Purpose: This study aimed to evaluate the safety and efficacy of gemcitabine and cisplatin (GP) regimen in combination with immune checkpoint inhibitor sintilimab as neoadjuvant therapy for muscle-invasive bladder cancer (MIBC) patients and the feasibility of the following selective bladder sparing surgery. Materials and Methods: Patients with histopathologically confirmed urothelial carcinoma without distant metastases (T2-4a, N ≤ 1, M0, American Joint Committee of Cancer 8th) and with adequate organ function will be enrolled. The therapeutic regimen was sintilimab 200 mg once on day 8, gemcitabine 1,000 mg/m2 and cisplatin 35 mg/m2 once on days 1 and 8, every 21 days for four cycles. The primary endpoint was pathologic complete response (pCR, pT0N0) rate. The secondary end points were ypT < 2 rate, R0 resection rate, event-free survival, and safety. Results: From May 4, 2020, to May 20, 2023, 55 patients were enrolled. Forty-six patients were evaluated for efficacy. Among the 42 patients who underwent surgery, 16 patients (38.0%) achieved pCR. Thirty-three patients (78.6%) achieved pT < 2. With a median follow-up of 15.7 months, the 1-year event-free survival was 91.3%. Notwithstanding the poor pathological baseline characteristic of a high T3-T4a proportion (39.1%), a promising bladder preservation (including 22 patients transurethral resection of bladder tumor, 5 patients partial cystectomy, and 4 surveillances) rate was achieved (67.4%). The most common grade ≥ 3 treatment-related adverse events was neutropenia (n=15, 27.3%), which was related to chemotherapy. There were no grade 3 immune-related adverse events. Conclusion Neoadjuvant GP plus sintilimab is a promising regimen for MIBC patients, with relatively high pT < 2 rate and triggering the emerging roles for the multi-disciplinary team decision-making for bladder sparing surgery.

Objective To explore the feasibility of magnetic compression technique (MCR) in the treatment of severe single mid-ureteral stricture in a rabbit model. Methods After 10 female New Zealand rabbits were selected, the distal end of the right ureter was ligated with silk thread. Two weeks after the operation, when the right ureter was dilated, the mid-ureter was ligated again with silk thread to create a severe single mid-ureteral stricture animal model. Longitudinal incisions were made at the upper and lower ends of the ligation site, and cylindrical NdFeB magnets with central holes (sub-magnets and main magnets) were placed to anastomose and recanalize the mid-ureteral stricture. The magnets were adjusted to the appropriate position to automatically align and attract each other. The longitudinal incision sites of the ureter were sutured with 6-0 Prolene thread, and the abdominal cavity was closed layer by layer. The operation time was recorded. X-ray films were taken every two days to confirm the position of the magnets and record the time of magnet detachment. Three weeks after the operation, the anastomotic specimens were obtained, and the formation of the anastomosis was evaluated with gross observation and histological staining. Results Two weeks after ligation, all experimental rabbits showed obvious dilation of the right ureter. The mid-ureteral ligation and placement of the male and female magnets were successfully completed in all 10 experimental rabbits, with an operation time of (24.00±5.15)minutes. The male and female magnets attracted each other well. X-ray examination showed that the magnets detached and entered the distal ureter (14.0±1.9) days after magnetic compression. The recanalization of the severe single mid-ureteral stricture was successfully achieved. The gross specimens and histological examination of the anastomosis showed that the anastomosis remained patent and the mucosal healing was good. All experimental rabbits survived well after the operation without serious complications. Conclusion MCT provides a new idea and novel method for the treatment of mid-ureteral stricture. This study confirmed the feasibility of this technique in treating severe single mid-ureteral stricture in a rabbit model. The operation is relatively simple and has potential for clinical application.

his cross-sectional study employed convenience sampling to enroll 1 994 community-dwelling older adults (aged ≥65 years) undergoing health examinations at a Guangzhou community hospital between January and December 2024, aiming to investigate associations between blood lipid profiles and cognitive impairment. Cognitive function was assessed using the AD8 scale, with demographic characteristics (age, sex, education, occupation), health status (hypertension, diabetes mellitus), and lifestyle factors (smoking/alcohol use) collected via questionnaires. Fasting blood samples quantified triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). Propensity score matching (PSM) balanced baseline characteristics between lipid-level groups. Pre-PSM analyses revealed significant intergroup differences: TG groups differed in sex, BMI, alcohol use, hypertension, and self-rated health ( P<0.05); TC groups in sex, age, occupation, diabetes, and hypertension; LDL-C groups in sex, age, occupation, diabetes, hypertension, and daily living ability; HDL-C groups in sex, age, education, occupation, BMI, smoking, diabetes, and hypertension. Post-PSM adjustment eliminated baseline differences ( P>0.05). Multivariable logistic regression adjusted for demographic, clinical, and lifestyle factors demonstrated that elevated TG levels conferred a 48% reduced risk of cognitive dysfunction [ OR (95% CI): 0.52 (0.29-0.94)], whereas TC, LDL-C, and HDL-C showed no significant associations (all P>0.05). These findings suggest an inverse association between higher triglyceride levels and cognitive dysfunction risk in older adults, highlighting TG′s potential protective role in cognitive health.

OBJECTIVE To explore the risk factors for serum COVID-19 antibodies in the population of Fuzhou to provide scientific basis for prevention and control strategies.METHODS The prospective study and the multi-stage stratified random sampling method were performed to select at least 200 subjects from each of the 12 counties(cit-ies)in Fuzhou.Questionnaires follow-ups and serum collections were conducted in Mar,Jun,Sep,and Dec.2024,respectively.The antibody levels in Dec.were divided into a high protective antibody group(IgG antibody≥50 AU/ml)and a low protective antibody group(IgG antibody≤20 AU/ml).The influencing factors of serum anti-body levels were analyzed by multivariate logistic regression model.RESULTS A total of 2816 subjects were en-rolled.In Mar,1454 subjects with high-protective antibodies were identified.After nine months of follow-up,of the 1454 subjects,344 had high protective antibodies and 369 had low protective antibodies in Dec..There were statistically significant differences in age,presence of typical symptoms after infection,underlying diseases,surgi-cal history,healing time,smoking and drinking histories between the high and low antibody groups(P<0.05).Multivariate logistic regression model showed that older age,underlying diseases,history of surgery,smoking and drinking were risk factors which could reduce antibody levels(P<0.05),while typical symptoms after infec-tion and longer recovery time were protective factors which could increase antibody levels(P<0.05).After the COVID-19 infection in spring of 2024,the serum antibody levels in Fuzhou residents showed the downward trend,especially after Sep.2024,with a more pronounced downward trend.CONCLUSIONS According to the risk factors of COVID-19 antibody levels,prevention and control efforts should be focused on the key population.It is necessa-ry to strengthen health education and carry out vaccination to maintain the levels of immunity to protect population from COVID-19 infection.

his cross-sectional study employed convenience sampling to enroll 1 994 community-dwelling older adults (aged ≥65 years) undergoing health examinations at a Guangzhou community hospital between January and December 2024, aiming to investigate associations between blood lipid profiles and cognitive impairment. Cognitive function was assessed using the AD8 scale, with demographic characteristics (age, sex, education, occupation), health status (hypertension, diabetes mellitus), and lifestyle factors (smoking/alcohol use) collected via questionnaires. Fasting blood samples quantified triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). Propensity score matching (PSM) balanced baseline characteristics between lipid-level groups. Pre-PSM analyses revealed significant intergroup differences: TG groups differed in sex, BMI, alcohol use, hypertension, and self-rated health ( P<0.05); TC groups in sex, age, occupation, diabetes, and hypertension; LDL-C groups in sex, age, occupation, diabetes, hypertension, and daily living ability; HDL-C groups in sex, age, education, occupation, BMI, smoking, diabetes, and hypertension. Post-PSM adjustment eliminated baseline differences ( P>0.05). Multivariable logistic regression adjusted for demographic, clinical, and lifestyle factors demonstrated that elevated TG levels conferred a 48% reduced risk of cognitive dysfunction [ OR (95% CI): 0.52 (0.29-0.94)], whereas TC, LDL-C, and HDL-C showed no significant associations (all P>0.05). These findings suggest an inverse association between higher triglyceride levels and cognitive dysfunction risk in older adults, highlighting TG′s potential protective role in cognitive health.

Objective To investigate and elucidate the effect of trigonelline(TRG)on the ARPE-19 ferroptosis sig-naling pathway under hypoxia conditions.Methods ARPE-19 cells were routinely cultured and intervened with different concentrations of TRG.According to the optimal concentration(40 mg·L-1)of TRG determined for ARPE-19 interven-tion,the cells were divided into an NC group(routinely cultured for 24 h),a CoCl2 group(treated with 150 mmol·L-1 CoCl2 for 24 h),a Fer-1 group(treated at first with 1 μmol·L-1 Fer-1 for 12 h and then with 150 mumol·L-1 CoCl2 for 12 h),and a TRG group(treated at first with 40 mg·L-1 TRG for 24 h and then with 150 mmol·L-1 CoCl2 for 24 h).The levels of glutathione(GSH),malondialdehyde(MDA)and Fe2+ions in each group of cells were evaluated by detectionkits.The levels of reactive oxygen species(ROS)in each group of cells were detected by flow cytometry.Western blot was used to analyze the expression levels of hypoxia-induced factor-1α(HIF-1α),vascular endothelial growth factor(VEGF),glutathione peroxidase 4(GPX4)and acyl-CoA synthetase long-chain family member 4(ACSL4)in each group of cells.The expression levels of VEGF and ACSL4 proteins in each group of cells were measured by immunofluorescence staining.Results The ROS levels in TRG and Fer-1 groups were significantly lower than those in the CoCl2 group(t=27.91,31.61;both P＜0.01).The change trend of MDA and Fe2+levels was the same with that of ROS levels in each group.Com-pared with those in the CoCl2 group,the GSH levels were increased significantly(t=15.95,12.76;both P＜0.01)and the relative expression levels of HIF-1α and VEGF proteins were decreased significantly in Fer-1 and TRG groups(all P＜0.01).The CoCl2 group had higher ACSL4 levels and lower GPX4 levels than the NC group(t=31.05,13.18;both P＜0.01).Fer-1 and TRG groups had lower ACSL4 expression levels and higher GPX4 expression levels than the CoCl2 group(all P＜0.01).The results of immunofluorescence staining showed that the expression levels of VEGF and ACSL4 proteins in the CoCl2 group were higher than those in the NC group.The expression levels of VEGF and ACSL4 proteins in Fer-1 and TRG groups were lower than those in the CoCl2 group.Conclusion TRG protects ARPE-19 cells from hypoxia-induced oxidative stress damage by inhibiting ferroptosis.

[Objective]Hepatic tuberculosis(HTB),an exceptionally rare and clinically heterogeneous form of extra-pulmonary tuberculosis,is frequently misdiagnosed as hepatocellular carcinoma,lymphoma,or pyogenic liver abscess,this diagnostic challenge contributing to persistently high rates of missed and incorrect diagnoses.This study aims to sys-tematically analyze clinical profiles of HTB patients to provide evidence-based guidance for early identification,accurate diagnosis,and timely intervention.[Methods]We conducted a retrospective analysis of all HTB cases confirmed at Sun Yat-sen Memorial Hospital between January 2012 and December 2023.Comprehensive data were collected and evaluated,including demographic characteristics,clinical presentations,laboratory findings,imaging features,and histopathological results.[Results]Ten patients(9 males,1 female;mean age 44.6±15.5 years)were enrolled totally,with prevalent symp-tom of abdominal pain or distension(8/10).Among the patients tested,purified protein derivative(PPD)was positive in 2 of 6 cases,serum tuberculosis antibody was positive in 1 of 5,and T-cell spot of tuberculosis(T-SPOT)was positive in 3 of 5.Chest imaging(n=9)revealed active miliary tuberculosis in 1 case and inactive post-tuberculous sequelae in 5 cases,while the remainder showed no abnormalities.Contrast-enhanced CT(n=6)demonstrated hypodense patchy or nodular le-sions with absent or mild heterogeneous enhancement.MRI(n=3)showed well-circumscribed oval/round hypointense lesions on T1-weighted imaging(T1WI)and mildly hyperintense ones on T2-weighted imaging(T2WI)and diffusion weighted imaging(DWI).Percutaneous or surgical liver biopsy was performed in 8/10 cases,revealing chronic granuloma-tous inflammation in all subjects and acid-fast bacilli in 2 specimens.[Conclusion]HTB lacks pathognomonic clinical or radiological features,and conventional laboratory tests exhibit low sensitivity.A high index of suspicion is warranted for pa-tients presenting with hepatic nodular lesions accompanied by fever,abdominal pain,or emaciation.Early pathogen detec-tion and histopathological confirmation via liver biopsy are critical to minimize diagnostic delays and ensure prompt initia-tion of anti-tuberculous therapy.

Objective:To analyze the echocardiographic and genetic characteristics of fetuses with common arterial trunk（CAT）.Methods:A retrospective analysis was conducted on 77 480 fetal echocardiograms examined at the Maternal-Fetal Medicine center in Fetal Heart Disease of Beijing Anzhen Hospital from November 2010 to November 2024.Among them，106 fetuses were initially diagnosed with CAT，and 95 cases were ultimately confirmed（0.1%，95/77 480）. The echocardiographic and genetic features of CAT fetuses were analyzed. According to the modified Van Praagh classification，CAT was divided into types A1-A4［with ventricular septal defect（VSD）］and B1-B4（without VSD）based on the origin of the pulmonary artery branches and the presence or absence of a VSD. Additionally，CAT was categorized into isolated and complex types based on the presence of associated intracardiac or extracardiac anomalies.Results:① Among the 95 confirmed CAT fetuses，type A accounted for 90.5%（86/95），and type B accounted for 9.5%（9/95）. All 9 type B CAT fetuses exhibited no overriding of the arterial trunk ， with 8 cases showing left ventricular hypoplasia accompanied by mitral atresia or absence.② Of the 95 CAT fetuses，14 were isolated（14.7%，14/95） ， and 81 were complex（85.3%，81/95）.The main associated intracardiac anomalies included：single ventricle（22 cases），complete atrioventricular septal defect（12 cases），anomalous pulmonary venous drainage（10 cases），right aortic arch with mirror-image branching（16 cases），and persistent left superior vena cava（14 cases）. ③ Genetic testing was performed in 31 fetuses，with 18 showing positive results，primarily 22q11.21 deletion syndrome（29.0%，9/31）. Conclusions:Apart from VSD，the most common intracardiac anomaly associated with CAT fetuses is single ventricle. Type B CAT without trunk overriding is often associated with left ventricular hypoplasia and mitral atresia or absence. The most frequent genetic abnormality in CAT fetuses is 22q11.21 deletion syndrome. Prenatal echocardiography should clarify the CAT subtype and associated anomalies，and genetic testing is strongly recommended for perinatal counseling and prognostic evaluation.

OBJECTIVE To explore the risk factors for serum COVID-19 antibodies in the population of Fuzhou to provide scientific basis for prevention and control strategies.METHODS The prospective study and the multi-stage stratified random sampling method were performed to select at least 200 subjects from each of the 12 counties(cit-ies)in Fuzhou.Questionnaires follow-ups and serum collections were conducted in Mar,Jun,Sep,and Dec.2024,respectively.The antibody levels in Dec.were divided into a high protective antibody group(IgG antibody≥50 AU/ml)and a low protective antibody group(IgG antibody≤20 AU/ml).The influencing factors of serum anti-body levels were analyzed by multivariate logistic regression model.RESULTS A total of 2816 subjects were en-rolled.In Mar,1454 subjects with high-protective antibodies were identified.After nine months of follow-up,of the 1454 subjects,344 had high protective antibodies and 369 had low protective antibodies in Dec..There were statistically significant differences in age,presence of typical symptoms after infection,underlying diseases,surgi-cal history,healing time,smoking and drinking histories between the high and low antibody groups(P<0.05).Multivariate logistic regression model showed that older age,underlying diseases,history of surgery,smoking and drinking were risk factors which could reduce antibody levels(P<0.05),while typical symptoms after infec-tion and longer recovery time were protective factors which could increase antibody levels(P<0.05).After the COVID-19 infection in spring of 2024,the serum antibody levels in Fuzhou residents showed the downward trend,especially after Sep.2024,with a more pronounced downward trend.CONCLUSIONS According to the risk factors of COVID-19 antibody levels,prevention and control efforts should be focused on the key population.It is necessa-ry to strengthen health education and carry out vaccination to maintain the levels of immunity to protect population from COVID-19 infection.

Objective To analyze challenges in translating exercise management evidence for patients with metabolism-associated fatty liver disease(MAFLD),develop actionable strategies,and evaluate the application of best evidence.Methods Utilizing the evidence translation model,the best evidence was implemented for MAFLD patients in 4 phases:evidence acquisition,baseline practice review,intervention,and outcome evaluation.We compared the knowledge of exercise management evidence,implementation rates of review indicators,completion of exercise programs,BMI,liver stiffness measurement,controlled attenuation parameters,and patient satisfaction among medical staff at a tertiary hospital in Fujian Province during baseline(March-May 2023),mid-practice(June-August 2023),and late-practice(September-November 2023)phases.Results A total of 88 patients were included at baseline review,95 during mid-practice,and 107 in late-practice.Significant improvements were observed in the implementation rates of 21 review indicators,nurses'knowledge,completion rate,BMI,and controlled attenuation parameters compared to the data at baseline(P＜0.05).Conclusion The application of best evidence in exercise management for MAFLD patients enhances nurses'knowledge,standardizes nursing practices,and reduces patients'BMI and controlled attenuation parameters.