Objective To develop a preoperative question prompt list(QPL)for older patients with benign prostatic hyperplasia(BPH)and evaluate its effectiveness in application.Methods This trial adopted a randomized controlled design.The QPL was developed by literature review,expert discussions,and Delphi consultation.Convenience sampling was used to subject 76 older BPH inpatients treated in our department,and then they were randomly divided into control(routine communication,n=38)and intervention(QPL-assisted communication,n=38)groups.Number of the questions patient asking,communication duration,information recall,and communication quality were compared between the 2 groups.Results In the 2 rounds of expert consultation,the response rate of questionnaire was 94.44%and 100%,the authority coefficient was 0.89 and 0.93,the coefficient of variation was 0.05～0.22 and 0～0.11,and Kendall's coefficients was 0.645(Chi-square=87.782,P<0.001)and 0.733(Chi-square=74.789,P<0.001),respectively.The final QPL included 3 themes and 7 questions.The intervention group asked more questions(4.03±1.89 vs 2.11±1.27,P<0.05)but spent similar time for communication(8.18±2.11 vs 7.67±1.72 min,P>0.05).At 1 d before discharge,better information recall(8.74±1.12 vs 6.49±1.68,P<0.001)and communication quality(60.06±6.25 vs 54.86±7.98,P<0.05)were observed in the intervention group when compared with the control group.Conclusion Our developed preoperative communication QPL is of scientificalness and effectiveness for elderly BPH patients.This tool can not only encourage question-asking behavior,but also improve information recall and communication quality in the patients.

Early-onset colorectal cancer (EOCRC) shows a different epidemiological trend compared to later-onset colorectal cancer, with its incidence rising in most regions and countries worldwide. However, the reasons behind this trend remain unclear. The etiology of EOCRC is complex and could involve both genetic and environmental factors. Apart from Lynch syndrome and Familial Adenomatous Polyposis, sporadic EOCRC exhibits a broad spectrum of pathogenic germline mutations, genetic polymorphisms, methylation changes, and chromosomal instability. Early-life exposures and environmental risk factors, including lifestyle and dietary risk factors, have been found to be associated with EOCRC risk. Meanwhile, specific chronic diseases, such as inflammatory bowel disease, diabetes, and metabolic syndrome, have been associated with EOCRC. Interactions between genetic and environmental risk factors in EOCRC have also been explored. Here we present findings from a narrative review of epidemiological studies on the assessment of early-life exposures, of EOCRC-specific environmental factors, and their interactions with susceptible loci. We also present results from EOCRC-specific genome-wide association studies that could be used to perform Mendelian randomization analyses to ascertain potential causal links between environmental factors and EOCRC.
Humans ; Colorectal Neoplasms/etiology* ; Risk Factors ; Genome-Wide Association Study ; Genetic Predisposition to Disease/genetics*

BACKGROUND:Studies have shown that there is a close relationship between dendritic spine plasticity and Alzheimer's disease,and that resistance or aerobic exercise has some efficacy in improving cognitive dysfunction,but the mechanism of action is unclear.OBJECTIVE:To investigate the effect of aerobic exercise or resistance exercise on dendritic spine plasticity in the hippocampal CA1 region of APP/PS1 transgenic mice.METHODS:Thirty 3-month-old male APP/PS1 mice were selected and randomly divided into three groups:a model group,a resistance exercise group,and an aerobic exercise group.The same litter of 3-month-old C57BL/6J mice were selected as a blank group.Mice in the resistance exercise group were subjected to ladder-climbing exercise and those in the aerobic exercise group were subjected to treadmill exercise for 12 weeks.At the end of the exercise intervention,the water maze experiment and the new arm of the Y maze were used to assess behavioral changes in mice.Hematoxylin-eosin staining,Nissl staining,Golgi staining,and electron microscopy were performed to observe neuronal morphology,Nissl bodies,dendritic spines,and ultrastructural changes in the synapses of the hippocampal region of the mouse brain.The protein expression levels of hippocampal amyloid-beta1-42,Ras,and Drebrin were measured using Western blot analysis.RESULTS AND CONCLUSION:Mice in the model group exhibited a prolonged escape latency over 5 consecutive days(P＜0.05,P＜0.01)and significantly fewer entries into the new arm of the Y maze(P＜0.01).Dendritic spine density in the CA1 region of the hippocampus,as well as Ras and Drebrin expression in the hippocampal tissues of mice in the model group,were lower than those in the normal group(P＜0.01),and amyloid-beta1-42 expression in the hippocampal tissues was higher in the model group compared with the normal group(P＜0.01).Mice in the resistance exercise group and the aerobic exercise group displayed a shortened escape latency over the same 5-day period(P＜0.05,P＜0.01)and showed a significantly greater number of entries into the new arm of the Y maze compared with the normal group(P＜0.01).Dendritic spine density in the CA1 region of the hippocampus,as well as Ras and Drebrin expression in the hippocampal tissues,were higher in both the resistance exercise group and the aerobic exercise group compared with the model group(P＜0.01).Amyloid-beta1-42 expression in the hippocampal tissue was lower in both exercise groups than in the model group(P＜0.01).To conclude,long-term regular aerobic or resistance exercise interventions can increase dendritic spine density and synaptic plasticity in the CA1 region of the hippocampus,enhancing spatial learning and memory abilities in a mouse model of Alzheimer's disease.These effects may be associated with increased expression of Ras and Drebrin proteins in the hippocampus.

Objective:To explore the clinical efficacy of pelvic floor biofeedback combined with electroacupuncture therapy in the treatment of chronic pelvic floor pain syndrome (CPPS).Methods:Ninety CPPS patients admitted to the Dongguan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine from August 2022 to July 2023 were selected prospectively, and they were divided into two groups by random number table method, each group with 45 cases. The control group received pelvic floor biofeedback treatment alone, while the observation group received pelvic floor biofeedback combined with electroacupuncture treatment. The two groups were treated once a day, 10 times as a course of treatment. After two courses of treatment, the clinical efficacy, pain degree before and after treatment, inflammatory factor levels, SF-36 health questionnaire (SF-36) scores, pelvic floor surface myoelectric parameters, and incidence of adverse reactions were compared between the two groups.Results:The total effective rate in the observation group after treatment was higher than that in the control group: 95.56% (43/45) vs. 75.56% (34/45), there was statistical difference ( χ2 = 7.28, P<0.05). After treatment, the visual analogue scale (VAS) scores, levels of procalcitonin (PCT), interleukin-6 (IL-6) and C-reactive protein (CRP) in the two groups were decreased, and SF-36 scores were increased, there were statistical differences ( P<0.05); the VAS scores, PCT, IL-6 and CRP levels in the observation group were lower than those in the control group, and SF-36 scores was higher than that in the control group: (2.11 ± 0.24) scores vs. (2.87 ± 0.34) scores, (0.92 ± 0.08) ng/L vs. (1.26 ± 0.09) ng/L, (24.08 ± 2.52) μg/L vs. (28.49 ± 3.10) μg/L, (4.55 ± 0.51) mg/L vs. (6.06 ± 0.63) mg/L, (74.55 ± 7.29) scores vs. (70.18 ± 7.80) scores, there were statistical differences ( P<0.05). After treatment, the surface muscle potential of pelvic floor muscle were increased in the front resting stage, rapid contraction stage, tension contraction stage, endurance contraction stage and post-resting stage, and the above parameters in the observation group were higher than those in the control group: (3.56 ± 0.34)μV vs.(3.20 ± 0.37) μV, (35.26 ± 3.05) μV vs. (31.47 ± 3.08) μV, (34.22 ± 3.25) μV vs. (31.15 ± 3.01)μV, (29.77 ± 3.17) μV vs. (27.04 ± 2.68) μV, (3.21 ± 0.27) μV vs. (3.00 ± 0.34) μV, there were statistical differences ( P<0.05). The incidence rate of adverse reactions in the two groups had no statistical difference ( P>0.05). Conclusions:Pelvic floor biofeedback combined with electroacupuncture in the treatment of CPPS has good clinical effect, and can relief pain response, regulate the inflammatory response and pelvic floor function, and have high safety.

AIM:This study aimed to investigate the mechanisms by which treadmill exercise ameliorates de-pressive-like behaviors and hippocampal neuronal damage in chronic restraint stress(CRS)mice by regulating mitophagy via the Sirt1/PGC-1α signaling axis.METHODS:Forty C57BL/6J mice were randomly assigned to control,CRS,CRS+exercise(EXE)and EXE groups(n=10).The mice in CRS and CRS+EXE groups underwent 4 h of daily restraint for 28 consecutive days to establish a depression model.The mice in CRS+EXE and EXE groups received 8 weeks of treadmill training(6 sessions per week).Depressive-like behaviors were evaluated using the open field test,sucrose preference test,and tail suspension test.Hippocampal neuronal morphology and pathological changes were examined using hematoxy-lin-eosin and Nissl staining,while neuronal apoptosis was assessed through TUNEL staining.Mitochondrial ultrastructure was examined via transmission electron microscopy.Mitochondrial membrane potential and ATP content were measured using JC-1 assay and ATP assay kits,respectively.The expression levels of silent information regulator 1(Sirt1),peroxi-some proliferator-activated receptor γ coactivator-1α(PGC-1α),PTEN-induced kinase 1(PINK1)and parkin were as-sessed at both mRNA and protein levels by RT-qPCR and Western blot assays,as well as key markers of mitophagy[mi-crotubule-associated protein 1 light chain 3(LC3)and P62]and apoptosis(cleaved caspase-9 and cleaved caspase-3).RESULTS:Compared with control group,CRS mice exhibited significantly reduced central zone entries and time(P<0.01),decreased sucrose preference(P<0.01),increased immobility time(P<0.01),severe hippocampal neuronal damage,elevated apoptosis rate(P<0.01),mitochondrial deterioration;reduced membrane potential and ATP content(P<0.01),decreased mRNA expressions of Sirt1,PGC-1α,PINK1,and parkin(P<0.01),reduced protein levels of Sirt1,PGC-1α,PINK1,parkin and LC3(P<0.01),and increased expression of P62,cleaved caspase-9,and cleaved caspase-3(P<0.01).The mice in CRS+EXE group showed significant improvements in all these parameters compared to CRS group(P<0.05 or P<0.01).CONCLUSION:Treadmill exercise mitigates CRS-induced depressive-like behaviors,mi-tochondrial dysfunction,and neuronal apoptosis in mice by activating the hippocampal Sirt1/PGC-1α/mitophagy axis.

AIM:This study aimed to investigate the mechanisms by which treadmill exercise ameliorates de-pressive-like behaviors and hippocampal neuronal damage in chronic restraint stress(CRS)mice by regulating mitophagy via the Sirt1/PGC-1α signaling axis.METHODS:Forty C57BL/6J mice were randomly assigned to control,CRS,CRS+exercise(EXE)and EXE groups(n=10).The mice in CRS and CRS+EXE groups underwent 4 h of daily restraint for 28 consecutive days to establish a depression model.The mice in CRS+EXE and EXE groups received 8 weeks of treadmill training(6 sessions per week).Depressive-like behaviors were evaluated using the open field test,sucrose preference test,and tail suspension test.Hippocampal neuronal morphology and pathological changes were examined using hematoxy-lin-eosin and Nissl staining,while neuronal apoptosis was assessed through TUNEL staining.Mitochondrial ultrastructure was examined via transmission electron microscopy.Mitochondrial membrane potential and ATP content were measured using JC-1 assay and ATP assay kits,respectively.The expression levels of silent information regulator 1(Sirt1),peroxi-some proliferator-activated receptor γ coactivator-1α(PGC-1α),PTEN-induced kinase 1(PINK1)and parkin were as-sessed at both mRNA and protein levels by RT-qPCR and Western blot assays,as well as key markers of mitophagy[mi-crotubule-associated protein 1 light chain 3(LC3)and P62]and apoptosis(cleaved caspase-9 and cleaved caspase-3).RESULTS:Compared with control group,CRS mice exhibited significantly reduced central zone entries and time(P<0.01),decreased sucrose preference(P<0.01),increased immobility time(P<0.01),severe hippocampal neuronal damage,elevated apoptosis rate(P<0.01),mitochondrial deterioration;reduced membrane potential and ATP content(P<0.01),decreased mRNA expressions of Sirt1,PGC-1α,PINK1,and parkin(P<0.01),reduced protein levels of Sirt1,PGC-1α,PINK1,parkin and LC3(P<0.01),and increased expression of P62,cleaved caspase-9,and cleaved caspase-3(P<0.01).The mice in CRS+EXE group showed significant improvements in all these parameters compared to CRS group(P<0.05 or P<0.01).CONCLUSION:Treadmill exercise mitigates CRS-induced depressive-like behaviors,mi-tochondrial dysfunction,and neuronal apoptosis in mice by activating the hippocampal Sirt1/PGC-1α/mitophagy axis.

Objective:To explore the clinical efficacy of pelvic floor biofeedback combined with electroacupuncture therapy in the treatment of chronic pelvic floor pain syndrome (CPPS).Methods:Ninety CPPS patients admitted to the Dongguan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine from August 2022 to July 2023 were selected prospectively, and they were divided into two groups by random number table method, each group with 45 cases. The control group received pelvic floor biofeedback treatment alone, while the observation group received pelvic floor biofeedback combined with electroacupuncture treatment. The two groups were treated once a day, 10 times as a course of treatment. After two courses of treatment, the clinical efficacy, pain degree before and after treatment, inflammatory factor levels, SF-36 health questionnaire (SF-36) scores, pelvic floor surface myoelectric parameters, and incidence of adverse reactions were compared between the two groups.Results:The total effective rate in the observation group after treatment was higher than that in the control group: 95.56% (43/45) vs. 75.56% (34/45), there was statistical difference ( χ2 = 7.28, P<0.05). After treatment, the visual analogue scale (VAS) scores, levels of procalcitonin (PCT), interleukin-6 (IL-6) and C-reactive protein (CRP) in the two groups were decreased, and SF-36 scores were increased, there were statistical differences ( P<0.05); the VAS scores, PCT, IL-6 and CRP levels in the observation group were lower than those in the control group, and SF-36 scores was higher than that in the control group: (2.11 ± 0.24) scores vs. (2.87 ± 0.34) scores, (0.92 ± 0.08) ng/L vs. (1.26 ± 0.09) ng/L, (24.08 ± 2.52) μg/L vs. (28.49 ± 3.10) μg/L, (4.55 ± 0.51) mg/L vs. (6.06 ± 0.63) mg/L, (74.55 ± 7.29) scores vs. (70.18 ± 7.80) scores, there were statistical differences ( P<0.05). After treatment, the surface muscle potential of pelvic floor muscle were increased in the front resting stage, rapid contraction stage, tension contraction stage, endurance contraction stage and post-resting stage, and the above parameters in the observation group were higher than those in the control group: (3.56 ± 0.34)μV vs.(3.20 ± 0.37) μV, (35.26 ± 3.05) μV vs. (31.47 ± 3.08) μV, (34.22 ± 3.25) μV vs. (31.15 ± 3.01)μV, (29.77 ± 3.17) μV vs. (27.04 ± 2.68) μV, (3.21 ± 0.27) μV vs. (3.00 ± 0.34) μV, there were statistical differences ( P<0.05). The incidence rate of adverse reactions in the two groups had no statistical difference ( P>0.05). Conclusions:Pelvic floor biofeedback combined with electroacupuncture in the treatment of CPPS has good clinical effect, and can relief pain response, regulate the inflammatory response and pelvic floor function, and have high safety.

BACKGROUND:Studies have shown that there is a close relationship between dendritic spine plasticity and Alzheimer's disease,and that resistance or aerobic exercise has some efficacy in improving cognitive dysfunction,but the mechanism of action is unclear.OBJECTIVE:To investigate the effect of aerobic exercise or resistance exercise on dendritic spine plasticity in the hippocampal CA1 region of APP/PS1 transgenic mice.METHODS:Thirty 3-month-old male APP/PS1 mice were selected and randomly divided into three groups:a model group,a resistance exercise group,and an aerobic exercise group.The same litter of 3-month-old C57BL/6J mice were selected as a blank group.Mice in the resistance exercise group were subjected to ladder-climbing exercise and those in the aerobic exercise group were subjected to treadmill exercise for 12 weeks.At the end of the exercise intervention,the water maze experiment and the new arm of the Y maze were used to assess behavioral changes in mice.Hematoxylin-eosin staining,Nissl staining,Golgi staining,and electron microscopy were performed to observe neuronal morphology,Nissl bodies,dendritic spines,and ultrastructural changes in the synapses of the hippocampal region of the mouse brain.The protein expression levels of hippocampal amyloid-beta1-42,Ras,and Drebrin were measured using Western blot analysis.RESULTS AND CONCLUSION:Mice in the model group exhibited a prolonged escape latency over 5 consecutive days(P＜0.05,P＜0.01)and significantly fewer entries into the new arm of the Y maze(P＜0.01).Dendritic spine density in the CA1 region of the hippocampus,as well as Ras and Drebrin expression in the hippocampal tissues of mice in the model group,were lower than those in the normal group(P＜0.01),and amyloid-beta1-42 expression in the hippocampal tissues was higher in the model group compared with the normal group(P＜0.01).Mice in the resistance exercise group and the aerobic exercise group displayed a shortened escape latency over the same 5-day period(P＜0.05,P＜0.01)and showed a significantly greater number of entries into the new arm of the Y maze compared with the normal group(P＜0.01).Dendritic spine density in the CA1 region of the hippocampus,as well as Ras and Drebrin expression in the hippocampal tissues,were higher in both the resistance exercise group and the aerobic exercise group compared with the model group(P＜0.01).Amyloid-beta1-42 expression in the hippocampal tissue was lower in both exercise groups than in the model group(P＜0.01).To conclude,long-term regular aerobic or resistance exercise interventions can increase dendritic spine density and synaptic plasticity in the CA1 region of the hippocampus,enhancing spatial learning and memory abilities in a mouse model of Alzheimer's disease.These effects may be associated with increased expression of Ras and Drebrin proteins in the hippocampus.

Objectives:Analyze the clinical characteristics of patients with primary antiphospholipid syndrome (PAPS) progressing to systemic lupus erythematosus (SLE).Explore the risk factors for the progression from PAPS to SLE.Methods:The clinical data of 262 patients with PAPS enrolled in Peking Union Medical College Hospital from February 2005 to September 2021 were evaluated. Assessments included demographic data, clinical manifestations, laboratory tests (serum levels of complement, anti-nuclear antibodies, anti-double-stranded DNA antibodies), treatment, and outcomes. Kaplan-Meier analysis was used to calculate the prevalence of SLE in patients with PAPS. Univariate Cox regression analysis was employed to identify the risk factors for PAPS progressing to SLE.Results:Among 262 patients with PAPS, 249 had PAPS (PAPS group) and 13 progressed to SLE (5.0%) (PAPS-SLE group). Univariate Cox regression analysis indicated that cardiac valve disease ( HR=6.360), positive anti-double-stranded DNA antibodies ( HR=7.203), low level of complement C3 ( HR=25.715), and low level of complement C4 ( HR=10.466) were risk factors for the progression of PAPS to SLE, whereas arterial thrombotic events ( HR=0.109) were protective factors ( P<0.05 for all). Kaplan-Meier analysis showed that the prevalence of SLE in patients suffering from PAPS with a disease course>10 years was 9%-15%. Hydroxychloroquine treatment had no effect on the occurrence of SLE in patients with PAPS ( HR=0.753, 95% CI 0.231-2.450, P=0.638). Patients with≥2 risk factors had a significantly higher prevalence of SLE compared with those with no or one risk factor (13-year cumulative prevalence of SLE 48.7% vs. 0 vs. 6.2%, P<0.001 for both). Conclusions:PAPS may progress to SLE in some patients. Early onset, cardiac-valve disease, positive anti-dsDNA antibody, and low levels of complement are risk factors for the progression of PAPS to SLE (especially in patients with≥2 risk factors). Whether application of hydroxychloroquine can delay this transition has yet to be demonstrated.

Objective To compare the clinical efficacy of abdominal ultrasound-guided endoscopic retrograde appendicitis therapy(ERAT)with laparoscopic appendectomy(LA)for acute uncomplicated appendicitis using propensity score matching.Methods The clinical data of 441 patients with acute uncomplicated appendicitis admitted to the Third People's Hospital of Yunnan Province from March 2020 to April 2023 were collected.The cases were classified based on the differences in surgical method and divided into the ERAT group(n = 30)and LA group(n = 411).The clinical efficacy of patients was compared between the two groups after reducing confounding bias by propensity score matching(PSM).Results After PSM,a total of 30 pairs of patients in the two groups were successfully matched,and the baseline data of the two groups met the requirements for comparability.At 24 hours after the operation,the ERAT group exhibited lower white blood cells,neutrophil counts,and C-reactive protein levels compared to the LA group,and these differences were statistically significant(P<0.05).There was no significant difference in the operation time and total effective rate between the ERAT group and the LA group(P>0.05).However,the ERAT group had lower intraoperative blood loss and shorter pain relief time compared to the LA group,and these differences were statistically significant(P<0.05).Conclusion Abdominal ultrasound-guided endoscopic retrograde appendicitis treatment is an effective,safe,and feasible technique with good prospects for the treatment of acute uncomplicated appendicitis.