Objective:To evaluate the long-term effectiveness of lingual mucosal graft ureteroplasty (LMGU) for managing long-segment (≥5 cm) ureteral strictures in a multi-institutional cohort of patients.Methods:A multi-center retrospective case series study was conducted on clinical data from 42 patients undergoing LMGU for long-segment ureteral strictures (≥5 cm) across five institutions between February 2017 and June 2024. The cohort comprised 31 males and 11 females, with an age of (43.4±12.0) years (range: 15 to 64 years) and a body mass index of (24.6±2.6) kg/m2 (range: 16.0 to 30.0 kg/m2). Strictures involved the left ureter in 24 cases and right ureter in 18 cases, demonstrating a stricture length of (6.4±1.5) cm (range: 5.0 to 11.5 cm). Surgical interventions included either onlay ureteroplasty or augmented anastomotic ureteroplasty, selected according to intraoperative findings. Intraoperative parameters, postoperative complications, and follow-up outcomes were analyzed.Results:Laparoscopic surgery was performed in 22 cases and robot-assisted surgery in 20 cases. Among the 42 patients, 22 underwent onlay ureteroplasty while 20 received augmented anastomotic ureteroplasty. The graft length was (5.9±1.8) cm (range: 3.0 to 12.0 cm), operative time (191.5±55.6) minutes (range: 105.0 to 350.0 minutes), and intraoperative estimated blood loss (86.7±73.6) ml (range: 10.0 to 400.0 ml). All procedures were successfully completed without conversion to open surgery. The postoperative hospital stay was (7.6±2.0) days (range: 4.0 to 15.0 days), with double-J stent removal at 6 to 8 weeks postoperatively. During a follow-up of (49.1±25.0) months (range: 12.0 to 99.0 months), no stricture recurrence was observed in any patient.Conclusion:LMGU is a safe, feasible, and effective long-term technique for managing long-segment (≥5 cm) ureteral strictures.

Objective:To explore the optimal duration of preoperative imatinib therapy in patients with locally advanced gastrointestinal stromal tumors (GIST) in order to optimize surgical timing and long-term survival benefits.Methods:A total of 171 patients with locally advanced GIST who received preoperative imatinib therapy and subsequent surgical resection between November 2012 and October 2024 at Fujian Cancer Hospital and Union Hospital of Fujian Medical University were retrospectively analyzed. Patients were divided into three groups according to the duration of preoperative imatinib treatment: short-term (≤6 months, n=50), intermediate-term (7-12 months, n=87), and long-term (>12 months, n=34). Imaging response, pathological efficacy, recurrence-free survival (RFS), and overall survival (OS) were compared among the groups. Univariate and multivariate Cox regression analyses were used to identify the optimal treatment duration. Results:The median duration of preoperative imatinib therapy was 9 (6, 12) months. After treatment, the average maximum tumor diameter decreased from (10.37±5.74) cm to (6.99±4.34) cm, with an average shrinkage of 31.5%. The objective response rates in the short-, intermediate-, and long-term groups were 50.0% (25/50), 58.6% (51/87), and 52.9% (18/34), respectively; high-grade pathological response rates were 28.0% (14/50), 37.9% (33/87), and 29.4% (10/34), with no statistically significant differences among groups (all P>0.05). With a median follow-up of 46 months, 39 patients experienced recurrence and 20 died. The intermediate-term group had 3- and 5-year RFS rates of 87.1% and 79.6%, respectively, significantly better than those of the short-term group (75.5% and 55.5%, P=0.004). The long-term group had 3- and 5-year RFS rates of 85.3% and 75.5%, which were between the other two groups, but not significantly different (all P>0.05). For OS, the intermediate-term group had 3- and 5-year rates of 97.3% and 92.7%, superior to the short-term group (84.4% and 72.4%, P=0.007), while the long-term group (88.2% and 79.4%) showed no significant advantage (all P>0.05). Stratified analysis revealed that among non-gastric primary tumor patients with c-Kit exon 11 mutations, partial response on imaging, or postoperative imatinib ≤24 months, the intermediate-term group had significantly better RFS and OS than the short-term group (all P<0.05), but had no differences compared to the long-term group ( P>0.05). Multivariate Cox regression analysis indicated that preoperative imatinib duration was not an independent factor for RFS ( P>0.05), but treatment for 7-12 months was an independent protective factor for OS ( HR=0.275, 95% CI: 0.089-0.851, P=0.025), while prolonging therapy beyond 12 months conferred no additional OS benefit ( P>0.05). Conclusions:In patients with locally advanced GIST, preoperative imatinib therapy for 7-12 months yielded the most favorable prognosis, with significantly improved RFS and OS compared to ≤6 months of treatment. Extending preoperative therapy beyond 12 months did not provide additional survival benefit.

Objective:To evaluate the long-term effectiveness of lingual mucosal graft ureteroplasty (LMGU) for managing long-segment (≥5 cm) ureteral strictures in a multi-institutional cohort of patients.Methods:A multi-center retrospective case series study was conducted on clinical data from 42 patients undergoing LMGU for long-segment ureteral strictures (≥5 cm) across five institutions between February 2017 and June 2024. The cohort comprised 31 males and 11 females, with an age of (43.4±12.0) years (range: 15 to 64 years) and a body mass index of (24.6±2.6) kg/m2 (range: 16.0 to 30.0 kg/m2). Strictures involved the left ureter in 24 cases and right ureter in 18 cases, demonstrating a stricture length of (6.4±1.5) cm (range: 5.0 to 11.5 cm). Surgical interventions included either onlay ureteroplasty or augmented anastomotic ureteroplasty, selected according to intraoperative findings. Intraoperative parameters, postoperative complications, and follow-up outcomes were analyzed.Results:Laparoscopic surgery was performed in 22 cases and robot-assisted surgery in 20 cases. Among the 42 patients, 22 underwent onlay ureteroplasty while 20 received augmented anastomotic ureteroplasty. The graft length was (5.9±1.8) cm (range: 3.0 to 12.0 cm), operative time (191.5±55.6) minutes (range: 105.0 to 350.0 minutes), and intraoperative estimated blood loss (86.7±73.6) ml (range: 10.0 to 400.0 ml). All procedures were successfully completed without conversion to open surgery. The postoperative hospital stay was (7.6±2.0) days (range: 4.0 to 15.0 days), with double-J stent removal at 6 to 8 weeks postoperatively. During a follow-up of (49.1±25.0) months (range: 12.0 to 99.0 months), no stricture recurrence was observed in any patient.Conclusion:LMGU is a safe, feasible, and effective long-term technique for managing long-segment (≥5 cm) ureteral strictures.

Objective:To explore the optimal duration of preoperative imatinib therapy in patients with locally advanced gastrointestinal stromal tumors (GIST) in order to optimize surgical timing and long-term survival benefits.Methods:A total of 171 patients with locally advanced GIST who received preoperative imatinib therapy and subsequent surgical resection between November 2012 and October 2024 at Fujian Cancer Hospital and Union Hospital of Fujian Medical University were retrospectively analyzed. Patients were divided into three groups according to the duration of preoperative imatinib treatment: short-term (≤6 months, n=50), intermediate-term (7-12 months, n=87), and long-term (>12 months, n=34). Imaging response, pathological efficacy, recurrence-free survival (RFS), and overall survival (OS) were compared among the groups. Univariate and multivariate Cox regression analyses were used to identify the optimal treatment duration. Results:The median duration of preoperative imatinib therapy was 9 (6, 12) months. After treatment, the average maximum tumor diameter decreased from (10.37±5.74) cm to (6.99±4.34) cm, with an average shrinkage of 31.5%. The objective response rates in the short-, intermediate-, and long-term groups were 50.0% (25/50), 58.6% (51/87), and 52.9% (18/34), respectively; high-grade pathological response rates were 28.0% (14/50), 37.9% (33/87), and 29.4% (10/34), with no statistically significant differences among groups (all P>0.05). With a median follow-up of 46 months, 39 patients experienced recurrence and 20 died. The intermediate-term group had 3- and 5-year RFS rates of 87.1% and 79.6%, respectively, significantly better than those of the short-term group (75.5% and 55.5%, P=0.004). The long-term group had 3- and 5-year RFS rates of 85.3% and 75.5%, which were between the other two groups, but not significantly different (all P>0.05). For OS, the intermediate-term group had 3- and 5-year rates of 97.3% and 92.7%, superior to the short-term group (84.4% and 72.4%, P=0.007), while the long-term group (88.2% and 79.4%) showed no significant advantage (all P>0.05). Stratified analysis revealed that among non-gastric primary tumor patients with c-Kit exon 11 mutations, partial response on imaging, or postoperative imatinib ≤24 months, the intermediate-term group had significantly better RFS and OS than the short-term group (all P<0.05), but had no differences compared to the long-term group ( P>0.05). Multivariate Cox regression analysis indicated that preoperative imatinib duration was not an independent factor for RFS ( P>0.05), but treatment for 7-12 months was an independent protective factor for OS ( HR=0.275, 95% CI: 0.089-0.851, P=0.025), while prolonging therapy beyond 12 months conferred no additional OS benefit ( P>0.05). Conclusions:In patients with locally advanced GIST, preoperative imatinib therapy for 7-12 months yielded the most favorable prognosis, with significantly improved RFS and OS compared to ≤6 months of treatment. Extending preoperative therapy beyond 12 months did not provide additional survival benefit.

Objective:To compare the clinical results of modified posterolateral approach combined medial approach versus traditional posterolateral approach combined with medial approach in open reduction and internal fixation of trimalleolar ankle fracture.Methods:A retrospective cohort study was used to analyze the clinical data of 46 patients with trimalleolar ankle fracture admitted to the First Affiliated Hospital of Naval Military Medical University from June 2013 to June 2019, including 14 males and 32 females, at age of 19-71 years [(49.2±14.9)years]. There were 33 patients with supination-external rotation type IV ankle fracture and 13 with pronation-external rotation type IV ankle fracture according to Lauge-Hansen classification. Open reduction and internal fixation was performed through the modified posterolateral approach combined with medial approach in 25 patients (modified approach group), and through the traditional posterolateral approach combined with medial approach in 21 patients (traditional approach group). The visual analogue score (VAS) at 3 days and 1 week after surgery, fracture healing time, range of ankle flexion and extension and Baird-Jackson score at the final follow-up and postoperative complications (numbness of the affect limb, wound necrosis, etc.) were compared between the two groups.Results:All patients were followed up for 11-21 months [(14.8±2.2)months]. There was no statistical difference in VAS or fracture healing time at 3 days after surgery between the two groups (all P>0.05). The VAS was 3.0 (3.0, 4.0)points in modified approach group at 1 week after surgery, significantly lower than 4.0 (3.0, 5.0)points in traditional approach group ( P<0.05). At the final follow-up, there was no statistical difference in range of ankle plantarflexion between the two groups ( P>0.05), but range of ankle dorsiflexion was significantly greater in modified approach group [(11.8±2.8)°] than that in traditional approach group [(8.1±3.5)°] ( P<0.01). At the final follow-up, Baird-Jackson score was not statistically different between the two groups ( P>0.05). There were 4 patients with numbness and 2 with wound necrosis in traditional approach group, but no numbness or wound necrosis occurred in modified approach group ( P<0.01). Conclusion:Both the modified posterolateral approach combined with medial approach and traditional posterolateral approach combined with medial approach can achieve good clinical results in open reduction and internal fixation of trimalleolar ankle fractures, but the former has advantages of better pain relief, better recovery of ankle dorsiflexion and less complications.

The acoustic detection method based on machine learning and signal processing is an important method of pathological voice detection and the extraction of voice features is one of the most important. Currently, the features widely used have disadvantage of dependence on the fundamental frequency extraction, being easily affected by noise and high computational complexity. In view of these shortcomings, a new method of pathological voice detection based on multi-band analysis and chaotic analysis is proposed. The gammatone filter bank was used to simulate the human ear auditory characteristics to analyze different frequency bands and obtain the signals in different frequency bands. According to the characteristics that turbulence noise caused by chaos in voice will worsen the spectrum convergence, we applied short time Fourier transform to each frequency band of the voice signal, then the feature gammatone short time spectral self-similarity (GSTS) was extracted, and the chaos degree of each band signal was analyzed to distinguish normal and pathological voice. The experimental results showed that combined with traditional machine learning methods, GSTS reached the accuracy of 99.50% in the pathological voice database of Massachusetts Eye and Ear Infirmary (MEEI) and had an improvement of 3.46% compared with the best existing features. Also, the time of the extraction of GSTS was far less than that of traditional nonlinear features. These results show that GSTS has higher extraction efficiency and better recognition effect than the existing features.
Acoustics ; Databases, Factual ; Fourier Analysis ; Humans ; Noise ; Signal Processing, Computer-Assisted

The WHO Classification of Thoracic Tumors (5 th edition) mainly has the following changes in the chapter of pleural malignant mesothelioma. (1) The concept of mesothelioma in situ and its diagnostic method have been established for the first time; (2) The tumour grading of pleural malignant mesothelioma was added, it was divided into low grade and high grade according to the cellular atypia, mitotic activity and presence of necrosis. (3) The morphological features of pleural malignant mesothelioma was classified into architectural pattern, cellular and stromal features, the correlation between histological features and prognosis was refined, and some of the controversial cellular types have been reclassified. In this review, we introduced the changes of related pathologic diagnosis, in the WHO Classification of Thoracic Tumors (5 th edition) and discussed its clinical significance.

The WHO Classification of Thoracic Tumors (5 th edition) mainly has the following changes in the chapter of pleural malignant mesothelioma. (1) The concept of mesothelioma in situ and its diagnostic method have been established for the first time; (2) The tumour grading of pleural malignant mesothelioma was added, it was divided into low grade and high grade according to the cellular atypia, mitotic activity and presence of necrosis. (3) The morphological features of pleural malignant mesothelioma was classified into architectural pattern, cellular and stromal features, the correlation between histological features and prognosis was refined, and some of the controversial cellular types have been reclassified. In this review, we introduced the changes of related pathologic diagnosis, in the WHO Classification of Thoracic Tumors (5 th edition) and discussed its clinical significance.

Background and Objectives: Psoriasis is a chronic inflammatory skin disease, which the mechanisms behind its initiation and development are related to many factors. DMSCs (dermal mesenchymal stem cells) represent an important member of the skin microenvironment and play an important role in the surrounding environment and in neighbouring cells, but they are also affected by the microenvironment. We studied the glucose metabolism of DMSCs in psoriasis patients and a control group to reveal the relationship among glucose metabolism, cell proliferation activity，and VEC (vascular endothelial cell) differentiation in vitro, we demonstrated the biological activity and molecular mechanisms of DMSCs in psoriasis. Methods: and Results: We found that the OCR of DMSCs in psoriatic lesions was higher than that in the control group, and mRNA of GLUT1 and HK2 were up-regulated compared with the control group. The proliferative activity of DMSCs in psoriasis was reduced at an early stage, and mRNA involved in proliferation, JUNB and FOS were expressed at lower levels than those in the control group. The number of blood vessels in psoriatic lesions was significantly higher than that in the control group (p＜0.05), which the mRNA of VEC differentiation, CXCL12, CXCR7, HEYL and RGS5 tended to be increased in psoriatic lesions compared to the control group, in addition to Notch3. Conclusions We speculated that DMSCs affected local psoriatic blood vessels through glucose metabolism, and the differentiation of VECs, which resulted in the pathophysiological process of psoriasis.

Objective:To investigate the association between systemic inflammation response index (SIRI) and early neurological deterioration (END) in patients with basal ganglia hemorrhage (BGH), and then set up a prediction Nomogram model for END.Methods:The retrospective cohort study was conducted. A total of 146 patients with BGH from January 2016 to December 2018 were chosen in the Affiliated Jiangyin Hospital of Southeast University Medical College. The patients were divided into the END group ( n=34) and non-END group ( n=112), according to whether END occurred or not. The normally distributed data were presented as the mean±standard deviation ( Mean± SD), and the groups were compared using the t test. The non-normally distributed data were expressed as M ( P25, P75), and this data was analysed via the Kruskal-Wallis test. Categorical variables were described as numbers of patients (%) and compared using chi-square analysis or Fisher exact test, as appropriate. Univariate analysis and multivariate logistic regression analysis were used to identify the risk factors of END occurrence, and the relationship with SIRI. Then, each factor was scored by Nomogram method to construct the prediction model. Receiver operating characteristic curve (ROC) was drawn to assess the predictive value of SIRI and Nomogram model in the occurrence of END. Results:Univariate analysis showed that the occurrence of END was associated with hematoma volume, presence of intraventricular hemorrhage, blood glucose, lymphocyte count and SIRI ( P<0.05). Multivariate logistic regression analysis showed that hematoma volume ( P<0.001), presence of intraventricular hemorrhage ( P=0.012) and SIRI ( P=0.023) are independent risk factors for END occurrence. ROC curve analysis showed that SIRI has certain predictive value for END occurrence, and the optimal cut-off value was SIRI=5.40×10 9/L. Then these risk factors were incorporated into the Nomogram. Statistically analysis showed the model had a good predictive value, and the model combining the SIRI and other prognostic factors (AUC=0.869, 95% CI: 0.804-0.935, P<0.001) showed more favorable discriminative ability than the model without the SIRI (AUC=0.811, 95% CI: 0.734-0.889, P<0.001) and the model using the SIRI only (AUC=0.716, 95% CI: 0.622-0.810, P<0.001). Conclusion:SIRI is closely correlated with the occurrence of END in patients with BGH, and the nomogram model combining the SIRI has a more accurately predictive value, which improved the early identification and screening of END, and patient outcomes.