Purpose To explore the clinical and pathological features,differential diagnosis,treatment methods and prognosis of urachal adenocarcinoma.Methods Nineteen cases of urachal adenocarcinoma were collected and an-alyzed by combining clinical symptoms,auxiliary examinations,histology,immunohistochemical,and genetic testing and 11 cases of bladder adenocarcinomas.Results Among the 19 patients(15 males,4 females;age range:33-75 years,mean:55 years),tumors were located at the dome or anterior wall of the bladder.Histological subtypes includ-ed mucinous adenocarcinoma(6 cases),adenocarcinoma not otherwise specified(4 cases),enteric-type adenocarci-noma(6 cases),adenocarcinoma with focal mucinous differentiation(1 case),adenocarcinoma with signet-ring cell carcinoma(1 case),and metastatic urachal adenocarcinoma(1 case).Immunophenotypic analysis revealed membra-nous positivity for β-catenin,diffuse positivity for CK34βE 12,MUC-2,and CK20,focal CK7 positivity in some cases,and rare GATA-3 positivity.Mutations in p53 were observed,while KRAS,NRAS,BRAF,and PIK3CA mutations were absent.In colorectal adenocarcinomas,CK34βE12 positivity was 40％,nuclear β-catenin positivity was 48％,and MUC-2 expression was approximately 50％.In bladder adenocarcinomas,GATA-3 and MUC-2 positivity rates were 45％and 63.6％,respectively.Conclusion Distinguishing urachal adenocarcinoma from colorectal and primary bladder adenocarcinomas remains challenging.Urachal adenocarcinoma should be suspected in patients with anterior bladder wall or dome lesions,gross hematuria,or mucinuria.No definitive diagnostic markers currently exist for ura-chal adenocarcinoma.Immunophenotypic features such as membranous β-catenin,MUC-2,and CK7 positivity may fa-vor urachal adenocarcinoma over colorectal adenocarcinoma.Additional markers(e.g.,GATA-3,CK20,CK34βE12)aid in differential diagnosis,though individual markers lack specificity.Comprehensive evaluation integrating clinical presentation,imaging,and clinicopathological features is essential for accurate diagnosis.

Purpose To explore the clinical and pathological features,differential diagnosis,treatment methods and prognosis of urachal adenocarcinoma.Methods Nineteen cases of urachal adenocarcinoma were collected and an-alyzed by combining clinical symptoms,auxiliary examinations,histology,immunohistochemical,and genetic testing and 11 cases of bladder adenocarcinomas.Results Among the 19 patients(15 males,4 females;age range:33-75 years,mean:55 years),tumors were located at the dome or anterior wall of the bladder.Histological subtypes includ-ed mucinous adenocarcinoma(6 cases),adenocarcinoma not otherwise specified(4 cases),enteric-type adenocarci-noma(6 cases),adenocarcinoma with focal mucinous differentiation(1 case),adenocarcinoma with signet-ring cell carcinoma(1 case),and metastatic urachal adenocarcinoma(1 case).Immunophenotypic analysis revealed membra-nous positivity for β-catenin,diffuse positivity for CK34βE 12,MUC-2,and CK20,focal CK7 positivity in some cases,and rare GATA-3 positivity.Mutations in p53 were observed,while KRAS,NRAS,BRAF,and PIK3CA mutations were absent.In colorectal adenocarcinomas,CK34βE12 positivity was 40％,nuclear β-catenin positivity was 48％,and MUC-2 expression was approximately 50％.In bladder adenocarcinomas,GATA-3 and MUC-2 positivity rates were 45％and 63.6％,respectively.Conclusion Distinguishing urachal adenocarcinoma from colorectal and primary bladder adenocarcinomas remains challenging.Urachal adenocarcinoma should be suspected in patients with anterior bladder wall or dome lesions,gross hematuria,or mucinuria.No definitive diagnostic markers currently exist for ura-chal adenocarcinoma.Immunophenotypic features such as membranous β-catenin,MUC-2,and CK7 positivity may fa-vor urachal adenocarcinoma over colorectal adenocarcinoma.Additional markers(e.g.,GATA-3,CK20,CK34βE12)aid in differential diagnosis,though individual markers lack specificity.Comprehensive evaluation integrating clinical presentation,imaging,and clinicopathological features is essential for accurate diagnosis.

Objective:To summarize the best evidence for the use of ankle pump exercises in preventing perioperative lower limb deep vein thrombosis (DVT) in patients undergoing joint replacement surgery and to evaluate its clinical application.Methods:This study utilized an evidence-based continuous quality improvement model. A systematic search was conducted for relevant clinical practice guidelines, expert consensus, systematic reviews, and randomized controlled trials (RCTs) from both domestic and international sources. The best evidence was evaluated and summarized, and audit indicators were developed for baseline assessments. Facilitating and hindering factors were analyzed based on the baseline results. From December 2022 to April 2023, the evidence was applied in the Department of Orthopedics at Henan Provincial People's Hospital. The pre-evidence group for baseline assessments included 36 joint replacement patients and 18 nurses from the orthopedic unit between December 2022 and January 2023, while the post-evidence group included 36 joint replacement patients and the same 18 nurses between March and April 2023. The knowledge level of nurses, the effectiveness of ankle pump exercises, the execution rate, and patient compliance were compared before and after evidence-based practice.Results:A total of 12 articles were included in the study, comprising one clinical practice guideline, five expert consensus papers, one systematic review, and five RCTs. Ten best practices were summarized in terms of applicable populations, exercise assessment, exercise positions, timing, methods, frequency, and patient education. After implementing evidence-based practice, the knowledge scores of nurses on ankle pump exercises significantly improved from (70.56±9.98) to (82.78±8.26) ( P<0.01). The compliance rates of audit items 2, 3, 4, 5, and 6 among nurses increased from 0, 22.2%, 0, 27.8%, and 11.1% respectively, to 94.4%, 94.4%, 83.3%, 100.0%, and 100.0% respectively ( P<0.01). On the patient side, the compliance rates for audit items 7 and 8 increased from 5.6% and 0 to 86.1% and 94.4%, respectively ( P<0.01) . Conclusions:Implementing evidence-based ankle pump exercises to prevent DVT in joint replacement patients can significantly improve nurses' knowledge of evidence-based practice, standardize the practice of ankle pump exercises, and explore balanced educational strategies that enhance patient compliance, ensuring clinical practices are evidence-based.

Objective To investigate associations between three-dimensional(3D)morphology of cervical vertebrae and skeletal mat-uration by cone-beam computed tomography(CBCT)and establish corresponding regression models for quantitatively evaluating cervical vertebral maturation(CVM).Methods The analyzed sample consisted of 358 CBCT images(175 male,183 female),of which 277 images were randomly selected as the model development group and 81 as the performance test group.Twenty-one 3D morphological pa-rameters were defined and measured,incorporating all parts of the cervical vertebrae,including the cervical vertebral bodies,transverse processes,spinous processes,pedicles,lamina,and articular processes.The cervical vertebral maturation index(CVMI)was determined by experienced orthodontists as reference standard.Spearman's rank correlation coefficient and multivariable stepwise regression analysis were used to identify the associations and build regression models.The performance test group was employed to ex-amine each model's reliability.Paired-samples Wilcoxon signed-rank test compared the CVMI of the model prediction with the reference standard.Results Three-dimensional morphological changes in various parts of the cervical vertebrae correlated with CVMI(P＜0.05).Six 3D morphometric parameters were each recognized for male and female models,three of which were identical.The adjusted R2 was 0.899 for males and 0.902 for females,with corresponding accuracies of 85.0%and 85.4%,respectively.These models showed no difference as compared with the reference standard(P＞0.05).Con-clusion New associations were found between 3D morphology of cer-vical vertebrae and skeletal maturation.The 3D-driven morphometric CVM assessment method and corresponding regression models exhibited good credibility and high consistency with experts.

Objective:To observe the application effect of health education based on health action process approach (HAPA) theory in perioperative patients undergoing knee arthroplasty.Methods:Using the convenient sampling method, a total of 168 patients who underwent knee arthroplasty in Henan Provincial People's Hospital from March 2020 to May 2021 were selected, and they were randomly divided into the observation group (85 cases) and the control group (83 cases). The control group received routine care, while the observation group received health education based on HAPA theory on the basis of the control group. The scores of Self-efficacy for Rehabilitation Outcome Scale (SER) and Quality of Life Questionnaire Core 30 (QLQ-C30), postoperative recovery indicators and complications, patient compliance and patient satisfaction before and after intervention were compared between the two groups.Results:After intervention, scores of SER, QLQ-C30, compliance and satisfaction in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05). The first time of getting out of bed, the time of knee flexion greater than or equal to 90°and the length of hospital stay in the observation group was shorter than those in the control group, and the total incidence of complications was lower than that in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Health education based on HAPA theory can effectively improve the self-efficacy, compliance and quality of life of patients undergoing knee arthroplasty, reduce the risk of complications, promote postoperative recovery and obtain satisfaction of patients.

Objective:To explore the effect of feedback health education combined with positive psychological suggestion on the rehabilitation of patients undergoing artificial total knee arthroplasty.Methods:From August 2020 to July 2021, the convenient sampling method was used to select 126 patients with artificial total knee arthroplasty admitted to the Orthopedic Department of Henan Provincial People's Hospital. They were randomly divided into the control group and the observation group in a 1∶1 ratio using a random number table method. The control group received routine health education combined with positive psychological suggestion, while the observation group received feedback based health education combined with positive psychological suggestion intervention. The level of knowledge, attitude and practice, scores on the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Visual Analogue Scale (VAS), American Knee Society (AKS) score, knee swelling rate and nursing satisfaction were compared between two groups of patients.Results:The knowledge, attitude and practice scores of the two groups at discharge were higher than those at admission ( P<0.05), and the knowledge, attitude and practice scores of the observation group were higher than those of the control group at discharge ( P<0.05). The SAS and SDS scores of the observation group were lower than those of the control group before and on the third day after surgery ( P<0.05). The VAS of the observation group on the first day and 2 weeks after surgery were lower than those of the control group ( P<0.05), while AKS was higher than that of the control group ( P<0.05). The postoperative swelling rates in the observation group were lower than those in the control group at 1 week and 3 months after surgery ( P<0.05). The nursing satisfaction scores of the observation group in terms of health education, service attitude, department environment, psychological intervention, and nursing outcomes were higher than those of the control group ( P<0.05) . Conclusions:Feedback health education combined with positive psychological cues can improve the knowledge, attitude and practice levels of patients undergoing artificial total knee arthroplasty, reduce anxiety and depression, and improve rehabilitation effectiveness and nursing satisfaction.

Compulsive sexual behavior disorder is characterized by the inability to control one′s frequent sexual behaviors or fantasies. It will bring physical pain and psychological distress to the patients and increase the risk of venereal diseases. Research abroad on compulsive sexual behavior disorder is increasing, while domestic studies are rare due to in sufficient attention in clinical practice. To increase the understanding of compulsive sexual behavior disorder, this article reviewed the epidemiology, clinical features, evaluation, diagnosis, and treatment with medications and psychotherapy, providing more comprehensive information on compulsive sexual behavior disorder.

Compulsive sexual behavior disorder is characterized by the inability to control one′s frequent sexual behaviors or fantasies. It will bring physical pain and psychological distress to the patients and increase the risk of venereal diseases. Research abroad on compulsive sexual behavior disorder is increasing, while domestic studies are rare due to in sufficient attention in clinical practice. To increase the understanding of compulsive sexual behavior disorder, this article reviewed the epidemiology, clinical features, evaluation, diagnosis, and treatment with medications and psychotherapy, providing more comprehensive information on compulsive sexual behavior disorder.

Objective:To carry out the overview of systematic reviews on effectiveness and safety assessment of pneumatic compression devices (PCD) on preventing venous thromboembolism (VTE) .Methods:Systematic reviews or Meta-analysis comparing PCD with other physical prophylaxis and drug prophylaxis were retrieved by computer in the Cochrane Library, PubMed, Embase, China National Knowledge Internet (CNKI) , China Biological Medicine, WanFang data from building the database to 31st March 2019. Two researchers independently implemented the literature screening, data extraction and quality evaluation. The Assessment of Multiple Systematic Reviews (AMSTAR) tool was used to quality assessment of methodology for included literatures. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used to quality evaluation for outcome indexes.Results:Totals of 15 systematic reviews or Meta-analysis were included with 8 in Chinese and 7 in English. There were 11 literatures published after 2012. Quality assessment of methodology showed that 3 literatures met 11 items of AMSTAR, and other researches had the defect existed in different aspects. Evidences with the medium quality displayed the effectiveness of intermittent pneumatic compression devices in VTE prevention which could reduce the incidence of adverse events caused by separate drug prophylaxis, such as bleeding, through combining with drug prophylaxis. Application of intermittent pneumatic compression devices for VTE prevention should be based on clinical guidelines. At present, there was limited evidence guiding selection of specific device and device type.Conclusions:Intermittent pneumatic compression devices are safe and effective in VTE prevention which still needs to be demonstrated by researches with the large sample and high of quality.

Objective: To establish a mouse model of osteoarthritis (OA) and study the bone microarchitecture and bone metabolism of tibial subchondral bone in early stage of OA. Methods: The mouse model of post-traumatic osteoarthritis (PTOA) with anterior cruciate ligament (ACLT) was established by using c57 mice. The Sham operation group served as the control group. All mice were fed with conventional diet. All mice were sacrificed after 4 weeks. The degeneration of knee joint was observed by HE staining and Safranin O-Fast Green staining. The number of osteoclasts was counted by TRAP staining. Micro CT was used to analyze the quantitative parameters of the microstructure of tibia subchondral bone in mice. Serum levels of bone resorption biomarker CTX I and cartilage degeneration marker CTX II were determined. Results: After ACLT 4 weeks, the average score of OARSI in ACLT group was 3.2, which was higher than that in Sham group, and the joint degeneration occurred in mice, presenting the pathological characteristics of early OA. Compared with the sham operation phase, the total subchondral bone volume (TV) of ACLT group was 4.72 mm³, increased by 13.6%; the bone trabecular resolution (Tb.Sp) was 0.130 and 0.154 mm, respectively, and the ACLT group also increased by 18.8%; the bone volume/tissue volume (BV/TV) was 0.470 and 0.294, respectively, and the ACLT group decreased by 48.9%; the bone trabecular thickness (Tb.Th) was 0.162 and 0.083 mm groups, ACLT decreased by 37.5%. Trap staining showed that the number of osteoclasts per unit volume in ACLT group was 72, which was significantly higher than that in sham operation group. The CTX I of mice in the sham operated ACLT group and sham operated group were 20.9 ng/ml and 18.29 ng/ml, with an increase of 48.9% in the ACLT group; the CTX II of mice in the ACLT group and sham operated group were 35.5 ng/ml and 28.6 ng/ml, with an increase of 24.1% in the ACLT group. Conclusion ACLT Mouse model can successfully construct early OA, which confirms the early loss of osteochondral bone and the pathological changes of osteoclast activation in OA, and provides a new specific target for the treatment of OA.