Liver disease is a major global health issue, severely impacting patients' quality of life and life expectancy. Integrated Traditional Chinese and Western Medicine demonstrates unique advantages in the field of liver disease treatment. Therefore, this article elaborates on the research progress of integrated traditional Chinese and Western medicine in viral hepatitis, metabolic dysfunction-associated steatotic liver disease, cirrhosis, and liver cancer.

Liver disease is a major global health issue, severely impacting patients' quality of life and life expectancy. Integrated Traditional Chinese and Western Medicine demonstrates unique advantages in the field of liver disease treatment. Therefore, this article elaborates on the research progress of integrated traditional Chinese and Western medicine in viral hepatitis, metabolic dysfunction-associated steatotic liver disease, cirrhosis, and liver cancer.

Vesical vaginal fistula is the most common urogenital fistula. This article reportd a case treating by transurethral intravesical suturing combined with vaginal anterior wall suturing. The patient was followed up for 6 months after surgery, showing no symptoms, normal urine flow, and no recurrence of fistula. This surgical approach is simple to perform, minimally invasive, and has a quick recovery, which suggests the feasibility of this procedure. However, large sample studies are needed to verify its efficacy and safety.

Vesical vaginal fistula is the most common urogenital fistula. This article reportd a case treating by transurethral intravesical suturing combined with vaginal anterior wall suturing. The patient was followed up for 6 months after surgery, showing no symptoms, normal urine flow, and no recurrence of fistula. This surgical approach is simple to perform, minimally invasive, and has a quick recovery, which suggests the feasibility of this procedure. However, large sample studies are needed to verify its efficacy and safety.

Objective:To summarize the efficacy and safety of transurethral partial cystectomy combined with intravesical suturation in the treatment of bladder cancer.Methods:The clinical data of 28 patients with bladder cancer who were admitted in Zhengzhou People's Hospital from July 2020 to October 2021 were analyzed retrospectively. There were 22 males and 6 females, with the average age of (68.8±8.9) years old. Twenty cases were with single bladder tumor, and 8 cases were with multiple bladder tumors. The diameter of single bladder tumor measured by CT was less than 4 cm, with a median tumor diameter of 2.3(0.9, 2.8)cm. All 28 patients underwent transurethral partial cystectomy combined with intravesical suturation for the first time. Intraoperative intravesical instillation was conducted with 1 g gemcitabine. Bladder hot reperfusion treatment was performed with gemcitabine 2 g at 45℃ immediately after operation. The patients underwent reexamination with cystoscopy every 3 months after operation.Results:All the 28 patients successfully completed the operation. The average operation time was (128.3±16.3)min. No obturator nerve reflection was induced during operation. Muscularis tissue was found in all tumor pathological specimens after operation, among which 4 cases showed muscularis infiltration. Pathology of tumor basal and peripheral tissues showed tumor cell infiltration in 3 cases (1 case full-thickness infiltration, namely the incision margin was positive). The median continuous irrigation time of bladder after operation was 24.0(20.9, 25.0)h. The median time of indwelling catheter after operation was 6.5(6.0, 7.0)days, and one case developed severe bladder spasm. All patients were followed up, with a median follow-up of 7.5(4.0, 10.8) months.Postoperative recurrence occurred in 3 cases, all of which were ectopic recurrence in bladder.The 1-year recurrence rate was 10.7% (3/28).Conclusions:In the first surgical treatment of bladder cancer, transurethral partial cystectomy combined with intravesical suturation can provide accurate pathological staging, and low positive surgical margin rate. Immediate suturation of bladder wound during operation and immediate bladder perfusion chemotherapy can provide short bladder irrigation time, with few adverse reactions and low incidence of complications.

【Objective】 To investigate the current status of incision sites to obtain intact specimens in laparoscopic nephrectomy by urologists in China, so as to provide reference for the standardized procedure. 【Methods】 During Jun.20, 2021 and Jul.4, 2021, more than 20 000 urologists in a WeChat group were surveyed with a questionnaire. The general data, incision sites and related complications were statistically analyzed. 【Results】 A total of 601 valid questionnaires were collected, covering urologists from 31 provinces, autonomous regions and municipalities. Surgical approaches: 68 urologists chose trans-abdominal approach, 432 chose posterior abdominal space approach, 101 chose both surgical approaches. Incision sites: 97 urologists chose lumbar transverse incision, 202 chose dorsal oblique incision of the waist, 119 chose ventral oblique incision, 93 chose the paramedian incision, 112 chose the lower abdominal oblique incision (Gibson), 11 chose the transverse lower abdominal incision (Pfannenstiel), 7 chose the median incision of the lower abdomen, 2 chose the median incision in the upper abdomen, 15 chose axillary midline direct incision; 399 chose to cut off the muscles, and 202 chose not to. Complications: 232 urologists reported pain after 2 weeks, 369 reported no pain; 325 reported numbness after 2 weeks, 276 reported no numbness; 66 reported incisional hernia, 535 reported no hernia. 【Conclusions】 Chinese urologists tend to choose retroperitoneoscopic nephrectomy and waist incision to obtain intact specimens. Transperitoneal laparoscopic nephrectomy has a variety of incisions for intact specimens. There is no standardized incision sites to obtain intact specimens.

Objective To assess the association of metabolic syndrome (MetS) and low-level high density lipoprotein-cholesterol (HDL-C) with the invasion of prostate cancer (PCa) in the patients after radical prostatectomy (RP). Methods We collected and analyzed the data of 232 PCa patients treated with RP for prospective multicenter clinical study.The MetS was assessed according to NCEP-ATP Ⅲ.Patients were divided into MetS group and non-MetS group.Locally advanced PCa was defined as a pT-stage≥3.ISUP Gleason grading system (GS) were used for pathological grading.Logistic regression analyses assessed the association of MetS and its components with pathological data. Results MetS was an independent risk factor for GS≥8 after RP.Low HDL-C level was associated with locally advanced PCa.The risks of adverse pathological features increased with the number of MetS components. Conclusion Low HDL-C level and 4 or more MetS components are associated with higher risk of adverse pathological features of PCa.

[Abstract] Objective: To investigate the expression of long non-coding RNA (lncRNA) HULC in bladder cancer tissues and its relationship with the clinicopathological features of patients, as well as the effect of silencing HULC on the proliferation, apoptosis, migration and invasion of bladder cancer 5637 cells. Methods: A total of 102 pairs of cancer tissue and adjacent normal tissue samples from bladder cancer patients who underwent surgical resection in Zhengzhou People’s Hospital from June 2014 to December 2017 were selected, as well as bladder cancer 5637 cell line and human normal bladder epithelial SV-HUC-1 cell line. The expression of HULC in bladder cancer tissues and cells was detected by qPCR, and the correlation between HULC and clinicopathological features of bladder cancer patients was analyzed. The effect of HULC on prognosis was evaluated by Kaplan-Meier survival curve. si-HUL and si-NC plasmids were transfected into 5637 cells by siRNA interference technology, and the effects of silencing HULC on proliferation, apoptosis, migration and invasion of 5637 cells were determined by CCK-8, Flow cytometry, Wound-healing assay and Transwell method, respectively. Results: The expression of HULC in bladder cancer tissues was significantly higher than that in normal tissues (P<0.05), and its expression level was correlated with tumor grade, tumor stage and lymph node metastasis (P<0.05). The OS and PFS of patients with high HULC expression were significantly lower than those with low expression (all P<0.05). The expression level of HULC in 5637 cells was significantly higher than that in SV-HUC-1 cells (P<0.01). After silencing HULC, the proliferation, migration and invasion of 5637 cells were significantly decreased (P<0.01), and the apoptosis rate was significantly increased (P<0.01). Conclusion: lncRNA HULC is highly expressed in bladder cancer tissues and 5637 cells. Silencing HULC expression can inhibit the proliferation, migration and invasion but promote apoptosis of bladder cancer cells.

Objective To screen and verify hub genes TPM1 and CALD1 that can affect the diagnosis and prognosis of bladder cancer (BLCA). Methods We obtained gene chip expression data of 414 and 188 cases of bladder cancer from TCGA and GEO, respectively. By constructing a weighted gene co-expression network analysis (WGCNA) and identifying differentially-expressed genes between tumor tissues and normal tissues, the pivotal genes that were highly associated with bladder cancer were obtained, and the STRING database was used to construct a protein interaction network to screen out prognostic-related pivotal genes. We took 29 cases of bladder cancer samples from People's Hospital of Zhengzhou as external verification results. Results A total of 915 and 464 differentially-expressed genes were screened from the TCGA database and GSE13507, respectively. Two modules with the strongest correlation were obtained through WGCNA: the blue module (Pearson cor=0.60, P=1E-44) and the cyan module (Pearson cor=0.52, P=7E-19), and 156 intersection genes were obtained. Through protein interaction network analysis, 10 pivotal genes were screened out. TPM1 and CALD1 genes had the greatest correlation with the survival of bladder cancer patients, which was verified by external experimental verification group. Conclusion TPM1 and CALD1 are closely related to the prognosis of bladder cancer patients. They are also pivotal genes to promote tumor progression.

Objective To analyze the pathogenesis and clinical characteristics of drug-induced liver injury (DILI) and to explore the corresponding nursing interventions. Methods From January 2011 to December 2013, a total of 84 patients with chronic drug-induced liver injury in Beijing You'an Hospital were recruited by convenience sampling method according to the diagnostic criteria of Guidelines for the Management of Drug-Induced Liver Injury. The demographic characteristics, the possible drugs and clinical characteristics were inputted into Epidata management database and were analyzed using SPSS 16.0. Results In the study, there were 132 kinds of drugs which induced chronic liver injury. Thirty-three of all the recruited patients were using over 2 kinds of medications, among which traditional Chinese medicine accounted for 47.0%, which were mainly used for dermatopathy, rheumatosis and healthcare. The second were non-steroidal anti-inflammatory drugs and antituberculosis drugs. Fifty-six patients had underlying diseases, accounting for 66.7%, of which 16 patients had more than 2 underlying diseases. The main clinical manifestations were fatigue, anorexia and jaundice. 14.3% of the patients showed complications. Conclusions The incidence of drug-induced liver injury was increasing with years. It's important to conduct the health education of drug-using safety, especially to the elderly women and the ones with underlying diseases. The course of chronic liver injury was long and tends to relapse, so it's essential to observe the reaction to drugs and take correspondent measures during the nursing work. Besides, we need to pay much attention to psychological counseling of the patients.