Objective To compare the efficacy and safety of transurethral blue laser vaporization of the prostate, transurethral resection of the prostate (TURP) or plasmakinetic resection of the prostate in the treatment of benign prostatic hyperplasia (BPH). Methods The domestic and foreign clinical studies on transurethral blue laser vaporization of the prostate (observation group), TURP or plasmakinetic resection of the prostate (control group) in the treatment of BPH during Jan. 2015 and Mar. 2025 were retrieved. The data were extracted with Cochrane systematic review method. The operation time, decrease in hemoglobin, bladder irrigation time, catheter indwelling time, total complication rate, retrograde ejaculation rate and urinary incontinence rate of the two groups were compared with RevMan 5.3.0 statistical software. Results A total of 5 Chinese studies involving 491 patients (248 in the observation group and 243 in the control group) were included in the Meta-analysis. Compared with the control group, the observation group had shorter operation time [MD=-20.80, 95%CI:-26.88—-14.72, P＜0.00001], less decrease in hemoglobin [MD=-10.61, 95%CI: -20.21—-1.01, P=0.03], shorter bladder irrigation time [MD=-17.85, 95%CI: -32.62—-3.09, P=0.002], shorter catheter indwelling time [MD=-1.71, 95%CI: -2.81—- 0.62, P=0.002], lower total complication rate [OR=0.11, 95%CI: 0.06—0.21, P＜0.00001], lower retrograde ejaculation rate [OR=0.05, 95%CI: 0.02—0.16, P＜0.00001] and lower urinary incontinence rate [OR=0.24, 95%CI: 0.07—0.79, P=0.02]. There were no significant differences in other complications between the two groups (P＞0.05). The international erectile function score (IIEF-5) of the observation group was significantly higher than that of the control group [MD=1.87, 95%CI:1.16—2.57, P＜0.00001]. There were no significant differences in international prostate symptom score (IPSS), maximum urinary flow rate (Qmax) and post-voiding residual (PVR) between the two groups (P＞0.05). Conclusion All three surgical procedures can effectively improve the lower urinary tract symptoms of BPH patients. Compared with TURP or plasmakinetic resection of the prostate, transurethral blue laser vaporization of the prostate has obvious advantages in terms of perioperative recovery, reduction of total complications, urinary incontinence and retrograde ejaculation rates, and preservation of sexual function.

Background: Whether there is a causal relationship between childhood obesity and increased risk of chronic kidney disease (CKD) remains controversial. This study sought to explore how body size in childhood and adulthood independently affects CKD risk in later life using a Mendelian randomization (MR) approach. Methods: Univariate and multivariate MR was used to estimate total and independent effects of body size exposures. Genetic associations with early-life and adult body size were obtained from a genome-wide association study of 453,169 participants in the U.K. Biobank, and genetic associations with CKD were obtained from the CKDGen and FinnGen consortia. Results: A larger genetically predicted early-life body size was associated with an increased risk of CKD (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.14 to 1.41; P= 1.70E-05) and increased blood urea nitrogen (BUN) levels (β=0.010; 95% CI, 0.005 to 0.021; P=0.001). However, the association between the impact of early-life body size on CKD (OR, 1.12; 95% CI, 0.95 to 1.31; P=0.173) and BUN level (β=0.001; 95% CI, –0.010 to 0.012;P= 0.853) did not remain statistically significant after adjustment for adult body size. Larger genetically predicted adult body size was associated with an increased risk of CKD (OR, 1.37; 95% CI, 1.21 to 1.54; P= 4.60E-07), decreased estimated glomerular filtration rate (β=–0.011; 95% CI, –0.017 to –0.006; P=5.79E-05), and increased BUN level (β= 0.010; 95% CI, 0.002 to 0.019; P= 0.018). Conclusion Our research indicates that the significant correlation between early-life body size and CKD risk is likely due to maintaining a large body size into adulthood.

Spinal trauma, primarily caused by high-energy external forces, predominantly manifest as vertebral fracture and spinal cord injury. These conditions are characterized by spinal pain, restricted mobility, and sensory and autonomic dysfunction, significantly compromising patients′ quality of life and life expectancy. Current diagnostic and therapeutic practices for spinal fracture remain susceptible to subjective clinical experience, resulting in misdiagnosis, underdiagnosis, and imprecise surgical execution. Similarly, the therapeutic efficacy of spinal cord injury rehabilitation is frequently limited by a lack of personalized treatment protocols. The growing integration of artificial intelligence (AI) in medicine presents novel opportunities to overcome these obstacles. By excelling in image interpretation, data analytics, clinical decision support, and personalized rehabilitation planning, AI has emerged as a prominent focus of modern research. To this end, the authors reviewed the research progress in the application of AI in the diagnosis and treatment of spinal fracture and rehabilitation of spinal cord injury, providing a reference for AI-assisted precision diagnosis and treatment of vertebral fracture and rehabilitation of spinal cord injury.

Objective To observe the value of 18F-prostate specific membrane antigen(PSMA)-1007 PET/MRI for diagnosing seminal vesicle invasion(SVI)of prostatic cancer(PCa).Methods Totally 92 male patients with PCa who underwent radical prostatectomy were retrospectively enrolled and divided into positive group(n=26)and negative group(n=66)based on postoperative pathology showed SVI or not.PET/MRI parameters,including maximum standard uptake value(SUVmax),minimum apparent diffusion coefficient(ADCmin),mean apparent diffusion coefficient(ADCmean),SUVmax/ADCmin,SUVmax/ADCmean,PSMA tumor volume(PSMA-TV)and total lesion PSMA(TL-PSMA)were compared between groups.The receiver operating characteristic curve was drawn,and the efficacy of each parameter for diagnosing SVI was analyzed.Results Among 92 cases of PCa,18F-PSMA-1007 PET/MRI showed 30 cases with SVI and 62 cases without SVI,with accuracy of 73.91％,sensitivity of 61.54％,specificity of 78.79％,positive predictive value of 53.33％and negative predictive value of 83.87％.Significant differences of ADCmin,PSMA-TV and TL-PSMA were found between groups(all P＜0.05).The area under the curve(AUC)of SUVmax,ADCmin,ADCmean,SUVmax/ADCmin,SUVmax/ADCmean,PSMA-TV and TL-PSMA for diagnosing SVI of PCa was 0.554,0.341,0.396,0.603,0.581,0.755 and 0.705,respectively.The AUC of PSMA-TV was higher than other parameters except for TL-PSMA,with sensitivity of 84.60％and specificity of 56.10％.Conclusion 18 F-PSMA-1007 PET/MRI was helpful for diagnosing SVI of PCa.

This study was aimed at investigating the effectiveness of various host nucleic acid removal and non-specific amplifica-tion techniques in animal tissue samples,to increase the accuracy of pathogen identification in tissue samples.Simulated samples were prepared with a mixture of mouse lung tissue homogenates and Klebsiella pneumoniae fluids,and processed with six host nucleic acid removal kits and three non-specific amplification techniques.The effectiveness of each method in removing host DNA and enriching nucleic acids of pathogenic microorganisms was evaluated through real-time fluorescence quantitative PCR and high-throughput se-quencing.For host nucleic acid removal techniques,the method of selective cleavage and quantitative degradation of host DNA(Com-plete5 kit)effectively decreased the host nucleic acid content in tissue samples and increased the relative abundance of pathogen nucleic acids.In contrast,the magnetic bead method for host DNA removal(Next microbiome DNA enrichment Kit kit)was less effec-tive.At lower pathogen concentrations(77 CFU/mL),the Vazyme kit was more effective than the other kits in removing host nucleic acids.Non-specific amplification techniques(MALBAC whole genome amplification,MDA isothermal amplification,and random primer amplification)were not applicable to tissue samples and were not effective in increasing the relative abundance of pathogen nucleic acids.Selective lysis and quantitative degradation of host DNA were suitable for processing tissue samples with high host back-ground and low pathogenic microorganism levels,whereas non-specific amplification methods were not applicable to tissue samples for pre-processing of macro-genome high-throughput sequencing.

AIM:To investigate whether casein kinase 2(CK2)/calmodulin(CaM)/small-conductance Ca2+-activated K+channel type 2(SK2)signaling pathway mediates autophagy-induced sympathoexcitation in the paraventricu-lar nucleus(PVN)of rats with chronic heart failure(CHF).METHODS:We randomly divided 180 Wistar rats,aged 6 to 8 weeks,into 10 groups:sham+dimethyl sulfoxide(DMSO),sham+artificial cerebrospinal(aCSF),CHF+DMSO,CHF+aCSF,CHF+rapamycin(RAPA),CHF+3-methyladenine(3-MA),CHF+5,6-dichlorobenzimidazole riboside(DRB),CHF+calmidazolium chloride(CMDZ),CHF+N-cyclohexyl-N-[2-(3,5-dimethyl-1H-pyrazol-1-yl)-6-methyl-pyrimidin-4-yl]-amine(CyPPA),and CHF+apamin groups.We measured cardiac function,hemodynamic parameters,anatomic indicators,and sympathetic drive indicators(n=18).Western blot was used to examine the protein levels of mi-crotubule-associated protein 1 light chain 3-II(LC3-II)/LC3-I,beclin-1,P62,CK2α,SK2,and phosphorylated CaM.The number of SK2-positive neurons was measured using immunofluorescence staining.The NG108 cells were randomly divided into 6 groups:DMSO,aCSF,RAPA,3-MA,RAPA+DRB,and RAPA+CMDZ groups.Radioisotope 32P-ATP pro-tein kinase activity assays were used to detect CK2 activity in cultured NG108 cells.We used Western blot to examine the protein levels of CK2α,SK2,and phosphorylated CaM.RESULTS:Compared with CHF rats treated with vehicle,CHF rats treated with RAPA or apamin exhibited increased sympathetic drive indicators,but decreased left ventricular ejection fraction and fractional shortening(P<0.01).However,CHF symptoms,including sympathoexcitation,were attenuated by 3-MA,DRB,CMDZ or CyPPA infusion into the PVN(P<0.01).In CHF rats,RAPA infusion into the PVN induced CK2 activity,up-regulated LC3-II/LC3-I,beclin-1,CK2α,and phosphorylated CaM levels,but down-regulated P62 and SK2 expression,as well as the number of SK2-positive neurons(P<0.05 or P<0.01).In CHF rats,infusion of 3-MA or DRB into the PVN decreased CK2 activity,and down-regulated phosphorylated CaM level(P<0.01).Infusion of 3-MA,DRB or CMDZ into the PVN up-regulated SK2 expression and the number of SK2-positive neurons(P<0.01).In cultured NG108 cells,RAPA induced CK2 activation and up-regulated the expression of CK2α and the phosphorylation of CaM,but down-regulated SK2 expression(P<0.01).Treatment with RAPA increased the level of phosphorylated CaM and down-regulated SK2 expression in cultured NG108 cells(P<0.01),which was inhibited by DRB and CMDZ(P<0.05 or P<0.01).CONCLUSION:In rats with CHF,the CK2/CaM/SK2 signaling pathway in the PVN contributes to autophagy-induced sympathoexcitation.

Objective·To explore the effect of intermittent theta burst stimulation(iTBS)targeting the left dorsolateral prefrontal cortex(DLPFC)on reducing craving in alcohol-dependent patients during the withdrawal period,as well as its impact on patients'emotions and cognitive functions.Methods·A total of 41 inpatients with alcohol dependence in the withdrawal period were recruited from the Addiction Department of Mental Health Center,Shanghai Jiao Tong University School of Medicine,and randomly assigned to the experimental group(20 patients)and the control group(21 patients).Both groups received routine inpatient treatment for alcohol-dependence.The experimental group received real iTBS stimulation targeting the left DLPFC on the basis of routine inpatient treatment,while the control group received sham stimulation with the same parameters.The intervention course lasted for 2 weeks,with a total of 10 sessions.The Visual Analogue Scale(VAS),Beck Depression Inventory(BDI),and Beck Anxiety Inventory(BAI)were used to measure the craving,anxiety,and depression of the patients before and after the intervention.The behavioral tasks of the detection task(DET),identification task(IDN),two back task(TWOB),the Groton maze learning task(GML),and international shopping list task(ISL)in the CogState software package were used to assess the cognitive processing speed,attention/vigilance,working memory,spatial problem-solving/error monitoring ability,and verbal learning and memory of the patients before and after the intervention.Results·Repeated measures ANOVA showed that the time effect[F=126.713,P＜0.001,partial η2(ηp2)=0.765]and interaction effect(F=7.080.P=0.011,ηp2=0.154)of the VAS scores in the two groups of patients were statistically significant.The time effect(F=9.114,P=0.004,ηp2=0.189),group effect(F=5.557,P=0.024,ηp2=0.125),and interaction effect(F=4.977,P=0.032,η2=0.113)of the TWOB score were all statistically significant.Only the time effects of BDI(F=45.273,P＜0.001,ηp2=0.578),BAI(F=31.432,P＜0.001,ηp2=0.473),GML(F=8.993,P=0.005,ηp2=0.209),and ISL(F=26.657,P＜0.001,ηp2=0.439)scores were statistically significant.There were no statistically significant effects of time,group,or interaction on the DET and IDN scores.Simple effect analysis showed that the VAS score of the real stimulation group was lower than that of the sham stimulation group after the intervention(F=8.805,P=0.005,ηp2=0.184),and the TWOB score of the real stimulation group was higher than that of the sham stimulation group(F=11.293,P=0.002,ηp2=0.225).Conclusion·Combining iTBS with routine inpatient treatment can enhance the efficacy of reducing alcohol craving in alcohol-dependent patients during the withdrawal period,and improve their working memory.

Pregabalin, a structural analog of γ-aminobutyric acid (GABA), has been widely prescribed since its approval in 2004 for treating various neuropathic pain conditions. In Western countries, it is also approved for managing anxiety disorders. However, concerns about its potential for abuse and dependence have led to its reclassification as a second-line treatment in recent years. Although pregabalin addiction has been reported in international studies, there have been no such reports within China. This article presents a case of addiction stemming from pregabalin abuse to manage anxiety symptoms. The patient experienced withdrawal symptoms after discontinuing the drug, which were successfully treated. The development of pregabalin addiction, withdrawal symptoms, and the OD(overdose) pattern of drug abuse in this case should draw the attention of clinicians in China.

Objective:This study aims to explore the optimization needs of the cognitive training tool "Fun Brain" from a professional perspective, providing insights for its enhancement and application.Methods:In April 2024, a qualitative research approach was employed, involving group interviews with 61 elderly health professionals organized into 9 groups. The interviews primarily focused on the user experience and optimization suggestions related to the "Fun Brain" app. Thematic analysis was conducted, with NVivo 14 software utilized for data management and processing. Data analysis followed Braun and Clarke′s six-phase procedure to ensure the scientific and systematic extraction of themes. Furthermore, high-frequency word analysis was performed, offering crucial clues for subsequent thematic analysis.Results:The study identified 12 initial themes and 6 optimization themes, with a primary focus on age-appropriate interfaces, personalized modules, and feedback mechanisms. These themes were refined into three core themes, including adaptation of training content, optimization of interaction design, and enhancement of participant motivation.Conclusion:Optimizing cognitive training tools for elderly users requires careful consideration of their specific needs, particularly regarding functional adaptation, interface design, and interactive experience. Implementing these optimizations can improve user engagement and training effectiveness, offering both scientific and practical guidance for the design and promotion of cognitive training tools.

BACKGROUND:Most rotator cuff injuries occur in the supraspinatus tendon.Clinical treatment of rotator cuff injuries is very limited due to the lack of blood vessels and the complex anatomical structure of the rotator cuff.The rapid development of tissue engineering technology and stem cell biology has brought new hope for improving the quality of tendon repair.OBJECTIVE:To prepare human umbilical cord mesenchymal stem cells/gelatin methacrylate composite scaffolds by bio-3D printing technology to observe the effect of this scaffold on repairing rotator cuff injury.METHODS:(1)In vitro cell assay:The gelatin microcarrier was prepared.The tissue engineered stem cells were constructed by inoculating human umbilical cord mesenchymal stem cells on the surface of gelatin microcarrier.Gelatin methacrylate hydrogel printing ink was prepared.Tissue engineered stem cells were re-suspended with gelatin methacrylate hydrogel printing ink and put into the bio-ink container of 3D printer for printing.Human umbilical cord mesenchymal stem cells/gelatin methacrylate composite scaffold was obtained after 5 minutes of blue light irradiation and curing.The activity of human umbilical cord mesenchymal stem cells in scaffolds was detected by dead/alive staining and CCK-8 assay.(2)In vivo animal experiments:A random block design method was used to randomly assign 24 SD rats to 4 groups with 6 rats in each group.No treatment was given in the normal group.The rotator cuff injury model of supratinatus tendon tear was established in the rotator cuff injury group,the simple scaffold group,and the cellular scaffold group.The gelatin methacrylate scaffold and human umbilical cord mesenchymal stem cell/gelatin methacrylatecomposite scaffold were implanted into the tendon injury after the model was made in the simple scaffold group and the cellular scaffold group,respectively.Four weeks after operation,behavioral tests and histopathological morphology observation of supraspinatus tendon of rotator cuff were performed.RESULTS AND CONCLUSION:(1)In vitro cellular assay:The dead/alive staining showed that gelatin microcarrier could reduce the damage of human umbilical cord mesenchymal stem cells caused by 3D printing process.With the extension of culture time,the survival rate of human umbilical cord mesenchymal stem cells increased in the scaffold.The results of CCK-8 assay showed that with the extension of culture time,the activity of human umbilical cord mesenchymal stem cells in the scaffold did not change significantly.(2)In vivo animal experiments:Behavioral test results showed that compared with rotator cuff injury group and simple scaffold group,cellular scaffold group significantly improved limb motor function.The results of hematoxylin-eosin and Masson staining of rotator cuff supraspinatus tendon showed that compared with rotator cuff injury group and simple scaffold group,the muscle fiber arrangement in the cellular scaffold group was more regular;there was no obvious inflammatory cell infiltration,and the percentage of collagen volume decreased.The results of immunofluorescence staining showed that the expression levels of interleukin 6 and tumor necrosis factor α in the rotator cuff supraspinatus tendon were significantly decreased in the cellular scaffold group compared with the rotator cuff injury group and the simple scaffold group.(3)The results showed that bio-3D-printed cell scaffolds encapsulating human umbilical cord mesenchymal stem cells/gelatin methacrylate could promote tissue repair and regeneration of rotator cuff injuries.