Objective To investigate the characteristics of peripheral blood in the treatment of aplastic anemia(AA)with Bushen Shengxue Method and Yiqi Yangxue Method combined with Western medicine.Methods Totally 492 AA patients who were treated in 19 centers including Xiyuan Hospital China Academy of Chinese Medical Sciences from September 2018 to March 2021 were selected,and were randomized into three groups:161 cases in the Bushen Shengxue group,164 cases in the Yiqi Yangxue group,and 167 cases in the control group.All three groups were orally administered cyclosporine and androgens.Bushen Shengxue group was given Bushen Shengxue Granules,Yiqi Yangxue group was given Yiqi Yangxue Granules,and the control group was given placebo(half dosage of Bushen Shengxue granules).The general data,overall efficacy,and peripheral blood at the 1st month,the 4th month,and 6th month after treatment were analyzed.Results The total effective rate of Bushen Shengxue group was 98.8％(159/161),which was significantly higher than that of Yiqi Yangxue group(79.9％)and the control group(61.7％),with statistical significance(P＜0.001);The total effective rate of Yiqi Yangxue group was significantly higher than that of the control group(P＜0.001).Compared with before treatment,the hemoglobin(HGB)levels of all three groups of patients significantly increased after treatment(P＜0.001,P＜0.01),and the platelet levels of Bushen Shengxue group and the control group significantly increased after treatment(P＜0.001);after treatment,the HGB levels in the three groups were ranked from high to low as the Bushen Shengxue group,Yiqi Yangxue group and the control group(P＜0.01).25％of patients had HGB levels exceeding 20％of baseline values,Bushen Shengxue group took 1 month,while Yiqi Yangxue group and control group took 4 months;25％of patients had an increase in HGB levels exceeding 50％of the baseline value,Bushen Shengxue group took 6 months,while Yiqi Yangxue group and control group took more than 6 months.At 6 months,the number of patients with HGB elevation exceeding 20％and 50％of baseline values in Bushen Shengxue group was higher than that in Yiqi Yangxue group and the control group(P＜0.05,P＜0.001).25％of patients had white blood cell elevation exceeding 50％of the baseline value,Bushen Shengxue group took 4 months,Yiqi Yangxue group took 6 months,and the control group took more than 6 months.25％of patients showed an increase in platelet levels exceeding 100％of the baseline value,Bushen Shengxue group took 4 months,while Yiqi Yangxue group and control group took 6 months;at 6 months,the number of patients in Bushen Shengxue group and Yiqi Yangxue group with platelet elevation exceeding 20％of the baseline value was significantly higher than that in the control group(P＜0.01,P＜0.05).Conclusion Bushen Shengxue method combined with Western medicine intreating AA is better than the method of Yiqi Yangxue method combined with Western medicine.In terms of improving HGB,it is reflected in shortening the recovery time and increasing the number of beneficiaries,and the dosage can affect the recovery time and the number of beneficiaries at the same time;in terms of improving white blood cell and platelet,it is reflected in shortening the recovery time,and the dosage can affect the recovery time.

Objective:To compare the safety and efficacy of novel en-bloc Holmium laser enucleation of the prostate（HoLEP）with complete membranous urethral mucosa sparing technique with traditional 2-lobe technique HoLEP in benign prostatic hyperplasia（BPH）treatment.Methods:The data of BPH patients treated with HoLEP from January 2023 to May 2024 in Xinhua Hospital，School of Medicine，Shanghai Jiaotong University were retrospectively reviewed. Seventy-two patients received novel en-bloc HoLEP with complete membranous urethral mucosa sparing technique（novel en-bloc group），while 79 patients received traditional 2-lobe technique HoLEP（traditional 2-lobe technique group）.There was no significant difference between novel en-bloc group and traditional 2-lobe technique group in the age［（71.0 ± 7.1）years vs.（69.8 ± 6.5）years］，body mass index［（24.5 ± 2.8）kg/m 2 vs.（23.9 ± 3.5）kg/m 2］，international prostate symptom score（IPSS）［26.0（22.0，28.0）vs. 25.0（22.0，28.0）］，quality of life（QOL）score［5.0（5.0，6.0）vs. 5.0（5.0，6.0）］，prostate sepcific antigen（PSA）［4.98（2.40，11.11）ng/ml vs. 4.38（1.62，7.54）ng/ml］and prostate volume［（74.06 ± 42.67）ml vs.（70.10 ± 33.94）ml］（all P > 0.05）. The incidence of acute urinary retention in novel en-bloc group was significantly higher than that in traditional 2-lobe technique group［31.94%（23/72）vs. 17.72%（14/79）， P = 0.042］.The procedure of novel en-bloc was shown as followed：expose the prostatic capsule near the verumontanum and expand the initial capsule plane on both sides. The prostatic urethral mucosa was cut off in a circular pattern medial to the external urethral sphincter，which could form a complete “circular mucosal pad”. Seperate the apical gland along the capsule plane at 12 o’clock and expand the capsule plane until the bladder neck was reached.The bladder neck was then used as a marker so as to separate the glands on both sides along the capsule plane and merge with the initial plane. The entire lobe of the prostate was finally removed along the surgical capsule of the prostate. The procedure of traditional two lobe method was shown as followed：expose the prostatic capsule near the verumontanum and then divide the prostate into two lobes by longitudinal incision at 6 and 12 o’clock. The mucosa was horizontally cut at 12 o’clock，medial to the external urethral sphincter in order to preserve the apical urethral mucosal flap. The twp lobes were then removedd respectively along the capsule layer. The surgery-related indicators，perioperative complications and other data were compared between the two groups，as well as IPSS，QOL score，lower urinary tract symptoms，and the incidence of stress urinary incontinence in the two groups 1 month after surgery. Results:Compared with the patients underwent 2-lobe technique HoLEP，the patients underwent novel en-bloc HoLEP had lower hemoglobin loss［0.50（-5.50，7.50）g/L vs. 7.00（1.00，13.25）g/L， P = 0.003］，lower operation time［（72.06 ± 34.37）min vs.（85.42 ± 40.35）min， P = 0.030］，higher surgical efficacy［（0.72 ± 0.31）g/min vs.（0.55 ± 0.29）g/min， P = 0.002］and lower incidence of stress urinary incontinence one month after operation［2.78%（2/72）vs. 10.13%（8/79）， P = 0.070］. There was no significant difference in the incidence of postoperative gross hematuria［0 vs. 2.53%（2/79）］，postoperative sepsis［1.39%（1/72）vs. 1.27%（1/79）］，postoperative dysuria［4.17%（3/72）vs. 5.06%（4/79）］，postoperative IPSS improvement［12.0（11.0，13.0）vs. 12.0（10.0，14.0）］and postoperative QOL improvement［3.0（2.0，3.0）vs. 3.0（2.0，3.0）］between the two groups（ P > 0.05）. The patients were further divided into 2 sub-groups according to whether prostate volume ≥ 60 ml or not. In the patients of prostate volume < 60 ml，surgical efficacy was significantly higher in novel en-bloc HoLEP group than that in traditional 2-lobe technique group［（0.55 ± 0.25）g/min vs.（0.41 ± 0.19）g/min， P = 0.028］. In the patients of prostate volume ≥ 60 ml，the surgical efficacy of novel en-bloc HoLEP was also higher［（0.88 ± 0.28）g/min vs.（0.66 ± 0.31）g/min， P = 0.006］. Conclusions:Novel en-bloc HoLEP with complete membranous urethral mucosa sparing technique was demonstrated to has lower blood loss，shorter operation time，higher surgical efficacy and lower incidence of stress urinary incontinence，which is suitable of all sizes of prostate.

Minimally invasive enucleation of pancreatic tumors has become a focal topic in the field of pancreatic surgery. This technique, which allows for complete tumor removal while preserving maximal pancreatic function, has seen widespread application in clinical practice in recent years. Preoperative evaluation is essential, requiring a thorough assessment of the necessity, feasibility, and appropriateness of surgery, and a careful choice between follow-up observation, parenchyma-sparing resection, or radical resection. If the lesion carries a potential risk of malignancy, radical resection, such as pancreaticoduodenectomy, should be performed. During minimally invasive local resection, selecting an appropriate surgical approach, accurately localizing the tumor, protecting the main pancreatic duct (MPD), and effectively repairing and reconstructing the MPD in case of injury are key to ensuring both surgical safety and efficacy. In addition, pancreatic wound management and the long-term prognosis of patients who undergo MPD repair and reconstruction are also areas of significant concern.

Objective:This multicenter retrospective study aimed to analyze the clinicopathological features of duodenal adenocarcinoma (DA) and identify prognostic factors for postoperative survival.Methods:Demographic characteristics, clinicopathological features, treatment outcomes and survival of DA patients undergoing surgical treatment at 18 Chinese medical centers from January 2012 to December 2023 were retrospectively analyzed.Results:Among the 2 056 DA patients included, 46.8% (963) had extra-ampullary DA (EA-DA), and 53.2% (1 093) had peri-ampullary DA (PA-DA). The 1-, 3-, and 5-year overall survival (OS) rates for patients who underwent radical surgery were 93.2%, 71.0%, and 57.2%, respectively. The median overall survival was 76 months, and the median progression-free survival (PFS) was 65 months. No differences in survival were observed between the laparotomy group and minimally invasive surgery (MIS) group either before or after propensity score matching (OS: 76 vs. 75 months before PSM, P=0.986; OS: 75 vs. 75 months after PSM, P=0.602). Furthermore, there were no significant differences between-group in operation time and postoperative complications ( P＞0.05). The MIS group experienced less intraoperative blood loss and shorter hospital stays. The multivariate Cox regression analysis revealed that advanced age ( HR=1.43,95% CI:1.18-1.73), elevated carbohydrate antigen 19-9 levels ( HR=1.24,95% CI:1.02-1.51), perineural invasion ( HR=1.44,95% CI:1.14-1.81), vascular invasion ( HR=1.35,95% CI:1.07-1.71), advanced T stage (T3-4 vs. T1-2: HR=1.86,95% CI:1.49-2.31), regional lymph node metastasis ( HR=1.93,95% CI:1.58-2.36), preoperative biliary drainage ( HR=1.26,95% CI:1.04-1.53), intraoperative blood loss ( HR=1.34,95% CI:1.11-1.62), clinically significant postoperative pancreatic fistulas ( HR=1.53,95% CI:1.12-2.09), and postoperative hemorrhage ( HR=1.62,95% CI:1.14-2.29) were independent risk factors for poor prognosis after surgery (all P＜0.05). Conclusions:Radical surgery is associated with favorable overall survival among DA patients, and no difference in survival is observed between EA-DA and PA-DA patients. MIS is a reliable alternative for DA treatment.

Radiation-induced esophageal injury (RIEI) is a frequent complication following radiotherapy for thoracic and head-neck malignancies, which may lead to severe sequelae including esophageal stricture and perforation, adversely affecting patients' quality of life and therapeutic outcomes. With advancements in radiotherapy techniques — particularly the adoption of unconventional fractionation regimens, concurrent chemoradiotherapy, and combined molecular targeted / immunotherapy — the incidence of RIEI has been increasing. In this review, recent advances in understanding the pathogenesis, clinical manifestations, risk factors, and management strategies for RIEI were comprehensively summarized. Current therapeutic approaches have evolved beyond conventional anti-inflammatory and nutritional support to include novel interventions such as targeted therapy, free radical scavengers, and microbiota modulation, etc. Future research should prioritize the development of optimized, individualized prevention and treatment protocols to mitigate RIEI risk and improve patient prognosis.

The global incidence of head and neck cancer (HNC) is rising, with over 60% of patients presenting at a locally advanced stage. Radiotherapy remains a cornerstone of HNC treatment, and advancements in modern techniques and concurrent chemotherapy have improved local control and survival rates of HNC patients. However, these benefits also bring challenges in the management of toxicities. Due to the proximity of salivary glands and tumors, especially the highly radiosensitive parotid and submandibular glands, this condition is among the most common adverse effects of radiotherapy. Radiation damages acinar cells and ducts, causing glandular atrophy, fibrosis, and reduced saliva secretion, thereby leading to xerostomia and related complications. The risk and severity of injury are associated with the radiation dose and volume affecting the glands. Prevention and management strategies emphasize precise radiotherapy planning, target optimization, and supportive care. Emerging multimodal imaging techniques offer potential for non-invasive prediction and early diagnosis and treatment of radiation-induced salivary gland injury. Future research in regenerative medicine, tissue engineering, and molecular biology aims to elucidate molecular mechanisms, such as signaling pathways and genomics, facilitating personalized strategies to mitigate radiotherapy-induced toxicities and enhance the quality of life of patients.

Objective:This multicenter retrospective study aimed to analyze the clinicopathological features of duodenal adenocarcinoma (DA) and identify prognostic factors for postoperative survival.Methods:Demographic characteristics, clinicopathological features, treatment outcomes and survival of DA patients undergoing surgical treatment at 18 Chinese medical centers from January 2012 to December 2023 were retrospectively analyzed.Results:Among the 2 056 DA patients included, 46.8% (963) had extra-ampullary DA (EA-DA), and 53.2% (1 093) had peri-ampullary DA (PA-DA). The 1-, 3-, and 5-year overall survival (OS) rates for patients who underwent radical surgery were 93.2%, 71.0%, and 57.2%, respectively. The median overall survival was 76 months, and the median progression-free survival (PFS) was 65 months. No differences in survival were observed between the laparotomy group and minimally invasive surgery (MIS) group either before or after propensity score matching (OS: 76 vs. 75 months before PSM, P=0.986; OS: 75 vs. 75 months after PSM, P=0.602). Furthermore, there were no significant differences between-group in operation time and postoperative complications ( P＞0.05). The MIS group experienced less intraoperative blood loss and shorter hospital stays. The multivariate Cox regression analysis revealed that advanced age ( HR=1.43,95% CI:1.18-1.73), elevated carbohydrate antigen 19-9 levels ( HR=1.24,95% CI:1.02-1.51), perineural invasion ( HR=1.44,95% CI:1.14-1.81), vascular invasion ( HR=1.35,95% CI:1.07-1.71), advanced T stage (T3-4 vs. T1-2: HR=1.86,95% CI:1.49-2.31), regional lymph node metastasis ( HR=1.93,95% CI:1.58-2.36), preoperative biliary drainage ( HR=1.26,95% CI:1.04-1.53), intraoperative blood loss ( HR=1.34,95% CI:1.11-1.62), clinically significant postoperative pancreatic fistulas ( HR=1.53,95% CI:1.12-2.09), and postoperative hemorrhage ( HR=1.62,95% CI:1.14-2.29) were independent risk factors for poor prognosis after surgery (all P＜0.05). Conclusions:Radical surgery is associated with favorable overall survival among DA patients, and no difference in survival is observed between EA-DA and PA-DA patients. MIS is a reliable alternative for DA treatment.

Objective To investigate the characteristics of peripheral blood in the treatment of aplastic anemia(AA)with Bushen Shengxue Method and Yiqi Yangxue Method combined with Western medicine.Methods Totally 492 AA patients who were treated in 19 centers including Xiyuan Hospital China Academy of Chinese Medical Sciences from September 2018 to March 2021 were selected,and were randomized into three groups:161 cases in the Bushen Shengxue group,164 cases in the Yiqi Yangxue group,and 167 cases in the control group.All three groups were orally administered cyclosporine and androgens.Bushen Shengxue group was given Bushen Shengxue Granules,Yiqi Yangxue group was given Yiqi Yangxue Granules,and the control group was given placebo(half dosage of Bushen Shengxue granules).The general data,overall efficacy,and peripheral blood at the 1st month,the 4th month,and 6th month after treatment were analyzed.Results The total effective rate of Bushen Shengxue group was 98.8％(159/161),which was significantly higher than that of Yiqi Yangxue group(79.9％)and the control group(61.7％),with statistical significance(P＜0.001);The total effective rate of Yiqi Yangxue group was significantly higher than that of the control group(P＜0.001).Compared with before treatment,the hemoglobin(HGB)levels of all three groups of patients significantly increased after treatment(P＜0.001,P＜0.01),and the platelet levels of Bushen Shengxue group and the control group significantly increased after treatment(P＜0.001);after treatment,the HGB levels in the three groups were ranked from high to low as the Bushen Shengxue group,Yiqi Yangxue group and the control group(P＜0.01).25％of patients had HGB levels exceeding 20％of baseline values,Bushen Shengxue group took 1 month,while Yiqi Yangxue group and control group took 4 months;25％of patients had an increase in HGB levels exceeding 50％of the baseline value,Bushen Shengxue group took 6 months,while Yiqi Yangxue group and control group took more than 6 months.At 6 months,the number of patients with HGB elevation exceeding 20％and 50％of baseline values in Bushen Shengxue group was higher than that in Yiqi Yangxue group and the control group(P＜0.05,P＜0.001).25％of patients had white blood cell elevation exceeding 50％of the baseline value,Bushen Shengxue group took 4 months,Yiqi Yangxue group took 6 months,and the control group took more than 6 months.25％of patients showed an increase in platelet levels exceeding 100％of the baseline value,Bushen Shengxue group took 4 months,while Yiqi Yangxue group and control group took 6 months;at 6 months,the number of patients in Bushen Shengxue group and Yiqi Yangxue group with platelet elevation exceeding 20％of the baseline value was significantly higher than that in the control group(P＜0.01,P＜0.05).Conclusion Bushen Shengxue method combined with Western medicine intreating AA is better than the method of Yiqi Yangxue method combined with Western medicine.In terms of improving HGB,it is reflected in shortening the recovery time and increasing the number of beneficiaries,and the dosage can affect the recovery time and the number of beneficiaries at the same time;in terms of improving white blood cell and platelet,it is reflected in shortening the recovery time,and the dosage can affect the recovery time.

Objective:To compare the safety and efficacy of novel en-bloc Holmium laser enucleation of the prostate（HoLEP）with complete membranous urethral mucosa sparing technique with traditional 2-lobe technique HoLEP in benign prostatic hyperplasia（BPH）treatment.Methods:The data of BPH patients treated with HoLEP from January 2023 to May 2024 in Xinhua Hospital，School of Medicine，Shanghai Jiaotong University were retrospectively reviewed. Seventy-two patients received novel en-bloc HoLEP with complete membranous urethral mucosa sparing technique（novel en-bloc group），while 79 patients received traditional 2-lobe technique HoLEP（traditional 2-lobe technique group）.There was no significant difference between novel en-bloc group and traditional 2-lobe technique group in the age［（71.0 ± 7.1）years vs.（69.8 ± 6.5）years］，body mass index［（24.5 ± 2.8）kg/m 2 vs.（23.9 ± 3.5）kg/m 2］，international prostate symptom score（IPSS）［26.0（22.0，28.0）vs. 25.0（22.0，28.0）］，quality of life（QOL）score［5.0（5.0，6.0）vs. 5.0（5.0，6.0）］，prostate sepcific antigen（PSA）［4.98（2.40，11.11）ng/ml vs. 4.38（1.62，7.54）ng/ml］and prostate volume［（74.06 ± 42.67）ml vs.（70.10 ± 33.94）ml］（all P > 0.05）. The incidence of acute urinary retention in novel en-bloc group was significantly higher than that in traditional 2-lobe technique group［31.94%（23/72）vs. 17.72%（14/79）， P = 0.042］.The procedure of novel en-bloc was shown as followed：expose the prostatic capsule near the verumontanum and expand the initial capsule plane on both sides. The prostatic urethral mucosa was cut off in a circular pattern medial to the external urethral sphincter，which could form a complete “circular mucosal pad”. Seperate the apical gland along the capsule plane at 12 o’clock and expand the capsule plane until the bladder neck was reached.The bladder neck was then used as a marker so as to separate the glands on both sides along the capsule plane and merge with the initial plane. The entire lobe of the prostate was finally removed along the surgical capsule of the prostate. The procedure of traditional two lobe method was shown as followed：expose the prostatic capsule near the verumontanum and then divide the prostate into two lobes by longitudinal incision at 6 and 12 o’clock. The mucosa was horizontally cut at 12 o’clock，medial to the external urethral sphincter in order to preserve the apical urethral mucosal flap. The twp lobes were then removedd respectively along the capsule layer. The surgery-related indicators，perioperative complications and other data were compared between the two groups，as well as IPSS，QOL score，lower urinary tract symptoms，and the incidence of stress urinary incontinence in the two groups 1 month after surgery. Results:Compared with the patients underwent 2-lobe technique HoLEP，the patients underwent novel en-bloc HoLEP had lower hemoglobin loss［0.50（-5.50，7.50）g/L vs. 7.00（1.00，13.25）g/L， P = 0.003］，lower operation time［（72.06 ± 34.37）min vs.（85.42 ± 40.35）min， P = 0.030］，higher surgical efficacy［（0.72 ± 0.31）g/min vs.（0.55 ± 0.29）g/min， P = 0.002］and lower incidence of stress urinary incontinence one month after operation［2.78%（2/72）vs. 10.13%（8/79）， P = 0.070］. There was no significant difference in the incidence of postoperative gross hematuria［0 vs. 2.53%（2/79）］，postoperative sepsis［1.39%（1/72）vs. 1.27%（1/79）］，postoperative dysuria［4.17%（3/72）vs. 5.06%（4/79）］，postoperative IPSS improvement［12.0（11.0，13.0）vs. 12.0（10.0，14.0）］and postoperative QOL improvement［3.0（2.0，3.0）vs. 3.0（2.0，3.0）］between the two groups（ P > 0.05）. The patients were further divided into 2 sub-groups according to whether prostate volume ≥ 60 ml or not. In the patients of prostate volume < 60 ml，surgical efficacy was significantly higher in novel en-bloc HoLEP group than that in traditional 2-lobe technique group［（0.55 ± 0.25）g/min vs.（0.41 ± 0.19）g/min， P = 0.028］. In the patients of prostate volume ≥ 60 ml，the surgical efficacy of novel en-bloc HoLEP was also higher［（0.88 ± 0.28）g/min vs.（0.66 ± 0.31）g/min， P = 0.006］. Conclusions:Novel en-bloc HoLEP with complete membranous urethral mucosa sparing technique was demonstrated to has lower blood loss，shorter operation time，higher surgical efficacy and lower incidence of stress urinary incontinence，which is suitable of all sizes of prostate.

Minimally invasive enucleation of pancreatic tumors has become a focal topic in the field of pancreatic surgery. This technique, which allows for complete tumor removal while preserving maximal pancreatic function, has seen widespread application in clinical practice in recent years. Preoperative evaluation is essential, requiring a thorough assessment of the necessity, feasibility, and appropriateness of surgery, and a careful choice between follow-up observation, parenchyma-sparing resection, or radical resection. If the lesion carries a potential risk of malignancy, radical resection, such as pancreaticoduodenectomy, should be performed. During minimally invasive local resection, selecting an appropriate surgical approach, accurately localizing the tumor, protecting the main pancreatic duct (MPD), and effectively repairing and reconstructing the MPD in case of injury are key to ensuring both surgical safety and efficacy. In addition, pancreatic wound management and the long-term prognosis of patients who undergo MPD repair and reconstruction are also areas of significant concern.