Objective To explore the short-term efficacy of endoscopic submucosal dissection (ESD) in the treatment of early carcinoma in the remnant stomach. Methods A retrospective study was conducted on 45 patients with early residual gastric cancer underwent ESD at the Endoscopy Center of Zhongshan Hospital, Fudan University from December 2014 to April 2024, with a total of 45 lesions. The patients were divided into an anastomotic group (n=15) and a non-anastomotic group (n=30) based on the location of tumor occurrence, and their clinical data, endoscopic diagnosis and treatment, and histopathological conditions were compared between the two groups. Results All 45 patients had lesions with redness and erosion. There were 9 cases of poor lifting of submucosal injection in the anastomotic group and 2 cases in the non-anastomotic group, respectively, and the difference was statistically significant (P<0.05). ESD surgery was performed on 13 lesions in the anastomotic group and 28 lesions in the non-anastomotic group, with surgery times of 80.00 (50.00, 100.00) min and 55.00 (43.75, 80.00) min, respectively. The difference in surgery time between the two groups was statistically significant (P=0.03). Among the 45 patients, ESD surgery achieved curative resection in 35 cases, including 11 cases in the anastomotic group and 24 cases in the non-anastomotic group, with no statistically significant difference. Conclusions Careful preoperative evaluation of early carcinoma in the remnant stomach is essential to prevent oversight. Lesions at anastomotic sites and suture lines present higher technical challenges for complete resection. ESD is safe and effective, with auxiliary traction technique available when necessary.

Objective: To explore the association between preoperative aspartate transaminase to alanine transaminase (AST/ALT) ratio and the outcomes of urothelial cancers. Methods: After a systematic search of Web of Science，PubMed and Embase before Aug.2024，14 studies were included in the Meta-analysis.The hazard ratios (HRs) with 95% confidence interval (CI) for overall survival (OS)，cancer-specific survival (CSS)，and recurrence-free survival (RFS) were analyzed using STATA 15.0 software. Results: The Meta-analysis included a total of 8190 patients.Urothelial cancer patients with an elevated preoperative AST/ALT ratio had worse OS (HR=1.92，95% CI：1.38-2.67，P<0.001)，CSS (HR=2.12，95% CI：1.48-3.05，P<0.001)，and RFS (HR=1.63，95% CI：1.27-2.10，P<0.001).In subgroup analyses，preoperative AST/ALT ratio had a better predictive value for OS，CSS，and RFS in patients with bladder cancer than in patients with upper tract urothelial carcinoma，and a better predictive value in Asian population than in Caucasian population (P<0.001). Conclusion: A high preoperative AST/ALT ratio is associated with poor OS，CSS and RFS in urothelial cancers，particularly among the Asian population.

Objective To explore the efficacy and safety of conversion therapy for advanced hepatocellular carcinoma(HCC)with macrovascular invasion.Methods A total of 149 patients with advanced HCC with macrovascular invasion who were treated at our hospital from Jul.2019 to Jun.2021 were enrolled.All patients received systemic therapy combined with local therapy,and were assigned to conversion therapy group(n=42)and non-conversion therapy group(n=107)according to whether they ultimately underwent surgical treatment.The long-term prognosis and adverse reactions of these patients after conversion therapy were analyzed.Results The median event-free survival of 149 patients was 15.5 months,and the median overall survival had not been reached.The median event-free survival in the conversion therapy and non-conversion therapy groups were 19.8 months and 10.7 months,respectively,with the median overall survival being not reached and 28.2 months,respectively.Multifactor Cox regression analysis showed that conversion therapy was a protective factor for overall survival(hazard ratio[HR]=0.125,95％confidence interval[CI]0.016-0.966),but not for event-free survival.The 1-year and 2-year overall survival rates of the conversion therapy and non-conversion therapy groups were 100.0％,96.4％and 72.1％,53.4％,respectively,and the difference in survival curves between the 2 groups was statistically significant(P=0.003).The 1-year and 2-year event-free survival rates were 77.5％,33.8％and 47.3％,31.5％,respectively.There was no significant difference in survival curves between the 2 groups(P=0.070).The differences of the overall incidences of targeted and immunotherapy-related adverse reactions in the conversion therapy group and non-conversion therapy group(66.7％[28/42]vs 72.0％[77/107],P=0.524)and the incidences of grade Ⅲ to Ⅳ adverse reactions(23.8％[10/42]vs 27.1％[29/107],P=0.681),were not statistically significant.Conclusion For patients with advanced HCC with macrovascular invasion,conversion therapy can significantly improve the prognosis without serious adverse reactions.

Objective To evaluates the effects of cross-balance training on knee function,dynamic balance,and rectus femoris(RF)activation in patients after anterior cruciate ligament reconstruction(ACLR).Methods Forty ACLR patients at 5th-6th week after operation were randomly divided into experimental group and control group.The experimental group received the cross-balance training on the basis of standard rehabilitation,while the control group received only standard rehabilitation.Knee function was assessed with the Lysholm score,dynamic balance,and root mean square(RMS)of RF surface electromyography.The correlation between RMS and dynamic balance was also examined.Results After intervention,the Lysholm score of the experimental group was significantly higher than that of the control group(P<0.01).Regarding balance function,both the gait line length and single support line length of the experimental group were significantly greater than those of the control group(P<0.01).Conversely,the mediolateral displacement of the experimental group was significantly lower than that of the control group(P<0.01).Furthermore,the RF RMS of the experimental group was significantly larger than that of the control group(P<0.01).The RF RMS was positively correlated with the gait line length and single support line length,whereas it was negatively correlated with the mediolateral displacement(P<0.05).Conclusions Cross-balance training significantly enhances knee function,dynamic balance,and RF activation in post-ACLR patients,supports the theory of cross-education.Cross-balance training has certain application values in ACL postoperative rehabilitation.

Objective To evaluates the effects of cross-balance training on knee function,dynamic balance,and rectus femoris(RF)activation in patients after anterior cruciate ligament reconstruction(ACLR).Methods Forty ACLR patients at 5th-6th week after operation were randomly divided into experimental group and control group.The experimental group received the cross-balance training on the basis of standard rehabilitation,while the control group received only standard rehabilitation.Knee function was assessed with the Lysholm score,dynamic balance,and root mean square(RMS)of RF surface electromyography.The correlation between RMS and dynamic balance was also examined.Results After intervention,the Lysholm score of the experimental group was significantly higher than that of the control group(P<0.01).Regarding balance function,both the gait line length and single support line length of the experimental group were significantly greater than those of the control group(P<0.01).Conversely,the mediolateral displacement of the experimental group was significantly lower than that of the control group(P<0.01).Furthermore,the RF RMS of the experimental group was significantly larger than that of the control group(P<0.01).The RF RMS was positively correlated with the gait line length and single support line length,whereas it was negatively correlated with the mediolateral displacement(P<0.05).Conclusions Cross-balance training significantly enhances knee function,dynamic balance,and RF activation in post-ACLR patients,supports the theory of cross-education.Cross-balance training has certain application values in ACL postoperative rehabilitation.

Inflammatory bowel disease(IBD)is a disease characterized by chronic,recurrent intestinal inflammation,includ-ing Crohn's disease(CD)and ulcerative colitis(UC).Etiology and pathogenesis of IBD are unknown,and the treatment is difficult.In recent years,immunocellular therapy represented by regulatory T(Treg)cell therapy and dendritic cell(DC)therapy has developed rapidly in the field of immune-related disease treatment,and some progress has also been made in the treatment of IBD.This review will introduce application and progression of Treg cell therapy and DC therapy in IBD treatment.

Objective To investigate the changing trends in etiology and treatment of male urethral stricture in recent 10 years.Methods A total of 940 male patients with urethral stricture admitted to the Department of Urology of Beijing Jishuitan Hospital during Jan.2013 and Dec.2022 were continually collected.The clinical data were divided into two groups according to the time of admission,namely the group from 2013 to 2017 and the group from 2018 to 2022,for a comparative analysis of the previous and subsequent 5 years.The etiology,location,length and the type of treatment of urethral stricture were retrospectively analyzed.Results The causes of the 940 cases of male urethral stricture were trauma in 447(47.55％),iatrogenic injury in 220(23.40％),idiopathic causes in 128(13.62％),lichen sclerosus(LS)in 78(8.30％),infection in 46(4.89％),and other causes in 21(2.23％).The treatment methods were urethroplasty in 691(73.51％),direct vision internal urethrotomy(DVIU)in 122(12.98％),urethral dilatation in 86(9.15％),and suprapubic cystostomy in 41(4.36％).Compared with the previous 5 years,in the past 5 years,the proportion of urethral stricture caused by trauma decreased significantly(60.34％vs.41.71％,P＜0.001),while the proportion of iatrogenic injury increased significantly(17.63％vs.26.05％,P=0.005).In the past 5 years,the proportion of urethroplasty increased from 68.81％to 75.66％(P=0.027),while the proportion of DVIU decreased from 19.66％to 9.92％(P＜0.001).Inthe past 5 years,the proportion of membranous urethral stenosis decreased significantly(26.98％vs.50.85％,x2=51.06,P＜0.001),the proportion of penile urethral stricture(21.40％vs.7.80％,=26.37,P＜0.001)and meatal stenosis(9.30％vs.4.75％,x2=5.80,P＜0.001)increased significantly.Conclusion In the past decade,trauma was the main cause of male urethral strictures,but its proportion showed a decreasing trend.Iatrogenic injury led to a gradual increase in urethral strictures,which was the second leading cause of male urethral stricture.The application of urethroplasty increased significantly,making it the main treatment method for male urethral stricture.

Objective:To evaluate the surgical methods for treating distal urethral stricture.Methods:The clinical data of 80 patients with distal urethral stricture in Beijing Jishuitan Hospital,Captial Medical University between January 2018 and December 2022 were retrospectively collected.Including male geni-tal lichen sclerosus(MGLS)33 cases,iatrogenic injury 25 cases,postoperative hypospadias 12 cases,and other causes such as trauma 10 cases.Among these cases,strictures involved the urethral meatus in 54 instances,of which 38 were treated with meatotomy(MO),7 with penile skin flap urethroplasty(PSFU),and 9 with oral mucosa graft urethroplasty(OMGU).There were also 26 instances where stric-tures involved both the navicular fossa and meatus;one case underwent PSFU while 25 underwent OMGU.Based on different surgical methods used for treatment purposes we divided the patients into MO group,PSFU group and OMGU group.The age of the three groups was(48.8±20.0)years,(53.3±21.8)years and(44.5±16.4)years.The mean±SD body mass index(BMI)was(28.6±3.9)kg/m2,(29.6±3.2)kg/m2 and(29.2±4.8)kg/m2.The preoperative maximum flow rate was(5.8±2.3)mL/s,(6.8±2.4)mL/s and(5.7±3.1)mL/s.Results:All the operations were suc-cessfully completed without Clavien Ⅲ or Ⅳ complications.The median length of strictures(measured intraoperatively)in the three groups were 1.1(1.0,1.6),1.5(1.1,2.0)and 4.0(2.5,5.0)cm.The median operation time was 60.0(60.0,75.0),85.0(75.0,112.5)and 180.0(75.0,330.0)min.The median estimated blood loss was 5.0(2.0,10.0),15.0(5.0,42.5)and 180.0(135.0,216.3)mL.The median postoperative hospital stay was 3.5(2.0,5.0),6.5(3.5,7.0)and 7.5(7.0,11.3)days.The median follow-up duration was 40.0(26.3,57.3),55.0(18.8,62.8)and 52.5(30.5,64.0)months.The median postoperative maximum flow rate was 18.3(15.5,19.8),19.2(16.1,20.1)and 17.2(14.2,19.6)mL/s.Among the 38 patients with MO,33 cases had nor-mal urination without reintervention,and 5 cases experienced recurrent strictures and required regular urethral dilation.Among the 8 patients with PSFU,7 cases had normal urination without reintervention,and one case developed a urinary fistula,for which intervention was recommended but the patient opted to maintain the status quo.Among the 34 patients with OMGU,28 cases had normal urination without re-intervention.There were 6 instances of stenosis recurrence,with 5 cases requiring regular urethral dila-tions and one case requiring reconstructive surgery.The overall success rate of operation was 85.0％,and the reintervention rate was 15.0％.Statistical analysis revealed significant differences in etiologies among the three groups(P=0.002),as well as in stricture locations(P＜0.001),length of strictures(P＜0.001),operation time(P＜0.001),estimated blood loss(P＜0.001)and postoperative hospital stays(P＜0.001).However,no significant differences were observed in terms of age,BMI,history of previous urethral stricture surgeries,preoperative maximum flow rate,follow-up duration,postoperative maximum flow rate and reintervention rate.Univariate and multivariate Logistic regression analyses indi-cated that a history of previous urethral stricture surgeries was a risk factor for postoperative reintervention(P=0.026).Conclusion:MO and PSFU are primarily suitable for treating short-segment(≤1.5 cm)distal penile urethral strictures,whereas OMGU is more appropriate for longer segment strictures.MO and OMGU can both be utilized in managing MGLS cases.PSFU and OMGU are more conducive to im-proving the appearance of the urethral meatus.The success rate of surgical management of distal penile urethral stricture is 85.0％,15.0％of the patients still require surgical intervention after surgery,and having history of previous urethral stricture surgeries is a risk factor for postoperative reintervention.