Objective:To analyze the value of abdominal CT angiography (CTA) and three-dimensional reconstruction fusion technology for larger (2 - 5 cm) gastric submucosal tumors (SMT) in the preoperative evaluation of super minimally invasive surgery(SMIS).Methods:A retrospective study was conducted, collecting data from 20 patients with gastric SMTs measuring 2 - 5 cm in diameter who were hospitalized in the the First Medical Center of the Chinese PLA General Hospital from March 2023 to December 2024. All patients underwent abdominal CTA prior to SMIS, and three-dimensional reconstructions of the tumors were performed. Clinical data were collected to analyze the visualization of the tumors and surrounding blood vessels in the fused three-dimensional images and the corresponding surgical plans.Results:In 19 cases, the abdominal CTA and three-dimensional imaging clearly and intuitively displayed the anatomical structures surrounding the tumors and provided panoramic images of small blood vessels around the tumors, enabling the selection of appropriate surgical plans. One case required conversion to laparoscopic surgery due to the intraoperative discovery of a small artery.Conclusions:The abdominal CTA examination and gastric SMT three dimensional reconstruction before SMIS can better display the anatomical location of the tumor and its relationship with surrounding small blood vessels, which is beneficial for gastroenterologists to formulate surgical plans and facilitate the smooth progress of SMIS under endoscopy.

Objective:To analyze the value of abdominal CT angiography (CTA) and three-dimensional reconstruction fusion technology for larger (2 - 5 cm) gastric submucosal tumors (SMT) in the preoperative evaluation of super minimally invasive surgery(SMIS).Methods:A retrospective study was conducted, collecting data from 20 patients with gastric SMTs measuring 2 - 5 cm in diameter who were hospitalized in the the First Medical Center of the Chinese PLA General Hospital from March 2023 to December 2024. All patients underwent abdominal CTA prior to SMIS, and three-dimensional reconstructions of the tumors were performed. Clinical data were collected to analyze the visualization of the tumors and surrounding blood vessels in the fused three-dimensional images and the corresponding surgical plans.Results:In 19 cases, the abdominal CTA and three-dimensional imaging clearly and intuitively displayed the anatomical structures surrounding the tumors and provided panoramic images of small blood vessels around the tumors, enabling the selection of appropriate surgical plans. One case required conversion to laparoscopic surgery due to the intraoperative discovery of a small artery.Conclusions:The abdominal CTA examination and gastric SMT three dimensional reconstruction before SMIS can better display the anatomical location of the tumor and its relationship with surrounding small blood vessels, which is beneficial for gastroenterologists to formulate surgical plans and facilitate the smooth progress of SMIS under endoscopy.

Objective To observe the effects of hemoperfusion(HP)combined with hemodialysis on cholinesterase(ChE)activity and inflammatory factors in patients with acute organophosphorus pesticide poisoning(AOPP).Methods A retrospective cohort study was conducted.Seventy-three AOPP patients admitted to the department of emergency of Yingshang People's Hospital from January 2020 to December 2022 were enrolled.The patients were divided into HP group(31 cases)and HP+continuous renal replacement therapy(CRRT)group(42 cases)according to different treatment regimens.All patients were given supportive treatment according to the standard protocol after admission.HP was given to the patients as soon as possible after admission,and the treatment time was between 2 hours and 3 hours,with an interval of 24 hours.Patients in HP+CRRT group were treated with continuous veno-venous hemodiafiltration(CVVHDF)after HP.The serum ChE,tumor necrosis factor-α(TNF-α),and interleukins(IL-1,IL-6)levels were compared between the two groups after admission(T0),at the end of the first HP/HP+CRRT(T1),at the end of the second HP/HP+CRRT(T2),and at the end of the third HP/HP+CRRT(T3).The ChE recovery time,the incidence of intermediate syndrome(IMS),the length of hospital stay,and the rate of admission to ICU were also compared.Results With the extension of treatment time,the ChE activity at T1,T2,and T3 in the two groups was significantly higher than that at T0,and the levels of TNF-α,IL-1,and IL-6 were significantly lower than those at T0,reaching the trough value at T3,and the changes in HP+CRRT group were more significant than those in HP group[ChE activity(U/L):2 903.26±164.43 vs.2 292.98±350.96,TNF-α(ng/L):78.24±10.75 vs.100.55±15.58,IL-1(ng/L):95.98±22.56 vs.127.94±18.74,IL-6(ng/L):34.36±8.66 vs.58.74±10.46,all P<0.05].The recovery time of ChE activity and length of hospital stay in HP+CRRT group were significantly shorter than those in HP group[ChE activity recovery time(days):4.42±1.17 vs.7.31±1.46,length of hospital stay(days):9.25±2.14 vs.12.75±2.30,both P<0.05],the incidence of IMS and ICU admission rate were significantly lower than those in HP group[the incidence of IMS:33.33%(14/42)vs.61.29%(19/31),ICU admission rate:9.52%(4/42)vs.29.03%(9/31),both P<0.05].Conclusion For AOPP patients,HP+CRRT is superior to HP alone in the clearance of inflammatory factors,restoring ChE activity,reducing the incidence of IMS,and shortening the length of hospital stay,making it a valuable option for clinical application.

HBV/HCV dual infection is not uncommon, especially in highly endemic areas and among individuals at elevated risk of infection, because of the common transmission mode of hepatitis B virus (HBV) and hepatitis C virus (HCV) and may be underestimated due to the presence of occult HBV infection. HBV/HCV dual infection is associated with more rapid progression to advanced severe liver disease, severely increased fibrosis or cirrhosis, liver decompensation, and the development of hepatocellular carcinoma, thus requiring effective antiviral treatment. However, the intracellular interaction between HBV and HCV has not been fully elucidated at present. This paper summarizes the recent research on HBV/HCV dual infection and the current status of treatment and emphasizes the aspects that need further clarification in order to provide a basis for exploring treatment strategies for dual infection.

Objective:To explore the relationship between intestinal microbiomes and asthenospermia.Methods:This was a retrospective case control study. A total of 32 men with asthenospermia and 30 normal men (named control group) were included. The subjects were recruited from Department of Andrology of Shenyang Jinghua Hospital from January 2021 to June 2021. Basic information was collected, semen quality was tested, abundance of intestinal bacteria in feces was detected using 16S rDNA full length assembly sequencing technology (16S-FAST).Results:In patients with asthenospermia, the total sperm count [112.22×10 6 (79.13×10 6, 179.76×10 6)], forward progressive motility rate [22.93% (16.71%, 28.02%)], non-forward progressive motility rate [5.60% (3.98%, 7.62%)] were significantly lower and immobile sperm rate [72.19% (65.27%,78.92%)] was significantly higher than those of control group [166.76×10 6 (110.17×10 6, 262.79×10 6), P=0.022; 42.37% (35.21%, 57.88%), P<0.001; 8.82% (6.18%,11.14%), P=0.001; 50.88% (33.33%, 56.24%), P<0.001], and there were no significant differences in age and body mass index between the two groups (all P>0.05). The participating population can be divided into enterotype 1 (Bacteroide enterotype) and enterotype 2 (Prevotella enterotype). There was no significant difference in α diversity between asthenospermia group and control group in two enterotypes (all P>0.05). In the population with enterotype 2, β diversity analysis clearly separated the microbiome of men with asthenospermia and healthy controls, and the abundance of Proteobacteria phylum, Clostridium sp., Ruminococcus bromii, Phocea massiensis, C. disporicum, Tyzzerella sp. Marseille_P3062, Howardella ureilytica, C. perfringens, and C. sp. BG-C151 species were more abundant in men with asthenospermia compared with control group [linear discriminant analysis (LDA)>2]; while in the population with enterotype 1, β diversity analysis could not separate the microbiome of men with asthenospermia and non-asthenospermia men ( P>0.05). In addition, KEGG analysis showed that in the population with enterotype 2, thiamine metabolism PATH ko00730 pathway, which was closely related to differential bacteria, was significantly less abundant in asthenospermia group than in control group (LDA>2). Conclusion:The intestinal microbiome and KEGG functional pathways differed significantly between asthenospermia and normozoospermia in population with enterotype 2, while there was no difference in the enterotype 1 population. Changes in intestinal microbiome may have an impact on sperm motility in specific populations.

Objective:To explore the relationship between intestinal microbiomes and asthenospermia.Methods:This was a retrospective case control study. A total of 32 men with asthenospermia and 30 normal men (named control group) were included. The subjects were recruited from Department of Andrology of Shenyang Jinghua Hospital from January 2021 to June 2021. Basic information was collected, semen quality was tested, abundance of intestinal bacteria in feces was detected using 16S rDNA full length assembly sequencing technology (16S-FAST).Results:In patients with asthenospermia, the total sperm count [112.22×10 6 (79.13×10 6, 179.76×10 6)], forward progressive motility rate [22.93% (16.71%, 28.02%)], non-forward progressive motility rate [5.60% (3.98%, 7.62%)] were significantly lower and immobile sperm rate [72.19% (65.27%,78.92%)] was significantly higher than those of control group [166.76×10 6 (110.17×10 6, 262.79×10 6), P=0.022; 42.37% (35.21%, 57.88%), P<0.001; 8.82% (6.18%,11.14%), P=0.001; 50.88% (33.33%, 56.24%), P<0.001], and there were no significant differences in age and body mass index between the two groups (all P>0.05). The participating population can be divided into enterotype 1 (Bacteroide enterotype) and enterotype 2 (Prevotella enterotype). There was no significant difference in α diversity between asthenospermia group and control group in two enterotypes (all P>0.05). In the population with enterotype 2, β diversity analysis clearly separated the microbiome of men with asthenospermia and healthy controls, and the abundance of Proteobacteria phylum, Clostridium sp., Ruminococcus bromii, Phocea massiensis, C. disporicum, Tyzzerella sp. Marseille_P3062, Howardella ureilytica, C. perfringens, and C. sp. BG-C151 species were more abundant in men with asthenospermia compared with control group [linear discriminant analysis (LDA)>2]; while in the population with enterotype 1, β diversity analysis could not separate the microbiome of men with asthenospermia and non-asthenospermia men ( P>0.05). In addition, KEGG analysis showed that in the population with enterotype 2, thiamine metabolism PATH ko00730 pathway, which was closely related to differential bacteria, was significantly less abundant in asthenospermia group than in control group (LDA>2). Conclusion:The intestinal microbiome and KEGG functional pathways differed significantly between asthenospermia and normozoospermia in population with enterotype 2, while there was no difference in the enterotype 1 population. Changes in intestinal microbiome may have an impact on sperm motility in specific populations.

HBV/HCV dual infection is not uncommon, especially in highly endemic areas and among individuals at elevated risk of infection, because of the common transmission mode of hepatitis B virus (HBV) and hepatitis C virus (HCV) and may be underestimated due to the presence of occult HBV infection. HBV/HCV dual infection is associated with more rapid progression to advanced severe liver disease, severely increased fibrosis or cirrhosis, liver decompensation, and the development of hepatocellular carcinoma, thus requiring effective antiviral treatment. However, the intracellular interaction between HBV and HCV has not been fully elucidated at present. This paper summarizes the recent research on HBV/HCV dual infection and the current status of treatment and emphasizes the aspects that need further clarification in order to provide a basis for exploring treatment strategies for dual infection.

Humans ; Melanoma/therapy* ; Immunotherapy ; Syndrome ; Skin Neoplasms

Objective:To evaluate the predictive value of proximal ureteral diameter (D1)to distal ureteral diameter (D2)ratio (DDR) for impacted stones in the middle and upper ureter.Methods:The clinical data of 173 patients with middle and upper ureteral calculi admitted to the Third Hospital of Shanxi Medical University from January 2014 to November 2021 were retrospectively analyzed. There were 75 males and 98 females, with the median age of 56.0 (51.0, 62.0) years old and median body mass index of 26.1 (24.8, 27.2) kg/m 2. The imaging data of the patients were analyzed. The impacted stones were defined as the inability of the contrast agent to pass through the site of obstruction when intravenous urography or CT urography was performed, resulting in the inability of the ureter to visualize normally in parts below the site of obstruction. D1 was defined as the proximal ureteral diameter at the lower pole of the kidney on horizontal CT images. D2 was defined as the ureteral diameter 3 cm from the calculi. The stone diameter, stone CT value, D1, D2, and DDR were compared between impacted stone group and non-impacted stone group. Univariate logistic regression analysis was used to analyze the different indicators. Random number table was used to divide the training set and validation set according to the ratio of 7∶3. Through least absolute shrinkage and selection operator(LASSO) regression analysis, the independent influencing factors were obtained and the nomogram model was established (Model 1). Receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to verify the predictive efficacy of the model, and the other three effective models (Model 2-4) were constructed by stepwise multivariate logistic regression. The deLong test was used to compare whether there was a significant difference in the AUC between Model 1 and the other three models, and the net benefit of patients was analyzed by clinical decision curve analysis(DCA). Results:In this study, 64 cases (37.0%) were impacted ureteral calculi and 109 cases (63.0%) were non-impacted ureteral calculi, and there were significant differences in diameter[7.8(6.2, 8.8)mm vs. 6.3(5.2, 8.1)mm] , CT value[878.5(763.8, 940.5)HU vs.764.0 (613.0, 854.0) HU], D1[11.1(8.9, 14.9) mm vs. 9.1(7.1, 10.8) mm], D2[4.1(3.1, 4.9) mm vs. 5.0(4.1, 5.9) mm] and DDR[3.1(2.3, 3.9) vs. 1.8(1.4, 2.4)] between the two groups( P < 0.05). The results of univariate logistic regression analysis showed that stone diameter ( OR = 1.333, P < 0.001), CT value ( OR = 1.002, P=0.002), D1 ( OR = 1.146, P<0.001), D2 ( OR = 0.652, P < 0.001) and DDR ( OR = 2.995, P<0.001) were the influencing factors of impacted stones. The training set and validation set included 122 cases and 51 cases, respectively, without significant differences in their image characteristics and outcomes ( P > 0.05). The results of LASSO regression analysis showed that λ corresponding to the simplest result in the optimal range was 0.0908, and three variables were included at this time, and the influencing factors of impacted stones were stone diameter (coefficient 0.0700, OR = 1.073), CT value (coefficient 0.0003, OR = 1.001) and DDR (coefficient 0.5960, OR = 1.815). Moreover, Model 1 was established. According to the model fitting results, ROC curves were plotted, and the AUC of Model 1 was 0.862, and the AUCs of Model 2-4 were 0.859, 0.762, and 0.793, respectively. After deLong test, there was no significant difference between Model 1 and Model 2 ( Z = 0.248, P = 0.804). The AUC of Model 1 was superior to that of Model 3 ( Z = 2.888, P = 0.004) and Model 4 ( Z = 2.321, P = 0.020). The DCA suggested that Model 1 could improve the net benefit rate by up to approximately 21% of patients. Conclusions:DDR is the influencing factor of impacted ureteral calculi, and the model constructed by DDR, stone CT value and stone diameter can effectively predict the probability of impacted ureteral calculi in the middle and upper ureter.

Objective:To investigate the correlation between different serum uric acid (SUA) levels and impaired fasting glucose (IFG) in adults.Methods:From March 2019 to February 2020, 5006 adults in Wuxi area of Taihu Sanatorium in Jiangsu Province were selected as subjects. Quintile method was divided into the following five groups: Q1: SUA<270 μmol/L, Q2: 270 μmol/L SUA 318 μmol/L or less, Q3: 319 μmol/L ≤SUA≤360 μmol/L, Q4: 361 μmol/L SUA 410 μmol/L or less, and Q5: SUA>410 μmol/L. Correlation was analyzed by logistic analysis, with IFG as the outcome index, five SUA groups as the observation index, and gender, age, body mass index (BMI), blood lipid, and blood pressure as confounding factors. Three logistic regression analysis models were constructed to explore the relationship between different SUA level groups and IFG risk, as well as the influence of BMI on the risk correlation between SUA and IFG.Results:The BMI, DBP, FPG, TC, TG, and LDL-C all increased with the increase in SUA level; however, HDL-C gradually decreased with the increase in SUA level (P<0.01). The SUA levels among the five groups were positively correlated with fasting blood glucose level in the IFG group ( r=0.589, P<0.001). After adjusting for age, sex, and BMI, SUA level was strongly associated with fasting glucose in the IFG group ( r=0.534, P<0.001). After further adjustment for blood lipid and blood pressure, the correlation persisted ( r=0.523, P<0.001). With Q1 as the control group, the calculated OR values of IFG risk were 1.199, 2.660, 2.784 and 3.629, respectively. After further adjustment for various confounding factors, the calculated OR values of each group were 1.130, 2.389, 2.350 and 2.895, respectively. The IFG risk in the group with SUA level in the corresponding Q2 and Q5 groups was 1.13 times and 2.90 times higher, respectively, than that in the normal group, indicating that with the increase in SUA level, the IFG risk in the population increased. With the increase in BMI and SUA levels after BMI stratification, the mean fasting glucose level increased ( P<0.001). Conclusion:The SUA level and IFG risk are closely related. Increased SUA level increases IFG risk, and SUA and IFG are associated with weight gain, which should be paid attention to.