Objective:This study aimed to evaluate the prognostic factors of clinical and histopathological parameters,including age,gender,tumor stage,tumor grade,tumor differentiation,lymph node metastasis(LNM),tumor frequency,and tumor count,in patients undergoing radical cystectomy(RC)combined with Mainz Pouch Ⅱ bladder reconstruction.Methods:A total of 237 bladder cancer patients(198 male and 39 female)who underwent RC combined with Mainz Pouch Ⅱ bladder reconstruction without chemotherapy or radiotherapy,from January 2004 to January 2023,were included in this study.Kaplan-Meier and Cox regression analyses were performed to assess the impact of age,tumor grade,tumor stage,tumor differentiation,LNM,tumor frequency,and tumor count on 5-year overall survival(OS)and 5-year cancer-specific survival(CSS).Results:The mean age at diagnosis was 59.8 years,with 198 male and 39 female patients.The mean follow-up duration was 47.8 months.In univariate analysis,patients younger than 65 years had significantly higher 5-year OS and 5-year CSS compared to those aged≥65 years.Patients with urothelial carcinoma showed better 5-year OS than those with non-urothelial carcinoma.Additionally,tumor stage,tumor grade,and LNM were negatively associated with 5-year OS and 5-year CSS.On multivariate analysis,only tumor grade and LNM remained statistically significant(P<0.05).Conclusions:Tumor grade and LNM were identified as independent prognostic risk factors for 5-year OS and 5-year CSS following RC combined with Mainz PouchⅡ bladder reconstruction.Moreover,the application of RC combined with Mainz Pouch Ⅱ bladder reconstruction should consider the patient's preferences and physical condition.

Objective:This study aimed to evaluate the prognostic factors of clinical and histopathological parameters,including age,gender,tumor stage,tumor grade,tumor differentiation,lymph node metastasis(LNM),tumor frequency,and tumor count,in patients undergoing radical cystectomy(RC)combined with Mainz Pouch Ⅱ bladder reconstruction.Methods:A total of 237 bladder cancer patients(198 male and 39 female)who underwent RC combined with Mainz Pouch Ⅱ bladder reconstruction without chemotherapy or radiotherapy,from January 2004 to January 2023,were included in this study.Kaplan-Meier and Cox regression analyses were performed to assess the impact of age,tumor grade,tumor stage,tumor differentiation,LNM,tumor frequency,and tumor count on 5-year overall survival(OS)and 5-year cancer-specific survival(CSS).Results:The mean age at diagnosis was 59.8 years,with 198 male and 39 female patients.The mean follow-up duration was 47.8 months.In univariate analysis,patients younger than 65 years had significantly higher 5-year OS and 5-year CSS compared to those aged≥65 years.Patients with urothelial carcinoma showed better 5-year OS than those with non-urothelial carcinoma.Additionally,tumor stage,tumor grade,and LNM were negatively associated with 5-year OS and 5-year CSS.On multivariate analysis,only tumor grade and LNM remained statistically significant(P<0.05).Conclusions:Tumor grade and LNM were identified as independent prognostic risk factors for 5-year OS and 5-year CSS following RC combined with Mainz PouchⅡ bladder reconstruction.Moreover,the application of RC combined with Mainz Pouch Ⅱ bladder reconstruction should consider the patient's preferences and physical condition.

Pancreatic neuroendocrine neoplasms(pNENs)are rare and highly heterogeneous pancreatic tumors with insidious clinical manifestations.They have a high propensity for distant metastasis,with liver metastases being the most common,significantly impacting patient prognosis.Despite extensive research on treating pNEN with liver metastases in recent years,many controversies and gaps remain.With the advancement of multidisciplinary treatment approaches,therapeutic strategies for pNEN liver metastases have been continuously refined,encompassing surgical resection,local therapies(such as radiofrequency ablation and transarterial interventions),and systemic treatments(including chemotherapy,targeted therapy,immunotherapy,radionuclide therapy,and endocrine therapy).Combination therapy has become an emerging trend.Radical surgery remains the preferred option for resectable cases,while for inoperable or treatment-intolerant patients,a rational combination of local and systemic therapies can improve survival outcomes.Additionally,endocrine therapy is crucial in symptom relief and quality-of-life improvement for patients with functional pNEN.Multidisciplinary collaboration in formulating individualized treatment plans can significantly enhance patient prognosis.This review summarizes recent advancements in treating pNEN liver metastases,providing a reference for clinical decision-making.

Objective To investigate the clinical effect of free electromyography(fEMG)monitoring as-sisted unilateral biportal endoscopy(UBE)in the treatment of lumbar disc herniation.Methods Forty pa-tients with lumbar disc herniation were included.The UBE lumbar nucleus pulposus resection under general anesthesia was performed.The operation whole process was completed under the fEMG monitor.The recorded potential was displayed on the monitor screen and the myoelectrical activity was played through speaker.The treatment effect was evaluated by the Visual Analogue Scale(VAS)score and Oswestry Disability Index(ODI).Results All 40 patients completed the surgery successfully,and the postoperative symptoms were im-proved significantly.The VAS scores before operation and in postoperative 3 months were 7(6,8)points and 0(0,1)points respectively,and the difference between the two time points was statistically significant(P＜0.05).The ODI before operation and in postoperative 3 months were(58.30±11.58)and(13.28±5.20)re-spectively,and the difference between the two time points also was statistically significant(P＜0.05).The VAS score and ODI in postoperative 1 year were 1(0,1)points and(13.13±0.40)respectively,showing sta-tistically significant difference compared with before surgery(P＜0.05),but there was no statistically signifi-cant difference compared with postoperative 3 months(P＞0.05).There were 8 cases developing the abnor-mal EMG changes such as spike,burst or tonic fEMG during surgery,with an incidence rate of 20％.After surgery in 8 cases,7 cases had burning radiculalgia and paresthesia of lower extremity,and 1 case had no obvi-ous neuralgia,with a false positive rate of 12.5％.The patients without abnormal fEMG reaction during sur-gery had no significant postoperative neuralgia,and the false negative rate was zero.Conclusion fEMG moni-toring assisted UBE under general anesthesia is a safe and easy method for the treatment of lumbar disc herni-ation.

Pancreatic neuroendocrine neoplasms(pNENs)are rare and highly heterogeneous pancreatic tumors with insidious clinical manifestations.They have a high propensity for distant metastasis,with liver metastases being the most common,significantly impacting patient prognosis.Despite extensive research on treating pNEN with liver metastases in recent years,many controversies and gaps remain.With the advancement of multidisciplinary treatment approaches,therapeutic strategies for pNEN liver metastases have been continuously refined,encompassing surgical resection,local therapies(such as radiofrequency ablation and transarterial interventions),and systemic treatments(including chemotherapy,targeted therapy,immunotherapy,radionuclide therapy,and endocrine therapy).Combination therapy has become an emerging trend.Radical surgery remains the preferred option for resectable cases,while for inoperable or treatment-intolerant patients,a rational combination of local and systemic therapies can improve survival outcomes.Additionally,endocrine therapy is crucial in symptom relief and quality-of-life improvement for patients with functional pNEN.Multidisciplinary collaboration in formulating individualized treatment plans can significantly enhance patient prognosis.This review summarizes recent advancements in treating pNEN liver metastases,providing a reference for clinical decision-making.

Objective:To explore effect of IgG receptor FcγRⅡB on neuronal injury and imbalance of Th17/Treg in experi-mental autoimmune encephalomyelitis(EAE)model mice.Methods:C57BL/6 mice were randomly divided into control group,EAE group,FcγRⅡB group and EAE+FcγRⅡB group,with 15 mice in each group.EAE model was induced by subcutaneous injection of MOG35-55 peptide and treated with FcγRⅡB lentiviral solution.After modeling was established,body weight of mice was weighed every day,and neurological function was scored for 30 d;after 30 days,mice were sacrificed.HE staining was used to observe patho-logical changes of brain tissue,LFB staining was used to assess structural changes of spinal cord myelin,and immunofluorescence staining was used to detect spinal cord cerebral cortex neuron nuclear antigen(NeuN)and Caspase-3 expressions,TUNEL staining was used to detect apoptosis of neurons,ELISA was used to detect serum IL-6,IL-17,IL-10 and TGF-β levels,flow cytometry was used to analyze proportion of Th17 and Treg cells in spleen,Western blot was used to determine protein expressions of retinoic acid-related orphan receptor γt(RORγt)and Forkhead family transcription factor 3(Foxp3)in spinal cord tissue.Results:Compared with control group,mice in EAE group had decreased body weight,increased neurological function scores,obvious infiltration of inflamma-tory cells in brain tissue,and signs of demyelination in spinal cord,fluorescence expression intensity of NeuN was weakened and fluorescence expression intensity of Caspase-3 was enhanced,there were more TUNEL-positive stained cells,number of apoptotic cells was increased,levels of IL-6 and IL-17 in serum were increased,and levels of IL-10 and TGF-β were decreased,proportion of Th17 cells in spleen was increased,proportion of Treg was decreased,expression of RORγt protein in spinal cord tissue was up-regu-lated while relative expression of Foxp3 protein was down-regulated(P<0.05);compared with EAE group,weight of mice in EAE+FcγRⅡB group was increased,neurological function score was decreased,infiltration of inflammatory cells in brain tissue was reduced,demyelination of spinal cord was improved,fluorescence expression intensity of NeuN was enhanced,and fluorescence expression intensity of Caspase-3 was weakened,there were fewer TUNEL-positive stained cells,number of apoptotic cells was decreased,levels of IL-6 and IL-17 in serum were decreased,while levels of IL-10 and TGF-β were increased,at the same time,proportion of Th17 cells in spleen was decreased and proportion of Treg was increased,expression of RORγt protein in spinal cord tissue was down-regulated,while expression of Foxp3 protein was up-regulated(P<0.05).Conclusion:FcγRⅡB has neuroprotective effect on EAE mice,and can reduce infiltration of inflammatory cells and demyelination in brain tissue,whose mechanism may be related to regulation of cytokine levels and immune balance of Th17/Treg cells.

Objective:To investigate the effect of glucocorticoids on brain injury in rats with Streptococcus pneumoniae(SP)meningitis,as well as the changes of cerebrospinal fluid immunoglobulin levels under this effect.Methods:A total of 40 SD rats were divided into control group,model group,low-dose methylprednisolone sodium succinate group(Low-MSS)and high-dose methylpred-nisolone sodium succinate group(High-MSS)according to random table method,with 10 rats in each group.Except for the control group,SP meningitis models were established in other groups.Rats in Low-MSS group and High-MSS group were injected with methyl-prednisolone sodium succinate by tail vein at doses of 5 mg/kg and 10 mg/kg,respectively,once a day for 21 days.Neurobehavioral scores of rats after modeling were performed by Loeffler method;contents of immunoglobulin IgA,IgM and IgG in cerebrospinal fluid of rats were detected by immunoturbidimetry;levels of inflammatory cytokines TNF-α,IL-6 and IFN-γ in supernatant of rats brain ho-mogenate were determined by ELISA;HE staining was used to detect pathological changes of rats brain tissue;Nissl staining was used to detect the number of neuronal cells in rats brain tissue;TUNEL staining was used to detect the number of apoptotic cells in rats brain tissue;immunofluorescence staining was used to detect expressions of GFAP and S-100b,the marker proteins of rat brain tissue injury.Results:Before SP injection,there was no difference in neurobehavioral scores between control group and model group(P>0.05),at 24 h,48 h and 72 h after SP injection,neurobehavioral scores in model group were significantly lower than those in control group(P<0.05).Compared with control group,contents of IgA,IgM and IgG in cerebrospinal fluid of rats in model group were in-creased,and contents of TNF-α,IL-6 and IFN-γ in supernatant of the brain homogenate were also increased,the tissue was obviously damaged,accompanied by a large number of inflammatory cells infiltration,the number of neuronal cells were decreased,the number of apoptotic cells were increased,and the fluorescence density values of S-100b and GFAP were increased(P<0.05);compared with model group,contents of IgA,IgM and IgG in cerebrospinal fluid of rats in Low-MSS group and High-MSS group were decreased,and contents of TNF-α,IL-6 and IFN-γ in brain homogenate supernatant were also decreased(P<0.05),brain tissue damage was alleviated,inflammatory cell infiltration was significantly reduced,neuronal cells were increased,the number of apoptotic cells were decreased,and the fluorescence density values of S-100b and GFAP were also decreased(P<0.05).In addition,the improvement effect of various indexes and brain tissue damage in High-MSS group was better than that in Low-MSS group,and the difference were statistically signifi-cant(P<0.05).Conclusion:Glucocorticoid methylprednisolone sodium succinate can effectively improve the brain tissue damage in SP meningitis rats,regulate the levels of immunoglobulin IgA,IgM and IgG,and has a protective effect on SP meningitis rats.

Objective To explore esomeprazole(EMZ)on acetaminophen(APAP)pharmacokinetics and intestinal microbial balance.Methods A total of 14 rats were randomly allocated into two groups,with 7 rats in each group:acetaminophen group(APAP group),and acetaminophen+esomeprazole combination group(APAP+EMZ group),respectively.Rats in the combination group were fed in the metabolic cage.Equivalent 3.6 mg·kg-1·d-1 esomeprazole was administered intragastrically to the combination group for 14 days;Similarly,an equal volume of 0.9％sodium chloride soution(NaCl)was fed to the APAP group for 14 days.During this period,fecal samples were collected from the rats before and after 14 days of EMZ administration for microbial 16S rRNA sequencing.On the 15th day,both the APAP group and APAP+EMZ groups were administratered an equivalent of 44.82 mg·kg-1 APAP by the same method after the regular EMZ administration.The concentrations of APAP in rat plasma were determined by the UPLC-MS/MS method.Main pharmacokinetic parameters were processed and compared using the software DAS 3.0.1 and SPSS 24.0.Results The pharmacokinetic parameter Cmax of APAP was significantly different between APAP group and APAP+EMZ group(P＜0.05).Compared with APAP group,Cmax increased by 120.38％in the APAP+EMZ group.The pharmacokinetic parameters(AUC(0-∞)、CL、t 1/2、tmax)of APAP showed no statistical differences between APAP group and APAP+EMZ group(P＞0.05).The results of 16SrRNA of intestinal flora showed that the abundance of Lactobacillus,Bacteroides,Clostridium,and Escherichia decreased compared with that before drug administration,while the abundance of Bifidobacterium increased.However,the relative abundance of the above flora showed no prominent differences before and after the EMZ intervention(P＞0.05).Conclusions This study showed that when combining EMZ with APAP,the relative abundance of those related flora,which may influence the β-Glucuronidase,all changed to some extent,but made no difference in statistics.The effect of EMZ on the Cmax of APAP was statistically significant.However,the use of EMZ for two weeks did not alter the other pharmacokinetics of APAP by affecting the gut microbiota.

Radiocarpal fracture-dislocation (RFD) is a rare injury normally associated with the destruction of bones, joints and ligaments. The improper diagnosis and treatment of RFD will cause severe complications and affect the long-term function of wrist joints. The difficulties of clinical diagnosis and treatment lie in the accurate diagnosis, identification and reconstruction of the structure of specific injury. As the foreign and domestic literatures are mainly case analyses or systemic case reports rather than large-scale reports, there still lacks a systemic knowledge of the standard diagnosis and treatment of RFD clinically, thus leading to problems such as missed diagnosed or misdiagnosed, improper application of treatment methods and incomplete reconstruction. Therefore, the authors reviewed relevant literatures about the features, diagnosis and treatment of RFD, in order to provide references for the clinical diagnosis and treatment of RFD.

Objective: To discuss the effect of high-density fat-binding SVF-GEL in female facial lipofilling. Methods: This is a retrospective study including 32 female patients, received facial fat transplantation during June 2017 to June 2018 in Yichun College. Each patient underwent high-density fat-binding SVF-GEL transplantation for facial surgery. Patients′satisfaction with the surgery and the rate of secondary surgery was evaluated. Fat was harvested from the inner thigh, centrifuged at 1200 g for 3 min, and the liquid was removed. The upper 2/3 part is prepared for SVF-GEL, for further used in delicate lipofilling in eyelid, tear groove and nasolabial groove. The lower 1/3 high density fat was used for volume restoration, such as forehead, temporal area and cheek. Results: All patients had significant improvements in facial contours with mild swelling and short recovery time. The satisfaction rate was 68.8%(22/32), and the second operation rate was 15.6%(5/32). Conclusions High-density fat-binding SVF-GEL transplantation can achieve good results in correcting facial volume loss.