OBJECTIVE To conduct a comprehensive clinical evaluation of four nucleoside （acid） analogues that have been approved and marketed in China， such as entecavir， tenofovir disoproxil fumarate， tenofovir alafenamide fumarate， and tenofovir amibufenamide. METHODS According to the Guideline for the Administration of Clinical Comprehensive Evaluation of Drugs （2021 edition， trial implementation）， a comprehensive search was conducted across databases including CNKI， Wanfang Data， VIP， PubMed， the Cochrane Library， Embase， as well as relevant official websites. Drug package inserts， guidelines， consensus statements， and relevant literature for the four drugs were collected and subjected to a comprehensive evaluation across six dimensions： safety， efficacy， cost-effectiveness， innovativeness， suitability， and accessibility. RESULTS The scores for entecavir in terms of safety， efficacy， cost-effectiveness， innovativeness， suitability， and accessibility-along with its comprehensive score-were 13， 14， 13， 10， 18， and 6， totaling 74 points. For tenofovir disoproxil fumarate， the respective scores were 13， 17， 18， 8， 18， and 7， totaling 81 points. For tenofovir alafenamide fumarate， the scores were 14， 20， 12， 8， 18， and 5， totaling 77 points. Finally， for tenofovir amibufenamide， the scores were 10.5， 17， 10， 6， 15， and 4， totaling 62.5 points. CONCLUSIONS Tenofovir disoproxil fumarate， with the highest score， is recommended as the first-line option， suitable for adults， children， and pregnant women. However， caution is warranted for potential renal impairment. Tenofovir alafenamide fumarate is recommended as a second-line alternative， particularly for individuals at high risk for bone and renal damage. Entecavir has a score similar to tenofovir alafenamide fumarate but requires dosing on an empty stomach and dose adjustment based on renal function of patients. Tenofovir amibufenamide received the lowest score and is considered a weak recommendation. The clinical application of these nucleoside （acid） analogues should be individualized based on the patient’s age， physiological status， and risk factors.

Objective To explore the clinical application value of contrast-enhanced ultrasound in the differential diagnosis of testicular masses.Methods A total of 63 patients at the First Affiliated Hospital of Wenzhou Medical University with testicular masses from January 2014 to August 2024 were sellected.All patients underwent both conventional ultrasound and contrast-enhanced ultrasound examinations.Among them,pathological results were obtained through surgical resection in 55 cases,and 8 non-tumorous patients were diagnosed through clinical follow-up.According to the results,testicular masses were classified into neoplastic and non-neoplastic lesions.Neoplastic lesions were further divided into benign and malignant masses.The routine ultrasound parameters,serum tumor markers and ultrasound contrast parameters were analyzed.Results In the differential diagnosis between neoplastic and non-neoplastic lesions of the testis,there were significant statistical differences in the maximum diameter of the mass,blood flow grade,enhancement time,and enhancement intensity(P<0.05).In the differential diagnosis between benign and malignant testicular masses,significant statistical differences were found in mass location,maximum diameter of the mass,echo characteristics,blood flow grade indicators,enhancement time,and enhancement intensity(P<0.05).Conclusion Contrast-enhanced ultrasound may have certain reference value in the diagnosis of testicular masses.Hypo-enhancement or non-enhancement,along with slow enhancement,may be manifestations of benign lesions.

Micro/nanoplastics (MNPs), recognized as emerging environmental pollutants, are widely distributed in natural environments. Due to their small particle size and significant migratory capacity, MNPs can infiltrate diverse environmental matrices, then invade and accumulate in the organism via the skin, respiration, and digestion. Recently, concerns have grown over the detrimental effects and potential toxicity of MNPs on reproductive health. This review summarized published epidemiological and toxicological studies related to MNPs exposure and their effects on reproductive health. Firstly, this review critically examined the current landscape of epidemiological evidence and found that MNPs (e.g., polystyrene, polypropylene, polyvinyl chloride, polyethylene, etc.) are present in various biological specimens from both males and females, and their presence may be associated with an increased risk of reproductive disorders. Secondly, extensive toxicological studies revealed that MNPs exposure induces reproductive health damage through mechanisms such as disrupting the microstructure of reproductive organs and altering molecular-level expressions. Oxidative stress, inflammatory responses, and apoptosis are identified as potential links between MNPs exposure and reproductive damage. Finally, this review addressed the prevalent shortcomings in existing studies and proposed future directions to tackle the challenges posed by MNPs-induced reproductive harm. These insights aim to inform strategies for safeguarding public reproductive health and ecological security, providing a scientific foundation for mitigating risks associated with MNPs pollution.

Objective To explore the clinical application value of contrast-enhanced ultrasound in the differential diagnosis of testicular masses.Methods A total of 63 patients at the First Affiliated Hospital of Wenzhou Medical University with testicular masses from January 2014 to August 2024 were sellected.All patients underwent both conventional ultrasound and contrast-enhanced ultrasound examinations.Among them,pathological results were obtained through surgical resection in 55 cases,and 8 non-tumorous patients were diagnosed through clinical follow-up.According to the results,testicular masses were classified into neoplastic and non-neoplastic lesions.Neoplastic lesions were further divided into benign and malignant masses.The routine ultrasound parameters,serum tumor markers and ultrasound contrast parameters were analyzed.Results In the differential diagnosis between neoplastic and non-neoplastic lesions of the testis,there were significant statistical differences in the maximum diameter of the mass,blood flow grade,enhancement time,and enhancement intensity(P<0.05).In the differential diagnosis between benign and malignant testicular masses,significant statistical differences were found in mass location,maximum diameter of the mass,echo characteristics,blood flow grade indicators,enhancement time,and enhancement intensity(P<0.05).Conclusion Contrast-enhanced ultrasound may have certain reference value in the diagnosis of testicular masses.Hypo-enhancement or non-enhancement,along with slow enhancement,may be manifestations of benign lesions.

Neuro-enhancement,by intervening on nerves for non-medical purposes,improves people's physical,mental,and cognitive functions.While benefiting people,it also raises ethical risks of privacy,fairness,autonomy,and identity recognition between themselves and"artificial life".Faced with these serious ethical risk challenges,it is urgent to propose countermeasures that respect and safeguard the basic rights of human beings,promote fair benefits with the principle of priority,standardize the information dissemination of neuro-enhancement,strengthen public education and training of ethical on neuro-enhancement technologies and advance responsible innovation,as well as carry out ethical education for neuroscience practitioners,with a view to promoting the healthy development of the field of neuroscience.

Objective:To explore the efficacy and safety of TiRobot combined with three-dimensional imaging in the minimally invasive surgery for pelvic fractures.Methods:A retrospective analysis was conducted of the 40 patients with pelvic fracture who had been treated by fixation with S1 and S2 sacroiliac screws at Department of Orthopaedics and Traumatology, Yangjiang People's Hospital from January 2019 to May 2021. They were divided into 2 groups according to their treatment methods. In the TiRobot group of 20 cases subjected to percutaneous sacroiliac screw fixation assisted by TiRobot combined with three-dimensional imaging, there were 13 males and 7 females with an age of (38.2 ± 8.8) years. In the manual group of 20 cases subjected to fixation with manual placement of sacroiliac screws under conventional C-arm fluoroscopy, there were 11 males and 9 females with an age of (37.3 ± 9.2) years. The 2 groups were compared in terms of fluoroscopy time for screw placement, guide needle adjustment, operation time, intraoperative blood loss, visual analogue scale (VAS) 72 hours after operation, postoperative hospital stay, time to ambulation, excellent to good rate of screw placement, complication rate, fracture union time, Majeed score at 6 months after operation, and excellent to good rate of functional evaluation.Results:There was no significant difference between the 2 groups in their preoperative general data, showing they were comparable ( P > 0.05). In the TiRobot group, fluoroscopy time for screw placement [(8.2 ± 2.9) s], guide needle adjustment [(0.4 ± 0.2) times], operation time [(67.4 ± 5.5) min], and intraoperative blood loss [(36.5 ± 8.0) mL] were significantly less than those in the manual group [(40.4 ± 4.5) s, (8.6 ± 0.7) times, (78.4 ± 7.2) min, and (41.6 ± 7.8) mL], postoperative VAS [3.0 (4.0, 5.0) points] was significantly lower than that in the manual group [4.0 (5.0, 6.0) points], the excellent to good rate of screw placement (100%, 40/40) was significantly higher than that in the manual group (85.0%, 34/40), and the complication rate (5.0%,1/20) was significantly lower than that in the manual group (35.0%, 7/20) (all P < 0.05). There was no significant difference between the 2 groups in postoperative hospital stay, time to ambulation, fracture union time, Majeed score, or excellent to good rate of functional evaluation ( P > 0.05). Conclusion:In the minimally invasive surgery for pelvic fractures, TiRobot combined with three-dimensional imaging leads to positive outcomes, because it can reduce operation time and radiation exposure, improve accuracy of screw placement, and increase safety.

Objective: To analyze the clinical features and airway inflammatory phenotypes in patients with severe asthma. Methods: Patients with severe asthma were recruited in this cross-sectional study in our center. History of asthma, blood and sputum samples, and respiratory function were tested and recorded. The phenotypes of inflammation in airway were evaluated. Results: A total of 35 asthmatic patients with the mean age 41.4 years were involved in this study from January 2013 to December 2013. The disease duration were (14.3±13.6) years with mostly male in China-Japan Friendship Hospital. Thirteen patients reported the history of smoking. Twenty-one patients had the complications such as allergic rhinitis, followed by chronic rhinosinusitis of 11 cases, nasal polyp of 7 cases, gastroesophageal reflux disease of 5. The forced expiratory volume in one second/predicted value ratio (FEV₁%pred) in 29 patients was lower than 80%.Twenty-one participants did not react in bronchial reversibility test. Sixteen patients were administrated with oral cortical steroids (OCS). The average annual cost per patient was 22 thousand RMB. Sixteenrefractory asthmatics were diagnosed as eosinophilic asthma. Conclusions The clinical features associated with severe asthma include male gender, smoking, persistent airway limitation. Systemic use of corticosteroids is common and treatment costs are high. The eosinophilic asthma is the main inflammatory phenotype in patients with severe asthma.

To analyze the clinical features and airway inflammatory phenotypes in patients with severe asthma. Methods Patients with severe asthma were recruited in this cross?sectional study in our center. History of asthma, blood and sputum samples, and respiratory function were tested and recorded. The phenotypes of inflammation in airway were evaluated. Results A total of 35 asthmatic patients with the mean age 41.4 years were involved in this study from January 2013 to December 2013. The disease duration were (14.3 ± 13.6) years with mostly male in China?Japan Friendship Hospital. Thirteen patients reported the history of smoking. Twenty?one patients had the complications such as allergic rhinitis, followed by chronic rhinosinusitis of 11 cases, nasal polyp of 7 cases, gastroesophageal reflux disease of 5. The forced expiratory volume in one second/predicted value ratio (FEV1%pred) in 29 patients was lower than 80%.Twenty?one participants did not react in bronchial reversibility test. Sixteen patients were administrated with oral cortical steroids (OCS). The average annual cost per patient was 22 thousand RMB. Sixteenrefractory asthmatics were diagnosed as eosinophilic asthma. Conclusions The clinical features associated with severe asthma include male gender, smoking, persistent airway limitation. Systemic use of corticosteroids is common and treatment costs are high. The eosinophilic asthma is the main inflammatory phenotype in patients with severe asthma.

Objective To understand the status quo of shared leadership and identity perception among male nurses,and to analyze the correlation between them.Methods By convenient sampling,a total of 210 male nurses from 6 ClassⅢ hospitals in Zhejiang Province were investigated with Shared Leadership Questionnaire and Perceived Insider Status Scale from August to September 2017.Pearson correlation analysis was used to analyze the correlation between shared leadership and identity perception.A total of 210 questionnaires were distributed,and 204 valid questionnaires were collected.Results The scores of shared leadership and identity perception of these male nurses were (59.86±11.45) and (17.69±4.59) respectively,and there was a positive correlation between the two (r=0.271,P＜ 0.05).Conclusions The level of shared leadership and identity perception of male nurses is lower than middle level,and shared leadership level affected their identity perception level.It is suggested that hospital managers take measures to ensure that male nurses share leadership level in order to improve their level of identity perception and promote the retention and development of male nurses.

OBJECTIVETo observe the effect difference between fire needle combined with chemotherapy and fire needle on quality of life in patients with chemotherapy of non-small cell lung cancer (NSCLC).

METHODSWith randomized controlled method, a total of 60 patients with chemotherapy of NSCLC were divided into an observation group (fire-needle plus chemotherapy group) and a control group (chemotherapy group), 30 cases in each one. The observation group was treated with fire needle atpoints which consisted of Geshu (BL 17) and Danshu (BL 19), combined with chemotherapy selected from TP (paclitaxel+cisplatin)/GP (gemcitabine+cisplatin)/DP (docetaxel+cisplatin)/NP (vinorelbine+cisplatin) by the oncologist according to patients' condition. The fire needle was given once a day for 7 days, and chemotherapy was given for 21 days. The control group was treated with chemotherapy alone for 21 days. Before and after treatment, response evaluation criteria in solid tumors (RECIST) was applied for evaluation, and Karnofsky performance status (KPS) and functional assessment of cancer therapy-lung (FACT-L) were applied for evaluation of quality of life in patients with chemotherapy of NSCLC.

RESULTSThe effective rate was 20.0% (6/30) and the stability rate was 73.3% (22/30) in the observation group, which were insignificantly higher than 16.7% (5/30) and 63.3% (19/30) in the control group, respectively (both>0.05). The KPS after treatment was lower than that before treatment in the control group (<0.05); the KPS after treatment was similar to that before treatment in the observation group (>0.05); the KPS in the observation group after treatment was higher than that in the control group (<0.05). The total score and each item score of FACT-L after treatment were higher than those before treatment in the observation group (all<0.05); the physical score and emotional score of FACT-L after treatment were higher than those before treatment in the control group (both<0.05); the total score, physical score, functional score and subscale score in the observation group were significantly higher than those in the control group after treatment (all<0.05), while the social/family score and emotional score in the observation group were insignificantly higher than those in the control group (both>0.05). The differences of KPS total score before and after treatment in the two groups had moderate positive correlation with differences of FACT-L total score (<0.01).

CONCLUSIONFire needle can improve quality of life in patients of NSCLC chemotherapy.