Objective:To analyze the disease burden and economic burden of stroke attributed to smoking and tobacco exposure in public places among residents of Hangzhou before and after the implementation of the regulations on smoking control in public places of Hangzhou City (2019) ("Regulations").Methods:It was a cross-sectional study. Data were obtained from the tobacco use survey and stroke mortality surveillance system in Hangzhou in 2018 and 2021. Population Attributable Fractions and Disability-Adjusted Life Years (DALYs) attributable to smoking and tobacco exposure in public places were calculated following the methodology framework of the Global Burden of Disease Study 2019 (GBD 2019). The economic burden of stroke disease attributable to smoking and tobacco exposure in public places, was calculated based on medical costs, direct non-medical costs and indirect cost data obtained from a self-designed questionnaire.Results:The smoking rate in Hangzhou decreased from 43.03% in 2018 to 34.73% in 2021 for males, whereas it marginally increased from 0.75% to 0.97% for females. The tobacco exposure rate in public places decreased from 53.74% to 35.73% for males and from 35.24% to 23.03% for females. The DALY rate for stroke attributable to smoking decreased from 92.13×10 -5 to 71.04×10 -5 for males, whereas it increased from 1.49×10 -5 to 1.83×10 -5 for females. Similarly, the DALY rate for stroke attributable to tobacco exposure in public places decreased from 70.52×10 -5 to 45.22×10 -5 for males and from 43.91×10 -5 to 29.64×10 -5 for females. The total economic burden of stroke attributable to smoking and tobacco exposure in public places in Hangzhou City in 2018 was 398.996 3 million yuan and 476.554 2 million yuan, respectively; both of them decreased to 349.448 6 million yuan and 339.157 0 million yuan in 2021, respectively. Conclusions:The implementation of the new version of the "Regulations" has achieved remarkable tobacco control effects in Hangzhou. The burden of disease and the economic burden of stroke attributable to smoking and exposure to tobacco in public places are significantly reduced.

Objective To summarize and evaluate the treatment strategies and clinical outcomes of bladder inflammatory myofibroblastic tumor(IMT),so as to provide reference for the diagnosis and treatment of this rare entity.Methods A retrospective analysis was conducted on the clinical data of two patients with bladder IMT treated at Shandong Provincial Hospital Affiliated to Shandong First Medical University.In combination with literature analysis,the clinical characteristics,treatment methods and prognosis of this disease were analyzed.Results Both patients presented with painless terminal macroscopic hematuria.Patient 1 was a 42-year-old male with a 6 cm bladder mass detected by cystoscopy,with no muscular involvement.Transurethral en bloc resection with a 1470 nm diode laser was performed,followed by a second transurethral resection.Patient 2 was a 21-year-old male with a 5 cm bladder mass visualized on cystoscopy,with no muscular invasion.Transurethral en bloc resection using a 1470 nm diode laser was conducted,followed by transurethral laser marking the margin of the wound and laparoscopic partial cystectomy.Preoperative cystoscopic biopsy and postoperative pathology diagnosed it as IMT,which invaded the superficial muscular layer and the margin was negative.Patient 1 was followed for 40 months and patient 2 for 15 months.Follow-up cystoscopy performed every 3 months showed no evidence of recurrence.This article also summarized the relevant literature on bladder IMT over the past five years.Conclusion Bladder IMT is an extremely rare neoplasm with nonspecific clinical manifestations,posing challenges in both diagnosis and treatment.However,early recognition and definitive pathological diagnosis,combined with bladder-sparing surgical strategies such as en bloc resection,often result in favorable outcomes,with reduced risk of recurrence and improved quality of life.

Objective To summarize and evaluate the treatment strategies and clinical outcomes of bladder inflammatory myofibroblastic tumor(IMT),so as to provide reference for the diagnosis and treatment of this rare entity.Methods A retrospective analysis was conducted on the clinical data of two patients with bladder IMT treated at Shandong Provincial Hospital Affiliated to Shandong First Medical University.In combination with literature analysis,the clinical characteristics,treatment methods and prognosis of this disease were analyzed.Results Both patients presented with painless terminal macroscopic hematuria.Patient 1 was a 42-year-old male with a 6 cm bladder mass detected by cystoscopy,with no muscular involvement.Transurethral en bloc resection with a 1470 nm diode laser was performed,followed by a second transurethral resection.Patient 2 was a 21-year-old male with a 5 cm bladder mass visualized on cystoscopy,with no muscular invasion.Transurethral en bloc resection using a 1470 nm diode laser was conducted,followed by transurethral laser marking the margin of the wound and laparoscopic partial cystectomy.Preoperative cystoscopic biopsy and postoperative pathology diagnosed it as IMT,which invaded the superficial muscular layer and the margin was negative.Patient 1 was followed for 40 months and patient 2 for 15 months.Follow-up cystoscopy performed every 3 months showed no evidence of recurrence.This article also summarized the relevant literature on bladder IMT over the past five years.Conclusion Bladder IMT is an extremely rare neoplasm with nonspecific clinical manifestations,posing challenges in both diagnosis and treatment.However,early recognition and definitive pathological diagnosis,combined with bladder-sparing surgical strategies such as en bloc resection,often result in favorable outcomes,with reduced risk of recurrence and improved quality of life.

Objective:To analyze the disease burden and economic burden of stroke attributed to smoking and tobacco exposure in public places among residents of Hangzhou before and after the implementation of the regulations on smoking control in public places of Hangzhou City (2019) ("Regulations").Methods:It was a cross-sectional study. Data were obtained from the tobacco use survey and stroke mortality surveillance system in Hangzhou in 2018 and 2021. Population Attributable Fractions and Disability-Adjusted Life Years (DALYs) attributable to smoking and tobacco exposure in public places were calculated following the methodology framework of the Global Burden of Disease Study 2019 (GBD 2019). The economic burden of stroke disease attributable to smoking and tobacco exposure in public places, was calculated based on medical costs, direct non-medical costs and indirect cost data obtained from a self-designed questionnaire.Results:The smoking rate in Hangzhou decreased from 43.03% in 2018 to 34.73% in 2021 for males, whereas it marginally increased from 0.75% to 0.97% for females. The tobacco exposure rate in public places decreased from 53.74% to 35.73% for males and from 35.24% to 23.03% for females. The DALY rate for stroke attributable to smoking decreased from 92.13×10 -5 to 71.04×10 -5 for males, whereas it increased from 1.49×10 -5 to 1.83×10 -5 for females. Similarly, the DALY rate for stroke attributable to tobacco exposure in public places decreased from 70.52×10 -5 to 45.22×10 -5 for males and from 43.91×10 -5 to 29.64×10 -5 for females. The total economic burden of stroke attributable to smoking and tobacco exposure in public places in Hangzhou City in 2018 was 398.996 3 million yuan and 476.554 2 million yuan, respectively; both of them decreased to 349.448 6 million yuan and 339.157 0 million yuan in 2021, respectively. Conclusions:The implementation of the new version of the "Regulations" has achieved remarkable tobacco control effects in Hangzhou. The burden of disease and the economic burden of stroke attributable to smoking and exposure to tobacco in public places are significantly reduced.

Objective: In order to analyze the characteristics of the outbreak of acute respiratory tract infection in children caused by respiratory syncytial virus(RSV). Methods: The field epidemiological investigations were conducted for the two outbreaks in kindergartens in Hangzhou. Data were analyzed by descriptive method. Samples with positive respiratory syncytial virus nucleic acid were sequenced using PCR. Results: The two outbreaks occurred in kindergartens. There were 21 cases in kindergarten A, lasting 11 days, and 43 cases in kindergarten B, lasting 33 days. The epidemic curve showed a proliferation pattern. The cases were concentrated in nurseries and K1 classes, primarily among children aged 2-4 years. The most common symptoms were fever and cough, mainly upper respiratory tract infection, and no severe cases were found. Upper respiratory tract samples were collected and detected as positive for RSV. Four samples were sequenced and identified as subgroup B. Conclusion During the outbreak of acute respiratory infection in kindergartens, respiratory syncytial virus should be given primary consideration in the process of identification of the outbreak caused by other respiratory infections, and strictly control measures should be taken to reduce the long term impact of the epidemic.

Objective:To evaluate the diagnostic value of serum prostate-specific antigen (PSA) levels and multi-parameter magnetic resonance imaging (mpMRI) in patients with granulomatous prostatitis after intravesical Bacillus Calmette-Guérin (BCG) therapy.Methods:The medical records of eight patients with pathologically proven granulomatous prostatitis in Shandong Provincial Hospital Affiliated to Shandong University from January, 2015 to June, 2020, were enrolled and analyzed in this retrospective study. All 8 patients (ages 47-76, mean 63.6) underwent pelvic mpMRI and serum tPSA levels before TURBT, which showed the results of tPSA, f/t and mpMRI were normal before TURBT (0.45-3.62 ng/ml, 0.20-0.51 and normal signal intensities on T1WI and T2WI, respectively). All patients underwent intravesical BCG therapy after post-TURBT 4-6-weeks’ intravesical gemcitabine therapy as a result of pathologically proven middle and high risk NMIBC via cystoscopy.Results:The results of tPSA levels in all 8 patients were elevated after intravesical BCG therapy after 9-15 months (mean 10.5 months), with 4 patients above 4 (6.77-12.89)ng/ml and 4 patients within the normal ranges(2.02-2.68)ng/ml, and f/t levels decreased to lower than 0.16 (0.09-0.15)in all patients. The mpMRI abnormal signals in all patients were all located in the peripheral zone of prostate. All nodular lesions of prostate mpMRI showed lower signal intensity (SI) on T2WI, higher SI on DWI and lower SI on ADC after BCG therapy. All patients underwent prostate biopsy for abnormal signal on prostate mpMRI. The biopsy pathologic results of all patients were granulomatous prostatitis.Conclusions:When elevated PSA and abnormal signals on prostate mpMRI after intravesical BCG therapy occurred, prostate biopsy may not be required for secondary granulomatous prostatitis patients with non-muscle invasive bladder cancer in combination of clinical history.

with flutamide has a syn-ergistic action in inhibiting the proliferation of LNCaP.