Purpose: It was aimed to clarify the casual connection between prostate cancer (PCa) and arthritis by utilizing two-sample Mendelian randomization (MR) analysis and data from National Health and Nutrition Examination Survey (NHANES) database. Materials and Methods: This study utilized NHANES data. Through association analysis and risk stratification analysis, the association between arthritis and PCa were examined. MR analysis was performed to elucidate the causal relationship between arthritis and PCa. Sensitivity analysis and Steiger directionality test confirmed the reliability of the MR analysis results. Results: A total of 23,608 (PCa:controls=413:23,195) participants after a sample exclusion and variable definition process were screened in NHANES database. Adjustments across three diverse models consistently revealed a notable influence of arthritis on PCa progression. Arthritis was identified as a risk factor for PCa (odds ratio [OR] 1.88, 95% confidence interval [CI] 1.36–2.62, p<0.001). Subsequent analysis indicated that in the arthritis-adjusted model with multiple covariates, the area under the curve of the receiver operating characteristic curve was 0.94. The inverse variance weighting method of MR analysis showed a causal relationship between rheumatoid arthritis (RA) and PCa (OR 1.090, 95% CI 1.053–1.128, p<0.001) as well as osteoar-thritis and PCa (OR 1.002, 95% CI 1.001–1.004, p=0.002). This suggested that RA and osteoarthritis were risk factors for PCa. The heterogeneity (p>0.05), horizontal pleiotropy (p>0.05), leave-one-out and Steiger test confirmed reliability of MR results. Conclusions NHANES database and MR analyses identified arthritis as a risk factor for PCa, offering fresh avenues for preventive and therapeutic approaches.

Image-guided targeted biopsy is currently the mainstream method of prostate cancer puncture biopsy, while risk stratification based on imaging and biochemical markers may become the new standard. This paper comprehensively reviews the latest advancements in various imaging techniques and strategies of targeted prostate biopsy. Ultrasound-assisted prostate biopsy mainly includes transrectal ultrasound (TRUS), transrectal-contrast enhanced ultrasound (TR-CEUS), and transrectal real-time elastography (TRTE), which can significantly increase the diagnosis rate of prostate cancer when combined with biopsy. Three-dimensional transrectal ultrasound (3D-TRUS) technology may be used in patients with a negative previous biopsy. At present, micro-ultrasound (Micro-US), the latest ultrasound method, is not inferior to mp-MRI in targeted biopsy of the prostate. Targeted biopsy by mp-MRI has improved the detection rate of clinically significant prostate cancer (csPCa), and the common NMR targeted technologies are magnetic resonance imaging-visual-targeted biopsy (MRI-visual-TB), magnetic resonance imaging-fusion-targeted biopsy (MRI-fusion-TB), and in-bore magnetic resonance imaging-target biopsy (MRI-TB). The fusion of MRI and Micro-US imaging for targeted biopsy has also become a new targeted biopsy method, and MR robot-assisted biopsy is gradually being applied. PET/CT improves localization of tumors and may be valuable for initial staging, re-staging after biochemical recurrence, even in patients with MRI-negative prostate cancer. PET/CT targeted biopsy using tracer has been shown to yield good diagnostic efficacy. PET/MRI technology has the potential to be the imaging test for needle-free biopsies in the future. The development of technology has led to the adaptation and optimization of biopsy strategies in clinical practice.

Objective:To investigate the conversion of stromal vascular fraction (SVF) in the microenvironment of radiation-induced skin injuries to provide guidance for clinical applications.Methods:Based on a random number table, C57BL/6N mice were categorized into four groups: the blank control, negative control, acute injury, and chronic injury groups, with each group containing 25 mice. The backs of mice in the blank control, acute injury, and chronic injury groups were exposed to 15 Gy X-ray irradiation. Then, the mice in the negative control, acute injury, and chronic injury groups were injected subcutaneously with the SVF derived from B6/G-R mice. The survival of these mice was observed 1, 3, 7, 14, and 21 d after the injection through fluorescence tracing and in vivo imaging. Accordingly, the clinical SVF injection regimens were optimized based on the experimental result of mice. Finally, local SVF injection was performed on different frequencies for patients in different wound conditions, with the efficacy being observed. Results:The fluorescence of SVF was observed from the tissue slices of the acute injury, chronic injury, and negative control groups 14 d post-injection. The result showed that the fluorescence intensity of SVF 1, 3, and 7 d post-injection was in the order of the negative control group > the acute injury group > the chronic injury group. The acute injury group ranked at the top and the chronic injury group remained at the bottom 14 d after the injection. The fluorescence of SVF in each group was barely detected 21 d after the injection. Compared to the negative control group, the acute injury group exhibited statistical differences only 14 d post-injection ( t = 4.11, P < 0.05), while the chronic injury group displayed statistical differences 1, 3, 7, and 14 d after the injection ( t = 3.88-5.74, P < 0.05). Furthermore, the acute injury group exhibited significantly higher fluorescence intensity of SVF than the chronic injury group ( t = 4.73-8.38, P < 0.05). The half-life of SVF for the negative control, acute injury, and chronic injury groups was 6.336, 6.014, and 2.163 d, respectively. As indicated by the application of SVF transplantation based on traditional surgical protocols in the clinical trial, SVF can significantly promote wound repair, with earlier SVF transplantation being more beneficial for wound healing. Conclusions:The conversion of SVF differs in the microenvironments of acute and chronic radiation-induced skin injuries. This can serve as an essential guide for the administration timing and injection frequency of SVF in clinical applications.

Objective:To develop a risk prediction model for identifying bronchopulmonary dysplasia (BPD) associated pulmonary hypertension (PH) in very premature infants.Methods:This was a retrospective cohort study. The clinical data of 626 very premature infants whose gestational age <32 weeks and who suffered from BPD were collected from October 1 st, 2015 to December 31 st, 2021 of the Seventh Medical Center of the People′s Liberation Army General Hospital as a modeling set. The clinical data of 229 very premature infants with BPD of Hunan Children′s Hospital from January 1 st, 2020 to December 31 st, 2021 were collected as a validation set for external verification. The very premature infants with BPD were divided into PH group and non PH group based on the echocardiogram after 36 weeks′ corrected age in the modeling set and validation set, respectively. Univariate analysis was used to compare the basic clinical characteristics between groups, and collinearity exclusion was carried out between variables. The risk factors of BPD associated PH were further screened out by multivariate Logistic regression, and the risk assessment model was established based on these variables. The receiver operating characteristic (ROC) area under curve (AUC) and Hosmer-Lemeshow goodness-of-fit test were used to evaluate the model′s discrimination and calibration power, respectively. And the calibration curve was used to evaluate the accuracy of the model and draw the nomogram. The bootstrap repeated sampling method was used for internal verification. Finally, decision curve analysis (DCA) to evaluate the clinical practicability of the model was used. Results:A total of 626 very premature infants with BPD were included for modeling set, including 85 very premature infants in the PH group and 541 very premature infants in the non PH group. A total of 229 very premature infants with BPD were included for validation set, including 24 very premature infants in the PH group and 205 very premature infants in the non PH group. Univariate analysis of the modeling set found that 22 variables, such as artificial conception, fetal distress, gestational age, birth weight, small for gestational age, 1 minute Apgar score ≤7, antenatal corticosteroids, placental abruption, oligohydramnios, multiple pulmonary surfactant, neonatal respiratory distress syndrome (NRDS)>stage Ⅱ, early pulmonary hypertension, moderate-severe BPD, and hemodynamically significant patent ductus arteriosus (hsPDA) all had statistically significant influence between the PH group and the non PH group (all P<0.05). Antenatal corticosteroids, fetal distress, NRDS >stage Ⅱ, hsPDA, pneumonia and days of invasive mechanical ventilation were identified as predictive variables and finally included to establish the Logistic regression model. The AUC of this model was 0.86 (95% CI 0.82-0.90), the cut-off value was 0.17, the sensitivity was 0.77, and the specificity was 0.84. Hosmer-Lemeshow goodness-of-fit test showed that P>0.05. The AUC for external validation was 0.88, and the Hosmer-Lemeshow goodness-of-fit test suggested P>0.05. Conclusions:A high sensitivity and specificity risk prediction model of PBD associated PH in very premature infants was established. This predictive model is useful for early clinical identification of infants at high risk of BPD associated PH.

Objective:To explore the effect of identifying pelvic lymph nodes by different injection of indocyanine green (ICG) during fluorescent laparoscopic radical cystectomy.Methods:The data of 54 male bladder cancer patients admitted to the First Hospital of Shanxi Medical University from September 2021 to September 2022 were analyzed. Preoperative cystoscopic biopsy all revealed a pathological diagnosis of urothelial carcinoma. All patients underwent fluorescent laparoscopic radical cystectomy plus pelvic lymph node dissection.They were divided into 3 groups according to the annotated route: 6 in the medial malleolus injection group, 68(61, 73) years; 4 in the perineal injection group, 67(59, 74) years; 44 in the medial malleolus and perineum, 64(45, 78) in the combined injection group. Under general anesthesia, patients were placed in the supine position with 0.3 to 0.5 ml of subcutaneous ICG solution (2.5 mg/ml) injected from 1.0 to 1.5 h before surgery. In the medial malleolus injection group, 0.3 to 0.5 ml (0.75 mg/place) was injected at 2 cm above the medial malleolus and 0.3 to 0.5 ml (0.75 mg/place) at two symmetrical sites above the anus. Intraoperatively, 4K fluorescent laparoscopy was used to observe the color development of the injection site and lymphatic vessels in vitro, and then to observe the development of pelvic lymph nodes in vivo.Results:In 3 groups, inguinal lymph nodes were developed about 30 min after ICG injection, and 1 h later, the longest (4.5±0.3) h. The external iliac and common iliac lymph nodes, the obturatorius lymph nodes in the perineal injection group, and the inguinal, obturatorius, external iliac, internal, anterior sacral, and common iliac lymph nodes in the medial malleolar and perineal injection group. In this study, in 54 cases, the postoperative pathological examination confirmed that the removed fluorescently labeled tissue was lymph node tissue, and the lymph node detection rate was 100%. The postoperative stage was pT 2, 14, 32 pT 3 and 8 pT 4; 4 pNx, 44 pN 0, 5 pN 1and 1 pN 2. In the medial malleolar injection group, 2 patients staged pT 2, 3 stage pT 3, 1 stage pT 4; 1stage pNx stage, 4 stage pN 0 and 1 stage pN 1 stage. In the perineal injection group, 4 patients had postoperative pathological stage pT 3N 0; in the medial malleolar and perineal injection group, 12 pT 2, 25 and 7 pT 3; 3 pNx, 36 pN 0, 4 pN 1 and 1pN 2. Conclusions:ICG injection through the perineum and subcutaneous labeling of pelvic lymph nodes, and the simple malleolus or perineal injection can not completely develop the pelvic lymph nodes. The combined injection could fully develop the pelvic lymph nodes, which may accurately guide the operator to locate, identify and remove pelvic lymph nodes.

Objective:To investigate the practical efficacy of low-intensity pulsed ultrasound(LIPUS)and its effects on hemodynamics in patients with coronary heart disease and angina pectoris.Methods:As a single-center randomized controlled study, 66 elderly patients with coronary heart disease and angina pectoris treated at Qilu Hospital of Shandong University between November 2021 and August 2022 were consecutively recruited.Participants were divided into an ultrasound group and a control group via the random number table method, with 33 in each group.Both groups were given conventional drug treatment, and the ultrasound group was supplemented with LIPUS treatment.After 20 sessions of treatment, the clinical efficacy, blood lipid levels, inflammatory factors and hemodynamics from noninvasive monitoring before and after treatment were compared.Results:There were no statistically significant differences in baseline data between the two groups( P>0.05). After treatment, marked effectiveness was seen in 12 cases(36.4%), effectiveness in 18 cases(54.5%), ineffectiveness in 2 cases(6.1%)and aggravation in 1 case(3%)in the ultrasound group, with a total effectiveness rate of 90.9 %.In the control group, marked effectiveness was seen 2 cases(6.1%), effectiveness in 19 cases(57.6%)and ineffectiveness in 9 cases(27.3%), with a total effectiveness rate of 63.6%.Statistically significant favorable results were achieved in the ultrasound treatment group, compared with the control group( P<0.05). Also, compared with the control group, patients in the ultrasound group showed lower total cholesterol[(2.31±1.03)mmol/L vs.(4.36±0.76)mmol/L, P<0.01], decreased low-density lipoprotein cholesterol[(1.24±0.70)mmol/L vs.(1.74±0.44)mmol/L, P<0.01], decreased triglycerides[(1.04±0.40)mmol/L vs.(1.28±0.49)mmol/L, P<0.05], decreased apolipoprotein B[(0.67±0.25)g/L vs.(0.90±0.14)g/L, P<0.01], decreased interleukin-6[(2.87±2.52)ng/L vs.(4.66±3.30)ng/L, P<0.05], and decreased high-sensitivity C-reactive protein[(1.04±1.41)mg/L vs.(3.80±5.78)mg/L, P<0.05]. Concerning hemodynamics, there was an increase in cardiac output[(4.92±1.05)L/min vs.(4.39±0.97)L/min, P<0.05], stroke volume[(75.85±17.50)ml/beat vs.(66.97±15.57)ml/beat, P<0.05], cardiac index[(37.50±7.14)ml·beat -1·m -2vs.(43.29±7.96)ml·beat -1·m -2, P<0.01], and stroke volume index[(3.05±0.45)L/min 2vs.(2.51±0.43)L/min 2, P<0.01], but a decrease in systemic vascular resistance[(1 358.29±325.23)dyne·s -1·cm -5vs.(1 617.94±526.27)dyne·s -1·cm -5, P<0.05], total vascular resistance[(4.07±24.30)% vs.(21.32±31.94)%, P<0.05], and average heart rate[(63.43±7.42)beats/min vs.(69.11±10.89)beats/min, P<0.05]. Conclusions:LIPUS treatment can improve symptoms, blood lipid profiles, inflammatory factors and hemodynamics in patients with coronary heart disease and angina pectoris.It is a safe and effective adjuvant therapy for elderly patients with coronary heart disease and angina pectoris.

Influenza is a worldwide infectious disease caused by influenza virus. It has posed great challenges on public health and social stability since 1918. At present, vaccination is the most effective way to prevent and control influenza epidemics. Broad-spectrum antiviral drugs and neutralizing antibodies against influenza virus have been widely studied in recent years. Hemagglutinin (HA), which is on the surface of influenza virus, plays an important role in the stage of viral invasion into host cells. It is the main effective antigenic component of current influenza vaccines, as well as the main target of broad-spectrum neutralizing antibodies and broad-spectrum antiviral drugs. This review summarized the progress in the development of novel influenza vaccines, neutralizing antibodies, and antiviral drugs based on influenza virus HA, as well as other prevention and control measures, hoping to present new ideas for future influenza prevention and control.

Objective:To investigate the short-term clinical efficacy of SuperCAP artificial femoral head replacement and proximal femoral anti rotation intramedullary nail (PFNA) internal fixation in the treatment of intertrochanteric fractures in patients with osteoporosis.Methods:A retrospective analysis was conducted on the clinical data of patients with osteoporosis and intertrochanteric fractures admitted to the Orthopedic Department of Changsha First Hospital from January 2017 to January 2020. The patients underwent SuperCAP artificial femoral head replacement or PFNA internal fixation surgery. According to the inclusion and exclusion criteria, a total of 32 cases were included in the SuperCAP group and 46 cases in the PFNA group. We compared the age, gender, fracture classification, bone density, American Society of Anesthesiologists (ASA) score, surgical time, postoperative weight bearing time, intraoperative bleeding volume, incidence of perioperative complications, and Oxford Hip Score (OHS) between two groups of patients.Results:There was no statistically significant difference in age, gender, fracture classification, bone density, ASA score, surgical time, intraoperative bleeding, and the OHS at 6 months and 1 year after surgery between the two groups of patients (all P>0.05). The SuperCAP group had better postoperative weight bearing time, incidence of perioperative complications, and OHS at 1 week, 1 month, and 3 months compared to the PFNA group (all P<0.05). Conclusions:SuperCAP minimally invasive approach for the treatment of osteoporotic femoral intertrochanteric fractures can achieve the same effect as PFNA internal fixation, and the short-term effect of SuperCAP artificial femoral head replacement is better than PFNA internal fixation.

Objective:This study aimed to evaluate the effect of enhanced external counterpulsation(EECP)on left ventricular function in elderly patients with coronary slow flow phenomenon(CSFP)using two-dimensional speckle tracking echocardiography(2D-STE).Methods:This prospective case-control study included 30 patients aged ≥60 years with no stenotic lesions in the coronary arteries but with slow blood flow phenomenon in more than one major coronary artery who were treated at the Department of Geriatrics, Qilu Hospital, Shandong University, between December 2017 and December 2018, and were divided into a medication group with 16 participants and a medication plus EECP group with 14 participants, using the numerical lottery method.Patients in the group treated with EECP received 6-week 36-h EECP therapy in addition to lifestyle modification and drug treatment.Fourteen patients with normal coronary blood flow served as the control group.Conventional echocardiography and 2D-STE were used to evaluate changes in left ventricular function in the CSF patients before and after drug treatment and EECP.Results:Compared with the control group before treatment, patients in the drug treatment group and the drug treatment plus EECP group showed a decrease in mitral annular early diastolic velocity( P<0.01), an increase in the ratio of peak mitral early diastolic blood flow velocity to the mean peak mitral annular early diastolic velocity( P<0.05), and a decrease in left ventricular longitudinal strain during systole( P<0.01), the longitudinal systolic myocardial strain rate( P<0.01)and the early diastolic longitudinal peak strain rate( P<0.01).There was no statistically significant difference in values from conventional echocardiographic parameters before and after treatment in CSF patients of the medication group(all P>0.05).In the group receiving EECP, there were statistically significant differences in pre-and post-treatment values in ventricular septal early diastolic velocity[(6.22 ± 0.64)cm/s vs.(6.69 ± 0.44)cm/s], lateral wall early diastolic velocity[(8.01±0.68)cm/s vs.(8.41±0.29)cm/s], mitral valve to mitral annulus early diastolic peak velocity ratio[(10.51±1.38) vs.(9.74±0.37)], longitudinal left ventricular systolic strain[(-16.21±0.46)% vs.(-16.80±0.48)%], left ventricular systolic longitudinal strain rate[(-1.29±0.03)s -1vs.(-1.35±0.04)s -1], and early diastolic longitudinal strain rate[(1.35±0.03)s -1vs.(1.40±0.03)s -1](t-values were -3.70、-2.74、2.23、10.25、12.30、-19.15, all P<0.05). Conclusions:2D-STE can evaluate subclinical myocardial dysfunction early and quantitatively in elderly patients with CSF, and objectively reflect changes in left ventricular function before and after clinical intervention with EECP.

Objective:To investigate the efficacy of Mirabegron plus microecologics for the treatment of overactive bladder(OAB)in elderly women.Methods:In this prospective study, 104 patients diagnosed with OAB in the urology department of our hospital between February 2020 and December 2021 were recruited.The participants were randomly divided into two groups, with 52 in each.Group I was treated with Mirabegron alone(50 mg, qd)and Group Ⅱ was treated with Mirabegron(50 mg, qd)plus probiotics(3.5 g, bid)for 12 weeks.The efficacy was evaluated based on results before and after treatment, using measurements including the daily frequencies of urinary urgency, nocturia, daytime urination, urge incontinence and bladder capacity.The overactive bladder symptom score(OABSS), the quality-of-life score, and the number of lower urinary tract infections during treatment were also collected.Results at different treatment stages(week 4 and week 12)were compared within each group and between the two groups by Dunnett's test.Results:The symptoms of OAB in both groups were significantly improved after 12 weeks' treatment.In the group(Group Ⅱ)receiving the combination of two drugs, results from four measurements, the frequency of 24-hour urination(6.6 ± 0.7 vs.7.1 ± 1.2), the frequency of 24-hour urinary urgency(0.6 ± 0.6 vs.1.1 ± 0.7), the frequency of daily nocturia(0.8 ± 0.7 vs.1.3 ± 0.6)and the quality-of-life score(1.2 ± 0.7 vs.2.3 ± 0.8), were all significantly more favorable than in the group(Group I)treated with Mirabegron( P<0.05).The incidence of lower urinary tract infections and constipation was significantly reduced in the group with drug combination treatment. Conclusions:The efficacy of Mirabegron combined with microecologics for the treatment of OAB is better than that of Mirabegron alone, and the incidence of adverse events such as infections and constipation is also lower.