Objective:To evaluate the treatment efficacy of prostatic abscess and summarize clinical experience.Methods:A retrospective analysis was conducted on clinical data from 23 patients diagnosed with prostatic abscess at Yanbian University Hospital between December 2019 and April 2024. The mean age was (57.72±16.09) years, and BMI was (22.63±2.80) kg/m 2. Comorbidities included diabetes mellitus in 15 cases (65.2%), cardiovascular/cerebrovascular diseases in 12 cases, and hepatitis with cirrhosis in 2 cases. Medical histories comprised benign prostatic hyperplasia in 3 cases (13.0%), prostatitis in 3 cases (13.0%), and recent catheterization in 7 cases. Clinical manifestations included lower urinary tract symptoms in 19 cases and varying degrees of fever in 14 cases. All patients underwent urinary bacterial culture upon admission, with positive results in 8 cases (34.8%): Klebsiella pneumoniae (4 cases), Escherichia coli (2 cases), Staphylococcus aureus (1 case), and Pseudomonas aeruginosa (1 case). All patients received urinary tract ultrasound, while 10 underwent full abdominal CT and 20 underwent prostate MRI. Prostatic abscess was confirmed in 20 cases, while 3 suspected cases were intraoperatively confirmed. In the 23 cases, the maximum abscess cavity diameter ranged from 11 to 70 mm; multiple abscesses (≥2) were observed in 12 cases (52.2%), with pelvic and scrotal involvement noted in 4 cases. All patients received systemic antibiotic therapy, with 4 cases managed conservatively due to favorable baseline status, significant response to antibiotics, and low abscess complexity; 4 cases with favorable baseline status, good response to anti-infective therapy, and younger age, along with at least one large abscess cavity (33-70 mm in diameter), underwent ultrasound-guided transperineal drainage after confirmation of abscess localization strictly within the prostatic region and established purulent material; and 15 cases with poorly controlled infections and complex abscesses (multiloculated/multiple abscesses/extensive involvement/diameter ≥30 mm/volume ≥20 cm 2), abscess cavity (11-40 mm in diameter), underwent transurethral incision and drainage. Results:The follow-up period ranged from 3 months to 1 year, with a mean duration of 10.8 months. No residual or recurrent abscesses were observed in the transurethral incision and drainage group, while 2 cases in the ultrasound-guided drainage group and 1 case in the conservative management group showed persistent abscesses, all of whom were diabetic patients. A comparative analysis stratified by diabetes status revealed significantly higher levels of white blood cell count [16.7 (11.8, 17.4) ×10 9/L vs. 11.9 (7.1, 14.5) ×10 9/L, P = 0.045] and procalcitonin [1.40 (0.8, 3.2) ng/ml vs. 0.3(0, 2.0) ng/ml, P = 0.042] at admission in the diabetic group compared to the non-diabetic group. Conclusions:If the patient has a favorable baseline status and demonstrates a stable clinical response to antibiotic therapy, either ultrasound-guided drainage or conservative management may be selected based on abscess characteristics such as size and location. However, for patients with complex abscesses, particularly those showing suboptimal response to antibiotics, transurethral incision and drainage is recommended. This study also identified diabetes mellitus as a potential significant factor influencing both the severity at disease onset and the prognosis of prostatic abscess.

Objective:To evaluate the treatment efficacy of prostatic abscess and summarize clinical experience.Methods:A retrospective analysis was conducted on clinical data from 23 patients diagnosed with prostatic abscess at Yanbian University Hospital between December 2019 and April 2024. The mean age was (57.72±16.09) years, and BMI was (22.63±2.80) kg/m 2. Comorbidities included diabetes mellitus in 15 cases (65.2%), cardiovascular/cerebrovascular diseases in 12 cases, and hepatitis with cirrhosis in 2 cases. Medical histories comprised benign prostatic hyperplasia in 3 cases (13.0%), prostatitis in 3 cases (13.0%), and recent catheterization in 7 cases. Clinical manifestations included lower urinary tract symptoms in 19 cases and varying degrees of fever in 14 cases. All patients underwent urinary bacterial culture upon admission, with positive results in 8 cases (34.8%): Klebsiella pneumoniae (4 cases), Escherichia coli (2 cases), Staphylococcus aureus (1 case), and Pseudomonas aeruginosa (1 case). All patients received urinary tract ultrasound, while 10 underwent full abdominal CT and 20 underwent prostate MRI. Prostatic abscess was confirmed in 20 cases, while 3 suspected cases were intraoperatively confirmed. In the 23 cases, the maximum abscess cavity diameter ranged from 11 to 70 mm; multiple abscesses (≥2) were observed in 12 cases (52.2%), with pelvic and scrotal involvement noted in 4 cases. All patients received systemic antibiotic therapy, with 4 cases managed conservatively due to favorable baseline status, significant response to antibiotics, and low abscess complexity; 4 cases with favorable baseline status, good response to anti-infective therapy, and younger age, along with at least one large abscess cavity (33-70 mm in diameter), underwent ultrasound-guided transperineal drainage after confirmation of abscess localization strictly within the prostatic region and established purulent material; and 15 cases with poorly controlled infections and complex abscesses (multiloculated/multiple abscesses/extensive involvement/diameter ≥30 mm/volume ≥20 cm 2), abscess cavity (11-40 mm in diameter), underwent transurethral incision and drainage. Results:The follow-up period ranged from 3 months to 1 year, with a mean duration of 10.8 months. No residual or recurrent abscesses were observed in the transurethral incision and drainage group, while 2 cases in the ultrasound-guided drainage group and 1 case in the conservative management group showed persistent abscesses, all of whom were diabetic patients. A comparative analysis stratified by diabetes status revealed significantly higher levels of white blood cell count [16.7 (11.8, 17.4) ×10 9/L vs. 11.9 (7.1, 14.5) ×10 9/L, P = 0.045] and procalcitonin [1.40 (0.8, 3.2) ng/ml vs. 0.3(0, 2.0) ng/ml, P = 0.042] at admission in the diabetic group compared to the non-diabetic group. Conclusions:If the patient has a favorable baseline status and demonstrates a stable clinical response to antibiotic therapy, either ultrasound-guided drainage or conservative management may be selected based on abscess characteristics such as size and location. However, for patients with complex abscesses, particularly those showing suboptimal response to antibiotics, transurethral incision and drainage is recommended. This study also identified diabetes mellitus as a potential significant factor influencing both the severity at disease onset and the prognosis of prostatic abscess.

Objective:To investigate the application value of antegrade splenic superior region dissection first in laparoscopic total gastrectomy of obesity gastric cancer.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 21 obesity patients with gastric cancer who underwent laparoscopic total gastrectomy in Renji Hospital of Shanghai Jiaotong University School of Medicine from July 2018 to October 2023 were collected. There were 16 males and 5 females, aged (58±13)years. All 21 patients underwent laparoscopic total gastrec-tomy with antegrade splenic superior region dissection first. Observation indicators: operation time, volume of intraoperative blood loss, laparotomy conversion, intraoperative splenic hemorrhage or gastric hemorrhage, lymph node dissection, time to postoperative first flatus, time to postoperative initial liquid food intake, duration of postoperative hospital stay, postoperative complication. Measure-ment data with normal distribution were represented as Mean± SD, and count data were expressed as absolute numbers. Results:All 21 patients underwent laparoscopic total gastrectomy success-fully, with the operation time of (283±47)minutes, time for splenogastric ligament and vascular manage-ment of (34±12)minutes, volume of intraoperative blood loss of (143±86)mL, and no laparotomy conversion. There was no intraoperative splenic hemorrhage or gastric haemorrhage. The total number of lymph node dissected in 21 patients was 375, with the number of lymph node dissected as (21±9)per case. Time to postoperative first flatus, time to postoperative initial liquid food intake and duration of postoperative hospital stay in 21 patients were (3.1±0.7)days, (4.0±0.8)days and (10.1±3.0)days, respectively. There were 2 patients with postoperative complications, including 1 case of incision infection and 1 case of lung infection. The 2 patients with postoperative com-plications were recovered and discharged after conservative treatment. There was no death during the postoperative 30 days.Conclusion:The application of antegrade splenic superior region dissec-tion first in laparoscopic total gastrectomy is safe and feasible, which can reduce surgical difficulty.

Due to its unique anatomical location, there are many unresolved issues in the diagnosis and treatment of esophagogastric junction (EGJ) cancer, which is not only a hot topic of concern in various related disciplines, but also a controversial topic among scholars in both the East and the West academia. The 15 th International Gastric Cancer Congress in 2023 focuses on EGJ cancer, organi-zing consensus voting among experts from various disciplines on surgery, digestive endoscopy, and oncology issues before the conference. Multiple sub venues are also set up to discuss related issues. Meanwhile, Japanese scholars have proposed that the lymph node dissection process for EGJ cancer, modified based on the lymph node dissection therapeutic value index, is expected to be updated in the new version of the Japanese gastric cancer treatment guideline. The perioperative treatment of EGJ cancer highlights the differences in concepts and measures between the East and the West academia. Asian scholars focus on neoadjuvant chemotherapy based on DOS treatment plan, while European and American scholars hope to find the best perioperative treatment plan from the neoadjuvant chemoradiotherapy of CROSS research. However, the new adjuvant therapy regimen with the addition of immune checkpoint inhibitors has only established advantages in tumor regression and decline, and has not yet shown significant benefits in long-term survival. It cannot be denied that the diagnosis and treatment of EGJ cancer are still constantly exploring and advancing. In the future, we look forward to more new evidence-based medicine to provide ideas and expand our horizons for minimally invasive, precise, individualized, and comprehensive clinical diagnosis and treatment. Based on our understanding and insights into the differences and controversies between Eastern and Western scholars in the background, concepts, technologies, and treatment plans of EGJ cancer, the authors elaborate and analyze the hot issues of EGJ cancer diagnosis and treatment, combined with the latest content of the 2023 IGCC and other international conferences, in order to bring more thinking and analysis to colleagues and better guide clinical work.

Due to its unique anatomical location, there are many unresolved issues in the diagnosis and treatment of esophagogastric junction (EGJ) cancer, which is not only a hot topic of concern in various related disciplines, but also a controversial topic among scholars in both the East and the West academia. The 15 th International Gastric Cancer Congress in 2023 focuses on EGJ cancer, organi-zing consensus voting among experts from various disciplines on surgery, digestive endoscopy, and oncology issues before the conference. Multiple sub venues are also set up to discuss related issues. Meanwhile, Japanese scholars have proposed that the lymph node dissection process for EGJ cancer, modified based on the lymph node dissection therapeutic value index, is expected to be updated in the new version of the Japanese gastric cancer treatment guideline. The perioperative treatment of EGJ cancer highlights the differences in concepts and measures between the East and the West academia. Asian scholars focus on neoadjuvant chemotherapy based on DOS treatment plan, while European and American scholars hope to find the best perioperative treatment plan from the neoadjuvant chemoradiotherapy of CROSS research. However, the new adjuvant therapy regimen with the addition of immune checkpoint inhibitors has only established advantages in tumor regression and decline, and has not yet shown significant benefits in long-term survival. It cannot be denied that the diagnosis and treatment of EGJ cancer are still constantly exploring and advancing. In the future, we look forward to more new evidence-based medicine to provide ideas and expand our horizons for minimally invasive, precise, individualized, and comprehensive clinical diagnosis and treatment. Based on our understanding and insights into the differences and controversies between Eastern and Western scholars in the background, concepts, technologies, and treatment plans of EGJ cancer, the authors elaborate and analyze the hot issues of EGJ cancer diagnosis and treatment, combined with the latest content of the 2023 IGCC and other international conferences, in order to bring more thinking and analysis to colleagues and better guide clinical work.

Objective:To explore the effects of different concentrations of 2-hydroxybenzylamine(2-HOBA)on atherosclerosis and vascular smooth muscle cell senescence and the underlying mechanisms.Methods:Fourteen apolipoprotein E-deficient(ApoE-/-)mice were used to establish an atherosclerosis model and were divided into two groups(n=7)using the random number method: a high-fat diet(HD)group and a high-fat diet plus 2-HOBA(1 mg/ml)(HD+ HOBA)group.Pulse wave velocity was used to assess vascular stiffness and a treadmill was used to assess exercise endurance.Oil Red O staining was used to detect the size and number of atherosclerotic plaques.Masson staining was used to detect the morphology of collagen fibers and elastic fibers in the plaque, the size of the necrotic core area of the plaque, and the thickness of the fibrous cap.Mouse smooth muscle cells were treated with different concentrations of 2-HOBA(100 μmol/L, 250 μmol/L and 500 μmol/L)to establish an H 2O 2-induced senescence model.Senescence-associated β-galactosidase staining was used to detect cell senescence.Real-time quantitative polymerase chain reaction(RT-qPCR)was used to detect the mRNA expression levels of senescence-related secretory phenotype factors, and Western blot was used to detect the expression levels of senescence-related signaling proteins. Results:Compared with the HD group, the HD+ HOBA group showed that the area and number of aortic atherosclerotic plaques were decreased, and the atherosclerotic plaques were stabilized.In addition, compared with the HD group, vascular stiffness in the HD+ 2-HOBA group decreased by 26%(2.59±0.32 mm/ms vs.3.50±0.28 mm/ms), with a statistically significant difference( P<0.01), and exercise endurance increased by 62%[(143.74±24.25)m vs.(233.50±30.21)m, P<0.01], suggesting that 2-HOBA was able to improve aortic vascular stiffness and exercise endurance in mice.2-HOBA ameliorated H 2O 2-induced vascular smooth muscle cell senescence and decreased the mRNA levels of H 2O 2-induced senescence-associated secretory phenotype factors such as interleukin-1β, interleukin-6, tumor necrosis factor-α and monocyte chemoattractant protein-1.Meanwhile, 2-HOBA also inhibited the expression of p53 and p21, the key signaling factors of senescence. Conclusions:2-HOBA suppresses the development and progression of atherosclerosis through inhibiting oxidative stress-related p53/p21 signaling activation and ameliorating vascular smooth muscle cell senescence and the aging-related inflammatory phenotype.

Objective:To investigate relationships between serum growth differentiation factor 15 (GDF15) and glycolipid metabolism in patients with metabolic associated fatty liver disease (MAFLD).Methods:The current investigation was a cross-sectional study. A total of 333 patients from the Fengxian District Central Hospital were recruited into the study after physical examination from February 2020 to February 2021. There were 107 patients with MAFLD and type 2 diabetes mellitus (T2DM), including 54 males and 53 females with a mean age of (57±11) years. There were 65 patients with simple MAFLD only, including 32 men and 33 women with a mean age of (49±5) years. There were 105 patients with T2DM only, including 53 men and 52 women, with a mean age of (56±10) years. A control group of 56 people without MAFLD or diabetes,28 male, 28 female, mean age (48±6) years, was also included in the study. Serum GDF15 was measured via enzyme-linked immunosorbent assays. IBM SPSS 26.0 was used for statistical analysis. Logistic regression was used to evaluate relationships between GDF15 and metabolic abnormalities in MAFLD patients.Results:GDF15 progressively increased in the control [385 (296, 484) ng/L], nonobese MAFLD [388 (319, 435) ng/L], obese MAFLD [426 (354, 527) ng/L], T2DM [664 (483, 900) ng/L], and MAFLD+T2DM groups [770 (560, 1 074) ng/L]( H=113.82, P=0.001). There was no significant difference in serum GDF15 between the simple MAFLD [406 (339, 524) ng/L] and control group ( U=1 505.50, P=0.132). GDF15 was significantly higher in the MAFLD+T2DM group than in the T2DM-only group ( U=4 573.50, P=0.019). In logistic regression analysis increased GDF15 was associated with increased risks of simple MAFLD [odds ratio ( OR)=2.202], T2DM ( OR=29.656), and MAFLD+T2DM( OR=58.197). In patients with MAFLD, serum GDF15 was higher in the FIB4 index>1.45 group [773 (534, 1 162) ng/L] than in the FIB4 index<1.45 group [527 (389, 787) ng/L] ( U=1 709.50, P<0.001). Increased GDF15 was associated with an increased risk of advanced liver fibrosis ( OR=2.388). Conclusion:In patients with simple MAFLD, GDF15 level was not significantly higher than in the control group. In the T2DM-only group and the MAFLD+T2DM group GDF15 was significantly higher than in the control group. Increased serum GDF15 was associated with increased risk and severity of MAFLD complicated with abnormal glucose and lipid metabolism. High GDF15 increased the risk of advanced fibrosis in MAFLD patients.

Objective:To investigate the clinicopathological characteristics of eosionphilic Chromophobe renal cell carcinoma (eChRCC), and differences in morphology, immunophenotype and clinical prognosis betweeneChRCC, renal oncocytoma(RO) and classic Chromophobe renal cell carcinoma (cChRCC).Methods:The clinicopathologic data of 17 patients diagnosed as eChRCC from the Affiliated Hospital of Qingdao University (13 cases) and 971 Hospital of PLA Navy (4 cases) from October 2006 to February 2019 were collected. Immunohistochemical analysis was carried out to compare the immunophenotypes between 17 cases with ChRCC, 27 cases with RO and 30 cases with cChRCC.Resuls:Among the 17 patients, seven were males and ten were females, and the age ranged from 40 to 75 years (median 54 years). Clinically, 15 cases of 17 were found accidentally by physical examination. The tumor size ranged from 1.8 cm to 10.0 cm (average 5.7 cm) and the cut surface of 15 cases were solid, one case was solicl and cystic, and one was cystic. Most showed gray to red, and partially soft, gray to yellow appearances. Microscopically, most tumors presented solid growth pattern with vary number of alveolar structures (12 cases). Some were predominately characterized by cystic structure (3 cases), alveolar structure(1 case) and microcapsule structure (1 case). There were boundaries with varying degrees of clarity between tumor cells in 16 cases. The cytoplasm of tumor cells was eosinophilic and the nuclei were small round or irregular with focal perinuclear haloes in 14 cases. Large polygonal cells with light-stained cytoplasm appeared focally in 9 cases, and edematous areas with scarce tumor cells were found in 4 cases. Among 7 cases, 4 cases focally invaded peripheral renal parenchyma, 2 cases invaded adipose tissues outside the renal capsule, and 1 case presented invasion of renal sinus. Immunohistochemically, all cases were moderate to strong positive for EMA and claudin-7. CK7, CD117 and Ksp-cad were highly expressed with the expression rates of 12/17, 15/17, 14/17, respectively. Cyclin D1, AMACR, CD10, S100A1, and RCC were rarely expressed with the expression rates of 4/17, 3/17, 4/17, 1/17 and 1/17, respectively. On the contrary, all cases were negative for vimentin, CAⅨ, HMB45 and Melan A. The Ki-67 proliferation index of the 17 cases was 1%?5%. Follow-up data were available for all 17 patients from 7 to 154 months. Among them, 15 patients were alive without tumor recurrence or metastasis, one patient died of pulmonary metastasis after 31 months of surgery and one patient died of hepatic metastasis after 38 months of surgery.Conclusion:eChRCC has overlapping morphology and immunophenotype with RO. eChRCC is characterized by solid nest or alveolar structure, distinct border between tumor cells, perinuclear halos and lacking of interstitial looseness and edema. Scattered large polygonal cells with light-stained cytoplasm in tumor tissue play a significant role in the diagnosis of eChRCC. The positive expression of CK7, CD117, claudin-7 and Ksp-cad, and negative expression of cyclin D1, S100A1 are helpful to the diagnosis and differential diagnosis of eChRCC. The prognosis of eChRCC after complete surgical resection is excellent and few cases may have long-term metastasis. There is no significant difference in prognosis between eChRCC and cChRCC, but eChRCC shows better outcome than RO.

Gastric cancer is one of the malignant tumors with high morbidity and high mortality in China.Research has shown that viral infection is closely related to the occurrence of gastric cancer.EpsteinBarr virus-associated gastric cancer characterized by EB virus infection has been classified as a subtype of gastric cancer,whose epidemiology,pathogenesis,clinical and histopathologic features have been studied in detail.At the same time,oncolytic viruses reveal the inhibitory effect of the virus on tumors,and their ability to target and kill tumor cells is used in the treatment of some advanced cancers.This article will review the research advances about relevance to gastric cancer of several viruses that have been reported and the latest progress in anticancer mechanisms and combined therapies for oncolytic viruses.

Objective To investigate the morphological features and immunophenotypes of eosinophilic renal tumors in order to provide references for the differential diagnosis of this tumor.Methods A cohort of 75 cases of eosinophilic renal tumors were collected.The morphological features of the tumors were observed under microscope, and the immunophenotypes of the tumors were detected using tissue microarray and immunoshistochemistry.Results There were some overlaps between the different types of eosinophilic renal tumors in morphology, but each had its distinct characteristics.Immunohistochemically, renal oncocytoma ( RO) and eosinophilic chromophobe renal cell carcinoma ( ChRCC) shared some common immumophenotypes, except for the expression of CK7, with the expression rates of 2/19 in RO and 17/20 in eosinophilic ChRCC, respectively.Eosinophilic clear cell renal cell carcinoma mainly showed positive immunostaining for Vimentin and CAⅨ, whereas negative for CK7 and CD117 in most cases ( 10/15 ).AMACR was diffusely expressed in the majority of eosinophilic papillary renal cell carcinoma ( PRCC, 10/13).Furthermore, vimentin, CK7 and CD10 were positively expressed in eosinophilic PRCC with the expression rates of 8/13, 9/13 and 6/13, respectively;while CAⅨ, CD117 and TFE3 were all negatively expressed in eosinophilic PRCC.Epithelioid angiomyolipoma generally showed positive expression of vimentin,SMA and HMB45, but negative expression of CAⅨ and CK7.Vimentin, CD10, AMACR and TFE3 were strongly expressed in XP11.2 translocation renal cell carcinoma;on the contrary, CK7, CD117and HMB45 were not expressed in the majority of the tumor.Conclusion With full understanding of the morphology of different types of eosinophilic renal tumors, the immunostaining of vimentin, CAⅨ, CK7, CD10, AMACR, CD117, TFE3 and HMB45 could play a crucial role in the differential diagnosis of these tumors.