Objective To evaluate the early imaging characteristics and function of bladder wall reconstruction neourethra(BWN)after robot-assisted laparoscopic prostatectomy(RALP)for prostate cancer with magnetic resonance imaging(MRI)and voiding cystourethrography(VCUG).Methods A total of 36 patients who underwent RALP using BWN technique at Taizhou People's Hospital during Mar.2021 and Jun.2023 were enrolled.Postoperative MRI was used to measure the length,wall thickness,and lumen shape of the new urethra.The morphology of the new urethra in 19 patients was observed under VCUG during the storage phase,voiding phase,and interrupted voiding phase.Results The patients'median age was 73.00 years(range:68.00 to 76.25),the prostate volume was(45.01±7.18)cm3,and the median total prostate-specific antigen(tPSA)level was 10.77 ng/mL(range:7.30 to 14.86).Two patients were classified as T1 stage,25 as T2,and 9 as T3.Gleason scores were ≤6 in 7 patients and ≥8 in 8 patients.Risk classification was low risk in 2 patients and high risk in 8 patients.Postoperatively,urinary control rates at 1,3,and 6 months were 91.67％,97.22％,and 100％,respectively.MRI revealed a median new urethra length of 15.13 mm(range:12.71 to 20.26)and a median wall thickness of 6.84 mm(range:6.18 to 8.20).The urethral lumen had a complete muscular layer and mucosal layer,which appeared petal-like.In patients with urinary incontinence,residual urine was visible in the new urethra and at the anastomosis site.Of the 19 patients who underwent VCUG,16 could close the new urethra during the storage and interrupted voiding phases,and open it during the voiding phase;3 could not close it well during the storage and interrupted voiding phases.Conclusion MRI and VCUG clearly demonstrate that the BWN technique can successfully create a new urethra with good functionality,which helps improve urinary control after RALP for prostate cancer.

Ankylosing spondylitis (AS) combined with lower cervical fracture is often categorized into unstable fracture, with a high incidence of neurological injury and a high rate of disability and morbidity. As factors such as shoulder occlusion may affect the accuracy of X-ray imaging diagnosis, it is often easily misdiagnosed at the primary diagnosis. Non-operative treatment has complications such as bone nonunion and the possibility of secondary neurological damage, while the timing, access and choice of surgical treatment are still controversial. Currently, there are no clinical practice guidelines for the treatment of AS combined with lower cervical fracture with or without dislocation. To this end, the Spinal Trauma Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate Clinical guidelines for the treatment of ankylosing spondylitis combined with lower cervical fracture in adults ( version 2024) in accordance with the principles of evidence-based medicine, scientificity and practicality, in which 11 recommendations were put forward in terms of the diagnosis, imaging evaluation, typing and treatment, etc, to provide guidance for the diagnosis and treatment of AS combined with lower cervical fracture.

OBJECTIVE To establish the project approval evaluation system for traditional Chinese medicine （TCM） preparations in medical institutions guided by new drug conversion， to improve the success rate of approval for TCM preparations in medical institutions and lay the foundation for the later drug conversion. METHODS Research and development team used the literature research method and brainstorming method to list and organize relevant elements of project evaluation and determine the initial indicator system. Experts were consulted using the Delphi method to confirm the evaluation index. The weights were calculated based on the proportion of importance scores for each indicator and assigned specific scores to each item. The indicator system was used to evaluate 31 TCM preparations applied for filing by various departments of our hospital from April to July 2023. RESULTS After two rounds of 17 experts’ consultation， the final TCM preparation system included five primary indicators， i.e. theoretical basis， clinical research foundation， pharmaceutical foundation， prescription， and clinical value， as well as 17 secondary indicators including prescription source， traditional Chinese medicine theory， clinical positioning and so on. Human experience was considered as the item which would be rejected as one vote. Based on the above indicator system， our hospital further improved the filing and project approval process for TCM preparations in medical institutions. Among the 31 TCM preparations applied for filing by various departments from April to July 2023， 8 TCM preparations with a score ≥65 were selected for development. CONCLUSIONS The evaluation system is objective， comprehensive， and highly operable. It is suitable for the selection of TCM preparations in medical institutions before research and development.

Objective To observe the clinical efficacy and safety of pidomoide oral solution combined with budesonide suspension for inhalation in the treatment of recurrent respiratory tract infections(RRTIs)in children.Methods Children with recurrent respiratory tract infection were divided into control and treatment groups according to cohort methods.Control group was given the initial dose of pidotimod oral solution 400 mg bid,adjusted to 400 mg each time after 10 days of continuous treatment,qd;treatment group was given budesonide suspension for inhalation 0.5 mg atomized inhalation therapy on the basis of control group,bid;both groups were treated for 8 weeks.The disappearance time of clinical symptoms,humoral immunity[immunoglobulin G(IgG),immunoglobulin M(IgM),immunoglobulin A(IgA)],cytokine[human insulin-like growth factor-1(IGF-1),monocyte chemotactic protein-1(MCP-1),and cyclooxygenase-2(COX-2)]levels in the 2 groups were compared.The clinical efficacy of the children was evaluated and the incidence of adverse drug reactions was counted.Results A total of 47 cases were enrolled in the control group and 53 cases in the treatment group.The total clinical effective rate of treatment group and control group was 92.45％and 76.60％,respectively,and the difference was statistically significant(P＜0.05).After treatment,the difference of clinical symptom disappearance time between treatment group and control group was statistically significant(P＜0.05).After treatment,IgG levels in treatment group and control group were(11.26±0.85)and(10.92±0.69)g·L-1;IgM levels were(1.58±0.35)and(1.23±0.32)g·L-1;IgA levels were(1.57±0.24)and(1.36±0.30)g.L-1;IGF-1 levels were(149.67±25.81)and(130.24±24.73)μg·mL-1;MCP-1 levels were(71.35±11.89)and(99.36±12.27)pg·mL-1;COX-2 levels were(16.87±4.59)and(20.53±4.83)U·L-1.Compared with the control group,the above indexes in treatment group were statistically significant(all P＜0.05).There was no significant difference in the incidence of adverse drug reactions between treatment group and control group(11.32％vs 6.38％,P＞0.05).Conclusion Pidotimod oral solution combined with budesonide suspension for inhalation can significantly relieve the clinical symptoms of children with RRTIs,improve humoral immunity,improve clinical efficacy,and have high safety.

Objective:To analyze the monitoring results of human brucellosis prevention and control project in Gansu Province, in order to provide reference for the next revision of prevention and control plans.Methods:The data from the "China Disease Prevention and Control Information System" in Gansu Province from 2016 to 2022 and the annual data of human brucellosis cases reported by the active monitoring reports in various project counties (districts) were input into Excel 2016 software and a database was established. The epidemiological situation of brucellosis, the coverage of brucellosis prevention and control projects, the number of detected cases and health education were analyzed and compared by descriptive epidemiological method.Results:From 2016 to 2022, 70 to 82 out of 86 counties (districts) in Gansu Province were found to have human outbreaks of brucellosis, with brucellosis prevention and control projects covering 17 to 43 counties (districts). A total of 19 855 cases of human brucellosis were reported online in the province, with an average annual incidence of 11.07/100 000 and an annual incidence ranging from 6.03/100 000 to 20.89/100 000. There was a statistically significant difference in incidence among years (χ 2 = 5 264.84, P < 0.001). Through active monitoring, a total of 433 303 cases of brucellosis (tiger red plate agglutination test, RBT) were initially screened in project counties (districts) throughout the province, with 13 277 positive cases and a positive rate of 3.06% (13 277/433 303). Then the laboratory confirmed test (test-tube agglutination test, SAT) for brucellosis was carried out, with 9 967 positive cases and a positive rate of 2.30% (9 967/433 303). The infection rate of brucellosis in the population (SAT positive) was compared between different years, and the difference was statistically significant (χ 2 = 600.12, P < 0.001). In the project counties (districts), 7 481 confirmed cases of brucellosis were detected by active surveillance, and 15 794 cases were reported online, accounting for 47.37% (7 481/15 794) of the total number of cases reported online. The average awareness rate of brucellosis knowledge among medical personnel increased from 70.49% before training to 88.89% after training. The average awareness rate of brucellosis prevention and control knowledge among high-risk groups increased from 63.49% before health education to 89.05% after health education, and the behavior formation rate increased from 62.84% to 86.04%. Conclusions:From 2016 to 2022, the epidemic scope of human brucellosis in Gansu Province has been expanding year by year, and the coverage of prevention and control project is relatively small. The proportion of cases detected through active screening is relatively low. It is necessary to increase special funding investment, expand project coverage, strengthen high-risk group screening, education and behavioral intervention, and follow-up management of acute stage patient, so as to identify patients as early as possible and curb the upward trend of the epidemic.

Objective:To investigate the application of (4R)-4-(3-[ 18F]fluoranyl-5-fluorophenyl)-1-((3-methylpyridin-4-yl)methyl)pyrrolidin-2-one( 18F-SynVesT-1), a synaptic vesicle glycoprotein 2A (SV2A) radioactive tracer, in patients with Alzheimer′s disease (AD). Methods:A total of 20 AD patients (2 males, 18 females, age (66.4±8.1) years) with positive β-amyloid (Aβ) deposition and 20 normal controls (NC; 9 males, 11 females, age (62.6±8.6) years ) without Aβ deposition were retrospectively recruited from Huashan Hospital, Fudan University between December 2021 and December 2022. All of them underwent 18F-SynVesT-1 PET/MR and 18F-Florbetapir (AV45) PET/CT scans. Preprocessing of brain 18F-SynVesT-1 PET images was carried out using statistical parametric mapping (SPM). The differences of the uptke of 18F-SynVesT-1 (synaptic density) between two groups based on ROI were compared by using either the independent-sample t test or Mann-Whitney U test. Spearman rank correlation analysis was performed to assess the relationship between synaptic density and cognitive performance. For voxelwise analysis, a general linear model was constructed to analyze differences in synaptic density between the two groups using the independent-sample t test. Furthermore, a multiple linear regression model was developed to explore the relationship between synaptic density and cognitive performance. Results:Compared to the NC group, the AD group exhibited significant widespread reduction in synaptic density across the cortical regions ( P<0.05, false discovery rate (FDR)-corrected), particularly in the medial temporal lobe (0.84±0.09 vs 1.04±0.09; t=-6.95, P<0.001), lateral temporal lobe (1.15±0.13 vs 1.31±0.08; t=-4.56, P<0.001), and lateral parietal lobe (1.24(1.04, 1.26) vs 1.32(1.23, 1.39); z=-3.25, P=0.001). Moreover, synaptic density in extensive cortical regions showed a positive correlation with mini-mental state examination (MMSE) and Montreal cognitive assessment-basic (MoCA-B) scores ( P<0.05, FDR-corrected). Notably, significant associations were observed between MMSE and MoCA-B scores and synaptic density in the lateral temporal lobe ( rs values: 0.71, 0.74, both P<0.001) and medial temporal lobe ( rs values: 0.71, 0.74, both P<0.001). Conclusions:18F-SynVesT-1 PET imaging is a valuable tool for evaluating synaptic density, specifically in the context of AD. The observed widespread reduction in synaptic density across cortical regions of patients with AD are closely related to cognitive decline.

China prospective multicenter birth cohort (Prospective Omics Health Atlas birth cohort, POHA birth cohort) study was officially launched in 2022. This study, in collaboration with 12 participating units, aims to establish a high-quality, multidimensional cohort comprising 20 000 naturally conceived families and assisted reproductive families. The study involves long-term follow-up of parents and offspring, with corresponding biological samples collected at key time points. Through multi-omics testing and analysis, the study aims to conduct multi-omics big data research across the entire maternal and infant life cycle. The goal is to identify new biomarkers for maternal and infant diseases and provide scientific evidence for risk prediction related to maternal diseases and neonatal health.

OBJECTIVE: To investigate the clinical efficacy and safety of percutaneous foraminal endoscopy in the treatment of lumbar lateral recess stenosis in elderly. METHODS: The clinical data of 31 elderly patients with lumbar lateral recess stenosis treated by percutaneous foraminal endoscopic decompression from March 2018 to August 2019 were retrospectively analyzed. Including 16 males and 15 females, aged from 65 to 81 years with an average of (71.13±5.20) years, the course of disease ranged from 3 months to 7 years with an average of (14.36±6.52) months. Visual analogue scale (VAS) and Oswestry disability index (ODI) were used to assess clinical symptom and functional status before operation and 1, 6, 12 months after operation. At the final follow-up, the modified Macnab standard was used to evaluate clinical efficacy. RESULTS: All patients were completed the operation successfully. The operation time was from 75 to 120 min with an average of (97.84±11.22 ) min. All 31 patients were followed up from 12 to 28 months with an average of (17.29±5.56) months. Postoperative lumbago-leg pain VAS and ODI were significantly improved at 1, 6, and 12 months(P<0.01). At the final follow-up, according to the modified Macnab standard to evaluate the effect, 23 got excellent results, 5 good, 3 fair. One patient had severe adhesions between peripheral tissues and nerve root, and postoperative sensory abnormalities in the lower extremities were treated conservatively with traditional Chinese medicine and neurotrophic drugs, which recovered at 2 weeks after surgery. No complications such as nerve root injury and infection occurred. CONCLUSION The intervertebral foraminal endoscopy technique, which is performed under local anesthesia for a short period of operation, ensures adequate decompression while minimizing complications, and is a safe and effective surgical procedure for elderly patients with lumbar lateral recess stenosis.
Male ; Female ; Humans ; Aged ; Infant ; Constriction, Pathologic/surgery* ; Spinal Stenosis/surgery* ; Decompression, Surgical/methods* ; Retrospective Studies ; Lumbar Vertebrae/surgery* ; Endoscopy/methods* ; Treatment Outcome

It is well established that increased excitability of the presympathetic neurons in the hypothalamic paraventricular nucleus (PVN) during hypertension leads to heightened sympathetic outflow and hypertension. However, the mechanism underlying the overactivation of PVN presympathetic neurons remains unclear. This study aimed to investigate the role of endogenous corticotropin-releasing factor (CRF) on the excitability of presympathetic neurons in PVN using Western blot, arterial blood pressure (ABP) and renal sympathetic nerve activity (RSNA) recording, CRISPR/Cas9 technique and patch-clamp technique. The results showed that CRF protein expression in PVN was significantly upregulated in spontaneously hypertensive rats (SHRs) compared with normotensive Wistar-Kyoto (WKY) rats. Besides, PVN administration of exogenous CRF significantly increased RSNA, heart rate and ABP in WKY rats. In contrast, knockdown of upregulated CRF in PVN of SHRs inhibited CRF expression, led to membrane potential hyperpolarization, and decreased the frequency of current-evoked firings of PVN presympathetic neurons, which were reversed by incubation of exogenous CRF. Perfusion of rat brain slices with artificial cerebrospinal fluid containing CRF receptor 1 (CRFR1) blocker, NBI-35965, or CRF receptor 2 (CRFR2) blocker, Antisauvagine-30, showed that blocking CRFR1, but not CRFR2, hyperpolarized the membrane potential and inhibited the current-evoked firing of PVN presympathetic neurons in SHRs. However, blocking CRFR1 or CRFR2 did not affect the membrane potential and current-evoked firing of presympathetic neurons in WKY rats. Overall, these findings indicate that increased endogenous CRF release from PVN CRF neurons enhances the excitability of presympathetic neurons via activation of CRFR1 in SHRs.
Rats ; Animals ; Rats, Inbred SHR ; Paraventricular Hypothalamic Nucleus/physiology* ; Receptors, Corticotropin-Releasing Hormone/metabolism* ; Rats, Inbred WKY ; Corticotropin-Releasing Hormone/metabolism* ; Neurons/physiology* ; Hypertension ; Sympathetic Nervous System

Twelve compounds were isolated from Liquidambaris Resina by silica gel column chromatography and thin layer chromatography. Their structures were identified on the basis of spectral data, electron capture detector data, and physicochemical properties as(2'R, 3'R)-2',3'-dihydroxy-hydrocinnamyl-(E)-cinnamate(1),(E)-cinnamyl-(E)-cinnamate(2), cinnamic acid(3), 28-norlup-20(29)-en-3-one-17β-hydroperoxide(4), erythrodiol(5), 13β,28-epoxy-30-hydroxyolean-1-en-3-one(6),(3β)-olean-12-ene-3,23-diol(7), 2α,3α-dihydroxy-olean-12-en-28-oic acid(8), 28-hydroxyolean-12-en-3-one(9), 3-epi-oleanolic acid(10), 3-oxo-oleanolic acid(11), and hederagenin(12). Compound 1 was a new cinnamic acid ester derivative and compounds 2-4,6-8, and 12 were isolated from Liquidambaris Resina for the first time. Compounds 4, 5, 10, and 12 exerted inhibitory effects on the proliferation of human umbilical vein endothelial cells(HUVEC) with the IC_(50) values of(17.43±2.17),(35.32±0.61),(27.50±0.80), and(46.30±0.30) μmol·L~(-1), respectively.
Humans ; Oleanolic Acid ; Endothelial Cells ; Esters ; Cinnamates ; Triterpenes/chemistry* ; Molecular Structure