In recent years， hyperuricemia （HUA） has shown a rapidly increasing incidence and tends to occur in increasingly young people， with a wide range of cardiac， renal， joint， and cancerous hazards and all-cause mortality associations. Western medicine treatment has limitations such as large liver and kidney damage， medication restriction， and easy recurrence. The intestine is the major extra-renal excretion pathway for uric acid （UA）， and the intestinal microecology can be regulated to promote UA degradation. It offers great potential to develop UA-lowering strategies that target the intestinal microecology， which are promising to provide safer and more effective therapeutic approaches. Traditional Chinese medicine （TCM） can treat HUA via multiple targets and multiple pathways from a holistic view， with low toxicity and side effects. Studies have shown that intestinal microecology is a crucial target for TCM in the treatment of HUA. However， its specific mechanism of action has not been fully elucidated. Focusing on the key role of intestinal microecology in HUA， this review explores the relationship between intestinal microecology and HUA in terms of intestinal flora， intestinal metabolites， intestinal UA transporters， and intestinal barriers. Furthermore， we summarize the research progress in TCM treatment of HUA by targeting the intestinal microecology， with the aim of providing references for the development of TCM intervention strategies for HUA and the direction of future research.

Endometrial cancer is one of the common malignant tumors of the female reproductive system.Its incidence rate in China is second only to cervical cancer,posing a serious threat to women's life and health,and the onset shows a trend of affecting younger individuals.Currently,the primary treatment for endometrial cancer is surgical intervention,and some postoperative patients and those with postoperative recurrence require adjuvant radiotherapy.Pelvic external beam radiotherapy(EBRT)and vaginal brachytherapy(VBT)are two modalities of postoperative radiotherapy.The appropriate postoperative radiotherapy approach should be selected based on individual conditions and guideline recommendations.Most patients can achieve satisfactory treatment outcomes through surgery and postoperative adjuvant radiotherapy.However,the specific indications for postoperative radiotherapy in endometrial cancer patients and the radiotherapy principles for those with postoperative recurrence are relatively complex,and recommendations for radiotherapy modalities in postoperative patients vary slightly across different guidelines.This article reviews the treatment principles for endometrial cancer patients in recent years,as well as the indications for postoperative and post operative recurrent radiotherapy and the radiotherapy techniques,aiming to provide a reference for radiotherapy in the endometrial cancer patients.

Objective To compare the surgical outcomes of the sequence of screw and rod placement for Lenke type 5C adolescent idiopathic scoliosis(AIS).Methods Lenke type 5C AIS patients who underwent posterior orthopedic fusion and fixation in our hospital from Jan.2013 to Dec.2020 were recruited.Based on surgical sequences,22 cases were assigned to bilateral group(after bilateral screw placement,orthopedics was performed on the convex side and then on the concave side),and 20 cases were assigned to convex group(screws placed on the convex side and performed orthopedics,followed by the concave side).The operation-related indicators(including operation time),imaging parameters,quality of life scores were compared between the 2 groups before and 2 years after surgery.Complications of the 2 groups were analyzed.Results The operation time in the bilateral group was significantly longer than that in the convex group([232.8±13.1]min vs[198.4±16.5]min,P＜0.01).At the last follow-up 2 years after operation,the Cobb angle and its correction rate in the convex group were better than those in the bilateral group([8.0±2.3]° vs[9.9±3.2]°,P=0.03;[81.9±5.4]%vs[77.8±5.8]%,P=0.02).The rate of pedicle screw breach rate was 5.4%(17/312)in the bilateral group and 1.4%(4/280)in the convex group,with significant difference(P＜0.01).At the last follow-up 2 years after operation,the treatment satisfaction of quality of life assessment of the bilateral group was 4.61±1.38,and that of the convex group was 4.50±1.44,but there was no significant difference between the 2 groups(P＞0.05).There were no abnormal electrophysiological monitoring or operation-related complications in the 2 groups.Conclusion For Lenke type 5C AIS,the convex side of pedicle screw placement and orthopedics followed by concave side of pedicle screw placement and orthopedics can achieve better surgical effect.

In the past, aortic dissection, aortic aneurysm, and other aortic diseases, primarily rely on surgical intervention. In recent years, due to breakthroughs in materials science, endovascular therapy has become the first choice for the surgical treatment of most aortic diseases. However, traditional endovascular repair cannot fully meet the clinical needs for certain complex lesions involving the aortic arch and the originations of visceral arteries. The emergence of physician-modified stent technology has brought new hope for the treatment of complex aortic diseases. This article provides a detailed introduction to the concept, development, technical characteristics, and applications of physician-modified stents in the treatment of aortic diseases, analyzing their advantages and limitations. Physician-modified stents serve as a powerful complement to traditional endovascular interventions and commercial branched stents, yet further research and refinement are still required.

Objective:To compare the efficacy and safety of Rotarex mechanical thrombectomy (Rotarex) combined with drug-coated balloon (DCB) versus percutaneous transluminal angioplasty (PTA) combined with DCB in the treatment of femoropopliteal artery in-stent restenosis (ISR).Methods:A multicenter, prospective, randomized controlled trial was conducted. 46 patients with femoropopliteal artery ISR admitted to five hospitals (Beijing Friendship Hospital, Capital Medical University; Beijing Chaoyang Hospital, Capital Medical University; Beijing Jishuitan Hospital, Capital Medical University; Xuanwu Hospital, Capital Medical University; Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University) from July 2020 to June 2024 were enrolled. Patients were randomly divided into the Rotarex+ DCB group ( n=24) and the PTA+ DCB group ( n=22) using a random number table. The clinical data of the two groups were collected, including clinical characteristics, Fontaine classification, stent placement location, stent duration, and lesion length. The primary endpoint was the target blood vessel patency rate at 6 and 12 months postoperatively; the secondary endpoints included improvement in clinical symptoms (Fontaine classification), rate of reintervention, and safety indicators. Measurement data were expressed as mean±standard deviation ( ± s), and the t-test was used for comparison between groups; count data were expressed as the number of cases and percentages, and intergroup comparisons were performed using the Chi-test or Fisher exact probability method. Results:At 12 months postoperatively, the target blood vessel patency rate in the Rotarex+ DCB group was significantly higher than that in the PTA+ DCB group (81.8% vs 45.5%, P=0.012), and the proportion of patients in Fontaine classification stage I was also higher (86.4% vs 45.5%, P=0.004). The results at the 6-month follow-up were consistent (target blood vessel patency rate: 87.0% vs 59.1%, P=0.035). In terms of safety, no severe complications such as arterial rupture, amputation, or procedure-related death occurred during the perioperative period in either group. During the postoperative follow-up, no amputation or procedure-related deaths occurred in either group. Conclusion:For the treatment of femoropopliteal artery ISR, Rotarex mechanical thrombectomy combined with DCB is significantly superior to PTA+ DCB in terms of 12-month target blood vessel patency rate and improvement of clinical symptoms, with comparable safety.

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.

Objective To explore relationship between glucose metabolism and neonatal weight in high-risk gestational diabetes melli-tus(GDM).Method A retrospective study was conducted on 779 pregnant women who underwent prenatal examinations at Tongzhou Maternity and Child Health Care Hospital in Beijing from March to June 2022.The data on pre-pregnancy weight,mid-and late-preg-nancy glycated albumin(GA)and glycated hemoglobin(HbA1c),pre-delivery weight,gestational weight gain,and neonatal birth weight were collected.A GDM risk assessment model was established using multivariate logistic regression to classify pregnant women into high-risk and low-risk groups for GDM,followed by separate management strategies.Regression discontinuity(RD)analysis was applied to evaluate the relationship between gestational glucose metabolism status and neonatal birth weight.Results Among the 779 pregnant women,the overall incidence of macrosomia was 7.32％.The high-risk GDM group exhibited significantly higher pre-pregnan-cy weight,late-pregnancy HbA1c,and GA levels compared to the low-risk group(all P＜0.001).Neonatal birth weight in the high-risk group was significantly higher than that in the low-risk group(P＜0.05),with a significantly increased macrosomia incidence(13.55％vs 5.77％,P＜0.05).RD analysis revealed a jump reduction of 199.59 g(P=0.029)in neonatal birth weight at the risk score thresh-old.Conclusion Lifestyle glucose metabolism management in high-risk GDM pregnant women may effectively reduce neonatal birth weight,mitigated the trend of excessive gestational weight gain,and improved late-pregnancy HbA1c and GA levels,providing evi-dence-based support for maternal and child health services.

Objective To study the correlation between expression levels of serum Spexin and Pannexin 1 protein,glucose and lipid metabolism and insulin resistance in elderly patients with diabetic cataract.Methods A total of 118 elderly diabetic cataract patients were selected as the case group,and 103 elderly diabetic non-cataract patients were selected as the control group who were treated in the same hospital during the same period.Serum levels of Spexin and Pannexin1 were detected by enzyme-linked immunosorbent assay(ELISA).Fasting blood glucose(FPG)and glycosylated hemoglobin(HbA1c)were measured.Lipid metabolism related indicators including triacylglycerol(TG),high density lipoprotein cholesterol(HDL-C),total cholesterol(TC)and low density lipoprotein cholesterol(LDL-C)were detected in two groups of patients.Insulin resistance related indexes:fasting insulin(FINS),insulin sensitivity index(ISI),insulin resistance index(HOMA-IR)and islet beta cell function index(HOMA-β)were also detected.The correlation between serum Spexin and Pannexin1 levels,glucolipid metabolism and ISI was detected by Pearson method.Receiver operating characteristic(ROC)curves were used to assess the predictive value of serum Spexin and Pannexin1 levels and their combination in the development of cataract in elderly diabetic patients.Results The level of Spexin was lower in the observation group than that in the control group,and the level of Pannexin1 was higher than that in the control group(P＜0.01).Levels of TG,TC,LDL-C,FPG,HbA1c,FINS and HOMA-IR of the observation group increased compared with the control group,while HDL-C,ISI and HOMA-β levels decreased compared with the control group(P＜0.01).Pearson correlation analysis showed that serum Spexin level was positively correlated with ISI and HOMA-β,and negatively correlated with TG,TC,LDL-C,FPG,HbA1c,FINS and HOMA-IR in elderly patients with diabetic cataract(P＜0.05).Serum Pannexin1 was negatively correlated with ISI and HOMA-β,and positively correlated with TG,TC,LDL-C,FPG,HbA1c,FINS and HOMA-IR(P＜0.05).There was no correlation between the above indexes and HDL-C(P＞0.05).The combination of both serum Spexin and Pannexin1 predicted the development of cataracts in elderly diabetic patients was better than serum Spexin and Pannexin1 assessed individually(Z both combination-Spexin=3.220,P=0.001,Z both combination-Pannexin1=4.838,P＜0.001).Conclusion In elderly patients with diabetic cataract,the expression of serum Spexin decreases and the expression of Pannexin1 increases,and they have a certain correlation with glucose and lipid metabolism and insulin resistance

Objective:To compare the clinical effect of femoral neck system (FNS) and cannulated compression screw internal fixation in the treatment of femoral neck fractures in young and middle-aged patients.Methods:The databases of CNKI, Wanfang Data Knowledge Service Platform, VIP, Chinese Medical Journal Full-text Database, PubMed, Embase, Web of Science and Cochrane Library were searched. The intraoperative blood loss, intraoperative fluoroscopy times, hospital stay, fracture healing time, Harris hip function score, partial weight-bearing time and complication rate were extracted to compare the clinical efficacy of the two surgical methods. Stata18.0 statistical software was used for meta-analysis.Results:A total of 699 patients from 11 studies were included in this study. Compared with cannulated compression screw internal fixation, the FNS had a shorter operation time [ WMD= -8.54, 95% CI(-14.87, -2.21), P=0.008], fewer intraoperative fluoroscopy times[ WMD= -8.29, 95% CI(-11.45, -5.12), P< 0.001], a shorter fracture healing time [ WMD=-1.59, 95% CI(-2.49, -0.68), P=0.001], a shorter partial weight-bearing time[ WMD=-3.45, 95% CI(-4.43, -2.46), P<0.001], a lower incidence of postoperative complications [ RR=0.41, 95% CI(0.22, 0.76), P= 0.004], and a lower incidence of postoperative nonunion [ RR=0.40, 95% CI(0.18, 0.88), P=0.022]. Meanwhile, the FNS group had more intraoperative blood loss [ WMD=9.53, 95% CI(2.70, 16.35), P=0.006] and a higher Harris hip function score at the last follow-up [ WMD=3.50, 95% CI(2.11, 4.89), P<0.001] than the cannulated compression screw internal fixation group. There were no statistically significant differences in the length of hospital stay [ WMD=-0.48, 95% CI(-0.82, -0.13), P=0.092] or the incidence of femoral head necrosis [ RR=0.57, 95% CI(0.26, 1.24), P=0.159] between the two groups. Conclusion:Compared with cannulated compression screw internal fixation in the treatment of femoral neck fracture in young and middle-aged patients, FNS has more intraoperative blood loss, but it has more advantages in operation time, intraoperative blood loss, intraoperative fluoroscopy times, postoperative fracture healing time, Harris hip function score, partial weight-bearing time, postoperative nonunion rate and postoperative complications rate.

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.