Objective:To evaluate the clinical efficacy of intervertebral disc radiofrequency(RF)ablation combined with dorsal medial branch(DMB)neurotomy in elderly patients suffering from chronic low back pain.Methods:A retrospective analysis was conducted on patients aged 60 years and older with chronic low back pain admitted to Beijing Hospital from March 2023 to September 2024.The combined treatment group underwent intervertebral disc radiofrequency ablation combined with radiofrequency treatment of the dorsal medial branch of the spinal nerve.The single treatment group underwent intervertebral disc radiofrequency ablation alone.Pain visual analogue scale(VAS)scores were assessed before treatment and on the first day, 3 months, and 6 months post-treatment.The Oswestry Disability Index(ODI)and Barthel Index were evaluated before treatment and at 3 months and 6 months post-treatment.Clinical efficacy was compared between the two groups.Results:A total of 115 elderly patients with chronic low back pain were enrolled, aged 61 to 72 years(mean 66.5 ± 5.6 years), with 44 males.The combined therapy group consisted of 71 patients, and the monotherapy group consisted of 44 patients.All patients were followed up continuously for 6 months.At all-time points post-treatment, the VAS scores in the combined therapy group were significantly lower than those in the monotherapy group( t=-4.887, -10.095, -7.687, all P<0.05); at 3 and 6 months post-treatment, the combined therapy group showed significantly greater improvements in ODI( t=-3.645, -9.451, both P<0.001)Barthel Index improvement were significantly greater than those in the monotherapy group( t=6.578, 8.530, both P<0.001); the overall good-to-excellent rate in the combined therapy group was 88.7%, higher than the 72.7% in the monotherapy group( χ2=4.85, P<0.05). Conclusions:Combined disc RF ablation and DMB neurotomy provide superior pain relief, functional recovery, and improvement in daily activities compared to single disc ablation in elderly patients with CLBP.This minimally invasive approach represents a safe and effective therapeutic strategy for managing chronic low back pain in the geriatric population.

During the healing of diabetic wounds,prolonged inflammation,difficulty in angiogenesis,and decreased epithelialization ability of keratinocytes often appear,which lead to delayed wound healing.Autophagy is a catabolic pathway that degrades intracellular proteins,promotes cell survival,and maintains cellular biological functions.Recent studies have shown that autophagy affects the healing of diabetic wounds through various mechanisms.This article reviews the potential mechanism of autophagy in diabetic wound healing:autophagy may delay wound healing by causing a decrease in the phagocytic ability and polarization of macrophages,a decrease in the angiogenesis ability of endothelial progenitor cells,a decrease in the migration ability and proliferation of keratinocytes,and an increase in the apoptosis of fibroblasts,which may provide new ideas for finding therapeutic targets for diabetic wound healing.

Objective To review the application of sexual dysfunction intervention in cervical cancer patients,and refine the intervention elements,so as to provide ideas and methods for the development of personalized intervention measures.Methods Guided by the 2021 updated methodological guidelines for scoping reviews from the Joanna Briggs Institute in Australia,CINAHL,PubMed,Web of Science,Embase,Cochrane Library,CNKI,Wanfang and VIP databases were systematically searched from inception to February 29,2024,and the included literature were analyzed and summarized.Results A total of 17 studies were included,involving 9 randomized controlled trials,7 quasi-experimental studies and 1 pilot study.The theoretical basis of the intervention includes PLISSIT model,BETTER model,FOCUS program,PERMA flourish theory,empowerment theory,the trans-theoretical model and narrative therapy.The intervention content involves 4 themes:sexual problem disclosing,sexual science education,sexual physiological rehabilitation and sexual psychological rehabilitation.The main forms are offline and online independent or combined intervention.The outcomes include sexual health function,social function,psychological status and self-management.Conclusion Sexual dysfunction interventions have a positive impact on cervical cancer patients.Future research should develop sexual dysfunction interventions with more comprehensive content,richer forms and more accurate evaluation based on the in-depth understanding of the theoretical connotation,and play the role of nurse-led multidisciplinary teams to maintain the long-term sexual and reproductive health of cervical cancer patients.

Objective To review the application of sexual dysfunction intervention in cervical cancer patients,and refine the intervention elements,so as to provide ideas and methods for the development of personalized intervention measures.Methods Guided by the 2021 updated methodological guidelines for scoping reviews from the Joanna Briggs Institute in Australia,CINAHL,PubMed,Web of Science,Embase,Cochrane Library,CNKI,Wanfang and VIP databases were systematically searched from inception to February 29,2024,and the included literature were analyzed and summarized.Results A total of 17 studies were included,involving 9 randomized controlled trials,7 quasi-experimental studies and 1 pilot study.The theoretical basis of the intervention includes PLISSIT model,BETTER model,FOCUS program,PERMA flourish theory,empowerment theory,the trans-theoretical model and narrative therapy.The intervention content involves 4 themes:sexual problem disclosing,sexual science education,sexual physiological rehabilitation and sexual psychological rehabilitation.The main forms are offline and online independent or combined intervention.The outcomes include sexual health function,social function,psychological status and self-management.Conclusion Sexual dysfunction interventions have a positive impact on cervical cancer patients.Future research should develop sexual dysfunction interventions with more comprehensive content,richer forms and more accurate evaluation based on the in-depth understanding of the theoretical connotation,and play the role of nurse-led multidisciplinary teams to maintain the long-term sexual and reproductive health of cervical cancer patients.

Objective:To evaluate the clinical efficacy of intervertebral disc radiofrequency(RF)ablation combined with dorsal medial branch(DMB)neurotomy in elderly patients suffering from chronic low back pain.Methods:A retrospective analysis was conducted on patients aged 60 years and older with chronic low back pain admitted to Beijing Hospital from March 2023 to September 2024.The combined treatment group underwent intervertebral disc radiofrequency ablation combined with radiofrequency treatment of the dorsal medial branch of the spinal nerve.The single treatment group underwent intervertebral disc radiofrequency ablation alone.Pain visual analogue scale(VAS)scores were assessed before treatment and on the first day, 3 months, and 6 months post-treatment.The Oswestry Disability Index(ODI)and Barthel Index were evaluated before treatment and at 3 months and 6 months post-treatment.Clinical efficacy was compared between the two groups.Results:A total of 115 elderly patients with chronic low back pain were enrolled, aged 61 to 72 years(mean 66.5 ± 5.6 years), with 44 males.The combined therapy group consisted of 71 patients, and the monotherapy group consisted of 44 patients.All patients were followed up continuously for 6 months.At all-time points post-treatment, the VAS scores in the combined therapy group were significantly lower than those in the monotherapy group( t=-4.887, -10.095, -7.687, all P<0.05); at 3 and 6 months post-treatment, the combined therapy group showed significantly greater improvements in ODI( t=-3.645, -9.451, both P<0.001)Barthel Index improvement were significantly greater than those in the monotherapy group( t=6.578, 8.530, both P<0.001); the overall good-to-excellent rate in the combined therapy group was 88.7%, higher than the 72.7% in the monotherapy group( χ2=4.85, P<0.05). Conclusions:Combined disc RF ablation and DMB neurotomy provide superior pain relief, functional recovery, and improvement in daily activities compared to single disc ablation in elderly patients with CLBP.This minimally invasive approach represents a safe and effective therapeutic strategy for managing chronic low back pain in the geriatric population.

Organoids are novel in vitro models that can effectively simulate the complexities of tumor microenvironments.Compared to tra-ditional preclinical models,organoids retain most of the histological and molecular properties of the primary tumor;therefore,they are more useful for studying tumor heterogeneity,underlying functional pathways,and immune microenvironments as well as for research on biomarker discovery,drug screening,and individual chemotherapy.Furthermore,current limitations,challenges such as low modeling suc-cess rates,high costs,and lack of standardization are expected to be overcome by continued innovations in bioengineering technologies and interdisciplinary integration.This article reviews the advantages,establishment processes,and prospects and challenges associated with the clinical application of organoids in bladder cancer.

[Objective] To explore the clinical application of cutaneous ureterostomy-flap embedding in radical cystectomy plus urinary diversion. [Methods] The clinical data of 10 patients with bladder cancer treated with this method in our hospital during Feb.and May 2023 were involved.Cutaneous ureterostomy-flap embedding was used in urinary diversion.The stoma-free rate and stenosis rate of stomas within 1 year postoperatively, differences in renal function indicators 1 day before operation and 1 year after operation, urinary diversion-related complications within 6 months postoperatively, including hydronephrosis, urinary tract infections, renal stones were analyzed. [Results] All surgeries were successfully completed.At 1 year postoperatively, renal function indicators showed no significant difference compared to preoperative levels (P>0.05). At 6 months postoperatively, 1 patient developed renal stones, successfully treated with surgery; 2 had urinary tract infection, recovered after antibiotic treatment; 2 had mild unilateral hydronephrosis, alleviated with conservative management.At 1 year postoperatively, the catheter-free rate was 80%(8/10), with no worsening of hydronephrosis or occurrence of ureteral obstruction, and the stent placement duration ranged from 97 to 211 days, average (151.63±42.47) days.The ureteral stent was not removed in 2 patients within 1 year, so the stoma stenosis rate was 20%(2/10). [Conclusion] The application of flap embedding in urinary diversion following radical cystectomy is a simple and safe procedure, with few postoperative complications, high success rate of stent removal, and overall favorable outcomes.

Objective:To compare the short and medium-term effects of arthroscopic surgery versus intra-articular injections for rotator cuff tears with concomitant shoulder stiffness in elderly patients.Methods:We performed a retrospectively study that included 116 patients with rotator cuff tears combined with shoulder stiffness between January 2015 and June 2017, with 56 patients receiving arthroscopic surgery (the surgery group)and 60 patients given intra-articular injections (the control group). The visual analogue scale (VAS)score, range of motion (ROM), American Shoulder and Elbow Surgeons (ASES)score, University of California Los Angeles (UCLA)score were recorded before treatment and 3, 6 and 12 months after treatment.Results:Compared with pre-treatment, VAS scores were lower and ROM, ASES and UCLA scores were higher in both groups after treatment ( P<0.05). At 3 months after treatment, VAS scores were higher and ASES and UCLA scores were lower in the surgery group than in the control group ( P<0.05), while there was no significant difference in ROM between the two groups ( P>0.05). At 6 and 12 months after treatment, VAS scores were lower, ROM was larger, and ASES and UCLA scores were higher in the surgery group than in the control group ( P<0.05). Conclusions:In patients with rotator cuff tears combined with shoulder stiffness, both arthroscopic surgery and intra-articular injections can alleviate pain and improve ROM and shoulder joint function.After 6 months of treatment, greater improvement is achieved in patients undergoing arthroscopic surgery than in patients receiving intra-articular injections.

Objective To investigate the diagnostic value of narrow-band imaging for flat bladder lesions.Methods Forty-nine patients with flat bladder lesions diagnosed by white light cystoscopy + narrow-band imaging followed by transurethral resection were included.The diagnostic value of narrow-band imaging was evaluated based on postoperative pathological results.Results A total of 59 flat lesions were identified,in which 8 were normal urothelium,3 were chronic inflammation,1 was papillary urothelial neoplasm of low malignant potential,1 were mild dysplasia,1 was moderate dysplasia,1 were severe dysplasia,3 were carcinoma in situ,16 were low-grade papillary urothelial carcinoma,16 were high-grade papillary urothelial carcinoma,and 8 were invasive papillary urothelial carcinoma.For narrow-band imaging,the sensitivity was 86.7 ％ (39/45),specificity was 57.1％ (8/14),diagnostic accuracy was 79.7 ％ (47/ 59),false-positive rate was 42.9％ (6/14),positive predictive value was 86.7％ (39/45),negative predictive value was 57.1％ (8/14),area under ROC curve was 0.719.Among these lesions,the sensitivity and specificity for postoperative recurrent lesions were 100％ (3/3) and 40％ (2/5),respectively,and those for erythematous patch-like lesions were 90％ (9/10) and 100％ (4/4),respectively.Conclusion Narrow-band imaging can improve the detection rate for flat bladder tumor lesions,and reduce the risk for missed diagnosis under white light cystoscopy,especially for otherwise indistinguishable erythematous patch-like lesions.

Objective To perform an exploratory investigation on confocal laser endomicroscopy (CLE) in the diagnosis of malignant bladder tumour.Methods From June 10 to July 11,2017,6 male bladder cancer patients underwent white light cystoscopy (WLC) + CLE examination,aging 64-86 years (median 72 years).All patients received TURBT on suspected lesions.WLC and CLE imaging results were recorded and validated by pathologic specimens.Results Lesions confirmed by histopathology were 3 low grade non-invasive papillary urothelial carcinomas,1 high grade non-invasive papillary urothelial carcinoma,1 low grade invasive urothelial carcinoma,1 high grade invasive urothelial carcinoma,1 carcinoma in situ (CIS),1 high grade dysplasia,1 cystitis glandularis,1 chronic inflammation,and 1 scar tissue.For CLE images in the normal urothelium,three layers of cells with different presentation were observed,namely,the superficial umbrella cells,the intermediate cells smaller in size and uniformly shaped,and the capillary network in the lamina propria.For non-invasive urothelial carcinoma,tumour cells appeared as papillary lesions growing from fibrovascular cores,with low grade cells appearing monomorphic and more cohesively arranged,and high grade cells relatively pleomorphic,more disorganised and with tortuous blood vessels in the fibrovascular core.For invasive urothelial carcinoma,tumour cells invaded the lamina propria,with uniform appearances,poor cohesion and indistinct cellular borders,and high grade ones were more pleomorphic.CIS and inflammation both appeared as erythematous patch-like flat lesions under WLC and sometimes difficult to differentiate.Under CLE,the former appeared as dysplastic and disorganised cells with indistinct cellular borders,with intact lamina propria,and inflammatory cells were discovered as infiltrative clusters in the lamina propria that were uniformly shaped and loosely connected.Dysplasia appeared somewhat similar compared with CIS under WLC,but with lower cellular irregularity as confirmed with pathology.Cellular appearance and structure in scar tissue was similar to that in the normal urothelium,but superficial umbrella cells were more likely absent,with thinner cell layers,and inflammatory infiltration was sometimes discovered in the lamina propria.Conclusions CLE provides real-time cellular imaging of the urothelium,and shows promising potential for clinical diagnosis,especially in differentiating fiat urothelial lesions.Large prospective studies are required for further validation.