ObjectiveTo explore the mechanisms of Qingchang Wenzhong Decoction （清肠温中方， QWD） in treating ulcerative colitis （UC）. MethodsA total of 100 male C57BL/6J mice were assigned to a pseudo-germ-free group （n=45） and a conventional group （n=55） using a random number table. Pseudo-germ-free model was established by giving antibiotic treatment and subsequently subjected to acute UC induction. After the model was successfully established， the 45 pseudo-germ-free acute UC mice were randomly allocated to a pseudo-germ-free model group， a pseudo-germ-free QWD group， and a pseudo-germ-free mesalazine group， with 15 mice in each group. The 55 conventional mice were randomly divided into a normal control group （n=10）， as well as a conventional model group， a conventional QWD group， and a conventional mesalazine group， with 15 mice in each group. Except for the normal control group， acute UC models were established in all other groups. Mice in the control group received no intervention. From day 32 of the experiment， mice in the pseudo-germ-free QWD group and the conventional QWD group were administered with QWD granules at a dose of 9.71 g/（kg·d） by gavage with deionized water， while those in the pseudo-germ-free mesalazine group and the conventional mesalazine group were given mesalazine enteric-coated tablets at a dose of 151.67 mg/（kg·d） by gavage. Mice in the remaining groups received an equal volume of deionized water once daily for 7 consecutive days. On day 25 of the experiment， six mice were randomly selected from both the pseudo-germ-free group and the conventional group to measure body weight， and fecal samples were collected for 16S rDNA sequencing to compare differences in gut microbiota， including operational taxonomic units （OTUs）， Shannon index， Observed_species index， and phylogenetic diversity （PD whole tree）. On day 39， body weight was measured in all groups， and the disease activity index （DAI） was evaluated. Colon length and colon wet weight were recorded. Histopathological changes in colonic tissues were assessed by hematoxylin and eosin （HE） staining， and histological injury scores were determined. In addition， the expression levels of mucopolysaccharides and mucin 2 （MUC2） in colonic tissues were measured. ResultsOn day 25， there was no significant difference in body weight between the pseudo-germ-free group and the conventional microbiota group （P＞0.05）. Compared to the conventional microbiota group， the pseudo-germ-free group showed significantly reduced OTUs， Shannon index， Observed_species index， and PD whole tree （P＜0.01）. On day 39， compared to the normal control group， mice in the conventional model group showed a significant decrease in the body weight and an increase in DAI， along with increased colon wet weight， shortened colon length， markedly elevated histopathological scores， and reduced expression of mucopolysaccharides and MUC2 （P＜0.01）. In contrast， no significant differences were observed in these parameters in the pseudo-germ-free model group （P＞0.05）. Compared to the conventional model group， the conventional QWD group showed significant improvement in all measured parameters， whereas the conventional mesalazine group showed reductions only in DAI scores and colon wet weight （P＜0.01）. No statistically significant differences were observed among the pseudo-germ-free model group， the pseudo-germ-free QWD group， and the pseudo-germ-free mesalazine group （P＞0.05）. ConclusionQWD may promote the reconstruction of the intestinal mucus barrier by regulating the intestinal flora， thereby exerting a therapeutic effect on acute UC.

ObjectiveTo explore the mechanisms of Qingchang Wenzhong Decoction （清肠温中方， QWD） in treating ulcerative colitis （UC）. MethodsA total of 100 male C57BL/6J mice were assigned to a pseudo-germ-free group （n=45） and a conventional group （n=55） using a random number table. Pseudo-germ-free model was established by giving antibiotic treatment and subsequently subjected to acute UC induction. After the model was successfully established， the 45 pseudo-germ-free acute UC mice were randomly allocated to a pseudo-germ-free model group， a pseudo-germ-free QWD group， and a pseudo-germ-free mesalazine group， with 15 mice in each group. The 55 conventional mice were randomly divided into a normal control group （n=10）， as well as a conventional model group， a conventional QWD group， and a conventional mesalazine group， with 15 mice in each group. Except for the normal control group， acute UC models were established in all other groups. Mice in the control group received no intervention. From day 32 of the experiment， mice in the pseudo-germ-free QWD group and the conventional QWD group were administered with QWD granules at a dose of 9.71 g/（kg·d） by gavage with deionized water， while those in the pseudo-germ-free mesalazine group and the conventional mesalazine group were given mesalazine enteric-coated tablets at a dose of 151.67 mg/（kg·d） by gavage. Mice in the remaining groups received an equal volume of deionized water once daily for 7 consecutive days. On day 25 of the experiment， six mice were randomly selected from both the pseudo-germ-free group and the conventional group to measure body weight， and fecal samples were collected for 16S rDNA sequencing to compare differences in gut microbiota， including operational taxonomic units （OTUs）， Shannon index， Observed_species index， and phylogenetic diversity （PD whole tree）. On day 39， body weight was measured in all groups， and the disease activity index （DAI） was evaluated. Colon length and colon wet weight were recorded. Histopathological changes in colonic tissues were assessed by hematoxylin and eosin （HE） staining， and histological injury scores were determined. In addition， the expression levels of mucopolysaccharides and mucin 2 （MUC2） in colonic tissues were measured. ResultsOn day 25， there was no significant difference in body weight between the pseudo-germ-free group and the conventional microbiota group （P＞0.05）. Compared to the conventional microbiota group， the pseudo-germ-free group showed significantly reduced OTUs， Shannon index， Observed_species index， and PD whole tree （P＜0.01）. On day 39， compared to the normal control group， mice in the conventional model group showed a significant decrease in the body weight and an increase in DAI， along with increased colon wet weight， shortened colon length， markedly elevated histopathological scores， and reduced expression of mucopolysaccharides and MUC2 （P＜0.01）. In contrast， no significant differences were observed in these parameters in the pseudo-germ-free model group （P＞0.05）. Compared to the conventional model group， the conventional QWD group showed significant improvement in all measured parameters， whereas the conventional mesalazine group showed reductions only in DAI scores and colon wet weight （P＜0.01）. No statistically significant differences were observed among the pseudo-germ-free model group， the pseudo-germ-free QWD group， and the pseudo-germ-free mesalazine group （P＞0.05）. ConclusionQWD may promote the reconstruction of the intestinal mucus barrier by regulating the intestinal flora， thereby exerting a therapeutic effect on acute UC.

Objective: To explore the learning curve of transurethral 450 nm blue light vaporization of the prostate (TUBVP) in a district hospital，in order to provide reference for clinicians who plan to perform TUBVP. Methods: The clinical data of 56 patients with benign prostatic hyperplasia (BPH) who received TUBVP performed by the same group of surgeons in Chang'an District Hospital during Jun. and Dec. 2023 were retrospectively analyzed. Cumulative sum (CUSUM) was used to fit the learning curve of ratio of volume to operating time (RVOT) of prostate volume /450 nm blue light. The learning curve was divided into different stages according to the inflection points，and the clinical data of patients operated at different stages were analyzed and compared. Results: The learning curve of TUBVP was 21 cases，including 1-21 cases in the learning stage，22-38 cases in the improvement stage and 39-56 cases in the maturity stage. With the increase of cases，the postoperative bladder irrigation time reduced \[40.00 (26.00，44.50) h vs. 23.00(20.50，34.00) h vs. 23.50(14.75，40.75) h\]，with statistical difference (P<0.05). The surgical efficiency increased \[(0.51±0.14) vs. (0.55±0.17) vs. (0.63±0.23)\]，while the reduction of hemoglobin \[(6.43±7.35) g/L vs. (5.65±10.91) g/L vs. (2.61±7.36) g/L\]，catheter indwelling time \[70.0 (66.0，106.0) h vs. 71.0 (66.0，89.0) h vs. 66.0 (58.5，78.5) h\]，and incidence of complications (9.5% vs. 5.9% vs. 0) in the three stages showed a gradually decreasing trend，but with no statistical significance (P>0.05). Conclusion: The learning curve of TUBVP is 21 cases. For clinicians in district hospitals，TUBVP is a worthy choice.

OBJECTIVE To evaluate the efficacy， safety and cost-effectiveness of toripalimab （Tor） combined with chemotherapy （CT） in the treatment of locally advanced or metastatic non-small cell lung cancer （NSCLC）. METHODS PubMed， the Cochrane Library， Embase， Web of Science， CBM， CNKI， Wanfang Data， and Health Technology Assessment （HTA） related websites were searched to collect the HTA reports， systematic reviews/meta-analyses and pharmacoeconomic studies of Tor+CT in the treatment of locally advanced or metastatic NSCLC from database/website inception to March 31， 2025. After data extraction and quality evaluation， the results of the included studies were analyzed descriptively. RESULTS A total of eleven studies were included， involving five systematic reviews/meta-analyses， and six pharmacoeconomic studies. Among the five systematic reviews/ meta-analyses， two were of high quality， while there was one each of moderate， low， and very low quality. All six pharmacoeconomic studies were of good quality. In terms of efficacy， compared with CT， Tor+CT significantly improved patients’ progression-free survival （PFS） and overall survival （P＜0.05）. In addition， compared with ipilimumab+CT， durvalumab， durvalumab+tremelimumab and sugemalimab+CT， Tor+CT could also improve the PFS （P＜0.05）. In terms of safety， there was no significant difference in the incidence of grade≥3 adverse events between patients receiving Tor+CT and CT （P＞0.05）； while Tor+CT had a lower incidence of grade≥3 adverse E-mail： events， compared with camrelizumab+CT， pembrolizumab+ 3233255290@qq.com ipilimumab， nivolumab+CT and atezolizumab+CT （P＜0.05）.In terms of cost-effectiveness， Tor+CT treatment had certain cost-effectiveness advantages， compared with CT. CONCLUSIONS Compared with CT， other programmed death-1/programmed death-ligand 1 inhibitors alone， or their combination with CT， Tor+CT for the treatment of locally advanced or metastatic NSCLC has good efficacy， safety and cost-effectiveness.

Objective:To explore the changes of brain excitation/inhibition balance and gray matter volume (GMV) and their correlations with clinical features in benign childhood epilepsy with centrotemporal spikes (BECTS).Methods:A cross-sectional study was performed; 83 BECTS children enrolled from Department of Diagnostic Radiology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University from January 2015 to January 2024 were selected as BECTS group. During the same period, 101 age- and gender-matched healthy children were recruited as healthy control group through advertisements in local primary schools. Data of conventional MRI and resting-state functional MRI (rs-fMRI) of the two groups were collected. Whole brain GMV was analyzed by voxel-based morphometry (VBM), and Hurst index was calculated based on time series data of blood oxygen level dependent (BOLD) signal of rs-fMRI. Correlations of GMV and Hurst index with disease duration and onset age in children with BECTS were explored by Pearson correlation analysis.Results:Compared with the healthy control group, the BECTS group had significantly increased GMV and decreased Hurst index in the bilateral Rolandic region ( P<0.05). Pearson correlation analysis showed that in the BECTS group, GMV in bilateral Rolandic region was negatively correlated with onset age ( r=-0.267, P=0.015) and positively correlated with disease course ( r=0.267, P=0.015); Hurst index in bilateral Rolandic region was positively correlated with onset age ( r=0.323, P=0.003) and negatively correlated with disease course ( r=-0.240, P=0.029); Hurst index was negatively correlated with GMV in bilateral Rolandic region ( r=-0.328, P=0.003). Conclusion:BECTS children have excitation/inhibition imbalance in epilepsy-related regions and cortical structural delay, and both of them are related to onset age and disease course.

Objective:To explore the changes of brain excitation/inhibition balance and gray matter volume (GMV) and their correlations with clinical features in benign childhood epilepsy with centrotemporal spikes (BECTS).Methods:A cross-sectional study was performed; 83 BECTS children enrolled from Department of Diagnostic Radiology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University from January 2015 to January 2024 were selected as BECTS group. During the same period, 101 age- and gender-matched healthy children were recruited as healthy control group through advertisements in local primary schools. Data of conventional MRI and resting-state functional MRI (rs-fMRI) of the two groups were collected. Whole brain GMV was analyzed by voxel-based morphometry (VBM), and Hurst index was calculated based on time series data of blood oxygen level dependent (BOLD) signal of rs-fMRI. Correlations of GMV and Hurst index with disease duration and onset age in children with BECTS were explored by Pearson correlation analysis.Results:Compared with the healthy control group, the BECTS group had significantly increased GMV and decreased Hurst index in the bilateral Rolandic region ( P<0.05). Pearson correlation analysis showed that in the BECTS group, GMV in bilateral Rolandic region was negatively correlated with onset age ( r=-0.267, P=0.015) and positively correlated with disease course ( r=0.267, P=0.015); Hurst index in bilateral Rolandic region was positively correlated with onset age ( r=0.323, P=0.003) and negatively correlated with disease course ( r=-0.240, P=0.029); Hurst index was negatively correlated with GMV in bilateral Rolandic region ( r=-0.328, P=0.003). Conclusion:BECTS children have excitation/inhibition imbalance in epilepsy-related regions and cortical structural delay, and both of them are related to onset age and disease course.

Objective:To explore the feasibility of using self-made visual throat forceps to remove hypopharyngeal foreign bodies. Methods:The throat forceps were combined with the endoscope and connected to a monitor via a data cable resulting in a visual throat forceps apparatus. This device was utilized to examine and treat the hypopharyngeal foreign bodies. Results:Among 53 patients, foreign bodies were detected in 51,with 48 cases involving hypopharyngeal foreign bodies. All were successfully extracted using the visual throat forceps. Three cases, diagnosed as esophageal foreign bodies by electronic gastroscopy, were treated using the same method. Conclusion:Visual throat forceps can be used to examine the hypopharynx and remove foreign bodies. It has the advantages of simple operation, rapid operation, and high success rate of foreign body removal from the hypopharynx. It is worthy of clinical application.
Humans ; Hypopharynx/surgery* ; Pharynx/surgery* ; Endoscopes ; Surgical Instruments ; Foreign Bodies/diagnosis*

【Objective】 To investigate the application value of 450 nm blue laser vaporization in the treatment of benign prostatic hyperplasia (BPH) in district hospitals, so as to provide reference for the selection of BPH treatment methods in district-level hospitals. 【Methods】 The clinical data of 39 BPH patients who received surgical treatment in Chang’an Hospital during Jan.and Sep.2023 were retrospectively analyzed.The patients were divided into two groups, including 19 in blue laser group treated with 450 nm blue laser vaporization and 20 in the TURP group treated with transurethral resection of the prostate (TURP).The operation time, hemoglobin decline, postoperative bladder irrigation time, catheter indwelling time and adverse events were compared between the two groups. 【Results】 All operations were successfully completed.In the blue laser group, the operation time [(45.11±22.08) min vs.(81.25±29.37) min], postoperative bladder irrigation time [(34.05±9.41) h vs.(47.60±9.05) h] and the decrease of hemoglobin [(7.79± 5.86) g/L vs.(16.40±10.23) g/L] were significantly lower than those in the TURP group (P<0.05).There was 1 case of urinary retention in the blue laser group, and there was no significant difference in indwelling catheter time between the two groups (P>0.05). 【Conclusion】 The 450 nm blue laser vaporization of prostate has advantages of less blood loss, shorter operation time and shorter postoperative irrigation time.Therefore, it should be considered as a preferable option for BPH in primary hospitals.

Objective To evaluate both the causal relationship between plasma metabolites and the risk of knee osteoarthritis(KOA)and the potential mediating or masking effect of immune cells using Mendelian randomization(MR)systems.Methods The GWAS data on 1400 plasma metabolites,731 immune cell traits and KOA was retrieved from the genome-wide association study(GWAS)database.Two-way MR analysis was used to evaluate the causal relationship between plasma metabolism and KOA.Two-step mediation MR analysis was conducted to evaluate immune cell traits that might have mediating or masking effects.Results After sensitivity analysis and screening,65 plasma metabolites and 35 immune cell traits were found to have causal relationships with KOA(P＜0.05).Mediation analysis found that CD45RA+CD28-CD8br％CD8br had a mediating effect in the causal relationship between three metabolites(2-hydroxyhi-ppurate,X-07765,X-23739)and the risk of KOA.2-hydroxyhippurate(salicylic acid)exerted a masking effect,and the effect ratio was 0.0412.Conclusion A variety of plasma metabolites and immune cell traits are causally related to KOA,which should not be regarded as a simple degenerative joint disease.The protective effect of salicylic acid against KOA may be weakened by its role in inducing the differentiation of Treg cells,which is worthy of more studies.

Objective:To evaluate the accuracy of an artificial intelligence (AI) model in measuring key angles on pelvic radiographs of the hip and assess its effectiveness in diagnosing developmental dysplasia of the hip (DDH) and borderline developmental dysplasia of the hip (BDDH).Methods:A retrospective analysis was conducted using anteroposterior pelvic X-ray films from 1,029 patients with suspected DDH. The data were collected from the Department of Radiology, Fourth Medical Center of the Chinese PLA General Hospital. Among the patients, 273 were male, and 756 were female, with an average age of 57.01 ± 18.16 years (range, 12-88 years). The dataset was randomly divided into a training set (720 cases), a test set (206 cases), and a validation set (103 cases). Two radiologists identified and marked key anatomical points of the hip joint to establish the training dataset, which was then used to develop a deep learning-based AI model capable of locating these key anatomical positions. Using the identified anatomical points, the AI model automatically measured and calculated the Sharp angle, center-edge (CE) angle, and T?nnis angle in the test dataset. The measurement results from the AI model were compared with those of the radiologists to evaluate the model's accuracy. The validation set was used to optimize model parameters, and the test dataset was used to evaluate the diagnostic performance of DDH. Receiver operating characteristic (ROC) curves were employed to assess the diagnostic efficacy of the AI model for DDH and BDDH.Results:The accuracy rates of the AI model in measuring the left Sharp angle, CE angle, and T?nnis angle for diagnosing DDH were 89.8%, 90.1%, and 86.8%, respectively. For the right side, the accuracy rates were 93.7%, 92.2%, and 80.5%, respectively. There were no statistically significant differences in the mean values of the Sharp, T?nnis, and CE angles between manual and AI measurements ( P>0.05). Pearson correlation tests and intraclass correlation coefficient (ICC) analyses revealed high consistency between AI and manual measurements of the Sharp angle, T?nnis angle, and CE angle, with r-values and ICC values exceeding 0.75. Additionally, the AI model performed measurements significantly faster (1.7±0.1 s) than radiologists (88.1±8.4 s and 90.3±7.4 s, P<0.001). The areas under the ROC curves (AUCs) for diagnosing DDH using the Sharp angle, CE angle, and T?nnis angle measured by the AI model were 0.883, 0.922, and 0.908 (left side) and 0.924, 0.871, and 0.922 (right side), respectively. For diagnosing BDDH, the AUCs of the left and right CE angles measured by the AI model were 0.787 and 0.676, respectively. Kappa test results indicated good agreement between the AI model and manual measurements as well as final clinical diagnoses. For the CE angle, the κ value of the AI model was 0.663, while κ values for the Sharp and T?nnis angles were all greater than 0.800. Conclusion:The convolutional neural network-based AI model effectively and automatically measures the Sharp, CE, and T?nnis angles and demonstrates high diagnostic efficacy for DDH and BDDH.