Objective To investigate the clinical efficacy of transurethral plasma electrotomy with rod electrode and end-to-end urethral anastomosis in the treatment of short urethral stricture.Methods 125 male patients with short urethral stricture(＜2 cm)who were admitted to our hospital from January 2014 to December 2020 were retrospectively analyzed.According to different surgical methods,they were divided into transurethral plasma resection with rod electrode(minimally invasive group)and urethral end-to-end anastomosis(open group).According to the length of urethral stricture,the minimally invasive group was divided into minimally invasive group 1(stricture length≤1 cm),minimally invasive group 2(stricture length1-2 cm),open group 1(stricture length ≤1 cm)and open group 2(stricture length 1-2 cm).The four groups were compared with each other,and the surgical success rates were compared between the four groups.Results The success rate of the minimally invasive group 1 and the open group 1 was 88.57％and 93.10％,respectively.There was no significant difference between the two groups(P＞0.05).The surgical success rate of the minimally invasive group 2 and the open group 2 was 67.86％and 90.91％,respectively.The surgical success rate of the minimally invasive group 2 was significantly lower than that of the open group 2.The difference was statistically significant(P＜0.05).The surgical success rate of minimally invasive group 1 and minimally invasive group 2 was 88.57％and 67.86％,respectively,the difference was statistically significant(P＜0.05).The success rate of operation in the open group 1 and the open group 2 was 93.10％and 90.91％,respectively,and there was no significant difference between the two groups(P＞0.05).Conclusion Transurethral plasma resection with rod electrode is preferred for urethral stricture with length≤1 cm,because the success rate of this surgery is the same as that of open surgery,and the surgical trauma is small and the recovery is fast.For 1-2 cm urethral stricture,minimally invasive surgery has less trauma and faster recovery,but open surgery has a higher success rate.The choice of surgical method needs to weigh the advantages and disadvantages and take comprehensive consideration.

Objective:To investigate the tau deposition pattern in Alzheimer′s disease (AD) and its correlation with cognition by 18F-MK6240 PET imaging. Methods:From August 2021 to February 2022, 46 elderly people over 55 years old (16 males, 30 females; age (68.9±7.7) years) were included from outpatient and community in Shanghai. Structural brain MRI, β-amyloid (Aβ) PET imaging, tau-PET imaging and comprehensive neuropsychological tests batteries were conducted. The subjects were divided into AD group ( n=16) and normal cognition (NC) group ( n=30) according to the 2018 National Institute on aging and Alzheimer′s Association (NIA-AA) diagnostic criteria. Quantitative analysis was conducted to investigate the tau deposition pattern in AD after preprocessing 18F-MK6240 PET images with MRI images. SUV ratio (SUVR) of brain regions such as entorhinal cortex, hippocampus, parahippocampal gyrus, amygdala, insular lobe, frontal lobe, precuneus, occipital lobe, thalamus and putamen were analyzed, with cerebellum as reference region. The differences of tau deposition in brain regions between AD and NC groups were analyzed by independent-sample t test. The associations between SUVR and Mini-Mental State Examination (MMSE) score and Montreal Cognitive Assessment-Basic (MoCA-B) score were analyzed by Pearson correlation analysis. Results:AD displayed a significant tau deposition in frontal lobes, temporal lobes and parietal lobes compared with NC. SUVR of brain regions in AD group were higher than those in NC group ( t values: 3.37-9.61, all P<0.05). SUVR in brain regions were negatively correlated with MMSE score ( r values: from -0.735 to -0.350, all P<0.05) and MoCA-B score ( r values: from -0.723 to -0.367, all P<0.05). Conclusion:18F-MK6240 PET can demonstrate the tau deposition in the brain of AD patients, and the tau deposition is related to cognitive function.

ObjectiveTo investigate the efficacy and safety of CalliSpheres microsphere-transcatheter arterial chemoembolization (CSM-TACE) versus conventional transcatheter arterial chemoembolization (cTACE) in the treatment of hepatocellular carcinoma (HCC) through a meta-analysis. MethodsPubMed, Web of Science, Cochrane Library, CNKI, Wanfang Data, and VIP were searched for all Chinese and English articles on the application of CSM-TACE and cTACE in HCC published up to the end of October, 2020. After quality assessment was performed for the articles included, RevMan 5.3 software provided by Cochrane Library was used for analysis. ResultsA total of 15 studies were included, with 1535 patients in total. This meta-analysis showed that compared with the patients receiving cTACE, the patients receiving CSM-TACE had significantly higher 1-year overall survival rate (odds ratio ［OR］=2.26, 95% confidence interval ［CI］: 1.63-3.13, P＜0.000 01), 2-year overall survival rate (OR=1.73, 95%CI: 1.20-2.50, P=0.003), and 2-year progression-free survival rate (OR=1.60, 95%CI: 1.05-2.43, P=0.03). In terms of safety, compared with the patients receiving cTACE, the patients receiving CSM-TACE had significantly lower incidence rates of postoperative vomiting (OR=0.65, 95%CI: 0.46-0.92, P=0.01), bone marrow suppression (OR=0.17, 95%CI: 0.05-0.54, P=0.003), and neutropenia (OR=0.18, 95%CI: 0.07-045, P=0.000 3), while there were no significant differences between the two groups of patients in postoperative pyrexia, abdominal pain, and ascites (all P＞0.05). ConclusionCSM-TACE has significant advantages in improving 1- and 2-year overall survival rates and 2-year progression-free survival rates and can significantly reduce the incidence rates of postoperative vomiting, bone marrow suppression, and neutropenia. Therefore, CSM-TACE is a safe and effective treatment method.

Objective:To explore the role of WeChat platform combined with flipped classroom in improving the working ability of resident doctors in the fever clinic.Methods:A total of 118 resident doctors who rotated in the fever clinic of department of emergency medicine were selected as the study subjects, and they were randomized into experimental group and control group, with 59 people in each group. The experimental group used WeChat platform and flipped classroom teaching, and the control group used traditional teaching. The results of theory assessment, operation performance and questionnaire survey were compared between the two groups. SPSS 26.0 statistical software was used for t test and chi-square test. Results:There was no significant difference in theoretical test scores between the experimental group and the control group ( P>0.05). The experimental group scored (91.61±3.01) points and the control group scored (84.52±4.02) points in operational assessment, with significant differences ( t=-10.85, P<0.05). The results of the satisfaction survey showed that there was no significant difference in teaching time distribution between the two groups, and the experimental group was better than the control group in any other aspects. Conclusion:The use of WeChat platform combined with flipped classroom during the COVID-19 epidemic can improve the level of operational skills of the resident doctors to wear or take off the protective clothing and collect nasopharyngeal swabs, help residents to avoid the infections, and improve the level of daily diagnosis and treatment of fever clinic.

Objective:To observe the clinical effect of self-made traditional Chinese medicine combined with acupuncture and moxibustion in the treatment of non-small cell lung cancer, and its effect on the serum T cell subsets of patients.Methods:From November 2015 to November 2018, 104 patients with non-small cell lung cancer admitted to Lishui Hospital of Traditional Chinese Medicine were selected in the research.They were divided into observation group and control group according to random number table method, with 52 cases in each group.The control group was treated with arterial infusion chemotherapy, while the observation group was treated with traditional Chinese medicine decoction combined with traditional Chinese medicine acupuncture and moxibustion on the basis of chemotherapy.The clinical symptoms and serum T lymphocyte subsets of the two groups were observed and compared before and after treatment, and the adverse reactions of the two groups were recorded.Results:The symptom scores of the control group and the observation group were (8.49±2.43)points and (8.41±2.21)points, respectively, which were lower than those before treatment[(11.11±2.25)points and (6.23±2.02)points]( t=104.962, 82.738, all P<0.05). The symptom score of the observation group was lower than that of the control group( t=11.638, P<0.05). The incidence of liver function damage in the observation group was 15.38%(6/52), which was significantly lower than that in the control group[34.62%(13/52)](χ 2=5.128, P<0.05). After treatment, the immunologic indicators (CD 3+, CD 4+, CD 8+, CD 4+/CD 8+) in the observation group were (63.24±20.40)%, (35.16±5.02)%, (27.55±13.54)%, (1.28±0.32), respectively, which were significantly improved compared with before treatment[(51.14±15.58)%, (25.64±6.19)%, (36.04±12.65)% and (0.71±0.11)], the differences were statistically significant ( t=18.103, 58.675, 68.789, 19.573, all P<0.05). The improvements of immunological indicators in the observation group were better than those in the control group[(55.84±15.21)%, (28.79±4.23)%, (32.51±9.51)%, (0.89±0.15)], the differences were statistically significant ( t=2.097, 6.997, 2.162, 7.958, all P<0.05). Conclusion:Traditional Chinese medicine decoction combined with acupuncture and moxibustion can effectively improve the clinical symptoms, improve immune function and alleviate adverse reactions of chemotherapy in patients with stage Ⅲ B and Ⅳ non-small cell lung cancer.

Circadian rhythm disorder is a common physiological change of cancer survivors, which is mainly manifested in rest activity rhythm change, sleep wake disorder and the decrease of sleep efficiency at night, which further affect their physiological, psychological outcome and disease outcome. This paper reviews the concept, mechanism, influence and intervention methods of circadian rhythm disorder in cancer patients, in order to provide references for effective intervention of circadian rhythm disorder in cancer survivors.

TSCI have dyskinesia and sensory disturbance that can cause various life-threaten complications. The patients with traumatic spinal cord injury (TSCI), seriously affecting the quality of life of patients. Based on the epidemiology of TSCI and domestic and foreign literatures as well as expert investigations, this expert consensus reviews the definition, injury classification, rehabilitation assessment, rehabilitation strategies and rehabilitation measures of TSCI so as to provide early standardized rehabilitation treatment methods for TSCI.

Objective To explore the effects of Yiqi Jianpi decoction on inflammatory reaction, immune function and nutritional status in patients after surgery of laparoscopic rectal cancer. Methods Eighty-two patients with post-operative laparoscopic rectal cancer resection admitted to Pingxiang People's Hospital from June 2017 to March 2019 were enrolled, and according to whether traditional Chinese medicine (TCM) was used or not, they were divided into a western medicine treatment control group (control group) and a combined traditional Chinese and western medicine treatment group (combined group), 41 cases in each group. The control group was treated with symptomatic conventional western therapy, while the combined group was additionally treated with Yiqi Jianpi decoction based on the conventional western treatment as in the control group; the composition of the decoction: hedyotis herba, herba agrimoniae, radix astragali each 30 g; radix codonopsis, ganoderma lucidum each 20 g; rizoma atractylodes, poria cocos and prunella chinensis 15 g each; pinellia ternata 9 g, licorice root 6 g; all the above ingredients were together boiled with water and the fluid (decoction) was filtered, 150 mL once orally taken, twice a day, 21 days constituting one therapeutic course, and the clinical efficacy was evaluated after 1 course of therapy. The changes of TCM syndrome score, simple health situation scale (SF-36) score, inflammatory indexes, immune function and nutritional status of the two groups were observed before and after treatment. Results After treatment, the levels of TCM syndrome score, C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and CD8+ in the two groups were significantly lower than those before treatment, while the levels of SF-36 score, CD4+, CD4+/CD8+, transferrin (TRF) and albumin (Alb) were significantly higher than those before treatment (all P < 0.05), and the degree of changes in the combined group were more significant than those in control group [TCM syndrome score: 3.79±2.22 vs. 6.86±2.02, SF-36 score:75.18±4.13 vs. 64.17±4.01, CRP (mg/L): 4.54±1.31 vs. 5.71±2.21, IL-6 (μg/L): 20.21±2.21 vs. 26.12±2.13, TNF-α (μg/L): 33.04±4.56 vs. 36.41±3.23, CD4+: 0.37±0.03 vs. 0.35±0.03, CD8+: 0.25±0.03 vs. 0.28±0.03, CD4+/CD8+: 1.51±0.39 vs. 1.19±0.37, TRF (g/L): 3.05±0.41 vs. 2.28±0.42, Alb (g/L): 43.88±2.28 vs. 39.86±2.03, all P < 0.05]. Conclusion Yiqi Jianpi decoction in the treatment of patients after surgery of laparoscopic rectal cancer can effectively promote the recovery of gastrointestinal function, reduce the inflammatory reaction, elevate the immune function and improve clinical prognosis.

Objective To investigate the value of quantitative analysis parameters of dynamic contrast-enhanced MRI (DCE-MRI) in distinguishing low or high grade prostate cancer.Methods Data of DCE-MRI in 26 patients with prostate cancer confirmed by surgical pathology following radical prostatectomy were retrospectively analyzed.These patients were divided into low grade prostate cancer (n=10) group or high grade prostate cancer group (n=16).The parameters,including transport constant (K trans),rat constant (Kep) and extravascular extracellular volume fraction (Vc.) were measured and compared between the two groups.ROC curve was used to determine the efficacy of the parameters in distinguishing low or high grade prostate cancer.The correlation between the parameters and Gleason score were assessed.Results Ktrans,Kep and Ve values in the low grade prostate cancer group was (0.22± 0.07)/min,(1.24 ± 0.57)/min and 0.21±0.08 respectively,and (0.36±0.10)/min,(1.82±0.66)/min,0.21±0.10 respectively in the high grade prostate cancer group.The differences of K trans and Kep were statistically significant between the two groups (both P＜0.05),while of Vc.was not statistically significant (P=0.994).The area under ROC curves of K trans and keapvalues for distinguishing low or high grade prostate cancers was 0.872 and 0.737,respectively.No correlation was found between any parameters nor Gleason scores (all P＞0.05).Conclusion K trans and Kep,the quantitative analysis parameters of DCE-MRI,contribute to the differential diagnosis of low and high grade prostate cancer.

Objective To analyze the clinical efficacy of gamma-ray fractionated stereotactic radiotherapy (FSRT) in the treatment of intracranial metastatic polycystic tumors.Methods Forty cases with 61 metastatic polycystic tumors were selected from 189 patients with 373 intracranial metastatic tumors admitted to our hospital from 2013 to 2015.All cases received gamma-ray FSRT.The isodose line at 50％ was defined as the prescription dose.The prescription dose was ranged from 40 to 48 Gy/10-12f.The survival rate was calculated by Kaplan-Meier method.The single factor analysis was performed by Log-rank method.Results The median follow-up time was 21months (range:6-39 months).The median survival time was 15.3 months.The 6-month,1-and 2-year local control rate was 93％,82％ and 79％,respectively.The 1-and 2-year survival rate was 63％ and 30％.Single factor analysis demonstrated that the volume of cysts and the volume of lesions were not significantly correlated with local control rate (P=0.17 and 0.48).Conclusion Gamma-ray FSRT can be adopted to treat intracranial metastatic polycystic tumors,which yields similar clinical efficacy to metastatic solid tumors.It deserves wide application in clinical practice due to high local control rate and safety.