Objective To investigate the correlation between the expression of microRNA-4319(miRNA-4319)and microRNA-4262(miRNA-4262)in early gastric carcinoma tissue and postoperative recurrence after endoscopic submucosal dissection(ESD).Methods From May 2018 to March 2020,396 patients with early gastric carcinoma who underwent ESD were regarded as the disease group,meantime,98 patients with normal gastric mucosa gastritis confirmed by pathological examination were as the control group.Quantitative reverse transcription polymerase chain reaction(qRT-PCR)method was applied to detect the relative expression levels of miRNA-4319 and miRNA-4262 in tissues;follow up on postoperative recurrence of early gastric carcinoma patients,and the expression levels and clinical pathological characteristics of miRNA-4319 and miRNA-4262 were compared between recurrent and non recurrent patients.Multivariate Logistic regression analysis was applied to analyze the influencing factors of recurrence in early gastric carcinoma patients after ESD;receiver operating characteristic curve(ROC curve)was applied to analyze the predictive value of miRNA-4319 and miRNA-4262 in early gastric carcinoma tissue for recurrence after ESD.Results The expression levels of miRNA-4319 and miRNA-4262 in the disease group were lower than those in the control group,the differences were statistically significant(P＜0.05);The expression levels of miRNA-4319 and miRNA-4262 in the recurrence group were decreased,and the proportion of submucosal invasion was increased,the differences were statistically significant(P＜0.05).The depth of invasion to the submucosal level(OR=3.158,95％CI:1.395～7.151)was a risk factor for recurrence after ESD in patients with early gastric carcinoma(P＜0.05),and miRNA-4262 ≥ 0.76(OR=0.561,95％CI:0.370～0.852)and miRNA-4319 ≥ 0.69(OR=0.482,95％CI:0.255～0.911)were protective factors for recurrence after ESD in patients with early gastric carcinoma(P＜0.05);The area under the curve(AUC)of miRNA-4319,miRNA-4262 and their combination for predicting recurrence after ESD in patients with early gastric carcinoma was 0.889(95％CI:0.854～0.918),0.914(95％CI:0.882～0.940)and 0.964(95％CI:0.940～0.980),respectively,which was superior to the individual predictions of miRNA-4319 and miRNA-4262 respectively(P＜0.05).Conclusion MiRNA-4319 and miRNA-4262 are low expressed in tissues of early gastric carcinoma patients,they are closely related to postoperative recurrence after ESD.

Gout significantly impacts both physical health and quality of life,while current pharmacological treatments face notable limitations.TCM non-pharmacological therapies have shown promising potential in the management of gout,offering diverse approaches with favorable efficacy.This article summarized the characteristics,clinical efficacy and mechanisms of different TCM non-pharmacological therapies for treating gout.Recent studies suggest that these therapies may be applied across all clinical stages of gout.During the acute phase,they can rapidly reduce joint inflammation and relieve pain.In the intercritical phase,they help prevent recurrence,decrease the frequency of attacks,and shorten episode duration.In the chronic tophaceous phase,they alleviate persistent symptoms,improve joint function,and support minimally invasive tophi removal.TCM non-pharmacological therapies have their own characteristics and good safety,and can be combined for clinical use,providing TCM treatment strategies for gout.

Objective:To analyze the correlation between sex hormone levels and micropenis after mild hypospadias surgery in children.Methods:A case control study was carried out.The clinical data of 71 children aged 1 to 13 years who underwent mild hypospadias surgery at the First Affiliated Hospital of Xinxiang Medical University from April 2022 to April 2024 were analyzed.Preoperatively, the children were divided into a mild hypospadias group (Group A) and a mild hypospadias with micropenis group (Group B) based on the stretched penile length (SPL).Prolactin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), progesterone, and testosterone (TES) levels of the 2 groups were measured.Multivariate Logistic regression analysis was used to construct a risk prediction model.The discrimination capability of the model was evaluated using the receiver operating characteristic (ROC) curve.SPL and sex hormone levels were measured again 6 months after surgery.The children were divided into a normal penile group (Group AA) and a micropenis group (Group BB) after mild hypospadias according to SPL.Multivariate Logistic regression analysis was used to construct a risk prediction model, which was evaluated using the ROC curve.Results:The levels of FSH, LH and TES in group A before the operation were 3.28(2.02, 4.46) IU/L, 0.53(0.25, 0.79) IU/L and 25.24(17.94, 36.67) ng/dL, respectively, and those in group B were 1.42(1.10, 1.84) IU/L, 0.14(0.09, 0.23) IU/L and 15.73 (12.92, 17.00) ng/dL, respectively.The difference was all statistically significant (all P<0.05).Multivariate Logistic regression analysis showed statistical significance ( OR=0.515, 95% CI: 0.271-0.977; OR=0.035, 95% CI: 0.002-0.542; OR=0.883, 95% CI: 0.796-0.980).The area under the ROC curve (AUC) of the prediction model was 0.906, with a sensitivity of 75.00% and a specificity of 95.74%.The levels of FSH, LH and TES in the postoperative AA group were 2.97 (1.88, 4.28) IU/L, 0.46 (0.23, 0.78) IU/L and 20.92 (17.34, 33.27) ng/dL, respectively.The median levels of FSH, LH and TES in the BB group were 1.52 (1.27, 1.82) IU/L, 0.17 (0.12, 0.26) IU/L and 15.08(11.68, 16.68) ng/dL, respectively.The difference was all statistically significant (all P<0.05).Multivariate Logistic regression analysis showed statistical significance ( OR=0.484, 95% CI: 0.236-0.992; OR=0.061, 95% CI: 0.004-0.939; OR=0.891, 95% CI: 0.795-0.999).The AUC of the prediction model constructed was 0.877, with a sensitivity of 94.12% and a specificity of 68.52%. Conclusions:Lower FSH, LH and TES levels are risk factors for the micropenis after mild hypospadias surgery, and preoperative hormone levels have higher predictive value.

Objective To investigate the correlation between the expression of microRNA-4319(miRNA-4319)and microRNA-4262(miRNA-4262)in early gastric carcinoma tissue and postoperative recurrence after endoscopic submucosal dissection(ESD).Methods From May 2018 to March 2020,396 patients with early gastric carcinoma who underwent ESD were regarded as the disease group,meantime,98 patients with normal gastric mucosa gastritis confirmed by pathological examination were as the control group.Quantitative reverse transcription polymerase chain reaction(qRT-PCR)method was applied to detect the relative expression levels of miRNA-4319 and miRNA-4262 in tissues;follow up on postoperative recurrence of early gastric carcinoma patients,and the expression levels and clinical pathological characteristics of miRNA-4319 and miRNA-4262 were compared between recurrent and non recurrent patients.Multivariate Logistic regression analysis was applied to analyze the influencing factors of recurrence in early gastric carcinoma patients after ESD;receiver operating characteristic curve(ROC curve)was applied to analyze the predictive value of miRNA-4319 and miRNA-4262 in early gastric carcinoma tissue for recurrence after ESD.Results The expression levels of miRNA-4319 and miRNA-4262 in the disease group were lower than those in the control group,the differences were statistically significant(P＜0.05);The expression levels of miRNA-4319 and miRNA-4262 in the recurrence group were decreased,and the proportion of submucosal invasion was increased,the differences were statistically significant(P＜0.05).The depth of invasion to the submucosal level(OR=3.158,95％CI:1.395～7.151)was a risk factor for recurrence after ESD in patients with early gastric carcinoma(P＜0.05),and miRNA-4262 ≥ 0.76(OR=0.561,95％CI:0.370～0.852)and miRNA-4319 ≥ 0.69(OR=0.482,95％CI:0.255～0.911)were protective factors for recurrence after ESD in patients with early gastric carcinoma(P＜0.05);The area under the curve(AUC)of miRNA-4319,miRNA-4262 and their combination for predicting recurrence after ESD in patients with early gastric carcinoma was 0.889(95％CI:0.854～0.918),0.914(95％CI:0.882～0.940)and 0.964(95％CI:0.940～0.980),respectively,which was superior to the individual predictions of miRNA-4319 and miRNA-4262 respectively(P＜0.05).Conclusion MiRNA-4319 and miRNA-4262 are low expressed in tissues of early gastric carcinoma patients,they are closely related to postoperative recurrence after ESD.

Gout significantly impacts both physical health and quality of life,while current pharmacological treatments face notable limitations.TCM non-pharmacological therapies have shown promising potential in the management of gout,offering diverse approaches with favorable efficacy.This article summarized the characteristics,clinical efficacy and mechanisms of different TCM non-pharmacological therapies for treating gout.Recent studies suggest that these therapies may be applied across all clinical stages of gout.During the acute phase,they can rapidly reduce joint inflammation and relieve pain.In the intercritical phase,they help prevent recurrence,decrease the frequency of attacks,and shorten episode duration.In the chronic tophaceous phase,they alleviate persistent symptoms,improve joint function,and support minimally invasive tophi removal.TCM non-pharmacological therapies have their own characteristics and good safety,and can be combined for clinical use,providing TCM treatment strategies for gout.

Knee osteoarthritis is a common joint disease within osteoarthritis,characterized by pain,swelling,and limited functionality as the main clinical manifestations.In severe cases,it affects daily life and falls under the category of"impediment syndrome"or"bone impediment"in TCM.The author believes that the theory of"bones,tendons,and muscles"is closely related to this disease.Treatment should focus on simultaneously nourishing the liver,spleen and kidneys,considering tendons,bones and muscles,while also dispelling wind,cold and dampness.The clinical application of Sanbi Decoction has shown good efficacy,and this discussion aimed to provide ideas for the diagnosis and treatment of knee osteoarthritis.

Objective To construct an evidence-based practice program of discharge preparation services for hip replacement patients based on the best evidence,and to evaluate its clinical effects,aiming to provide references for the implementation of relevant interventions.Methods Knowledge to Action Framework was used as a guide to summarise the best evidence on discharge preparation services for hip replacement patients and to select services based on clinical context.We selected 38 hip replacement patients and 17 healthcare professionals from the De-partment of Orthopaedic Surgery at a tertiary A hospital in Shanghai in September-October 2023 to conduct a baseline review,identify facilitating and hindering factors,and develop a practice protocol.We also selected 38 hip replacement patients and 17 healthcare professionals from November-December 2023 on this ward for evidence-based practice.Nurses'rates of completion of review indicators,levels of knowledge of discharge preparation ser-vices,and discharge planning competencies were compared before and after practice.Patients'readiness for dis-charge,hip function,and unplanned readmissions were also compared before and after the practice.Results After evidence-based practice,nurses'completion rates of review indicators,knowledge of discharge preparation services,and discharge planning competencies were higher than baseline levels(P＜0.05).Hip replacement patients showed a significant improvement in readiness for discharge and hip function(P＜0.001).Conclusion The implementation of an evidence-based practice program of discharge preparation services improves nurses'knowledge and skills,and also contributes to the discharge readiness and hip function of hip replacement patients.

Knee osteoarthritis is a common joint disease within osteoarthritis,characterized by pain,swelling,and limited functionality as the main clinical manifestations.In severe cases,it affects daily life and falls under the category of"impediment syndrome"or"bone impediment"in TCM.The author believes that the theory of"bones,tendons,and muscles"is closely related to this disease.Treatment should focus on simultaneously nourishing the liver,spleen and kidneys,considering tendons,bones and muscles,while also dispelling wind,cold and dampness.The clinical application of Sanbi Decoction has shown good efficacy,and this discussion aimed to provide ideas for the diagnosis and treatment of knee osteoarthritis.

Objective:To analyze the correlation between sex hormone levels and micropenis after mild hypospadias surgery in children.Methods:A case control study was carried out.The clinical data of 71 children aged 1 to 13 years who underwent mild hypospadias surgery at the First Affiliated Hospital of Xinxiang Medical University from April 2022 to April 2024 were analyzed.Preoperatively, the children were divided into a mild hypospadias group (Group A) and a mild hypospadias with micropenis group (Group B) based on the stretched penile length (SPL).Prolactin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), progesterone, and testosterone (TES) levels of the 2 groups were measured.Multivariate Logistic regression analysis was used to construct a risk prediction model.The discrimination capability of the model was evaluated using the receiver operating characteristic (ROC) curve.SPL and sex hormone levels were measured again 6 months after surgery.The children were divided into a normal penile group (Group AA) and a micropenis group (Group BB) after mild hypospadias according to SPL.Multivariate Logistic regression analysis was used to construct a risk prediction model, which was evaluated using the ROC curve.Results:The levels of FSH, LH and TES in group A before the operation were 3.28(2.02, 4.46) IU/L, 0.53(0.25, 0.79) IU/L and 25.24(17.94, 36.67) ng/dL, respectively, and those in group B were 1.42(1.10, 1.84) IU/L, 0.14(0.09, 0.23) IU/L and 15.73 (12.92, 17.00) ng/dL, respectively.The difference was all statistically significant (all P<0.05).Multivariate Logistic regression analysis showed statistical significance ( OR=0.515, 95% CI: 0.271-0.977; OR=0.035, 95% CI: 0.002-0.542; OR=0.883, 95% CI: 0.796-0.980).The area under the ROC curve (AUC) of the prediction model was 0.906, with a sensitivity of 75.00% and a specificity of 95.74%.The levels of FSH, LH and TES in the postoperative AA group were 2.97 (1.88, 4.28) IU/L, 0.46 (0.23, 0.78) IU/L and 20.92 (17.34, 33.27) ng/dL, respectively.The median levels of FSH, LH and TES in the BB group were 1.52 (1.27, 1.82) IU/L, 0.17 (0.12, 0.26) IU/L and 15.08(11.68, 16.68) ng/dL, respectively.The difference was all statistically significant (all P<0.05).Multivariate Logistic regression analysis showed statistical significance ( OR=0.484, 95% CI: 0.236-0.992; OR=0.061, 95% CI: 0.004-0.939; OR=0.891, 95% CI: 0.795-0.999).The AUC of the prediction model constructed was 0.877, with a sensitivity of 94.12% and a specificity of 68.52%. Conclusions:Lower FSH, LH and TES levels are risk factors for the micropenis after mild hypospadias surgery, and preoperative hormone levels have higher predictive value.

Objective To construct an evidence-based practice program of discharge preparation services for hip replacement patients based on the best evidence,and to evaluate its clinical effects,aiming to provide references for the implementation of relevant interventions.Methods Knowledge to Action Framework was used as a guide to summarise the best evidence on discharge preparation services for hip replacement patients and to select services based on clinical context.We selected 38 hip replacement patients and 17 healthcare professionals from the De-partment of Orthopaedic Surgery at a tertiary A hospital in Shanghai in September-October 2023 to conduct a baseline review,identify facilitating and hindering factors,and develop a practice protocol.We also selected 38 hip replacement patients and 17 healthcare professionals from November-December 2023 on this ward for evidence-based practice.Nurses'rates of completion of review indicators,levels of knowledge of discharge preparation ser-vices,and discharge planning competencies were compared before and after practice.Patients'readiness for dis-charge,hip function,and unplanned readmissions were also compared before and after the practice.Results After evidence-based practice,nurses'completion rates of review indicators,knowledge of discharge preparation services,and discharge planning competencies were higher than baseline levels(P＜0.05).Hip replacement patients showed a significant improvement in readiness for discharge and hip function(P＜0.001).Conclusion The implementation of an evidence-based practice program of discharge preparation services improves nurses'knowledge and skills,and also contributes to the discharge readiness and hip function of hip replacement patients.