Objective To compare the efficacy and safety of transurethral blue laser vaporization of the prostate, transurethral resection of the prostate (TURP) or plasmakinetic resection of the prostate in the treatment of benign prostatic hyperplasia (BPH). Methods The domestic and foreign clinical studies on transurethral blue laser vaporization of the prostate (observation group), TURP or plasmakinetic resection of the prostate (control group) in the treatment of BPH during Jan. 2015 and Mar. 2025 were retrieved. The data were extracted with Cochrane systematic review method. The operation time, decrease in hemoglobin, bladder irrigation time, catheter indwelling time, total complication rate, retrograde ejaculation rate and urinary incontinence rate of the two groups were compared with RevMan 5.3.0 statistical software. Results A total of 5 Chinese studies involving 491 patients (248 in the observation group and 243 in the control group) were included in the Meta-analysis. Compared with the control group, the observation group had shorter operation time [MD=-20.80, 95%CI:-26.88—-14.72, P＜0.00001], less decrease in hemoglobin [MD=-10.61, 95%CI: -20.21—-1.01, P=0.03], shorter bladder irrigation time [MD=-17.85, 95%CI: -32.62—-3.09, P=0.002], shorter catheter indwelling time [MD=-1.71, 95%CI: -2.81—- 0.62, P=0.002], lower total complication rate [OR=0.11, 95%CI: 0.06—0.21, P＜0.00001], lower retrograde ejaculation rate [OR=0.05, 95%CI: 0.02—0.16, P＜0.00001] and lower urinary incontinence rate [OR=0.24, 95%CI: 0.07—0.79, P=0.02]. There were no significant differences in other complications between the two groups (P＞0.05). The international erectile function score (IIEF-5) of the observation group was significantly higher than that of the control group [MD=1.87, 95%CI:1.16—2.57, P＜0.00001]. There were no significant differences in international prostate symptom score (IPSS), maximum urinary flow rate (Qmax) and post-voiding residual (PVR) between the two groups (P＞0.05). Conclusion All three surgical procedures can effectively improve the lower urinary tract symptoms of BPH patients. Compared with TURP or plasmakinetic resection of the prostate, transurethral blue laser vaporization of the prostate has obvious advantages in terms of perioperative recovery, reduction of total complications, urinary incontinence and retrograde ejaculation rates, and preservation of sexual function.

OBJECTIVE To assess the cost-effectiveness of durvalumab combined with chemotherapy as a first-line treatment for advanced biliary tract cancer from the perspective of the Chinese healthcare system. METHODS Using data from the TOPAZ-1 clinical trial， a three-state Markov model comprising progression-free survival （PFS）， progressive disease （PD） and death was developed， with a cycle length of 21 days and a 10-year time horizon. Patients in the observation group received durvalumab in combination with gemcitabine and cisplatin， whereas those in the control group received placebo plus the same chemotherapy regimen. The evaluation indexes were quality-adjusted life year （QALY） and the incremental cost-effectiveness ratio （ICER）. The willingness-to-pay （WTP） threshold was set at three times the 2024 Chinese per capita gross domestic product （GDP） （287 247 yuan/QALY）. The sensitivity analyses， along with scenario analyses， were performed. RESULTS In the base-case analysis， the ICER of observation group compared to control group was 1 166 344.46 yuan/QALY， far exceeding the WTP threshold， indicating that the regimen was not cost-effective. One-way sensitivity analysis identified the PD state utility， discount rate， cost of durvalumab， and PFS state utility as the main drivers of ICER variation. Probabilistic sensitivity analysis showed that， at the above WTP threshold， the probability of the acceeptance of this regimen was 0， further supporting the robustness of the base-case findings. In the scenario analysis， inclusion of a patient assistance program reduced the ICER to 235 885.16 yuan/ QALY， below the above WTP threshold， suggesting cost-effectiveness under this assistance program. However， when applying a regional WTP threshold set at three times the per capita GDP （158 475 yuan/QALY） of Gansu Province （the province with the lowest GDP in China in 2024）， the ICER remained above the threshold， indicating that the regimen was not cost-effective at the regional level. CONCLUSIONS At current pricing， durvalumab plus chemotherapy as a first-line treatment for advanced biliary tract cancer is not cost-effective in China. Although the introduction of a patient assistance program can substantially reduce the ICER and achieve cost-effectiveness at a WTP threshold set at three times the 2024 per capita GDP of China， due to limited affordability in low-income areas， the program remains not cost-effective.

This paper reported the clinical manifestations, pathological features, immunophenotype and follow-up of two patients with superficial CD34-positive fibroblastic tumor (SCPFT), who were admitted to Shandong Provincial Hospital in 2022 and 2023, and discussed the relevant literatures. The two patients, aged 43 and 20 years old, were both male. Their tumors were located in the perineum and the back of left shoulder, respectively. Both presented as single slow-growing subcutaneous masses with a course typically measured in years, accompanied by mild tenderness but without pain or pruritus. Microscopically, spindled to epithelioid cells and pleomorphous nuclear cells arranged in cellular fascicles and solid sheets were the main findings. Immunophenotypically, positive expression of CD34 was found in both cases. Extended resection ensured negative marginal and basal margins for both cases. No recurrence was observed after 22 and 12 months of follow-up, respectively. Clinical features, pathology, and differential diagnosis were discussed and summarized through a review of relevant literature. SCPFT is a novel type of fibroblastic tumor categorized as a low-grade malignant soft tissue tumor with unique pathological and biological characteristics that is relatively rare clinically. Routine resection may lead to recurrence; therefore, long-term follow-up is necessary. The combination of morphological characteristics and immunohistochemistry is helpful to diagnosis. It is important to differentiate this disease from other tumors to avoid misdiagnosis or mistreatment.

Objective To explore the impact of ondansetron's use within 24 h before delirium assess-ment in ICU patients on the risk of delirium occurrence.Methods All data were derived from the Critical Care Medical Information Database(MIMIC)-Ⅲ,MIMIC-Ⅳ and the eICU Collaborative Research Database.The research subjects were the patients who were admitted to ICU for treatment for the first time and had re-cords of delirium assessment.The research variable was whether ondansetron was used within 24 h before de-lirium assessment.The main observation indicator was whether delirium occurred after the patient entering to ICU,and whether the patient died during hospitalization or was discharged and returned home was taken as the secondary observation indicator.The propensity score matching eliminated confounding factors,and the stepwise logistic regression and nearest neighbor matching were used to analyze the influencing factors.Results A total of 78 364 patients had the delirium assessment records,among them 22 158 patients had the positive assessment results.A total of 294 patients who used ondansetron within 24 h before delirium assess-ment were taken as the ondansetron group,and 78 070 patients who did not use ondansetron were taken as the control group.Propensity score matching corrected most of the covariates between the two groups.The results of multivariate logistic regression analysis showed that the use of ondansetron was a protective factor for the delirium occurrence(OR=0.72,95％CI:0.53-0.96),and the results of nearest neighbor matching analysis also supported this association(OR=0.48,95％CI:0.31-0.76).However,the use of ondansetron had no effect on the outcome of in-hospital death or discharge home for critically ill patients(P＞0.05).Conclusion Ondansetron may be an effective drug for the prevention or treatment of delirium in critically ill patients.

OBJECTIVE To systematically analyze the functional system and construction requirements for infection prevention and control('infection control system'in short)in medical institutions so as to facilitate the effective,standardized and practical construction of the infection control system.METHODS The questionnaires were de-signed based on the relevant criteria and literatures that were released in China with the combination of expect con-sultant and were distributed to experts or professionals involving multiple fields such as hospital infection manage-ment,clinical medical treatment and information technology.The questionnaires were recycled,summarized and analyzed.RESULTS The list of functions of the infection control system(consultative draft)was formulated after review of literatures and expert consultation,including fundamental functions such as data management,case sur-veillance and intervention feedback as well as the advanced functions like target surveillance,occupational protec-tion and interconnection.The surveyed subjects agreed unanimously after the questionnaire survey that all of the function modules and elements enlisted were important,the average score of importance was more than 4 points,the score of coefficient of variable(CV)for importance of the function modules was less than 0.25,indicating that there was high consistency in the opinions among the surveyed subjects.The element of tracing and epidemiologi-cal survey function was adopted and added according to the feedback suggestions from some of the subjects;two function elements including data query and clinical interaction were revised,and the list of function requirements for the infection control systems was finally defined.CONCLUSION The requirements for functions of the infection control system that are determined in the study can provide important bases and data support for the research and standardized development of future infection control system.

Pulpitis is a prevalent inflammatory disease in dentistry, and root canal therapy remains the primary clinical treatment for it. However, pulp removal leads to reduced tooth fracture resistance and complications such as secondary infection and tooth fracture. As a potential alternative, vital pulp therapy (VPT) relies on precise assessment of pulp status; yet current clinical diagnostic methods lack specificity. The establishment of appropriate animal models for pulpitis is crucial for investigating its pathogenesis, developing specific diagnostic biomarkers, and optimizing VPT strategies. This review systematically summarizes experimental animals selection based on anatomical compatibility and pathological similarity, as well as model construction methods and multimodal evaluation systems for pulpitis animal models, aiming to provide insights for related researches.

Objective:To investigate the impact of olanzapine and risperidone on the cognitive function, sensory gating function and clinical symptoms of patients with first-episode schizophrenia(FES).Additionally, to analyze the correlation between sensory gating inhibitory deficits and cognitive impairment in FES patients.Methods:A total of 71 FES patients were selected in the Third People's Hospital of Zhongshan City from March 2023 to March 2024, and 60 healthy controls were recruited during the same period.The FES patients were divided into olanzapine group and risperidone group by random number table.Olanzapine group was treated with variable doses of olanzapine(10-20 mg/d), and risperidone group was treated with variable doses of risperidone(3-6 mg/d).The MATRICS consensus cognitive battery(MCCB) was used to evaluate the cognitive function of the patients, P50 index was measured by auditory paired condition-stimulus paradigm, and the efficacy was evaluated by positive and negative syndrome scale(PANSS) score reduction rate before and after 6 weeks of treatment.Healthy controls were assessed cognitive function only once with P50.SPSS 25.0 software was used for data processing. Perform statistical analysis using paired sample t-test, Wilcoxon signed rank test, independent sample t-test, Mann Whitney U test, χ2 test and generalized linear model. Results:Before treatment, the S2 amplitude of FES (1.74 (0.91, 2.79) μV) was higher than that of healthy controls (1.70 (1.04, 2.71) μV) (Wald χ2=4.483, P=0.034), the S2/S1 ratio of FES (0.58 (0.43, 0.78)) was higher than that of healthy controls (0.41 (0.31, 0.57)) (Wald χ2=10.909, P=0.001), and the difference of FES amplitude of S1-S2 was (1.22 (0.43, 1.92) μV) was lower than that of healthy controls (2.23 (1.54, 3.07) μV) (Wald χ2=17.679, P<0.001). There was no significant difference in PANSS, MCCB and P50 between olanzapine group and risperidone group before treatment (all P>0.05). After treatment, there was no significant difference in response rate between the two groups ( χ2=0.059, P=0.808), the PANSS scores were lower than those before treatment, the MCCB test results were higher than those before treatment (both P<0.05), and the P50 results were not statistically significant different compared with those before treatment (both P>0.05). The generalized linear model showed that the S1, S2 amplitude of the P50 had positive impact on the connection test score in the MCCB test ( β=0.466, P=0.020; β=0.879, P=0.009), other indicators were not found to have an impact on the test scores of the MCCB test (all P>0.05). Conclusion:Olanzapine and risperidone can significantly improve the cognitive function of FES, but the improvement of sensory gating deficits is limited. The pathogenic mechanism of sensory gating inhibitory deficits in FES may be different from that of cognitive dysfunction.

Objective:To explore the efficacy in the treatment of chronic apical periodontitis caused by dental trauma in young permanent teeth with the combination of autologous platelet-poor plasma(PPP)and concentrate growth factors(CGF).Methods:80 young children with chronic apical periodontitis of permanent teeth admitted to the Department of Dentistry and Endodontics of Stomatological Hospital from September 2021 to September 2023 were included,and the patients were divided into three groups A,B and C using a computer-generated random number table.Group A was treated with bioceramic material iRoot BP Plus.Group B was treated with CGF,and Group C was treated with CGF combined with PPP.Clinical and imaging evaluations were performed af-ter treatment.Results:At the last follow-up,the treatment effectiveness rate of the CGF+PPP group was 85.71％,which was sig-nificantly higher than the 52.00％of the iRoot BP Plus group and 59.26％of the CGF group(P＜0.05).In terms of root develop-ment,the root canal length and root canal wall thickness increased more significantly in the CGF+PPP group after treatment(P＜0.05).Regarding the reduction in periapical lesion volume,the reduction in lesion volume in the CGF+PPP group was more obvi-ous(P＜0.05).Comparing the recovery status of the affected teeth after treatment,the proportion of normal pulp vitality and normal tooth color in the CGF+PPP group was significantly higher than that in the iRoot BP Plus group(P＜0.05).Conclusion:Autolo-gous platelet-poor plasma combined with CGF can more effectively promote tooth root development and lesion healing than iRoot BP Plus or CGF alone in the treatment of chronic apical periodontitis caused by trauma to young permanent teeth.

Objective:To explore the efficacy in the treatment of chronic apical periodontitis caused by dental trauma in young permanent teeth with the combination of autologous platelet-poor plasma(PPP)and concentrate growth factors(CGF).Methods:80 young children with chronic apical periodontitis of permanent teeth admitted to the Department of Dentistry and Endodontics of Stomatological Hospital from September 2021 to September 2023 were included,and the patients were divided into three groups A,B and C using a computer-generated random number table.Group A was treated with bioceramic material iRoot BP Plus.Group B was treated with CGF,and Group C was treated with CGF combined with PPP.Clinical and imaging evaluations were performed af-ter treatment.Results:At the last follow-up,the treatment effectiveness rate of the CGF+PPP group was 85.71％,which was sig-nificantly higher than the 52.00％of the iRoot BP Plus group and 59.26％of the CGF group(P＜0.05).In terms of root develop-ment,the root canal length and root canal wall thickness increased more significantly in the CGF+PPP group after treatment(P＜0.05).Regarding the reduction in periapical lesion volume,the reduction in lesion volume in the CGF+PPP group was more obvi-ous(P＜0.05).Comparing the recovery status of the affected teeth after treatment,the proportion of normal pulp vitality and normal tooth color in the CGF+PPP group was significantly higher than that in the iRoot BP Plus group(P＜0.05).Conclusion:Autolo-gous platelet-poor plasma combined with CGF can more effectively promote tooth root development and lesion healing than iRoot BP Plus or CGF alone in the treatment of chronic apical periodontitis caused by trauma to young permanent teeth.