Objective To explore the correlation between chronic diseases and the risk of benign prostatic hyperplasia(BPH)in middle-aged and older Chinese man.Methods Data from the 2013 China Health and Retirement Longitudinal Study(CHARLS)were used,including 4 509 male participants aged 45 years and older.Chronic diseases and BPH diagnoses were obtained through a questionnaire survey.Logistic regression analysis was performed to identify independent risk factors for BPH.Restricted cubic splines(RCS)were used to explore the nonlinear relationship between variables and BPH prevalence,while stratified analyses were conducted to assess the differential impact of chronic diseases on BPH prevalence in different subgroups.Results Compared to patients without BPH,those with BPH had a significantly higher prevalence of comorbid chronic diseases,including hypertension,diabetes,chronic respiratory diseases,chronic heart disease,stroke,chronic kidney disease,chronic digestive diseases,arthritis or rheumatism,depression,and memory-related disorders.Multivariable Logistic regression analysis indicated that factors such as the 10-item Center for Epidemiological Studies Depression Scale(CESD-10)scores(OR=1.043,95% CI:1.022-1.063,P<0.001),chronic respiratory disease(OR=1.518,95% CI:1.143-1.998,P=0.003),chronic heart disease(OR=1.515,95% CI:1.143-1.998,P=0.003),chronic kidney disease(OR=2.384,95% CI:1.799-3.137,P<0.001),and chronic digestive disease(OR=1.427,95% CI:1.129-1.796,P=0.003)were independently associated with the occurrence of BPH.RCS analysis demonstrated no non-linear association between age,BMI,and CESD-10 scores and BPH.Stratified analysis revealed that the influence of these chronic conditions on BPH remained constantly stable across different subgroups.Conclusion BPH is commonly comorbid with various chronic diseases.Future treatment strategies for BPH should consider the shared pathological mechanisms between BPH and these chronic conditions,with a focus on integrated interventions targeting common pathways.

Objective:To compare the efficacy of the detection kit based on MicroDrop microdroplet digital PCR platform that can identify mycoplasma pneumonia and common drug-resistance mutation,and throughout targeted next-generation sequencing(tNGS)in detecting common drug-resistance mutations of mycoplasma pneumonia.Methods:A total of 300 samples of clinical respiratory tract of pneumonia inpatients at Guangdong Provincial People's Hospital between 2023 and 2024 were collected.Both the detection kit for drug-resistance mutation of mycoplasma pneumoniae and the tNGS method were employed to detect drug-resistance mutation genes.For samples with inconsistent results,Sanger sequencing was used for verification.Results:For the 300 samples,the detection rates of positive mycoplasma pneumonia of the detection kit for drug-resistance mutation of mycoplasma pneumoniae and the tNGS method were respectively 87.00%and 78.67%,with a Kappa value of 0.711,indicating a relatively high level of agreement between the two methods.Among 25 samples with inconsistent results,Sanger sequencing was employed for validation.The results revealed that for samples with low-frequency gene mutations,the reagent kit maintained reliable detection capability,whereas tNGS exhibited missed detections.Thus,the reagent kit demonstrates superior performance in detecting low-frequency mutation samples.Conclusion:The detection rate of low-frequency mutation samples by the digital PCR-based mycoplasma pneumoniae drug-resistance mutation detection kit is higher than that of the tNGS method.This approach helps enhance the accuracy of detection results,providing a rapid and precise means of detecting drug-resistance genes for clinical diagnosis and treatment.

Objective:To explore the impact of the two-way referral model on compliance and prognosis in patients with heart failure.Methods:This bidirectional cohort study enrolled chronic heart failure (CHF) patients treated at Qilu Hospital of Shandong University or designated primary hospitals between March 2018 and March 2022. Patients were categorized into two groups based on referral status: two-way referral group (participating in the referral model with≥1 follow-up visit at primary hospitals) and the core hospital group (receiving treatment and follow-up exclusively at Qilu Hospital). Baseline clinical characteristics were collected and compared between groups. Patients underwent followed-up, with primary endpoints including follow-up rate, drug (β-blockers, angiotension converting enzyme inhibitor (ACEI)/angiotensin Ⅱ receptor blockers (ARB)/angiotensin receptor-neprilysin inhibitor (ARNI), sodium-glucose cotransporter 2 inhibitors and mineralocorticoid receptor antagonists) utilization rate and target dose achievement rate. Secondary endpoints encompassed changes from baseline in left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDd), and N-terminal pro-brain natriuretic peptide (NT-proBNP), plus cardiovascular mortality and heart failure rehospitalization. Generalized linear mixed models analyzed longitudinal trends in LVEF, LVEDd, and NT-proBNP levels. Kaplan-Meier curves and Cox regression evaluated LVEF recovery rates, supplemented by subgroup analyses. Multivariate logistic regression was used to identify factors influencing target dose achievement rate for β-blockers and ACEI/ARB/ARNI therapies in CHF patients.Results:A total of 357 patients were enrolled, aged 53 (41, 63) years, including 256 males (71.7%). 157 patients were in the two-way referral group and 200 patients in the core hospital-treated group. Compared with the core hospital-treated group, the two-way referral group had lower baseline LVEF (28 (22, 34)% vs. 31 (23, 36)%, P=0.021) and systolic blood pressure (116 (104, 125) mmHg vs. 121 (109, 134) mmHg (1 mmHg=0.133 kPa), P=0.010). The 12-month follow-up rate of the two-way referral group was higher than the core hospital-treated group (73.8% vs. 56.0%, P=0.004). No significant between-group differences were observed in drug utilization rate of β-blockers, ACEI/ARB/ARNI, or sodium-glucose cotransporter 2 inhibitors during follow-up (all P>0.05), while mineralocorticoid receptor antagonists use showed a declining trend in both groups. Although the core hospital-treated group had higher target dose achievement rates for β-blockers (65.4% vs. 49.3%, P=0.042) and ACEI/ARB/ARNI (79.8% vs. 65.8%, P=0.046) than the two-way referral group, multivariate logistic regression indicated that the two-way referral model was not a negative predictor for these outcomes (all P>0.05). Both groups showed improved NT-proBNP, LVEDd, and LVEF from baseline (all P<0.001) with no significant difference in trends between groups (all P>0.05). There was no significant difference in the composite incidence (7.6% vs. 6.5%, P=0.674) and cumulative incidence (log-rank P=0.684) of cardiovascular death and heart failure rehospitalization at 12 months between two groups. Conclusion:The two-way referral model demonstrates advantages in improving medication adherence, drug utilization rates, and targetdoseachievement rates among CHF patients. This model not only promotes cardiac functional recovery but also reduces risks of cardiovascular mortality and heart failure rehospitalization, achieving comparable therapeutic and management outcomes to those observed in core hospital-treated patients.

Objective To explore the correlation between chronic diseases and the risk of benign prostatic hyperplasia(BPH)in middle-aged and older Chinese man.Methods Data from the 2013 China Health and Retirement Longitudinal Study(CHARLS)were used,including 4 509 male participants aged 45 years and older.Chronic diseases and BPH diagnoses were obtained through a questionnaire survey.Logistic regression analysis was performed to identify independent risk factors for BPH.Restricted cubic splines(RCS)were used to explore the nonlinear relationship between variables and BPH prevalence,while stratified analyses were conducted to assess the differential impact of chronic diseases on BPH prevalence in different subgroups.Results Compared to patients without BPH,those with BPH had a significantly higher prevalence of comorbid chronic diseases,including hypertension,diabetes,chronic respiratory diseases,chronic heart disease,stroke,chronic kidney disease,chronic digestive diseases,arthritis or rheumatism,depression,and memory-related disorders.Multivariable Logistic regression analysis indicated that factors such as the 10-item Center for Epidemiological Studies Depression Scale(CESD-10)scores(OR=1.043,95% CI:1.022-1.063,P<0.001),chronic respiratory disease(OR=1.518,95% CI:1.143-1.998,P=0.003),chronic heart disease(OR=1.515,95% CI:1.143-1.998,P=0.003),chronic kidney disease(OR=2.384,95% CI:1.799-3.137,P<0.001),and chronic digestive disease(OR=1.427,95% CI:1.129-1.796,P=0.003)were independently associated with the occurrence of BPH.RCS analysis demonstrated no non-linear association between age,BMI,and CESD-10 scores and BPH.Stratified analysis revealed that the influence of these chronic conditions on BPH remained constantly stable across different subgroups.Conclusion BPH is commonly comorbid with various chronic diseases.Future treatment strategies for BPH should consider the shared pathological mechanisms between BPH and these chronic conditions,with a focus on integrated interventions targeting common pathways.

Objective:To compare the efficacy of the detection kit based on MicroDrop microdroplet digital PCR platform that can identify mycoplasma pneumonia and common drug-resistance mutation,and throughout targeted next-generation sequencing(tNGS)in detecting common drug-resistance mutations of mycoplasma pneumonia.Methods:A total of 300 samples of clinical respiratory tract of pneumonia inpatients at Guangdong Provincial People's Hospital between 2023 and 2024 were collected.Both the detection kit for drug-resistance mutation of mycoplasma pneumoniae and the tNGS method were employed to detect drug-resistance mutation genes.For samples with inconsistent results,Sanger sequencing was used for verification.Results:For the 300 samples,the detection rates of positive mycoplasma pneumonia of the detection kit for drug-resistance mutation of mycoplasma pneumoniae and the tNGS method were respectively 87.00%and 78.67%,with a Kappa value of 0.711,indicating a relatively high level of agreement between the two methods.Among 25 samples with inconsistent results,Sanger sequencing was employed for validation.The results revealed that for samples with low-frequency gene mutations,the reagent kit maintained reliable detection capability,whereas tNGS exhibited missed detections.Thus,the reagent kit demonstrates superior performance in detecting low-frequency mutation samples.Conclusion:The detection rate of low-frequency mutation samples by the digital PCR-based mycoplasma pneumoniae drug-resistance mutation detection kit is higher than that of the tNGS method.This approach helps enhance the accuracy of detection results,providing a rapid and precise means of detecting drug-resistance genes for clinical diagnosis and treatment.

Objective:To explore the impact of the two-way referral model on compliance and prognosis in patients with heart failure.Methods:This bidirectional cohort study enrolled chronic heart failure (CHF) patients treated at Qilu Hospital of Shandong University or designated primary hospitals between March 2018 and March 2022. Patients were categorized into two groups based on referral status: two-way referral group (participating in the referral model with≥1 follow-up visit at primary hospitals) and the core hospital group (receiving treatment and follow-up exclusively at Qilu Hospital). Baseline clinical characteristics were collected and compared between groups. Patients underwent followed-up, with primary endpoints including follow-up rate, drug (β-blockers, angiotension converting enzyme inhibitor (ACEI)/angiotensin Ⅱ receptor blockers (ARB)/angiotensin receptor-neprilysin inhibitor (ARNI), sodium-glucose cotransporter 2 inhibitors and mineralocorticoid receptor antagonists) utilization rate and target dose achievement rate. Secondary endpoints encompassed changes from baseline in left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDd), and N-terminal pro-brain natriuretic peptide (NT-proBNP), plus cardiovascular mortality and heart failure rehospitalization. Generalized linear mixed models analyzed longitudinal trends in LVEF, LVEDd, and NT-proBNP levels. Kaplan-Meier curves and Cox regression evaluated LVEF recovery rates, supplemented by subgroup analyses. Multivariate logistic regression was used to identify factors influencing target dose achievement rate for β-blockers and ACEI/ARB/ARNI therapies in CHF patients.Results:A total of 357 patients were enrolled, aged 53 (41, 63) years, including 256 males (71.7%). 157 patients were in the two-way referral group and 200 patients in the core hospital-treated group. Compared with the core hospital-treated group, the two-way referral group had lower baseline LVEF (28 (22, 34)% vs. 31 (23, 36)%, P=0.021) and systolic blood pressure (116 (104, 125) mmHg vs. 121 (109, 134) mmHg (1 mmHg=0.133 kPa), P=0.010). The 12-month follow-up rate of the two-way referral group was higher than the core hospital-treated group (73.8% vs. 56.0%, P=0.004). No significant between-group differences were observed in drug utilization rate of β-blockers, ACEI/ARB/ARNI, or sodium-glucose cotransporter 2 inhibitors during follow-up (all P>0.05), while mineralocorticoid receptor antagonists use showed a declining trend in both groups. Although the core hospital-treated group had higher target dose achievement rates for β-blockers (65.4% vs. 49.3%, P=0.042) and ACEI/ARB/ARNI (79.8% vs. 65.8%, P=0.046) than the two-way referral group, multivariate logistic regression indicated that the two-way referral model was not a negative predictor for these outcomes (all P>0.05). Both groups showed improved NT-proBNP, LVEDd, and LVEF from baseline (all P<0.001) with no significant difference in trends between groups (all P>0.05). There was no significant difference in the composite incidence (7.6% vs. 6.5%, P=0.674) and cumulative incidence (log-rank P=0.684) of cardiovascular death and heart failure rehospitalization at 12 months between two groups. Conclusion:The two-way referral model demonstrates advantages in improving medication adherence, drug utilization rates, and targetdoseachievement rates among CHF patients. This model not only promotes cardiac functional recovery but also reduces risks of cardiovascular mortality and heart failure rehospitalization, achieving comparable therapeutic and management outcomes to those observed in core hospital-treated patients.

Chemoresistance to 5-fluorouracil (5-FU) is a significant challenge in treating colorectal cancer (CRC). Novel combined regimens to thwart chemoresistance are therefore urgently needed. Herein, we demonstrated that the combination of Avenanthramide A (AVN A) and 5-FU has significant therapeutic advantages against CRC. Mechanistically, AVN A directly binds to the S198 site of the histone lysine demethylase KDM4C to promote its degradation, which subsequently fosters H3K9me3 occupancy on the MIR17HG promoter to block its transcription and derepress Bim expression. AVN A enhanced the therapeutic efficacy of 5-FU via impairing the KDM4C/MIR17HG/GSK-3β negative feedback loop. Importantly, the clinical correlation of the KDM4C/MIR17HG/Bim signaling axis with 5-FU response was validated in the refractory CRC patients. We provide evidence for the enhanced effectiveness of 5-FU when combined with AVN A in chemoresistant xenografts, CRC organoids, and Apc ^Min/+ mouse model. Additionally, AVN A mitigated the systemic adverse effects of 5-FU. Overall, our findings demonstrate that combinatorial therapy with AVN A and 5-FU represents an appealing opportunity and highlights KDM4C/MIR17HG/GSK-3β negative feedback loop which confers therapeutically exploitable vulnerability to chemo-refractory CRC patients.

Hypersplenism is a common complication caused by liver cirrhosis and portal hypertension, and at present, splenectomy and partial splenic artery embolization (PSE) are the main methods for the treatment of hypersplenism. Splenectomy has a marked effect in the treatment of hypersplenism and can significantly improve the clinical symptoms of patients with hypersplenism. Compared with splenectomy, PSE causes partial splenic parenchymal infarction and thus achieve similar clinical efficacy as partial splenectomy while preserving the spleen and its function. Although PSE is an effective method for the treatment of hypersplenism, there are few reports on the effect of PSE on liver fibrosis, immunity, and liver regeneration in China and globally. This article summarizes the common causes of hypersplenism, the mechanism of PSE in the treatment of hypersplenism, the therapeutic effect of different embolization methods and materials, and the effect of PSE on liver fibrosis, immunity, and liver regeneration, so as to provide a theoretical basis and new ideas for the clinical treatment of hypersplenism.

Objective:To establish a qualitative and quantitative analysis method of ginsenoside Rb1, cinnamic acid, paeoniflorin and berberine in Wenxin formula based on UPLC-MS/MS MRM model so as to provide a rapid and accurate evaluation method for the research and development of new drugs.Methods:Adopting Waters ACQUITY UPLCTM HSS T3 (2.1 mm×100 mm, 1.8 μm) and gradient elution was performed by mobile methanol-0.03% formic acid water. chromatographic column was used with electrospray ionization source in the scanning mode of multiple reactive ion monitoring (MRM) for ion separation and screening. The retention time and the relative abundance ratio (qualitative ion pairs/quantitative ion pairs) was used for qualitative analysis, while quantitative ion pairs was used for quantitative analysis.Results:The four components tested in Wenxin Formula have been qualitatively detected and showed a good linear relationship, the method showed accuracy, precision, repeatability, and stability, the recovery rate was 96.24%-104.19% and RSD was 1.29%-3.30%. Conclusion:The established method is simple, accurate, rapid and sensitive, which is reliable for the qualitative and quantitative study of the four main components in Wenxin Formula.

Objective: In this study, a new surgical technique was developed to reconstruct the lateral nail fold in the duplicated thumbs with a common nail and postoperative outcomes were evaluated. Methods: From December 2012 to October 2015, sixteen duplicated thumbs with a common nail were treated in our hospital using a flap from resected finger pulp which did not include the nail and phalanx. Unilateral inverting suture was performed between the flap and nail bed to reconstruct the lateral nail fold and nail groove. Postoperative outcomes were evaluated by Wang-Gao scoring system (total 12). Results: The follow-up period ranged from 10 to 45 months. The reconstructed nails were smooth and had a natural lunula, and the nail width was about 80%-100% of their normal sides. There was a right angle between the nail epithelium and lateral nail fold in four cases, and an acute angle in two cases. The reconstructed nails were asymmetrical in these thumbs. One patient showed a hypertrophy in the lateral nail fold. The reconstructed nails were evaluated by Wang-Gao scoring system: 10 in 2 cases, 11 in 4 and 12 in 10. All the cases had excellent results. Conclusions The nail width usually is more than 80% of the normal sides in the radial polydactyly with a common nail. The surgical technique can reconstruct a natural lateral nail fold and nail groove, and avoid the nail deformity caused by the Bilhaut-Cloquet procedure.