ObjectiveTo investigate the association between endothelin receptor type A gene （EDNRA） and congenital bilateral absence of the vas deferens （CBAVD）. MethodsThis case-control study consisted of 124 subjects with CBAVD and 100 fertile controls.Two single nucleotide polymorphisms （SNPs： rs5335 and rs1801708） in the EDNRA gene were genotyped via PCR， PCR-RFLP analysis， and direct sequencing. ResultsNo significant differences existed between EDNRA polymorphisms and CBAVD phenotype （rs1801708： P=0.220 2， 0.163 2； rs5335： P=0.805 8， 0.818 6）. However， the rs1801708-rs5335 haplotype AG was notably associated with an increased risk of CBAVD （P=0.008 6， OR=2.178， 95% CI： 1.207-3.929）. A significantly protective effect of rs1801708-rs5335 haplotype GG on CBAVD （P=0.038 5， OR= 0.671， 95% CI： 0.460-0.980） was observed. After Bonferroni correction， the result for haplotype A-G remained significant （P =0.008 6<0.012 5）， while haplotype G-G was not significant. ConclusionThe rs1801708-rs5335 AG haplotype of EDNRA is a potential risk factor for CBAVD development in Han Chinese.

Objective To analyze the clinical efficacy and safety of transurethral blue laser vaporization of prostate (BVP) in the treatment of benign prostatic hyperplasia (BPH), and to explore the feasibility of its promotion in primary hospitals. Methods Clinical data of 30 BPH patients undergoing BVP in our hospital during Sep. and Dec. 2024 were retrospectively analyzed. The preoperative prostate volume, decrease in hemoglobin level 2 hours after operation, operation time, postoperative bladder irrigation time, catheter indwelling time, and intra-/postoperative complications were recorded. The changes of international prostate symptom score (IPSS), quality of life (QoL) score, and maximum urinary flow rate (Qmax) were compared before operation and 6 months after operation. Results The mean prostate volume was (46.9±15.7) mL. BVP was successfully completed in 28 patients. The 2 unsuccessful cases (6.7%) converted to transurethral resection of the prostate (TURP) due to intraoperative bleeding. For the 28 successful cases, the median postoperative 2-hour hemoglobin decrease was 4 (2, 11) g/L, mean operation time (59.8±13.2) min, median postoperative bladder irrigation time 21 (18, 23) h, median postoperative catheter indwelling time 5 (5, 5) d, and median postoperative hospital stay 6 (5, 6) d. After catheter removal, urinary retention with infection occurred in 1 case (3.6%), and hemorrhage in 1 case (3.6%). No severe complications occurred during the perioperative period. At 6 months postoperatively, the 28 patients showed significant improvement compared to preoperative values in IPSS[11 (10, 11) vs. 22 (21, 26), P＜0.001], QoL score[2 (2, 3) vs. 5 (5, 6), P＜0.001], and Qmax[ (17.2±5.6) mL/s vs. (7.8±1.4) mL/s, P＜0.001]. Conclusion BVP is a safe and effective treatment for BPH, offering advantages such as minimal blood loss, short operation time, and few complications. It effectively improves patients' lower urinary tract symptoms and quality of life, and is recommended for promotion in primary hospitals.

ObjectiveTo construct a machine learning model combining two-dimensional shear wave elastography （2D-SWE） and serological markers， and to investigate its clinical value in differentiating primary biliary cholangitis （PBC） from overlap syndrome （OS）. MethodsA total of 199 patients with pathologically confirmed PBC or OS in Nantong Third People’s Hospital from January 2021 to December 2025 were retrospectively enrolled， with 125 patients in the PBC group and 74 in the OS group. The patients were randomly divided into a training set with 139 patients and a test set with 60 patients at a ratio of 7∶3. Related data were collected， including serological markers， conventional two-dimensional ultrasound parameters， and 2D-SWE parameters （including velocity of shear wave ［VS］ and liver fibrosis index ［LFI］）. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test was used for comparison of categorical data between two groups. The univariate and multivariate Logistic regression analyses were used to identify independent predictive factors， which were then incorporated into six machine learning models， and 5-fold cross-validation was used for optimization of parameters. The indicators including the area under the receiver operating characteristic curve （AUC） were compared in the test set to determine the best model， and the SHapley additive exPlanations （SHAP） analysis was used for model interpretation. ResultsFemale patients accounted for 87.8% in the OS group and 79.2% in the PBC group. Compared with the PBC group， the OS group had significantly higher age， VS， LFI， splenic area， aspartate aminotransferase， total bilirubin， prothrombin time， immunoglobulin G （IgG）， and immunoglobulin M （Z=-2.883， -6.524， -4.000， -3.061， -2.194， -2.372， -4.079， -6.964， and -2.709， all P<0.05） and a significantly lower platelet count （Z=4.098， P<0.001）， and there were also significant differences between the two groups in the proportion of patients with positive anti-nuclear antibody， fibrosis stage， and inflammation grade （χ²=3.458， 63.198， and 101.038， all P<0.05）. Variables without multicollinearity were included in the regression analysis， and the multivariate Logistic regression analysis showed that VS （odds ratio ［OR］=4.503， 95% confidence interval ［CI］： 1.698 — 11.943， P=0.003）， LFI （OR=1.813， 95%CI： 1.050 — 3.132， P=0.033）， and IgG （OR=1.121， 95%CI： 1.026 — 1.226， P=0.012） were independent predictive factors for differentiating PBC from OS. Six machine learning models were constructed based on these variables， among which the logistic regression model showed the best predictive performance in the test set， with an AUC of 0.881 （95%CI： 0.788 — 0.974）， a sensitivity of 0.731， and a specificity of 0.794. The SHAP analysis showed that IgG contributed the most to model prediction. ConclusionThe noninvasive multimodal machine learning model combining 2D-SWE parameters （VS， LFI） and serum IgG can effectively differentiate PBC from OS， providing a reference for clinical decision-making regarding the need for liver biopsy.

The diagnostic value of Mycobacterium tuberculosis(MTB)complex and rifampicin resistance test kits(fluorescence PCR method)in detecting for MTB complex and rifampicin resistancein sputum samples was evaluated.A total of 271 patients with suspected tuberculosis were prospectively and consecutively enrolled at Hunan Chest Hospital between April 1,2024,and November 30,2024.Of these,229 patients were confirmed to have tuberculosis,whereas 42 patients were not-tuberculosis samples were col-lected from all patients and subjected to fluorescence PCR,Xpert MTB/RIF(abbreviated as Xpert),and MGIT 960 culture and drug sensitivity testing.Clinical diagnosis and MTB culture results served as reference standards for TB diagnosis,whereas phenotypic drug susceptibility testing and Xpert served as reference standards to for assessment of rifampicin resistance.The sensitivity,specificity,positive predictive value,and negative predictive value of the fluorescence PCR method were analyzed.Kappa tests were performed to analyze the concordance between detection techniques.With clinical diagnosis as the gold standard,the sensitivity and specificity of the fluorescence PCR method for the diagnosis of TB were 65.1%(149/229)and 97.6%(41/42),and the consistency test for the fluo-rescence PCR and Xpert methods showed high consistency(Kappa value=0.993).With the MGIT 960 liquid culture as the reference standard,the positive detection rate of the fluorescence PCR method for the detection of patients with positive cultures was 91.9%(102/111,95%CI:85.2%-96.2%),and the positive detection rate for 147 patients with sputum culture-negative TB was 27.9%(41/147,95%CI:21.3%-35.6%).With the phenotypic drug sensitivity test as the gold standard,the sensitivity and specificity of the fluo-rescence PCR method for the detection of rifampicin resistance were 100.0%(31/31)and 96.6%(28/29)respectively,and the consis-tency between tests was high(Kappa value=0.967).With Xpert as the gold standard,the sensitivity and specificity of fluorescence PCR for the detection of rifampicin resistance were 95.8%(46/48)and 99.0%(99/100),respectively,and the consistency between tests was high(Kappa value=0.953).Finally,samples with rifampicin resistance detected with the fluorescence PCR method had a clear rpoB gene mutation type according to one-generation sequencing.In conclusion,the fluorescence PCR method showed high sen-sitivity in detecting MTB complex groups and rifampicin resistance,and had high concordance with Xpert.Therefore,this technique can serve a rapid test for TB diagnosis to increase the rate of positive TB pathology and detection of rifampicin resistance.This method is particularly suitable for use in lower-income countries and economically disadvantaged grassroots communities.

Objective:To identify the serotype and genotype characteristics of the first cluster infection of Brucella in Nujiang Lisu Autonomous Prefecture of Yunnan Province. Methods:The information of seven suspected cluster brucellosis cases reported in Lanping County, Nujiang Lisu Autonomous Prefecture in April 2023 were collected, blood samples were collected, and the strains were isolated and cultured. Serological methods were employed for brucellosis diagnosis, bacterial species identification was performed using BCSP31-PCR and AMOS-PCR. Multilocus locus variable-number tandem repeat analysis (MLVA) was conducted for strain genotyping, followed by phylogenetic analysis comparing the strains with those from other regions of China.Results:All seven cases were diagnosed with brucellosis, they were all villagers from the same village and had daily contact with sheeps. Four suspected Brucella strains were isolated, identified as Brucella melitensis biotype by BCSP31-PCR and AMOS-PCR. The four isolated strains exhibited identical MLVA-16 genotype, with MLVA-8 genotype 42 and MLVA-11 genotype 180, belonging to the Eastern Mediterranean lineage. Compared with the MLVA-16 of the isolated strains from other regions of China, the four isolated strains formed an independent cluster. Conclusion:The first cluster infection of Brucella in Nujiang Lisu Autonomous Prefecture of Yunnan Province is caused by Brucella melitensis biotype, and the four isolated strains have showed unique MLVA genotype.

Objective:To study the resistance of Aedes albopictus to commonly used insecticides in Hangzhou, and to investigate the polymorphism distribution characteristics of voltage-gated sodium channel (VGSC) and acetylcholinesterase (AchE) 1 (Ace-1) genes in Aedes albopictus in the region, providing a scientific basis for control of Aedes albopictus in Hangzhou. Methods:From May to June 2023, Aedes albopictus larvae and pupae were collected from residential areas across divided different urban areas by directions in Hangzhou. They were reared in the laboratory, and their resistance to malathion, propoxur, pyrethroid insecticides (permethrin, deltamethrin, and beta-cypermethrin) was evaluated using the World Health Organization-recommended adult mosquito contact tube method. The 24 h mortality rates of adult mosquito of 98% - 100% was susceptible, 80% - < 98% was suspected resistance, < 80% was resistant. Genomic DNA was extracted from adult Aedes albopictus, and mutations in the VGSC and Ace-1 genes were detected through PCR amplification and Sanger sequencing. Results:The 24 h mortality rates of adult Aedes albopictus exposed to 0.5% malathion, 0.05% propoxur, 0.4% permethrin, 0.03% deltamethrin, and 0.08% beta-cypermethrin in Hangzhou were 100% (75/75), 96.00% (72/75), 41.43% (29/70), 17.33% (13/75), and 32.86% (23/70), respectively. A total of 146 surviving Aedes albopictus were tested for VGSC gene mutations at diagnostic doses of pyrethroid insecticides. Among them, 6 Aedes albopictus (4.11%) had a gene mutation at position V1016, and 146 Aedes albopictus (100%) had a gene mutation at position F1534. A total of 63 Aedes albopictus that died at diagnostic doses of pyrethroid insecticides were analyzed for VGSC gene mutations. No gene mutation was detected at position V1016, while 63 Aedes albopictus (100%) had a gene mutation at position F1534. One non synonymous mutation was detected at position V1016 of the VGSC gene, which was a heterozygous mutation of V1016V to V1016V/G. Two non synonymous mutations were detected at position F1534 of the VGSC gene, namely F1534F to F1534S or a F1534F/S heterozygous mutation. No Ace-1 gene mutation was detected in all Aedes albopictus exposed to 0.05% propoxur ( n = 75). Conclusions:The Aedes albopictus in Hangzhou has developed resistance to permethrin, deltamethrin, and beta-cypermethrin. It shows suspected resistance to propoxur and sensitivity to malathion. Moreover, a high frequency of mutations in the VGSC gene has been observed in these mosquitoes. It is crucial to enhance resistance monitoring in Aedes albopictus populations in Hangzhou and to implement the rational rotation of chemical insecticides to slow down the progress of drug resistance.

Objective To analyze the health economics of ultra-short wave therapy adjuvant to drug therapy for acute pharyngitis,and to provide a more cost-effective treatment option for clinical management.Methods Seventy patients with acute pharyngitis were randomly divided into a control group(35 cases)and an ultra-short wave group(35 cases).The control group received conventional drug therapy,while the ultra-short wave group received ultra-short wave therapy in addition to conventional drug therapy.The cure rate,treatment duration,direct costs,indirect costs,and total costs were compared between the two groups for clinical efficacy and health economics analysis.Results The cure rate in the ultra-short wave group was significantly higher than that in the control group(P=0.008),while the total treatment cost and treatment duration were significantly re-duced.To achieve the same therapeutic effect,the ultra-short wave group required 129.73 yuan less than the control group.Conclusion Ultra-short wave therapy adjuvant to conventional drug treatment for acute pharyngitis can more rapidly alleviate symptoms,reduce indirect costs due to work absence,without significantly increasing treatment expenses.It is a safe,effective,and economical therapy with higher therapeutic value compared to drug therapy alone,and is worthy of widespread promotion.

Objective:To explore effect of Astragalus polysaccharides(APS)through TLR4/NF-κB signal pathway on intesti-nal immune inflammation of rats with dampness stagnancy due to spleen deficiency syndrome based on fecal microbiota transplantation.Methods:Rats with dampness stagnancy due to spleen deficiency syndrome were fed with high-fat and low-protein diet and subjected to exhaustive swimming,transplant flora microbiota after intervention of APS.General condition,changes in weight gain,time of weight exhaustion swimming,spleen index and thymus index were tested.Pathological manifestations of duodenal tissue inflammation were observed by HE staining.Serum IL-1β,IL-6 and TNF-α concentrations of rats were determined by ELISA.Protein levels of TLR4,NF-κB p65 and IκBα in colon were determined by Western blot.Results:Compared with model group,general condition rating,changes in weight gain and time of weight exhaustion swimming in APS-FTG group were increased significantly(P<0.01);spleen index and thymus index were increased;pathological manifestations of duodenal inflammation were significantly relieved;serum IL-1β,IL-6 and TNF-α concentrations were decreased significantly(P<0.01),TLR4 and NF-κB p65 levels in colon were decreased significantly(P<0.05 and P<0.01),IκBα level was in colon increased significantly(P<0.01).Conclusion:APS improves intestinal microbiota of rats with dampness stagnancy due to spleen deficiency syndrome and inhibits TLR4/NF-κB pathway activation through intestinal flora,thus improving intestinal immune inflammation status in rats with dampness stagnancy due to spleen deficiency syndrome.

Osteoarthritis(OA)is a common joint disease in clinical practice,and cartilage damage is a typical pathological change.The pathogenesis of OA is complex,and various adverse factors can lead to the occurrence of OA.Mitochondria are im-portant organelles within cells and play important roles in cellular physiological and pathological activ-ities.Mitochondrial quality control is an important regulatory mechanism in the body to maintain nor-mal mitochondrial structure and function,mainly including mitochondrial biogenesis,mitochondrial dynamics,mitochondrial autophagy,mitochondrial oxidative stress,and other forms.The imbalance of mitochondrial quality control in chondrocytes is closely related to the occurrence and development of osteoarthritis,and regulating the balance of mi-tochondrial quality control is a potential therapeu-tic point for osteoarthritis.The author reviewed rel-evant research literature in recent years to provide a review of the relationship between mitochondrial quality control and the occurrence and develop-ment of osteoarthritis,in order to provide new ideas and directions for the research and diagnosis and treatment strategies of osteoarthritis.

Background:Optimizing cultivation techniques for traditional Chinese medicine has become a crucial means to improve the quality of medicinal materials.Microbial agents,as environmentally friendly and efficient plant growth promoters and soil conditioners,have increasingly attracted attention in eco-agriculture research.Objective:Our understanding remains limited regarding how the application of microbial agents,alone or in combination,affects changes in the rhizosphere microbiome and its association with the bioactive components of medicinal materials.Methods:In this study,Epimedium pubescens Maxim.was employed as a model plant to examine the effects of 2 microbial agents(Paenibacillus mucilaginosus and Bacillus subtilis)applied individually and in combination on plant growth and the accumulation of bioactive components.Additionally,this study explored the relationship between the rhizosphere microbiome and plant development.Results:The application of microbial agents increased the yield of E.pubescens leaves by 20.30％to 33.66％and enhanced the total flavonol glycosides content by 11.40％to 29.94％.Meanwhile,microbial treatments reshaped the rhizosphere microbiome,promoted the enrichment of beneficial microorganisms(e.g.,Frankia and Paenibacillus),suppressed phytopathogenic fungi such as Didymella and Scytalidium,and enhanced the stability of the soil microbial co-occurrence network.The partial least squares path model suggested that microbial agents not only directly impact the quality of medicinal herbs but also indirectly alter the accumula-tion of bioactive components by modulating the soil microbiome.Conclusion:These findings deepen our understanding of the relationship between medicinal plant quality and rhizosphere micro-biomes as mediated by microbial agents.They also provide a basis for designing and manipulating synthetic microbial communities to promote sustainable development in eco-agriculture.