Objective To investigate the application of fusion imaging in the initial prostate biopsy.Methods Retrospective analysis was made on 40 patients who underwent initial ultrasound-guided prostate biopsy in Shanghai Jiao Tong University Affiliated 6th People's Hospital from August 2014 to May 2015.All patients underwent preoperative magnetic resonance imaging (MRI) scans one week prior to surgery and the results showed that all patients had suspicious positive prostate cancer lesions,while there were no positive findings in the same area in sonography.All patients with prostate cancer have been confirmed by pathologic examination.Image fusion technology was used to guide the biopsy of lesions which were suspected as prostate cancer by MRI,and then the prostate underwent systematic biopsy by 10 needles under the guide of ultrasound.R× C Chi-square test was used to compare the positive ratio among imaging fusion biopsy,systematic biopsy and combined method in the diagnosis of prostate cancer.Fourfold table Chi-square test was used to compare to undetected rate between fusion imaging biopsy and systematic biopsy in the diagnosis of prostate cancer.The differences of detection rate in the Gleason score more than 7 points of prostate cancer between fusion imaging biopsy and systematic biopsy was compared by Fisher exact test.Results In this group of 40 patients with prostate biopsy,14 cases (35.0％) were diagnosed prostate cancer by systematic biopsy,19 cases (47.5％) were diagnosed prostate cancer by image fusion biopsy,and 22 cases (55.0％) were diagnosed prostate cancer by systematic biopsy combined with image fusion.The difference of diagnostic positive rate among combined method of biopsy,image fusion biopsy and systematic biopsy had not statistically significant (P ＞ 0.05).Three cases (13.6％,3/22) of prostate cancer patients were missed in image fusion method group,and 8 cases (36.4％,8/22) of prostate cancer patients have not been diagnosed by systematic biopsy,which indicated the umdetected rate of systematic biopsy is higher than that of image fusion biopsy in prostate cancer diagnosis,and there was a statistical difference between the two groups (x2=8.338,P=0.005).Among 19 cases of prostate cancer patients who were diagnosed by image fusion biopsy method,Gleason score were greater than 7 points in 15 cases (78.9％,15/22).Among 14 cases of prostate cancer patients who were diagnosed by systematic biopsy method,Gleason score were greater than 7 points in 6 cases (42.9％,6/14).The positive rate of Gleason score ≥ 7 points in fusion imaging biopsy was higher than that of systematic biopsy,which had a statistical difference (Fisher exact probability method,P=0.039).Conclusion Image fusion method can be used to reduce the tndetected rate of prostate cancer and improve the detection rate of the high-grade prostate cancer.

The pathogenic and therapeutic effect of gut microbiome is a hot topic in recent years .Many researchers gradually focused on the relationship between the eating disorder and the gut microbiome .The gradual in-depth studies show that gut microbiome can intervene in the host′s metabolic state by multiple approaches to regulate appetite and bring new inspiration for the treatment of dis -eases.In this article, we review all important findings in this field and discuss the mechanism how gut microbiome effects appetite regu -lation.

Peak Torque(PT),Total Work(TW),Average Power(AP),Torque Acceleration Energy(TAE),Set Total Work(STW),Endurance Ratio (ER)and DOrsal/plantar ratio of ankle dorsal and plantarflexion were tested in 101 patients with lumbar disc protrusion using a Cybex一6000 isokinetic muscle test-ing instrument.The results showed the most tested of the affected side was signficantly lower than that onthe opposite side. The PT,TW and STW of the affected side was lower 70一80%than that on the oppo-site side. The rest was lower 20一30%than another side. No significant difference of endurance ratios be-tween the affected and unaffected sides was noted.

Objective Based on network pharmacology,molecular docking and animal experiment,this study explored the mechanism of Icariin combined with Prednisone in the treatment of steroid-resistant nephrotic syndrome(SRNS)in rats.Methods The targets of Icariin active components were determined by TCMSP,GeneCards and CTD databases.The targets of SRNS were screened from GeneCards,OMIM,CTD and DRUGBANK databases,Remove and integrate.Venn graph was drawn to obtain the intersection target.A protein-protein interaction network was constructed using STRING database,and core targets were screened by topological analysis using Cytoscape 3.7.2.DAVID 6.8 was employed for GO term enrichment and KEGG pathway enrichment.And AutoDockTools Vina,PyMOL for molecular docking.SRNS rat model was constructed.The body weight of rats was measured,The 24-hour urinary protein quantity was detected,and the pathological morphology of renal tissue was observed by HE staining.,and the expression of core target proteins was de tected by Western blot.Results Network pharmacologic analysis showed that 139 targets corresponding to Icariin active ingredients were obtained,and 58 common targets were obtained by intersection with 1476 SRNS related targets.In PPI network,the top three degree values were Akt,JUN and IL6.KEGG enrichment analysis showed that Icariin played a therapeutic role in SRNS mainly by PI3K/AKT singnaling pathway.Molecular docking verification showed that Akt,PI3K and autophagy-related protein LC3-II had good binding activity with Icariin.Animal experiment result showed that Icariin combined with Prednisone significantly increased the body weight of SRNS rats(P<0.05),decreased the 24 hour urine protein quantity(P<0.01),and improved the glomerular morphological changes.The results of Western-blotting showed that Icariin combined with Prednisone could significantly improve the abnormal decrease of LC3-II protein and the abnormal increase of Akt and PI3K protein expression in renal tissue of SRNS rats(P<0.01).Conclusion Icariin can play a role in the treatment of SRNS through a multi-target and multi-pathway,regulate the PI3K-Akt signaling pathway,and increase the autophagy activity of kidney tissue in SRNS rats,which may be one of its main mechanisms.

Objective:To explore the status and influencing factors of incontinence-associated dermatitis among elderly inpatients in 52 hospitals nationwide, and to analyze the nursing of elderly inpatients with incontinence, so as to provide a reference for clinical intervention.Methods:On March 31, 2021, convenience sampling was used to select 14 675 elderly inpatients from 52 hospitals across the country as the research object. The self-designed Incontinence-associated Dermatitis Questionnaire for Elderly Inpatients was used to collect general demographic data, health status, incontinence, and skin nursing. Binomial Logistic regression was used to investigate the influencing factors of incontinence-associated dermatitis in elderly inpatients.Results:Among 14 675 elderly inpatients, the prevalence rates of xerosis cutis, incontinence and incontinence-associated dermatitis were 38.78% (5 691/14 675) , 11.06% (1 623/14 675) and 1.91% (280/14 675) , respectively. The prevalence of mild, moderate and severe incontinence-associated dermatitis were 1.27% (186/14 675) , 0.55% (81/14 675) , and 0.09% (13/14 675) , respectively. Among the nursing of 1 623 elderly inpatients with incontinence, the items with low implementation rate were the use neutral lotion to clean skin (14.17%, 230/1 623) , use of skin protectant after moisturizing (17.68%, 287/1 623) , moisturizing after cleansing the skin (28.90%, 469/1 623) . The results of binomial Logistic regression analysis showed that xeroderma, fecal incontinence, urinary and fecal incontinence, ≥2 kinds of combined medication, and hospital stay >30 days were risk factors for incontinence-associated dermatitis in elderly inpatients.Conclusions:The risk factors of incontinence-associated dermatitis in elderly inpatients mainly include xerosis cutis, type of incontinence, ≥2 kinds of combined medication, and hospital stay >30 days.

Objective:To evaluate the impact of self-crosslinked hyaluronic acid (SCH) gel on endometrium recovery after artificial abortion.Methods:A multicenter, prospective randomized controlled trial was conducted across 18 hospitals from December 2021 to February 2023, involving 382 women who underwent artificial abortion. Participants were randomly allocated to receive either treatment with SCH gel (SCH group) or no treatment (control group) in a 1∶1 ratio. The primary outcome was endometrium thickness in 14 to 18 days after the first postoperative menstruation. Secondary outcomes included changes in menstrual volume during the first postoperative menstruation, menstruation resumption within 6 postoperative weeks, time to menstruation resumption, duration of the first postoperative menstruation, and incidence of dysmenorrhea.Results:Baseline characteristics of participants were comparable between the two groups (all P>0.05), with 95.3% (182/191) in SCH group and 92.7% (177/191) in the control group completed the study. The postoperative endometrial thickness in SCH group was significantly greater than that in the control group [(9.78±3.15) vs (8.95±2.32) mm; P=0.005]. SCH group also had significantly fewer participants with reduced menstrual volume [23 cases (12.6%, 23/182) vs 31 cases (17.5%, 31/177); P=0.038]. Although SCH group experienced less dysmenorrhea during the first postoperative menstrual period, this difference was not statistically significant [28.5% (51/179) vs 37.1% (65/175); P=0.083]. Outcomes were similar between SCH group and the control group regarding the proportion of participants who resumed menstruation within 6 weeks postoperatively, time to menstruation resumption, and duration of the first postoperative menstruation ( P=0.792, 0.485, and 0.254, respectively). No serious adverse events were observed during the study period, and no adverse events were attributed to SCH gel treatment. Conclusion:The application of SCH gel after artificial abortion is safe and might aid in the recovery of the endometrium.

OBJECTIVE To establi sh the method for the con tent determination of 11 components in Terminalia chebula from different origins ，and to provide reference for their quality evaluation and superior provenance screening. METHODS Taking 16 batches of T. chebula from different origins as test samples ，high performance liquid chromatography tandem triple quadrupole mass spectrometry was established to determine the contents of 11 components，such as vitexin ，gallic acid ，methyl gallate ，ethyl gallate，ellagic acid ，corilagin，shikimic acid ，ferulic acid ，luteolin，quercetin and rutin. The determination was performed on Shim-pack GIST-HP C 18 column with mobile phase consisted of 0.1％ formic acid solution-methanol at the flow rate of 0.25 mL/ min（gradient elution ）. The sample size was 3 μL，and the column temperature was 35 ℃. Electrospray ionization source was used in positive and negative ion mode ，with multiple reaction monitoring. The atomized gas flow rate was 3 L/min，the heating gas flow rate was 10 L/min，the interface temperature was 300 ℃，the desolvent temperature was 526 ℃，and the heating block temperature was 400 ℃ . Grey correlation analysis （GRA）and technique for order preference by similarity to ideal solution （TOPSIS）methods were used to compare ，analyze and comprehensively evaluate T. chebula from different origins. RESULTS The results of content determination methodology met the relevant requirements. The contents of 11 components in 16 batches of T. chebula were 7.27-106.38，5 370.24-31 010.43，21.42-1 097.50，4.26-111.09，17 940.42-38 490.18，6 247.26-40 182.18，12 125.94- 209 519.96，2.71-9.04，0.24-44.12，1.49-9.17 and 25.35-126.51 μg/g，respectively. The results of GRA and TOPSIS analysis showed that the comprehensive qualities of sample H 12（from Yunnan ），H11（from Guangxi ），H5（from Hunan ），H14（from Guangdong），H13（from Sichuan ），H8（from Guangdong ），H1（from Yunnan ）were better. CONCLUSIONS The established method is fast ，sensitive and reliable ，and can be suitable for comprehensive evaluation of the internal quality and superior provenance screening of T. chebula .

OBJECTIVE To establish the HPLC fingerprint of Mongolian medicine Sanzisan ，and to evaluate its internal quality by chemical pattern recognition technique comprehensively. METHODS HPLC method was used. Using geniposide as reference，HPLC fingerprints of 15 batches of Sanzisan were drawn with Similarity Evaluation System of TCM Chromatogram Fingerprint（2012 edition）. Similarity evaluation and common peaks identification were conducted. Combined with cluster analysis （CA），principal component analysis （PCA），and orthogonal partial least squares-discriminant analysis （OPLS-DA），the quality of 15 batches of Sanzisan was evaluated ，and the differential markers that affected its quality were screened. RESULTS There were 29 common peaks in 15 batches of Sanzisan ，and the similarity was no less than 0.952，indicating that the chemical composition of the 15 batches of Sanzisan had good consistency. A total of 13 common peaks were identified ，which were chebulic acid ，gallic acid，punicalin，punicalagin A ，punicalagin B ，jasminoside B ，caffeic acid ，corilagin，geniposide，chebulagic acid ，1，2，3，4，6- O-galloylglucose，chebulinic acid ，ellagic acid. Both CA and PCA could divide 15 batches of Sanzisan into four categories ，and the classification results were consistent ，indicating that the quality of 15 batches of Sanzisan had certain differences. Fourteen differential markers （chebulic acid ，gallic acid ，ellagic acid ，etc）that lead to the quality difference between batches were screened out by OPLS-DA. CONCLUSIONS Established HPLC fingerprint analysis method is simple and stable. Combined with chemical pattern recognition analysis ，it can be used for the quality control of Sanzisan.

Objective:To understand the current situation of nurses in 52 hospitals in China on mastery of knowledge about skin injury in the elderly based on the background of mixed-mode homogenization training.Methods:Using the convenient sampling method, a total of 1 067 nurses from 52 hospitals in China were selected as the research objects in January 2021. A self-designed questionnaire on knowledge of skin injury in the elderly was used to investigate the nurses through the questionnaire star and univariate analysis was used to analyze the influencing factors. A total of 1 067 questionnaires were distributed and 1 067 valid questionnaires were recovered, and the effective recovery rate was 100%.Results:The knowledge scores of pressure injury, incontinence-associated dermatitis, skin tear and xerosis cutis among 1067 nurses were (95.66±7.37) , (95.65±9.15) , (91.37±15.45) and (87.67±15.91) , respectively. The results of univariate analysis showed that hospital grade was the influencing factor of nurses' knowledge score of pressure injury, skin tear and incontinence-associated dermatitis ( P<0.05) , educational background was the influencing factor of nurses' knowledge score of skin tear ( P<0.05) , professional title was the influencing factor of nurses' knowledge scores of pressure injury, incontinence-associated dermatitis and xerosis cutis ( P<0.05) . Conclusions:Hospitals at all levels need to strengthen the theoretical and practical knowledge training for nurses on skin xerosis and skin tear in the elderly, especially for nurses with primary titles and lower education in grassroots hospitals.

Objective: The clinical characteristics of dural arteriovenous fistula with pulsatile tinnitus were analyzed to deepen the understanding of the disease. Methods: The clinical data of five patients complained of pulsatile tinnitus and diagnosed dural arteriovenous fistula in Henan People's Hospital from May 2013 to June 2018 were retrospectively analyzed, including 3 males and 2 females, aged 27-65 years. Results: The main clinical symptoms of the five patients were continuous pulsatile tinnitus, accompanied/not accompanied by headache, memory decline, etc., with a course of three months to 20 years. They were diagnosed as dural arteriovenous fistula by digital subtraction angiography, and three cases of tinnitus disappeared and two cases of tinnitus were relieved after embolization. Conclusions The dural arteriovenous fistula is a rare and complicated disease. When the patient complain of the pulsatile tinnitus, the related etiology should be considered and managed properly.