Objective To investigate the regulatory mechanism of the central nervous system in patients with refractory overactive bladder (rOAB) using diffusion tensor imaging (DTI) and graph theory analysis. Methods A total of 43 rOAB patients (rOAB group) and 46 matched healthy controls (HC group) were recruited during May and Nov.2024. All participants were scanned with DTI, and surveyed with the overactive bladder symptom score (OABSS), and overactive bladder questionnaire (OAB-q). Their age, gender, height, weight, and educational years were collected.DTI plus graph theory analysis was employed to explore the alterations in global and local topological properties of the brain structural network in rOAB patients. Brain regions showing significant group differences in structural metrics [specifically, the right paracentral lobule (PCL.R) ]were further used as seed points for functional connectivity (FC) analysis. Correlations between the nodal clustering coefficient (NCp) of the identified region, FC strength, OABSS, and OAB-q score were investigated. Results The OABSS [8 (6,10) vs.0 (0,1) ]and OAB-q [71 (53,80) vs.20 (19,24) ]were higher in the rOAB group than the HC group (P<0.001). Graph theory analysis revealed no statistically significant differences in global network metrics between the two groups (P>0.05). However, the NCp was significantly higher in the PCL.R of rOAB group compared to HC group (P<0.05, FDR-corrected).FC analysis using the PCL.R as a seed region demonstrated significantly reduced FC value in the left cerebellar crus Ⅱ (Cerebelum_Crus2_L) of the rOAB group (P<0.05, FDR-corrected). Partial correlation analysis showed that the NCp of PCL.R was positively correlated with both OABSS (r=0.255, P=0.018) and OAB-q score (r=0.257, P=0.017). Conversely, the FC of Cerebelum_Crus2_L was significantly negatively correlated with OABSS (r=-0.545, P<0.001) and OAB-q score (r=-0.535, P<0.001). Conclusion Patients with rOAB exhibit distinct brain structural network alterations compared to healthy individuals, primarily manifestation in the NCp value of PCL.R increased, and the FC intensity of Cerebelum_Crus2_L is significantly weakened. These alterations in the topological properties of the structural network may be implicated in the pathogenesis of rOAB.

Objective:To investigate the expressions and correlations of miRNA-495-3p (miR-495-3p) and Hillday cross-recognition protein (HJURP) in laryngeal carcinoma tissues, and their relationship with clinicopathological features of patients.Methods:Cancerous tissues and corresponding paracancerous tissues (more than 1 cm away from the boundary of cancerous tissue) were selected from 30 patients with primary laryngeal squamous cell carcinoma in the First Affiliated Hospital of Zhengzhou University from June to October 2023. Real-time fluorescence quantitative polymerase chain reaction was used to detect the relative expression of miR-495-3p. The relative expression of HJURP protein was detected by Western blotting. The correlation between miR-495-3p and HJURP in laryngeal carcinoma was analyzed by Pearson method.Results:Compared with paracancerous tissues, the relative expression of miR-495-3p in laryngeal cancer tissues was lower (0.28±0.06 vs. 1.00±0.00), and the difference was statistically significant ( t = -66.57, P < 0.001); the relative expression of HJURP protein in laryngeal carcinoma tissues was higher (10.2±5.6 vs. 1.0±0.0), and the difference was statistically significant ( t = 9.02, P < 0.001). The results of Pearson correlation analysis showed that miR-495-3p was negatively correlated with HJURP in laryngeal cancer tissues ( r = -0.63, P < 0.001). The relative expression of miR-495-3p in patients with lymph node metastasis was lower than that in patients without lymph node metastasis (0.23±0.03 vs. 0.30±0.05), and the difference was statistically significant ( t = -4.89, P < 0.001); the relative expression of HJURP protein was higher than that in patients without lymph node metastasis (13.6±5.1 vs. 8.8±5.3), and the difference was statistically significant ( t = 2.33, P = 0.030). The relative expression of miR-495-3p in patients with clinical stage Ⅲ-Ⅳ was lower than that in patients with stage Ⅰ-Ⅱ (0.23±0.03 vs. 0.32±0.04), and the difference was statistically significant ( t = 7.22, P < 0.001); the relative expression of HJURP protein was higher than that in patients with stage Ⅰ-Ⅱ (15.3±5.4 vs. 6.9±2.2), and the difference was statistically significant ( t = -5.85, P < 0.001). Conclusions:In laryngeal carcinoma, the expression of miR-495-3p is decreased, and the expression of HJURP protein is increased; the two are related.

Objective To investigate the effect of ultrasound-guided transverse abdominal plane block(TAPB)on pain inhibition and stress response in patients undergoing laparoscopic sleeve gastrectomy(LSG).Methods 98 cases of laparoscopic sleeve Gastrectomy patients admitted from March 2021 to October 2022 were selected as the research object,and they were randomly divided into control group(49 cases)and observation group(49 cases)by double blind method.The control group received general anesthesia,and the observation group received TAPB+general anesthesia.The postoperative pain,analgesic dosage,stress level,hemodynamics and adverse reactions of the two groups were compared.Results The dosage of sufentanil and propofol in the observation group,as well as the effective press frequency of the intravenous analgesia pump 48 hours after surgery[(232.38±29.62)μg,(328.40± 40.68)mg and(5.60±1.25)],were lower than those in the control group[(294.07±35.88)μg,(402.25±46.74)mg and(9.75±2.40)](P＜0.05).The visual analogue scale(VAS)scores for each time period of the observation group were(2.43±0.49),(2.29±0.46),(2.85±0.49),(2.41± 0.39),(2.12±0.41)and(1.82±0.32),respectivly.While,the control group were(2.95±0.46),(3.22±0.51),(3.92±0.47),(3.13±0.65),(2.83±0.57)and(2.05±0.53),respectivly.The difference between the two groups was statistically significant(P＜0.05).At the time of tracheal intubation(T2),at the end of operation(T3),and at the time of leaving the anesthesia recovery room(T4),the fluctuation range of mean arterial pressure[86.00(79.00,94.00)mmHg,87.00(80.00,90.00)mmHg and 89.00(84.00,95.00)mmHg vs 82.00(75.00,90.00)mmHg,85.00(77.00,93.00)mmHg and 87.00(80.00,97.00)mmHg],heart rate[78.00(67.00,83.00)times/min,80.00(74.00,86.00)times/min and 81.00(76.00,90.00)times/min vs 78.00(67.00,83.00)times/min,80.00(74.00,86.00)times/min and 81.00(76.00,90.00)times/min]and blood oxygen saturation[97.38(97.00,97.75)％,98.69(98.30,99.05)％and 99.16(98.80,99.35)％vs 96.54(96.15,96.80)％,98.02(97.65,98.45)％and 98.73(98.43,99.15)％]in the observation group was significantly smaller than that of the control group(P＜0.05).In the observation group,cortisol levels were(192.47 ±40.25)ng/ml,(151.34±39.62)ng/ml and(118.69±30.57)ng/ml at 6 hours,24 hours and 48 hours,respectively,while in the control group were(206.24±45.34)ng/ml,(178.24±37.58)ng/ml and(143.63±32.34)ng/ml,respectively;C-reactive protein(CRP)in the observation group were(25.24±6.29)mg/L,(20.93±5.83)mg/L and(13.61±4.29)mg/L,respectively,while in the control group were(28.13±6.92)mg/L,(23.25±5.21)mg/L and(16.38±4.35)mg/L,respectively;interleukin-6(IL-6)in the observation group were(44.87±7.95)pg/L,(38.34±6.13)pg/L and(34.27±5.32)pg/L,respectively,while in the control group were(56.43±7.23)pg/L、(42.24±6.58)pg/L、(37.66±6.03)pg/L,respectively.The difference between the two groups was statistically significant(P＜0.05).The total incidence of adverse reactions of the observation group(4.08％)was lower in than that of the control group(20.41％)(P＜0.05).Conclusion Ultrasound-guided TAPB for LSG patients has a good effect on postoperative pain suppression,can reduce the stress response of the body after surgery,and is safe.

Objective To explore the effect of a new organ preservation solution with HOE642 on the apoptosis of the donor lung from a modified lung transplantation model of rabbits.Methods 24 male rabbits were divided into two groups [low potassium dextran (LPD) group and HOE group],established rabbit models for next 2-h reperfusion using LPD solution or new organ preservation solution.Detected the levles of apoptosis index and caspase-3,the expression of Fas/Fas-L and Bcl-2/Bax.Results Compared with LPD group,HOE group revealed significant lower level of apoptosis index and caspase-3 (P＜0.05),lower expression of Fas/Fas-L and Bax,and higher expression of Bcl-2 (P＜0.05).Conclusion The potential donor lung protective mechanism offered by the new organ preservation solution with HOE642 might be the inhibition of apoptosis via both intrinsic and extrinsic pathways.

Objective To evaluate the diagnostic value of urine-based prostate cancer antigen 3 ( PCA3 ) score in detecting prostate cancer during initial prostatic biopsy .Methods Urine was collected after digital rectal examination ( DRE) ( three strokes per lobe ) from 248 men before prostate biopsy .The specimens were collected between January 2010 and December 2012.The expression of PCA3 mRNA and prostate specifc antigen (PSA) mRNA was determined by quanti-tative real time polymerase chain reaction ( qRT-PCR ) .PCA3 scores were calculated by PCA 3 mRNA/PSA mRNA × 1000 .The ability of the PCA3 score to predict the biopsy outcome was assessed with AUC-ROC analysis and compared with the serum PSA levels.Results The rate of positive prostate biopsy was 32.3%(80 patients with positive prostatic biopsy versus 168 patients with negative prostate biopsy ) .PCA3 scores were significantly higher in patients with positive biopsy than in those with negative biopsy results (P<0.001).The ROC curve analysis demonstrated that the area under the ROC curve (AUC) of serum total PSA (tPSA), PCA3 score and the duplex model combining tPSA and PCA 3 score was 0.620, 0.693 and 0.724, respectively.Further analysis of the diagnostic performance of PCA3 score revealed that at a cut-off of 90.2456, the sensitivity was 67.5%and the specificity was 61.9%for discriminating positive biopsy from negative biopsy. The duplex model combining tPSA and PCA 3 score represented a better approach than tPSA alone in PCa diagnosis by pros-tatic biopsy (P=0.011), but there was no statistically significant difference between tPSA and PCA 3 score (P=0.160). In addition , a comprehensive diagnostic model based on multiple risk factors of prostate cancer combined with PCA 3 score could further improve the predictive accuracy of prostate cancer .Conclusion PCA3 could be a good predictor of prostate cancer in initial prostate biopsy in Chinese population .The comprehensive diagnostic model can improve the diagnostic potency .Further large-scale multicenter studies in China are needed to confirm our findings .

Objective To explore clinical effect and safety of intermittent androgen suppression treatment of advanced prostate cancer in elderly patients.Methods 78 patients with advanced prostate cancer were enrolled,and randomly divided into the observation group and the control group (n=39 each).Patients in observation group were treated with intermittent androgen suppression treatment.Patients in control group were treated with persistent androgen suppression treatment.Results The time of therapy was much longer in observation group than in control group (P＜ 0.001).Quality of life was better in observation group than in control group (P＜0.05).The incidences of adverse reactions including anemia,fever and abnormal liver function were lower in observation group than in control group (all P＜0.05).Conclusions Intermittent androgen suppression treatment prolongs time to androgen-independent progression,improve the quality of life,reduce drug dosage and the incidence of adverse reactions in the treatment of advanced prostate cancer in the elderly.

[Objective]To explore the technique and effect of anterior cervical decompression for the treatment of the mixed type of ossification of posterior longitudinal ligament. [Methods]Data on 37 patients(24 males and 13 females,with mean age of 54.3 years) who underwent resection or floating of posterior longitudinal ligament were reviewed.The occupying rate of OPLL ranged 32%~85% with an average of 51.4%.The Japanese Orthopaedic Association(JOA) scores ranged 4 ~14 points with an average of 7.9 points before operation.[Results]The Mean follow-up duration was 16 months(range,6~36 months).The JOA scores were 10.3 and 11.1 at 3 and 12 months after surgery.The results were excellent in 72.7% and good in 78.8%.[Conclusion]The resection of the longitude ligament and floating in anterior cervical decompression is a safe and effective treatment for the mixed type of ossification of posterior longitudinal ligament.

Objective To evaluate the efficacies of different ventilatory pattern during one lung ventilation (OLV). Methods During OLV, all patients underwent two different ventilatory pattern, total volume (10ml/kg) without PEEP and half tidal volume (5ml/kg) with PEEP of 7cmH 2O. The arterial blood samples were collected for blood gases analysis immediately before one lung ventilation, 30min following two different OLV pattern and 30 min after resuming two lung ventilation. The airway pressure and hemodynamic parameters were monitored simutaneously. Results PaO 2 and PaCO 2 were higher during half tidal volume than during total tidal volume(P

Objective To evaluate the changes of pulmonary gas exchange and intrapulmonary shunt during orthotopic liver transplantation (OLT) Methods Eleven ASA Ⅲ Ⅳ patients (male 8, female 3) with end stage liver diseases were studied Age ranged from 17 67 yr Anesthesia was induced with midazolam 0 1 mg?kg -1 , fentanyl 5?g?kg -1 and pipecuronium 0 1 mg?kg -1 and maintained with isoflurane inhalation and intermittent iv boluses of fentanyl and pipecuronium combined with epidural anesthesia (T 8 9 ) The patients were mechanically ventilated with 100% O 2 during operation After induction of anesthesia Swan Ganz catheter was inserted via right internal jugular or subclavian vein Cardiac output (CO),mixed venous oxygen saturation and core venous temperature were continuously monitored with continuous cardiac output monitor (Baxter,Vigilance) ECG, CVP, SpO 2 and P ET CO 2 were also continuously monitored during operation Radial artery was cannulated for continuous direct blood pressure monitoring Arterial and mixed venous blood samples were taken at the beginning of operation, 120 min during preanhepatic stage, 30 and 60 min during anhepatic stage, 5 and 60 min during neohepatic stage and at the end of operation Alveolar arterial oxygen partial pressure difference (A aDO 2) , intrapulmonary shunt (Qs/Qt) , oxygen delivery index (DO 2I) and oxygen consumption (VO 2 I ) were calculated During operation body temperature was maintained above 35 5℃ Veno venous bypass (VVB) was performed during anhepatic stage Results At the beginning of operation, when FiO 2 was 100%, PaO 2 was only (376?141) mmHg, A aDO 2 and Qs/Qt were all higher than normal values There were no significant changes in all parameters 120 min during preanhepatic stage as compared with those at the beginning of operation PaO 2 increased and A aDO 2 and VO 2I decreased significantly during anhepatic stage Qs/Qt, A aDO 2 and PaCO 2 increased and PaO 2 decreased significantly, but there were no significant changes in cardiac index, DO 2I and VO 2I during early neohepatic stage Cardiac index, DO 2I and VO 2I increased at 60 min during neohepatic stage and at the end of operation Conclusions There are severe changes of pulmonary gas exchange during OLT

Objective To assess the effect of propofol on changes in plasma enzymes (CPK,LDH), lipid peroxides (MDA) and metabolites of arachidonic acid (TXB 2,6 keto PGF 1? ) after ischemia reperfusion of lower extremity.Methods 19 ASAⅠ Ⅱscheduled for bilateral total knee replacement were randomly allocated to one of the two groups: isoflurane group (group I,n=10) and propoful group(group P, n=9). The patients were premedicated with intramuscular pethidine 50mg and scopolamine 0.3mg 30min before operation. In isoflurane group anesthesia was induced with midazolam 0.15mg?kg -1 ,fentanyl 3?g?kg -1 and vecuronim 0.1mg?kg -1 and maintained with 0.8% isoflurane after tracheal intubation. In propofol group anesthesia was induced with propofol 2mg?kg -1 ,fentanyl 3?g?kg -1 and vecuronim 0.1mg?kg -1 and maintained with propofol infusion 8mg?kg -1 ?h -1 . In both groups general anesthesia was supplemented with epidural block performed at L 2 3 . Blood samples were taken from femoral vein before the tourniquet of right leg was inflated(0min) and 5,10,20min after replace of left leg for determination of plasma creatine phosphokinase(CPK),lactate dehydrogenase(LDH),MDA,TXB 2 and 6 keto PGF 1? levels.Results In group P CPK and LDH levels decreased significantly at 10,20min and MDA level at 5min(P