Objective: To investigate the safety and feasibility of transurethral blue laser vaporization of the prostate (BVP) under intravenous anesthesia without intubation. Methods: Clinical data of 30 benign prostatic hyperplasia (BPH) (prostate volume <40 mL) patients undergoing BVP under intravenous anesthesia without intubation in our hospital during Jul.and Nov.2024 were retrospectively analyzed.Preoperative and 1-month postoperative international prostate symptom score (IPSS), quality of life score (QoL), maximum urinary flow rate (Qmax), and postvoid residual volume (PVR) were compared.The operation time, cumulative blue laser activation time, recovery time, postoperative bladder irrigation time, postoperative catheter indwelling time, postoperative 2-hour visual analog scale (VAS) score and incidence of surgical and anesthetic complications were recorded. Results: All 30 patients successfully completed BVP under intravenous anesthesia without intubation.The operation time was (12.5±5.0) min, cumulative laser activation time (9.8±4.1) min, recovery time (6.8±1.2) min, postoperative bladder irrigation time (11.0±4.6) h, postoperative catheter indwelling time (2.7±1.1) days and postoperative 2-hour VAS score was (3.0±1.3).No cases required conversion to intubated general anesthesia, and no severe perioperative surgical or anesthetic complications occurred.Significant improvements in IPSS, QoL, Qmax, and PVR were observed 1 month postoperatively (P＜0.001). Conclusion: BVP under intravenous anesthesia without intubation in the treatment of prostate volume <40 mL BPH is clinically feasible, significantly improving lower urinary tract symptoms without significant surgical or anesthetic complications.

Objective To assess the level of research integrity awareness among clinical nursing personnel in Yunnan Province,analyze the influencing factors,and identify related risks.Methods From June 2025 to July 2025,a research integrity awareness questionnaire was conducted on 697 clinical nursing personnel from a university-affiliated tumor hospital and children's hospital using the Questionnaire Star platform.The survey content included basic information,research integrity awareness status,research integrity construction awareness,and the causes of research misconduct.Data were analyzed using SPSS 27.0.Results The research integrity awareness score of clinical nursing personnel was(47.49±11.06),with an overall awareness rate of 51.48%.Univariate analysis showed statistically significant differences in awareness scores based on nursing categories(t=-2.45),marital status(F=5.557),age(F=2.735),work experience(F=4.775),highest education level(F=13.11),whether serving as a master's supervisor(t=2.693),participation in research projects(t=4.95),whether they had published papers as the first author or corresponding author(t=5.11),and attendance of research integrity training(t=12.48)(P<0.05).Multivariate linear regression analysis indicated that marital status,highest education level,and participation in research integrity training were significant factors influencing clinical nursing personnel's research integrity awareness(P<0.05).The main reason for research misconduct was lack of research integrity awareness The(76.47%),and 92.37%of clinical nursing personnel believed further strengthening of research integrity construction was necessary.Conclusion The research integrity awareness level of clinical nursing personnel needs improvement.Hospitals should enhance research integrity training,improve research integrity management systems,and optimize scientific talent evaluation mechanisms.

Objective To analyze the symptomatic improvement effects of vitamin D in children with autism spectrum disorder(ASD)based on the microbiota-gut-brain axis.Methods Seventy-two children with ASD were randomly divided into an observation group and a control group,with 36 cases in each group.Three cases dropped out in the control group.The observation group received 1200 IU/day of vitamin D supplementation in addition to conventional rehabilitation training,while the control group received only conventional rehabilitation training.The intervention lasted for 12 weeks.Assessments were conducted before and after the intervention using the childhood autism rating scale(CARS),autism behavior checklist(ABC),and repetitive behavior scale-revised(RBS-R).Resting-state functional connectivity of the brain was measured using near-infrared functional imaging,and serum levels of 25(OH)D3,inflammatory cytokines,and gut microbiota were analyzed.The differences in these indicators before and after the intervention were compared between the two groups to evaluate clinical efficacy.Results The between-group differences in pre-and post-intervention changes showed that the observation group had significantly greater improvements than the control group in the following measures:CARS scores(-5.92±1.40 vs.-2.55±1.43),RBS-R scores(-5.99±1.01 vs.-3.10±1.47),resting-state brain functional connectivity(0.19±0.15 vs.0.10±0.18),serum 25(OH)D3 levels[(34.89±8.18)ng/mL vs.(0.68±6.73)ng/mL],serum interleukin-6(IL-6)levels[(-6.60±6.07)pg/mL vs.(-0.74±9.45)pg/mL],IL-1β levels[(-2.56±1.33)pg/mL vs.(-0.04±2.13)pg/mL],and tumor necrosis factor-α(TNF-α)levels[(-4.09±3.85)pg/mL vs.(0.21±4.05)pg/mL](P<0.05).Post-intervention,significant differences in gut microbial β-diversity were observed between the two groups(R2=0.030,P=0.040,Adonis).LEfSe analysis revealed that the observation group exhibited enrichment in Clostridia(LDA=4.747,P=0.003),Clostridiales(LDA=4.747,P=0.003),Clostridiaceae(LDA=3.476,P=0.001),Lachnospiraceae(LDA=4.709,P=0.004),Odoribacteraceae(LDA=3.458,P=0.027),Odoribacter(LDA=3.458,P=0.027),Burkholderiales(LDA=3.339,P=0.038),Firmicutes(LDA=4.764,P=0.003),and Betaproteobacteria(LDA=3.338,P=0.037).Conclusion Vitamin D supplementation can modulate gut microbial diversity in children with ASD,significantly influence the abundance of specific gut microbiota,reduce systemic inflammatory cytokines,enhance brain functional connectivity,and alleviate clinical symptoms of ASD.

Objective To analyze the symptomatic improvement effects of vitamin D in children with autism spectrum disorder(ASD)based on the microbiota-gut-brain axis.Methods Seventy-two children with ASD were randomly divided into an observation group and a control group,with 36 cases in each group.Three cases dropped out in the control group.The observation group received 1200 IU/day of vitamin D supplementation in addition to conventional rehabilitation training,while the control group received only conventional rehabilitation training.The intervention lasted for 12 weeks.Assessments were conducted before and after the intervention using the childhood autism rating scale(CARS),autism behavior checklist(ABC),and repetitive behavior scale-revised(RBS-R).Resting-state functional connectivity of the brain was measured using near-infrared functional imaging,and serum levels of 25(OH)D3,inflammatory cytokines,and gut microbiota were analyzed.The differences in these indicators before and after the intervention were compared between the two groups to evaluate clinical efficacy.Results The between-group differences in pre-and post-intervention changes showed that the observation group had significantly greater improvements than the control group in the following measures:CARS scores(-5.92±1.40 vs.-2.55±1.43),RBS-R scores(-5.99±1.01 vs.-3.10±1.47),resting-state brain functional connectivity(0.19±0.15 vs.0.10±0.18),serum 25(OH)D3 levels[(34.89±8.18)ng/mL vs.(0.68±6.73)ng/mL],serum interleukin-6(IL-6)levels[(-6.60±6.07)pg/mL vs.(-0.74±9.45)pg/mL],IL-1β levels[(-2.56±1.33)pg/mL vs.(-0.04±2.13)pg/mL],and tumor necrosis factor-α(TNF-α)levels[(-4.09±3.85)pg/mL vs.(0.21±4.05)pg/mL](P<0.05).Post-intervention,significant differences in gut microbial β-diversity were observed between the two groups(R2=0.030,P=0.040,Adonis).LEfSe analysis revealed that the observation group exhibited enrichment in Clostridia(LDA=4.747,P=0.003),Clostridiales(LDA=4.747,P=0.003),Clostridiaceae(LDA=3.476,P=0.001),Lachnospiraceae(LDA=4.709,P=0.004),Odoribacteraceae(LDA=3.458,P=0.027),Odoribacter(LDA=3.458,P=0.027),Burkholderiales(LDA=3.339,P=0.038),Firmicutes(LDA=4.764,P=0.003),and Betaproteobacteria(LDA=3.338,P=0.037).Conclusion Vitamin D supplementation can modulate gut microbial diversity in children with ASD,significantly influence the abundance of specific gut microbiota,reduce systemic inflammatory cytokines,enhance brain functional connectivity,and alleviate clinical symptoms of ASD.

[Purpose]To analyze the compliance rates and influencing factors for gastroscopy and colonoscopy in gastrointestinal cancer screening,and to provide evidence and management recom-mendations for gastrointestinal cancer screening programs.[Methods]The study was based on the joint gastrointestinal cancer screening program conducted in Fenghua District of Ningbo City in 2023.The target population underwent risk assessments,following which high-risk individuals were mobilized for gastroscopy and colonoscopy screenings.The x2 test was used to compare the positive rates of gastrointestinal cancer risk assessments and the compliance rates of clinical screenings among populations with different characteristics.Multivariable Logistic regression models were applied to analyze the factors associated with compliance rates of clinical gastroscopy and colonoscopy screenings among high-risk individuals.[Results]A total of 48 587 individuals were included in the analysis,with an average age of(63.95±7.48)years old.Among them,39.45％(19 166 individuals)were male.The positive rates of risk assessment for upper gastrointestinal cancer and colorectal cancer were 39.00％(18 949 individuals)and 16.02％(7 782 individuals),respectively.The compliance rates for gastroscopy and colonoscopy were 59.51％(11 227/18 949)and 50.85％(3 957/7 782),respectively.Multivariable Logistic regression analysis revealed that unmarried in-dividuals and those with an assessment interval of more than 14 d had lower compliance with gas-troscopy(both P＜0.05).High-risk individuals for upper gastrointestinal cancer with BMI≥24 kg/m2,gastrointestinal symptoms,history of upper gastrointestinal diseases,family history of cancers,history of gastroscopy,lower intake of fresh vegetables and fruits,and higher intake of processed meats had higher compliance with gastroscopy(all P＜0.05).High educational levels and an assess-ment interval of more than 14 d were associated with lower compliance with colonoscopy(both P＜0.05).Among individuals at high risk for colorectal cancer,those with gastrointestinal symptoms,history of upper gastrointestinal diseases,higher intake of processed meats and fried or grilled foods,and a positive risk assessment for upper gastrointestinal cancer had higher compliance with colonoscopy(all P＜0.05).[Conclusion]Participants in the joint gastrointestinal cancer screening program exhibit high compliance with both gastroscopy and colonoscopy.Compliance with gas-troscopy and colonoscopy is associated with individual lifestyle,health conditions,disease history,medical history,and family history of cancers.

Objective:To investigate the clinical application of 3-dimensional CT angiography(3D-CTA) in the repair of mandibular defects with deep circumflex iliac arterial flaps.Methods:From January 2019 to January 2020, 5 patients with postoperative defects of mandibular tumors were treated in the Department of Stomatology of the First Affiliated Hospital of Bengbu Medical College, including 2 males and 3 females. The ages of the patients ranged from 30 to 70 years, with an average of 52 years. CT angiography of both lower limbs was performed before operation. Data were processed using the CT workstation. According to the size and shape of the defect in the recipient site, the 3D model of the deep circumflex iliac arterial flap(DCIA) was constructed. the contour of the DCIA was observed and measured, and the data was recorded, including the diameter of the vassel at the starting point, the angle between the line from the starting point to the anterior superior iliac spine and the line between the bilateral anterior superior iliac spine, and the distance from the starting point to the anterior superior iliac spine. According to the 3D model, a composite tissue flap pedicled with DCIA was designed and prepared for mandibular defect repair. The actual situation during the procedure was compared with the preoperative 3D model simultaneously.Results:The diameter of the DCIA at the starting point was (2.30±0.24) mm. The angle between the line from the starting point to the anterior superior iliac spine and the line between the bilateral anterior superior iliac spine was 39.3°±6.1°, and the distance from the starting point to the anterior superior iliac spine was (5.83±0.24) cm. The shape and position of the DCIA were basically consistent with the three-dimensional model. All the flaps survived well after operation. All the patients were followed up for 3 to 6 months, the bilateral maxillofacial region were basically symmetrical. The postoperative imaging examination showed that the iliac osteocutaneous flap healed well, and the height and width of mandibular alveolar ridge were restored satisfactorily. There were no complications such as numbness in the donor site, abdominal hernia and gait abnormality.Conclusions:The 3D model of the DCIA produced by 3D-CTA can accurately locate the position and route of the vessel, clearly display the three-dimensional spatial relationship between the skin, muscles and bones around the target blood vessel, and significantly reduce the complications and operative time.

Objective:To investigate the clinical application of 3-dimensional CT angiography(3D-CTA) in the repair of mandibular defects with deep circumflex iliac arterial flaps.Methods:From January 2019 to January 2020, 5 patients with postoperative defects of mandibular tumors were treated in the Department of Stomatology of the First Affiliated Hospital of Bengbu Medical College, including 2 males and 3 females. The ages of the patients ranged from 30 to 70 years, with an average of 52 years. CT angiography of both lower limbs was performed before operation. Data were processed using the CT workstation. According to the size and shape of the defect in the recipient site, the 3D model of the deep circumflex iliac arterial flap(DCIA) was constructed. the contour of the DCIA was observed and measured, and the data was recorded, including the diameter of the vassel at the starting point, the angle between the line from the starting point to the anterior superior iliac spine and the line between the bilateral anterior superior iliac spine, and the distance from the starting point to the anterior superior iliac spine. According to the 3D model, a composite tissue flap pedicled with DCIA was designed and prepared for mandibular defect repair. The actual situation during the procedure was compared with the preoperative 3D model simultaneously.Results:The diameter of the DCIA at the starting point was (2.30±0.24) mm. The angle between the line from the starting point to the anterior superior iliac spine and the line between the bilateral anterior superior iliac spine was 39.3°±6.1°, and the distance from the starting point to the anterior superior iliac spine was (5.83±0.24) cm. The shape and position of the DCIA were basically consistent with the three-dimensional model. All the flaps survived well after operation. All the patients were followed up for 3 to 6 months, the bilateral maxillofacial region were basically symmetrical. The postoperative imaging examination showed that the iliac osteocutaneous flap healed well, and the height and width of mandibular alveolar ridge were restored satisfactorily. There were no complications such as numbness in the donor site, abdominal hernia and gait abnormality.Conclusions:The 3D model of the DCIA produced by 3D-CTA can accurately locate the position and route of the vessel, clearly display the three-dimensional spatial relationship between the skin, muscles and bones around the target blood vessel, and significantly reduce the complications and operative time.

Objective:To explore the incidence rates, clinical features, risk factors and its impacts on survival of central nervous system complications (CNSC) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:From June 2011 to October 2018, 237 consecutive patients undergoing allo-HSCT were retrospectively analyzed.Results:The incidence of CNSC was 10.5%(25/237) and the median time 82(-4 - 810) days post-transplantation. The most common instances of CNSC were drug-associated encephalopathy (n=6), CNS infection (n=5), unexplained convulsions (n=4), metabolic encephalopathy (n=3), immune-related encephalopathy (n=3), primary central relapse (n=3) and cerebrovasculopathy (n=1). The most common clinical symptom was epileptic seizure (n=11). CsA-related encephalopathy was manifested mainly as posterior reversible encephalopathy syndrome on brain MRI. Metabolic encephalopathy is mostly demyelination. Most hippocampal lesions were caused by immune-related encephalopathy or CNS infection. Analysis of risk factors indicated that umbilical cord blood transplantation, HLA incompatible transplantation and delayed platelet implantation were high risk factors for post-transplantation occurrence of CNSC. Survival analysis suggested that non-relapse mortality rate (42.9%, 9/21) in group with CNSC of malignant hemoblastosis was higher than that in group without CNSC (15.3%, 27/176) and inter-group difference was statistically significant ( χ2=9.511, P=0.005). The 1/3-year OS rates in group with CNSC were lower than those in group without CNSC (56.6% vs 77.8%; 37.1% vs 65.7%). And the difference was statistically significant ( P=0.022). Conclusions:With a complex etiology, CNSC is one of serious complications after allo-HSCT and it significantly reduces the overall survival rate of patients. Umbilical cord blood transplantation, HLA incompatible transplantation and delayed platelet implantation are high-risk groups for CNSC.

Objective:To study the effect and safety of endoscopic ultrasonography guided reverse dissection for refractory benign esophageal stricture.Methods:Seventeen patients with refractory benign esophageal stricture were selected for endoscopic ultrasonography guided reverse dissection in Shunde Hospital, Southern Medical University from January 2016 to December 2019. The clinical data including operation success rate, complications and clinical efficacy were analyzed.Results:All 17 patients were successfully treated with endoscopic ultrasonography guided reverse dissection. The operating time was 38.82±24.27 minutes. No serious complications such as major bleeding, perforation, and infection were found during and after the operation. The follow-up time ranged from 3 to 44 months. Four patients had symptoms of dysphagia again at 3, 12, 18, and 26 months after operation, and re-examination of gastroscopy revealed recurrent esophageal stenosis. The rest of the patients did not re-stenosis until the last time of follow-up.Conclusion:Endoscopic ultrasonography guided reverse dissection is a safe and effective treatment for refractory benign esophageal stricture.

Objective To analyze the effect of haploidentical hematopoietic stem cell transplantation (HID-HSCT) on high-risk acute lymphoblastic leukemia (ALL),and to explore the influence of minimal residual disease (MRD) before transplant on the outcomes.Methods A retrospective analysis was performed on 39 high risk ALL patients receiving HID-HSCT in our hospital from Jan.2013 to Jan.2018.The clinical features,stem cell engraftment,complications,survival and recurrence were compared between patients with pretransplant MRD + and MRD-.Results All the 39 patients presented with successful engraftment.The overall survival (OS) was 54.67％;the disease free survival (DFS) was 40.96％;the incidence rate of acute graft versus host disease (aGVHD) was 53.8％,including 23.1％ Ⅱ-Ⅳ degree aGVHD and 2.6％ Ⅲ-Ⅳ degree aGVHD.There was no significant difference in stem cell engraftment,GVHD,cytomegalovirus infection and hemorrhagic cystitis between MRD + and MRD-patients.DFS and OS in MRD + patients were significantly lower than those in MRD-patients;the cumulative RR rate increased significantly,and there was no significant difference in cumulative TRM.Conclusion HID-HSCT was an effective method to treat high-risk ALL,but MRD + patients had high recurrence rate and poor prognosis.Strategy adjustment should be considered to reduce tumor residual and the transplantation strategy should be optimized for these kinds of high risk patients,so as to improve long-term outcomes.