients who complained of tinnitus and visited the Department of Otolaryngology, Head and Neck Surgery at West China Hospital of Sichuan University from March 15 to June 28, 2023 were included. All participants underwent pure tone audiometry and acoustic impedance testing before filling out THI-CM, and the results were subjected to confirmatory factor analysis.

A cross-sectional study was carried out. A total of 300 patients aged (47±13) years participated in this study. There were 175 females (58.3%) and 125 males (41.7%). The confirmatory factor analysis showed that χ²/df was 1.597<3.00, root mean square error of approximation (RMSEA) was 0.039<0.05, and standardized root mean square residual (SRMR) was 0.091>0.08. The incremental fit index (IFI), Tucker-Lewis index (TLI), comparative fit index (CFI), and goodness of fit index (GFI) were 0.960, 0.954, 0.960, and 0.902, respectively. The overall model fitted well. Except for one item with a load of 0.493, the load values of the other items were between 0.553 and 0.771. The composite reliability (CR) values of the three dimensions of the scale were between 0.769 and 0.901 (all CR>0.7). The average variance extracted (AVE) values ranged from 0.403 to 0.505 (all AVE<0.7), indicating poor convergent validity of the scale. The square value of AVE in each dimension of the scale was smaller than the correlation coefficient between factors, indicating poor discriminant validity of the scale.

The THI-CM has good structural validity, which can be used as an effective tool to evaluate the overall severity of tinnitus. However, its convergent validity and discriminant validity are poor.

To investigate the correlation of body composition indices with exercise capacity and nutritional status in male chronic obstructive pulmonary disease (COPD) patients.

The clinical data of 90 male COPD patients admitted to the Department of Respiratory and Critical Care Medicine of China-Japan Friendship Hospital from January 2021 to September 2022 were retrospectively collected, and the patients were subjected to a pulmonary function test, body composition measurement, 6-minute walking test distance (6MWD) test, and dominant handgrip strength measurement (HGS). The patients were categorized into COPD Global Initiative for COPD (GOLD) grade 1, 2, 3 and 4 groups according to the severity of lung function. Based on the fat-free mass index (FFMI), patients were categorized into a low FFMI group (FFMI<17 kg/m²) and a normal FFMI group (FFMI≥17 kg/m²). Based on phase angle (PhA), patients were categorized into the low PhA group (PhA<5°) and the normal PhA group (PhA≥5°). Based on 6MWD, patients were divided into impaired endurance group (6MWD<350 m) and normal endurance group (6MWD≥350 m). Differences in body composition indexes, exercise capacity, and nutritional status of patients in different subgroups were compared. A trend test was used to analyze the trend of GOLD grading and body composition indexes. Correlation analysis was used to analyze the correlation of FFMI, PhA, skeletal muscle mass index (SMI), basal metabolic rate (BMR), and visceral fat index (VFI) with 6MWD, HGS, post-diastolic exertional expiratory volume in the first second as a percentage of exertional lung capacity (FEV₁%pred), and body mass index (BMI).

The age of 90 male COPD patients was 66 (59, 71) years. FFMI, PhA, SMI, BMR, VFI, HGS, and 6MWD tended to decrease with increasing GOLD levels (all P<0.05). In the low FFMI group (31 cases), PhA [5.0° (4.7°, 5.1°) vs 5.8° (5.6°, 6.3°)], SMI [6.3 (5.3, 6.9)vs 8.3 (7.7, 9.1) kg/m²], and BMR [(1 294.5±387.2) vs (1 538.7±207.5) kcal(1 kcal=4.184 kJ)], VFI [(10.0±4.2) grades vs (14.2±3.3) grades], 6MWD [(430.5±90.8) vs (537.2±85.5) m], FEV₁%pred [(37.8±7.9)% vs (73.7±21.5)%], BMI [(20.2±3.8) vs (25.5±2.9) kg/m²] were lower than those in the normal FFMI group (59 cases, all P<0.05). In the low PhA group (23 cases), FFMI [(16.7±2.2) vs (19.5±1.5) kg/m²], SMI [6.6 (5.9, 7.0) vs 7.3 (7.7, 9.0) kg/m²], BMR [(1 251.8±246.2) vs (1 547.5±206.6) kcal], 6MWD [(451.0±47.1) vs (538.3±87.5) m], HGS [(29.6±4.0) vs (36.4±7.2) kg], FEV₁%pred [(51.2±15.3)% vs (72.9±22.8)%], BMI [(20.9±3.7) vs (25.5±2.8) kg/m²] were lower than those of the normal PhA group (67 cases, all P<0.05). In the impaired endurance group (21 cases) PhA [5.2° (5.1°, 5.3°) vs 5.8° (5.6°, 6.3°)], FEV₁%pred [(34.2±15.4)% vs (72.7±22.2)%] were lower than those in the normal endurance group (69 cases, all P<0.05). Correlation analysis showed that FFMI was positively correlated with HGS, FEV₁%pred, and BMI (r values of 0.327, 0.235, and 0.782, all P<0.05); PhA was positively correlated with 6MWD, FEV₁%pred, and BMI (r values of 0.341, 0.258, and 0.251, all P<0.05); SMI was positively correlated with HGS and BMI (r values of 0.411 and 0.710, all P<0.05); BMR was positively correlated with 6MWD, HGS, FEV₁%pred, and BMI (r values of 0.338, 0.508, 0.285, and 0.676, all P<0.05); VFI was positively correlated with BMI (r value of 0.791, P<0.001).

FFMI is positively correlated with HGS, FEV₁%pred, and BMI; PhA is positively correlated with 6MWD, FEV₁%pred, and BMI; SMI is positively correlated with HGS and BMI; BMR is positively correlated with 6MWD, HGS, FEV₁%pred, and BMI; VFI is positively correlated with BMI. Body composition indexes may reflect the exercise capacity and nutritional status of male COPD patients.

To analyze MRI and clinical characteristics of idiopathic inflammatory myopathy (IIM) activity and construct a prediction model.

A retrospective analysis was conducted on 326 patients with IIM from December 2019 to December 2023 at General Hospital of Ningxia Medical University, including 112 males and 214 females, aged(53.7±15.3) years. According to histopathology and electromyography, they were divided into active phase group(n=86) and inactive phase group (n=240). The two groups were randomly divided into the training set and the verification set according to the ratio of 7∶3. The single factor analysis, least absolute shrinkage and selection operator (Lasso), random forest algorithm, and multivariate logistic regression model were used to screen the risk factors of IIM activity and construct a prediction model. Receiver operating characteristic (ROC) curve and calibration curve were used to evaluate the performance of prediction model.

There were significant differences in gender, age, T₁ value, T₂ value, creatine kinase-MB(CKMB), creatine kinase (CK) and lactate dehydrogenase (LDH) between the two groups(all P<0.05). Lasso and random forest algorithm screened 5 variables for analysis, age (λ=-0.009), T₂ value (λ=-2.564), CKMB (λ=-0.256), CK (λ=-0.492), LDH (λ=-2.786) respectively. Multivariate logistic regression model showed that age (OR=1.603, 95%CI: 1.030-1.096), T₂(OR=352.269, 95%CI: 13.303-9 328.053), CKMB (OR=2.470, 95%CI: 1.497-4.075), CK(OR=4.973, 95%CI: 2.583-9.575), LDH(OR=1 155.247, 95%CI: 152.387-8 757.954) were risk factors for active IIM patients. A prediction model nomograms were drawn with the above risk factors included. The area under the ROC curve (AUC) of the prediction model for the training set MRI combined with clinical indicators was higher than that of the clinical indicator model [0.914 (95%CI: 0.873-0.955) vs 0.901 (95%CI: 0.858-0.945), P<0.001], with sensitivity of 88.3% and 90.7%, and specificity of 81.7% and 75.0%, respectively. The AUC of the prediction model for the validation set MRI combined with clinical indicators was higher than that of the clinical model [0.982 (95%CI: 0.873-0.955) vs 0.934 (95%CI: 0.858-0.945), P<0.001], with sensitivity of 97.2% and 88.5%, and specificity of 100.0% and 92.3%, respectively. The calibration curves plotted in the training set and test set, respectively, fit well with the ideal curve.

The nomogram model of MRI combined with clinical indicators can effectively predict the activity of IIM.

To explore the risk factors of contralateral central lymph nodes (Cont-CLNs) metastasis in intermediate-to-high risk unilateral papillary thyroid carcinoma and establish a prediction model.

The clinical data of 206 patients receiving thyroid cancer surgery at Nantong University Affiliated Hospital between January 2021 and June 2023 were retrospectively analyzed, including 50 males and 156 females, with an age of [M(Q₁, Q₃)] 49.0(33.8, 57.0) years old. The risk factors of Cont-CLNs metastasis were screened by univariate analysis and multivariate logistic regression analysis. A nomogram was constructed for predicting Cont-CLNs metastasis in intermediate-to-high risk uPTC. The area under the receiver operating characteristic (ROC) curve(AUC), calibration curve, and decision curve analysis (DCA) were used to evaluate the model′s predictive ability, accuracy, and clinical applicability, respectively. R language was used to randomly select 70% of the patients to establish a validation group for internal validation of the model.

Patients were divided into a metastasis group (n=56) and a non-metastasis group (n=150) based on the occurrence of Cont-CLNs metastasis. The ages of the two groups were 39.0 (28.0, 56.8) years and 51.0 (38.8, 57.0) years, respectively. There were statistically significant differences in gender, maximum tumor diameter (>1 cm), ipsilateral central lymph nodes (Ipsi-CLNs) metastasis, number of Ipsi-CLNs metastases (≥4), and lateral lymph node metastasis and Cont-CLNs metastasis between the two groups (all P<0.05). The results of multivariate logistic regression analyses showed that males(OR=2.926, 95%CI: 1.063-8.051), maximum tumor diameter>1 cm(OR=4.471, 95%CI: 1.344-14.877), and number of Ipsi-CLNs metastases≥4 (OR=5.011, 95%CI: 1.815-13.834) were risk factors for Cont-CLNs metastasis (all P<0.05). The AUC of the ROC curve, sensitivity, and specificity for predicting Cont-CLNs metastasis in intermediate-to-high risk uPTC by the prediction model in the modeling group were 0.821 (95%CI: 0.744-0.898), 82.5%, and 63.4%, respectively. In the internal validation group, the AUC of the ROC curve, sensitivity, and specificity for predicting Cont-CLNs metastasis in intermediate-to-high risk uPTC by the prediction model were 0.810 (95%CI: 0.717-0.902), 63.3%, and 83.7%, respectively. The calibration curves of the modeling group and the validation group showed that the model had good calibration ability. The DCA curves of the modeling group and the validation group indicated that the prediction model had good clinical adaptability.

The prediction model constructed in this study has good predictive performance for Cont-CLNs metastasis in intermediate-to-high uPTC. When patient with intermediate-to-high risk uPTC is male, with maximum tumor diameter>1 cm, and the number of Ipsi-CLNs metastases≥4 should be alert to Cont-CLNs metastasis, and bilateral central lymph node dissection may be considered.

To investigate the changes in gene expression related to intestinal fatty acid oxidation and carnitine metabolism in patients with ulcerative colitis (UC).

A retrospective study was conducted involving patients with UC (UC group) and non-UC controls (control group) who underwent routine colonoscopy to exclude polyps at Peking Union Medical College Hospital between January 1, 2018, to December 31, 2023. Colon tissue samples were collected from both groups and RNA was extracted. Real-time fluorescence quantitative polymerase chain reaction technology was used to detect the mRNA expression levels of genes related to fatty acid oxidation and carnitine metabolism and to analyze their correlation with inflammatory gene expression. The expression of genes linked to fatty acid oxidation and carnitine metabolism was analyzed by analyzing the colonic mucosal transcriptome data of UC patients and controls in high-throughput gene expression database (GEO). Immunohistochemistry was used to examine the expression of the carnitine transporter SLC6A14 in the intestinal tissues of both groups at the protein level. Eight-week-old male C57BL/6 mice were selected and divided into a drinking water group (drinkind daily water) and a dextran sodium sulfate (DSS) group (drinking 2.5% DSS solution) with 4 mice in each group. DSS was used to induce an acute colitis model in mice and detect the difference in mRNA expression levels of SLC6A14 and interleukin-6 (IL-6) in the intestinal tissues of the both groups of mice.

A total of 22 patients were included in the UC group, with 12 males and 10 females, aged 16-64 (40±12) years. The control group consisted of 10 patients, with 3 males and 7 females, aged 43-72 (64±8) years. The UC group had lower mRNA expression levels of genes related to fatty acid oxidation and transport in the intestine compared to those in the control group, such as CD36 [0.40 (0.27, 0.55) vs 0.93 (0.39, 2.93)], CPT1A [0.39 (0.07, 0.54) vs 0.93 (0.41, 1.71)], CPT1B (0.37±0.36 vs 1.37±0.89), CPT2 [0.36 (0.30, 0.43) vs 1.14 (0.68, 1.34)], CRAT [0.31 (0.25, 0.41) vs 1.06 (0.64, 1.73)], CROT [0.14 (0.10, 0.21) vs 0.95 (0.77, 1.27)] (all P<0.05). The mRNA expression levels of genes related to carnitine transport in the UC group were lower than those in the control group, such as OCTN1 [0.18 (0.10, 0.41) vs 0.83 (0.41, 1.47)], OCTN2 [0.01 (0.00, 0.01) vs 0.47 (0.35, 2.15)] (both P<0.05). The mRNA expression levels of the carnitine transporter gene SLC6A14 in the intestine of UC patients was higher than that of the control group [11.31 (5.34, 23.50) vs 0.78 (0.07, 3.70), P<0.001], and showed a positive correlation with the inflammatory gene IL-6 (r=0.425, 95%CI: 0.076-0.681, P=0.019). Analysis of the GEO database revealed lower expression levels of CD36, CPT1A, CPT2, CRAT and CROT in UC group compared to controls (all P<0.05), while the expression levels of SLC6A14 were higher than those in control group (P<0.05). The protein expression level of SLC6A14 in colon tissue of UC group was higher than that of control group (0.45±0.07 vs 0.30±0.01, P=0.019). The mRNA expression of SLC6A14 in the intestine of DSS group was higher compared to that in the drinking water group (1.83±0.90 vs 0.60±0.10, P=0.035).

The expression levels of genes associated with intestinal fatty acid oxidation and carnitine metabolism (CD36, CPT1A, CPT1B, CPT2, CRAT, CROT, OCTN1, and OCTN2) are decreased in UC patients, while the expression level of SLC6A14, a gene capable of transporting both amino acids and carnitine, is increased.

Craniopharyngioma is a rare benign tumor originating from residual epithelial cells during embryonic development of the pituitary gland. Panhypopituitarism is a common complication after its treatment, which seriously affects the quality of life of patients. A young female patient with panhypopituitarism after craniopharyngioma resection was treated with glucocorticoid, thyroid hormone and antidiuretic hormone. Growth hormone was supplemented from the age of 16, and the lifetime height of 164 cm was reached at the age of 18. Development of secondary sexual characteristics by sequential estrogen and progesterone therapy from 18 years of age. Solving fertility problems by ovulation induction treatment at the age of 28. After multi-disciplinary long-term comprehensive treatment and regular follow-up, this patient had satisfactory quality of life, good health status and successful pregnancy and delivery. His diagnosis and treatment experience can provide reference for multidisciplinary treatment of postoperative craniopharyngioma patients.

This paper reports a case of vascular tinnitus caused by carotid-cavernous fistula. A 43-year-old female was seen for "pulsatile tinnitus in the right ear for 8 months". Eight months before the treatment, the patient developed right vascular pulsatile tinnitus without obvious trigger. The symptoms worsened six months ago. A blowing-like murmur consistent with the patient's pulse rhythm could be heard near the patient's right temporal region, and the right pulsatile tinnitus decreased after compressing the right external carotid artery. Cerebral angiography revealed carotid-cavernous fistula, and embolization of the right external carotid artery was performed. Intraoperative exploratory angiography revealed 90% embolization of arteriovenous fistula. After 6 months follow-up, the loudness of vascular tinnitus on the right side of the patient was significantly reduced, which did not affect the patient's sleep and daily life.

The patient, a 60-year-old male, visited the Respiratory Disease Center of Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine on November 2, 2022 because of "chest pain, chest tightness, cough and expectoration during eating for more than 2 months after resection of right lower lobe lung cancer, accompanied by intermittent fever". Gastroscopy confirmed bronchoesophageal fistula (BEF), bronchopleural fistula (BPF), esophageal diverticular fistula (middle segment), pulmonary infection, and empyema. After anti-infection, thoracic drainage, nutritional support and correction of acid-base imbalance, bronchopleural fistula and esophageal diverticular fistula were treated by combined bronchoscopy and digestive endoscopy. After 12 months of follow-up, the patient's vital signs were stable, the right remaining lung recovered well, and the esophageal anastomotic clip was well fixed.

Epidermoid cyst of the spleen is a rare benign lesion of the spleen. Its clinical manifestations are not specific, and its preoperative imaging and biochemical diagnosis are difficult. It is easy to be misdiagnosed at the initial diagnosis, and the final diagnosis depends on histopathological examination. This article reviewed the diagnosis and treatment of a patient with abnormal elevation of carbohydrate antigen-199 in spleen epidermoid cyst, and combined with relevant literature reports, summarized the characteristics of this disease, in order to provide ideas and directions for further research on spleen epidermoid cyst.

In 2023, the International Union of Obstetrics and Gynecology (FIGO) revised the staging of endometrial cancer (EC) again after 2009. This modification breaks through the limitations of traditional anatomical assessment and integrates related factors such as molecular typing, pathological type, and lymphovascular space invasion (LVSI) to further refine the sub-staging. The application of FIGO 2023 new staging has resulted in stage changes in more than 1/4 of EC patients, mainly with stage increases, and most stage changes are concentrated in early (stages I and II) patients. The new staging has higher accuracy in the judgment of patient prognosis, and is expected to further promote the development of individualized treatment for patients. However, the new staging also has certain limitations, and more detailed staging may bring certain difficulties to clinical use and data statistics; The introduction of molecular typing may lead to widening disparities in the management of tumor patients in economically developed and underdeveloped regions; The integration of emerging molecular biology data and existing molecular typing may speed up the updating of staging and bring challenges to clinical work; The introduction of pathological parameters also puts forward higher requirements for pathologists, and it is necessary to formulate more strict and uniform pathological standards according to the pathological characteristics of EC. This article mainly reviews the benefits and limitations of the new staging of FIGO 2023 for patients with early stage EC.

This article reviews the clinical progress achieved in the field of non-small cell lung cancer (NSCLC) at home and abroad in 2023 and puts forward corresponding reflections. Targeted therapy and immunotherapy have revolutionized the clinical practice of NSCLC. Perioperative immunotherapy can significantly improve the rate of major pathology response (MPR) and event-free survival (EFS) in patients with operable driver-negative NSCLC, thus becoming the standard treatment option for patients with resectable early-to middle-stage NSCLC. Following the approval of nivolumab in combination with chemotherapy for neoadjuvant therapy in patients with resectable (tumor ≥4 cm or lymph node positive) NSCLC, programmed cell death receptor 1 (PD-1) /programmed cell death ligand 1 (PD-L1) monoclonal antibodies at home and abroad have successively announced the results of perioperative immunotherapy studies. Domestic toripalimab combined with chemotherapy significantly increased the main MPR rate and EFS rate of stage III operable NSCLC, and became one of the new regimens for the treatment of perioperative NSCLC. At the same time, in NSCLC patients with anaplastic lymphoma kinase (ALK) fusion mutations, adjuvant targeted therapy has achieved significant disease-free survival (DFS) benefits compared with traditional chemotherapy; In the field of NSCLC with advanced epidermal growth factor receptor (EGFR) mutations, targeted combination chemotherapy has significantly improved progression-free survival (PFS) in the first-line treatment of advanced NSCLC. Targeted drugs have also made some progress in NSCLC with rare mutations in the advanced stage. At the same time, the development of antibody conjugate drugs is very rapid, and the new antibody conjugate drugs of human epidermal growth factor receptor-3 (HER3) and human trophoblast cell surface glycoprotein antigen 2 (TROP2) currently under development have also shown gratifying results.

Tinnitus is a common symptom, often accompanied by anxiety, depression, hearing problems, sleep disturbances, and poor concentration. A small number of tinnitus patients are seriously troubled, and this group needs to be effectively identified in advance to monitor disease progression and judge prognosis. In recent years, P300, as a neuroelectrophysiological technique with intentional attention, has been used gradually in patients with tinnitus. This article reviews the application of P300 amplitude and incubation period in patients with tinnitus and the application of P300 in predicting the curative effect of patients with tinnitus.

A 7-year-old male was diagnosed with Burkitt's lymphoma at Zhengzhou Children's Hospital of Henan Children's Hospital in July 2023. The affected sites include nasopharynx, sinus area, neck, bilateral axillary, abdominal cavity, skull, and maxillofacial bone. Chemotherapy was performed successively with cyclophosphamide + vincristine + bonisone, cyclophosphamide + vincristine + bonisone + daunorubicin + methotrexate and other regimens; Multiple intravenous infusions of red blood cells, platelets and use of granulocyte stimulating factor to manage the problem of bone marrow suppression after chemotherapy. PET/CT was re-examined in October 2023, and the glucose uptake (FDG) was significantly reduced compared with that before chemotherapy, and the extent of lesions was significantly reduced; In the same month, the child had repeated fever, with a fever peak of 39.4 ℃, accompanied by pain in both lower limbs, which was not severe. Physical examination: Multiple mung bean-sized nodules can be palpable subcutaneously and intramuscularly in both lower limbs, which are hard in texture, poor in activity, painful in pressing, and untouched in superficial lymph nodes; There were no yellowing stains, bleeding spots and rash on the whole body. The total number of white blood cells was 14.97×10 by blood routine⁹/L, C-reactive protein 103.16 mg/L, procalcitonin 0.134 μ g/L. Bilateral tibia and fibula MRI revealed bilateral tibial bone marrow cavities (Figure 1, coronal lipid pressure T₂WI, indicated by red arrows), subcutaneous and intramuscular layers of both calves (Figure 2, axial fat pressure T₂WI, indicated by red arrows) with multiple nodular hypertension, which showed nodular obvious enhancement after enhancement (Figure 3, T₁WI enhancement, indicated by red arrows). After multidisciplinary consultation, we considered fungal infections in soft tissues and bone marrow of both lower limbs, and recommended pathological biopsy. Incision and biopsy of subcutaneous lesions of right lower limb under general anesthesia, puncture of intratibial lesions and pathology and culture were performed, and the results showed Candida tropicalis infection. Later, a plain CT scan of the chest was performed, which showed multiple nodules in the upper lobes of both lungs (Figure 4, shown by white arrows), and fungal infection was considered. Second-generation sequencing of peripheral blood suggests that the sequence number of Candida tropicalis is 27. The clinical diagnosis was candida sepsis and sepsis, and anti-infective treatments such as meropenem, amphotericin B, caspofungin, linezolid, vancomycin and voriconazole were successively applied. The clinical symptoms of the children gradually improved, and the inflammatory indexes gradually tended to normal. After reexamination of MRI of both tibias and fibula, the abnormal signals in the original bone marrow cavity and surrounding soft tissues basically disappeared.

Reference 126 on page 2220 in Guidelines for the Diagnosis and Treatment of Chronic Thromboembolic Pulmonary Hypertension (2024 Edition), Volume 104, Issue 24, 25 June 2024, Chinese Journal of Medicine, should be : Romanov A, Cherniavskiy A, Novikova N, et al. Pulmonary artery denervation for patients with residual pulmonary hypertension after pulmonary endarterectomy [J]. J Am Coll Cardiol, 2020, 76 (8): 916 – 926. DOI: 10.1016/j.jacc.2020.06.064 .. In addition, the units of some members of the external audit expert group on pages 2214~2215 have changed, and the relevant contents should be: Li Yuying (Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Southwest Medical University); Wu Xueling (Department of Respiratory and Critical Care Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine); Xing Xiqian (Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Yunnan University). Corrections are hereby made.