Methods: This retrospective study analyzed 32 consecutive IDS patients who underwent UEDD surgery. Clinical features, laboratory data (erythrocyte sedimentation rate and C-reactive protein), and treatment outcomes were analyzed. Results: Definite microorganisms were identified in 27 patients (84.3%), with 24 (88.9%) meeting cure criteria. The cure rate was significantly higher in the detected pathogen group compared to the undetected pathogen group (88.9% vs. 80%; χ²=19.36, p<0.0001). Metagenomic next generation sequencing (mNGS) provided faster diagnosis (41.72±6.81 hours) compared to tissue culture (95.74±35.47 hours, p<0.05). The predominant causative pathogen was Mycobacterium tuberculosis, followed by Staphylococcus aureus. Significant improvements were observed in Visual Analog Scale pain scores, from a mean of 7.9 preoperatively to 1.06 at 1 year postoperatively. The Oswestry Disability Index revealed a similar trend, showing significant improvement (p<0.05). Conclusions UEDD is a viable alternative to traditional open surgery for managing IDS in high-risk patients. UEDD offers a dual therapeutic-diagnostic advantage during the initial admission phase, enabling simultaneous debridement, neurological decompression, and targeted biopsy in a single intervention. Compared with traditional tissue culture, mNGS enables rapid microbiological diagnosis and extensive pathogen coverage.

Methods: This retrospective study analyzed 32 consecutive IDS patients who underwent UEDD surgery. Clinical features, laboratory data (erythrocyte sedimentation rate and C-reactive protein), and treatment outcomes were analyzed. Results: Definite microorganisms were identified in 27 patients (84.3%), with 24 (88.9%) meeting cure criteria. The cure rate was significantly higher in the detected pathogen group compared to the undetected pathogen group (88.9% vs. 80%; χ²=19.36, p<0.0001). Metagenomic next generation sequencing (mNGS) provided faster diagnosis (41.72±6.81 hours) compared to tissue culture (95.74±35.47 hours, p<0.05). The predominant causative pathogen was Mycobacterium tuberculosis, followed by Staphylococcus aureus. Significant improvements were observed in Visual Analog Scale pain scores, from a mean of 7.9 preoperatively to 1.06 at 1 year postoperatively. The Oswestry Disability Index revealed a similar trend, showing significant improvement (p<0.05). Conclusions UEDD is a viable alternative to traditional open surgery for managing IDS in high-risk patients. UEDD offers a dual therapeutic-diagnostic advantage during the initial admission phase, enabling simultaneous debridement, neurological decompression, and targeted biopsy in a single intervention. Compared with traditional tissue culture, mNGS enables rapid microbiological diagnosis and extensive pathogen coverage.

OBJECTIVE To further standardize the dispensing management standard of intravenous infusion drugs for clinical trials in pharmacy intravenous admixture services （PIVAS）， and provide reference for medical institutions to provide high-quality pharmaceutical services. METHODS Initiated by PIVAS Group， Hospital Pharmacy Professional Committee， Shanghai Pharmaceutical Association， jointly led by Longhua Hospital， Shanghai University of Traditional Chinese Medicine and Shanghai Geriatric Medical Center， a writing group was established by PIVAS experts from multiple medical institutions to discuss the basic requirements and dispensing process of intravenous infusion drugs for clinical trials in PIVAS. The experts from the leading unit sorted out， summarized， analyzed， fed back and revised the opinions， and finally reached Expert Consensus on Dispensing Management of Intravenous Infusion Drugs for Clinical Trials in PIVAS. RESULTS & CONCLUSIONS The main contents of this consensus include information management， operation process， fund management and document management of intravenous infusion drugs for clinical trials in PIVAS. This consensus establishes a more standardized model for dispensing management of intravenous infusion drugs for clinical trials in PIVAS， by standardizing clinical trail drug management operational procedures， accurately recording and preserving drug-related information， with the aim of achieving standardized and meticulous management of PIVAS’s receipt of clinical trial drugs.

Methods: This retrospective study analyzed 32 consecutive IDS patients who underwent UEDD surgery. Clinical features, laboratory data (erythrocyte sedimentation rate and C-reactive protein), and treatment outcomes were analyzed. Results: Definite microorganisms were identified in 27 patients (84.3%), with 24 (88.9%) meeting cure criteria. The cure rate was significantly higher in the detected pathogen group compared to the undetected pathogen group (88.9% vs. 80%; χ²=19.36, p<0.0001). Metagenomic next generation sequencing (mNGS) provided faster diagnosis (41.72±6.81 hours) compared to tissue culture (95.74±35.47 hours, p<0.05). The predominant causative pathogen was Mycobacterium tuberculosis, followed by Staphylococcus aureus. Significant improvements were observed in Visual Analog Scale pain scores, from a mean of 7.9 preoperatively to 1.06 at 1 year postoperatively. The Oswestry Disability Index revealed a similar trend, showing significant improvement (p<0.05). Conclusions UEDD is a viable alternative to traditional open surgery for managing IDS in high-risk patients. UEDD offers a dual therapeutic-diagnostic advantage during the initial admission phase, enabling simultaneous debridement, neurological decompression, and targeted biopsy in a single intervention. Compared with traditional tissue culture, mNGS enables rapid microbiological diagnosis and extensive pathogen coverage.

Objective: To summarize the long-term efficacy and safety of sacral neuromodulation (SNM) in treating refractory interstitial cystitis/bladder pain syndrome (IC/BPS)，so as to provide clinical evidence for this therapeutic approach. Methods: This study retrospectively analyzed the data of 27 patients with refractory IC/BPS treated at our hospital during Jan.2015 and Dec.2021.All patients underwent SNM Ⅱ.The therapeutic effects were evaluated with Global Response Assessment (GRA).The preoperative and postoperative daily urinary frequency，nocturia frequency，functional bladder capacity，O'Leary-Sant score，pelvic pain，urgency and frequency (PUF) score，quality of life (QoL) score，and visual analogue scale (VAS) score were compared. Results: During the follow-up of (55.55±16.33) months，12 patients showed no symptom relief (GRA≤4)，while 15 experienced symptom relief (GRA>4)，resulting in an efficacy rate of 55.56% (15/27).The average daily urination frequency decreased from (28.74±13.84) to (24.74±16.33) times,the O'Leary-Sant score decreased from (30.19±5.35) to (25.63±9.34)，PUF score decreased from (25.63±5.34) to (22.04±8.29)，QoL score decreased from (5.67±0.55) to (4.33±1.57)，and VAS score decreased from (8.04±1.91) to (5.33±3.09)，the differences were statistically significant (P<0.05). No complications such as incision infections or pain at the implant site were observed. Conclusion: SNM is safe and effective for refractory IC/BPS，but there is a risk of long-term failure.Therefore，patients should be discreetly selected.

Objective To evaluate the value of postoperative radiotherapy (PORT) in patients with stage ⅢA-N2 non-small cell lung cancer who received complete resection and chemotherapy. Methods Patients with stage ⅢA-N2 non-small cell lung cancer who received complete resection and chemotherapy were chosen from the SEER Research Plus Database [17 Registries, November 2012 Submission (2000-2019)]. The patients were divided into a PORT group and a non-PORT group according to whether the PORT was used. To balance baseline characteristics between non-PORT and PORT groups, R software was used to conduct a propensity score matching (PSM) with a ratio of 1 : 1 and a matching tolerance of 0.01. Both the Cox regression analysis and Kaplan-Meier survival analysis were conducted to evaluate the value of PORT in terms of overall survival (OS) and disease-specific survival (DSS). Results In total, 2468 patients with stage ⅢA-N2 non-small cell lung cancer were enrolled, including 1078 males and 1390 females with a median age of 65 (58-71) years. There were 1336 patients in the PORT group, and 1132 patients in the non-PORT group. Cox regression analysis showed that PORT was not significantly associated with OS (multivariate analysis: HR=1.051, 95%CI 0.949-1.164, P=0.338) and DSS (multivariate analysis: HR=1.094, 95%CI 0.976-1.225, P=0.123). No statistical difference was found in the OS or DSS between non-PORT group and PORT group after PSM analysis (P＞0.05). Conclusion PORT does not have a survival benefit for patients with stage ⅢA-N2 non-small cell lung cancer who received complete resection and chemotherapy.

Objective:To investigate the efficacy and safety of laparoscopic subtotal cystectomy with augmentation ileocystoplasty(SC-CP) and laparoscopic total cystectomy with ileal conduit (TC-IC) for refractory interstitial cystitis/bladder pain syndrome (IC/BPS).Methods:Clinical data of 39 patients diagnosed with refractory IC/BPS treated with SC-CP and TC-IC in Beijing Chaoyang Hospital of Capital Medical University from January 2008 to December 2023 were retrospectively analyzed. All patients were female, and had unsatisfactory results after more than three types of conservative + minimally invasive treatments. There were 12 patients in the SC-CP group and 27 patients in the TC-IC group. In the SC-CP group, the patients had the age of (50.8±14.4) years old, preoperative medical history of (4.7±2.5) years, daytime voiding frequency of 25.0 (18.5, 45.0) times/day, nocturia frequency of 12.5 (10.0, 15.0) times/night, functional bladder capacity of 40.0(18.5, 47.5) ml, and anesthetized bladder capacity of 150.0 (150.0, 195.0) ml. The patients in TC-IC group had the age of (60.3±8.0) years old, preoperative medical history of (6.5±3.6) years, daytime voiding frequency of 30.0 (20.0, 40.0) times/day, nocturia frequency of 10.0 (8.0, 15.0) times/night, functional bladder capacity of 50.0(30.0, 60.0) ml, and anesthetized bladder capacity of 200.0 (150.0, 330.0) ml. SC-CP was performed to resect the bladder wall beyond the trigone and bladder neck, and bladder enlargement was performed by using an ileal segment anastomosed to the remaining bladder. TC-IC was performed to resect the entire bladder, and a segment of free ileum with a mesentery was taken, which was closed proximally and then anastomosed to the ureters on both sides, and a cutaneous ureterostomy was performed at the distal end. The patients in the two groups were followed up after the operation, and the intraoperative conditions and postoperative complications were recorded. The visual analogue scale (VAS) score, quality of life (QOL) score, O′Leary-Sant score, pelvic pain and urgency/ frequency patient symptom scale (PUF) score were recorded before and after the operation, and the differences were compared to evaluate the improvement of symptoms.Results:In the SC-CP group, the operation time was 240.0 (202.8, 293.8) min, the intraoperative hemorrhage was 50.0 (27.5, 50.0) ml, and the postoperative hospital stay was 12.0 (7.3, 16.5) days. In the TC-IC group, the operation time was 300.0 (240.0, 329.0) min, the intraoperative hemorrhage was 100.0 (50.0, 100.0) ml, and the postoperative hospital stay was 10.0 (8.0, 12.0) days. The median follow-up time of 39 patients was 31.0(10.0, 70.0) months, and the follow-up time of SC-CP group and TC-IC group was 11.0 (4.0, 22.0) and 56.0 (13.0, 75.0) months, respectively. Compared with preoperative data of SC-CP group, the postoperative VAS score [10.0 (10.0, 17.5) points vs. 90.0 (90.0, 98.8) points], the QOL score [1.0 (1.0, 2.0) points vs. 6.0 (6.0, 6.0) points], the O′Leary-Sant score [10.0 (8.5, 13.5) points vs. 35.0 (33.3, 35.8) points], and the PUF score [11.0 (7.3, 12.8) points vs. 29.5 (28.3, 32.0) points] of SC-CP group were all significantly reduced ( P < 0.05). Compared with preoperative data of TC-IC group, the postoperative VAS score [0 vs. 95.0 (90.0, 96.0) points], the QOL score [2.0 (1.0, 3.0) points vs. 6.0 (6.0, 6.0) points], the O′Leary-Sant score [1.0 (1.0, 2.0) points vs. 35.0 (35.0, 36.0) points] and the PUF score [3.0 (3.0, 4.0) points vs. 32.0 (29.0, 32.0) points] of TC-IC group were all significantly reduced ( P< 0.05). Two patients in the SC-CP group required postoperative clean intermittent catheterization, and one patient underwent TC-IC for residual bladder pain. Three patients in the TC-IC group had postoperative bowel obstruction relieved by conservative treatment, and two patients had postoperative wound infection cured by dressing change. Conclusions:Both SC-CP and TC-IC have better efficacy in patients with refractory IC/BPS. Although TC-IC has more potent relief of pain symptoms, SC-CP is closer to the normal human urination habit, eliminating the need to carry an ostomy bag, which is especially suitable for young patients with recalcitrant IC/BPS.

Objective:To analyze the clinical characteristics and all-cause mortality influencing factors of patients with Keshan disease.Methods:Clinical data of patients with Keshan disease from Keshan disease areas in Sichuan Province and Yunnan Province were collected and retrospectively analyzed for clinical characteristics and survival status during regular follow-up. According to the survival status of patients, the survey subjects were divided into a survival group and a death group. All-cause mortality (referring to the death caused by various reasons throughout the follow-up period) was used as the study endpoint. Kaplan-Meier (K-M) survival curve analysis and log-rank χ 2 test were performed, univariate and multivariate Cox regression analysis were used for all-cause mortality factor analysis. Results:A total of 176 patients with Keshan disease were collected, including 92 cases in Sichuan Province and 84 cases in Yunnan Province. Among all the patients, there were 105 males, accounting for 59.66%, and 71 females, accounting for 40.34%. The age was (53.89 ± 13.19) years old. Thirty-five cases died from all causes, with a mortality rate of 19.89%. There were significant differences in age ( t = 2.09, P = 0.038), New York Heart Association (NYHA) cardiac function grading (χ 2 = 14.62, P < 0.001) and ventricular premature contraction (χ 2 = 6.82, P = 0.009) between the survival group and the death group. K-M survival curve analysis showed that patients with Keshan disease complicated by premature ventricular contraction and high NYHA cardiac function grading (Ⅲ and Ⅳ) had higher all-cause mortality (log-rank χ 2 = 8.72, 22.49, P < 0.05). Univariate Cox regression analysis showed that NYHA cardiac function grading and ventricular premature contraction ( HR = 3.09, 2.71, P < 0.05) were predictive influencing factors for all-cause mortality in patients with Keshan disease. Multivariate Cox regression analysis showed that NYHA cardiac function grading ( HR = 6.57, P = 0.002) and ventricular premature contraction ( HR = 2.98, P = 0.050) were independent factors for all-cause mortality in patients with Keshan disease. Conclusions:Among 176 patients with Keshan disease, the number of patients with poor cardiac function (NYHA cardiac function grading Ⅲ and Ⅳ) and arrhythmia is high. NYHA cardiac function grading and ventricular premature contractions are independent influencing factors for all-cause mortality in patients with Keshan disease.

Objective:To illustrate the characteristics of the distribution of prophages among the Group A Streptococcus(GAS) by mining the existing whole genome sequencing of the GAS, performing bioinformatic analyses, extracting data about prophages, and analyzing the state of prophages in the genome and genetic composition of some prophages. Methods:It was a retrospective study.Genome assembly sequences of GAS reported in GenBank till May 2020 were collected, and the important background information of these strains was sorted out to create a local genomic database.A phylogenetic tree of the whole genome of GAS was conducted using the bioinformatics software.The core genome was analyzed, and potential prophages and their integrity in the genome were predicted to obtain the characteristics of the distribution of prophages.Genotype types, number of core genes, and number, length and carrying rate of prophages in the database for GAS were analyzed.Results:A database containing the genome sequence of 2 529 GAS strains was established, involving 140 emm genotypes.These strains were isolated from 19 countries from East Asia, Europe, America and Oceania.Stratified by the disease background, these strains were mainly divided into invasive infection, non-invasive infection and immune sequelae.Prophage analysis of 1 798 genomes showed that at least one complete prophage was detected in 1 366 (76.0%) genomes.The number of complete prophages of each strain ranged from 0 to 6, and the length ranged from 32.8 to 62.6 kb, which was mainly 30-40 kb in length.The phiHKUssa, phiHKUvir and phiHKU488 were the most common prophages present in dominant clones circulated in China in recent years, which mainly carried virulence genes like the speC, spd1 and ssa. Conclusions:Prophages are widely distributed in the genome of GAS, which are of great significance in the evolution and expansion of dominating clones and thus reshape the population structure within the emm genotype.The establishment of a local genome database provides important baseline data for molecular epidemiological surveillance.

Objective To design and synthesize the conjugate (compound 1) of chlorin e₆ (compound 3) with fluorouracil (5-Fu) as novel pH-responsive dual-mode antitumor photosensitizer by acyl hydrazone bond coupling, based on literature reports that combination of 5-Fu and photosensitizer possess synergistic anti-tumor effect, and investigate its photodynamic antitumor activity and mechanism. Methods Lead compound 3 was obtained by alkali degradation with 25% KOH-CH₃OH on pheophorbide a (compound 4) which was prepared through acid hydrolysis of chlorophyll a in crude chlorophyll extracts from silkworm excrement. Reflux reaction of 5-Fu with P₂S₅ in pyridine formed crude 4-thio-5-fluorouracil which was followed to react with hydrazine hydrate (N₂H₄·H₂O) in CH₃OH to give 5-fluorouracil-4-hydrazone (compound 2). Then, treatment of compound 3 i.e. acid alkali degradation product of chlorophyll a in silkworm excrement with EDC·HCl generated its 17¹- and 15² cyclic anhydride which was followed to directly react with intermediate compound 2 to successfully get title compound 1. In addition, its pH-responsive 5-Fu release and photodynamic antitumor activity and their mechanisms in vitro were investigated. Results Compound 1 could responsively release 5-Fu at pH 5.0, with a cumulative release rate of 60.3% within 24 h. It exhibited much higher phototoxicity against melanoma B16-F10 and liver cancer HepG2 cells than talaporfin and its precursor compound 3, with IC₅₀ value being 0.73 μmol/L for B16-F10 cells and 0.90 μmol/L for HepG2 cells, respectively. Upon light irradiation, it also could significantly induce cell apoptosis and intracellular ROS level and block cell cycle in S phase. Its structure was confirmed by UV, ¹H-NMR, ESI-MS and elemental analysis data. Conclusion The conjugate compound 1 of compound 3 and 5-Fu has the advantages of strong PDT anticancer activity, high therapeutic index (i.e. dark toxicity/phototoxicity ratio) and responsively release 5-Fu at pH 5.0 etc. which shows “unimolecular” dual antitumor effects of PDT and chemotherapy and is worthy of further research and development.