This study aims to analyze the screening results and epidemiological characteristics of prostate cancer (PCa) among elderly males in the rural areas of Songjiang, Shanghai City, through the implementation of a preliminary prostate-specific antigen (PSA) screening based on a community-linkage model, and to explore an effective screening approach. A retrospective observational study design was employed to collect data from residents who underwent PSA screening at Songjiang Hospital affiliated to Shanghai Jiao Tong University School of Medicine, in collaboration with multiple community health service centers in Songjiang District, Shanghai City, between June 2022 and June 2024, through free clinics and annual health examinations. Prostate biopsy was recommended for individuals with total PSA (tPSA) levels >10 ng/ml and those with 4 ng/ml≤tPSA≤10 ng/ml and abnormal free-to-total PSA (f/tPSA) ratios. Clinical characteristics of detected PCa patients were analyzed. Follow-up was conducted through phone calls and home visits by family doctors, coupled with enhanced health education. The results indicated that a total of 17 198 residents participated in the screening, among which 2 234 (12.99%) had tPSA levels between 4 ng/ml and 10 ng/ml, and 257 (1.49%) had tPSA levels >10 ng/ml. Ultimately, 417 residents underwent prostate biopsy, with 171 being diagnosed with PCa, yielding a positive biopsy rate of 41.00% and a PCa detection rate of 0.99%. The predominant pathological subtype among PCa patients was adenocarcinoma (168 cases, 98.24%). Of the 146 PCa patients who received treatment, the majority were classified as intermediate or high-risk (124 cases, 84.93%). Furthermore, with the optimization of the screening model, there was a significant increase in the proportion of subsequent outpatient visits. In conclusion, the community-linkage-based PSA screening model demonstrated high effectiveness in screening for PCa among elderly males in the rural areas of Songjiang, Shanghai City. Epidemiological findings revealed that PCa patients in this region are primarily composed of intermediate and high-risk groups, highlighting the need for intensified early screening and health education.

This study aims to analyze the screening results and epidemiological characteristics of prostate cancer (PCa) among elderly males in the rural areas of Songjiang, Shanghai City, through the implementation of a preliminary prostate-specific antigen (PSA) screening based on a community-linkage model, and to explore an effective screening approach. A retrospective observational study design was employed to collect data from residents who underwent PSA screening at Songjiang Hospital affiliated to Shanghai Jiao Tong University School of Medicine, in collaboration with multiple community health service centers in Songjiang District, Shanghai City, between June 2022 and June 2024, through free clinics and annual health examinations. Prostate biopsy was recommended for individuals with total PSA (tPSA) levels >10 ng/ml and those with 4 ng/ml≤tPSA≤10 ng/ml and abnormal free-to-total PSA (f/tPSA) ratios. Clinical characteristics of detected PCa patients were analyzed. Follow-up was conducted through phone calls and home visits by family doctors, coupled with enhanced health education. The results indicated that a total of 17 198 residents participated in the screening, among which 2 234 (12.99%) had tPSA levels between 4 ng/ml and 10 ng/ml, and 257 (1.49%) had tPSA levels >10 ng/ml. Ultimately, 417 residents underwent prostate biopsy, with 171 being diagnosed with PCa, yielding a positive biopsy rate of 41.00% and a PCa detection rate of 0.99%. The predominant pathological subtype among PCa patients was adenocarcinoma (168 cases, 98.24%). Of the 146 PCa patients who received treatment, the majority were classified as intermediate or high-risk (124 cases, 84.93%). Furthermore, with the optimization of the screening model, there was a significant increase in the proportion of subsequent outpatient visits. In conclusion, the community-linkage-based PSA screening model demonstrated high effectiveness in screening for PCa among elderly males in the rural areas of Songjiang, Shanghai City. Epidemiological findings revealed that PCa patients in this region are primarily composed of intermediate and high-risk groups, highlighting the need for intensified early screening and health education.

The ethical basis of public health policy is relatively weakness, which is mainly reflected in the conflict between individual rights and public interests, the lack of moral norm, the short of ethical review, the low level of relevant legislation, the weak of ethical consciousness and so on. Therefore, it is necessary to take measures to improve relevant ethical policies and regulations, establish an ethical framework for evaluating public health policies, highlight ethical values and strengthen ethical awareness in public health policy-making. Make it carry a certain ethical dimension to achieve the purposes of maintaining and improving health.

Gas therapy is emerging as a highly promising therapeutic strategy for cancer treatment. However, there are limitations, including the lack of targeted subcellular organelle accuracy and spatiotemporal release precision, associated with gas therapy. In this study, we developed a series of photoactivatable nitric oxide (NO) donors NRh-R-NO (R = Me, Et, Bn, iPr, and Ph) based on an N-nitrosated upconversion luminescent rhodamine scaffold. Under the irradiation of 808 nm light, only NRh-Ph-NO could effectively release NO and NRh-Ph with a significant turn-on frequency upconversion luminescence (FUCL) signal at 740 nm, ascribed to lower N-N bond dissociation energy. We also investigated the involved multistage near-infrared-controlled cascade release of gas therapy, including the NO released from NRh-Ph-NO along with one NRh-Ph molecule generation, the superoxide anion O₂^⋅- produced by the photodynamic therapy (PDT) effect of NRh-Ph, and highly toxic peroxynitrite anion (ONOO^‒) generated from the co-existence of NO and O₂^⋅-. After mild nano-modification, the nanogenerator (NRh-Ph-NO NPs) empowered with superior biocompatibility could target mitochondria. Under an 808 nm laser irradiation, NRh-Ph-NO NPs could induce NO/ROS to generate RNS, causing a decrease in the mitochondrial membrane potential and initiating apoptosis by caspase-3 activation, which further induced tumor immunogenic cell death (ICD). In vivo therapeutic results of NRh-Ph-NO NPs showed augmented RNS-potentiated gas therapy, demonstrating excellent biocompatibility and effective tumor inhibition guided by real-time FUCL imaging. Collectively, this versatile strategy defines the targeted RNS-mediated cancer therapy.

Objective:To evaluate the safety and feasibility of applying injectable cross-linked sodium hyaluronate isolation gel in radical hypofractionated radiation therapy for prostate cancer.Methods:In this prospective study, patients at Beijing Hospital who were pathologically diagnosed with clinical stage T 1-2N 0M 0 prostatic acinar adenocarcinoma by puncture and underwent radical radiation therapy were included. All patients received ultrasound-guided cross-linked sodium hyaluronate isolation gel injection and image-guided intensity-modulated radiation therapy (IG-IMRT). The prescription dose was moderately hypofractionated, with a prescription dose of 60 Gy in 20 fractions for 5 times a week, once daily, which was delivered to 95% of the planning target volume (PTV) of prostate and seminal vesicle. Analyze the prostate rectal spacing (PRS) at the baseline, on the day of injection, during the radiotherapy, 1 month and 3 months after radiotherapy, changes in rectal volume before and after injection, and incidence of rectum-related side effects. The changes in all indexes before and after injection were analyzed by using t-test. Results:A total of 13 patients were enrolled from March 2022 to February 2023. The isolation gel maintained morphologic stability without significant spatial changes during radiotherapy, and the mid-prostate had the best effect, with PRS up to 1 cm. At 3 months after radiotherapy, the isolation gel was seen to decreased in volume with a certain absorptive capacity. The irradiated volume of rectum was decreased significantly in all patients after gel injection, and the mean volumes of rectal V 60 Gy , V 50 Gy , V 30 Gy , and V 20 Gy before and after injection were 1.923% vs. 0.280%, 10.255% vs. 3.172%, 29.602% vs. 18.800%, and 49.452% vs. 40.259% (all P<0.005). The average values (range) of rectal V 60 Gy , V 50 Gy , V 30 Gy , V 20 Gy decreases were 84.9%( 29% - 100%), 69.6%(27%-100%), 36.3%(0%-75%), and 17.8%(0%-50%), respectively. No grade 3-4 side effects occurred in all patients, and there were no common grade 1-2 rectal side effects such as diarrhea, rectal bleeding, proctitis and anal pain, etc. Only one patient developed grade 1 constipation during radiotherapy. Conclusion:Injection of Chinese made cross-linked sodium hyaluronate isolation gel can significantly reduce the irradiated volume of rectum and the incidence of rectal toxicities in prostate cancer patients undergoing radical radiotherapy.

The ethical basis of public health policy is relatively weakness, which is mainly reflected in the conflict between individual rights and public interests, the lack of moral norm, the short of ethical review, the low level of relevant legislation, the weak of ethical consciousness and so on. Therefore, it is necessary to take measures to improve relevant ethical policies and regulations, establish an ethical framework for evaluating public health policies, highlight ethical values and strengthen ethical awareness in public health policy-making. Make it carry a certain ethical dimension to achieve the purposes of maintaining and improving health.

Objective:To evaluate the feasiblity and safety of in situ fenestration during the endograft of thoracic endovascular aortic repair (TEVAR) via the left subclavian artery (LSA).Methods:A total of 23 patients, including 17 patients with thoracic aortic dissection and 6 patients with thoracic aortic aneurysm, were respectively enrolled from October 2018 to June 2019 at Nanfang Hospital, Southern Medical University. All of the patients underwent in situ fenestration of LSA via the thoracic artery endograft following the TEVAR procedure. A 21 G preflex hollow needle was used to puncture the endograft from the medial segment of LSA for in situ feneatration. The success rate, clinical effect and complications were recorded on 1, 3 and 6 months after in situ fenestration.Results:The success rate was 100% in all the 23 patients with needle puncture in situ fenestration of LSA. The rechecked thoracic aorta angiography showed that both thoracic aortic main endograft and the LSA branch cover stent were well expanded, and there were no endoleaks occurred around the LSA branch cover stent. No hematoma was found in the supraclacicular fossa within all the perioperative period. A small pneumatothorax in the left pleural cavity which did not need treatment was being detected in 1 patient on the chest film 3 days after the procedure. The mean follow-uptime was (4.2±1.4) months. There were no retrograde tearing happened in the proximal end of the endograft, and no endoleak happened around the LSA branch cover stent either.Conclusion:The technique of needle puncture fenestration of LSA via the thoracic artery endograft is considered as a simple, safe, and effective method of in situ LSA reconstruction.

Objective:To investigate the impact of diabetes mellitus (DM) and stroke on long-term outcomes in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI).Methods:Total 411 consecutive ACS patients undergoing PCI at the Ninth People′s Hospital of Zhengzhou between December 2014 and June 2018 were recruited, including 319 males and 92 females with a mean age of (64.7±10.1) years. These patients were divided into 4 groups according to the presence or absence of history of diabetes or stroke: non-DM non-stroke group ( n=192) , DM group ( n=140), stroke group ( n=41), and DM+stroke group ( n=38). The data of baseline demographic characteristics, clinical feature, coronary angiographic findings, and cardiovascular adverse events during long-term follow-up were obtained. Kaplan-Meier curves were used to investigate the long-term clinical outcomes among groups. Results:The mean interval of follow-up was (24.1±13.8) months. Patients with DM+stroke had the highest rates of non-fetal myocardial infarction (χ 2=24.932) , non-fetal stroke (χ 2=9.434) , hospitalization due to heart failure/angina (χ 2=69.290) , revascularization (χ 2=22.918) , cardiovascular death(χ 2=13.473)and all-cause death(χ 2=17.724)as well as hard endpoint events (the sum of non-fetal myocardial infarction, non-fetal stroke, and all-cause death) (χ 2=30.268)and combined major adverse cardiovascular events (MACE) (the sum of hard endpoint events, hospitalization due to heart failure/angina, and revascularization) (χ 2=119.556)among 4 groups(all P<0.01). In Kaplan-Meier survival analysis, the cumulative ratio of freedom from all-cause death decreased significantly in DM+stroke group compared with no DM no stroke group ( HR=17.121, 95 %CI: 2.527-115.934, P<0.01), but no statistical difference was observed in the cumulative ratio of freedom from all-cause death between DM+stroke group and DM group or stroke group respectively ( HR=3.178, 95 %CI: 0.744-13.582; HR=1.383, 95 %CI: 0.374-5.118; all P>0.05) . Meanwhile, patients with DM+stroke presented significantly lower cumulated ratio free from combined MACE than patients with non-DM non-stroke ( HR=5.423, 95 %CI:2.941-10.036, P<0.01), and the cumulated ratio free from combined MACE also decreased significantly in DM+stroke group as compared to DM group or stroke group respectively ( HR=1.859,95 %CI: 1.167-2.962; HR=1.991,95 %CI: 1.178-3.364; all P<0.01) . Conclusions:ACS patients with combined history of DM and stroke have a worse long-term outcomes after PCI than those with DM alone or stroke alone or without DM or stroke. DM and stroke seemed to have an additive effect on decrease in the cumulative ratio free from combined MACE in ACS patients following PCI.

Objective To investigate the clinical applications of sandwich technique according to area calculation in endovascular aneurysm repair of patients with aorta and iliac artery lesions.Methods Six patients with aortoiliac artery disease confirmed by CT were treated using sandwich technique according to area calculation.The diameter of the main stent and two branches stents were chosen according to the area calculation.Technical success rate,patency of the stent graft and complications were observed.Results Technical success rate was 100％ (6/6),and no complications occurred in all the 6 patients.The clinical symptoms were significantly improved.Gutter endoleak was found in 1 patient 2 months after the procedure,and was managed by coil embolization successfully.No endoleak occurred in other patients during follow-up of 6-31 months.Conclusion For patients with special anatomy of aorta and iliac artery lesions,the application of area calculation in the sandwich technique provides a feasible approach in choosing the matching size of the main body stent and two side branches stents.

Objective To approach the protective effect of dexmedetomidine on mechanically ventilated patients with pulmonary contusion. Methods A prospective randomly controlled trial was conducted. 70 mechanically ventilated patients with pulmonary contusion from January 2010 to December 2012 in the Critical Care Medicine of Foshan Hospital of Traditional Chinese Medicine were divided into a control group and a therapy group by the difference in number odd or even,with 35 patients in each group. Based on the same principles of comprehensive treatment,the control group used midazolam,and the therapy group used dexmedetomidine for sedation. The measured parameters included oxygenation index(PaO2/FiO2),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6), and extra-vacular lung water index(EVLWI)for both groups on the1st and 5th day. The incidence of delirium,the time of mechanical ventilation,and the incidence of hypotension were observed in both groups. Results Compared with those on the 1st day,TNF-α,IL-6 and EVLWI on the 5th day were decreased significantly in both groups〔the control group TNF-α(ng/L):1.29±0.38 vs. 2.21±0.37,IL-6(ng/L):97.97±28.77 vs. 131.03±41.52,EVLWI (mL/kg):8.25±2.03 vs. 11.96±3.36;the therapy group TNF-α:1.06±0.33 vs. 2.32±0.37,IL-6:82.07±23.35 vs. 134.98±64.25, EVLWI(mL/kg):6.74±1.33 vs. 11.23±2.78, all P<0.05〕, PaO2/FiO2 was increased obviously〔mmHg(1 mmHg=0.133 kPa),the control group:285.80±30.65 vs. 213.00±33.70,the therapy group:315.00±34.50 vs. 229.50±37.00,both P<0.05〕,TNF-αand IL-6 had no significant difference compared between the therapy group and control group(TNF-α:1.06±0.33 vs. 1.29±0.38,IL-6:82.07±23.35 vs. 97.97±28.77), while EVLWI and PaO2/FiO2 in the therapy group had remarkable differences compared with those of the control group〔EVLWI(mL/kg):6.74±1.33 vs. 8.25±2.03,PaO2/FiO2(mmHg):315.00±34.50 vs. 285.80±30.65,both P<0.05〕. The incidence of delirium(8.57% vs. 22.86%)and time of mechanical ventilation(day:4.10±1.09 vs. 6.88±1.66)in the therapy group were decreased markedly compared with those of the control group,and the incidence of hypotension had no significant difference between treatment or control groups(17.14% vs. 14.29%,P>0.05). Conclusion Dexmedetomidine has protective effect on mechanically ventilated patients with pulmonary contusion, and it is an relatively ideal sedative drug for these patients.