Alveolar soft part sarcoma(ASPS)is a rare malignant tumor characterized by a lack of specific clinical manifestations,often presenting as painless,progressively enlarging masses.Its occur-rence in the retroperitoneum is uncommon.Due to the large retroperitoneal space,the tumor typically does not cause significant symptoms in the early stages,leading to advanced disease or metastasis at presentation,and consequently,poor prognosis.This article reported the clinical diagnosis and treatment of a patient with retroperitoneal ASPS and elucidated the features of epidemiology,clinical manifesta-tions,diagnostic modalities,and treatment approaches of this disease in conjunction with the literature.

Bladder cancer has a complex pathogenesis involving the dysregulation of multiple signaling pathways.The malignant progression of bladder cancer is closely associated with the aberrant activation of the Wnt/β-catenin signaling pathway,which is regulated by long non-coding RNAs(LncRNAs)at multiple levels,affecting tumor proliferation,metastasis,and drug resistance.LncRNAs regulate the Wnt/β-catenin pathway through three main mechanisms.Firstly,β-catenin stability,where SNHG7 inhibits GSK3β-mediated degradation,promoting nuclear accumulation of β-catenin,whereas GAS5 enhances its degradation via the miR-18a-5p/AXIN2 axis.Secondly,regulation of downstream target genes,with oncogenic LncRNAs such as CASC9 and PVT1 activating cyclin D1 and MMPs through miRNA sponging,driving epithelial-mesenchymal transition(EMT)and invasion,while the tumor-suppressive LncRNAs miR143HG inhibits β-catenin nuclear translocation.Thirdly,crosstalk with other signaling pathways,as exemplified by CARLo-7,which simultaneously activates both the Wnt/β-catenin and JAK2/STAT3 pathways,exacerbating the malignant phenotype.As potential biomarkers and therapeutic targets,LncRNAs have demonstrated promising potential in preclinical models.This review summarizes the key LncRNAs involved in bladder cancer and their mechanisms in regulating the Wnt/β-catenin pathway,providing new insights for the precise treatment of bladder cancer.

Bladder cancer has a complex pathogenesis involving the dysregulation of multiple signaling pathways.The malignant progression of bladder cancer is closely associated with the aberrant activation of the Wnt/β-catenin signaling pathway,which is regulated by long non-coding RNAs(LncRNAs)at multiple levels,affecting tumor proliferation,metastasis,and drug resistance.LncRNAs regulate the Wnt/β-catenin pathway through three main mechanisms.Firstly,β-catenin stability,where SNHG7 inhibits GSK3β-mediated degradation,promoting nuclear accumulation of β-catenin,whereas GAS5 enhances its degradation via the miR-18a-5p/AXIN2 axis.Secondly,regulation of downstream target genes,with oncogenic LncRNAs such as CASC9 and PVT1 activating cyclin D1 and MMPs through miRNA sponging,driving epithelial-mesenchymal transition(EMT)and invasion,while the tumor-suppressive LncRNAs miR143HG inhibits β-catenin nuclear translocation.Thirdly,crosstalk with other signaling pathways,as exemplified by CARLo-7,which simultaneously activates both the Wnt/β-catenin and JAK2/STAT3 pathways,exacerbating the malignant phenotype.As potential biomarkers and therapeutic targets,LncRNAs have demonstrated promising potential in preclinical models.This review summarizes the key LncRNAs involved in bladder cancer and their mechanisms in regulating the Wnt/β-catenin pathway,providing new insights for the precise treatment of bladder cancer.

OBJECTIVES: Reforming medical insurance payment methods is a key part of deepening the healthcare system reform. Understanding the influencing factors and underlying mechanisms of physicians' strategic behaviors under the diagnosis-related groups (DRG) payment system is crucial for reducing medical resource waste and improving the efficiency of health insurance fund utilization. METHODS: Based on the Theory of Planned Behavior, this study used grounded theory to construct a questionnaire encompassing belief, behavioral attitude, subjective norm, perceived behavioral control, behavioral intention, and behavior measurement items. Structural equation modeling was then used for empirical analysis. RESULTS: Physicians' behavioral intention had the most significant impact on their strategic behavior (β=0.606, P<0.001). Physician's attitude toward strategic behavior (β=-0.159, P<0.01), subjective norm (β=-0.093, P<0.05), and perceived behavioral control (β=-0.120, P<0.05) were major influencing factors of behavioral intention. Physicians' behavioral beliefs, normative beliefs, and control beliefs were significantly correlated with behavioral attitude (β=0.554, P<0.001), subjective norm (β=0.383, P<0.001), and perceived behavioral control (β=0.274, P<0.001), respectively. CONCLUSIONS Behavioral intention is the primary predictor driving physicians to engage in strategic behavior. Attitudes toward the behavior, subjective norms, and perceived behavioral control all significantly affect physicians' behavioral intentions.
Humans ; Physicians/psychology* ; Surveys and Questionnaires ; Attitude of Health Personnel ; Diagnosis-Related Groups/economics* ; Intention ; Female ; Male ; Adult

Objective To explore the correlation between hyponatremia at admission and all-cause mortality within one year after discharge in elderly patients with intestinal obstruction.Methods The 331 cases of elderly patients with intestinal obstruction(aged ≥ 60 years)who visited the General Surgery Department of Nanjing Meishan Hospital from January 2017 to December 2020 were selected as the research objects for retrospective cohort study analysis.According to the patient's blood sodium level at admission,they are divided into two groups:the hyponatremia group(Na＜135 mmol/L)and the non hyponatremia group(Na≥135 mmol/L).Divided into death group and survival group based on whether death occurred within one year after discharge.SPSS 25.0 software was used for statistical analysis.Independent sample t test,x2 test,Kaplan Meier method,and multivariate Cox regression analysis were used to observe the correlation between admission hyponatremia and all-cause mortality within one year after discharge in elderly patients with intestinal obstruction.Results A total of 331 patients were enrolled.The incidence of hyponatremia was 32.3％,and 56 deaths occurred within one year,accounting for 16.92％.The one-year mortality rate in the hyponatremia group was 23.4％(25/107),which was higher than 13.8％(31/224)in the non hyponatremia group.The difference was statistically significant(P＜0.05).The survival analysis(Kaplan Meier)results showed that the survival rate of the hyponatremia group was lower than that of the non hyponatremia group(Log Rank P＜0.05).After adjusting for other confounding factors in multivariate Cox regression analysis,hyponatremia(HR=1.88,95％CI:1.07-3.29)was an independent risk factor for one-year all-cause mortality in elderly patients with intestinal obstruction(P＜0.05).Conclusion Hyponatremia at admission is an independent risk factor for all cause mortality in elderly patients with intestinal obstruction within one year after discharge.

Objective:To investigate the effect of pelvic rotation around coronal axis on the placement angle of acetabular prosthesis after total hip arthroplasty.Methods:According to Murary's definition, the angle between the acetabular axis and the sagittal plane was defined as the acetabular abduction angle, and the angle between the acetabular axis and the coronal plane as the anterior inclination angle. A simple mathematical solid geometry model was established by using the mathematical software GeoGebra to simulate the dynamic changes of the acetabular prosthesis when it rotated around the coronal axis, and the calculation formula of the dynamic changes of the anterior inclination and abduction angle of the acetabular prosthesis was derived. MatLab software was used to generate the function graph of pelvis forward inclination and abduction angle and deduce the motion of acetabular prosthesis.Results:The dynamic changes of acetabular tilt angle and abduction angle when the pelvis rotated around the coronal axis were functionally related to the anterior-posterior tilt of the pelvis in a nonlinear pattern. When the pelvis rotates around the coronary axis, the anterior inclination angle formula is α 1=arcsin (sinβ 1×cosα×cosθ+cosβ 1×sinα); When the acetabulum axis faces downwards the abduction angle formula is θ 1=arccot (cosβ 1×cotθ-sinβ 1×tanα/sinθ); When the acetabulum axis faces upwards the abduction angle formula is θ 1=π-abs[arccot (cosβ 1×cotθ-sinβ 1×tanα/sinθ)] withα being the initial acetabular forward angle, θ being the initial acetabular abduction angle, α 1 being the forward angle of the acetabular prosthesis after pelvic rotation, θ 1 being the external expansion angle of the acetabular prosthesis after pelvic rotation and β 1 being the rotation angle of the pelvis around the coronal axis. When the pelvis is tilted backward, the anterior inclination angle of the acetabular prosthesis increases first and then decreases, and the abduction angle continues to increase. When the pelvis is tilted forward, the abduction angle decreases first and then increases, and the anterior inclination angle continues to decrease to negative. Conclusion:When the initial anterior inclination angle and abduction angle of acetabular prosthesis change, the curve of anterior inclination and abduction angle change accordingly. The larger the initial anterior inclination angle is, the faster it reaches its peak value, and the larger the peak value is, the faster the abduction angle changes. The larger the initial abduction angle is, the slower the initial anterior inclination angle and the abduction angle change.

Objective:To investigate the efficacy of different laparoscopic surgeries for gastrointestinal stromal tumors (GIST) of gastric cardia and fundus.Methods:The retrospective cohort study was conducted. The clinicopathological data of 251 patients with GIST of gastric cardia and fundus who underwent laparoscopic radical resection in 14 medical centers, including Guangdong Provincial People′s Hospital et al, from December 2007 to December 2021 were collected. There were 123 males and 128 females, aged 58(24,87)years. Observation indicators: (1) treatment; (2) clinicopathological data of patients undergoing different laparoscopic surgeries; (3) subgroup analysis for special laparoscopic techniques. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test or ANOVA. Measure-ment data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the Mann-Whitney U test or Kruskal-Wallis H test. Count data were described as absolute numbers or percentages. Comparison of ordinal data was conducted using the rank sum test. Results:(1) Treatment. Of the 251 patients,202 cases underwent gastric wedge resection, 26 cases underwent special laparoscopic techniques including 10 cases with serotomy and dissection and 16 cases with transluminal gastrectomy, 23 cases underwent structural gastrectomy including 6 cases with total gastrectomy and 17 cases with proximal partial gastrectomy. There were 24 patients had postoperative complications after surgery. (2) Clinicopathological data of patients undergoing different laparoscopic surgeries. The gender (male, female), age, tumor diameter, operation time, volume of intraoperative blood loss, length of incision, time to postoperative initial whole liquid food intake, time to postoperative initial semi-liquid food intake, duration of postoperative hospital stay, cases with perioperative complications, cases with mitotic count as ≤5/50 high power field, 6?10/50 high power field, >10/50 high power field, cases be classified as very low risk, low risk, medium risk, high risk according to the National Institutes of Health risk classification, cases with tumor located at fundus and gastric cardia were 93, 109, (59±11)years, 3.50(0.40,10.00)cm, 88.00(25.00,290.00)minutes,20.00(25.00,290.00)mL, 4.00(2.00,12.00)cm, 3.00(1.00,9.00)days, 4.00(1.00,16.00)days, 5.00(1.00,18.00)days, 14, 164, 31, 7, 47, 83, 50, 22, 30, 172 in patients undergoing gastric wedge resection, respectively. The above indicators were 19, 7, (49±14)years, 2.55(0.20,5.00)cm, 101.00(59.00,330.00)minutes, 27.50(2.00,300.00)mL, 4.50(0,6.00)cm, 2.50(1.00,10.00)days, 4.00(1.00,16.00)days, 6.00(1.00,18.00)days, 3, 20, 5, 1, 15, 5, 2, 4, 24, 2 in patients undergoing special laparos-copic techniques, and 11, 12, (52±10)years, 5.00(0.80,10.00)cm, 187.00(80.00,325.00)minutes, 50.00(10.00,300.00)mL, 6.00(4.00,12.00)cm, 4.00(2.00,8.00)days, 6.00(3.00,14.00)days, 8.00(2.00,18.00)days, 7, 11, 5, 7, 2, 6, 6, 9, 13, 10 in patients undergoing structural gastrectomy. There were significant differences in the above indicators among the three groups of patients ( χ2=6.75, F=10.19, H=17.71, 37.50, 35.54, 24.68, 16.09,20.20, 13.76, χ2=13.32, Z=28.98, 32.17, χ2=82.14, P<0.05). (3) Subgroup analysis for special laparoscopic techniques. The time to postoperative initial whole liquid food intake, time to postoperative initial semi-liquid food intake, classification of tumor location (endophytic type, exophytic type, parietal type) were 4.50(1.00,10.00)days, 8.00(3.00,12.00)days, 0, 8, 2 in patients undergoing serotomy and dissection, versus 2.00(1.00,4.00)days, 3.00(1.00,6.00)days, 16, 0, 0 in patients undergoing transluminal gastrectomy. There were significant differences in time to postoperative initial whole liquid food intake, time to postoperative initial semi-liquid food intake between them ( Z=-2.65, -3.16, P<0.05); and there was a significant difference in classification of tumor location between them ( P<0.05). Conclusions:Gastric wedge resection is the most commonly used laparoscopic technique for GIST of gastric cardia and fundus. The application of special laparoscopic techniques is focused on the GIST of cardia to preserve the function of the cardia.

Objective:To discuss the effect of hyperbaric oxygen（HBO）combined with catechin（Can）on lipopolysaccharide（LPS）-induced inflammatory response of human bone marrow stromal HS-5 cells and its mechanism of action.Methods:A portion of normal HS-5 cells in good condition were assigned as control group（DMEM medium），and another portion of HS-5 cells were used to establish the bone marrow inflammatory cell model induced by LPS which were then divided into four groups for different interventions：the model group（1.0 μg/ml LPS was added into the medium），the HBO group（1.0 μg/ml LPS was added into the medium and then treated with 0.2 MPa HBO），the Can group（1.0 μg/ml LPS and 150 μmol/L Can were added into the medium）and the combined group（1.0 μg/ml LPS and 150 μmol/L Can were added into the medium and then treated with 0.2 MPa HBO）. The proliferation of HS-5 cells in each group was detected by the CCK-8 method，and the expression levels of IL-1β，IL-6，TNF-α，and IL-10 in HS-5 inflammatory cell fluid were measured by ELISA. The apoptosis of HS-5 inflammatory cells in each group was detected by flow cytometry，and the expression levels of TLR6/NF-κB signaling pathway proteins in HS-5 inflammatory cells were detected by western blotting.Results:The results of the CCK-8 method showed that Can at the concentration of 150 μmol/L inhibited the proliferation of HS-5 cells induced by LPS at 1.0 μg/ml，which was used as a reference to establish an inflammatory cell model of bone marrow HS-5. The results of flow cytometry showed that the survival rate of HS-5 inflammatory cells in the combined group［（13.99±1.25）%］was significantly lower than that in the model group［（46.69±4.27）%］，the HBO group［（39.28±3.74）%］，and the Can group［（23.14±2.20）%］，with statistically significant differences（ P<0.05 or P<0.01）. Compared with the model group，the HBO group，and the Can group，the expression levels of proteins（TLR6 and p-NF-κB）in HS-5 inflammatory cells in the combined group were significantly decreased（ P<0.01）. Conclusion:Can combine with HBO has a strong anti-inflammatory effect on HS-5 inflammatory cells，and its possible mechanism of action is to inhibit LPS-induced bone marrow inflammatory response by regulating the TLR6/NF-κB signaling pathway，which can provide new ideas for the treatment of bone injuries.

Objective Tostudy the influence of pipe structures on the mixing uniformity of airborne effluents from nuclear power plant chimneys. Methods We used the computational fluid dynamics (CFD) method to simulate the velocity distribution and gas mixing in long straight pipes (I type) with square section and circular section, 90° single-bend pipes (L type) with square section and circular section, and 90° double-bend pipes (S type and U type) with square section and circular section. Results For the long straight pipe, due to the lack of flow disturbance caused by structural changes, the mixing effect was not good; when the pipe section was circular, it might take mixing distance 20 times the hydraulic diameter to achieve the uniformity index required by the relevant standard; for the square pipe, the distance might be longer. In the single bend pipe with square section, the velocity uniformity was improved more greatly after the bend, and the tracer gas met the mixing uniformity at a shorter distance (11 times the hydraulic diameter), as compared with the single bend pipe with circular section. For the S-type double-bend pipe, the tracer gas appeared uniformly mixed after a distance 6 times the hydraulic diameter in the square pipe, and 7 times the hydraulic diameter in the circular pipe. For the U-type double-bend pipe, the gas in the square pipe also achieved uniform mixing ata shorter distance downstream, and the airflow showed greater disturbance when passing through the bend. Conclusion The CFD method can make an accurate prediction for the change patterns of gas mixing uniformity in pipes with different structures, and can partially replace physical experiments to study the factors affecting the mixing uniformity of airborne effluents from the chimney of nuclear power plants.

Objective:To discuss the effect of hyperbaric oxygen（HBO）combined with catechin（Can）on lipopolysaccharide（LPS）-induced inflammatory response of human bone marrow stromal HS-5 cells and its mechanism of action.Methods:A portion of normal HS-5 cells in good condition were assigned as control group（DMEM medium），and another portion of HS-5 cells were used to establish the bone marrow inflammatory cell model induced by LPS which were then divided into four groups for different interventions：the model group（1.0 μg/ml LPS was added into the medium），the HBO group（1.0 μg/ml LPS was added into the medium and then treated with 0.2 MPa HBO），the Can group（1.0 μg/ml LPS and 150 μmol/L Can were added into the medium）and the combined group（1.0 μg/ml LPS and 150 μmol/L Can were added into the medium and then treated with 0.2 MPa HBO）. The proliferation of HS-5 cells in each group was detected by the CCK-8 method，and the expression levels of IL-1β，IL-6，TNF-α，and IL-10 in HS-5 inflammatory cell fluid were measured by ELISA. The apoptosis of HS-5 inflammatory cells in each group was detected by flow cytometry，and the expression levels of TLR6/NF-κB signaling pathway proteins in HS-5 inflammatory cells were detected by western blotting.Results:The results of the CCK-8 method showed that Can at the concentration of 150 μmol/L inhibited the proliferation of HS-5 cells induced by LPS at 1.0 μg/ml，which was used as a reference to establish an inflammatory cell model of bone marrow HS-5. The results of flow cytometry showed that the survival rate of HS-5 inflammatory cells in the combined group［（13.99±1.25）%］was significantly lower than that in the model group［（46.69±4.27）%］，the HBO group［（39.28±3.74）%］，and the Can group［（23.14±2.20）%］，with statistically significant differences（ P<0.05 or P<0.01）. Compared with the model group，the HBO group，and the Can group，the expression levels of proteins（TLR6 and p-NF-κB）in HS-5 inflammatory cells in the combined group were significantly decreased（ P<0.01）. Conclusion:Can combine with HBO has a strong anti-inflammatory effect on HS-5 inflammatory cells，and its possible mechanism of action is to inhibit LPS-induced bone marrow inflammatory response by regulating the TLR6/NF-κB signaling pathway，which can provide new ideas for the treatment of bone injuries.