This study retrospectively analyzed the clinical data of 43 patients with large-volume renal calculi treated with flexible ureteroscopic lithotripsy (FURL)at our hospital from August 2020 to August 2023. Among the patients, 26 were male and 17 were female; 22 had left-sided stones and 21 had right-sided stones. Thirty-three patients had preoperative placement of a double-J (D-J)stent, while 10 did not. The mean age was (42.7±11.1)years, the mean stone volume was (10.3±3.5)cm 3, and the mean operative time was (97.9±10.4)minutes. All procedures were completed using reusable flexible ureteroscopic lithotripsy. Twenty-two patients received traditional methods of stone expulsion after FURL (control group), while 21 patients received a combination of traditional methods and extracorporeal physical vibration lithotripsy (EPVL) after FURL (experimental group). The experimental group showed a significantly higher stone-free rate at one month (85.7% vs. 54.5%)and a lower reoperation rate (4.8% vs. 31.8%)compared to the control group. The difference in reoperation rates between the experimental and control groups was statistically significant ( P< 0.05). These results suggest that the combination of reusable ureteroscopic lithotripsy and EPVL is a feasible treatment option for large-volume renal calculi.

Objective:To investigate the dose characteristics of the Zeiss INTRABEAM system in air and water, providing dose reference for electronic brachytherapy.Methods:A Monte Carlo program was used to establish a three-dimensional model of a miniature X-ray source vacuum drift tube and a 4 cm spherical applicator. The process of electron beam bombardment on a gold target to generate X-rays was simulated, and parameters such as photon fluence spectrum, percentage depth dose, and half-value layer were calculated. Additionally, the radial dose uniformity in water was measured.Results:The average energy of X-rays at 3 cm in air was 20.8 keV, with a half-value layer of 0.08 mm Al. Under the influence of the applicator, the spectrum becomes hardened, with axial and radial average energies of 28.7 and 29.0 keV, respectively. In water, the percentage depth dose (PDD) curve follows an inverse cubic decay with depth, indicating strong dose concentration and rapid fall-off in near-field irradiation. The radial dose uniformity in water exceeded 99.5%.Conclusions:The INTRABEAM device emits low-energy X-rays characterized by shallow penetration depth, and concentrated dose delivery. Its highly uniform dose distribution ensures comprehensive coverage of the target area, making it particularly suitable for treating superficial tumors and for intraoperative radiotherapy at close range.

Objective To explore the influencing factors of readmission within 90 days in frail patients with chronic obstructive pulmonary disease(COPD),construct an early warning model and evaluate its discrimination and effectiveness.Methods A total of 831 COPD patients with frailty were included and divided into the readmission group(290 cases)and the control group(541 cases)based on whether they were readmitted within 90 days after discharge.The electronic medical record data were collected and compared between the two groups of patients.Multivariate Logistic regression analysis was used to screen independent influencing factors for readmission within 90 days in COPD weak patients.A predictive model was established.The column chart was drawn.The discriminability of the predictive model was evaluated through receiver operating characteristic(ROC)curves.The clinical practicality and the predictive model calibration were evaluated through decision curves and calibration curves.Results The body mass index(BMI)of the readmission group was lower than that of the non readmission group,and the proportion of acute exacerbation of COPD hospitalizations≥2 times in the past year,the Edmonton frailty scale(REFS)score and the Chalson comorbidity index(CCI)were higher in the readmission group than those of the non readmission group(P＜0.05).Multivariate Logistic regression analysis showed that BMI(OR=0.721,95%CI:0.636-0.818),the number of acute exacerbations of COPD hospitalizations in the past year(OR=3.040,95%CI:1.944-4.753),REFS score(OR=1.726,95%CI:1.486-2.005)and CCI score(OR=3.917,95%CI:3.079-4.983)were all independent influencing factors for readmission within 90 days in COPD frail patients(P＜0.05).Based on the results of multiple factor Logistic regression analysis,the column chart warning model was constructed.The AUC value of the ROC curve was 0.847(95%CI:0.820-0.874),the specificity was 87.20%and the sensitivity was 64.50%.The calibration curve of the predictive model was close to the diagonal,and the calibrationa degree was good.The decision curve suggested that the prediction model had clinical practicality.Conclusion The early warning model constructed based on the influencing factors of readmission hospitalization within 90 days in weak patients with COPD has good predictive effect and clinical practicability.

In recent years,the incidence and mortality of malignant tumors have been increasing year by year,becoming a se-rious challenge to global public health.Unlike traditional treatment methods,tumor immunotherapy activates the body's own immune system to against tumors,and has significant advantage such as minimal side effects,long-lasting efficacy,and strong targeting.Howev-er,immunotherapy also has issues such as frequent adverse reactions and high treatment costs.In order to enhance the efficacy of im-munotherapy,some phytochemicals are used in the field of immunotherapy as modulators.These phytochemicals not only increase the sensitivity of tumor cells to immune cells,but also reduce the expression of immune checkpoint proteins.Therefore,this article provides a review of phytochemicals that play an important role in tumor immunotherapy and their related mechanisms of action.

This study retrospectively analyzed the clinical data of 43 patients with large-volume renal calculi treated with flexible ureteroscopic lithotripsy (FURL)at our hospital from August 2020 to August 2023. Among the patients, 26 were male and 17 were female; 22 had left-sided stones and 21 had right-sided stones. Thirty-three patients had preoperative placement of a double-J (D-J)stent, while 10 did not. The mean age was (42.7±11.1)years, the mean stone volume was (10.3±3.5)cm 3, and the mean operative time was (97.9±10.4)minutes. All procedures were completed using reusable flexible ureteroscopic lithotripsy. Twenty-two patients received traditional methods of stone expulsion after FURL (control group), while 21 patients received a combination of traditional methods and extracorporeal physical vibration lithotripsy (EPVL) after FURL (experimental group). The experimental group showed a significantly higher stone-free rate at one month (85.7% vs. 54.5%)and a lower reoperation rate (4.8% vs. 31.8%)compared to the control group. The difference in reoperation rates between the experimental and control groups was statistically significant ( P< 0.05). These results suggest that the combination of reusable ureteroscopic lithotripsy and EPVL is a feasible treatment option for large-volume renal calculi.

Objective:To investigate the dose characteristics of the Zeiss INTRABEAM system in air and water, providing dose reference for electronic brachytherapy.Methods:A Monte Carlo program was used to establish a three-dimensional model of a miniature X-ray source vacuum drift tube and a 4 cm spherical applicator. The process of electron beam bombardment on a gold target to generate X-rays was simulated, and parameters such as photon fluence spectrum, percentage depth dose, and half-value layer were calculated. Additionally, the radial dose uniformity in water was measured.Results:The average energy of X-rays at 3 cm in air was 20.8 keV, with a half-value layer of 0.08 mm Al. Under the influence of the applicator, the spectrum becomes hardened, with axial and radial average energies of 28.7 and 29.0 keV, respectively. In water, the percentage depth dose (PDD) curve follows an inverse cubic decay with depth, indicating strong dose concentration and rapid fall-off in near-field irradiation. The radial dose uniformity in water exceeded 99.5%.Conclusions:The INTRABEAM device emits low-energy X-rays characterized by shallow penetration depth, and concentrated dose delivery. Its highly uniform dose distribution ensures comprehensive coverage of the target area, making it particularly suitable for treating superficial tumors and for intraoperative radiotherapy at close range.

In recent years,the incidence and mortality of malignant tumors have been increasing year by year,becoming a se-rious challenge to global public health.Unlike traditional treatment methods,tumor immunotherapy activates the body's own immune system to against tumors,and has significant advantage such as minimal side effects,long-lasting efficacy,and strong targeting.Howev-er,immunotherapy also has issues such as frequent adverse reactions and high treatment costs.In order to enhance the efficacy of im-munotherapy,some phytochemicals are used in the field of immunotherapy as modulators.These phytochemicals not only increase the sensitivity of tumor cells to immune cells,but also reduce the expression of immune checkpoint proteins.Therefore,this article provides a review of phytochemicals that play an important role in tumor immunotherapy and their related mechanisms of action.

Objective To explore the influencing factors of readmission within 90 days in frail patients with chronic obstructive pulmonary disease(COPD),construct an early warning model and evaluate its discrimination and effectiveness.Methods A total of 831 COPD patients with frailty were included and divided into the readmission group(290 cases)and the control group(541 cases)based on whether they were readmitted within 90 days after discharge.The electronic medical record data were collected and compared between the two groups of patients.Multivariate Logistic regression analysis was used to screen independent influencing factors for readmission within 90 days in COPD weak patients.A predictive model was established.The column chart was drawn.The discriminability of the predictive model was evaluated through receiver operating characteristic(ROC)curves.The clinical practicality and the predictive model calibration were evaluated through decision curves and calibration curves.Results The body mass index(BMI)of the readmission group was lower than that of the non readmission group,and the proportion of acute exacerbation of COPD hospitalizations≥2 times in the past year,the Edmonton frailty scale(REFS)score and the Chalson comorbidity index(CCI)were higher in the readmission group than those of the non readmission group(P＜0.05).Multivariate Logistic regression analysis showed that BMI(OR=0.721,95%CI:0.636-0.818),the number of acute exacerbations of COPD hospitalizations in the past year(OR=3.040,95%CI:1.944-4.753),REFS score(OR=1.726,95%CI:1.486-2.005)and CCI score(OR=3.917,95%CI:3.079-4.983)were all independent influencing factors for readmission within 90 days in COPD frail patients(P＜0.05).Based on the results of multiple factor Logistic regression analysis,the column chart warning model was constructed.The AUC value of the ROC curve was 0.847(95%CI:0.820-0.874),the specificity was 87.20%and the sensitivity was 64.50%.The calibration curve of the predictive model was close to the diagonal,and the calibrationa degree was good.The decision curve suggested that the prediction model had clinical practicality.Conclusion The early warning model constructed based on the influencing factors of readmission hospitalization within 90 days in weak patients with COPD has good predictive effect and clinical practicability.

At present, the major public health challenges caused by novel coronavirus infection have gradually subside. However, a large number of people are still suffering from long-novel coronavirus syndrome or post-novel coronavirus syndrome. The clinical manifestations of long coronavirus syndrome are related to multiple systems, such as respiratory, circulatory, nervous, digestive and musculoskeletal systems, with various long-term persistent symptoms after novel coronavirus infection. At the same time, the infection of the novel coronavirus is an important cause of frailty and sarcopenia in the elderly population. However, at present, the scholars have not paid enough attention to the skeletal muscle weakness caused by the novel coronavirus. Therefore, this paper focuses on the long-novel coronavirus syndrome and sarcopenia to explore the pathological mechanism of skeletal muscle attenuation caused by the SARS-CoV-2 mediated "cytokine storm", mitochondrial damage, hypoxia state and other links, so as to raise the attention of clinical and academic researchers and improve the clinical strategy of frailty and sarcopenia after novel coronavirus infection.

Influenza is an acute respiratory infection caused by influenza viruses (IFV), According to the World Health Organization (WHO), seasonal IFV epidemics result in approximately 3-5 million cases of severe illness, leading to about half a million deaths worldwide, along with severe economic losses and social burdens. Unfortunately, frequent mutations in IFV lead to a certain lag in vaccine development as well as resistance to existing antiviral drugs. Therefore, it is of great importance to develop anti-IFV drugs with high efficiency against wild-type and resistant strains, needed in the fight against current and future outbreaks caused by different IFV strains. In this review, we summarize general strategies used for the discovery and development of antiviral agents targeting multiple IFV strains (including those resistant to available drugs). Structure-based drug design, mechanism-based drug design, multivalent interaction-based drug design and drug repurposing are amongst the most relevant strategies that provide a framework for the development of antiviral drugs targeting IFV.