Objective To analyze the clinical efficacy and safety of transurethral blue laser vaporization of prostate (BVP) in the treatment of benign prostatic hyperplasia (BPH), and to explore the feasibility of its promotion in primary hospitals. Methods Clinical data of 30 BPH patients undergoing BVP in our hospital during Sep. and Dec. 2024 were retrospectively analyzed. The preoperative prostate volume, decrease in hemoglobin level 2 hours after operation, operation time, postoperative bladder irrigation time, catheter indwelling time, and intra-/postoperative complications were recorded. The changes of international prostate symptom score (IPSS), quality of life (QoL) score, and maximum urinary flow rate (Qmax) were compared before operation and 6 months after operation. Results The mean prostate volume was (46.9±15.7) mL. BVP was successfully completed in 28 patients. The 2 unsuccessful cases (6.7%) converted to transurethral resection of the prostate (TURP) due to intraoperative bleeding. For the 28 successful cases, the median postoperative 2-hour hemoglobin decrease was 4 (2, 11) g/L, mean operation time (59.8±13.2) min, median postoperative bladder irrigation time 21 (18, 23) h, median postoperative catheter indwelling time 5 (5, 5) d, and median postoperative hospital stay 6 (5, 6) d. After catheter removal, urinary retention with infection occurred in 1 case (3.6%), and hemorrhage in 1 case (3.6%). No severe complications occurred during the perioperative period. At 6 months postoperatively, the 28 patients showed significant improvement compared to preoperative values in IPSS[11 (10, 11) vs. 22 (21, 26), P＜0.001], QoL score[2 (2, 3) vs. 5 (5, 6), P＜0.001], and Qmax[ (17.2±5.6) mL/s vs. (7.8±1.4) mL/s, P＜0.001]. Conclusion BVP is a safe and effective treatment for BPH, offering advantages such as minimal blood loss, short operation time, and few complications. It effectively improves patients' lower urinary tract symptoms and quality of life, and is recommended for promotion in primary hospitals.

Liver transplantation is a radical treatment for progressive and irreversible end-stage liver disease. However, its clinical application has always been restricted by the core bottleneck of donor liver shortage. Living donor liver transplantation can alleviate the shortage of donor livers to a certain extent, but it requires simultaneous assurance of sufficient residual liver volume in donors to avoid liver insufficiency, as well as an adequate graft-to-recipient weight ratio to prevent small-for-size syndrome, which limits its clinical application. Dual-donor liver transplantation utilizes partial liver tissues from two donors as grafts. While ensuring donor safety, avoiding small-for-size syndrome in recipients, and expanding the donor pool, this technique significantly improves the utilization rate of donor livers and effectively eases the clinical contradiction of donor liver shortage. Based on recent domestic and international clinical practices and the latest diagnosis and treatment guidelines, this article systematically reviews the developmental background, donor and recipient evaluation and selection, surgical procedures and postoperative complications of dual-donor liver transplantation, aiming to provide references for the standardized promotion and clinical optimization of this technique.

Liver transplantation remains the optimal clinical treatment for patients with terminal liver diseases.Decades of persistent efforts from experts worldwide have propelled continuous innovation and advancement in this field.Chinese liver transplantation teams have achieved significant progress in the clinical liver transplantation.As organ transplantation enters its Era 2.0,ischemia-free organ transplantation has been expanded beyond the liver to include heart,lung,kidney and other transplantations,demonstrating broad application potential.Ischemia-free liver transplantation(ILFT)mitigates cell damage and postoperative complications associated with ischemia-reperfusion injury by maintaining continuous blood perfusion of the donor liver throughout procurement,preservation,and transplantation.This innovation also expands the utilization of marginal donor livers(e.g.,those from aged donors or with adipose infiltration),thereby alleviating donor shortage.Despite these advantages,ILFT faces challenges,including technical complexity,high equipment costs,and the absence of large-scale,multicenter long-term follow-up data.More effort should be put into optimizing portable perfusion systems,establishing standardized protocols,and investigating the synergistic potential of ILFT with immunomodulatory therapies.As the ILFT technology matures,it will improve liver transplantation outcomes,expand the donor pool,and enhance recipients'quality of life.This review presents the development of ILFT,criteria for donor and recipient selection,surgical techniques,and postoperative complications to lay a foundation for its broader clinical application.

BACKGROUND: The proportion of patients with non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations is relatively high in China. However, these patients currently lack significant benefits from available neoadjuvant treatment options. This study aims to explore the potential application value of neoadjuvant targeted therapy by evaluating its efficacy and safety in patients with EGFR-mutant resectable lung adenocarcinoma. METHODS: A multicenter retrospective study was used to analyze the treatment effect of patients with stage IIA-IIIB EGFR-mutant lung adenocarcinoma who underwent surgical resection after receiving neoadjuvant targeted therapy from July 2019 to October 2024. RESULTS: A total of 24 patients with EGFR-mutant lung adenocarcinoma from three centers were included in this study. All patients successfully underwent surgery and achieved R0 resection of 100.0%. The objective response rate (ORR) was 83.3% (20/24) . The major pathologic response (MPR) rate was 37.5% (9/24), with 2 patients (8.3%) achieving pathological complete response (pCR). During neoadjuvant therapy, 13 out of 24 patients (54.2%) experienced adverse events of grade 1-2, with no occurrences of ≥ grade 3. The most common treatment-related adverse events were rash (n=4, 16.7%), mouth sores (n=2, 8.3%), and diarrhea (n=2, 8.3%). The median follow-up time was 33.0 months, no deaths occurred in all patients, and the overall survival (OS) rate was 100.0%. The 1-year disease-free survival (DFS) rate was 91.1%, and the 2-year DFS rate remained at 86.2%. CONCLUSIONS The application of neoadjuvant targeted therapy in patients with EGFR-mutant resectable lung adenocarcinoma is safe and feasible, and is expected to become a highly promising neoadjuvant treatment option for the patients with EGFR-mutant lung adenocarcinoma.
Humans ; ErbB Receptors/metabolism* ; Male ; Female ; Middle Aged ; Adenocarcinoma of Lung/surgery* ; Neoadjuvant Therapy ; Lung Neoplasms/surgery* ; Aged ; Retrospective Studies ; Mutation ; Adult

Liver transplantation remains the optimal clinical treatment for patients with terminal liver diseases.Decades of persistent efforts from experts worldwide have propelled continuous innovation and advancement in this field.Chinese liver transplantation teams have achieved significant progress in the clinical liver transplantation.As organ transplantation enters its Era 2.0,ischemia-free organ transplantation has been expanded beyond the liver to include heart,lung,kidney and other transplantations,demonstrating broad application potential.Ischemia-free liver transplantation(ILFT)mitigates cell damage and postoperative complications associated with ischemia-reperfusion injury by maintaining continuous blood perfusion of the donor liver throughout procurement,preservation,and transplantation.This innovation also expands the utilization of marginal donor livers(e.g.,those from aged donors or with adipose infiltration),thereby alleviating donor shortage.Despite these advantages,ILFT faces challenges,including technical complexity,high equipment costs,and the absence of large-scale,multicenter long-term follow-up data.More effort should be put into optimizing portable perfusion systems,establishing standardized protocols,and investigating the synergistic potential of ILFT with immunomodulatory therapies.As the ILFT technology matures,it will improve liver transplantation outcomes,expand the donor pool,and enhance recipients'quality of life.This review presents the development of ILFT,criteria for donor and recipient selection,surgical techniques,and postoperative complications to lay a foundation for its broader clinical application.

Objective:To explore the effects of type D personality on mild cognitive dysfunction (MCI) in patients with coronary heart disease and the multiple mediating roles of dietary inflammation index (DII) and systemic immune inflammation index (SII) between type D personality and MCI.Methods:A cross-sectional study was used. A total of 321 patients diagnosed with coronary heart disease by coronary angiography in the Second Affiliated Hospital of Harbin Medical University from May 2022 to March 2023 were selected as the study objects by convenient sampling method. General Information Questionnaire, Type-D Personality Scale-14, Montreal Cognitive Assessment, and Semi-Quantitative Food Frequency Questionnaire were employed for data collection. DII and SII were used to evaluate dietary inflammatory potential and systemic inflammatory status, respectively. Structural equation modeling was utilized to analyze the mediating effectsamong type D personality, DII, SII and MCI.Results:A total of 306 valid questionnaires were collected. Among the 306 patients, there were 215 males (70.3%) and 91 females (29.7%), aged 27-70 (59.24 ± 9.16) years old. The structural equation model showed that type D personality could directly influence MCI (effect size = - 1.098, 95% CI - 1.869 - - 0.327), and could also mediate the occurrence of MCI in coronary heart disease patients through the single mediation of DII (effect size = - 0.374, 95% CI - 0.644 - - 0.128) and SII (effect size = - 0.450, 95% CI - 0.806 - - 0.132), as well as the chain mediation of DII and SII (effect size = - 0.146, 95% CI - 0.293 - - 0.027). Conclusions:Type D personality, DII and SII can affect the occurrence of MCI in CHD patients, and DII and SII play multiple mediating roles between type D personality and MCI in patients with coronary heart disease. Clinical and community nurses can improve the unhealthy dietary behavior, reduce the level of inflammation and delay the occurrence and development of MCI by early screening of type D personality in patients with coronary heart disease.

Klebsiella pneumoniae(KPn),as a conditioned pathogen that causes calf pneumonia,has caused serious harm to cattle industry,but the harm of Klebsiella pneumoniae to calves in Xin-jiang region is still unclear.In this study,to investigate the prevalence of KPn,its harm and some biological characteristics of pneumonia calves in Xinjiang,nasal swabs of pneumonia calves in some areas were collected aseptically,KPn isolation and identification were performed by routine meth-od,and 16S rDNA sequence evolutionary tree analysis was performed.The drug resistance was de-tected by K-B method,and a strain carrying multiple virulence was selected for mice median lethal dose test.The serotype,virulence gene and drug resistance gene of the strain were detected by PCR.The results showed that the detection rate of Klebsiella pneumoniae in nasal swabs of 218 pneumonia calves from Aksu,Changji and Yili regions of Xinjiang was as follows:14.68％(32/218),including 28.33％(17/60)in Aksu Prefecture,24.00％(6/25)in Changji Prefecture and 6.77％(9/133)in Yili Prefecture,they were divided into two serotypes,namely K1(7/32)and K5(5/32).A total of 13 KPn virulence genes were detected,mainly mrkD,ureA,wabG,uge and en-tB.LD50 was 2.38X 107cfu/mL.Drug susceptibility test and drug resistance gene detection showed that the isolated strain showed multiple drug resistance,and the resistance genes mainly carried blasHv and floR.16S rDNA sequence evolutionary tree results showed that the isolated strain had high homology with the isolates from Italy,Beijing and Shanghai of China.The detection rate of KPn in nasal swabs of pneumonia calves in Xinjiang region is high.The dominant serotypes are K1 and K5.The isolates carry a variety of virulence genes and have strong virulence.All of them are KPn strains producing ESBLs,suggesting that Klebsiella pneumoniae in Xinjiang region of China have a certain potential harm to calves.

This paper summarized Professor LI Yueqing's clinical experience in treating prostate cancer by stages from the perspective of deficiency and stasis. It is believed that the onset of prostate cancer is due to kidney deficiency， while blood stasis is the core pathogenesis， and dampness-heat， phlegm-turbid， and cancer toxins are the key pathological factors in the progression of the disease. The pathogenesis in the early stage of the disease is kidney qi depletion and dampness， heat and phlegm coagulation； in the middle stage， it is spleen and kidney depletion， phlegm coagulation and blood stasis； and in the late stage， the pathogenesis changes into yin deficiency and essence depletion， and stasis-turbid toxin obstruction. For treatment， the basic principle is to supplement and boost kidney qi， enrich and nourish the kidney yin. The main treatment methods are draining dampness， dissolving phlegm， dispelling stasis， clearing heat and resolving toxins， and the method of invigorating blood and dispelling stasis runs through the whole course of treatment. In the early stage， radical treatment is mainly used， and Longshe Yangquan Decoction （龙蛇羊泉汤） with modifications is supplemented to clear and drain dampness and heat. In the middle stage， androgen deprivation therapy is the basic treatment， and Bushen Tongqiao Decoction （补肾通窍汤） with modifications is used in combination to nourish the spleen and kidney， dissolve phlegm and dispel stasis. In the late stage， Dabuyin Pills and Liuwei Dihuang Pills （大补阴丸合六味地黄丸） with modifications is mainly used to enrich yin and supplement essence， resolve toxins and dissolve stasis， and prevent cancer recurrence.

Objective To propose a CT truncated data reconstruction model(DDTrans)based on projection and image dual-domain Transformer coupled feature learning for reducing truncation artifacts and image structure distortion caused by insufficient field of view(FOV)in CT scanning.Methods Transformer was adopted to build projection domain and image domain restoration models,and the long-range dependency modeling capability of the Transformer attention module was used to capture global structural features to restore the projection data information and enhance the reconstructed images.We constructed a differentiable Radon back-projection operator layer between the projection domain and image domain networks to enable end-to-end training of DDTrans.Projection consistency loss was introduced to constrain the image forward-projection results to further improve the accuracy of image reconstruction.Results The experimental results with Mayo simulation data showed that for both partial truncation and interior scanning data,the proposed DDTrans method showed better performance than the comparison algorithms in removing truncation artifacts at the edges and restoring the external information of the FOV.Conclusion The DDTrans method can effectively remove CT truncation artifacts to ensure accurate reconstruction of the data within the FOV and achieve approximate reconstruction of data outside the FOV.