Objective To explore the efficacy and safety of blue laser vaporization in the treatment of large-volume (＞80 mL) benign prostatic hyperplasia (BPH). Methods A retrospective analysis was conducted on the clinical data of 149 BPH patients with prostate volume＞80 mL who underwent blue laser vaporization at our hospital during Aug. 2023 and Aug. 2025. The 1-month postoperative maximum urinary flow rate (Qmax) and international prostate symptom score (IPSS), operation time, postoperative hemoglobin drop, bladder irrigation volume, catheter indwelling time, and incidence of postoperative complications were recorded and analyzed. Results All operations were successfully completed, without conversion to other approaches. The operation time was (41.47±11.05) minutes, postoperative hemoglobin drop (2.78±1.19) g/L, bladder irrigation volume (9.97±1.49) bags, and catheter indwelling time (3.30±1.85) days. One month after surgery, the Qmax was significantly higher than the preoperative value [(20.19±3.39) mL/s vs. (2.39±2.17) mL/s], while the IPSS was significantly lower [(4.46±0.87) vs. (27.69±2.06)], with statistically significant differences (P＜0.001). Postoperative complications included 1 case of incontinence (0.67%), 2 cases of urethral stricture/bladder neck contracture (1.34%), and 1 case of secondary bleeding (0.67%), all of which improved with symptomatic treatment. Conclusion Blue laser vaporization is effective for treating large-volume BPH, with advantages such as minimal bleeding risk, short operation time, fast recovery and safety.

YTHDF2 is a key m6A RNA modification"reader"that plays a crucial role in cell biological processes and tumor development.This review deeply explores the biological role of YTHDF2 and the advances in its application in tumors.The YTHDF2 structures are divided into mRNA procsomes and YTH domains,which recognize and bind m6A modified RNA molecules.It plays a biological role by promoting mRNA degradation,regu-lating cell signaling pathways and metabolism,and can regulate macrophage function and maintain an immunosup-pressive state in the tumor microenvironment.YTHDF2 has the potential to serve as diagnostic markers,therapeu-tic targets and prognostic evaluation biomarkers in different tumors,but currently relevant studies are insufficient in sample size,molecular mechanism and clinical application.In the future,research can be conducted on compre-hensive clinical research,in-depth analysis of molecular mechanisms,and research and development of optimized treatment strategies.

Objective:To observe effectiveness of combining diffusion tensor imaging (DTI) with motor evoked potentials (MEPs) in evaluating the upper limb motor functioning of stroke survivors.Methods:Thirty-seven stroke survivors with upper limb motor dysfunction were selected. At the 4th, 12th and 24th week after their onset, each was were assessed using Fugl-Meyer Upper Limb (FMA-UE) scoring, the National Institutes of Health stroke scale (NIHSS), the modified Rankin Scale (mRS), the Barthel Index (BI) and hemiplegic hand function classification. DTI was also applied and MEPs were measured. The patients were divided into an MEP positive group and an MEP negative group according to the existence of the MEP waveform. The DTI and MEP parameters were correlated with the FMA-UE scores, linear regressions were evaluated and a receiver operating characteristics curve was prepared to estimate the utility of DTI in predicting hand function. The sensitivity and specificity of MEPs in predicting hand function recovery were evaluated.Results:The asymmetry index (FAa) of the average anisotropy score of the posterior limb of the internal capsule and the FAa of the cerebral peduncle were both significantly correlated with the FMA-UE scores at the 12th and 24th weeks. The best cut-off points for predicting functional recovery of a patient′s hand were 0.155 for the FAa of the posterior limb of the internal capsule and 0.145 for the cerebral peduncle. Among the 37 patients, the MEPs of 8 (the MEP positive group) could be extracted, and their hand functions recovered completely. The sensitivity of the MEPs in predicting the complete recovery of hand function was 80% with 100% specificity. The linear regression analysis showed 77% prediction accuracy for the FAa and MEPs of the cerebral peduncle for upper limb motor function at the 24th week after onset. In the MEP negative group, two patients completely recovered their hand function, with one′s FAa less than 0.145, and the other′s more than 0.145. When the MEP was negative, the sensitivity of DTI in predicting the recovery of hand function was 50% with 81.5% specificity.Conclusions:DTI combined with MEPs can be used as an index to evaluate the prognosis of upper limb motor function in stroke patients.

Objective:To observe effectiveness of combining diffusion tensor imaging (DTI) with motor evoked potentials (MEPs) in evaluating the upper limb motor functioning of stroke survivors.Methods:Thirty-seven stroke survivors with upper limb motor dysfunction were selected. At the 4th, 12th and 24th week after their onset, each was were assessed using Fugl-Meyer Upper Limb (FMA-UE) scoring, the National Institutes of Health stroke scale (NIHSS), the modified Rankin Scale (mRS), the Barthel Index (BI) and hemiplegic hand function classification. DTI was also applied and MEPs were measured. The patients were divided into an MEP positive group and an MEP negative group according to the existence of the MEP waveform. The DTI and MEP parameters were correlated with the FMA-UE scores, linear regressions were evaluated and a receiver operating characteristics curve was prepared to estimate the utility of DTI in predicting hand function. The sensitivity and specificity of MEPs in predicting hand function recovery were evaluated.Results:The asymmetry index (FAa) of the average anisotropy score of the posterior limb of the internal capsule and the FAa of the cerebral peduncle were both significantly correlated with the FMA-UE scores at the 12th and 24th weeks. The best cut-off points for predicting functional recovery of a patient′s hand were 0.155 for the FAa of the posterior limb of the internal capsule and 0.145 for the cerebral peduncle. Among the 37 patients, the MEPs of 8 (the MEP positive group) could be extracted, and their hand functions recovered completely. The sensitivity of the MEPs in predicting the complete recovery of hand function was 80% with 100% specificity. The linear regression analysis showed 77% prediction accuracy for the FAa and MEPs of the cerebral peduncle for upper limb motor function at the 24th week after onset. In the MEP negative group, two patients completely recovered their hand function, with one′s FAa less than 0.145, and the other′s more than 0.145. When the MEP was negative, the sensitivity of DTI in predicting the recovery of hand function was 50% with 81.5% specificity.Conclusions:DTI combined with MEPs can be used as an index to evaluate the prognosis of upper limb motor function in stroke patients.

YTHDF2 is a key m6A RNA modification"reader"that plays a crucial role in cell biological processes and tumor development.This review deeply explores the biological role of YTHDF2 and the advances in its application in tumors.The YTHDF2 structures are divided into mRNA procsomes and YTH domains,which recognize and bind m6A modified RNA molecules.It plays a biological role by promoting mRNA degradation,regu-lating cell signaling pathways and metabolism,and can regulate macrophage function and maintain an immunosup-pressive state in the tumor microenvironment.YTHDF2 has the potential to serve as diagnostic markers,therapeu-tic targets and prognostic evaluation biomarkers in different tumors,but currently relevant studies are insufficient in sample size,molecular mechanism and clinical application.In the future,research can be conducted on compre-hensive clinical research,in-depth analysis of molecular mechanisms,and research and development of optimized treatment strategies.

Objective:To retrospectively analyze and summarize the clinical experience and therapeutic effect of anterograde Needle-perc combined with RIRS, namely N+ R (Needle perc + RIRS) technique in the treatment of complex calyceal diverticular stone.Methods:Retrospective analysis of 23 cases of complex renal caliceal diverticulum stones admitted to our hospital from January 2020 to December 2022. The complex factors mainly include the invisible cervical orifice of diverticulum, large stone volume, and special anatomical location, which makes single RIRS or PCNL treatment difficult or unsuccessful. There were 14 males and 9 females with an average age of (42.3±6.1) years. Three cases were upper calyceal diverticular stone, average size was (0.9±0.2)cm. Nine patients had diverticular stone in the middle posterior calyx, and the average size was (1.2±0.3)cm. The average size of four diverticular stone was (1.8±0.2)cm in the anterior middle calyx. Seven patients had diverticular stone with an average size of (1.3±0.1)cm in lower calyx. Among them, 12 patients underwent RIRS which were difficult or stone undiscovered, and 3 patients underwent PCNL and the operation was terminated due to failure of channel establishment. In our center, oblique supine lithotomy position (male) or prone split-leg position (female) was adopted, and the combined treatment of Needle-perc and RIRS was performed. Needle-perc puncture was completed under the guidance of full ultrasound. During the operation, methylene blue reagent or mutual guidance of two endoscopes was used to find the diverticulum neck and expand the outlet with holmium laser incision. Depending on the size and location of the stones, a single Needle-perc laser lithotripsy combined with stone removal in flexible ureteroscope was used, or dual lasers were be used simultaneously for stone removal under double endoscopes. The first stage stone free rate, operation time, hemoglobin decrease, complications, postoperative hospital stay and other conditions were analyzed.Results:All the 23 operations were completed successfully. The stone free rate within 48 hours and one month after surgery was 78.2% and 100.0% respectively. The average operation time was (61.5±12.2)min. The mean postoperative hospital stay was (2.8±0.6) days. The mean decrease of hemoglobin was (3.6±0.4)g/L. Three patients had fever and one patient had renal subcapsular effusion. After anti-inflammatory and symptomatic treatment, the patient was discharged. There was no incidence of Clavien-Dindo≥Ⅱcomplications such as blood transfusion, abdominal organ injury or urosepsis.Conclusions:Treatment of complex renal caliceal diverticulum stones using N+ R technique of anterograde needle-perc combined with RIRS can effectively improve the success rate of first-stage surgery. Overall, it is safe, efficient and feasible with the advantages of high stone free rate, lower damage, and few postoperative complications.

Objective To construct and validate a clinical prediction model for delayed extubation undergoing non-emergency major surgery based on the random forest algorithm.Methods Clinical data of 7 528 patients undergoing non-emergency major surgery under general anesthesia from January 2018 to De-cember 2022 were retrospectively collected.The patients were divided into two groups according to whether extubation was performed within 2 hours after surgery:non-delayed extubation group(≤2 hours)and de-layed extubation group(＞2 hours).All the patients were randomly divided into a training set and a valida-tion set in a ratio of 7 ∶ 3.The predictive factors for delayed extubation after surgery were screened through LASSO regression and Logistic regression.The random forest model was established and verified by random forest algorithm.Results There were 123 patients(1.6%)experienced delayed extubation after surgery.ASA physical status,department,intraoperative use of flurbiprofen ester,dexmedetomidine,glucocorticoid,hypocalcemia,severe anemia,intraoperative blood transfusion,and airway spasm were identified as inde-pendent predictive factors for delayed extubation.The area under curve(AUC)value of the random forest prediction model in the validation set was0.751(95%CI0.742-0.778),and the sensitivity was98.1%,and the specificity was 41.9%.Conclusion The predictive model of delayed extubation undergoing non-e-mergency major surgery based on random forest algorithm has a good predictive value,which may be helpful to prevent delayed extubation undergoing non-emergency major surgery.

Non-pharmaceutical interventions（NPIs）against the COVID-19 restricted the spread of respiratory infectious diseases.After the lifting of NPIs for the COVID-19 pandemic，a resurgence of respiratory syncytial virus（RSV）has been observed in multiple countries and regions globally，exhibiting epidemiological and clinical characteristics distinct from previous RSV epidemic during the pre-COVID-19 era.This resurgence poses new challenges for clinical management of RSV infection.This review elucidates the changes in epidemiological and clinical features of pediatric RSV epidemic after the lifting of NPIs，potential mechanisms underlying these changes，as well as advances in RSV prevention and control，aiming to enhance the understanding of pediatric RSV infection following the lifting of NPIs，and provides reference for further optimization of strategies in the prevention，control，and clinical management of pediatric RSV infection.

T-cell immunoglobulin and immunoreceptor tyrosine-based inhibitory motif domain(TIGIT)is a transmembrane glycoprotein expressed on the surface of immune cells.TIGIT expression is up-regulated in blad-der cancer and will have an important impact on bladder cancer development and poor prognosis.Immunotherapy that blocks TIGIT signaling is expected to improve the prognosis of bladder cancer.With further research,TIGIT is likely to become a target for bladder cancer diagnosis and treatment.This article reviews the structure,immuno-modulatory effect and the research progress of TIGIT in bladder cancer.

Objective To investigate the relationship between coronary artery plaque AI quantitative parameter and FFR-CT in coronary computed tomography angiography.Methods A total of 84 patients suspected of having CAD[52 males and 32 females,aged 27 to 81 years with a mean age of(58.1±11.9)years]were enrolled in this study.All patients underwent coronary computed tomography angiography.The CCTA data was processed using shukun(SK)software for labeling and analysis of the coronary arteries,as well as obtaining quantitative parameters of coronary artery plaque AI and corresponding FFR-CT values.The quantitative parameters included plaque length,total volume,minimum lumen area(MLA),minimal lumen degree(MLD),lipid composition volume and proportion,fibrous-lipid composition volume and proportion,fibrous composition volume and proportion,calcified composition volume and proportion.Coronary artery hemodynamic abnormality or myocardial ischemia was defined as an FFR-CT value≤0.8.Correlational analysis was performed to evaluate the association between AI plaque quantitative param-eters and FFR-CT values.Univariate and multivariate binary logistic regression analyses were conducted to identify independent risk factors for predicting FFR-CT≤0.8.The predictive performance of the model based on AI plaque quantitative parameters was assessed using receiver operating characteristic(ROC)curve analysis and calculation of the area under the curve(AUC).Sensitivities,specificities,diagnostic test accuracy rates were also calculated.Results The predominant symptoms observed in the cohort of 84 patients were chest pain(n=39,46.4%)and distress(n=27,32.1%).Spearman analysis results revealed a weak positive correlation between FFR-CT and MLA(r=0.49,P<0.0001),while weak negative correlations were found for plaque length,total volume,lipid composition volume,fibrous-lipid composition volume,fibrous composition volume,and calcified composition volume(r=-0.44,-0.56,-0.40,-0.36,-0.42,-0.40;all P<0.05).Additionally,MLD exhibited a moderate negative correlation with FFR-CT(r=-0.60,P<0.0001).In the univariate binary logistic regression analysis,several variables including plaque length,total volume,MLA,MLD,lipid composition volume,fibrous-lipid composition volume,fibrous composition volume,and calcified composition volume were found to be independently associated with FFR-CT≤0.8(All P<0.05).The adjusted multivariate binary logistic regression analysis model revealed that MLD was the sole independent predictor(OR=1.082,95%CI:1.034～1.133,P=0.001).The logistics re-gression model expression was logit(P)=0.079X1-4.052,where X1 represents the value of MLD and achieved a predictive accuracy of 85.2%.The ROC AUC of plaque length,total volume,MLA,MLD,lipid composition vol-ume,fibrous-lipid composition volume,fibrous composition volume and calcified composition volume were 0.796,0.886,0.711,0.754 and 0.698 respectively,and the coresponding sensitivities and specificities were 47.83%,73.91%,73.90%,52.17%,60.87%and 92.11%,73.68%,60.53%,84.21%,89.47%.The five in-dexes combined diagnostic model possessed the largest AUC of 0.906,and 73.91%,71.05%of sensitivity and specificity.Conclusion The AI quantitative parameters of coronary artery plaque exhibited varying degrees of correlation with FFR-CT,while MLD emerged as the sole independent predictor of FFR-CT≤0.8,demonstrating high diagnostic efficiency.