Prostate cancer is the second most common malignancy and the sixth leading cause of cancer-related death in men worldwide. Radical prostatectomy (RP) is the standard treatment for localized prostate cancer, but the procedure often results in postoperative erectile dysfunction (ED). The poor efficacy of phosphodiesterase 5 inhibitors after surgery highlights the need to develop new therapies to enhance cavernous nerve regeneration and improve the erectile function of these patients. In the present study, we aimed to examine the potential of heparin-binding epidermal growth factor-like growth factor (HB-EGF) in preserving erectile function in cavernous nerve injury (CNI) mice. We found that HB-EGF expression was reduced significantly on the 1 st day after CNI in penile tissue. Ex vivo and in vitro studies showed that HB-EGF promotes major pelvic ganglion neurite sprouting and neuro-2a (N2a) cell migration. In vivo studies showed that exogenous HB-EGF treatment significantly restored the erectile function of CNI mice to 86.9% of sham levels. Immunofluorescence staining showed that mural and neuronal cells were preserved by inducing cell proliferation and reducing apoptosis and reactive oxygen species production. Western blot analysis showed that HB-EGF upregulated protein kinase B and extracellular signal-regulated kinase activation and neurotrophic factor expression. Overall, HB-EGF is a major promising therapeutic agent for treating ED in postoperative RP.
Animals ; Male ; Heparin-binding EGF-like Growth Factor/therapeutic use* ; Erectile Dysfunction/etiology* ; Mice ; Penis/drug effects* ; Nerve Regeneration/drug effects* ; Penile Erection/drug effects* ; Peripheral Nerve Injuries/drug therapy* ; Cell Proliferation/drug effects* ; Apoptosis/drug effects* ; Cell Movement/drug effects* ; Prostatectomy/adverse effects* ; Mice, Inbred C57BL ; Reactive Oxygen Species/metabolism*

Background and Aims:Acute inferior vena cava thrombosis(IVCT)commonly occurs secondary to inferior vena cava filter(VCF)implantation.If not promptly treated,it may lead to serious complications such as bilateral lower limb swelling and pulmonary embolism and can also reduce the likelihood of successful filter retrieval.Percutaneous mechanical thrombectomy(PMT)and catheter-directed thrombolysis(CDT)are currently the main interventional treatments for IVCT,but comparative studies evaluating their efficacy and safety remain limited.This study was to conduct a prospective randomized controlled trial to compare the clinical efficacy and safety of AngioJet mechanical thrombectomy versus conventional CDT in the treatment of acute IVCT and to explore factors influencing filter retrieval rates,thereby providing evidence-based guidance for clinical decision-making.Methods:From January 2022 to December 2024,patients diagnosed with acute IVCT following VCF implantation were prospectively enrolled at the Department of Vascular Surgery,Beijing Jishuitan Hospital,Capital Medical University.Patients were randomly assigned to either the CDT group(n=46)or the PMT group(n=48)according to the interventional procedure used.The two groups were compared in terms of filter retrieval rates,thrombus clearance outcomes,operative time,thrombolytic drug dosage,and incidence of complications.Logistic regression analysis was used to identify factors associated with primary filter retrieval.Results:A total of 94 patients were enrolled,with 46 in the CDT group and 48 in the PMT group.Compared to the CDT group,the PMT group demonstrated a significantly higher primary filter retrieval rate(77.1%vs.43.5%),grade Ⅲ thrombus clearance rate(70.8%vs.37.0%),and better postoperative thrombus scores.Additionally,the PMT group required lower urokinase doses and shorter thrombolysis duration(all P<0.05).The overall filter retrieval rate and 3-month IVC patency were similar between groups,both exceeding 93%.Regarding safety,the CDT group had a higher incidence of catheter-related infections and medical adhesive-related skin injury,while vagal reflex symptoms were more frequent in the PMT group.Logistic regression analysis identified thrombus clearance rate as an independent factor significantly associated with primary filter retrieval in the PMT group(OR=190.773,P<0.05).Conclusion:Compared to CDT,AngioJet mechanical thrombectomy combined with manual aspiration achieves higher thrombus clearance and primary filter retrieval rates in the treatment of acute IVCT while also reducing thrombolysis duration and drug dosage.However,attention should be paid to the increased risk of vagal reflex symptoms.There was no significant difference between the two groups in secondary filter retrieval rates or long-term IVC patency.The choice of intervention should be based on the patient's condition,timing of filter retrieval,and individualized clinical considerations.

Objective To explore the correlation between tongue features of type 2 diabetes patients with coronary heart disease and glycosylated hemoglobin,liver function,blood lipids,C-reactive protein,so as to provide reference for related research.Methods Using the TFDA-1 tongue imaging device to collect patients'tongue images,experts will interpret the tongue images and extract objective parameters of the tongue images through the intelligent auxiliary diagnosis system of traditional Chinese medicine tongue diagnosis;Record patient laboratory indicators and use SPSS statistical software to analyze the correlation between tongue image distribution characteristics,tongue image parameter characteristics,and laboratory indicators using Spearman method.Results 702 patients with type 2 diabetes and coronary heart disease were included.In terms of glycated hemoglobin indicators,bruising parameters are positively correlated with HbA1c,while tongue tip RGB values are negatively correlated with HbA1c.In terms of liver function indicators,tongue edge redness,tongue tip and tongue texture R value are positively correlated with ALT and AST;Red tongue tip,tooth marks on the tongue,etc.are positively correlated with ALT;Fat tongue is positively correlated with AST.In terms of blood lipid indicators,parameters such as tooth mark tongue and tooth mark are positively correlated with TG;The parameters of white coating and tongue coating area are positively correlated with LDL-C;Thin coating is positively correlated with HDL-C,while thick coating is negatively correlated with HDL-C;Red tongue is negatively correlated with TCHO.In terms of C-reactive protein,red tongue,tip red,and edge red are positively correlated with CRP;The GB value of tongue root and tongue substance is negatively correlated with CRP.Conclusion Type 2 diabetes patients with coronary heart disease have tongue picture distribution,tongue shape parameters,tongue color parameters,coating color parameters and HbA1c,ALT,AST,TCHO,TG,HDL-C,LDL-C,CRP indicators in varying degrees of correlation.The combination of patients'tongue picture and laboratory indicators is helpful to clarify the diagnosis and prognosis of type 2 diabetes with coronary heart disease.

Objective:To analyze pain factors and changes in humoral immunity in patients with postherpetic neuralgia (PHN).Methods:A retrospective study was conducted involving 120 patients with herpes zoster (HZ) admitted to Xi'an Daxing Hospital from February 2022 to February 2024. Among these patients, 60 who developed PHN symptoms within 3 months after recovering from HZ were designated as the complication group, while 60 who did not develop PHN symptoms after recovering from HZ were designated as the simple group. Additionally, 60 healthy volunteers who underwent physical examinations during the same period were included as the healthy group. Both the combination and simple groups received treatment for 1 month. Pain mediators [β-endorphin (β-EP), substance P (SP), serotonin (5-HT), calcitonin gene-related peptide (CGRP), and neurosecretory protein VGF], inflammatory factors [tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and interferon-gamma (IFN-γ)], immunoglobulins (IgA, IgG, IgM), and T cell subsets (CD 3+, CD 4+, CD 8+, and CD 4+/CD 8+) were collected and compared among the three groups. Results:There were significant differences in the levels of β-EP, SP, 5-HT, CGRP, and VGF among the three groups ( F = 377.44, 988.37, 699.86, 800.74, 1421.88, all P < 0.05). The serum levels of TNF-α [(199.62 ± 21.13) μg/L and (194.61 ± 20.73) μg/L], IL-6 [(77.08 ± 12.91) μg/L and (58.70 ± 12.38) μg/L], and IFN-γ [(54.27 ± 6.21) mg/L and (29.17 ± 4.55) mg/L] in the complication and simple groups were significantly higher than those in the healthy group [(92.13 ± 11.54) μg/L, (46.13 ± 10.23) μg/L, and (12.58 ± 1.75) μg/L, all P < 0.05]. Additionally, the levels of IgA, IgG, IgM, and complement proteins (C3, C4) also showed statistically significant differences among the three groups ( F = 454.20, 237.78, 182.90, 33.11, 275.26, all P < 0.05). There was no statistically significant difference in cellular immunity levels between the simple and complication groups ( P > 0.05). However, the levels of T cell subsets (CD 3+, CD 4+, CD 8+) in both the simple and complication groups were lower than those in the healthy group, while the CD 4+/CD 8+ ratios were significantly higher in both the simple and complication groups compared to the healthy group (all P < 0.05). Pearson correlation analysis revealed that the serum level of β-EP was significantly negatively correlated with the serum levels of TNF-α, IL-6, IFN-γ, IgA, IgG, IgM, C3, and C4 (all P < 0.05). In contrast, the serum levels of SP, 5-HT, CGRP, and VGF were significantly positively correlated with the serum levels of TNF-α, IL-6, IFN-γ, IgA, IgG, IgM, C3, and C4 (all P < 0.05). Conclusions:The pain factors β-EP, SP, 5-HT, CGRP, and VGF, as well as the inflammatory cytokines TNF-α, IL-6, and IFN-γ, play important roles in the occurrence and persistence of neuropathic pain in patients with postherpetic neuralgia. The levels of immunoglobulins and T cell subsets in these patients serve as important indicators for analyzing changes in humoral immunity.

Objective:This study analyzed the clinical characteristics and early mortality risk factors in patients with hyperleukocytic acute leukemia (HAL) to provide a basis for predicting early prognosis.Methods:Data were retrospectively collected from 211 patients with primary HAL who visited the Emergency Center of the Hematology Hospital, Chinese Academy of Medical Sciences, between July 1, 2019 and November 30, 2021. The value of each indicator in early risk stratification and prognosis was analyzed.Results:The early-death group exhibited higher WBC, peripheral blood immature cell proportions, prothrombin times (PT), fibrinogen degradation products (FDP), and D-dimer levels than the non-early death group ( P<0.05). Mortality in hyperleukocytic AML (20.5% ) was significantly higher than that in hyperleukocytic ALL (9.3% ) ( P<0.05). There were significant differences in age, creatinine, PT, fibrinogen (FIB) levels, WBC, lactic dehydrogenase (LDH), uric acid, blood potassium, blood calcium, and blood phosphorus levels between the two groups of patients ( P<0.05). A WBC threshold of 255.96×10?/L predicted early mortality with 65.6% sensitivity and 69.0% specificity, with higher WBC levels associated with a 5.164-fold increased mortality risk ( P<0.05). The age, WBC, LDH, urea, PT, FDP and D-dimer of patients at the time of consultation are risk factors affecting the survival of HAL ( P<0.05) . Conclusion:HAL is a life-threatening condition with a high early mortality. Age, WBC, LDH, urea, PT, FDP and D-dimer are risk factors for early death in HAL.

Objective:To establish a three-dimensional navigation process for design and resection of perforator flaps based on multi-detector computed tomography angiography (MDCTA) and to explore its clinical application effects.Methods:This study was a retrospective observational study. From January 2021 to October 2023, 7 patients and 6 patients with post-traumatic skin and soft tissue defects in extremity and conformed to the inclusion criteria were admitted to the Affiliated Hospital of Jiangsu University and Wuxi No. 9 People's Hospital, respectively. There were 8 males and 5 females, aged 21 to 68 years. Nine patients had wounds on the hand and 4 patients had wounds on the foot. The wound area after debridement ranged from 8.0 cm×6.0 cm to 18.0 cm×17.0 cm. Through the three-dimensional navigation process based on MDCTA, 14 perforator flaps were designed and resected, including 11 free anterolateral thigh perforator flaps and 3 pedicled peroneal artery perforator flaps with sural nerve nutritional vessel chain, with flap size ranging from 9.0 cm×6.0 cm to 20.0 cm×15.0 cm. Six wounds in the flap donor sites were directly sutured, and eight wounds in the flap donor sites were transplanted with skin grafts. The consistency of the location, type, and source of the perforators was compared between the preoperative navigation display and actual intraoperative detection. Immediately after surgery, the coverage of wound by the flap was evaluated according to the self-made criteria. The postoperative flap survival was observed. The occurrence of complications was observed during follow-up. At the last follow-up, the appearance of the flaps was observed, the blood supply of the flaps and the hand function of the 9 patients with hand trauma were evaluated according to the trial standards for evaluation of partial function of upper extremity by the Hand Surgery Society of Chinese Medical Association, and the foot function of the 4 patients with foot trauma was assessed using the American Orthopaedic Foot & Ankle Society Ankle-Hindfoot Scoring System.Results:The location, type, and source of the perforators displayed in preoperative navigation were consistent with the actual intraoperative detection. Immediately after surgery, the coverage of the wounds by 11 flaps was rated as excellent, and that of 3 flaps was rated as moderate. Postoperatively, 13 flaps survived completely, and 1 flap had partial necrosis, which healed after a full-thickness skin grafting from the thigh. Patients were followed up for 4 to 24 months postoperatively, one patient developed a hematoma under the flap, and one patient had local infection. At the last follow-up, the flaps of all patients were good in color and texture, and 5 patients with bloated flaps post operation had good appearance after thinning surgery; the blood supply was excellent in 12 flaps and was good in 2 flaps; among patients with hand trauma, the hand function was rated as excellent in 2 cases, good in 4 cases, and poor in 3 cases; among patients with foot trauma, the foot function was rated as excellent in 3 cases and good in 1 case.Conclusions:The three-dimensional navigation process for design and resection of perforator flaps based on MDCTA realizes precise evaluation of perforator vessels in flap donor sites and skin and soft tissue defects in the recipient sites. Guided by the three-dimensional navigation process, the application of free anterolateral thigh perforator flaps and pedicled peroneal artery perforator flaps with sural nerve nutritional vessel chain in repairing skin and soft tissue defects in extremity realizes precise surgery, reducing flap donor site injury and achieving excellent clinical outcomes.

Metabolic dysfunction-associated steatotic liver disease(MASLD)is a chronic liver condition intricately linked to metabolic abnormalities such as obesity,type 2 diabetes,dyslipidemia,and hypertension.The global prevalence of MASLD continues to rise,posing a significant public health challenge.The pathogenesis of MASLD is multifactorial,with the"multiple-hit"hypothesis suggesting that hepatic lipid accumulation,insulin resistance,oxidative stress,gut microbiota dysbiosis,and genetic factors collectively drive disease progression.Currently,clinical management primarily relies on lifestyle interventions;however,there is a lack of targeted pharmacological interventions,and there is an urgent need to investigate novel adjunctive therapeutic strategies.In recent years,probiotics have demonstrated potential value in MASLD treatment due to their capacity to modulate gut microbiota,enhance insulin sensitivity,and reduce liver inflammation.This review systematically examines the pathogenesis of MASLD and the limitations of existing therapeutic approaches,synthesizing the latest evidence of probiotics-assisted therapy for MASLD from the perspectives of animal studies and clinical trials.By analyzing the target mechanisms and molecular pathways of different strains(e.g.,Bifidobacterium,Lactobacillus),this review explores the translational potential of probiotics in MASLD treatment,aiming to provide a theoretical foundation and future research directions.

Background and Aims:Acute inferior vena cava thrombosis(IVCT)commonly occurs secondary to inferior vena cava filter(VCF)implantation.If not promptly treated,it may lead to serious complications such as bilateral lower limb swelling and pulmonary embolism and can also reduce the likelihood of successful filter retrieval.Percutaneous mechanical thrombectomy(PMT)and catheter-directed thrombolysis(CDT)are currently the main interventional treatments for IVCT,but comparative studies evaluating their efficacy and safety remain limited.This study was to conduct a prospective randomized controlled trial to compare the clinical efficacy and safety of AngioJet mechanical thrombectomy versus conventional CDT in the treatment of acute IVCT and to explore factors influencing filter retrieval rates,thereby providing evidence-based guidance for clinical decision-making.Methods:From January 2022 to December 2024,patients diagnosed with acute IVCT following VCF implantation were prospectively enrolled at the Department of Vascular Surgery,Beijing Jishuitan Hospital,Capital Medical University.Patients were randomly assigned to either the CDT group(n=46)or the PMT group(n=48)according to the interventional procedure used.The two groups were compared in terms of filter retrieval rates,thrombus clearance outcomes,operative time,thrombolytic drug dosage,and incidence of complications.Logistic regression analysis was used to identify factors associated with primary filter retrieval.Results:A total of 94 patients were enrolled,with 46 in the CDT group and 48 in the PMT group.Compared to the CDT group,the PMT group demonstrated a significantly higher primary filter retrieval rate(77.1%vs.43.5%),grade Ⅲ thrombus clearance rate(70.8%vs.37.0%),and better postoperative thrombus scores.Additionally,the PMT group required lower urokinase doses and shorter thrombolysis duration(all P<0.05).The overall filter retrieval rate and 3-month IVC patency were similar between groups,both exceeding 93%.Regarding safety,the CDT group had a higher incidence of catheter-related infections and medical adhesive-related skin injury,while vagal reflex symptoms were more frequent in the PMT group.Logistic regression analysis identified thrombus clearance rate as an independent factor significantly associated with primary filter retrieval in the PMT group(OR=190.773,P<0.05).Conclusion:Compared to CDT,AngioJet mechanical thrombectomy combined with manual aspiration achieves higher thrombus clearance and primary filter retrieval rates in the treatment of acute IVCT while also reducing thrombolysis duration and drug dosage.However,attention should be paid to the increased risk of vagal reflex symptoms.There was no significant difference between the two groups in secondary filter retrieval rates or long-term IVC patency.The choice of intervention should be based on the patient's condition,timing of filter retrieval,and individualized clinical considerations.

Objective To explore the correlation between tongue features of type 2 diabetes patients with coronary heart disease and glycosylated hemoglobin,liver function,blood lipids,C-reactive protein,so as to provide reference for related research.Methods Using the TFDA-1 tongue imaging device to collect patients'tongue images,experts will interpret the tongue images and extract objective parameters of the tongue images through the intelligent auxiliary diagnosis system of traditional Chinese medicine tongue diagnosis;Record patient laboratory indicators and use SPSS statistical software to analyze the correlation between tongue image distribution characteristics,tongue image parameter characteristics,and laboratory indicators using Spearman method.Results 702 patients with type 2 diabetes and coronary heart disease were included.In terms of glycated hemoglobin indicators,bruising parameters are positively correlated with HbA1c,while tongue tip RGB values are negatively correlated with HbA1c.In terms of liver function indicators,tongue edge redness,tongue tip and tongue texture R value are positively correlated with ALT and AST;Red tongue tip,tooth marks on the tongue,etc.are positively correlated with ALT;Fat tongue is positively correlated with AST.In terms of blood lipid indicators,parameters such as tooth mark tongue and tooth mark are positively correlated with TG;The parameters of white coating and tongue coating area are positively correlated with LDL-C;Thin coating is positively correlated with HDL-C,while thick coating is negatively correlated with HDL-C;Red tongue is negatively correlated with TCHO.In terms of C-reactive protein,red tongue,tip red,and edge red are positively correlated with CRP;The GB value of tongue root and tongue substance is negatively correlated with CRP.Conclusion Type 2 diabetes patients with coronary heart disease have tongue picture distribution,tongue shape parameters,tongue color parameters,coating color parameters and HbA1c,ALT,AST,TCHO,TG,HDL-C,LDL-C,CRP indicators in varying degrees of correlation.The combination of patients'tongue picture and laboratory indicators is helpful to clarify the diagnosis and prognosis of type 2 diabetes with coronary heart disease.

Objective:To analyze pain factors and changes in humoral immunity in patients with postherpetic neuralgia (PHN).Methods:A retrospective study was conducted involving 120 patients with herpes zoster (HZ) admitted to Xi'an Daxing Hospital from February 2022 to February 2024. Among these patients, 60 who developed PHN symptoms within 3 months after recovering from HZ were designated as the complication group, while 60 who did not develop PHN symptoms after recovering from HZ were designated as the simple group. Additionally, 60 healthy volunteers who underwent physical examinations during the same period were included as the healthy group. Both the combination and simple groups received treatment for 1 month. Pain mediators [β-endorphin (β-EP), substance P (SP), serotonin (5-HT), calcitonin gene-related peptide (CGRP), and neurosecretory protein VGF], inflammatory factors [tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and interferon-gamma (IFN-γ)], immunoglobulins (IgA, IgG, IgM), and T cell subsets (CD 3+, CD 4+, CD 8+, and CD 4+/CD 8+) were collected and compared among the three groups. Results:There were significant differences in the levels of β-EP, SP, 5-HT, CGRP, and VGF among the three groups ( F = 377.44, 988.37, 699.86, 800.74, 1421.88, all P < 0.05). The serum levels of TNF-α [(199.62 ± 21.13) μg/L and (194.61 ± 20.73) μg/L], IL-6 [(77.08 ± 12.91) μg/L and (58.70 ± 12.38) μg/L], and IFN-γ [(54.27 ± 6.21) mg/L and (29.17 ± 4.55) mg/L] in the complication and simple groups were significantly higher than those in the healthy group [(92.13 ± 11.54) μg/L, (46.13 ± 10.23) μg/L, and (12.58 ± 1.75) μg/L, all P < 0.05]. Additionally, the levels of IgA, IgG, IgM, and complement proteins (C3, C4) also showed statistically significant differences among the three groups ( F = 454.20, 237.78, 182.90, 33.11, 275.26, all P < 0.05). There was no statistically significant difference in cellular immunity levels between the simple and complication groups ( P > 0.05). However, the levels of T cell subsets (CD 3+, CD 4+, CD 8+) in both the simple and complication groups were lower than those in the healthy group, while the CD 4+/CD 8+ ratios were significantly higher in both the simple and complication groups compared to the healthy group (all P < 0.05). Pearson correlation analysis revealed that the serum level of β-EP was significantly negatively correlated with the serum levels of TNF-α, IL-6, IFN-γ, IgA, IgG, IgM, C3, and C4 (all P < 0.05). In contrast, the serum levels of SP, 5-HT, CGRP, and VGF were significantly positively correlated with the serum levels of TNF-α, IL-6, IFN-γ, IgA, IgG, IgM, C3, and C4 (all P < 0.05). Conclusions:The pain factors β-EP, SP, 5-HT, CGRP, and VGF, as well as the inflammatory cytokines TNF-α, IL-6, and IFN-γ, play important roles in the occurrence and persistence of neuropathic pain in patients with postherpetic neuralgia. The levels of immunoglobulins and T cell subsets in these patients serve as important indicators for analyzing changes in humoral immunity.