Objective:To summarize the best evidence for the management of lower urinary tract dysfunction (LUTD) in total hysterectomy patients, so as to provide evidence-based basis for clinical practice.Methods:According to the "6S" pyramid model, literature related to the management of LUTD in total hysterectomy patients was successively searched from guide websites, evidence-based websites, professional websites and comprehensive databases. The search deadline was from the establishment of the databases to March 31, 2023. Two researchers evaluated the quality of the included literature, extracted evidence and recommended the level of evidence.Results:A total of 14 articles were included, including one clinical decision, two evidence summaries, three guidelines, one expert consensus and seven systematic evaluations. A total of 25 pieces of evidence were summarized from four aspects, such as symptom assessment, urinary tract management, symptom intervention and health education.Conclusions:Medical staff should manage lower urinary tract dysfunction in patients undergoing total hysterectomy based on evidence-based evidence to prevent or reduce the occurrence of lower urinary tract dysfunction in patients.

Objective:To explore the different categories of family resilience in cervical cancer patients and their influencing factors.Methods:From October 2022 to September 2023, 275 cervical cancer patients admitted to the First Hospital of Shanxi Medical University were selected as the study subject by convenience sampling. Cervical cancer patients were surveyed using the self-made General Information Questionnaire, Benefit Finding Scale (BFS), Connor-Davidson Resilience Scale (CD-RISC), and shortened Chinese Version of the Family Resilience Assessment Scale (FRAS-C). Latent profile analysis was used to investigate the family resilience of patients, and Logistic regression was used to analyze the influencing factors of family resilience in different categories.Results:A total of 275 questionnaires were distributed, and 253 valid questionnaires were collected, with a valid response rate of 92.0% (253/275). Family resilience of cervical cancer patients was divided into three categories of low resilience-negative coping group (18.6%, 47/253), moderate resilience-communication disorder group (59.3%, 150/253), and high resilience-inclusive understanding group (22.1%, 56/253). The per capita family monthly income, place of residence, primary caregivers, whether to undergo radiotherapy or chemotherapy, psychological resilience, and disease benefit finding were the influencing factors of family resilience in different categories of cervical cancer patients ( P<0.05) . Conclusions:The family resilience of cervical cancer patients can be divided into three latent categories. Medical and nursing staff should identify the characteristics of different categories of patients and provide targeted intervention measures to improve their family resilience.

Objective This study aims to analyze the factors influencing benefit finding among cervical cancer patients and their spouses,as well as the interconnections between these factors.The goal is to provide a foundation for developing targeted clinical interventions.Methods Using the convenience sampling method,cervical cancer patients and spouses of 245 pairs who attended or were hospitalized in a tertiary-level hospital in Taiyuan City from October 2022 to July 2023 were selected as study subjects.Data were collected using a general information questionnaire,the Distress Disclosure Index,the Connor-Davidson Resilience Scale,and the Benefit Finding Scale.Univariate analysis,Pearson correlation analysis,and multiple linear regression were employed to scrutinize the data,leading to the establishment of Actor-Partner Interdependence Model.Results Benefit finding scores for cervical cancer patients and their spouses were(65.31±7.94)and(69.87±9.63),respectively.Multiple linear regression revealed that the educational level of patients and their spouses,whether or not they received chemotherapy or radiotherapy,self-disclosure and psychological resilience were the factors that affected patients'benefit finding.Spouse's education level,occupation,self-disclosure,psychological resilience and patients'self-disclosure and psychological resilience were the influencing factors of spouse's benefit finding.The Actor-Partner Interdependence Model analysis indicated that the self-disclosure and psychological resilience of cervical cancer patients positively predicted their own benefit finding and that of their spouses(path coefficients were 0.415,0.501,0.216,and 0.168,respectively,all P＜0.05).However,spouses'self-disclosure and psychological resilience could only positively predict their own benefit finding(path coefficients were 0.188 and 0.254,respectively,all P＜0.05).Conclusion Benefit finding among cervical cancer patients and their spouses is moderate and influenced by various factors.Both self-disclosure and psychological resilience of cervical cancer patients and their spouses have positive subjective effects on their own benefit finding.Healthcare professionals should encourage both parties to engage in healthy interactions about the disease,take steps to increase the level of psychological resilience of both,and ultimately tap into a higher level of benefit finding.

The STAR tool was used to evaluate and analyze the science, transparency, and applicability of Chinese pathology guidelines and consensus published in medical journals in 2022. There were a total of 18 pathology guidelines and consensuses published in 2022, including 1 guideline and 17 consensuses. The results showed that the guideline score was 21.83 points, lower than the overall guideline average (43.4 points). Consensus ratings scored an average of 27.87 points, on par with the overall consensus level (28.3 points). Areas that scored above the overall level were "conflict of interest" and "working groups", while areas that scored below the overall level were "proposals", "funding", "evidence", "consensus approaches" and "accessibility". To sum up, the formulation of pathology guidelines and consensuses in 2022 is not standardized, and the evidence retrieval process, evidence evaluation methods and grading criteria for recommendations on clinical issues are not provided in the formulation process; the process and method for reaching consensus are not provided, the plan is lacking, and registration is not carried out. It is therefore suggested that guidelines/consensus makers in the field of pathology should attach importance to evidence-based medical evidence, strictly follow guideline formulation methods and processes, further improve the scientific, applicable and transparent guidelines/consensuses in the field, and better provide support for clinicians and patients.

Objective:To investigate the importance of cell block and immunohistochemistry in the accurate diagnosis of serous effusion.Methods:A retrospective study was conducted on 3 124 cases of serous effusion from the Department of Pathology, Beijing Hospital from 2018 to 2022, include 2 213 cases of pleural effusion, 768 cases of peritoneal effusion, 143 cases of pericardial effusion. There were 1 699 males (54.4%) and 1 425 females (45.6%), average age 69 years old. Of which 1 292 cases were prepared with cell blocks and examined with immunohistochemical stain.Results:The percentage of malignant diagnosis increased from 64.9% (839/1 292) to 84.0% (1 086/1 292) after cell block preparation, and 1 086 cases were accurately diagnosed with histological type and/or origin of primary tumor. The undetermined diagnosis of suspected malignancy decreased from 13.3% (172/1 292) to 0.1% (1/1 292) and that of atypical hyperplasia from 18.8% (243/1 292) to 0.4% (5/1 292). The negative result for malignancy rate increased from 3.0% (38/1 292) to 15.5% (200/1 292). The differences highlighted above were statistically significant (Pearson′s chi-squared test=12.739, P<0.01). Conclusion:Application of immunohistochemistry based on cell block can significantly improve malignant diagnosis in serous effusion, identify tumor origin and histological type as well as decrease the uncertain diagnosis.

Objective:To examine the clinicopathological and molecular pathological characteristics of patients with colorectal cancer(CRC)who have mutations in the POLE and POLD1 genes.Methods:In this study, we retrospectively collected data from 276 middle-aged and elderly patients aged 45 years and over who were diagnosed with colorectal cancer at Beijing Hospital between October 2020 and September 2022.We utilized next generation sequencing and bioinformatics analysis to screen for harmful germline and somatic mutations in the POLE and POLD1 genes.The study involved 276 patients, who were divided into three groups based on their genetic mutations.The deleterious mutation group had 6 cases, the mutation of unknown significance group had 18 cases, and the wild type group had 252 cases.We also collected clinical and pathological features of the patients and analyzed their correlation with other molecular pathological results such as tumor mutation burden(TMB), microsatellite instability(MSI), and gene co-mutation.Results:No germline mutations were detected in the POLE and POLD1 genes across all patients.Out of the 276 patients, 18(6.5%)were found to carry POLE mutations.Among these, 6(2.2%)were classified as deleterious mutations, 12(4.3%)were positive for POLE mutations of unknown significance, and the remaining patients had wild type POLE genes.Out of the 276 patients, POLD1 gene mutations of unknown significance were found in 10 patients(3.6%). Among the 276 patients, 5 cases(1.8%)carried two types of gene mutations.Patients in the deleterious mutation group showed earlier tumor stage( P<0.05)and a higher prevalence of low-grade tumor budding( P<0.05), with 6 patients being affected by this.Compared to the wild type group, colon cancer patients showed a higher frequency of deleterious mutations and variants of unknown significance in the poorly differentiated group( P<0.05). The median TMB in the deleterious mutation group was 257.76 muts/Mb, 74.4 muts/Mb in the mutation of unknown significance group, and 5.81 muts/Mb in the wild type group.The study found significant differences in TMB-H status among the three groups, with all P-values less than 0.01.MSI-H status was detected in 1 case(16.7%, 1/6), 14 cases(77.8%, 14/18), and 18 cases(7.1%, 18/276)in the deleterious mutation group, variant of undetermined significance group, and wild type group, respectively.Notably, patients with variants of undetermined significance had a higher MSI-H status than patients with wild type and POLE deleterious mutations, with all P-values less than 0.01.The frequencies of co-mutations in KRAS, NRAS, BRAF, and PIK3CA were higher in the deleterious mutation group compared to the mutation of undetermined significance group and wild type group(all P<0.05). Conclusions:Colorectal cancer(CRC)patients with harmful mutations and variants of undetermined significance exhibit unique clinicopathological features.Patients with variants of undetermined significance are more likely to develop colon cancer, show poor differentiation, and have higher frequencies of TMB-H(tumor mutational burden)and MSI-H(microsatellite instability-high).

【Objective】 To investigate the effect of prenatal stress (PS) on the profile changes of cardiac metabolites in offspring rats and to analyze the potential role of key differentiators in key differential signaling pathways. 【Methods】 UHPLC-Q-TOF/MS analysis was used to detect the changes of metabolite profile in the heart tissues of offspring rats in control group and PS group. KEGG pathway annotation and analysis were used to screen out metabolic differences in key signaling pathways and quantify their expression levels so as to predict the potential function of these key molecules in the effect of PS on the heart tissues of offspring rats. 【Results】 Compared with the control group rats, the signaling pathways in the PS offspring rats’ heart tissue that changed significantly included biosynthesis of amino acids, purine metabolism, pyrimidine metabolism, alanine, aspartate and glutamate metabolism, cAMP signaling pathways, arginine biosynthesis, GABAergic synapses, glutamate synapse, nicotine addiction, and regulation of actin cytoskeleton. Among them, the levels of L-glutamine, pseuduracil, uric acid, xanthine, 2’-deoxyadenosine 5’-monophosphate, cytosine 3’-monophosphate, and cytosine 5’-monophosphate were upregulated, while the level of argininosuccinic acid was downregulated, which enriched in purine metabolism, pyrimidine metabolism, and arginine biosynthesis pathway. 【Conclusion】 PS leads to abnormal changes of L-glutamine, pseuduracil, uric acid, and xanthine in the heart tissue of offspring rats, and PS may be a high risk factor for cardiovascular diseases in offspring rats.

Objective:To investigate the features of volume, distribution, grading and staging of prostate cancer(PCa)examined via whole-mount histopathology in transitional PCa.Methods:A total of 129 PCa patients undergone radical prostatectomy(RP)between July 2017 and March 2020 whose whole-mount prostate specimens were prepared after surgery were retrospectively studied.Pathological data on tumor locations, diameters and classification of the International Society of Urologic Pathology(ISUP), radiological data on regions of interest(ROI)and scores of the Prostate Imaging and Reporting Data System(PI-RADS v2)were recorded.The results of pathological whole-mount sections and prostate imaging were compared, and the characteristics and detection rates of lesions in different prostate regions were analyzed.Results:Of all 129 prostate specimens from RP, a total of 213 PCa lesions were detected through whole-mount histopathology.There were 21(9.9%)lesions involving both the peripheral zone(PZ)and the transition zone(TZ), with an average diameter of(2.82±0.71)cm.Of all lesions, 85(39.9%)involved PZ and 107(50.2%)involved TZ, with an average diameter of(1.36±0.81)cm and of(1.60±0.94)cm, respectively.The percentage of lesions involving TZ was higher than that lesions involving PZ, with larger diameters( P<0.05). Of 64 patients with complete MRI data, 105 PCa lesions were detected histopathologically by using whole mount sections, while 75 PCa lesions were detected by MRI, with a statistical difference( P<0.05). For lesions≥1.0 cm or lesions with an ISUP grade group≥2, the detection rate of MRI was lower in TZ lesions( P<0.05). Conclusions:PCa lesions within TZ account for a large proportion and have a relatively large tumor dimeter.PCa lesions within TZ are more likely to be missed in clinical examinations and on MRI, and clinicians should pay close attention during diagnosis and treatment.

Organ shortage is one of the important factors restricting the development of human organ transplantation. The identification and referral of potential donors determine the total scale of organ donation. Whether potential donors can be identified and referred is the most important reason for the difference of organ donation rates in different regions. This paper interprets the chapter of the identification and referral of potential donors in the Guide to the Quality and Safety of Organs for Transplantation (6th edition) issued by European Union in order to provide reference for the staff of organ procurement organization and related medical personnel in China and improve the organ donation rate in China.

Objective:To verify the value of whole genomic copy number variation (WGCNV) detection and scoring system in the diagnosis and prognosis of lung adenocarcinoma.Methods:Seventy-six lung adenocarcinoma specimens including ninety-one tumor samples and twenty adjacent non-tumor lung tissue samples were collected using Laser capture microdissection (LCM). Whole genomic amplification (WGA) was used to enrich DNA and construct a sequencing library for next generation sequencing (NGS). Changes of larger than 5Mb CNV in this study were analyzed and scored. The nuclear grading and score of tumor cells in the surgery and pleural effusion cytology of lung adenocarcinoma specimens were evaluated separately. For each case, we evaluated (1) nuclear size, (2) mitotic counts, (3) nuclear atypia, (4) atypical mitoses. The data of disease-free survive (DFS) and overall survive (OS) were collected for assessing the prognostic value of WGCNV score. Meanwhile, receiver operating characteristic (ROC) and area under curve (AUC) were used to define a cut-off value and evaluate the diagnostic significance in lung adenocarcinoma.Results:The WGCNV scores of twenty adjacent non-tumor lung tissue samples were treated as normal control and all of WGCNV scores of tumor samples range from 0 to 9.95, the median score was 2.7. The WGCNV scores were divided into three groups: low score group <1.74, medium score grade 1.74~4.23, high score grade >4.23. The WGCNV score was positively associated with the nuclear grade scoring ( r=0.780 90, P<0.001). The result for evaluation of prognostic value of the WGCNV scores showed that comparing with low WGCNV score group, Hazard Ratio (HR) of medium score group was 4.11 (95% CI=0.72~23.57) and high score group was 2.07 (95% CI=0.30~14.12). These results suggested that the risks of the medium and high WGCNV score group elevated. According to the analysis results of ROC curve, when the cut off value was 0.01, the sensitivity and specificity for lung adenocarcinoma diagnosis were 97.8% and 95.0% respectively, the positive predictive value (PPV) and negative predictive value (NPV) were 99.0% and 90.1%, respectively, the AUC was 0.981. In the differentiation of adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA) group and invasive adenocarcinoma group, when the cut off value was 1.8, the sensitivity and specificity between the two groups were 78.1% and 94.4%, and the PPV and NPV were 98.0% and 52.0%, respectively, the AUC was 0.896. Conclusion:This study verifies that WGCNV scoring system has a potential diagnostic and prognostic value in lung adenocarcinoma.