OBJECTIVE To probe into the new method to improve medical environment,and reduce hospital infection causing by the environmental factors.METHODS Using the nanometer photocatalysis technology clinically,to analyze the bacteriostatic effect of medical environment.RESULTS After use of the nanometer photocatalysis spraying material the surface sterilization effect was obvious on the three kinds of environmental objects.The withering away rate of bacterium on the object with total surface was 23.75-38.30%;the vertical surface bacterium withers away rate was 48.77-87.97%,the horizontal surface bacterium withers away rate was 12.50-77.20%,the air bacterium withering away rate was 1.52-60.00%.CONCLUSIONS The nanometer photocatalysis technology to sterilize and purify the medical environment has very good perspectives.

Objective To explore the effect and safety of magnetic resonance imaging and transrectal ultrasound (mpMRI-TRUS) image fusion targeted transperineal biopsy technique using electromagnetic needle tracking under local anesthesia. Methods We retrospectively analyzed the clinical and pathological data of 81 patients with mpMRI-TRUS image fusion targeted transperineal prostate biopsy using electromagnetic needle tracking under local anesthesia. Visual analog scale (VAS) and visual numeric scale (VNS) were used to evaluate the pain level and satisfaction of patients during prostate biopsy (VAS-1 and VNS-1), one hour after puncture (VAS-2 and VNS-2), and one day after surgery (VAS-3 and VNS-3). The perioperative clinical data and tumor positive rate of postoperative biopsy were recorded. Results The average prostate volume of 81 patients was 53.39±29.46 cm³. The PSA values of patients with PI-RADS scores of 2, 3, 4, and 5 were 9.14±2.31, 9.95±4.10, 14.77±6.36, and 32.17±24.39 ng/ml, respectively. The scores of VAS-1, VAS-2, and VAS-3 were 1.70±0.73, 1.16±0.58, and 0.53±0.55, respectively; the scores of VNS-1, VNS-2, and VNS-3 were 2.74±0.44, 3.69±0.46, and 3.84±0.37, respectively. The average surgical time was 17.47±3.44 minutes. Postoperative pathological results showed that the tumor positive rate of targeted prostate biopsy was 64.20%. According to the PI-RADS score for subgroup analysis, the tumor positive rates of patients with PI-RADS scores of 2, 3, 4, and 5 were 21.43%, 44.44%, 61.11%, and 96.77%, respectively. After transperineal prostate biopsy, gross hematuria occurred in 19.75% patients, and urinary retention occurred in 3.70%. The latter were relieved after symptomatic treatment. All patients did not experience complications, such as perineal puncture area hematoma, urinary tract infection, hematospermia, hematoma in perineal puncture area, urinary tract infection, hematospermia, vagus nerve reaction, or septic shock. Conclusion For suspected prostate cancer patients, mpMRI-TRUS image fusion targeted transperineal biopsy technique using electromagnetic needle tracking under local anesthesia is a feasible and easily tolerated surgical procedure. It has good safety and high tumor positive-detection rate, indicating that this technique is worthy of further clinical promotion and application.

Objective:To analyze the risk factors for postoperative one-year mortality in elderly patients with femoral intertrochanteric fracture following multidisciplinary treatment (MDT) by intramedullary nailing.Methods:The clinical data were retrospectively analyzed of the 158 elderly patients with femoral intertrochanteric fracture who had undergone MDT by proximal femoral intramedullary nailing between January 2018 and August 2020 at Department of Orthopedics, Trauma Center, Zhongda Hospital Affiliated to Southeast University. There were 41 males and 117 females with an average age of 82.5 years (from 65 to 95 years). By the modified Evans classification, there were 15 cases of type Ⅰ, 16 cases of type Ⅱ, 35 cases of type Ⅲ, 81 cases of type Ⅳ, and 11 cases of type Ⅴ. The one-year mortality was documented in the patients after surgery. To screen for risk factors, univariate analysis was conducted of gender, age, body mass index (BMI), modified Evans classification of fractures, time from injury to operation, American Society of Anesthesiologists (ASA) classification, Charlson comorbidity index (CCI) and comorbidities, as well as preoperative hemoglobin (Hb), serum albumin (ALB) and total lymphocyte count (TLC). The factors with P<0.05 were included in the multivariate logistic regression model analysis to determine the risk factors. Results:A total of 13 patients died within one year after surgery, yielding a mortality of 8.2% (13/158). Univariate analysis showed significant differences in age, body mass index, modified Evans classification of fractures, CCI and Hb between the surviving and dead patients ( P<0.05). Multivariate logistic regression analysis showed that age >85 years ( OR=0.122, 95% CI: 0.018 to 0.834, P=0.032), BMI>23.9 kg/m 2 ( OR=0.083, 95% CI: 0.013 to 0.510, P=0.007), CCI≥3 points ( OR=0.051, 95% CI: 0.090 to 0.275, P=0.001) and preoperative Hb<90 g/L ( OR=4.733, 95% CI: 1.036 to 21.624, P=0.045) were the independent risk factors for postoperative one-year mortality in the elderly patients with intertrochanteric fracture following MDT by proximal femoral intramedullary nailing. Conclusions:After MDT by proximal femoral intramedullary nailing of femoral intertrochanteric fractures, the geriatric patients with an age >85 years, BMI>23.9 kg/m 2, CCI≥3 points and Hb<90 g/L are likely to die. Therefore, special care should be taken for them.

【Objective】 To explore the efficacy and safety of multi-parametric magnetic resonance imaging and transrectal ultrasonography (mpMRI-TRUS) fusion targeted transperineal biopsy (TPB) under local anesthesia (LA) with "one-plane three-point" dual probe ultrasound localization. 【Methods】 Clinical data of 134 suspected prostate cancer (PCa) patients treated with this method in our hospital during Jan.and Sep.2023 were retrospectively analyzed.The same doctor applied visual analog scale (VAS) and visual digital scale (VNS) to evaluate the pain level and satisfaction of patients during TPB (VAS-1 and VNS-1) and 1 hour after TPB (VAS-2 and VNS-2), and recorded the perioperative clinical data and detection rate of clinically significant prostate cancer (csPCa). 【Results】 VAS-1 score was (1.60±0.68) and VAS-2 score was (1.13±0.55); VNS-1 score was (2.84±0.41), and VNS-2 score was (3.74±0.44).The operation time was (16.12±3.35) minutes.The postoperative pathological results showed that the detection rate of csPCa was 65.67% (88/134).According to the PI-RADS score in subgroup analysis, the detection rates of patients with PI-RADS scores of 2, 3, 4, and 5 were 23.08% (6/26), 52.94% (18/34), 62.50% (15/24) and 98.00% (49/50), respectively.After TPB, gross hematuria occurred in 20.90% (28/134) patients, and urinary retention occurred in 4.00% (5/125) patients, which were relieved after symptomatic treatment.No complications such as perineal puncture area hematoma, urinary tract infection, hematospermia, vagal nerve reaction, and septic shock occurred. 【Conclusion】 The mpMRI-TRUS fusion targeted TPB under LA with "one-plane three-point" dual probe ultrasound localization provides a feasible and tolerable surgical procedure for suspected PCa patients with a high detection rate of csPCa, which is worthy of further clinical promotion and application.

Objective To explore the application value of mpMRI-TRUS multi-modal image fusion transperineal biopsy technique using electromagnetic needle tracking under local anesthesia combined with rapid paraffin-embedded section of small specimen in the diagnosis of prostate cancer. Methods The clinicopathological data of 138 patients with PI-RADS score≥3 who underwent mpMRI-TRUS image fusion transperineal biopsy using electromagnetic needle tracking under local anesthesia were retrospectively analyzed. AI technology was used to fuse mpMRI and TRUS multi-mode images, and two-core targeted biopsies were performed on suspicious lesions, followed by 12-core systematic biopsies. The specimens obtained from targeted biopsies were sent for rapid paraffin-embedded section pathological examination, and the detection rates of csPCa were compared. Results The detection rate of csPCa in 138 patients was 71.01%. The detection rates of csPCa in targeted biopsies and systematic biopsies were 62.32% and 70.29%, respectively (P=0.20). The detection rate of combined biopsies was higher than those of targeted biopsies and systematic biopsies, but the difference was not statistically significant (P>0.05). The detection rates of csPCa in targeted biopsies, systematic biopsies, and combined biopsies in patients with PI-RADS score 3 were 30.95%, 38.10%, and 40.48%, respectively; and the percentages were 52.94%, 61.76%, and 61.76% in patients with PI-RADS score 4, respectively; and the percentages were 90.32%, 96.77%, and 96.77% in patients with PI-RADS score 5, respectively, without statistically significant difference (all P>0.05). In the subgroups with PI-RADS scores of 3, 4, and 5, the missed diagnosis rates of csPCa by targeted biopsies were 23.53%, 14.29%, and 6.67%, respectively. Conclusion For patients with suspected prostate cancer and PI-RADS v2.1 score≥3, transperineal biopsy using electromagnetic needle tracking combined with rapid paraffin-embedded section of small specimen can obtain pathological results rapidly and has good diagnostic accuracy. However, combined biopsy is still the most suitable method for the diagnosis of prostate cancer at present.

【Objective】 To explore the feasibility and accuracy of neutrophil-to-lymphocyte ratio (NLR) in the prediction of testicular torsion (TT) in children with acute scrotal pain. 【Methods】 A retrospective case-control study was performed on 158 pediatric patients with ultrasound suspicion of TT who underwent surgical testicular examination during Jan.2017 and Jan.2024.The patients were divided into TT group and non-TT group.Clinical data and laboratory data at admission were analyzed.Sensitivity and specificity of NLR to TT were determined with the area under the curve (AUC) represented on the receiver operating characteristic (ROC) curves. 【Results】 There were with no statistically significant differences in clinical data between the two groups (P>0.05).The NLR was significantly higher in the TT group than in the non-TT group [ (4.82±2.37) vs.(2.85±0.75), P<0.05] .The optimal cut-off value of TT predicted by NLR was 2.07, the AUC was 0.809 (95%CI:0.709-0.909), and the sensitivity and specificity were 97.9% and 93.3%, respectively, which were significantly higher than other factors. 【Conclusion】 For suspicious ultrasound diagnosis of pediatric acute scrotal pain cases, NLR can be used to predict the possibility of TT and may help to evaluate the urgent surgical treatment in these patients.

BACKGROUND: LY01005 (Goserelin acetate sustained-release microsphere injection) is a modified gonadotropin-releasing hormone (GnRH) agonist injected monthly. This phase III trial study aimed to evaluated the efficacy and safety of LY01005 in Chinese patients with prostate cancer. METHODS: We conducted a randomized controlled, open-label, non-inferiority trial across 49 sites in China. This study included 290 patients with prostate cancer who received either LY01005 or goserelin implants every 28 days for three injections. The primary efficacy endpoints were the percentage of patients with testosterone suppression ≤50 ng/dL at day 29 and the cumulative probability of testosterone ≤50 ng/dL from day 29 to 85. Non-inferiority was prespecified at a margin of -10%. Secondary endpoints included significant castration (≤20 ng/dL), testosterone surge within 72 h following repeated dosing, and changes in luteinizing hormone, follicle-stimulating hormone, and prostate specific antigen levels. RESULTS: On day 29, in the LY01005 and goserelin implant groups, testosterone concentrations fell below medical-castration levels in 99.3% (142/143) and 100% (140/140) of patients, respectively, with a difference of -0.7% (95% confidence interval [CI], -3.9% to 2.0%) between the two groups. The cumulative probabilities of maintaining castration from days 29 to 85 were 99.3% and 97.8%, respectively, with a between-group difference of 1.5% (95% CI, -1.3% to 4.4%). Both results met the criterion for non-inferiority. Secondary endpoints were similar between groups. Both treatments were well-tolerated. LY01005 was associated with fewer injection-site reactions than the goserelin implant (0% vs . 1.4% [2/145]). CONCLUSION: LY01005 is as effective as goserelin implants in reducing testosterone to castration levels, with a similar safety profile. TRIAL REGISTRATION ClinicalTrials.gov, NCT04563936.
Humans ; Male ; Antineoplastic Agents, Hormonal/therapeutic use* ; East Asian People ; Gonadotropin-Releasing Hormone/agonists* ; Goserelin/therapeutic use* ; Prostate-Specific Antigen ; Prostatic Neoplasms/drug therapy* ; Testosterone