Objective To investigate the clinicopathological characteristics of familial clustering gastric cancer and compare the differences among probands with different types of family history, providing clues for exploring the unique genetic background of familial gastric cancer in Chinese, particularly East Asian populations. Methods Data from 282 gastric cancer patients who underwent surgery at the Sixth Affiliated Hospital of Sun Yat-sen University between January 1 and December 31, 2018, were retrospectively collected. Valid family history of malignant tumors was obtained via telephone follow-up, with 184 patients ultimately included in the analysis. Probands were divided into five cohorts based on family history： overall positive/negative family history, positive/negative family history of gastric cancer, positive/negative family history of colorectal cancer, HDGC/non-HDGC （according to 2015 IGCLC criteria）, and FIGC/non-FIGC （according to 1999 IGCLC criteria）. The epidemiological and clinicopathological characteristics of probands across cohorts were compared. Results Among the 184 probands, 58 （31.5%） had a positive family history of malignant tumors. Gastric cancer was the most commonly clustered malignancy within these families （15/58, 25.9%）. Cohort analysis revealed that probands in the overall positive family history group （P=0.026）, the positive gastric cancer family history group （P=0.011）, and families meeting the FIGC criteria （P=0.004） had a significantly higher rate of HER2 positivity on immunohistochemistry compared to their respective negative or non-FIGC groups. Additionally, the positive gastric cancer family history group had a higher number of tumor deposits （P=0.042）. Probands from HDGC families exhibited characteristics including younger age and a higher proportion of poorly differentiated and diffuse-type gastric cancers. Conclusion Significant familial clustering of gastric cancer exists in the patient population from Southern China. Probands with a family history of gastric cancer, particularly those meeting FIGC criteria, exhibit a distinct feature of HER2 protein overexpression. This suggests that the underlying genetic mechanism may differ from the CDH1 mutation-associated HDGC common in Western populations or Lynch syndrome. The HER2-related signaling pathway may play an important role in the pathogenesis of familial clustering gastric cancer in the Chinese population.

Objective To explore the relationship between ETS transcription factor 4 （ETV4） and colorectal cancer. Methods Colorectalcancer tissues and adjacent tissues from 40 cancer patients were collected. RT-qPCR and immunohistochemistry were used to detect ETV4 expression levels. Bioinformatics methods were applied： cBioPortal for ETV4 mutation analysis, String to extract its protein-protein interaction network, UALCAN to analyze the correlation between ETV4 expression and clinical data like cancer stage, lymph node metastasis, age, and gender, and Kaplan-Meier Plotter to analyze the relationship between ETV4 expression and patient prognosis. Results RT-qPCR and immunohistochemistry showed that ETV4 expression was significantly higher in cancer tissues than in adjacent tissues （P<0.01）. cBioPortal showed that ETV4 mutations in colorectal cancer mainly included missense and splice mutations. UALCAN analysis indicated that ETV4 expression was correlated with TNM stage, histological subtype, and TP53 mutation status （P<0.05）, but not with age, gender, race, or weight （P>0.05）. Kaplan-Meier analysis demonstrated that high ETV4 expression was associated with significantly improved overall survival （OS; Logrank P=0.031, HR=0.8, 95%CI： 0.66~0.98） and post-progression survival （PPS; Logrank P=0.05, HR=0.64, 95%CI： 0.47~0.88） in colorectal cancer patients. Conclusion The upregulation of ETV4 in colorectal cancer tissues correlates with a better prognosis, indicating its potential as a promising prognostic biomarker and a novel therapeutic target.

Objective To investigate the influencing factors of postoperative microvascular invasion （MVI） in hepatocellular carcinoma （HCC） patients and provide a theoretical basis for neoadjuvant therapy. Methods Clinical data of 995 HCC patients who underwent surgery at Sun Yat-sen Memorial Hospital between January 2020 and December 2023 were retrospectively analyzed. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for MVI positivity. Results A total of 995 patients were included, with an MVI positivity rate of 38.4% （382/995）. Univariate analysis revealed significant differences between MVI-positive and MVI-negative groups in tumor stage （P<0.001）, differentiation grade （P<0.001）, and proportion of preoperative adjuvant therapy （P=0.044）. Multivariate analysis demonstrated that advanced tumor stage （OR=3.171） and absence of preoperative adjuvant therapy （OR=3.312） were independent risk factors for MVI positivity, while well-differentiated tumors served as a protective factor （OR=0.275） （all P<0.05 ）. Conclusion Higher tumor stage, poorer differentiation, and absence of preoperative adjuvant therapy significantly increase the risk of postoperative MVI in HCC patients. Individualized preoperative adjuvant therapy based on tumor stage and differentiation grade may reduce MVI risk.

Objective To investigate the effects of quercitrin on ventricular remodeling after myocardial infarction in mice and its underlying mechanisms,providing a basis for the application of quercitrin in cardiovascular diseases. Methods In the in vivo experiment,a mouse model of myocardial infarction was established. Single-cell RNA sequencing technology was used to analyze the immune cell and macrophage subtypes in the myocardial tissue of mice treated with quercitrin. In the in vitro experiment, mouse bone marrow macrophages were isolated and cultured. The polarization state of macrophages was detected after treatment with quercitrin. Western Blot and qPCR were used to detect the protein and gene expression of the JAK2/STAT3 signaling pathway,and the role of the pathway was verified using the JAK inhibitor Ruxolitinib. Results In the in vivo experiment, single-cell RNA sequencing revealed that quercitrin altered the composition of immune cells in the myocardium of mice with myocardial infarction. The total proportion of macrophages increased, with an increase in M2-type macrophage subtypes（such as Macro_Chil1, Macro_Cd163）and a decrease in M1-type（such as Macro_Cd86）. In the in vitro experiment, flow cytometry showed that quercitrin increased the proportion of M2-type macrophages（P<0.05）and decreased M1-type（P<0.01）. Western Blot and qPCR results indicated that the expression of TGF-β1,TGF-β2, VEGF-A,and VEGF-B in mouse macrophages was upregulated after quercitrin treatment（all P<0.001）, and this upregulation was reversed by the JAK inhibitor Ruxolitinib. Conclusion Quercitrin promotes M2 macrophage polarization by activating the JAK2/STAT3 signaling pathway,inhibits inflammatory responses,and promotes angiogenesis,thereby improving ventricular remodeling after myocardial infarction.

Objective To compare the effects of simultaneous bi-atrialbipolar radiofrequency ablation and simultaneous unipolar radiofrequency ablation during heart valve replacement in the treatment of patients with valvular heart disease complicated with atrial fibrillation, and the impact on echocardiographic parameters. Methods Using random number table method, 90 patients with valvular heart disease complicated with atrial fibrillation who were scheduled to undergo surgical treatment in the hospital from February 2022 to January 2025 were assigned to the bipolar group and the unipolar group, with 45 cases in each group.Both groups underwent heart valve replacement, and bi-atrial bipolar radiofrequency ablation and unipolar radiofrequency ablation were performed in the same period, respectively. The situation of sinus rhythm conversion at different time points after surgery was compared between the two groups. Echocardiographic parameters [left atrial diameter （LAD）, left ventricular ejection fraction （LVEF）, left ventricular fractional shortening （LVFS）and right atrial diameter （RAD）] of the two groups before surgery and at 3 months after surgery were compared. Postoperative complications observed in the two groups were recorded. Results The ablation time in the monopolar group was shorter than that in the bipolar group （P<0.05）; the sinus rhythm conversion rate in the bipolar group was higher than that in the monopolar group at 1 and 3 months post-operation （both P<0.05）; at 3 months post-operation, there was no statistically significant difference in left ventricular fractional shortening （LVFS） between the two groups （P>0.05）; the bipolar group had lower left atrial diameter （LAD） and right atrial diameter （RAD） than the monopolar group, and higher left ventricular ejection fraction （LVEF） than the monopolar group （all P<0.05）; the postoperative complication rate in the bipolar group was lower than that in the monopolar group （P<0.05）. Conclusion Concomitant biatrial bipolar radiofrequency ablation during cardiac valve replacement surgery can significantly improve cardiac function in patients with valvular heart disease combined with atrial fibrillation, reduce postoperative complications, and increase the postoperative sinus rhythm conversion rate.

Objective Parenchymal hematoma （PH） is a severe type of hemorrhagic transformation and is associated with poor outcomes in patients with acute ischemic stroke after endovascular thrombectomy treatment. This study explores the relationship between hypoperfusion intensity ratio （HIR） from CT perfusion imaging with postoperative PH and clinical outcomes. Methods We analyzed the clinical and imaging data of patients with acute anterior circulation large vessel occlusion treated with endovascular intervention in our stroke center from December 2020 to December 2022. HIR was calculated as the ratio of severe hypoperfusion area volume （Tmax>10 seconds） to hypoperfusion area volume （Tmax>6 seconds） from head CT perfusion imaging. The type of hemorrhagic transformation after endovascular thrombectomy treatment was determined according to Heidelberg grading criteria. We analyzed the relationship between clinical, and imaging data with postoperative HT and clinical outcomes at discharge. Results Fifty-five patients with acute anterior circulation large vessel occlusion were included in the study. Twenty-one patients （38.2%） developed HT after thrombectomy treatment, including nine with PH. HIR at admission was significantly higher in the PH group than in the non-PH group （0.58 vs. 0.33, P=0.010）. HIR was significantly higher in the poor clinical outcome group （modified Rankin Scale 3~6 points） than in the good outcome group （0.47 vs. 0.25, P<0.001）. In addition, atrial fibrillation, NIHSS score at admission, blood glucose, neutrophil-to-platelet ratio, cerebral blood flow <30%, Tmax>10 seconds, and PH after endovascular thrombectomy were significantly associated with poor clinical outcomes. HIR（OR=1132.791, 95%CI： 7.979~160 828.706, P=0.005）was one ofthe independent factors for poor clinical outcomes. Conclusion HIR at admission is significantly associated with PH after endovascular thrombectomy, and it is an effective imaging marker for poor clinical outcomes after endovascular thrombectomyfor patients with acute anterior circulation large vessel occlusion.

Objective To explore the feasibility of reducing the number of signal averages （NSA） to shorten MRI scanning time in patients with brain tumors. Methods Imaging data from 46 patients who were suspected of brain tumors and underwent contrast-enhanced brain MRI scans at Sun Yat-sen Memorial Hospital of Sun Yat-sen University were retrospectively analyzed between March 2015 and October 2024. The number of lesions detected, signal-to-noise ratio （SNR）, contrast-to-noise ratio （CNR）, overall image quality, and subjective scores of lesion boundaries were compared between the contrast-enhanced axial T1-weighted sequences with NSA=1 and those with NSA=2 for each patient. Results The SNRs, CNRs, and overall image quality scores of the contrast-enhanced sequence with NSA=2 were 310.78± 248.05, 112.80± 151.63, and 4.74± 0.58, respectively. In contrast, those of the contrast-enhanced sequence with NSA=1 were 237.40± 159.74, 89.29± 110.18, and 4.5± 0.59, respectively. The SNRs, CNRs, and overall image quality scores of the sequence were all significantly higher than the latter （P< 0.001, P=0.002, and P=0.028, respectively）. There were no statistically significant differences in the number of lesions detected or lesion boundary scores （both were 4.67± 0.56） between the contrast-enhanced sequences with NSA=2 and those with NSA=1 （P=0.564 and P=1.000, respectively）. Conclusion Reducing NSA of the contrast-enhanced sequence from 2 to 1 significantly shortened scanning time while maintaining the samediagnostic performance. Thus, reducing NSA of the contrast-enhanced sequence from 2 to 1 to shorten the scanning time of brain tumor patients is feasible.

Objective To explore the factors influencing stigmatization in patients with malignant breast cancer wounds, identify its core predictive factors, and construct and validate a clinical predictive model for stigmatization. Methods A cross-sectional survey was conducted on 67 patients using the following instruments： general information questionnaire, Stigma Scale for Chronic Illnesses 8-item version （SSCI-8）, Toronto Wound Symptom Assessment System-Wounds（TSAS-W）, Self-Rating Anxiety Scale （SAS）, Self-Rating Depression Scale （SDS）, Social Support Rating Scale （SSRS）, and Quality of Life Instruments for Cancer Patients-Breast Cancer（QLICP-BR）. Data analysis was performed using univariate analysis, Pearson correlation, and multiple linear regression analysis. Results The overall score for stigmatization was 13.3±5.76 points. Correlation analysis showed that stigmatization was significantly positively correlated with anxiety （r=0.537） and depression （r=0.464）, and wound symptoms （r=0.389） （all P<0.05）, strongly negatively correlated with quality of life （r=-0.718, P<0.01）, and marginally significantly negatively correlated with social support （r=-0.229, P=0.062）. Multivariate linear regression analysis showed that： Quality of life （β=-0.666, P<0.01） was the strongest negative predictor of stigma, while anxiety （β=0.234, P=0.088） and depression （β=-0.251, P=0.095） had marginal predictive effects. The final model explained 51.5% of the variance in stigmatization （adjusted R³=0.515, F=15.003, P<0.01）. Conclusion Stigmatization in patients with breast cancer wounds has a significant statistical association with quality of life, and a marginally significant association with anxiety and depression levels. Wound management can be combined with a focus on enhancing patient quality of life and alleviating anxiety and depression, in order to reduce patients' level of stigmatization.

This paper presents a case of a 43-year-old male diagnosed with left lobe intrahepatic cholangiocarcinoma following the detection of a left hepatic mass during a routine physical examination. Imaging evaluations confirmed tumor invasion into the middle hepatic vein, inferior vena cava, and hilar lymph nodes, leading to an initial assessment of unresectable disease. Following a multidisciplinary team （MDT） discussion, the patient was initiated on neoadjuvant therapy consisting of Gemcitabine/Cisplatin/Albumin-bound paclitaxel chemotherapy combined with sintilimab immunotherapy. Following four cycles of conversion therapy, the tumor significantly shrank, and the tumor marker CA19-9 markedly decreased, creating an opportunity for curative surgery.Subsequently, the patient successfully underwent extended left hepatectomy, caudate lobectomy,and regional lymph node dissection. Postoperative pathological examination confirmed an R0 resection. The patient recovered well postoperatively and continued adjuvant therapy. Over a follow-up period exceeding 24 months, no evidence of tumor recurrence was identified, and the patient maintained a favorable quality of life. This case suggests that chemotherapy combined with immunotherapy as a neoadjuvant approach can effectively convert initially unresectable locally advanced intrahepatic cholangiocarcinoma, providing patients with an opportunity for curative surgery and survival benefits.

Rectal cancer with liver metastasis is a common clinical condition, yet misdiagnosis remains a challenge. This article reports a rare case of hepatic paraganglioma that was initially misdiagnosed as rectal cancer with liver metastasis, leading to surgical exploration. The aim of presenting this case is to enhance clinical awareness of paragangliomas, particularly in atypical locations, and to minimize the incidence of misdiagnosis and underdiagnosis.