Objective To explore the anti-tumor effect of atractylenolide Ⅱ （ATL-Ⅱ） on colon cancer and its immunomodulatory mechanism. Methods A subcutaneous xenograft model of colon cancer was constructed using C57BL/6 mice. The mice were randomly divided into the model group （intraperitoneal injection of PBS）， ATL-Ⅱ low-dose （20 mg/kg） group， medium-dose （40 mg/kg） group， high-dose （60 mg/kg） group， as well as the 5-fluorouracil （5-FU 30 mg/kg） group， with 5 mice in each group， and the administration lasted for 21 days. HE staining was performed to detect the histopathological changes in the tumor tissues. The levels of expressions of Ki-67， Caspase-3， and Bcl-2 were detected by immunohistochemistry. The rates of CD8⁺ T and NK1.1 positive cells in tumor tissues were detected by immunofluorescence. The serum levels of granzyme B （GzmB） and interferon-λ （IFN-λ） were measured by ELISA. The levels of expressions of PD-L1 and proteins involved in the ERK/MAPK signaling pathway were analyzed by Western blotting. Results The tumor volumes of colon cancer xenograft mice in the model group， ATL -Ⅱ low-， medium-， high-dose groups and the 5-FU group were （1 845.17±65.72） ， （1 637.20±122.65）， （1 232.86±209.16）， （1 002.29±41.84）， and （911.59±294.71） mm³， respectively， with a statistically significant difference （F=125.61， P<0.001）. Compared with the model group， there were statistically significant differences in the ATL-Ⅱ low-， medium-， high-dose groups and the 5-FU group （all P<0.05）. Compared with the low-dose group， there were statistically significant differences in the ATL-Ⅱ medium-， high-dose groups and the 5-FU group （all P<0.05）， with a statistically significant difference also observed between the medium- and high-dose groups （P<0.05）. Compared with the ATL-Ⅱ medium- and high-dose groups， the 5-FU group demonstrated statistically significant differences （both P<0.05）. The mass of tumors of the five groups was （1.34±0.11）， （1.26±0.09）， （0.93±0.07）， （0.94±0.10）， and （0.59±0.08） g， respectively， with a statistically significant difference （F=88.88， P<0.001）. Compared with the model group， there were statistically significant differences in the ATL-Ⅱ medium-， high-dose groups and the 5-FU group （all P<0.05）. Compared with the low-dose group， there were statistically significant differences in the ATL-Ⅱ medium-， high-dose groups and the 5-FU group （all P<0.05）. Compared with the ATL-Ⅱ medium- and high-dose groups， there were statistically significant differences in the 5-FU group （both P<0.05）. The spleen indexes of the five groups were 7.42±0.88， 7.38±1.32， 8.42±0.78， 9.72±1.18， and 6.16±1.05， respectively， with a statistically significant difference （F=33.20， P<0.001）. Compared with the model group， there were statistically significant differences in the ATL-Ⅱ medium- and high-dose groups and the 5-FU group （all P<0.05）. Compared with the low-dose group， there were statistically significant differences in the ATL-Ⅱ medium-， high-dose groups and the 5-FU group （all P<0.05）， and the spleen index in the high-dose group was higher than that in the medium-dose group （P<0.05）. Compared with the ATL-Ⅱ medium- and high-dose groups， there were statistically significant differences in the 5-FU group （both P<0.05）. HE staining showed that， the tumor tissues of mice in the model group exhibited typical malignant tumor characteristics， including cellular density， large deeply stained nuclei， atypia， and reduced intercellular matrix. In tumor tissues of mice treated with ATL-Ⅱ and 5-FU， significantly reduced cell proliferation activity， loosely arranged cells， reduced mitotic activity， and markedly reduced necrotic areas were observed. In the ATL-Ⅱ medium-， high-dose groups and the 5-FU group， relatively small round or oval cells with large nuclei and deeply stained chromatin were observed. There were statistically significant differences in the percentage of positive areas for Ki-67， Caspase-3， and Bcl-2 among the five groups （F=13.86， P=0.043； F=477.63， P<0.001； F=40.48， P<0.001）. Compared with the model group， there were statistically significant differences in the ATL-Ⅱ medium-， high-dose groups and the 5-FU group （all P<0.05）. Compared with the low-dose group， there were statistically significant differences in the ATL-Ⅱ high-dose groups and the 5-FU group （both P<0.05）. Compared with the medium- and high-dose ATL-Ⅱ groups， there were statistically significant differences in the proportion of Caspase-3 positive areas in the 5-FU group （both P<0.05）. There was a statistically significant difference between the medium- and high-dose groups （P<0.05）. The positive cell rates for CD8⁺ T cells in the tumor tissues of the five groups were （10.33±3.53）%， （15.00±5.65）%， （30.33±10.51）%， （59.33±9.04）%， and （33.62±9.11）%， respectively， with a statistically significant difference （F=96.33， P<0.001）. Compared with the model group， there were statistically significant differences in the ATL-Ⅱ low-， medium-， high-dose groups and the 5-FU group （all P<0.05）. The ATL-Ⅱ medium-， high-dose groups and the 5-FU group were significantly different from the low-dose group （all P<0.05）， and a statistically significant difference was found between the medium- and high-dose groups （P<0.05）. The 5-FU group was significantly different from the ATL-Ⅱ high-dose group （P<0.05）. The positive cell rates for NK1.1 cells in the tumor tissues of the five groups were （12.33±6.52）%， （13.00±7.00）%， （35.33±9.51）%， （43.67±12.21）%， and （14.50±7.05）%， respectively， with a statistically significant difference （F=283.17， P<0.001）. The ATL-Ⅱ medium-， high-dose ATL-II groups and the 5-FU group showed statistically significant differences compared to the model group （all P<0.05）. The ATL-Ⅱ high-dose group was significantly different from the low-dose group （P<0.05）. The 5-FU group was significantly different from the ATL-Ⅱ medium- and high-dose groups （both P<0.05）. The serum GzmB levels in the five groups were （5.00±1.00）， （5.27±0.76）， （8.27±0.61）， （10.00±1.21）， （6.15±0.69） ng/L， respectively， with a statistically significant difference （F=21.45， P<0.001）. The ATL-Ⅱ medium-， high-dose groups and the 5-FU group showed statistically significant differences compared to the model group （all P<0.05）. The ATL-Ⅱ medium- and high-dose groups were significantly different from the low-dose group （both P<0.05）， and a statistically significant difference was found between the medium- and high-dose groups （P<0.05）. The 5-FU group were significantly differences from the ATL-Ⅱ medium- and high-dose groups （both P<0.05）. The serum IFN-λ levels in the five groups were （617.33±65.06）， （743.33±40.41）， （910.00±36.06）， （1 009.00±35.54）， （703.62±56.00） ng/L， respectively， with a statistically significant difference （F=43.08， P<0.001）. The ATL-Ⅱ low-， medium-， and high-dose groups showed statistically significant differences compared to the model group （all P<0.05）. The ATL-Ⅱ medium- and high-dose groups were significantly differences from the low-dose group （both P<0.05）， and a statistically significant difference was found between the medium- and high-dose groups （P<0.05）. The 5-FU group was significantly different from the ATL-Ⅱ medium- and high-dose groups （both P<0.05）. There were statistically significant differences in the expression levels of PD-L1， p-ERK/ERK， and p-MEK/MEK proteins among the five groups of tumor tissues （F=125.34， P<0.001； F=89.63， P<0.001； F=35.33， P=0.002）. Statistically significant differences in PD-L1 expression levels were found among the low-， medium-， high-dose ATL-Ⅱ groups and the 5-FU group compared to the model group （all P<0.05）. The ATL-Ⅱ high-dose group and the 5-FU group showed statistically significant differences compared to the low-dose group （both P<0.05）. A statistically significant difference was found between the ATL-Ⅱ medium- and high-dose groups （P<0.05）. The ATL-Ⅱ medium-dose group was significantly different from the 5-FU group （P<0.05）. Statistically significant differences in p-ERK/ERK expression levels were observed among the ATL-Ⅱ low-， medium-， high-dose groups and the 5-FU group compared to the model group （all P<0.05）. The ATL-Ⅱ medium-， high-dose groups and the 5-FU group showed statistically significant differences compared to the low-dose group （all P<0.05）. The 5-FU group was significantly different from the ATL-Ⅱ medium- and high-dose groups （both P<0.05）. Statistically significant differences in p-MEK/MEK expression levels were found among the ATL-Ⅱ low-， medium-， high-dose groups and the 5-FU group compared to the model group （all P<0.05）. The 5-FU group was significantly different from the low-dose group （P<0.05）. Conclusions Atractylenolide Ⅱ inhibits the activity of the ERK/MAPK signaling pathway， reduces the expression of PD-L1， enhances the infiltration of CD8⁺ T cells and NK cells， and promotes tumor cell apoptosis， thereby it can exert an anti-cancer effect on colon cancer.

Objective To analyze the positioning error and the overall setup errors （OSEs） of patients undergoing gamma knife pain-free face mask fractionated treatment for head tumors based on kV orthogonal image guidance. Methods A total of 58 patients who received image-guided fractionated gamma knife treatment for head tumors with a pain-free face mask at the Gamma Knife Treatment Center of Xi'an International Medical Center Hospital from July 1， 2022 to May 31， 2024 were included in the study. A kV-class orthogonal X-ray IGPS image-guided positioning system was used to collect positioning errors in three translational directions： left-right （X）， anterior-posterior （Y）， and head-foot （Z）， as well as in three rotational directions： left-right （P）， anterior-posterior （R）， and head-foot （Y） before correction. After online correction and combined with manual positioning verification， the corrected positioning errors were recalculated. The OSEs in translational and rotational directions were calculated before and after correction. The positioning errors in all six directions （X， Y， Z， P， R， Y） before and after correction were plotted. And the OSE scatter plots in translational and rotational directions were created accordingly. Errors in the six directions and OSEs in translational and rotational directions were compared. The OSEs in translational and rotational directions were analyzed across different age groups and genders. Results The pre-correction positioning errors in the X， Y， Z， P， R， Y directions for patients were （0.45±1.54） mm， -0.96 （-1.70， -0.28） mm， 1.67 （-0.15， 3.07） mm， （0.70±1.60）°， 0.65 （0.30， 1.19）°， （0.59±0.87）°， and the post-correction positioning errors were （-0.02±0.18） mm， 0.15 （0.10， 0.21） mm， 0.06 （-0.04， 0.16） mm， （0.20±0.79）°， 0.42 （0.19， 0.78）°， （0.20±0.63）°. There were statistically significant differences between before and after correction （t=2.30， P=0.025； Z=-5.43， P<0.001； Z=-4.10， P<0.001； t=2.56， P=0.013； Z=-3.21， P=0.001； t=3.21， P=0.002）. The OSEs in translational （X， Y， Z） and rotational （P， R， Y） directions before correction were 3.07 （1.93， 4.35） mm， 1.90 （1.28， 2.66）°， and the OSEs after correction were 0.27 （0.21， 0.33） mm， 1.08 （0.70， 1.54）°， with statistically significant differences （Z=-6.60， P<0.001； Z=-5.52， P<0.001）. For patients aged 18-44 years， the OSEs in translational （X， Y， Z） and rotational （P， R， Y） directions before and after correction were 3.65 （1.62， 3.95）， 0.21 （0.21， 0.31） mm， 3.25 （2.24， 3.96）°， 0.92 （0.59， 1.45）°； for patients aged 45-59 years， the OSEs were 3.57 （2.17， 5.22）， 0.29 （0.22， 0.35） mm， 1.89 （1.30， 2.30）°， 1.08 （0.62， 1.51）°； for patients aged 60-74 years， the OSEs were 2.92 （1.74， 4.06）， 0.24 （0.19， 0.35） mm， 2.16 （1.09， 2.95）°， 0.98 （0.78， 1.75）°； for patients aged 75-89 years， the OSEs were 3.24 （2.12， 4.37）， 0.29 （0.22， 0.47） mm， 1.73 （1.01， 1.83）°， 0.60 （0.47， 1.51）°. There were no statistically significant differences in OSEs of translational and rotational directions before and after correction among the four age groups （H=1.23， P=0.747； H=1.74， P=0.627； H=7.45， P=0.059； H=2.80， P=0.424）. For male patients， the OSEs before and after correction in translational （X， Y， Z） and rotational （P， R， Y） directions were （3.19±1.59）， 0.27 （0.27， 0.33） mm， 1.89 （1.27， 2.75）°， （0.84±0.59）°； for female patients， the OSEs were （3.22±1.99）， 0.26 （0.25， 0.35） mm， 1.90 （1.34， 2.41）°， （1.04±0.46）°. There were no statistically significant differences in OSEs of translational and rotational directions before and after correction between genders （t=-0.07， P=0.949； Z=-0.48， P=0.632； Z=-0.02， P=0.161； t=-2.80， P=0.424）. Conclusions The image-guided system， which is based on the kV orthogonal X-ray stereoscopic imaging， can significantly reduce the positioning errors between fractions of pain-free face mask gamma knife treatment for head tumor patients and improve the positioning accuracy of the gamma knife through the dual verification process of "automatic correction and manual review".

Objective To evaluate the diagnostic value of multimodal Nomogram model combining ¹⁸F-FDG PET/CT and ultrasound for triple negative breast cancer （TNBC）. Methods A total of 61 breast cancer patients admitted at Nanjing Drum Tower Hospital， Affiliated Hospital of Nanjing University Medical School from November 2016 to May 2024 were selected as the study subjects， including 12 cases of TNBC and 49 cases of non-TNBC. ¹⁸F-FDG PET/CT metabolic parameters maximum standardized uptake value （SUV_max）， mean standardized uptake value （SUV_mean）， minimum standardized uptake value （SUV_min）， tumor metabolic volume （MTV）， and total lesion glycolysis （TLG）， as well as the ultrasound parameters long diameter， short diameter， echogenicity， morphology， boundaries， posterior echogenicity， aspect ratio， microcalcifications， blood flow grading and Breast Imaging Reporting and Data System （BI-RADS） grading were compared between patients with and without TNBC. Least absolute shrinkage and selection operator （LASSO） regression was used for feature screening， and binary multivariate logistic regression analysis was conducted on the screened variables to obtain the independent influencing factors for diagnosing TNBC. The independent factors influencing the diagnosis of TNBC were established as Nomogram model and visualized. Receiver operator characteristic （ROC） curve， calibration curve and decision curve analysis （DCA） were used to evaluate the diagnostic efficacy， accuracy and clinical practicability of the model， respectively. Results There were statistically significant differences in SUV_max （Z=-2.43， P=0.015）， SUV_mean （Z=-2.54， P=0.011）， morphology （P=0.004）， boundaries （χ²=4.86， P=0.028）， posterior echogenicity （P=0.027）， and blood flow grading （χ²=4.52， P=0.034） between TNBC and non-TNBC patients. LASSO regression screened out three variables： SUV_max， morphology and blood flow grading. Multivariate analysis showed that， SUV_max （OR=1.20， 95%CI： 1.04-1.38， P=0.012）， morphology （OR=0.02， 95%CI： 0.01-0.49， P=0.016）， and blood flow grading （OR=0.06， 95%CI： 0.01-0.74， P=0.028） were the independent influencing factors for diagnosing TNBC. A Nomogram model was established based on the above independent influencing factors. ROC curve showed that， area under the curve （AUC） of SUV_max， morphology， blood flow grading， and the Nomogram model were 0.73 （95%CI： 0.60-0.83）， 0.66 （95%CI： 0.52-0.77）， 0.67 （95%CI： 0.54-0.79）， 0.90 （95%CI： 0.79-0.96）， respectively， and the diagnostic value of the Nomogram model was higher than that of SUV_max （Z=2.71， P=0.007）， morphology （Z=3.61， P<0.001）， and blood flow grading （Z=2.51， P=0.012） alone. Calibration curve and DCA showed better accuracy and clinical practicability of the Nomogram model. Conclusions Nomogram model constructed by combining the SUV_max of ¹⁸F-FDG PET/CT with the morphology and blood flow grading of ultrasound has a promising potential for diagnosing TNBC.

Objective To investigate the effect of abdominal circumference on intestinal radiation dose volume and acute intestinal toxicity in pelvic intensity modulated radiation therapy for rectal cancer. Methods A total of 150 patients with locally advanced rectal cancer （LARC） who received adjuvant and neoadjuvant concurrent chemoradiotherapy at the Affiliated Cancer Hospital of Guizhou Medical University from March 2023 to January 2025 were enrolled， including 82 cases of adjuvant radiotherapy and 68 cases of neoadjuvant radiotherapy. All patients underwent radiotherapy CT simulation positioning in the standard mode of prone position with abdominal board padding and bladder filling. Intestinal toxicity was categorized as a binary variable based on the occurrence of ≥2 grade acute intestinal toxicity. Linear and logistic regression models were used to analyze the factors influencing intestinal radiation dose volumes （V₁₀， V₂₀， V₃₀， V₄₀） and acute intestinal toxicity in LARC patients. Generalized additive models and piecewise linear and logistic regression analyses were employed to examine the threshold effects of abdominal circumference on intestinal radiation dose volumes and acute intestinal toxicity. The threshold value for abdominal circumference was determined based on the upper limit of the 95%CI for the threshold. A difference test was used to validate the differences in intestinal radiation dose volume and acute intestinal toxicity between small and medium-to-large abdominal circumferences. Results Univariate analysis showed that， gender， body mass， abdominal circumference， planning target volume （PTV）， intestinal volume were all influencing factors for the radiation dose volumes （V₁₀， V₂₀， V₃₀， V₄₀） of each intestinal segment of patients with LARC undergoing adjuvant radiotherapy （all P<0.05）. Body mass， abdominal circumference， intestinal volume were all influencing factors for the radiation dose volumes （V₁₀， V₂₀， V₃₀， V₄₀） of each intestinal segment of patients with LARC undergoing neoadjuvant radiotherapy （all P<0.05）. Body mass index （BMI）， abdominal circumference， intestinal volume and individual intestinal radiation volumes （V₁₀， V₂₀， V₃₀， V₄₀） were all influencing factors for the acute intestinal toxicity of patients with LARC undergoing adjuvant radiotherapy （all P<0.05）. Body mass， BMI， abdominal circumference， multiple intestinal radiation dose volumes（V₂₀， V₃₀， V₄₀） were all influencing factors for the acute intestinal toxicity of patients with LARC undergoing neoadjuvant radiotherapy （all P<0.05）. Multivariate analysis showed that， abdominal circumference （V₁₀： β=-1.01， 95%CI： -1.68--0.33， P=0.004； V₂₀： β=-0.94， 95%CI： -1.28--0.60， P<0.001； V₃₀： β=-0.58， 95%CI： -0.82--0.34， P<0.001； V₄₀： β=-0.41， 95%CI： -0.60--0.23， P<0.001） was an independent influencing factor for the radiation dose volume of each intestinal segment of patients with LARC undergoing adjuvant radiotherapy. Abdominal circumference （V₁₀： β=-0.92， 95%CI： -1.62--0.22， P=0.010； V₂₀： β=-0.84， 95%CI： -1.11--0.57， P<0.001； V₃₀： β=-0.42， 95%CI： -0.57--0.28， P<0.001； V₄₀： β=-0.30， 95%CI： -0.41--0.19， P<0.001） was an independent influencing factor for the radiation dose volume of each intestinal segment of patients with LARC undergoing neoadjuvant radiotherapy. Abdominal circumference （OR=0.86， 95%CI： 0.78-0.95， P=0.002） was an independent influencing factor for the acute intestinal toxicity of patients with LARC undergoing adjuvant radiotherapy. Abdominal circumference （OR=0.87， 95%CI： 0.79-0.96， P=0.004） was an independent influencing factor for the acute intestinal toxicity of patients with LARC undergoing neoadjuvant radiotherapy. The generalized additive model revealed a nonlinear relationship between abdominal circumference and intestinal radiation dose volume and acute intestinal toxicity of adjuvant radiotherapy patients. Further segmented regression analysis results showed that there was a threshold effect between abdominal circumference and intestinal radiation dose volume （V₁₀， V₂₀， V₃₀， V₄₀） and acute intestinal toxicity. The inflection point values between abdominal circumference and intestinal radiation dose volume V₁₀， V₂₀， V₃₀， V₄₀ in LARC patients undergoing adjuvant radiotherapy were all 71.9 cm； the inflection point values between abdominal circumference and the intestinal radiation dose volume V₁₀， V₂₀， V₃₀， V₄₀ in LARC patients undergoing neoadjuvant radiotherapy were 69.0， 69.0， 69.0， 68.6 cm， respectively； The inflection point values between abdominal circumference and acute intestinal toxicity in LARC patients undergoing adjuvant radiotherapy and neoadjuvant radiotherapy were 71.9 ， 69.0 cm， respectively. Based on the upper limit of the 95%CI threshold， the cutoff values for small and medium-to-large abdominal circumferences for patients undergoing adjuvant and neoadjuvant radiotherapy were set at 76.1， 71.9 cm， respectively. In patients undergoing adjuvant radiotherapy， the levels of intestinal radiation dose volume V₁₀ [（7.65±2.29） cm³ vs. （5.88±2.68） cm³， t=2.76， P=0.007]， V₂₀ [（4.28±1.27） cm³ vs. （2.72±1.31） cm³， t=4.81， P<0.001]， V₃₀ [（2.42±1.07） cm³ vs. （1.37±0.76） cm³， t=4.95， P<0.001]， V₄₀ [（1.69±0.74） cm³ vs. （0.92±0.58） cm³， t=4.93， P<0.001] in the small abdominal circumference group （n=22） were significantly higher than those in patients with medium-to-large abdominal circumferences （n=60）； In patients undergoing neoadjuvant radiotherapy， patients with small abdominal circumferences （n=11） had significantly higher V₂₀ [（3.09±0.84） cm³ vs. （2.28±1.17） cm³， t=2.17， P=0.033]， V₃₀ [1.44 （1.22， 1.53） cm³ vs. 0.91 （0.56， 1.22） cm³， Z=-3.04， P=0.002]， V₄₀ [0.93 （0.84， 1.09） cm³ vs. 0.44 （0.30， 0.81） cm³， Z=-3.19， P=0.001] than patients with medium-to-large abdominal circumferences （n=57）. In patients receiving adjuvant radiotherapy and neoadjuvant radiotherapy， there were statistically significant differences in acute intestinal toxicity between patients with small abdominal circumferences and with medium-to-large abdominal circumferences （χ²=10.46， P=0.001； χ²=8.13， P=0.004）. Conclusions In the standard mode （prone position with abdominal board padding and bladder filling）， abdominal circumference is an independent factor influencing the intestinal radiation dose volume and acute intestinal toxicity in rectal cancer radiotherapy patients. There is a significant non-linear threshold effect between abdominal circumference and different levels of intestinal radiation dose volume and acute intestinal toxicity. The impact of abdominal circumference on intestinal radiation dose volume and toxicity differs significantly before and after the inflection point value. Patients with smaller abdominal circumferences not only fail to achieve the expected benefits under the current standard radiotherapy regimen but also face higher risks of intestinal radiation dose volume and toxicity.

Objective To investigate the differences in prognosis between different surgical approaches in elderly patients with advanced ovarian cancer. Methods Based on the Surveillance， Epidemiology and End Results （SEER） database， a cohort of elderly patients with advanced ovarian cancer from 2000 to 2020 was established. Through propensity score matching， 2 094 patients were selected from those who underwent two different surgical approaches to form a matched cohort （SEER database cohort）， including 1 039 patients who received cytoreductive surgery and 1 055 patients who underwent local resection. Meanwhile， 148 elderly patients with advanced ovarian cancer who were treated at the First Affiliated Hospital of Shandong First Medical University from January 2012 to January 2024 were selected （hospital cohort）， among whom 85 underwent cytoreductive surgery and 63 underwent local resection. The prognostic differences among patients who underwent cytoreductive surgery and local resection in two cohorts and stratified by the International Federation of Gynecology and Obstetrics （FIGO） staging were evaluated， respectively. The relationship between the causes of death and surgical approaches in elderly patients with advanced ovarian cancer was analyzed. Results In the SEER database cohort， the median overall survival （OS） for patients who underwent cytoreductive surgery and local resection was 37 and 40 months， respectively， with 5-year OS rates of 31.47% and 33.74%， with no statistically significant difference （χ²=0.78， P=0.378）. After stratification by FIGO staging， the median OS for patients with stage ⅢB-ⅢC who underwent cytoreductive surgery （n=998） and local resection （n=962） was 38 and 40 months， respectively， with no statistically significant difference （χ²=0.20， P=0.659）. For patients with stage Ⅳ， the median OS for those who underwent cytoreductive surgery （n=41） and local resection （n=93） was 17 and 36 months， respectively， with a statistically significant difference （χ²=9.37， P=0.002）. Among 2 094 elderly patients with advanced ovarian cancer， 1 581 had clearly identified causes of death. In patients who underwent cytoreductive surgery， the proportions of deaths due to ovarian cancer and non-ovarian cancer were 94.52% （742/785） and 5.48% （43/785）， respectively. In patients who underwent local resection， the proportions of deaths due to ovarian cancer and non-ovarian cancer were 91.46% （728/796） and 8.54% （68/796）， respectively. There was a statistically significant difference in the distribution of causes of death between the two surgical approaches （χ²=5.69， P=0.017）. In the hospital cohort， the median OS for patients undergoing cytoreductive surgery and local resection was 39 and 51 months， respectively， with 5-year OS rates of 22.85% and 23.81%， with a statistically significant difference （χ²=6.71， P=0.010）. After stratification by FIGO staging， the median OS for patients with stage ⅢB-ⅢC undergoing cytoreductive surgery （n=29） and local resection （n=26） was 50 and 51 months， respectively， with no statistically significant difference （χ²=0.15， P=0.699）； for patients with stage Ⅳ undergoing cytoreductive surgery （n=56） and local resection （n=37）， the median OS was 35 and 47 months， respectively， with a statistically significant difference （χ²=6.55， P=0.011）. Conclusions The survival outcomes of local resection in elderly patients with advanced ovarian cancer are not inferior to those of cytoreductive surgery. For FIGO stage Ⅳ patients， the survival period following local resection is superior to that of cytoreductive surgery.

SHCBP1 is a type of Src homologous collagen that can specifically bind to the SH2 structural domain. It can act as a key regulatory protein， and exhibits abnormally high expression in a variety of malignant tumors. Through affecting the processes such as cell cycle， proliferation， and invasion， it participates in tumor genesis and development. In addition， high expression of SHCBP1 is closely related to chemotherapy resistance and poor prognosis of many malignant tumors， and its targeted inhibition can enhance the sensitivity of chemotherapy and provide new therapeutic strategies for a variety of solid tumors， making it an important biomarker for prognostic assessment and a potential therapeutic target.

The treatment of non-small cell lung cancer （NSCLC） faces significant challenges due to tumor heterogeneity and the complexity of the immune microenvironment. The cyclic GMP-AMP synthase （cGAS）-stimulator of interferon gene （STING） signaling pathway plays a dual role in NSCLC， serving both as a crucial hub for anti-tumor immunity and as a potential driver of metastasis. The clinical translation of STING agonists confronts a series of challenges， including delivery barriers， double-edged sword effects， and patient heterogeneity. Consequently， exploring the combined application of STING agonists with radiotherapy/chemotherapy， immune checkpoint inhibitors， and novel immunotherapies， alongside leveraging artificial intelligence-driven multi-omics models for individualized prediction and treatment， holds significant importance. A deeper understanding of the molecular regulatory network of the cGAS-STING signaling pathway and its dynamic functions within the tumor microenvironment is essential for overcoming the current clinical challenges of targeted therapies and advancing the precision development of NSCLC immunotherapy strategies.

Neoadjuvant therapy is the preferred treatment mode for locally advanced operable esophageal cancer， and its clinical value has been established through evidence-based medical evidence. Accurately identifying patients who can benefit before or during treatment is of great significance for formulating the overall treatment strategy. Clinical indicators such as age， gender， pathological characteristics， nutritional status， and hematological/histological indicators have certain value in predicting the efficacy of neoadjuvant therapy for esophageal cancer. However， the predictive effect of a single indicator is limited. It is necessary to comprehensively use multiple indicators and combine advanced technologies and methods to provide accurate and practical tools for clinical efficacy prediction.

Deficient mismatch repair/microsatellite instability-high （dMMR/MSI-H） metastatic colorectal cancer （CRC） is highly sensitive to immune checkpoint inhibitors due to the high tumor mutation load and neoantigen enrichment. However， 45%-60% of patients exhibit primary or acquired immunotherapy resistance. The mechanisms underlying this resistance are complex， involving tumor microenvironment heterogeneity， co-expression of multiple immune checkpoints， aberrant activation of oncogenic pathways， metabolic dysregulation， intestinal microbiota imbalance， HLA-Ⅰ molecule defects， and epigenetic regulation. Current strategies aimed at reversing immunotherapy resistance include combination immunotherapies， personalized neoantigen vaccines， intestinal microbiota transplantation， epigenetic interventions， and adoptive immune cell therapies. Further analysis of the potential mechanisms of immune therapy resistance in dMMR/MSI-H metastatic CRC， and the exploration of current strategies to overcome resistance can provide a theoretical basis for reversing the immunotherapy resistance in such patients.