Objective To evaluate the efficacy and safety of 450nm semiconductor blue laser vaporization prostatectomy in high-risk benign prostatic hyperplasia (BPH) patients without discontinuing anticoagulant drugs, so as to provide a safe and effectiveminimally invasive treatment option for such patients. Methods A total of 40 high-risk BPH patients who underwent 450nm semiconductor blue laser vaporization prostatectomy in our hospital during Sep. 2023 and Dec. 2024 were selected as the research subjects. The patients were divided into two groups: the oral medication group took oral anticoagulants during the perioperative period, while the discontinuation group discontinued anticoagulants, with 20 cases in either group. The perioperative indicators and changes including international prostate symptom score (IPSS), quality of life score (QoL), maximum urinary flow rate (Qmax) and post-void residual (PVR) were compared between the two groups.Results There were no statistically significant differences between the oral medication group and discontinuation group in operation time [(28.83±15.52)min vs. (26.43±14.02)min], postoperative catheter indwelling time [(3.04±0.89) d vs. (3.23±1.01) d], bladder irrigation time [(27.36±7.54) h vs. (25.46±7.10) h], and decrease in hemoglobin [(8.08±1.82)g/L vs. (7.56±1.68)g/L] (all P＞0.05). Three month after surgery, Qmax in both groups was higher, while IPSS, QoL and PVR were significantly lower (P＜0.05), but there were no statistically significant differences between the two groups (P＞0.05). No serious complications such as urinary incontinence or massive hemorrhage occurred.Conclusion 450nm semiconductor blue laser vaporization prostatectomy for high-risk BPH patients is characterized by high vaporization efficiency and good hemostatic effects. It can significantly improve the clinical symptoms with high safety, especially for high-risk patients who cannot discontinue anticoagulants.

Objective: To explore the latent classes of peer victimization among junior high school students, and to analyze the association between the characteristics of different classes and non suicidal self injury(NSSI) behavior,so as to provide scientific basis for the prevention and intervention of NSSI behavior among junior high school students. Methods: A census method was used to select 19 738 students from 16 junior high schools in a central urban area of Wuhan as research subjects from November to December 2024. The Multidimensional Peer Victimization Scale and a self designed NSSI questionnaire were used to assess peer victimization and NSSI behaviors. Latent profile analysis (LPA) was used to identify latent classes of peer victimization among students by sex. Binary Logistic regression model was used to analyze the association between latent classes of peer victimization and NSSI behavior among junior high school students of different genders. Results: Latent patterns of peer victimization among boys were classified into 4 groups:no victimization group (85.8%, n =8 874), low victimization-verbal type group (6.6%, n =682), low victimization-mixed type group (5.7%, n =587) and high victimization group (1.9%, n =195); girls were classified into 4 groups:no victimization group (87.0%, n =8 179), low victimization group (7.5%, n =702), high victimization-social type group (3.8%, n =360) and high victimization-physical type group (1.7%, n =159). After controlling for only child status, place of residence, parenting style, and self rated family socioeconomic status, binary Logistic regression analysis showed that the risk of NSSI behavior among boys increased sequentially in the low victimization-verbal type group( OR =4.14, 95% CI =3.22-5.31), low victimization-mixed type group ( OR =4.75, 95% CI =3.68-6.13), and high victimization group ( OR =8.26, 95% CI =5.83-11.71) compared to the no victimization group; the risks of NSSI behavior among girls increased sequentially in the low victimization group ( OR =3.06, 95% CI = 2.51-3.72), high victimization-social type group ( OR =4.01, 95% CI =3.13-5.15), and high victimization-physical type group ( OR =6.18, 95% CI =4.38-8.73) compared to the no victimization group (all P <0.05). Conclusions There are gender differences in the latent classes of peer victimization among junior high school students and the risk of NSSI behavior varies across different victimization classes. Targeted prevention and intervention should be implemented based on the gender of junior high school students and the characteristics of peer victimization students experience.

Objectives:To explore the predictive value of residual Murray's law-based quantitative flow ratio(μQFR)on long-term vessel-oriented composite endpoints(VoCE).Methods:This retrospective study included 3 510 patients from the FAVOR Ⅲ China trial.Offline residual μQFR analysis was performed on all vessels(diameter≥2.5 mm)with 50%-90%stenotic lesions.Patients were stratified into high-,intermediate-,and low-risk groups based on residual μQFR tertiles.The primary endpoint was 3-year VoCE,defined as a composite of cardiac death related to the target vessel,target vessel-related spontaneous myocardial infarction,and ischemia-driven target vessel revascularization.Results:Offline analysis was performed on 5 256 vessels from 3 510 patients.The mean residual μQFR was 0.92±0.75.The high-risk group(residual μQFR≤0.91)with 1 554 patients(1 958 vessels);the intermediate-risk group(residual μQFR 0.92-0.96)with 1 211 patients(1 906 vessels);and the low-risk group(residual μQFR>0.96)with 745 patients(1 392 vessels).Over 3-year follow-up,VoCE occurred in 227 vessels(4.3%).The 3-year VoCE incidence was significantly higher in the high-risk group compared to the intermediate-and low-risk groups(6.2%vs.4.1%vs.2.5%,log-rank P<0.001),primarily driven by ischemia-driven target vessel revascularization(5.0%vs.3.0%vs.1.6%,log-rank P<0.001).Hypertension(OR=0.83,95%CI:0.72-0.96),hypercholesterolemia(OR=0.84,95%CI:0.73-0.97),bifurcation lesions(OR=0.72,95%CI:0.63-0.83),moderate/severe calcification(OR=0.70,95%CI:0.57-0.84),and tandem lesions(OR=0.59,95%CI:0.47-0.75)were independent predictors of lower residual μQFR values.Conclusions:Lower residual μQFR is significantly associated with increased VoCE risk during the 3-year follow up period.

Glucagonoma is a rare neuroendocrine tumor derived from the pancreatic α cells, and alopecia is an uncommon clinical manifestation. We report a case of glucagonoma presenting with marked alopecia, aiming to raise clinicians′ awareness of this rare presentation.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

A mounting body of research suggests that circRNAs significantly contribute to the develop-ment of myocardial fibrosis.The microarray results of human circular RNA expression profile indicated that circHERC4_041 expression increased in the myocardium of patients with heart failure,RT-qPCR a-nalysis confirmed that the myocardial expression level of circHERC4_041 in individuals with heart failure were considerably elevated compared to that in healthy organ donors.Fluorescence in situ hybridization(FISH)confirmed that circHERC4_041 was abundant in the cytoplasm of human cardiomyocyte AC16.Overexpression of circHERC4_041 in mouse myocardial fibroblasts(mCFs)mediated by adenovirus in-hibited the expression of fibrosis-related proteins in mCFs.Experiments involving cell proliferation,wound healing,and Transwell assays demonstrated that overexpression of circHERC4_041 suppressed the growth and mobility of mCFs(P＜0.001).Sequence analysis results suggested that circHERC4_041 con-tains potential ribosome entry sequence(IRES)and open reading frame(ORF).Western blot confirmed that circHERC4_041 could translate the 516 amino acid HERC4-516aa protein,which was mainly located in the cytoplasm of the cell.Cell functional experiments confirmed that circHERC4_041 inhibited the fi-brotic phenotype of mCFs by specifically translating HERC4-516aa(P＜0.05).The specific interaction between HERC4-516aa and transglutaminase 2(TGM2)was confirmed by IP-MS screening and Co-IP i-dentification.Further results found that the degradation of TGM2 was promoted through proteasome path-way.The overexpression of TGM2 in mCFs facilitated by adenoviral vectors could counteract the suppres-sive effects of HERC4-516aa on the fibrotic phenotype of mCFs.Therefore,this study confirmed that the HERC4-516aa protein translated by circHERC4_041 can specifically bind to TGM2 to inhibit the fibrotic phenotype of myocardial fibroblasts.

Objective:To systematically integrate the lived experiences of women regarding decision-making participation and informed choice during intrapartum care, providing evidence-based guidance for improving obstetric healthcare management and service quality, and enhancing women′s childbirth experiences.Methods:Computerized searches were conducted in PubMed, Web of Science, Cochrane Library, CINAHL, PsycINFO, Scopus, ProQuest, China National Knowledge Infrastructure, Wanfang, Chinese Scientific Journals Database, and China Biology Medicine disc for qualitative studies on women′s experiences of shared decision-making participation and informed choice during childbirth. The search period spanned from January 1, 1997 to August 15, 2024. Literature quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. Meta-aggregation was employed to synthesize findings by grouping similar results into new categories and integrating outcomes based on logical relationships between categories.Results:Eleven studies were included, yielding 47 key findings synthesized into 10 categories and further integrated into four overarching themes: complex emotional experiences in intrapartum decision-making participation; Diverse coping strategies for intrapartum decision-making participation; multiple stressors faced during intrapartum decision-making participation; multifaceted support needs in intrapartum decision-making participation.Conclusions:Midwives and healthcare providers should deliver education on shared decision-making and informed choice during the third trimester. Continuous attention to maternal emotional shifts regarding decision-making participation and informed choice during labor is essential. Comprehensive decision support, effective intrapartum communication, and initiatives to promote maternal autonomy through empowerment and capacity building should be prioritized.

A mounting body of research suggests that circRNAs significantly contribute to the develop-ment of myocardial fibrosis.The microarray results of human circular RNA expression profile indicated that circHERC4_041 expression increased in the myocardium of patients with heart failure,RT-qPCR a-nalysis confirmed that the myocardial expression level of circHERC4_041 in individuals with heart failure were considerably elevated compared to that in healthy organ donors.Fluorescence in situ hybridization(FISH)confirmed that circHERC4_041 was abundant in the cytoplasm of human cardiomyocyte AC16.Overexpression of circHERC4_041 in mouse myocardial fibroblasts(mCFs)mediated by adenovirus in-hibited the expression of fibrosis-related proteins in mCFs.Experiments involving cell proliferation,wound healing,and Transwell assays demonstrated that overexpression of circHERC4_041 suppressed the growth and mobility of mCFs(P＜0.001).Sequence analysis results suggested that circHERC4_041 con-tains potential ribosome entry sequence(IRES)and open reading frame(ORF).Western blot confirmed that circHERC4_041 could translate the 516 amino acid HERC4-516aa protein,which was mainly located in the cytoplasm of the cell.Cell functional experiments confirmed that circHERC4_041 inhibited the fi-brotic phenotype of mCFs by specifically translating HERC4-516aa(P＜0.05).The specific interaction between HERC4-516aa and transglutaminase 2(TGM2)was confirmed by IP-MS screening and Co-IP i-dentification.Further results found that the degradation of TGM2 was promoted through proteasome path-way.The overexpression of TGM2 in mCFs facilitated by adenoviral vectors could counteract the suppres-sive effects of HERC4-516aa on the fibrotic phenotype of mCFs.Therefore,this study confirmed that the HERC4-516aa protein translated by circHERC4_041 can specifically bind to TGM2 to inhibit the fibrotic phenotype of myocardial fibroblasts.

Objective To explore the value of combining apparent diffusion coefficient(ADC)heterogeneity with morphological indicators in assessing the pathological grading of non-muscle invasive bladder cancer(NMIBC).Methods The MRI images of 86 patients confirmed with NMIBC by surgical pathology were analyzed retrospectively.All patients underwent T2WI,diffusion weighted ima-ging(DWI),and dynamic contrast enhancement(DCE)examinations.Two radiologists independently measured tumor largest diam-eter(LD),actual tumor-wall contact length(ACTCL),ADCmean,ADCmin,and ADCmax values.ADC heterogeneity was calculated using the formula(ADCmax-ADCmin)/ADCmean.Differences in quantitative parameters between low-and high-grade NMIBC were compared using the Mann-Whitney U test,while differences in qualitative parameters were compared using the chi-square test.Univariate and multivariate logistic regression analyses were used to identify independent predictors of high-grade NMIBC,and receiver operating characteristic(ROC)curves were drawn to evaluate the performance of ADC heterogeneity combined with morphological indicators in assessing high-grade NMIBC.Results ADC heterogeneity and ACTCL were independent predictors for preoperative assessment of NMIBC pathological grading.The area under the curve(AUC)of ADC heterogeneity and ACTCL in assessing high-grade NMIBC were 0.843 and 0.744,respectively.The combined AUC was 0.902.The difference was statistically significant(P<0.05).Conclusion The combination of ADC heterogeneity with ACTCL can effectively improve the efficiency of preoperative assessment of NMIBC pathological grading,and providing more precise clinical decision-making and prognosis monitoring.

Background and Aims:With the widespread use of electrosurgical devices in open thyroid surgery,the surgical smoke generated during procedures has become a significant concern,as it compromises surgical visibility,reduces operational efficiency,and poses health risks to medical staff.Currently,local smoke evacuation is commonly performed by an assistant using a handheld suction device,which is limited in range,interferes with surgical procedures,and increases labor costs.This study aimed to evaluate the effectiveness,safety,feasibility,and staff satisfaction associated with a self-made annular smoke evacuation device constructed from readily available materials for use in open thyroid surgery.Methods:A total of 82 patients undergoing open surgery for papillary thyroid carcinoma at Suqian First People's Hospital between March and June 2024 were randomly assigned to an observation group and a control group(41 patients each).During surgery,the observation group used a self-made annular smoke evacuation device for continuous smoke removal,while the control group used conventional manual suction via an assistant.Outcomes compared between the two groups included PM2.5 concentrations 30 cm above the surgical field,operative time,intraoperative blood loss,and medical staff satisfaction with smoke removal.Results:During thyroid tissue dissection,the PM2.5 concentration in the observation group was(63.26±11.71)μg/m3,corresponding to a"good"air quality level,while in the control group it was(126.35±40.12)μg/m3,ranging from"mild to severe pollution"—a statistically significant difference(P<0.05).In the observation group,operative times for unilateral and bilateral procedures were(31.25±11.36)min and(71.13±17.12)min,respectively,with intraoperative blood loss of(10.5±5.3)mL and(18.6±5.5)mL.In the control group,times were(39.27±15.42)min and(78.35±22.35)min,with blood loss of(12.5±5.8)mL and(20.5±6.5)mL,respectively—all differences not statistically significant(all P>0.05).Staff satisfaction was significantly higher in the observation group compared to the control group(97.6%vs.31.7%,P<0.05).Conclusion:The self-made annular smoke evacuation device demonstrated favorable results in open thyroid surgery,effectively reducing surgical smoke concentration,improving visibility,and minimizing health risks to medical staff without compromising surgical efficiency or safety.The device is cost-effective,easy to assemble,and can be repurposed postoperatively as a drainage tube,requiring no additional consumables.Its reusability and ease of integration offer strong practical value and clinical applicability.