Objective To explore the clinical efficacy and safety of immediate laparoscopic radical prostatectomy immediately following the diagnosis of locally advanced prostate cancer.Methods A retrospective analysis was performed for 63 patients with locally advanced prostate cancer who met the inclusion criteria diagnosed in The 1st People's Hospital of Qujing City,Yunnan Province from January 2018 to January 2023.All patients were diagnosed via ultrasound-guided transperineal prostate biopsy.The experimental group consisted of 37 patients who underwent immediate laparoscopic radical prostatectomy after pathological diagnosis,followed by postoperative adjuvant hormone therapy.The control group included 26 patients who first received 3 months of neoadjuvant hormone therapy before undergoing radical surgery,followed by adjuvant hormone therapy postoperatively.The two groups were compared in terms of surgical duration,intraoperative blood loss,length of hospital stay,duration of catheterization,positive surgical margin rate,rectal injury,positive lymph node rate,incidence of urinary fistula and lymphatic leakage,changes in PSA level,postoperative urinary control,biochemical recurrence and distant metastasis.Results In the control group,serum PSA levels,prostate volume,and clinical staging significantly decreased after neoadjuvant hormon therapy.The positive surgical margin rate in the experimental group was significantly higher than that in the control group,with a statistically significant difference(P<0.05).There were no statistically significant differences between the two groups in terms of surgical duration,intraoperative blood loss,length of hospital stay,duration of catheterization,rectal injury,positive lymph node rate,incidence of urinary fistula and lymphatic leakage(P>0.05).Follow-up at 18 to 36 months revealed no statistically significant differences between the two groups in terms of serum PSA levels at one month post-surgery,complete urinary control rate at six months post-surgery,and biochemical recurrence and distant metastasis at one and two years post-surgery(P>0.05).Conclusion Immediate laparoscopic radical prostatectomy following the diagnosis of locally advanced prostate cancer is a clinically safe and feasible treatment option.Noadjuvant hormone therapy reduces tumor staging,lowers the positive surgical margin rate,significantly decreases prostate volume,and provides greater operational space without increasing surgical risks.

Objective To evaluate the efficacy of complete pelvic floor peritoneal reconstruction in reducing postoperative ileus incidence and accelerating recovery following laparoscopic radical cystectomy with orthotopic neobladder construction.Methods A retrospective study was conducted to select 62 patients who underwent the operation in Qujing Hospital Affiliated to Kunming Medical University from January 2017 to September 2024.According to whether complete pelvic floor peritoneal reconstruction was performed during the operation,they were divided into the conventional group(n=25)and the reconstruction group(n=37).Postoperative ileus rates and recovery parameters were compared to assess the clinical value of complete pelvic floor peritoneal reconstruction.Results The reconstruction group showed better postoperative recovery compared to the routine group:gastrointestinal function recovery time[3(2,4)d vs 4(3,5)d,P=0.032],abdominal drainage time[12(10,13.5)d vs 14(12,15)d,P=0.006],pelvic drainage time[12(9,13.5)d vs 14(11,16)d,P=0.015],postoperative hospital stay[18(15.5,26)d vs 25(17,30.5)d,P=0.016],and hospital expenses[(53,695.67±10,182.43)yuan vs(60,803.73±14,449.24)yuan,P=0.027].Postoperative nutritional markers,including total protein[(64.49±6.82)g/L vs.(61.56±4.03)g/L,P=0.038]and albumin[(36.08±5.29)g/L vs.(33.40±3.57)g/L,P=0.020],were higher in the reconstruction group.No significant difference was found in ileus incidence(44.00%vs.32.43%,P=0.355).Other parameters—baseline characteristics,postoperative globulin and prealbumin levels,gastric tube retention,stent/catheter removal time,and complications(anastomotic leakage,urinary fistula,wound infection)—showed no intergroup differences(P>0.05).Conclusion The application of complete pelvic floor peritoneal reconstruction technique in laparoscopic radical cystectomy with orthotonic neobladder provides better protection for the intestine,reduces surgical area adhesions,promotes gastrointestinal function recovery,shortens abdominal and pelvic drainage times,accelerates patient rehabilitation,reduces hospital stay and expenses.However,whether it can effectively reduce postoperative intestinal obstruction rates still requires more data and experimental verification.

ObjectiveTo analyze the microbial diversity in the rhizosphere soil of Gastrodia elata with different yields and explore the influence of soil microorganisms on the yield of G. elata. MethodThe experiment adopted the 16S DNA and ITS high-throughput sequencing technologies to study the diversity of the bacterial and fungal community in the rhizosphere soil of G. elata with high yield （GC） and low yield （DC）. ResultProteobacteria， Firmicutes， and other unidentified Bacteria were dominant in the rhizosphere soil of G. elata. The dominant rhizosphere fungi were Ascomycota， Basidiomycota， and Mortierellomycota. There was no significant difference in microbial community abundance in the high-yield and low-yield rhizosphere soil of G. elata， but there was a significant difference in species composition. Thirty-eight microbes such as Bradyrhizobium， Schleiferilactobacillus， and Archaeorhizomyces were gathered in large numbers in the high-yield rhizosphere soil， and thirty microbes such as Fusarium， Coprinellus， and Nitrosotalea were gathered in large numbers in the low-yield rhizosphere soil. At the level of genus and species， there were six different species in the high-yield and low-yield rhizosphere soil of G. elata， among which Russula mariae， Archeaeorhizomyces， and Ilyonectria were gathered in the high-yield rhizosphere soil of G. elata， while Nitrosotalea， Coprinellus disserminatus， and Fusarium were gathered in the low-yield rhizosphere soil of G. elata. ConclusionThere are different microorganisms in the rhizosphere soil of G. elata with different yields， and it is speculated that these microorganisms are related to the yields of G. elata. The research results are expected to provide a vital theoretical basis for the follow-up study of the high yield of G. elata.

Objective To evaluate the efficacy and safety of transurethral resection of Prostate(TURP)combined with endocrine therapy in patients with advanced prostate cancer.Methods A retrospective analysis was conducted on 87 cases of late-stage prostate cancer with dysuria admitted between January 2014 and December 2017.We divided them into 2 groups.TURP group(n = 48)received transurethral resection of prostate,followed by regular endocrine therapy.The control group(n = 39)was only given regular endocrine therapy.Comparative analysis of indicators such as prostate-specific antigen before and after treatment,maximum urinary flow rate,residual urine volume,International Prostate Symptom Score(IPSS),and 5-year survival rate was performed between the two groups.Results Three months after TURP surgery,the symptoms of urinary difficulty significantly improved,and various indicators showed significant improvement compared to before the surgery.PSA levels also notably decreased compared to before the surgery.After 3 months of treatment,the TURP group showed significant improvements in IPSS,Qmax,RV,and PSA indicators compared to the control group(P<0.05).Both groups of patients experienced a gradual decrease in PSA levels after receiving standardized treatment.In the first 12 months of treatment,the PSA levels in the TURP group decreased more significantly compared to the control group,but after 12 months of treatment,the comparison difference was not statistically significant in the PSA levels between the two groups(P = 0.056).A 5-year follow-up comparison of the two groups of patients revealed that there was no statistically significant difference in survival(P = 0.734).Conclusion Transurethral resection of Prostate(TURP)combined with regular endocrine therapy can effectively improve the dysuria in prostate cancer patients,improve the quality of life of patients,and will not affect the five-year survival rate.TURP is a safe and effective treatment for advanced prostate cancer.

Objective:The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China.Methods:This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems.Results:According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%).Conclusion:Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.

Objective:To estimate the induced radioactive 56Mn and its level of iron in heavy concrete shielding wall due to neutron activation during tumor proton therapy. Methods:A Geant4 program was adopted to build the model of a heavy concrete shielding wall in a proton therapy room, simulate secondary neutrons generated by 245 MeV proton beam irradiating water phantom. The statistical distribution of radionuclide 56Mn in shielding wall was calculated. The shielding wall was layered every 10 cm thickness, the dose equivalent rate of radionuclide 56Mn in the first three shielding walls was calculated. Results:Under the maximum beam irradiation conditions (1.872 × 10 10), the number of radionuclide 56Mn in the first three layers of shielding walls are 3.10×10 8, 1.60×10 8, 9.33×10 8. The ambient dose equivalent rate at a distance of 1 m from the treatment room are 2.13×10 -3, 8.82×10 -4, 9.10×10 -4 μSv/h, and the total ambient dose equivalent rate for the first three layers was 3.92× 10 -3 μSv/h. Conclusions:During proton therapy, the shielded walls near the central axis of the beam produce more induced radioactivity. The induced radioactivity produced by the neutron-activated iron element at the ahead of the shielding wall is the strongest, and decreases exponentially as the thickness of the shield wall increases.The induced radioactivity in front of the shielding wall of proton therapy room should be concerned.

AIM:To explore the mechanisms underlying contraction induced by extracelluar acidosis (pHex6.8) in rat isolated coronary artery (RCA).METHODS:Using the microvessel tension recorder system, the effects of acid-base transporters on RCA contraction induced by pHex6.8 were explored by applying the selective pharmacological inhibitors of Na+-H+ exchanger 1 (NHE-1) and Na+-HCO-3 cotransporter (NBC), HOE-642 and S0859, respectively.The effects of chloride channel on RCA contraction induced by pHex6.8 were explored by applying the inhibitors of chloride channel (NPPB and NFA), and by replacing the extracellular NaCl with equimolar NaBr.RESULTS:pHex6.8 augmented the resting tension of RCA, and the maximum contraction was (3.90±0.95) mN.HOE-642 at 30 μmol/L and S0859 at 100 μmol/L both inhibited the contraction of RCA induced by pHex6.8 (P<0.01).NPPB and NFA both inhibited the contraction of RCA induced by pHex6.8 or KCl (60 mmol/L) in a concentration-dependent manner.NPPB and NFA (100 μmol/L) both inhibited the contraction of RCA induced by U46619 (1 μmol/L).Replacing the extracellular NaCl with equimolar NaBr almost completely inhibited RCA contraction induced by pHex6.8 (P<0.01), but had no obvious effect on the contraction induced by KCl (60 mmol/L) or U46619 (1 μmol/L).CONCLUSION:Extracellular acidosis-induced contraction in RCA may be related to the activated NHE-1 and NBC, and it may be also related to the enhanced chloride transport across the membrane.

Objective To investigate the clinical effect of lumbar catheter drainage combined with intrathecal injection on patients with cerebrospinal fluid leakage and intracranial infection.Methods A retrospective study was conducted.One hundred and fifty-two cases with cerebrospinal fluid leakage and intracranial infection were selected as our subjects who were hospitalized in the First Hospital of Yuncheng from 2006 to 2014.The patients were divided into lumbar puncture + intrathecal group (A),lumbar (group B) and lumbar intrathecal large pool + group (group C) based on post-processing methods.A experimental data were recorded and compared in terms of the total efficiency of treatment,the therapeutically effective time,bacterial clearance and security differences.Results After treatment,the levels of white blood cells,protein,glucose and intracranial pressure were changed compared with that of before treatment in three group(P ＜ 0.01),but there was no significant difference among the three groups(P ＞ 0.05).The therapy periods in group A,group B and group C were (12.80 ± 2.25) d,(12.64 ± 2.00) d and (9.44 ± 1.50) d respectively and the difference was significant(F =25.94,P ＜ 0.05).Compared with Group C,the therapy periods in group A and B were significant different(t =2.769,2.854;P ＜ 0.05),but there was no significant difference between group A and B (t =0.119,P =0.908).The cases with success.effect was 45 (89.1％) in group A,53 (94.6％) in group B,46 (95.8％) in group C,and there was no significant difference among three groups (P ＞ 0.05).In terms of bacterial clearance rate,33 cases(68.75％) was in group A,35 cases(72.91％) in group C and 23 cases (41.07％) in group B and the effective rate in group A or C were higher than that in group B (x2 =9.478,10.63 ; P ＜ 0.05).Conclusion The methods of lumbar catheter drainage combinedwith intrathecal injection is proved with a high clinical value of therapy,effective treatment can effectively shorten the time and improve the overall treatment effect.

Objective To summarize the clinical experiences of liver transplantation.Methods Of the nine patients, four operation was standard orthotopic liver transplantation,the latter five were the piggyback liver transplantation.The immunosuppressive protocols included methylprednisolone FK506 and mycophenolatemofeti. Meanwhile intravenous antihepatitis B immunoglobulin and Lamivudine were used to prevent hepatitis B recurrence.Results All patients were cured.Conclusion Liver transplantation can be employed for liver disease both cirrhosis and carcinoma as a conventional surgery.It is an effective way for the treatment of no metastatic liver carcinoma.The immunosuppressive protocols included methylprednisolone FK506 and mycophenolatemofeti,it can prevent immune rejection.

Objective To evaluate the expression of Sp3 gene of peripheral blood mononuclear cells (PBMC) in multiple sclerosis (MS) patients in Guizhou and the relationship between Sp3 gene expression and immunological function. Methods Two pairs of primers were used to amplify cDNAs generated from 31 MS patients and 30 healthy controls. The serum levels of sIL-2R were measured in 27 patients with MS and 30 healthy controls by sandwiched ELISA. Results The deficient expression of Sp3 gene in MS patients was significantly higher than that in control (41.9% ( 12/31 ) vs 6. 7% (2/30) ,x2 =7. 133 ,P =0. 008). The sIL-2R levels in MS patients were significantly higher than those in control (( 2788.5 ± 1079. 8 ), ( 1270. 7 ± 489. 4) μg/L, t = 6. 170, P = 0. 001 ). The concentration of sIL-2R in MS with negative ((3364.0 ± 1252.3) μg/L) and positive((2450.0 ± 827.0) μg/L) expression of Sp3 gene were significantly increased compared with control (F = 32. 059, P < 0. 05 ). The sIL-2R levels were significantly rising in MS patients with negative expression of Sp3 gene compared with MS patients with positive expression of Sp3 gene ( q = 4. 213, P < 0. 05 ). Conclusions A remarkable deficient expression of Sp3 gene in PBMC has been found in MS patients in Guizhou. sIL-2R may take part in the process of MS. The expression of Sp3 gene is not affected by immune state, however, MS patients with Sp3 deficient expression tend to have a more serious impairment in immunological functions.