Objective To measure the urethral meatus circumference in middle-aged and elderly males to undergo surgery for benign prostatic hyperplasia (BPH), and to collect data for developing endoscopic equipment suitable for the male urethra in China. Methods Clinical data were collected from patients (aged ≥50 years) who underwent transurethral resection of prostate in the First Affiliated Hospital of Xi'an Jiaotong University during Jan. and Dec. 2024. All patients had the urethral meatus circumference measured with a metal urethral probe before surgery, followed by the use of a F26.5 endoscopic sheath for surgery. The passage of urethral meatus using different types of metal urethral probes were observed. Results For the 183 patients, the types of endoscopic sheath smoothly passing through the urethral meatus were distributed as follows:42 cases (22.95%) with F26 or above, 66 cases (36.07%) with F25-26, 27 cases (14.75%) with F23-24, 26 cases (14.21%) with F21-22, 22 cases (12.02%) with F20 or below, and the smallest was F17 (1 case). Of all patients, 59.02% (108/183) were able to insert the F26.5 endoscopic sheath smoothly into the urethral meatus (≥F25), 28.96% (53/183) required force or urethral dilation before inserting (F21-F24), and 12.02% (22/183) needed to open the urethral meatus before inserting the endoscopic sheath (≤F20). Conclusion When the most common F26.5 endoscopic sheath is used, 40.98% of the patients have the possibility of urethral injury, which is significantly too big for male transurethral surgery. For patients undergoing transurethral BPH surgery, a thinner sheath should be used to reduce the possibility of urethral injury and secondary iatrogenic urethral stricture.

Objective To explore the clinical value of preoperative assessment and intraoperative frozen section pathology in screening patients suitable for testicular preservation surgery, so as to provide reference for reducing unnecessary radical orchiectomy in patients with benign testicular tumors. Methods A retrospective analysis was conducted on 121 patients who underwent surgical treatment for testicular tumors in the First Affiliated Hospital of Xi'an Jiaotong University during Jan. 2021 and Sep. 2025. Data were collected, including demographic information, preoperative imaging, serum tumor markers, surgical procedures, intraoperative frozen section, postoperative pathology, and postoperative testicular volume changes. Results Among the 121 patients, 105 underwent radical orchiectomy, with 91 malignant and 14 benign cases confirmed by postoperative pathology; 16 received testicular tumor enucleation, all confirmed as benign. Benign lesions accounted for 24.79% (30/121) of all cases. In patients undergoing tumor enucleation, intraoperative frozen section results were fully consistent with final pathological findings. Conclusion Preoperative differentiation between benign and malignant testicular tumors is crucial for selecting the appropriate surgical approach. For patients with preoperative findings suggesting benign lesions, testicular tumor enucleation combined with intraoperative frozen section can achieve precise treatment while maximizing testicular preservation.

Autoimmune hepatitis （AIH） is a chronic inflammatory liver disease mediated by T lymphocytes， and it can progress to liver cirrhosis or even liver failure without timely intervention. As a natural flavonoid compound， naringenin （NAR） shows a potential value in the prevention and treatment of AIH through multiple mechanisms such as remodeling immune homeostasis， targeted inhibition of inflammatory pathways， antioxidation， regulating hepatocyte metabolism and apoptosis， improving mitochondrial function， and regulating intestinal flora. However， the clinical translation and application of NAR is limited by issues such as low bioavailability and insufficient efficiency of liver-targeted delivery. This article systematically reviews the mechanism of action of NAR in the prevention and treatment of AIH， explores the potential signaling pathways involved in this process， and analyzes existing challenges in its translation and application and future research directions， so as to provide a reference for further research on NAR and its application in the prevention and treatment of AIH.

Objective To analyze the value of heparin-binding protein(HBP)and interleukin-17A(IL-17A)levels in bronchoalveolar lavage fluid in predicting prognosis of elderly patients with se-vere pneumonia.Methods A total of 105 elderly patients with severe pneumonia in the hospital from May 2022 to May 2024 were selected and divided into death group(n=32)and survival group(n=73)based on their survival outcomes within 28 days after admission.The levels of HBP and IL-17A in bronchoalveolar lavage fluid were compared between the two groups;the Logistic regression analysis was conducted to explore the influencing factors for prognosis in elderly patients with severe pneumoni-a;the receiver operating characteristic(ROC)curve was plotted to analyze the predictive efficiencies of HBP and IL-17A in bronchoalveolar lavage fluid for the prognosis of elderly patients with severe pneumonia.Results The levels of HBP and IL-17A in bronchoalveolar lavage fluid in the death group were significantly higher than those in the survival group(P＜0.01).There were significant differ-ences in the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score and blood lac-tate(Lac)level between the two groups(P＜0.01).Logistic regression analysis showed that HBP(OR=3.084,95％CI,1.326 to 4.694),IL-17A(OR=4.521,95％CI,2.164 to 7.841),APACHE Ⅱscore(OR=2.039,95％CI,1.069 to 2.859),and Lac(OR=2.627,95％CI,1.168 to 3.058)were influencing factors for the prognosis of elderly patients with severe pneumonia(P＜0.05).When the optimal cut-off values were set at 15.92 ng/mL for HBP and 109.34 pg/mL for IL-17A,the area under the curve(AUC)for the combined prediction of prognosis by HBP and IL-17A in bronchoalveolar lavage fluid was 0.852,with a 95％CI of 0.801 to 0.948.The AUC for the com-bined prediction of prognosis by HBP and IL-17A in bronchoalveolar lavage fluid was significantly higher than that for single tests(Z=2.906,2.416,P=0.007,0.014).Conclusion Increased levels of HBP and IL-17A in bronchoalveolar lavage fluid,decreased APACHE Ⅱ score,and in-creased Lac are influencing factors for the prognosis of elderly patients with severe pneumonia.Com-bined detection of HBP and IL-17A in bronchoalveolar lavage fluid has high sensitivity in predicting the prognosis of elderly patients with severe pneumonia.

Objective To investigate the diagnostic value of serum bromodomain-containing pro-tein 4(BRD4)combined with gastrin-17(G-17)in Helicobacter pylori(Hp)-positive early gastric cancer.Methods A total of 88 patients with Hp-positive early gastric cancer admitted to our hospital from September 2021 to September 2023 were selected as early gastric cancer group.Meanwhile,92 patients with Hp-positive precancerous lesions and 80 patients with Hp-positive gastritis admitted dur-ing the same period were selected as precancerous lesion group and gastritis group,respectively.En-zyme-linked immunosorbent assay(ELISA)was used to detect the serum levels of BRD4 and G-17.Multivariate logistic regression analysis was performed to screen the influencing factors of Hp-positive early gastric cancer.Receiver operating characteristic(ROC)curve analysis was used to evaluate the diagnostic value of serum BRD4 and G-17 in Hp-positive early gastric cancer.Results Compared with the gastritis group,the levels of BRD4 and G-17 in the precancerous lesion group and early gastric cancer group were significantly increased(P＜0.05).Furthermore,compared with the precancerous le-sion group,the levels of BRD4 and G-17 in the early gastric cancer group were also significantly elevated(P＜0.05).The proportion of patients with a family history of gastric cancer,those who preferred hot food,cold food,or high-salt food,as well as the levels of PG Ⅱ,BRD4,and G-17 were signifi-cantly higher in the early gastric cancer group than in the non-gastric cancer group,while the level of pepsinogen(PG)Ⅰ was significantly lower(P＜0.05).Logistic regression analysis revealed that preference for hot food,high-salt food,PG Ⅱ,BRD4,G-17,and PG Ⅰ were all influencing factors for Hp-positive early gastric cancer(P＜0.05).The area under the curve(AUC)values for serum BRD4,G-17,and their combination in diagnosing Hp-positive early gastric cancer were 0.793,0.830,and 0.912,respectively.The diagnostic efficacy of the combined detection was superior to that of single detection(P＜0.05).Conclusion The serum levels of BRD4 and G-17 are elevated in patients with Hp-positive early gastric cancer,and both exhibit certain diagnostic value for Hp-positive early gastric cancer,suggesting their potential as serum biomarkers for the diagnosis of Hp-positive early gastric cancer.

Objective:To investigate the value of gadoxetate disodium-enhanced MRI combined with T 1 mapping in preoperative prediction of cytokeratin 19 (CK19) and glypican-3 (GPC3) positive dual-phenotype hepatocellular carcinoma (DPHCC). Methods:This case-control study included retrospectively enrolled patients with pathologically confirmed HCC from Central People′s Hospital of Zhanjiang (training set, n=85; December 2020 to July 2022) and the Second Affiliated Hospital, School of Medicine, South China University of Technology (test set, n=35; April 2023 to April 2024). Patients were categorized into CK19 and GPC3 positive DPHCC group (training set=19, test set=11) and non-DPHCC group (training set=66, test set=24) based on postoperative immunohistochemical staining. All patients received preoperative MRI scans, including gadoxetate disodium-enhanced imaging and T 1 mapping. Clinical data were collected, qualitative MRI features were evaluated, and quantitative parameters were measured, including signal intensity, T 1 values, apparent diffusion coefficient (ADC), tumor-to-liver ADC ratio (rADC), tumor-to-liver signal intensity ratio, and T 1 relaxation time reduction rate (ΔT 1%). Statistical comparisons between groups were performed using independent t-tests, Mann-Whitney U tests, or χ2 tests. Multivariate logistic regression identified independent predictors of CK19 and GPC3 positive DPHCC, and a combined model was constructed. Predictive performance was evaluated using area under the receiver operating characteristic curve (AUC), with DeLong test comparing model performance. Results:Significant intergroup differences were observed in alpha-fetoprotein (AFP), total bilirubin, direct bilirubin, DWI target sign, rADC, hepatobiliary-phase T 1 (T 1HBP), and ΔT 1% ( P<0.05). Multivariate analysis identified AFP>20 ng/ml ( OR=5.835, 95% CI 1.019-33.397, P=0.048), DWI target sign ( OR=13.408, 95% CI 2.216-81.131, P=0.005), and ΔT1%≤31% ( OR=14.429, 95% CI 2.166-96.125, P=0.006) as independent predictors of DPHCC. The AUC values of the aforementioned three independent predictors and the combined model for predicting DPHCC were 0.641 (95% CI 0.530-0.742), 0.679 (95% CI 0.569-0.777), 0.740 (95% CI 0.634-0.829), and 0.886 (95% CI 0.799-0.945) in the training set, and 0.568 (95% CI 0.390-0.743), 0.669 (95% CI 0.490-0.818), 0.689 (95% CI 0.511-0.843), and 0.824 (95% CI 0.658-0.931) in the test set, respectively. The DeLong test results showed that in the training set, the diagnostic performance of the combined model was superior to those of the three individual features ( Z=3.68, P<0.001; Z=3.15, P=0.002; Z=3.15, P=0.002). In the test cohort, the combined model demonstrated better diagnostic performance than AFP>20 ng/ml and ΔT 1%≤31% ( Z=2.15, P=0.032; Z=2.12, P=0.034), while no statistically significant difference was observed compared with the DWI target sign ( Z=1.77, P=0.076). Conclusion:The integrated model incorporating clinical data, gadoxetate disodium-enhanced MRI, and T 1 mapping parameters effectively predicts CK19 and GPC3 positive DPHCC.

The medical mask,which is used as an important tool of preventing the spread of respiratory diseases,can effectively block the transmission of biological aerosols.The detection for the filtration efficiency of bacteria in medical mask is particular importance.The Andersen sampler,is one kind of device that samples microbial aerosols,is widely used in the inspection for the filtration efficiency for bacteria in medical masks.It mainly consists of six impactors with different pore sizes.It simulates the deposition process of the most of particles at different positions in respiratory system through the bacterial particles in biological aerosols impact respectively the surface of petri dishes with agar under different pore sizes.This paper explored the development background,structure and sampling principle,operation and counting procedures of the Andersen sampler,as well as its application and importance in the inspection for the filtration efficiency for bacteria in medical mask.

Objective:To investigate the expression of microRNA-4262 (miR-4262) and neuregulin 1 (NRG1) in non-small cell lung cancer (NSCLC) tissues and the relationship with prognosis.Methods:A total of 102 NSCLC patients who underwent surgical resection from January 2017 to February 2021 in Tongren People's Hospital of Guizhou Province were selected. The expression levels of miR-4262 and NRG1 were detected using real-time fluorescence quantitative PCR. The expression levels of miR-4262 and NRG1 in NSCLC cancer tissues and adjacent tissues, as well as NSCLC cancer tissues with different clinicopathological characteristics were analyzed. TargetScan database was used to predict the binding sites of miR-4262 and NRG1, and Pearson correlation coefficient was used to analyze the correlation between miR-4262 and NRG1 expression in NSCLC cancer tissues. Based on the mean expression levels of miR-4262 and NRG1 in NSCLC cancer tissues, the patients were divided into high miR-4262 expression group (miR-4262≥1.52, n=54) and low miR-4262 expression group (miR-4262<1.52, n=48), high NRG1 expression group (NRG1≥0.79, n=54) and low NRG1 expression group (NRG1<0.79, n=48). Kaplan-Meier survival curves were plotted to compare the 3-year overall survival (OS) rates between groups. Cox proportional risk regression model was used to analyze the influencing factors for the prognosis of NSCLC patients. Results:The expression level of miR-4262 was significantly higher in NSCLC tumor tissues compared to adjacent tissues (1.52±0.21 vs. 1.11±0.20), while NRG1 expression level was lower (0.79±0.11 vs. 1.06±0.11), there were statistically significant differences ( t=14.22, P<0.001; t=-15.13, P<0.001). The expression of miR-4262 was negatively correlated with NRG1 in cancer tissues of NSCLC patients ( r=-0.74, P<0.001). There were statistically significant differences in the expression levels of miR-4262 and NRG1 of NSCLC patients in tumor differentiation ( t=2.80, P=0.006; t=-2.80, P=0.006), TNM stage ( F=24.36, P<0.001; F=17.66, P<0.001), and lymph node metastasis ( t=4.02, P<0.001; t=-3.98, P<0.001). At the end of the follow-up period, 57 patients survived, and 45 died, with a 3-year OS rate of 55.88%. Patients with high miR-4262 expression had a significantly lower 3-year OS rate compared to those with low miR-4262 expression (35.19% vs. 79.17%), patients with high NRG1 expression had a significantly higher 3-year OS rate than those with low NRG1 expression (77.78% vs. 31.25%), there were statistically significant differences ( χ2=22.58, P<0.001; χ2=27.26, P<0.001). Univariate analysis showed that, age ( HR=2.47, 95% CI: 1.05-5.80, P=0.038), maximum tumor diameter ( HR=3.75, 95% CI: 1.61-8.74, P=0.002), differentiation degree ( HR=3.03, 95% CI: 1.32-6.96, P=0.009), TNM stage (stage Ⅱ, HR=3.45, 95% CI: 1.10-10.83, P=0.034; stage Ⅲ, HR=6.72, 95% CI: 2.03-22.26, P=0.002), lymph node metastasis ( HR=3.00, 95% CI: 1.29-6.96, P=0.010), miR-4262 expression ( HR=3.72, 95% CI: 1.48-9.35, P=0.005), and NRG1 expression ( HR=0.30, 95% CI: 0.13-0.73, P=0.008) were all influencing factors for OS in NSCLC patients. Multivariate analysis showed that, differentiation degree ( HR=5.47, 95% CI: 1.63-18.34, P=0.006), TNM stage (stage Ⅲ, HR=5.56, 95% CI: 1.23-25.14, P=0.026), lymph node metastasis ( HR=3.72, 95% CI: 1.19-11.60, P=0.024), miR-4262 expression ( HR=8.56, 95% CI: 2.26-32.41, P=0.002), and NRG1 expression ( HR=0.26, 95% CI: 0.09-0.76, P=0.014) were all independent influencing factors for OS in NSCLC patients. Conclusions:The expression of miR-4262 is high and the expression of NRG1 is low in cancer tissues of NSCLC patients. The 3-year OS rate of patients with high miR-4262 expression is lower than that of patients with low miR-4262 expression, and the 3-year OS rate of patients with high NRG1 expression is higher than that of patients with low NRG1 expression. Differentiation degree, TNM stage, lymph node metastasis, miR-4262 and NRG1 are all independent influencing factors for the prognosis of NSCLC patients.

Lung cancer is the leading cause of death worldwide. With the prevalence of CT screening and early diagnosis and treatment of lung cancer in China, more and more patients with early-stage lung cancer characterized with ground-glass opacity are discovered and urgently require treatment, which poses a significant challenge to surgeons. As an emerging technology, three dimensional reconstruction technology plays a crucial auxiliary role in clinical work. This review aims to briefly introduce this technology, focusing on its latest advances in surgical applications in early lung cancer screening, malignant risk assessment, and perioperative period application and medical education.