Objective To evaluate the clinical efficacy of acupuncture at Four Gates(bilateral LI4 and LR3)and other acupoints in treating postoperative pain after laparoscopic inguinal hernia repair and to explore its potential mechanism of action.Methods Sixty patients who underwent tension-free laparoscopic inguinal hernia repair at the Third Affiliated Hospital of Guangzhou University of Chinese Medicine between June 2024 and January 2025 and developed postoperative pain were enrolled.They were randomly divided into an observation group(n=30)and a control group(n=30)using a random number table.The control group received standard postoperative care,while the observation group received additional acupuncture at Four Gates and other acupoints(administered at 0 hour and 24 hours postoperatively).Clinical efficacy was assessed after 24 hours.Changes in the Numerical Rating Scale(NRS)for pain and the Bruggrmann Comfort Scale(BCS)were recorded.Serum levels of white blood cells(WBC),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),and cortisol(COR)were compared before and after treatment.Safety and adverse reactions were also evaluated.Results(1)After 4 hours and 24 hours of treatment,the NRS scores in the observation group were significantly improved(P＜0.05).Additionally,the observation group showed a significantly greater improvement in NRS scores than the control group during the same period,with statistically significant differences(P＜0.05).(2)After 4 hours and 24 hours of treatment,the BCS scores of both groups of patients were significantly improved(P＜0.05).The observation group showed a significantly greater improvement in BCS scores than the control group,with statistically significant differences(P＜0.05).(3)After treatment,the levels of WBC,CRP,and ESR in the observation group were significantly lower than those in the control group(P＜0.05).There was no statistically significant difference in COR levels between the two groups(P＞0.05).After treatment,the WBC levels in the observation group were slightly lower than before treatment,but the difference was not statistically significant(P＞0.05),while the WBC levels in the control group were significantly higher than before treatment(P＜0.05).(4)The overall response rate in the observation group was 96.70％(29/30),while that in the control group was 56.77％(17/30).The efficacy of the observation group was superior to that of the control group,with a statistically significant difference(P＜0.05).(5)No significant adverse reactions occurred in either the observation group or the control group.There was no statistically significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Acupuncture at Four Gates and other acupoints significantly alleviates postoperative pain,enhances patient comfort,and demonstrates excellent clinical efficacy with high safety.The treatment modulates postoperative WBC,CRP,ESR,and COR levels,suggesting systemic anti-inflammatory and stress-regulatory effects.

ObjectiveTraditional Chinese medicine (TCM) constitutes a valuable cultural heritage and an important source of antitumor compounds. Poria (Poria cocos (Schw.) Wolf), the dried sclerotium of a polyporaceae fungus, was first documented in Shennong’s Classic of Materia Medica and has been used therapeutically and dietarily in China for millennia. Traditionally recognized for its diuretic, spleen-tonifying, and sedative properties, modern pharmacological studies confirm that Poria exhibits antioxidant, anti-inflammatory, antibacterial, and antitumor activities. Pachymic acid (PA; a triterpenoid with the chemical structure 3β-acetyloxy-16α-hydroxy-lanosta-8,24(31)-dien-21-oic acid), isolated from Poria, is a principal bioactive constituent. Emerging evidence indicates PA exerts antitumor effects through multiple mechanisms, though these remain incompletely characterized. Neuroblastoma (NB), a highly malignant pediatric extracranial solid tumor accounting for 15% of childhood cancer deaths, urgently requires safer therapeutics due to the limitations of current treatments. Although PA shows multi-mechanistic antitumor potential, its efficacy against NB remains uncharacterized. This study systematically investigated the potential molecular targets and mechanisms underlying the anti-NB effects of PA by integrating network pharmacology-based target prediction with experimental validation of multi-target interactions through molecular docking, dynamic simulations, and in vitro assays, aimed to establish a novel perspective on PA’s antitumor activity and explore its potential clinical implications for NB treatment by integrating computational predictions with biological assays. MethodsThis study employed network pharmacology to identify potential targets of PA in NB, followed by validation using molecular docking, molecular dynamics (MD) simulations, MM/PBSA free energy analysis, RT-qPCR and Western blot experiments. Network pharmacology analysis included target screening via TCMSP, GeneCards, DisGeNET, SwissTargetPrediction, SuperPred, and PharmMapper. Subsequently, potential targets were predicted by intersecting the results from these databases via Venn analysis. Following target prediction, topological analysis was performed to identify key targets using Cytoscape software. Molecular docking was conducted using AutoDock Vina, with the binding pocket defined based on crystal structures. MD simulations were performed for 100 ns using GROMACS, and RMSD, RMSF, SASA, and hydrogen bonding dynamics were analyzed. MM/PBSA calculations were carried out to estimate the binding free energy of each protein-ligand complex. In vitro validation included RT-qPCR and Western blot, with GAPDH used as an internal control. ResultsThe CCK-8 assay demonstrated a concentration-dependent inhibitory effect of PA on NB cell viability. GO analysis suggested that the anti-NB activity of PA might involve cellular response to chemical stress, vesicle lumen, and protein tyrosine kinase activity. KEGG pathway enrichment analysis suggested that the anti-NB activity of PA might involve the PI3K/AKT, MAPK, and Ras signaling pathways. Molecular docking and MD simulations revealed stable binding interactions between PA and the core target proteins AKT1, EGFR, SRC, and HSP90AA1. RT-qPCR and Western blot analyses further confirmed that PA treatment significantly decreased the mRNA and protein expression of AKT1, EGFR, and SRC while increasing the HSP90AA1 mRNA and protein levels. ConclusionIt was suggested that PA may exert its anti-NB effects by inhibiting AKT1, EGFR, and SRC expression, potentially modulating the PI3K/AKT signaling pathway. These findings provide crucial evidence supporting PA’s development as a therapeutic candidate for NB.

Clinical chemotherapy for prostate cancer is still compromised by high treatment thresholds and severe off-target toxicity of drugs. Given the limited progress in improving therapeutic outcomes and reducing toxicity with the existing toolbox, efforts to broaden the chemotherapeutic window are highly desired. Here, we discover that gossypol (GSP, a natural compound) dramatically enhances the chemosensitivity of cabazitaxel (CTX), even at previously ineffective concentrations. Based on this interesting finding, we exploit a carrier-free chemotherapeutic nano-booster for prostate cancer treatment, which is molecularly co-assembled by GSP and cabazitaxel (CTX). GSP not only readily forms nanoassembly with CTX, but also functions as a chemotherapeutic enhancer that unlocks an ultra-low-dose chemotherapeutic window. Not only that, precise dual-drug nanoassembly confers CTX a significantly larger maximum tolerable dose. As expected, the nano-booster exerts striking therapeutic benefits in mouse prostate tumor xenograft models. This study advances chemotherapeutic window expansion and self-sensitized chemotherapy toward clinical applicability.

Objective To investigate the safety parameters of the air-powered electrocautery hook and its advantages in laparoscopic surgery.Methods In pressure trauma experiments,21 healthy New Zealand White Rabbits were randomly divided into three groups.In each group,three sites(liver,intestine,and kidney)were selected from each rabbit,and the air-powered electrocautery hook was used under laparoscopy to apply pressure and time gradients in a cross-combination manner.The three groups of experimental rabbits were dissected at three time points:immediately after application,3 d post-application,and 7 d post-application.Pathological sections were prepared from the corresponding treated sites,and the extent of injury was assessed.In rabbit renal capsule removal experiment,another 20 healthy New Zealand White Rabbits were randomly divided into 2 groups.Renal capsule removal was performed by using an air-powered electrosurgical hook and a conventional electrosurgical hook,respectively,to compare the two groups in terms of surgical time,intraoperative bleeding volume,intraoperative complications,and the number of times of wiping speculum.Results In pressure trauma experiment,except for the intestinal tract at 3 seconds(P=0.060),the histopathological scores under 0.3 MPa pressure were significantly higher than those under 0.1 MPa(P<0.05)and 0.2 MPa(P<0.05)in all the tissues.In the tissue sampling groups at 3 d and 7 d post-surgery,no tissue damage was observed in any tissue at any time point under 0.1 MPa pressure.In rabbit renal capsule removal experiment,the aerodynamic electrocautery group had less intraoperative bleeding volume than the conventional electrocautery group[(2.9±0.5)ml vs.(3.4±0.5)ml,t=-2.280,P=0.035].There were no significant differences between the two groups in terms of surgical time,intraoperative complication rates,and the number of times of wiping speculum(P>0.05).Conclusions The safe pressure range for using the air-powered electrosurgical hook on the surfaces of the kidney and intestinal tract is within 0.2 MPa.Within the safe pressure range,blowing on tissue for 6 seconds or less is relatively safe.Using the air-powered electrosurgical hook in surgeries requiring the separation of loose connective tissue can reduce intraoperative bleeding.

Objective To observe the value of CT radiomics machine learning(ML)model for predicting stone free rate(SFR)of urinary calculi after retrograde intrarenal surgery(RIRS).Methods Totally 216 patients with urinary calculi who underwent RIRS were retrospectively enrolled and divided into residual group(n=73)and non-residual group(n=143).Univariate and multivariate logistic regression(LR)were performed to analyze clinical data and CT manifestations of stones to screen independent predictors of SFR after RIRS.Window width and window level normalization combined with max-min normalization(denoted as method a),max-min normalization(denoted as method b),window width and window level normalization(denoted as method c)and non-normalization(denoted as method d)of pre-RIRS abdominal CT were performed,respectively,and the best radiomics features of stones were extracted and screened to establish ML models,including support vector machine(SVM),LR and stochastic gradient descent(SGD)models,and the best ML model was screened.RUSS and modified S.T.O.N.E scores were evaluated based on pre-RIRS CT for predicting SFR of urinary calculi after RIRS.A combined model was then constructed with the independent predictors and the best ML model.The predictive efficacy of each model and scoring system were assessed.Results The number of stones,CT value and volume of the maximum stone were all independent predictors of SFR after RIRS(all P＜0.05).The area under the curve(AUC)of SVM model constructed with images preprocessed by method b was the highest(0.861),higher than that of the total scores of RUSS and modified S.T.O.N.E(AUC=0.750,0.759,both P＜0.05)but not different from that of combined model(AUC=0.853,P=0.775).Conclusion Radiomics SVM model based on max-min normalization preprocessed CT could effectively predict SFR of urinary calculi after RIRS.

Objective To observe the value of CT radiomics machine learning(ML)model for predicting stone free rate(SFR)of urinary calculi after retrograde intrarenal surgery(RIRS).Methods Totally 216 patients with urinary calculi who underwent RIRS were retrospectively enrolled and divided into residual group(n=73)and non-residual group(n=143).Univariate and multivariate logistic regression(LR)were performed to analyze clinical data and CT manifestations of stones to screen independent predictors of SFR after RIRS.Window width and window level normalization combined with max-min normalization(denoted as method a),max-min normalization(denoted as method b),window width and window level normalization(denoted as method c)and non-normalization(denoted as method d)of pre-RIRS abdominal CT were performed,respectively,and the best radiomics features of stones were extracted and screened to establish ML models,including support vector machine(SVM),LR and stochastic gradient descent(SGD)models,and the best ML model was screened.RUSS and modified S.T.O.N.E scores were evaluated based on pre-RIRS CT for predicting SFR of urinary calculi after RIRS.A combined model was then constructed with the independent predictors and the best ML model.The predictive efficacy of each model and scoring system were assessed.Results The number of stones,CT value and volume of the maximum stone were all independent predictors of SFR after RIRS(all P＜0.05).The area under the curve(AUC)of SVM model constructed with images preprocessed by method b was the highest(0.861),higher than that of the total scores of RUSS and modified S.T.O.N.E(AUC=0.750,0.759,both P＜0.05)but not different from that of combined model(AUC=0.853,P=0.775).Conclusion Radiomics SVM model based on max-min normalization preprocessed CT could effectively predict SFR of urinary calculi after RIRS.

Urinary tract obstruction symptoms as the predominant manifestation of interstitial cystitis/bladder pain syndrome (IC/BPS) are uncommon and can easily be misdiagnosed as bladder neck obstruction, benign prostatic hyperplasia, or prostatitis. This article reports three cases of such patients. Case 1 was a 61-year-old male, case 2 was a 53-year-old female, and case 3 was a 26-year-old male. Cases 1 and 2 were initially suspected of having bladder neck obstruction, and both underwent bladder neck incision, which resulted in poor outcomes. Case 3 was initially diagnosed with chronic prostatitis. All three patients were diagnosed with IC/BPS after undergoing bladder hydrodistention therapy. One patient received intravesical botulinum toxin A injection following hydrodistention. After treatment, the patients were followed up for 4 months, 2.5 months, and 1.5 months, respectively, and all reported satisfactory symptom improvement.

Objective To observe the mid-and long-term effects of Kegel training combined with Pilates training on urinary conti-nence recovery in different body mass index(BMI)male patients with urinary incontinence after prostatectomy.Methods From May,2023 to June,2024,48 patients in Beijing Bo'ai Hospital were recruited and divided into group A(<25 kg/m2,n=15),group B(25 to 30 kg/m2,n=18)and group C(>30 kg/m2,n=15)according to their BMI.All the groups performed Kegel training combined with Pilates training for two months,and followed up at six months from baseline.They were evaluated with one hour pad test,the number of daily urinary incontinence,In-ternational Consultation on Incontinence Questionnaire-Short Form(ICIQ-SF)and modified Oxford Rating Scale before treatment,and four weeks,eight weeks and six months after treatment.Results The intra-group effect,the inter-group effect and interaction effect were significant in the results of one hour pad test and the daily number of urinary incontinence(F>2.955,P<0.05).Post Hoc test showed that they were worse in group C than in groups A and B(P<0.05),and the number of daily urinary incontinence was more in group B than in group A(P<0.05).There was significant difference in the scores of ICIQ-SF and modified Ox-ford Rating Scale among groups in different time points after treatment(Z>10.476,P<0.05)except the score of ICIQ-SF four weeks after treatment(P>0.05),and they were the worst in group C.BMI(group A=1,group B=2,group C=3)was correlated with the results of one hour pad test(r=0.79,P<0.001),the number of daily uri-nary incontinence(r=0.68,P<0.001),and the scores of ICIQ-SF(r=0.68,P<0.001)and modified Oxford Rating Scale(r=-0.47,P=0.001)six months after treatment.Conclusion Kegel training combined with Pilates training could improve the urinary control in patients with urinary in-continence after prostatectomy.The decrease of BMI can promote the recovery of urinary control,and improve the symptoms of later urinary incontinence in mid-and long-term.

Objective To investigate the safety parameters of the air-powered electrocautery hook and its advantages in laparoscopic surgery.Methods In pressure trauma experiments,21 healthy New Zealand White Rabbits were randomly divided into three groups.In each group,three sites(liver,intestine,and kidney)were selected from each rabbit,and the air-powered electrocautery hook was used under laparoscopy to apply pressure and time gradients in a cross-combination manner.The three groups of experimental rabbits were dissected at three time points:immediately after application,3 d post-application,and 7 d post-application.Pathological sections were prepared from the corresponding treated sites,and the extent of injury was assessed.In rabbit renal capsule removal experiment,another 20 healthy New Zealand White Rabbits were randomly divided into 2 groups.Renal capsule removal was performed by using an air-powered electrosurgical hook and a conventional electrosurgical hook,respectively,to compare the two groups in terms of surgical time,intraoperative bleeding volume,intraoperative complications,and the number of times of wiping speculum.Results In pressure trauma experiment,except for the intestinal tract at 3 seconds(P=0.060),the histopathological scores under 0.3 MPa pressure were significantly higher than those under 0.1 MPa(P<0.05)and 0.2 MPa(P<0.05)in all the tissues.In the tissue sampling groups at 3 d and 7 d post-surgery,no tissue damage was observed in any tissue at any time point under 0.1 MPa pressure.In rabbit renal capsule removal experiment,the aerodynamic electrocautery group had less intraoperative bleeding volume than the conventional electrocautery group[(2.9±0.5)ml vs.(3.4±0.5)ml,t=-2.280,P=0.035].There were no significant differences between the two groups in terms of surgical time,intraoperative complication rates,and the number of times of wiping speculum(P>0.05).Conclusions The safe pressure range for using the air-powered electrosurgical hook on the surfaces of the kidney and intestinal tract is within 0.2 MPa.Within the safe pressure range,blowing on tissue for 6 seconds or less is relatively safe.Using the air-powered electrosurgical hook in surgeries requiring the separation of loose connective tissue can reduce intraoperative bleeding.

Objective To observe the mid-and long-term effects of Kegel training combined with Pilates training on urinary conti-nence recovery in different body mass index(BMI)male patients with urinary incontinence after prostatectomy.Methods From May,2023 to June,2024,48 patients in Beijing Bo'ai Hospital were recruited and divided into group A(<25 kg/m2,n=15),group B(25 to 30 kg/m2,n=18)and group C(>30 kg/m2,n=15)according to their BMI.All the groups performed Kegel training combined with Pilates training for two months,and followed up at six months from baseline.They were evaluated with one hour pad test,the number of daily urinary incontinence,In-ternational Consultation on Incontinence Questionnaire-Short Form(ICIQ-SF)and modified Oxford Rating Scale before treatment,and four weeks,eight weeks and six months after treatment.Results The intra-group effect,the inter-group effect and interaction effect were significant in the results of one hour pad test and the daily number of urinary incontinence(F>2.955,P<0.05).Post Hoc test showed that they were worse in group C than in groups A and B(P<0.05),and the number of daily urinary incontinence was more in group B than in group A(P<0.05).There was significant difference in the scores of ICIQ-SF and modified Ox-ford Rating Scale among groups in different time points after treatment(Z>10.476,P<0.05)except the score of ICIQ-SF four weeks after treatment(P>0.05),and they were the worst in group C.BMI(group A=1,group B=2,group C=3)was correlated with the results of one hour pad test(r=0.79,P<0.001),the number of daily uri-nary incontinence(r=0.68,P<0.001),and the scores of ICIQ-SF(r=0.68,P<0.001)and modified Oxford Rating Scale(r=-0.47,P=0.001)six months after treatment.Conclusion Kegel training combined with Pilates training could improve the urinary control in patients with urinary in-continence after prostatectomy.The decrease of BMI can promote the recovery of urinary control,and improve the symptoms of later urinary incontinence in mid-and long-term.