Objective:To examine the longitudinal relationships between perceived social support,life satis-faction and acceptance by others among relocated residents for poverty alleviation.Methods:A two-wave longitudi-nal survey was conducted with 383 relocated residents from 39 resettlement communities in Guizhou Province,with a six-month interval.Participants completed the Perceived Social Support Scale(PSSS),the Acceptance by Others Scale of the Acceptance of others Scale(AOS),and the Satisfaction With Life Scale(SWLS).Results:T1 PSSS scores positively predicted T2 acceptance by others scores(β=0.20,P＜0.001).T2 acceptance by others scores positively predicted T2 SMLS scores(β=0.45,P＜0.001).Perceived acceptance by others fully mediated the lon-gitudinal relationship between perceived social support and life satisfaction(effect=0.09,95％CI:0.03-0.18).Conclusion:Perceived social support predicts life satisfaction of relocated residents for poverty alleviation through perceived acceptance by others.

Objective:To explore the relationship between visceral adipose tissue (VAT) and the severity and prognosis of obese patients with acute pancreatitis (AP).Methods:The clinical data of 224 obese patients with AP admitted to The Third Affiliated Hospital of Chongqing Medical University and Chongqing Dongnan Hospital from January 2020 to December 2023 were collected, retrospectively. According to the severity of AP, they were divided into mild AP group (MAP group), moderately severe AP group (MSAP group), and severe AP group (SAP group). According to the in-hospital treatment outcomes of the patients, they were divided into the survival group and death group (death within 7-30 days after admission). The basic information of AP patients, the severity score of AP and laboratory indicators were collected. The visceral adiposity index (VAI) was calculated through the values of waist circumference, body mass index, triglycerides and high-density lipoprotein cholesterol; and the VAT area was measured by CT scan. The Spearman rank correlation analysis method was used to evaluate the correlation between the VAT area and the AP severity index as well as other indicators. Multivariate logistic regression analysis was used to analyze the influencing factors of in-hospital mortality in obese patients with AP. The receiver operating characteristic curve (ROC) was drawn, and the area under curve (AUC), cut-off value, sensitivity and specificity were calculated to evaluate the predictive value of VAT area for SAP, as well as the predictive value of VAT area for in-hospital mortality in obese AP patients.Results:The VAI of MAP group, MSAP group and SAP group were 1.63(1.21, 2.74), 2.30(1.28, 3.36) and 3.01(2.17, 3.86), respectively, and the VAT area were 138.90(121.30, 155.10)cm 2, 149.90(135.10, 166.70)cm 2 and 192.30(168.80, 223.80)cm 2, respectively. There were significant differences in VAI and VAT area among the three groups (all P values <0.05). Compared with MAP group, the area of VAI and VAT area in MSAP group and SAP group were significantly increased ( P<0.05), and the area of VAT in SAP group was further increased than that in MSAP group, the differences were statistically significant (all P values <0.05). Spearman analysis showed that the VAT area was significantly positively correlated with acute physiology and chronic health evaluationⅡ scoring system (APACHEⅡ) score, modified CT severity index (MCTSI), and Balthazar CT grading score (all P values <0.05). It was also significantly positively correlated with body mass index, serum glycated hemoglobin, triglycerides, low-density lipoprotein cholesterol and VAI (all P values <0.05). ROC analysis showed that the AUC value of VAI in identifying SAP was 0.641 (95% CI 0.562-0.720), the corresponding cut-off value was 2.75, the sensitivity was 57.6%, and the specificity was 69.0%; The AUC value of VAT area in identifying SAP was 0.869 (95% CI 0.813-0.924), the corresponding cut-off value was 165.85 cm 2, the sensitivity was 78.8%, and the specificity was 84.8%, and the predictive value of VAT area was significantly better than that of VAI ( P<0.001). The APACHEⅡ, MCTSI, Balthazar CT grading score, VAI and VAT area in the death group were significantly higher than those in the survival group, and the differences were statistically significant (all P values <0.05). Multivariate logistic regression analysis showed that VAT area was an independent predictor of in-hospital mortality in obese AP patients ( P<0.05), with an AUC value of 0.831 (95% CI 0.756-0.907), a cutoff value of 173.70 cm 2, a sensitivity of 77.8%, and a specificity of 85.5%. Conclusions:The VAT area is significantly associated with the aggravation of AP and the increased risk of in-hospital mortality in obese patients, and is expected to serve as a reliable indicator for predicting the severity and prognosis of obese patients with AP.

Objective:To explore the relationship between visceral adipose tissue (VAT) and the severity and prognosis of obese patients with acute pancreatitis (AP).Methods:The clinical data of 224 obese patients with AP admitted to The Third Affiliated Hospital of Chongqing Medical University and Chongqing Dongnan Hospital from January 2020 to December 2023 were collected, retrospectively. According to the severity of AP, they were divided into mild AP group (MAP group), moderately severe AP group (MSAP group), and severe AP group (SAP group). According to the in-hospital treatment outcomes of the patients, they were divided into the survival group and death group (death within 7-30 days after admission). The basic information of AP patients, the severity score of AP and laboratory indicators were collected. The visceral adiposity index (VAI) was calculated through the values of waist circumference, body mass index, triglycerides and high-density lipoprotein cholesterol; and the VAT area was measured by CT scan. The Spearman rank correlation analysis method was used to evaluate the correlation between the VAT area and the AP severity index as well as other indicators. Multivariate logistic regression analysis was used to analyze the influencing factors of in-hospital mortality in obese patients with AP. The receiver operating characteristic curve (ROC) was drawn, and the area under curve (AUC), cut-off value, sensitivity and specificity were calculated to evaluate the predictive value of VAT area for SAP, as well as the predictive value of VAT area for in-hospital mortality in obese AP patients.Results:The VAI of MAP group, MSAP group and SAP group were 1.63(1.21, 2.74), 2.30(1.28, 3.36) and 3.01(2.17, 3.86), respectively, and the VAT area were 138.90(121.30, 155.10)cm 2, 149.90(135.10, 166.70)cm 2 and 192.30(168.80, 223.80)cm 2, respectively. There were significant differences in VAI and VAT area among the three groups (all P values <0.05). Compared with MAP group, the area of VAI and VAT area in MSAP group and SAP group were significantly increased ( P<0.05), and the area of VAT in SAP group was further increased than that in MSAP group, the differences were statistically significant (all P values <0.05). Spearman analysis showed that the VAT area was significantly positively correlated with acute physiology and chronic health evaluationⅡ scoring system (APACHEⅡ) score, modified CT severity index (MCTSI), and Balthazar CT grading score (all P values <0.05). It was also significantly positively correlated with body mass index, serum glycated hemoglobin, triglycerides, low-density lipoprotein cholesterol and VAI (all P values <0.05). ROC analysis showed that the AUC value of VAI in identifying SAP was 0.641 (95% CI 0.562-0.720), the corresponding cut-off value was 2.75, the sensitivity was 57.6%, and the specificity was 69.0%; The AUC value of VAT area in identifying SAP was 0.869 (95% CI 0.813-0.924), the corresponding cut-off value was 165.85 cm 2, the sensitivity was 78.8%, and the specificity was 84.8%, and the predictive value of VAT area was significantly better than that of VAI ( P<0.001). The APACHEⅡ, MCTSI, Balthazar CT grading score, VAI and VAT area in the death group were significantly higher than those in the survival group, and the differences were statistically significant (all P values <0.05). Multivariate logistic regression analysis showed that VAT area was an independent predictor of in-hospital mortality in obese AP patients ( P<0.05), with an AUC value of 0.831 (95% CI 0.756-0.907), a cutoff value of 173.70 cm 2, a sensitivity of 77.8%, and a specificity of 85.5%. Conclusions:The VAT area is significantly associated with the aggravation of AP and the increased risk of in-hospital mortality in obese patients, and is expected to serve as a reliable indicator for predicting the severity and prognosis of obese patients with AP.

Objective:To examine the longitudinal relationships between perceived social support,life satis-faction and acceptance by others among relocated residents for poverty alleviation.Methods:A two-wave longitudi-nal survey was conducted with 383 relocated residents from 39 resettlement communities in Guizhou Province,with a six-month interval.Participants completed the Perceived Social Support Scale(PSSS),the Acceptance by Others Scale of the Acceptance of others Scale(AOS),and the Satisfaction With Life Scale(SWLS).Results:T1 PSSS scores positively predicted T2 acceptance by others scores(β=0.20,P＜0.001).T2 acceptance by others scores positively predicted T2 SMLS scores(β=0.45,P＜0.001).Perceived acceptance by others fully mediated the lon-gitudinal relationship between perceived social support and life satisfaction(effect=0.09,95％CI:0.03-0.18).Conclusion:Perceived social support predicts life satisfaction of relocated residents for poverty alleviation through perceived acceptance by others.

【Objective】 To explore the application value of ¹⁸F-PSMA PET/CT on the detection of metastatic lesions of prostate cancer with serum total prostate specific antigen (tPSA) ≤20 ng/mL and the predictive variables affecting the imaging results, and to establish a predictive nomogram for the metastasis of prostate cancer. 【Methods】 The imaging, pathological, serum and clinical data of 175 pathologically confirmed prostate cancer patients who underwent ¹⁸F-PSMA PET/CT examination during Jan.2020 and Oct.2021 were retrospectively collected.The patients were divided into metastatic group and non-metastatic group according to PET/CT imaging results, and the positive detection rate of metastatic lesions was calculated.The independent influencing factors of ¹⁸F-PSMA PET/CT in the positive detection of metastatic lesions were determined with univariate and multivariate logistic regression analyses.The predictive nomogram was established. 【Results】 Of the 175 patients, metastatic lesions were detected in 78 cases and not detected in 97 cases, with a detection rate of 44.6% (78/175).There were statistically significant differences between the metastatic group and the non-metastatic group in urinary tract symptoms, androgen deprivation treatment (ADT) at the time of PET/CT examination and the risk level of Gleason score (GS) (P<0.05).Univariate logistic regression showed that urinary tract symptoms(OR=3.64, P<0.001), GS risk (OR=3.96, P<0.001) and concurrent ADT treatment (OR=3.71, P<0.001) were associated with the positive detection rate of metastatic lesions.Multivariate Logistic regression showed that urinary tract symptoms (OR=3.19, P=0.002), GS high-risk group (OR=2.95, P=0.005) and concurrent ADT treatment (OR=3.27, P=0.001) were independent predictors of positive detection rate. 【Conclusion】 The probability of metastasis in newly diagnosed prostate cancer patients with tPSA≤20 ng/mL is high.¹⁸F-PSMA PET/CT is of high value for the early detection of metastasis.Urinary tract symptoms, GS high-risk group and concurrent ADT treatment are independent predictors of metastatic lesions.The predictive nomogram can help assist clinical optimization of imaging examination path.

Objective To explore the safety and efficacy of neoadjuvant chemotherapy(NAC)combined with immunotherapy before radical cystectomy plus pelvic lymph nodes dissection(RC-PLND)for muscle-invasive bladder cancer(MIBC).Methods The clinical data of 101 patients with MIBC who underwent neoadjuvant therapy followed by RC-PLND in the Department of Urology,the First Affiliated Hospital of Xi'an Jiaotong University during Jan.2019 and Dec.2023 were retrospectively analyzed,including 71 patients(70.3％)who received NAC(NAC group)and 30(29.7％)who received NAC combined with immunotherapy(NAC combine immunotherapy group).The clinical and pathological data and adverse events during neoadjuvant therapy were compared.Logistic regression analysis was used to explore the independent predictors of pathological complete response(pCR)and pathological partial response(pPR).Results There were no significant differences in the baseline data between the two groups(P＞0.05).However,the proportion of multiple tumors in patients receiving NAC before surgery was significantly higher than that in the NAC combined immunotherapy group(69.0％vs.46.7％,P=0.034).Compared with NAC group,NAC combined with immunotherapy group had significantly improved rate of pathological downstaging and pPR(60.6％vs.83.3％,P=0.026;45.1％vs.70.0％,P=0.022).Furthermore,the rate of pCR in patients undergoing NAC combined immunotherapy was higher than those undergoing NAC,but the difference was not significant(53.3％vs.33.8％,P=0.067).Logistic regression analysis revealed that clinical T-stage and tumor diameter were independent predictors of pCR and pPR(P＜0.05).In addition,the most common adverse events during neoadjuvant therapy were anemia,decreased white blood cells,nausea,and vomiting,but most of them were grade 1-2 and could be relieved through symptomatic treatment.Conclusion NAC combined with immunotherapy is safe and effective,which can improve the rate of pathological downstaging,pPR and pCR,without increasing the incidence of adverse reactions.

【Objective】 To explore the expressions of PBRM1 and PD-L1 in renal cell carcinoma (RCC), and the molecular mechanism of PBRM1 regulating PD-L1, in order to provide experimental results for clinical immunotherapy. 【Methods】 The protein expressions of PBRM1 and PD-L1 were detected with immunohistochemistry, and their mRNA expressions were determined by analyzing TCGA database. Meanwhile, the relationship between overall survival and mRNA expressions of PBRM1 and PD-L1 were analyzed in TCGA database. The exosomes were extracted with exoEasy Maxi Kit. Expressions of exosomal biomarkers CD63 and CD9 were detected with Western blotting, and their morphology was observed with transmission electron microscope. PD-L1 expression after IFN-γ, IL-6 and TNF-α treatment was detected with Western blotting. 【Results】 The expression of PBRM1 was significantly lower in canver tissue than in paracancerous tissue (P<0.001). The loss rate of PBRM1 was up to 76.4%. PBRM1 expression was not correlated with PD-L1 expression. PBRM1 deletion activated TNF-α/exosome signaling pathway, leading to increase of PD-L1 secretion in exosomes, which was then transported to the outside of cells. 【Conclusion】 There is no relationship between PBRM1 and PD-L1 protein expressions in RCC. However, PBRM1 mutation can lead to inflammatory signaling pathway activation, inducing PD-L1 secretion, which is encapsulated in exosomes and transported to the outside of cells, and affects the response of immunotherapy.

【Objective】 To compare the efficacy and safety of blue laser en bloc enucleation and traditional plasmakinetic electrocautery in the treatment of non-muscle invasive bladder cancer (NMIBC). 【Methods】 A total of 50 NMIBC patients treated in our hospital during Oct.2018 and Dec.2019 were enrolled. A randomized, incomplete blinding, parallel control design and non-inferior test method was adopted. The control group (electrocautery group) used plasmakinetic electrocautery for transurethral resection, and the experimental group (blue laser group) used semiconductor blue laser for transurethral en bloc enucleation. The effective resection rate, operation time, postoperative catheter indwelling time, length of hospital stay, perioperative hemoglobin changes and obturator nerve reflex were compared. 【Results】 There were 24 patients in the blue laser group and 26 in the electrocautery group. The effective dissection rate and hemostasis rate in both groups reached 100%. The blue laser group had slightly longer operation time than the electrocautery group (55 min vs.42 min, P=0.009), but lesser hemoglobin decrease (5.7 g/L vs. 10.4 g/L, P=0.007). There were no significant differences in urinary catheter indwelling time, length of hospital stay and reoperation rate between the two groups. The electrocautery group had 3 cases of obturator nerve reflex, while the blue laser group had none. 【Conclusion】 Compared with the traditional electrocautery, blue laser has good vaporization cutting and coagulation hemostatic effects on bladder tumor tissue, and can completely enucleate tumors in a front-firing model with less bleeding and no obturator nerve reflex, which can be used as a new, efficient, safe and easy-to-learn method for NMIBC surgery. However, its effects on postoperative recurrence rate and progression rate still need further studies.

【Objective】 To investigate the feasibility and safety of semiconductor blue laser in the treatment of non-muscle invasive bladder cancer (NMIBC) in the day surgery model. 【Methods】 The clinical data of 22 NMIBC patients (average age 55.8 years and tumor size 1.4 cm) who underwent outpatient screening and accepted blue laser ambulatory surgery in our hospital during Jun.2022 and Sep.2022 were retrospectively analyzed. On the day of admission, transurethral resection of cancer was performed using blue laser en bloc enucleation. On the day of surgery or in the morning of next day, bladder irrigation was stopped, the catheter was removed, and patients were discharged. The baseline data, pre-hospital waiting time, operation time, length of hospital stay, hemoglobin decrease, complications and management, follow-up, medical costs, and patients’ satisfaction rate were recorded. 【Results】 The pre-hospital waiting time was 2 to 7 days, average (4.1±1.3)days. The operation time was 29 to 50 minutes, average (40.8±5.5)minutes. The length of hospital stay was 0.6 to 1.2 days, average (0.9±0.2)days. Hemoglobin decrease was 1 g/L to 8 g/L, average (3.8±1.8)g/L. The catheter was indwelt for 0.5 to 1 day, average (0.7±0.1)day. The medical costs were 13 790 to 16 811 Yuan, average (14 941.5±690.2) Yuan. Patients’ satisfaction rate was 100.0%. Mild intraoperative and postoperative complications occurred in 2 cases. One patient developed symptoms of cystitis which disappeared after 2 days of oral antibiotic cefixime, and another patient developed bladder spasm which was relieved after oral solifenacin succinate tablets. No adverse events such as obturator nerve reflex or bladder perforation occurred. After removal of the catheter, no urinary retention was observed. 【Conclusion】 This study was the first to apply blue laser ambulatory surgery in the treatment of bladder cancer, confirming that it is a safe, feasible, economical and efficient model for selected patients, which can be promoted in suitable hospitals.

Objective:To investigate the risk factors and their warning value for the occurrence of sepsis in patients with severe multiple trauma.Methods:A retrospective cohort study was conducted to analyze the clinical data of 92 patients with severe multiple trauma admitted to Yuyao People′s Hospital from July 2019 to October 2021. There were 71 males and 21 females, with the age range of 36-55 years [(45.5±13.6)years]. The injury severity score (ISS) was 20-29 points [(25.3±6.4)points]. The patients were divided into sepsis group ( n=32) and non-sepsis group ( n=60) according to whether sepsis occurred during hospitalization. Data were recorded for the two groups, including gender, age, basic diseases, cause of injury, number of injury sites, ISS, post-injury complications, and levels of aryl hydrocarbon receptor (AHR), C-reactive protein (CRP) and procalcitonin (PCT) at 1, 3 and 5 days after injury. The above data were analyzed to identify their correlation with the occurrence of sepsis in patients with severe multiple trauma by univariate analysis. The independent risk factors for sepsis in patients with severe multiple trauma were determined by multivariate Logistic regression analysis. The warning value of the single or combined risk factors for the occurrence of sepsis in patients with severe multiple trauma was evaluated by the receiver operating characteristic (ROC) curve and area under the curve (AUC). Results:By univariate analysis, it was demonstrated that the occurrence of sepsis was correlated with ISS, level of AHR at day 1 after injury, level of CRP at day 3 after injury and level of PCT at day 3 after injury ( P<0.05 or 0.01), but not with age, sex, basic diseases, level of AHR at 3, 5 days after injury, level of PCT at 1, 5 days after injury and level of CRP at 1, 5 days after injury (all P>0.05). By multivariate Logistic regression analysis, higher ISS ( OR=1.12, 95% CI 1.01, 1.24, P<0.05), level of AHR at day 1 after injury ( OR=1.30, 95% CI 1.10, 1.52, P<0.01) and level of PCT at day 3 after injury ( OR=1.81, 95% CI 1.08, 3.03, P<0.05) were found to be strongly correlated with the occurrence of sepsis. ROC curve analysis showed that higher ISS (AUC=0.69, 95% CI 0.57, 0.76) and level of AHR at day 1 after injury (AUC=0.79, 95% CI 0.68, 0.90) had warning value for the occurrence of sepsis, and the warning efficiency of combined panel was much better (AUC=0.86, 95% CI 0.77, 0.95). Conclusions:Higher ISS, level of AHR at day 1 after injury and level of PCT at day 3 after injury are independent risk factors for the occurrence of sepsis in patients with severe multiple trauma. ISS, AHR and combination of both exhibit good warning value for the occurrence of sepsis in patients with severe multiple trauma.