Objective To identify potential immunosenescence markers in benign prostatic hyperplasia(BPH)and to explore BPH-related senescent phenotypes. Methods Three transcriptome datasets and one single-cell RNA-sequencing(scRNA-seq)dataset for BPH and normal prostate tissues were obtained from the Gene Expression Omnibus(GEO)database. The GSE7307 and GSE119195 were combined to analyze differentially expressed genes(DEGs). Enrichment analysis and immune infiltration analysis were used to explore aging-related changes in the immune microenvironment. Weighted gene coexpression network analysis(WGCNA)was applied to identify immune-related genes in GSE132714. ScRNA-seq data were employed to investigate the transcriptomic landscape, luminal cell heterogeneity, and aging-related alterations in BPH through cell-cell communication and pseudotime analysis. Finally, the results were validated with in vitro experiments. Results A total of 1202 DEGs and 627 immune-related genes were identified in BPH and normal prostate tissues. Enrichment analysis indicated that the vascular endothelial growth factor(VEGF)signaling pathway exhibited a downregulated aging phenotype in BPH. In scRNA-seq analysis, 9 cell types were identified. The VEGF signaling pathway in BPH exhibited an aging-related expression pattern, characterized by decreased vascular endothelial growth factor A(VEGFA)in luminal cells. Conclusion Our study identified VEGFA as a marker of immunosenescence in BPH, with changes of the VEGF pathway. Meanwhile, low expression of VEGFA, coupled with high expression of placental growth factor(PlGF)and vascular endothelial growth factor receptor(VEGFR), represented a senescent phenotype of the prostate.

Objective: To conduct network analysis of biased constitution to provide theoretical basis for daily health management. Methods: Purposive sampling and snowball sampling methods were used to collect the required data via a web-based questionnaire from February 3rd, 2022 to January 21st, 2023. The tendency scores of 8 biased constitutions (qi-deficiency type, yang-deficiency type, yin-deficiency type, phlegm-dampness type, damp-heat type, blood-stasis type, qi-depression type, and special diathesis type) were evaluated by 30-Item Short Version of Constitution in Chinese Medicine Questionnaire. Data analysis was conducted in R. The qgraph package was used to construct network analysis models and calculate the edge weight, namely regularised partial correlation coefficients (r) and centrality coefficients (including strength, closeness, betweenness and expected influence), while mgm was used to calculate the predictability of each node within the network. The ggplot2 package was used to visualize network analysis result, and bootnet was applied to assess the structural reliability and robustness of the network, including the r accuracy assessment, the stability assessment of the centrality coefficients, and the difference test result of node centrality coefficients. Results: A total of 3, 691 valid samples were obtained from the survey. The result of the network analysis showed that: (1) the strength of the association between phlegm dampness type and damp-heat type (r=0.370), qi-deficiency type and qi-depression type (r =0.315), qi-deficiency type and special diathesis type (r=0.260), qi-deficiency type and phlegm-dampness type (r=0.247), and the phlegm-dampness type and qi-depression type (r=0.247) was high. (2) The centrality of phlegm-dampness type and qi-deficiency type was the strongest, and the differences between the centrality coefficients of phlegm-dampness type and qi-deficiency type were not significant. There were no other nodes where all 4 centrality coefficients were not significantly different from qi-deficiency type and phlegm-dampness type, and the predictability of phlegm-dampness type and qi-deficiency type was the highest. (3)The result of the r accuracy assessment showed that the r of this network did not differ significantly from the average of multiple samples, so the r accuracy of this network was high. (4) Correlation stability(CS) coefficient of the four centrality indicators were CS Strength=0.59, CS Closeness=0.75, CS Betweenness=0.75, and CS Expected influence=0.75. This indicated that the stability of the centrality indicators of this network was very good. Conclusion Complex connections exist between various biased constitutions, and phlegm-dampness type and qi-deficiency type are the two key biased constitutions in the entire biased constitution.

Objective:To investigate the status of sedentary behavior and its influencing factors among inpatients with stable schizophrenia, providing empirical evidence for developing interventions to reduce sedentary behavior.Methods:A cross-sectional survey design was used to prospectively collect clinical data from 166 inpatients with stable schizophrenia (97 males, 69 females, mean age 56.4±8.4 years) hospitalized at the Shanghai Mental Health Center affiliated with Shanghai Jiao Tong University School of Medicine from February 2024 to May 2024. Sedentary behavior time was assessed using the Sedentary Behavior Questionnaire (SBQ), daily step count was measured via pedometers, and negative schizophrenic symptoms were evaluated using the Scale for the Assessment of Negative Symptoms (SANS). Patients were divided into a non-sedentary behavior group (≥5 000 steps/day, 66 cases) and a sedentary behavior group (<5 000 steps/day, 100 cases). Clinical variables were compared between the two groups, and binary logistic regression was used to identify influencing factors of sedentary behavior.Results:Stable inpatients with schizophrenia exhibited high levels of sedentary behavior, with an average daily sedentary time of (8.03±2.33) hours and a median daily step count of 3 352 (1 258-5 506) steps. Significant differences were observed between sedentary and non-sedentary behavior groups in Age ( t=-2.38),hospitalization duration ( Z=-1.53),blunted affect ( t=-8.37),poverty of thought ( t=-2.45),avolition ( t=-2.45),impoverished interests/social engagement ( t=-2.41),abdominal obesity ( χ2=9.18),and open vs. restricted hospital/wards environment ( χ2=8.88)(all P<0.05). Binary logistic regression analysis identified that hospital/wards environment ( OR=0.314, 95 %CI: 0.125-0.787),hospitalization duration ( OR=1.001, 95 %CI: 1.000-1.001),and the negative symptom of blunted affect ( OR=3.256, 95 %CI: 1.960-5.407)(all P<0.05) were significantly influencing factors for sedentary behavior in patients with stable schizophrenia. Conclusion:Hospitalized patients with stable schizophrenia exhibit high levels of sedentary behavior. Hospital/wards environment and blunted affect are significant factors influencing sedentary behavior.

Objective:To analyze the current situation of health-related quality of life (HRQOL) and its influencing factors among community-dwelling elderly with mild cognitive impairment (MCI) based on the health ecology model (HEM).Methods:From December 2023 to September 2024, a cross-sectional survey was conducted among 997 community-dwelling elderly in Beijing, Shandong, Chongqing and other regions. The EuroQol five-dimensional questionnaire 5 level (EQ-5D-5L), the Montreal cognitive assessment (MoCA), and the Pittsburgh sleep quality index (PSQI) were used to assess the subjects.Descriptive analysis, Mann-Whitney U test, Kruskal-Wallis test, and Tobit regression analysis were performed using Stata 18.0 software. Results:A total of 324 valid samples were finally obtained, and the health utility value of MCI elderly was 0.842(0.815, 0.951). Tobit regression analysis showed that ≥80 years old( β=-0.121, 95% CI=-0.193--0.050) in individual traits level, don't exercise( β=-0.196, 95% CI=-0.255--0.137) and poor quality of sleep ( β=-0.064, 95% CI=-0.116--0.013) in behavior characteristics level, and poor subjective economic status( β=-0.153, 95% CI=-0.261--0.045) in living and working conditions level were risk factors for the health utility value of the elderly with MCI. Drinking( β=0.096, 95% CI=0.022-0.171) in behavior characteristics level and participating in social activities( β=0.126, 95% CI=0.062-0.190) in interpersonal network level were protective factors for the health utility value of the elderly with MCI. Conclusions:The HRQOL of the community-dwelling elderly with MCI in China is low, and its influencing factors are multi-level. HEM should be combined to strengthen the intervention and management of the elderly with MCI from personal constitution to policy environment to improve their HRQOL.

Objective To evaluate the application value of aspiration catheter and debulking technology in the treatment of patients with intermediate-and high-risk pulmonary thromboembolism(PTE).Methods The clinical data of 28 patients with intermediate-and high-risk PTE were analyzed retrospectively.All subjects received thrombectomy using a 7F JR Guiding catheter.The success rate of surgery and the incidence of complications were counted,and the preoperative and postoperative values in heart rate(HR),systolic blood pressure(SBP),oxygen saturation(SO2),partial pressure of oxygen(PO2),Miller index,and mean pulmonary arterial pressure(MPAP)were compared.Results All patients were successfully treated,of which 26 cases obtained symptomatic relief after surgery.There were 2 cases of death in high-risk patients,of whom one died of myocardial infarction,and the other died of cerebral herniation after the procedure.One case reported the formation of pulmonary artery small dissection which disappeared within 2 months during conservative observation.The postoperative HR,Miller index,and MPAP decreased and SBP,SO2,and P()2 increased significantly than those of preoperative(P＜0.05).The follow-up period for this group ranged from 7 to 29 months,with a median follow-up of 14.6(7,19)months.During the follow-up period,no recurrences were observed.Conclusion The aspiration catheter and debulking technology demonstrate efficacy in treating intermediate-and high-risk PTE,and is associated with favourable success rates and low complication rates.The findings suggest its potential for wider clinical use.

Objective:To analyze the current situation of health-related quality of life (HRQOL) and its influencing factors among community-dwelling elderly with mild cognitive impairment (MCI) based on the health ecology model (HEM).Methods:From December 2023 to September 2024, a cross-sectional survey was conducted among 997 community-dwelling elderly in Beijing, Shandong, Chongqing and other regions. The EuroQol five-dimensional questionnaire 5 level (EQ-5D-5L), the Montreal cognitive assessment (MoCA), and the Pittsburgh sleep quality index (PSQI) were used to assess the subjects.Descriptive analysis, Mann-Whitney U test, Kruskal-Wallis test, and Tobit regression analysis were performed using Stata 18.0 software. Results:A total of 324 valid samples were finally obtained, and the health utility value of MCI elderly was 0.842(0.815, 0.951). Tobit regression analysis showed that ≥80 years old( β=-0.121, 95% CI=-0.193--0.050) in individual traits level, don't exercise( β=-0.196, 95% CI=-0.255--0.137) and poor quality of sleep ( β=-0.064, 95% CI=-0.116--0.013) in behavior characteristics level, and poor subjective economic status( β=-0.153, 95% CI=-0.261--0.045) in living and working conditions level were risk factors for the health utility value of the elderly with MCI. Drinking( β=0.096, 95% CI=0.022-0.171) in behavior characteristics level and participating in social activities( β=0.126, 95% CI=0.062-0.190) in interpersonal network level were protective factors for the health utility value of the elderly with MCI. Conclusions:The HRQOL of the community-dwelling elderly with MCI in China is low, and its influencing factors are multi-level. HEM should be combined to strengthen the intervention and management of the elderly with MCI from personal constitution to policy environment to improve their HRQOL.

Objective To evaluate the application value of aspiration catheter and debulking technology in the treatment of patients with intermediate-and high-risk pulmonary thromboembolism(PTE).Methods The clinical data of 28 patients with intermediate-and high-risk PTE were analyzed retrospectively.All subjects received thrombectomy using a 7F JR Guiding catheter.The success rate of surgery and the incidence of complications were counted,and the preoperative and postoperative values in heart rate(HR),systolic blood pressure(SBP),oxygen saturation(SO2),partial pressure of oxygen(PO2),Miller index,and mean pulmonary arterial pressure(MPAP)were compared.Results All patients were successfully treated,of which 26 cases obtained symptomatic relief after surgery.There were 2 cases of death in high-risk patients,of whom one died of myocardial infarction,and the other died of cerebral herniation after the procedure.One case reported the formation of pulmonary artery small dissection which disappeared within 2 months during conservative observation.The postoperative HR,Miller index,and MPAP decreased and SBP,SO2,and P()2 increased significantly than those of preoperative(P＜0.05).The follow-up period for this group ranged from 7 to 29 months,with a median follow-up of 14.6(7,19)months.During the follow-up period,no recurrences were observed.Conclusion The aspiration catheter and debulking technology demonstrate efficacy in treating intermediate-and high-risk PTE,and is associated with favourable success rates and low complication rates.The findings suggest its potential for wider clinical use.

Objective:To investigate the status of sedentary behavior and its influencing factors among inpatients with stable schizophrenia, providing empirical evidence for developing interventions to reduce sedentary behavior.Methods:A cross-sectional survey design was used to prospectively collect clinical data from 166 inpatients with stable schizophrenia (97 males, 69 females, mean age 56.4±8.4 years) hospitalized at the Shanghai Mental Health Center affiliated with Shanghai Jiao Tong University School of Medicine from February 2024 to May 2024. Sedentary behavior time was assessed using the Sedentary Behavior Questionnaire (SBQ), daily step count was measured via pedometers, and negative schizophrenic symptoms were evaluated using the Scale for the Assessment of Negative Symptoms (SANS). Patients were divided into a non-sedentary behavior group (≥5 000 steps/day, 66 cases) and a sedentary behavior group (<5 000 steps/day, 100 cases). Clinical variables were compared between the two groups, and binary logistic regression was used to identify influencing factors of sedentary behavior.Results:Stable inpatients with schizophrenia exhibited high levels of sedentary behavior, with an average daily sedentary time of (8.03±2.33) hours and a median daily step count of 3 352 (1 258-5 506) steps. Significant differences were observed between sedentary and non-sedentary behavior groups in Age ( t=-2.38),hospitalization duration ( Z=-1.53),blunted affect ( t=-8.37),poverty of thought ( t=-2.45),avolition ( t=-2.45),impoverished interests/social engagement ( t=-2.41),abdominal obesity ( χ2=9.18),and open vs. restricted hospital/wards environment ( χ2=8.88)(all P<0.05). Binary logistic regression analysis identified that hospital/wards environment ( OR=0.314, 95 %CI: 0.125-0.787),hospitalization duration ( OR=1.001, 95 %CI: 1.000-1.001),and the negative symptom of blunted affect ( OR=3.256, 95 %CI: 1.960-5.407)(all P<0.05) were significantly influencing factors for sedentary behavior in patients with stable schizophrenia. Conclusion:Hospitalized patients with stable schizophrenia exhibit high levels of sedentary behavior. Hospital/wards environment and blunted affect are significant factors influencing sedentary behavior.

Objective To evaluate the efficacy of endovascular treatment for ruptured descending thoracic aortic aneurysm(rDTAA),and to summarize the treatment experience.Methods The clinical data of 8 patients with rDTAA,who were admitted to the Department of Vascular Interventional Surgery,Zhangjiajie Municipal People's Hospital of China to receive treatment between January 2016 and June 2023,were retrospectively analyzed.The patients included 4 males and 4 females,with a median age of 70.5 years(61-78 years).Preoperative computed tomography angiography(CTA)was performed in all the 8 patients,and the diagnosis of rDTAA complicated by hematoma in the thoracic cavity and/or mediastinum was confirmed.Emergency thoracic endovascular aortic repair(TEVAR)was carried out in all the 8 patients.Results Complete isolation of the thoracic descending aortic aneurysm was achieved in 6 patients,and 2 of them received reconstruction of left subclavian artery by using chimney stent technique.The remaining two patients had a small amount of type Ⅰa endoleak,which disappeared after implantation of a cuff stent at the proximal site.During hospitalization,one patient died of septic shock caused by thoracic aortic-esophageal fistula,and 3 patients developed respiratory failure after operation,which was recovered after thoracic drainage,anti-infection medication and ventilator-assisted breathing therapy.Two patients developed postoperative ischemic stroke,one of them presented as grade Ⅲ motor muscle weakness on the affected side accompanied by speech impairment,and the another patient presented as grade Ⅳ motor muscle weakness on the affected side accompanied by speech impairment.During the follow-up period,one patient died of sudden chest pain 7 months after surgery,and another patient who had not received chimney stent implantation developed type Ⅰa endoleak 18 months after operation,which disappeared after implantation of a cuff stent at the proximal site.The remaining 5 patients showed good clinical condition during the follow-up period.Conclusion For the treatment of rDTAA,TEVAR is clinically safe and effective.

Objective:To compare the application effect of domestic and imported intravenous radiofrequency closure system in the treatment of primary varicose veins of lower extremities.Methods:This single-center prospective, non-inferiority randomized controlled trial was performed in the Department of Vascular Surgery, the Fourth Affiliated Hospital, Zhejiang University School of Medicine from January 2021 to January 2022. Patients with primary varicose veins of lower extremities who met the ataxation criteria were randomly assigned to the experimental group(domestic novel venous radiofrequency closure system) or the control group(imported venous radiofrequency closure system) in a ratio of 1∶1. The two groups of subjects were compared in terms of target vein closure rate, technical success rate, system operation performance, incidence of adverse events and incidence of serious adverse events(SAE) within 6 months after surgery. Quantitative data were compared by Mann-Whitney U test, and categorical data were compared by χ2 test and non-inferiority test. Results:A total of 80 subjects were included in the trial (41 in the experimental group and 39 in the control group), including 27 males and 53 females, aged ( M(IQR)) 55(23) years (range:40 to 78 years). There were 48 cases of left lower limb and 32 cases of right lower limb. The technical success rate and system control performance between the groups were 100%.The incidence of adverse events (58.5% (24/41) vs. 61.5% (24/39), χ2=0.075, P=0.784), and the incidence of SAE (7.3% (3/41) vs. 5.1% (2/39), χ2=0.163, P=0.686) within 6 months after surgery in experimental group and control group had no statistical significance. There was one device-related adverse event in each of the two groups. In the experimental group, one patient developed endovenous heat-induced thrombosis after surgery and recovered after taking rivaroxaban tablets. One patient in the control group had pain in the upper right thigh for more than 1 day after operation, which was cured after using analgesic cream. No device-related SAE occurred. The venous closure rate of the experimental group was 100% (38/38) at 6 months after surgery, and that of the control group was 97.4% (37/38). The difference between the two groups was 2.63% (95% CI:-3.19 to 8.45, Z=4.865, P<0.01), and the 95% CI lower limit of the difference in target venous closure rate between two groups was greater than the non-inferiority threshold of -10.00%. Conclusion:The early application effect of the new domestic intravenous radiofrequency closure system in patients with primary varicose veins of lower extremities is in line with expectations, it is not inferior to the imported system.