Objective:To investigate the efficacy and safety of high-frequency irreversible electroporation (H-FIRE) in treating benign prostatic hyperplasia (BPH).Methods:This randomized controlled open-label multicenter clinical trial enrolled patients from nine medical centers in China between August 2020 and July 2022. Inclusion criteria: age 50–80 years, International Prostate Symptom Score (IPSS) ≥12, maximum urinary flow rate (Q max) >5 ml/min and ≤15 ml/min. Exclusion criteria: prostate malignancy, contraindications to surgery or anesthesia. Patients were randomized 1∶1 into the H-FIRE group (experimental) or the control group (daily oral 0.2 mg tamsulosin hydrochloride sustained-release capsules). Primary outcomes included Q max, IPSS, prostate volume, and International Index of Erectile Function-5 (IIEF-5) scores, measured at baseline, 1 and 3 months post-treatment. Results:A total of 160 cases were included in this study, including 80 cases in the experimental group and 80 cases in the control group, 30 cases in Renji Hospital, 7 cases in Qilu Hospital of Shandong University, 8 cases in Tongji Hospital, 3 cases in Hunan Provincial Hospital, 13 cases in Shanghai Pudong Hospital, 29 cases in Hwa Mei Hospital, 18 cases in Yiyuan County People's Hospital, and 38 cases in Shanghai East Hospital, and 14 cases in Sun Yat-sen Memorial Hospital. At 3 months of post-treatment, Q max in the experimental group increased by a median of 7.50 (3.55, 14.50) ml/s from the baseline value, whereas in the control group it increased by a median of 1.70 (-1.40, 6.00) ml/s, and the difference between the two groups was statistically significant ( P < 0.01, U = 1 083); and at 3 months of post-treatment, IPSS in the experimental group decreased by a median of 12.00 (7.00, 17.00) points in the test group and 6.00 (2.00, 11.00) points in the control group, and the magnitude of improvement in IPSS scores in the test group was significantly higher than that in the control group ( P < 0.01, U = 1 248); at 3 months of post-treatment, the prostate volume decreased by a median of 12.16 (5.69, 18.27) ml in the experimental group and 0 (-3.94, 6.89) ml in the control group, suggesting that H-FIRE significantly reduced prostate gland volume ( P<0.01, U=1 111). The difference in elevated IIEF-5 scores from baseline at 3 months of treatment between the experimental and control groups was not statistically significant[0(-2.00, 1.00) points vs. 0(-2.00, 1.50) points; P=0.54, U=2 338]. There were no serious adverse events in the two groups. Conclusions:H-FIRE could significantly improve both subjective and objective symptoms of BPH with a low risk of severe complications.

Objective:To analyze and clarify the meaning of the concept of self-advocacy among patients with chronic diseases using the Rodgers evolutionary concept analysis method.Methods:A systematic search was conducted in databases including PubMed, Web of Science, Cochrane Library, CINAHL, Embase, Medline, VIP, Wanfang, the China National Knowledge Infrastructure, and Chinese Biomedical Literature Database for studies related to self-advocacy in chronic disease patients from February 1, 1992, to June 30, 2024. The Rodgers evolutionary concept analysis method was applied to analyze the selected literature.Results:A total of 72 articles were included in this study. The concept attributes of self-advocacy in chronic disease patients were identified as cognitive awareness, self-action, and resource integration. The antecedents involved included personal characteristics, skill learning, and available support. The outcomes covered improved symptom management, adherence to treatment plans, enhanced nursing and quality of life, and reduced demand for healthcare. The measurement tools used were the Patient Self-Advocacy Scale, Self-Advocacy Scale, Elderly Safety Advocacy Empowerment Scale, and Female Cancer Patient Self-Advocacy Scale.Conclusions:The conceptual attributes of self-advocacy in chronic disease patients were clarified through the Rodgers evolutionary concept analysis method. Future research can combine quantitative and qualitative studies to further explore the significance of self-advocacy in patients with chronic diseases.

Objective:To analyze and clarify the meaning of the concept of self-advocacy among patients with chronic diseases using the Rodgers evolutionary concept analysis method.Methods:A systematic search was conducted in databases including PubMed, Web of Science, Cochrane Library, CINAHL, Embase, Medline, VIP, Wanfang, the China National Knowledge Infrastructure, and Chinese Biomedical Literature Database for studies related to self-advocacy in chronic disease patients from February 1, 1992, to June 30, 2024. The Rodgers evolutionary concept analysis method was applied to analyze the selected literature.Results:A total of 72 articles were included in this study. The concept attributes of self-advocacy in chronic disease patients were identified as cognitive awareness, self-action, and resource integration. The antecedents involved included personal characteristics, skill learning, and available support. The outcomes covered improved symptom management, adherence to treatment plans, enhanced nursing and quality of life, and reduced demand for healthcare. The measurement tools used were the Patient Self-Advocacy Scale, Self-Advocacy Scale, Elderly Safety Advocacy Empowerment Scale, and Female Cancer Patient Self-Advocacy Scale.Conclusions:The conceptual attributes of self-advocacy in chronic disease patients were clarified through the Rodgers evolutionary concept analysis method. Future research can combine quantitative and qualitative studies to further explore the significance of self-advocacy in patients with chronic diseases.

Objective:To investigate the efficacy and safety of high-frequency irreversible electroporation (H-FIRE) in treating benign prostatic hyperplasia (BPH).Methods:This randomized controlled open-label multicenter clinical trial enrolled patients from nine medical centers in China between August 2020 and July 2022. Inclusion criteria: age 50–80 years, International Prostate Symptom Score (IPSS) ≥12, maximum urinary flow rate (Q max) >5 ml/min and ≤15 ml/min. Exclusion criteria: prostate malignancy, contraindications to surgery or anesthesia. Patients were randomized 1∶1 into the H-FIRE group (experimental) or the control group (daily oral 0.2 mg tamsulosin hydrochloride sustained-release capsules). Primary outcomes included Q max, IPSS, prostate volume, and International Index of Erectile Function-5 (IIEF-5) scores, measured at baseline, 1 and 3 months post-treatment. Results:A total of 160 cases were included in this study, including 80 cases in the experimental group and 80 cases in the control group, 30 cases in Renji Hospital, 7 cases in Qilu Hospital of Shandong University, 8 cases in Tongji Hospital, 3 cases in Hunan Provincial Hospital, 13 cases in Shanghai Pudong Hospital, 29 cases in Hwa Mei Hospital, 18 cases in Yiyuan County People's Hospital, and 38 cases in Shanghai East Hospital, and 14 cases in Sun Yat-sen Memorial Hospital. At 3 months of post-treatment, Q max in the experimental group increased by a median of 7.50 (3.55, 14.50) ml/s from the baseline value, whereas in the control group it increased by a median of 1.70 (-1.40, 6.00) ml/s, and the difference between the two groups was statistically significant ( P < 0.01, U = 1 083); and at 3 months of post-treatment, IPSS in the experimental group decreased by a median of 12.00 (7.00, 17.00) points in the test group and 6.00 (2.00, 11.00) points in the control group, and the magnitude of improvement in IPSS scores in the test group was significantly higher than that in the control group ( P < 0.01, U = 1 248); at 3 months of post-treatment, the prostate volume decreased by a median of 12.16 (5.69, 18.27) ml in the experimental group and 0 (-3.94, 6.89) ml in the control group, suggesting that H-FIRE significantly reduced prostate gland volume ( P<0.01, U=1 111). The difference in elevated IIEF-5 scores from baseline at 3 months of treatment between the experimental and control groups was not statistically significant[0(-2.00, 1.00) points vs. 0(-2.00, 1.50) points; P=0.54, U=2 338]. There were no serious adverse events in the two groups. Conclusions:H-FIRE could significantly improve both subjective and objective symptoms of BPH with a low risk of severe complications.

Objective:To improve the awareness of neuroblastoma (NB) with cervical lymph node metastasis in children patients by summarizing the clinical features of such patients and analyzing their survival situation.Methods:The research analyzed the medical records of 225 patients with cervical lymph node metastasis of NB from April 1, 2007 to May 31, 2017 in Beijing Children′s Hospital, Capital Medical University.The treatment were divided into 2 phases according to treatment time (one from April 1, 2007 to December 31, 2011 and the other from January 1, 2012 to May 31, 2017). The survival situation and treatment effect in each phase were analyzed.The following up time ended at Jan 1, 2018.Results:(1)Clinical features: total 225 cases admitted in the research with about 37.3% of all the NB patients.One hundred girls(44.4%) and 125 boys(55.6%). The age from 2 months to 147 months, the me-dian age of patients was 37 months.The age under 18 months were 27 cases(12.1%). The majority primary site of tumor was located in retroperitoneal(174 cases, 77.3%) and mediastinum(48 cases, 21.3%). There were 33 cases which metastasic site confined to cervical lymph node(4N stage, 14.7%); 139 cases (62.1%) with bone marrow metastasis, 159 cases (71.0%) with bone metastasis.The number of patients in high-risk group was 208 cases(91.2%), while the low-risk and the medium-risk group was 17 cases(7.5%). (2)Treatment effect and survival analysis: a total of 200 cases received systemic treatment and followed-up in our hospital.The follow up time from 2 months to 123 months, the median follow up time was 23 months.The 3 year overall survival (OS) rate of all the patients was 56.4%, the 3 year event free survival (EFS) rate was 52.0%.While the 5-year OS was 46.5%, and the 5-year EFS was 39.7%.According to the first phase of treatment(April 1, 2007 to December 31, 2011), the 3-year EFS was 49.6%, and the 3-year OS was 54.4%, the 5-year EFS was 39.5%, and the 5-year OS was 44.7%.According to the second phase of treatment(January 1, 2012 to May 31, 2017), the 3-year EFS was 58.1%, and the 3-year OS was 57.3%.The 5-year EFS was 48.7%, and the 5-year OS was 46.8%.About the 4N patients, the 3-year EFS was 71.2%, and the 3-year OS was 82.2%.The 5-year EFS was 61.5%, and the 5-year OS was 76.7%.Conclusions:Cervical lymph node is one of the most common distant metastasis of NB.More than half of the patient with bone or bone marrow metastasis.The prognosis of patients′ metastatic disease limited to cervical lymph nodes(4N stage), but still worse than the foreigner haver reported.The probable reason is the proportion of high-risk patients in the center is higher than the foreign research.

Objective To study the effect of non-nutritional sucking intervention on low birth weight infants.Methods One hundred and forty cases of low birth weight infants were randomly divided into experimental group(n=73) and conventional group (n=67).Both groups of infants were treated with enteral nutrition.The experimental group was treated with non-nutritive sucking interventions.Results The abnormality rate of QRS wave(2.74％) and heart rate (4.11％) in experimental group were significantly lower than those in the conventional group (11.94 ％,17.91 ％),the differences were statistically significant (P＜ 0.05).In the experimental group,the meconium discharge time,recovery time,nasogastric tube indwelling time and the time of intestinal nutrition reached 481.4 kJ-1 · kg-1 · d-1 were significantly lower than that of the conventional group(P＜0.05).The incidence of bloating(2.74 ％),vomiting (2.74 ％) and gastric retention (5.48 ％) in experimental group were significantly lower than than of the conventional group (13.43％,11.94％,25.37％),P＜0.05.There was no significant difference in the incidence of apnea and diarrhea between the two groups (P＞0.05).Conclusion Non-nutritional sucking intervention can effectively reduce the incidence of ECG abnormalities and feeding complications in low birth weight infants.

OBJECTIVETo assess the impact of work-related musculoskeletal disorders (WRMDs) on work ability among workers.

METHODSA total of 1686 workers in various occupations, such as administration and education, were enrolled as subjects using the random cluster sampling method. The WRMDs and work ability of all subjects were evaluated using standardized Nordic questionnaires for the analysis of musculoskeletal symptoms and the Work Ability Index (WAI) scale, respectively. Comparison of work ability and its classification between the disease group and the non-disease group was performed by paired t test, RxC table χ2 test, and the Wilcoxon rank-sum test. The relationship between work duration and work ability was analyzed by the Spearman correlation test and a multi-level model.

RESULTS(1). The work ability of workers in the disease group was significantly lower than that in the non-disease group (P<0.0 1). (2) There were significant differences in work ability between workers with different work durations (<10 years, 10-20 years, and ≥20 years) (F=22.124, P< 0.01). With the increase in work duration, the work ability of workers declined in both groups, and the work ability of workers in the disease group (Spearman coefficient rs=-0. 172, P<0.01) had a more significant decline than that in the non-disease group (Spearman coefficient rs=-0.104, P<0.01). WRMDs were important risk factors for the decrease in work ability among workers. (3) There were significant differences in constituent ratios and levels of work ability classification between the disease group and the non-disease group (χ2=121.097, P<0.01; Z=-10.699, P<0.01). The proportions of workers with poor and medium work ability in the disease group were significantly higher than those in the non-disease group, while the proportion of works with excellent work ability in the disease group was significantly lower than that in the non-disease group. The similar characteristics in constituent ratios and levels of work ability classification could be found between the disease group and the non- disease group in various occupations (P<0.01).

CONCLUSIONWRMDs have a harmful effect on the work ability of workers, and the work ability of workers substantially declines with the increase in exposure time (work duration).

Humans ; Musculoskeletal Diseases ; physiopathology ; Occupational Health ; Occupations ; Risk Factors ; Surveys and Questionnaires ; Work Performance

OBJECTIVETo characterize the distribution of work-related musculoskeletal disorders (WRMD) among the occupational population.

METHODSA total of 1686 people of various occupations were recruited with random cluster sampling. Standardized Nordic questionnaires for the analysis of musculoskeletal systems were used to evaluate WRMD at the neck, shoulder, or lower back in the past one year. The annual prevalence of WRMD was determined. Difference analysis was performed with t-test, ANOVA, or chi-square test. The relationship between personal characteristics and WRMD was analyzed by unconditional logistic regression.

RESULTS(1) WRMD were most frequently observed at the neck, followed by the lower back, and was least observed at the shoulder (P < 0.05). The prevalence of WRMD among mental workers was significantly higher than those among physical workers and mental-physical workers (P < 0.01). The prevalence of WRMD among female workers was significantly higher than that among male workers (P < 0.05). (2) In general, the prevalence of WRMD significantly rose with the increases in age (<30, 30∼, 40∼, and ≥ 50 years) or working years (<10, 10∼, and ≥ 20 years) (P < 0.05). (3) In the face of sickness or injury, physical workers and mental workers showed a relatively high absence rate but a relatively low medical visiting rate (13.05%). (4) Unconditional logistic regression analysis showed that mental work, gender, and working year were the main influential factors for WRMD among workers.

CONCLUSIONWorkers of different types of occupation, genders, ages, and working years have different risks of WRMD at the neck, shoulder, and lower back.

Adult ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Musculoskeletal Diseases ; epidemiology ; Occupational Diseases ; epidemiology

Objective To evaluate the safety and efficacy of transumbilical single port laparoscopic cholecystectomy. Methods The clinical data of 16 patients who received transumbilical single port laparoscopic cholecystectomy at Xinqiao Hospital from January 2008 to May 2010 were retrospectively analysed. An incision with a length of 1.5 cm was made adjacent to the umbilicus, and then two 5 mm trocars and one 10 mm trocar were installed. After the establishment of pneumoperitoneum, a laparoscopic camera was placed via the 10 mm trocar,and laparoscopic instruments and a 5 mm ultrasonic scalpel were placed via the two 5 mm trocars, respectively.Cholecystectomy was performed in the same manner as for the conventional laparoscopic procedure. Results All the operations were successfully carried out. The operation time was 50-150 minutes. No drainage tube was inserted,and no complications such as bleeding or bile leakage were observed after the operation. Patients recovered well,and no scarring was observed around the umbilicus. Conclusions Transumbilical single-port laparoscopic cholecystectomy is safe and feasible, but it is more difficult than laparoscopic cholecystectomy in terms of manipulation.Transumbilical single-port laparoscopic cholecystectomy has the potential to replace laparoscopic cholecystectomy if the operative instruments are improved.

Objective To study 18F-deoxyglueose positron emission tomography computed tomo graphy(18 FDG PET-CT) in the diagnosis of cervical lymph node(LN) metastasis from rabbit nasopharyngeal VX2 carcinoma.Methods Nasopharyngeal VX2 carcinoma model using 30 rabbits was established. 18 FDG PET-CT,MRI and pathological diagnosis were performed and compared.ResultsFifty-three cervi cal LNs were picked up from resected specimens of 30 rabbits with nasopharyngeal VX2 carcinoma.There were 42 pathologically confirmed positive LNs.Positivity rate was significantly correlated with the volume and the shortest diameter of the LNs (r = 9.18,P =0.007 ; r = 2.77,P = 0.008).The diagnostic sensitivity of PET-CT was 96% (24/25) and 29% (5/17) for LNs with volume >0.5 cm3 and ≤0.5 cm3 ,83% (25/30) and 33% (4/12) for LNs with the shortest diameter ≥0.5 cm and < 0.5 cm,respectively.The diagnostic sensitivity,specificity and accuracy of PET-CT was 69% (29/42) ,100% (11/11) and 95% (40/42) ,com paring with 60% (25/42) ,91% (10/11) and 83% (35/42) of MRl,respectively.The volume measured by PET-CT images was not significantly different from the pathologically measured volume (t =-1.23,P = 0.233) ,while the volume measured by MRI was significantly different from the pathologically measured vol ume (t =-3.99,P = 0.001).Conclusions The sensitivity,specificity and accuracy of PET-CT are better than those of MRl,especially for the cervical lymph nodes with volume >0.5 cm3 or the shortest diameter ≤ 0.5 cm.PET-CT also can be used to detect the smaller metastatic lymph nodes,though the false negative rate is higher.