Objective To compare the efficacy and safety of transurethral blue laser vaporization of the prostate, transurethral resection of the prostate (TURP) or plasmakinetic resection of the prostate in the treatment of benign prostatic hyperplasia (BPH). Methods The domestic and foreign clinical studies on transurethral blue laser vaporization of the prostate (observation group), TURP or plasmakinetic resection of the prostate (control group) in the treatment of BPH during Jan. 2015 and Mar. 2025 were retrieved. The data were extracted with Cochrane systematic review method. The operation time, decrease in hemoglobin, bladder irrigation time, catheter indwelling time, total complication rate, retrograde ejaculation rate and urinary incontinence rate of the two groups were compared with RevMan 5.3.0 statistical software. Results A total of 5 Chinese studies involving 491 patients (248 in the observation group and 243 in the control group) were included in the Meta-analysis. Compared with the control group, the observation group had shorter operation time [MD=-20.80, 95%CI:-26.88—-14.72, P＜0.00001], less decrease in hemoglobin [MD=-10.61, 95%CI: -20.21—-1.01, P=0.03], shorter bladder irrigation time [MD=-17.85, 95%CI: -32.62—-3.09, P=0.002], shorter catheter indwelling time [MD=-1.71, 95%CI: -2.81—- 0.62, P=0.002], lower total complication rate [OR=0.11, 95%CI: 0.06—0.21, P＜0.00001], lower retrograde ejaculation rate [OR=0.05, 95%CI: 0.02—0.16, P＜0.00001] and lower urinary incontinence rate [OR=0.24, 95%CI: 0.07—0.79, P=0.02]. There were no significant differences in other complications between the two groups (P＞0.05). The international erectile function score (IIEF-5) of the observation group was significantly higher than that of the control group [MD=1.87, 95%CI:1.16—2.57, P＜0.00001]. There were no significant differences in international prostate symptom score (IPSS), maximum urinary flow rate (Qmax) and post-voiding residual (PVR) between the two groups (P＞0.05). Conclusion All three surgical procedures can effectively improve the lower urinary tract symptoms of BPH patients. Compared with TURP or plasmakinetic resection of the prostate, transurethral blue laser vaporization of the prostate has obvious advantages in terms of perioperative recovery, reduction of total complications, urinary incontinence and retrograde ejaculation rates, and preservation of sexual function.

Background: Whether there is a causal relationship between childhood obesity and increased risk of chronic kidney disease (CKD) remains controversial. This study sought to explore how body size in childhood and adulthood independently affects CKD risk in later life using a Mendelian randomization (MR) approach. Methods: Univariate and multivariate MR was used to estimate total and independent effects of body size exposures. Genetic associations with early-life and adult body size were obtained from a genome-wide association study of 453,169 participants in the U.K. Biobank, and genetic associations with CKD were obtained from the CKDGen and FinnGen consortia. Results: A larger genetically predicted early-life body size was associated with an increased risk of CKD (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.14 to 1.41; P= 1.70E-05) and increased blood urea nitrogen (BUN) levels (β=0.010; 95% CI, 0.005 to 0.021; P=0.001). However, the association between the impact of early-life body size on CKD (OR, 1.12; 95% CI, 0.95 to 1.31; P=0.173) and BUN level (β=0.001; 95% CI, –0.010 to 0.012;P= 0.853) did not remain statistically significant after adjustment for adult body size. Larger genetically predicted adult body size was associated with an increased risk of CKD (OR, 1.37; 95% CI, 1.21 to 1.54; P= 4.60E-07), decreased estimated glomerular filtration rate (β=–0.011; 95% CI, –0.017 to –0.006; P=5.79E-05), and increased BUN level (β= 0.010; 95% CI, 0.002 to 0.019; P= 0.018). Conclusion Our research indicates that the significant correlation between early-life body size and CKD risk is likely due to maintaining a large body size into adulthood.

Objective:To investigate the clinical effects and advantages of laparoscopic total mesorectal excision in the treatment of colorectal cancer.Methods:A total of 82 patients with colorectal cancer who received treatment at the Second Affiliated Hospital of Guizhou Medical University from January 2020 to January 2023 were selected for a prospective study. They were randomly assigned to two groups using a random number table, with 41 cases in each group. The control group underwent conventional laparotomy, while the observation group received laparoscopic total mesorectal excision. Clinical efficacy, clinical indicators, and immune function indicators were compared between the two groups.Results:The operation time for patients in the observation group was (1.98 ± 0.31) hours, the length of hospital stay was (8.32 ± 2.38) days, the recovery time for bowel function was (2.15 ± 0.34) days, and the intraoperative blood loss was (112.35 ± 12.66) mL, all of which were shorter and lower than those in the control group [(2.46 ± 0.32) hours, (14.52 ± 2.42) days, (3.25 ± 0.15) days, and (167.78 ± 12.35) mL, t = 6.90, 11.70, 18.95, 20.07, all P < 0.001). The short-term response rate in the observation group was higher than that in the control group ( χ2 = 4.10, P < 0.05). The immune function indicators in the observation group, including the CD4 +/CD8 + ratio (1.78 ± 0.54), immunoglobulin A [(3.87 ± 0.73) g/L], and immunoglobulin G [(11.83 ± 2.88) g/L], were all better than those in the control group [(1.36 ± 0.53), (1.78 ± 0.63) g/L, (6.37 ± 2.45) g/L, t = 3.55, 13.88, 9.25, all P < 0.001]. The incidence of complications in the observation group was 2.44% (1/41), which was significantly lower than that in the control group [19.51% (8/41), χ2 = 4.49, P < 0.05]. Conclusions:Laparoscopic total mesorectal excision for patients with colorectal cancer has significant advantages, including faster recovery, less bleeding, and fewer complications, making it more superior to conventional laparotomy.

Objective:To investigate the changes of lymphocyte to monocyte ratio (LMR), matrix metalloproteinase-2 (MMP-2), hypoxia inducible factor-1 (HIF-1 α) in patients with breast cancer undergoing surgical resection before and after radiotherapy and their relationship with short-term prognosis.Methods:106 patients with breast cancer who underwent surgical resection and radiotherapy from Jan. 2021 to Jan. 2024 were analyzed as the study subjects. All patients received the same scheme of radiotherapy. The changes of LMR, MMP-2, and HIF-1 α levels at different time points before and after radiotherapy were recorded, and the clinical efficacy of the two groups of patients after radiotherapy was compared. According to the short-term efficacy after radiotherapy, the patients were divided into 31 patients with poor efficacy (progression+deterioration) and 75 patients with good efficacy (complete remission+effective remission+partial remission). The basic clinical data of the two groups were compared. The binary regression analysis was used to analyze the factors that affect the short-term prognosis of patients with breast cancer who had undergone surgery after radiotherapy. A risk prediction model was constructed, and the ROC analysis model was used to predict the value.Result:Compared with before radiotherapy, LMR decreased and MMP-2 and HIF-1 α increased after one week of radiotherapy ( t=2.68, -2.76, -1.96, P=0.008, 0.006, 0.052); After one course of radiotherapy and three courses of radiotherapy, LMR increased and MMP-2 and HIF-1 α decreased ( t=-3.02, 5.14, 5.86, all P<0.05; t=-7.95, 19.80, 21.36, all P<0.001). Low expression of LMR, high expression of MMP-2 and high expression of HIF-1 α are independent risk factors for poor short-term prognosis of breast cancer patients after radiotherapy. LMR、MMP-2、HIF-1α、The prediction model can predict the poor short-term prognosis of breast cancer patients after radiotherapy. The AUC values were 0.780 (95% CI: 0.674~0.887), 0.759 (95% CI: 0.659~0.859), 0.840 (95% CI: 0.748~0.931), and 0.887 (95% CI: 0.808~0.965), respectively. When taking the cut-off values, the sensitivities were 0.853, 0.903, 0.677, and 0.920, and the specificities were 0.677, 0.533, 0.933, and 0.774, respectively. Bootstrap method (B=1000) was used to perform internal validation on the prediction model of poor short-term prognosis of breast cancer patients after radiotherapy. The results showed that the prediction curve after deviation correction was close to the ideal state, and the C-index reached 0.774, indicating that the model had strong prediction ability. In addition, the decision curve of the model shows that the net profit is always positive and better than the two invalid reference lines within the threshold probability range of 0.1 to 1.0. Conclusion:LMR of postoperative radiotherapy patients with breast cancer decreased first and then increased, MMP-2 and HIF-1 α increased first and then decreased, all of which are independent predictors of short-term prognosis. The combined model has a significant predictive effect on poor efficacy and can be used as an important reference for clinical prognosis evaluation.

In proton therapy,prompt gamma-ray imaging is considered as one of the most promising methods for assessing proton beam range.Prompt gamma-ray imaging detector evaluates the proton beam range based on the prompt gamma-ray distribution obtained by the prompt gamma-ray imaging system,which enables high-precision measurement of the proton beam range.Herein a proton beam range verification algorithm is designed for the newly developed prototype of the range verification detector(pixelated prompt gamma-ray imaging detector),which verifies the range estimation accuracy of the prototype for different phantoms and different energies of homogeneous media through Monte Carlo simulation.The results show that the accuracy of the proton beam range verification algorithm is within 0.5 mm of the safety margin error of the Bragg peak,and the measurement accuracy is significantly improved with the increase of the number of protons,indicating that the prototype algorithm is feasible for proton beam range verification.

Spinal trauma, primarily caused by high-energy external forces, predominantly manifest as vertebral fracture and spinal cord injury. These conditions are characterized by spinal pain, restricted mobility, and sensory and autonomic dysfunction, significantly compromising patients′ quality of life and life expectancy. Current diagnostic and therapeutic practices for spinal fracture remain susceptible to subjective clinical experience, resulting in misdiagnosis, underdiagnosis, and imprecise surgical execution. Similarly, the therapeutic efficacy of spinal cord injury rehabilitation is frequently limited by a lack of personalized treatment protocols. The growing integration of artificial intelligence (AI) in medicine presents novel opportunities to overcome these obstacles. By excelling in image interpretation, data analytics, clinical decision support, and personalized rehabilitation planning, AI has emerged as a prominent focus of modern research. To this end, the authors reviewed the research progress in the application of AI in the diagnosis and treatment of spinal fracture and rehabilitation of spinal cord injury, providing a reference for AI-assisted precision diagnosis and treatment of vertebral fracture and rehabilitation of spinal cord injury.

The treatment of castration-resistant prostate cancer (CRPC) faces major challenges characterized by acquired resistance to androgen deprivation therapy (ADT) and consequent aggressive tumor progression. In this context, ubiquitination and deubiquitination modifications, as key protein post-translational modifications, play a crucial role in prostate tumourigenesis and progression. In recent years, the regulation of ubiquitination and deubiquitination in CRPC by the androgen receptor signalling pathway and the tumour microenvironment has received extensive attention, and these dynamic regulatory processes have become important molecular events driving CRPC progression by affecting the proliferation, metastasis, and immune escape ability of tumour cells. Therefore, in-depth analysis of the mechanisms of ubiquitination and deubiquitination in CRPC will help develop new therapeutic targets and provide more therapeutic options for patients.

Objective To explore the clinical characteristics and speech recognition capabilities characteristics of patients with different subtypes of sudden deafness.Methods 280 patients with unilateral sudden deafness who visited the First Affiliated Hospital of Wenzhou Medical University from January 2022 to October 2024 were randomly selected.They were grouped based on the type of pure-tone hearing threshold curve and the degree of hearing loss before treatment(with 76 cases of ascending type,91 cases of descending type and 113 cases of flat type).The general conditions,clinical incidences,maximum speech recognition rates,and efficacy data of each group were compared.Results When comparing clinical symptoms regarding disease course,degree of hearing loss,tinnitus,ear tightness,dizziness,etc.,and therapeutic effects,the ascending-type hearing loss was characterized by a mild degree,a high incidence of ear tightness,and a favorable prognosis.The flat-type has a short course of illness,a high incidence of tinnitus,and severe hearing loss.The descending-type presented with a long disease course and a poor prognosis.These differences were statistically significant(P＜0.05).In the comparison of average pure-tone hearing threshold value at speech frequencies and speech recognition rate,the average hearing threshold value of the flat-type at speech frequencies was higher than that of the other two types,and its speech recognition rate was lower,with statistical significance(P＜0.05).Conclusion Patients with different subtypes of sudden deafness exhibit distinct characteristics in terms of onset and prognosis.Quantifying the speech recognition rates of sudden deafness patients with different subtypes and degrees of hearing loss can serve as a reference for clinical diagnosis and treatment.This is of great significance for enhancing the accuracy of clinical diagnosis of sudden deafness,formulating personalized treatment plans,and improving patient prognosis.

Objective To observe the value of 18F-prostate specific membrane antigen(PSMA)-1007 PET/MRI for diagnosing seminal vesicle invasion(SVI)of prostatic cancer(PCa).Methods Totally 92 male patients with PCa who underwent radical prostatectomy were retrospectively enrolled and divided into positive group(n=26)and negative group(n=66)based on postoperative pathology showed SVI or not.PET/MRI parameters,including maximum standard uptake value(SUVmax),minimum apparent diffusion coefficient(ADCmin),mean apparent diffusion coefficient(ADCmean),SUVmax/ADCmin,SUVmax/ADCmean,PSMA tumor volume(PSMA-TV)and total lesion PSMA(TL-PSMA)were compared between groups.The receiver operating characteristic curve was drawn,and the efficacy of each parameter for diagnosing SVI was analyzed.Results Among 92 cases of PCa,18F-PSMA-1007 PET/MRI showed 30 cases with SVI and 62 cases without SVI,with accuracy of 73.91％,sensitivity of 61.54％,specificity of 78.79％,positive predictive value of 53.33％and negative predictive value of 83.87％.Significant differences of ADCmin,PSMA-TV and TL-PSMA were found between groups(all P＜0.05).The area under the curve(AUC)of SUVmax,ADCmin,ADCmean,SUVmax/ADCmin,SUVmax/ADCmean,PSMA-TV and TL-PSMA for diagnosing SVI of PCa was 0.554,0.341,0.396,0.603,0.581,0.755 and 0.705,respectively.The AUC of PSMA-TV was higher than other parameters except for TL-PSMA,with sensitivity of 84.60％and specificity of 56.10％.Conclusion 18 F-PSMA-1007 PET/MRI was helpful for diagnosing SVI of PCa.

In order to improve the teaching quality for the interns in neurosurgery,PBL combined with CBL was intro-duced into the clinical teaching,under the teachers'guide,knowledge and experience was summarized through collecting prob-lems,combinig with cases,consulting literature and group discussion,etc.The teaching effect was evaluated in terms of ques-tionnaire survey,theory test and clinical skills examination,the results showed positive rate for the new teaching mode was 91％,improvement of clinical thinking approval rate 97.4％,excellence rate of theory test 96.2％,excellence rate of clinical skill exam-ination 93.6％.This teaching mode turned the interns into main subject of learning,and it had raised their interests and enthusi-asm,cultivated their clinical thinking ability to find problem and practical ability to solve problem,making them more qualified for the diagnosis and treatment of diseases.