Objective:To evaluate the efficacy of different surgical approaches in treating various types of small-volume benign prostatic hyperplasia (BPH).Methods:The data of 62 patients with small-volume BPH (≤30 ml) who were treated at Affiliated Jinhua Hospital, Zhejiang University School of Medicine from March 2018 to March 2023 were retrospective analyzed.The average age of the patients was (63.21 ± 5.38) years old.Among them, 9 patients had bladder calculi and 12 presented with urinary retention. Patients were stratified into two groups based on preoperative cystoscopy findings: 38 patients with hyperplasia of the middle or bilateral lobes underwent anterior lobe-sparing holmium laser enucleation of the prostate (HoLEP)(group A); 24 patients with bladder neck elevation and no significant hyperplasia received transurethral holmium laser incision of the prostate (group B). Preoperative baseline characteristics: international prostate symptom score(IPSS) were (23.68±4.89) and (22.59±3.62) respectively, quality of life (QOL) were (4.82±0.43) and (4.59±0.31) respectively, maximum flow rate (Q max)(7.89±1.83) ml/s and (7.26±1.72)ml/s respectively. The operative parameters (including procedure duration and catheterization time), postoperative complications (infection, urinary incontinence, and bladder neck contracture) were evaluated. Results:All 62 procedures were successfully completed. The mean operative time of group A was (32.36±6.17) minutes, postoperative catheterization duration was 1-3 days, and no cases of urinary incontinence or infection at 1-month follow-up. During the 12-month follow-up period, no cases of bladder neck contracture were observed in group A. The mean operative time of group B was (19.58 ± 3.87) minutes, and postoperative catheterization duration was 5-7 days. One case of fever with epididymitis was observed after operation, and there was no urinary incontinence at 1-month follow-up. During the 12-month follow-up period, no case of bladder neck contracture was observed in group B. Postoperative outcomes of group A and B at 1 month were as follows: IPSS (7.20±1.72) and (7.80±1.52) respectively, QOL (2.12±0.33) and (2.36±0.25) respectively, Q max(19.32±3.55)ml/s and (18.29±2.83)ml/s respectively.All postoperative parameters showed significant improvement compared with preoperative values ( P<0.05). Conclusions:For small-volume BPH, patients with middle or bilateral lobe hyperplasia can benefit from anterior lobe-sparing HoLEP, patients with bladder neck elevation and minimal hyperplasia can achieve optimal outcomes with transurethral holmium laser incision. Both approaches demonstrate significant symptom improvement with low rates of postoperative urinary incontinence and bladder neck contracture.

Objective:To evaluate the efficacy of different surgical approaches in treating various types of small-volume benign prostatic hyperplasia (BPH).Methods:The data of 62 patients with small-volume BPH (≤30 ml) who were treated at Affiliated Jinhua Hospital, Zhejiang University School of Medicine from March 2018 to March 2023 were retrospective analyzed.The average age of the patients was (63.21 ± 5.38) years old.Among them, 9 patients had bladder calculi and 12 presented with urinary retention. Patients were stratified into two groups based on preoperative cystoscopy findings: 38 patients with hyperplasia of the middle or bilateral lobes underwent anterior lobe-sparing holmium laser enucleation of the prostate (HoLEP)(group A); 24 patients with bladder neck elevation and no significant hyperplasia received transurethral holmium laser incision of the prostate (group B). Preoperative baseline characteristics: international prostate symptom score(IPSS) were (23.68±4.89) and (22.59±3.62) respectively, quality of life (QOL) were (4.82±0.43) and (4.59±0.31) respectively, maximum flow rate (Q max)(7.89±1.83) ml/s and (7.26±1.72)ml/s respectively. The operative parameters (including procedure duration and catheterization time), postoperative complications (infection, urinary incontinence, and bladder neck contracture) were evaluated. Results:All 62 procedures were successfully completed. The mean operative time of group A was (32.36±6.17) minutes, postoperative catheterization duration was 1-3 days, and no cases of urinary incontinence or infection at 1-month follow-up. During the 12-month follow-up period, no cases of bladder neck contracture were observed in group A. The mean operative time of group B was (19.58 ± 3.87) minutes, and postoperative catheterization duration was 5-7 days. One case of fever with epididymitis was observed after operation, and there was no urinary incontinence at 1-month follow-up. During the 12-month follow-up period, no case of bladder neck contracture was observed in group B. Postoperative outcomes of group A and B at 1 month were as follows: IPSS (7.20±1.72) and (7.80±1.52) respectively, QOL (2.12±0.33) and (2.36±0.25) respectively, Q max(19.32±3.55)ml/s and (18.29±2.83)ml/s respectively.All postoperative parameters showed significant improvement compared with preoperative values ( P<0.05). Conclusions:For small-volume BPH, patients with middle or bilateral lobe hyperplasia can benefit from anterior lobe-sparing HoLEP, patients with bladder neck elevation and minimal hyperplasia can achieve optimal outcomes with transurethral holmium laser incision. Both approaches demonstrate significant symptom improvement with low rates of postoperative urinary incontinence and bladder neck contracture.

Objective To compare the effectiveness and safety of transparency cap-assisted endoscopic full-thickness resection(EFTR-C)and endoscopic submucosal excavation(ESE)in the treatment of ≤1.5 cm intracavity growth type gastric stromal tumor.Methods A retrospective analysis was performed on the medi-cal records of 63 patients with ≤1.5 cm intraluminal growth type gastric stromal tumor treated in this hospi-tal from June 2019 to September 2023.The patients were divided into the EFTR-C group(n=33)and ESE group(n=30)according to surgical methods.The general data,operation situation,postoperative situation and follow-up were compared between the two groups.Results There was no statistically significant differ-ence in the intraoperative pneumoperitoneum rate,purse string suture rate,monoblock resection rate,complete resection rate and complication occurrence rate between the two groups(P＞0.05).The operative time,inci-dence rate of intraoperative bleeding,number of titanium clips,postoperative fasting time,postoperative hospi-talization duration and operation costs had statistical difference between the two groups(P＜0.05).Postoper-ative wound healing was good in both groups without recurrence,metastasis and death.Conclusion EFTR-C for the treatment of ≤1.5 cm intracavity growth type gastric stromal tumor has the advantages of simple op-eration,short operation time,low costs and rapid recovery compared with ESE.

ObjectiveTo explore the incidence, characteristics, and influencing factors of non-suicidal self-injury behavior (NSSI) in adolescent patients with mental disorders in Wenzhou City, and to provide a basis for proposing effective preventive intervention strategies. MethodsA total of 500 adolescent patients with mental disorders admitted to the Seventh People’s Hospital of Wenzhou City from June 2022 to June 2023 were selected as the research subjects. Based on the definitions in the Third Edition of the Chinese Classification Scheme and Diagnostic Standards for Mental Disorders (CCMD-3), whether the patients had experienced NSSI within the past year was evaluated. Patients were divided into two groups based on the presence of NSSI: the occurrence group and the non-occurrence group. A logistic regression model was used to analyze the influencing factors of NSSI in adolescent patients with mental disorders. ResultsAmong the 500 adolescent patients with mental disorders, the incidence of NSSI was 39.40%. Among the adolescent patients with mental disorders who experienced NSSI, the main areas of self-injury were the forearm and wrist, hand, accounting for 36.54% and 23.86%, respectively. The main methods of self-injury were cutting and collision, accounting for 50.25% and 29.44%, respectively. Childhood family dysfunction, academic pressure, childhood abuse experiences, campus violence, mother’s education level, and Loneliness Scale (LRS) scores were related factors for the occurrence of NSSI in adolescent patients with mental disorders, and the differences were statistically significant (P<0.05). Multivariate logistic regression analysis showed that having a mother with a junior college education or above, experiencing campus violence, childhood abuse experiences, childhood family dysfunction, high academic pressure and an LRS score >11 points were risk factors for NSSI in adolescent patients with mental disorders (all P<0.05). ConclusionThe occurrence of NSSI in adolescent patients with mental disorders is closely related to factors such as having a mother with a junior college education or above, high academic pressure, exposure to campus violence, childhood abuse experiences, childhood family dysfunction, and an LRS score >11 points.

Objective:To evaluate the clinical efficacy and advantage of urinary continence after holmium laser enucleation of the prostate (HoLEP)with reservation of different structures for benign prostatic hyperplasia (BPH).Methods:The data of 242 patients with BPH who underwent HoLEP in Affiliated Jinhua Hospital Zhejiang University School of Medicine from June 2020 to June 2023 were analyzed retrospectively.Of the 242 patients, 89 received anterior lobe-sparing HoLEP(Group A), 81 received HoLEP with partial urethral mucosa reservation(group B), and 72 received conventional HoLEP(group C). There were no significant differences among the three groups( P > 0.05)in terms of the age[(73.72±6.35)years old vs.(72.58±6.14)years old vs.(73.18±6.73)years old], prostate volume[(82.31±43.58)ml vs.(81.54±42.83)ml vs.(82.12±44.27)ml], the proportion of diabetes mellitus[11 cases(12.4%)vs. 9 cases(11.1%)vs. 7 cases(9.7%)], the proportion of calculus of bladder[9 cases(10.1%) vs. 6 cases(7.4%)vs. 6 cases(8.3%)], the proportion of urinary retention[20 cases(22.5%)vs.17 cases(21.0%)vs. 14 cases(19.4%)], international prostate symptom score(IPSS)[(22.47±3.56) vs.(21.83±4.18)vs.(21.54±3.37)], quality of life score (QOL)[(4.87±0.92) vs.(4.65±0.86) vs.(4.74±0.73)]and quantity of maximum flow rate(Q max)[(8.32±3.09)ml/s vs.(8.41±2.75)ml/s vs.(7.96±2.82)ml/s].The perioperative related indexes of the three groups were compared. IPSS, QOL, Q max, and the incidence of urinary incontinence at 1 week, 1 month and 3 months after surgery were compared in the three groups. Results:All procedures were performed successfully without conversion.Among groups A, B, and C, the differences of surgical enucleation time [(35.17±12.38)min vs. (34.19±10.26)min vs. (33.75±11.34)min], prostate enucleation mass [(57.43±37.58)g vs. (59.72±38.35)g vs. (60.37±39.52)g], retention of urinary catheter time [(3.18±1.55)d vs. (3.62±1.78)d vs. (3.49±1.69)d], the proportion of perforation of the peritoneum [1 case(1.1%) vs. 1 case(1.2%) vs. 2 cases (2.8%)], and the proportion of postoperative infections [1 case (1.1%) vs. 1 case (1.2%) vs. 2 cases (2.8%)]were not statistically significant ( P>0.05). At 1st week and 1st month after surgery in group A, IPSS[(9.41±2.21), (8.34±1.67) points], QOL[(2.17±0.58), (1.89±0.41)points], Q max[(20.53±5.18), (22.41±6.17)ml/s]were significantly improved as compared with those before surgery( P<0.05).At 1st week and 1st month after surgery in group B, IPSS[(10.19±2.47), (8.73±1.81) points], QOL[(2.63±0.62), (2.14±0.57)points], Q max[(19.64±4.59), (21.43±5.39)ml/s]were significantly improved as compared with those before surgery( P<0.05).At 1st week and 1st month after surgery in group C, IPSS[(10.35±1.98), (9.21±1.78)points], QOL[(2.79±0.76), (2.28±0.68)points], Q max[(20.21±5.83), (23.15±5.49)ml/s]were significantly improved as compared with those before surgery( P<0.05).There were no significant differences in the IPSS, QOL and Q max at the same time among the three groups( P>0.05).The incidence of postoperative urinary incontinence after one week in group A and group B were significantly lower than that in group C[2.2%(2/89) vs. 12.3%(10/81) vs. 34.7%(25/72), P<0.05], and the incidence of postoperative urinary incontinence after one week in group A was significantly lower than that in group B ( P<0.05). The incidence of postoperative urinary incontinence after one month in group A and group B were significantly lower than that in group C[0(0/89) vs. 6.2%(5/81) vs. 22.2%(16/72), P<0.05], and the incidence of postoperative urinary incontinence after one month in group A was significantly lower than that in group B( P< 0.05). Conclusions:Holmium laser enucleation of the prostate with anterior lobe-sparing can significantly reduce the incidence of urinary incontinence after operation, which is worthy of clinical application.

Objective:To evaluate the clinical efficacy and advantage of urinary continence after holmium laser enucleation of the prostate (HoLEP)with reservation of different structures for benign prostatic hyperplasia (BPH).Methods:The data of 242 patients with BPH who underwent HoLEP in Affiliated Jinhua Hospital Zhejiang University School of Medicine from June 2020 to June 2023 were analyzed retrospectively.Of the 242 patients, 89 received anterior lobe-sparing HoLEP(Group A), 81 received HoLEP with partial urethral mucosa reservation(group B), and 72 received conventional HoLEP(group C). There were no significant differences among the three groups( P > 0.05)in terms of the age[(73.72±6.35)years old vs.(72.58±6.14)years old vs.(73.18±6.73)years old], prostate volume[(82.31±43.58)ml vs.(81.54±42.83)ml vs.(82.12±44.27)ml], the proportion of diabetes mellitus[11 cases(12.4%)vs. 9 cases(11.1%)vs. 7 cases(9.7%)], the proportion of calculus of bladder[9 cases(10.1%) vs. 6 cases(7.4%)vs. 6 cases(8.3%)], the proportion of urinary retention[20 cases(22.5%)vs.17 cases(21.0%)vs. 14 cases(19.4%)], international prostate symptom score(IPSS)[(22.47±3.56) vs.(21.83±4.18)vs.(21.54±3.37)], quality of life score (QOL)[(4.87±0.92) vs.(4.65±0.86) vs.(4.74±0.73)]and quantity of maximum flow rate(Q max)[(8.32±3.09)ml/s vs.(8.41±2.75)ml/s vs.(7.96±2.82)ml/s].The perioperative related indexes of the three groups were compared. IPSS, QOL, Q max, and the incidence of urinary incontinence at 1 week, 1 month and 3 months after surgery were compared in the three groups. Results:All procedures were performed successfully without conversion.Among groups A, B, and C, the differences of surgical enucleation time [(35.17±12.38)min vs. (34.19±10.26)min vs. (33.75±11.34)min], prostate enucleation mass [(57.43±37.58)g vs. (59.72±38.35)g vs. (60.37±39.52)g], retention of urinary catheter time [(3.18±1.55)d vs. (3.62±1.78)d vs. (3.49±1.69)d], the proportion of perforation of the peritoneum [1 case(1.1%) vs. 1 case(1.2%) vs. 2 cases (2.8%)], and the proportion of postoperative infections [1 case (1.1%) vs. 1 case (1.2%) vs. 2 cases (2.8%)]were not statistically significant ( P>0.05). At 1st week and 1st month after surgery in group A, IPSS[(9.41±2.21), (8.34±1.67) points], QOL[(2.17±0.58), (1.89±0.41)points], Q max[(20.53±5.18), (22.41±6.17)ml/s]were significantly improved as compared with those before surgery( P<0.05).At 1st week and 1st month after surgery in group B, IPSS[(10.19±2.47), (8.73±1.81) points], QOL[(2.63±0.62), (2.14±0.57)points], Q max[(19.64±4.59), (21.43±5.39)ml/s]were significantly improved as compared with those before surgery( P<0.05).At 1st week and 1st month after surgery in group C, IPSS[(10.35±1.98), (9.21±1.78)points], QOL[(2.79±0.76), (2.28±0.68)points], Q max[(20.21±5.83), (23.15±5.49)ml/s]were significantly improved as compared with those before surgery( P<0.05).There were no significant differences in the IPSS, QOL and Q max at the same time among the three groups( P>0.05).The incidence of postoperative urinary incontinence after one week in group A and group B were significantly lower than that in group C[2.2%(2/89) vs. 12.3%(10/81) vs. 34.7%(25/72), P<0.05], and the incidence of postoperative urinary incontinence after one week in group A was significantly lower than that in group B ( P<0.05). The incidence of postoperative urinary incontinence after one month in group A and group B were significantly lower than that in group C[0(0/89) vs. 6.2%(5/81) vs. 22.2%(16/72), P<0.05], and the incidence of postoperative urinary incontinence after one month in group A was significantly lower than that in group B( P< 0.05). Conclusions:Holmium laser enucleation of the prostate with anterior lobe-sparing can significantly reduce the incidence of urinary incontinence after operation, which is worthy of clinical application.

Objective:To comprehensively analyze the medical resources and services supply in the cancer field of China.Methods:Data of 2018 were sampled from 41 tertiary public cancer hospitals in China, and the factor analysis method was used to extract common factors in resources or services, scoring respectively. Pearson correlation analysis was used in the collinearity test of the variables of both groups of common factors, while the second-order clustering method was used to analyze characteristic differences between the hospitals, and category difference was compared with t test. Results:Resource evaluation covered the two dimensions of basic resources(medical service and basic assurance resources)and high-end resources(high-end talents and academic resources). Service evaluation covered the two dimensions of medical service assurance(clinical services and basic assurance)and disciplinary sphere of influence(discipline construction and clinical efficiency). The factor of basic manpower and beds was significantly correlated with that of medical service and basic assurance( r=0.811, P<0.001), while the factor of high-end talents and academic resources was significantly correlated with that disciplinary construction and resource efficiency( r=0.906, P<0.001). The second-order cluster analysis found the 41 cancer hospitals as two categories, with the first category of five in Guangdong, Shanghai, Beijing and Tianjin, and the second category of the rest 36 hospitals. Significant differences were found between the two categories in terms of resource scoring, service scoring, high-end resources and disciplinary sphere of influence( P<0.001). Meanwhile, the GDP per capita of the cities in which these hospitals are located also had significant differences( P<0.001). Conclusions:Development of public tertiary cancer hospitals in China was imbalanced, as their differences were mainly found in levels of disciplinary development and efficiency of clinical services, which were closely related to the high-end talents and academic resources of the hospital in question.Furthermore, high quality medical care was mostly located in regions of higher development. The authors recommend to take a balanced consideration of the differences and distribution of cancer care services in China, in terms of performance classification of public hospitals and establishment of regional cancer centers of the country.

Objective:To investigate the role of advanced oxidation protein products (AOPPs) in epithelial - mesenchymal transition (EMT) of small intestinal epithelial cells, and provide basis for the study of mechanism of intestinal fibrosis (IF) in intestinal bowel disease (IBD) .Methods:The small intestinal crypt epithelial cells IEC-6 were cultured in vitro. AOPPs was made by hypochlorous acid oxidation of rat serum albumin (RSA) in vitro. IEC-6 cells were divided into blank control group, AOPPs group and RSA group. The different concentrations (50, 100, 200, 400 μg/ml) of AOPPs were used to interfere with IEC-6 cells respectively in AOPPs group, 50, 100, 200, 400 μg/ml RSA were used to interfere with IEC-6 cells respectively in RSA group and no intervention in blank control group. The morphological changes of IEC-6 cells were observed and apoptosis was detected by flow cytometry in 3 groups 24 h after intervention. When the apoptosis rate was highest, the concentration of AOPPs were analyzed statistically and used to interfere IEC-6 for 48 and 72 h. The difference of apoptosis rate were analyzed between the different times. The mRNA expression of E-cadherin, Fibronectin, Snail, Slug and Collagen Ⅰ were detected in blank control group, AOPPs group and RSA group by fluorescence quantitative PCR.Results:AOPPs could induce the apoptosis of IEC-6 cells with time- and concentration-dependent effects ( P<0.05) . The apoptosis rate was (17.30 ± 1.03) %, which reached the peak by the intervention of 400 μg/ml AOPPs for 72 h. AOPPs significantly decreased the mRNA expression of E-cadherin in IEC-6 cells, significantly increased the mRNA expression of Fibronectin and CollagenⅠ, and significantly increased the mRNA expression of transcription factor Snail and Slug (all P<0.05) . Conclusions:AOPPs can promote the ECT of small intestinal epithelial cells and play a role in IF of IBD by inducing the apoptosis of IEC-6 cells, inhibiting of the transcription of E-cadherin, up-regulating the gene expression of the transcription factors Snail and Slug, while increasing the gene expression of Fibronectin and CollagenⅠ.

Objective:To investigate the role of advanced oxidation protein products (AOPPs) in epithelial - mesenchymal transition (EMT) of small intestinal epithelial cells, and provide basis for the study of mechanism of intestinal fibrosis (IF) in intestinal bowel disease (IBD) .Methods:The small intestinal crypt epithelial cells IEC-6 were cultured in vitro. AOPPs was made by hypochlorous acid oxidation of rat serum albumin (RSA) in vitro. IEC-6 cells were divided into blank control group, AOPPs group and RSA group. The different concentrations (50, 100, 200, 400 μg/ml) of AOPPs were used to interfere with IEC-6 cells respectively in AOPPs group, 50, 100, 200, 400 μg/ml RSA were used to interfere with IEC-6 cells respectively in RSA group and no intervention in blank control group. The morphological changes of IEC-6 cells were observed and apoptosis was detected by flow cytometry in 3 groups 24 h after intervention. When the apoptosis rate was highest, the concentration of AOPPs were analyzed statistically and used to interfere IEC-6 for 48 and 72 h. The difference of apoptosis rate were analyzed between the different times. The mRNA expression of E-cadherin, Fibronectin, Snail, Slug and Collagen Ⅰ were detected in blank control group, AOPPs group and RSA group by fluorescence quantitative PCR.Results:AOPPs could induce the apoptosis of IEC-6 cells with time- and concentration-dependent effects ( P<0.05) . The apoptosis rate was (17.30 ± 1.03) %, which reached the peak by the intervention of 400 μg/ml AOPPs for 72 h. AOPPs significantly decreased the mRNA expression of E-cadherin in IEC-6 cells, significantly increased the mRNA expression of Fibronectin and CollagenⅠ, and significantly increased the mRNA expression of transcription factor Snail and Slug (all P<0.05) . Conclusions:AOPPs can promote the ECT of small intestinal epithelial cells and play a role in IF of IBD by inducing the apoptosis of IEC-6 cells, inhibiting of the transcription of E-cadherin, up-regulating the gene expression of the transcription factors Snail and Slug, while increasing the gene expression of Fibronectin and CollagenⅠ.

Objective To observe the effect of simulated microgravity on the photopic negative response (PhNR) of full-field flash ERG in adult mice.Methods In an experimental study,forty-eight adult male C57BL/6J mice (48 eyes) were randomly divided into model and control groups.Model mice were further divided into three subgroups of 8 each:tail-suspended for 15 days (subgroup A),tail-suspended for 30 days (subgroup B),and tail-suspended for 30 days followed by returning to normal position for 30 days (subgroup C).The three control subgroups were similarly fixed with a harness but kept in the normal position for corresponding periods of 15,30,and 60 days.The mice were immediately examined using ERG-PhNR,flash VEP,OCT and visually-guided behavior in vivo,and subsequently sacrificed to analyze the retinal histology in vitro.PhNR amplitude was measured from baseline to PhNR trough.N1 peak-time and N1-P1 amplitude of VEP was analyzed.The escape duration was used to quantitatively evaluate the visual function of mice.In addition,inner retinal thickness was analyzed by OCT imaging.Data were compared by the independent sample t-test.Results PhNR amplitude in the model subgroup A was obviously lower than the corresponding control subgroup,the difference was statistically significant (t=-3.196,P＜0.01).There was no significant difference in PhNR amplitude between the model subgroup B or C and the corresponding control subgroup (t=-1.976,0.285;P＞0.05).There was no significant difference in FVEP N1 peak-time or N1-P1 amplitude between any of the three model subgroups and the corresponding control subgroup (P＞0.05).There was no significant difference in OCT-measured inner retinal thickness between any of the three model subgroups and the corresponding control subgroup (t=-0.461,2.073,-0.402;P＞0.05).The three model subgroups showed almost normal retinal structure,including the retinal ganglion cell,inner pexiform layer,inner nuclear layer,outer plexiform layer,outer nuclear layer,ellipsoid zone and RPE.There was no significant difference in visually-guided escape time between any of the three model subgroups and the corresponding control subgroup (t=-0.637,-0.955,1.297;P＞0.05).Conclusion Via tail-suspension,short-term simulated microgravity can affect the PhNR of flash ERG;however,the change is reversible and does not affect visual function of mice.