Objective:To investigate the efficacy and safety of high-frequency irreversible electroporation (H-FIRE) in treating benign prostatic hyperplasia (BPH).Methods:This randomized controlled open-label multicenter clinical trial enrolled patients from nine medical centers in China between August 2020 and July 2022. Inclusion criteria: age 50–80 years, International Prostate Symptom Score (IPSS) ≥12, maximum urinary flow rate (Q max) >5 ml/min and ≤15 ml/min. Exclusion criteria: prostate malignancy, contraindications to surgery or anesthesia. Patients were randomized 1∶1 into the H-FIRE group (experimental) or the control group (daily oral 0.2 mg tamsulosin hydrochloride sustained-release capsules). Primary outcomes included Q max, IPSS, prostate volume, and International Index of Erectile Function-5 (IIEF-5) scores, measured at baseline, 1 and 3 months post-treatment. Results:A total of 160 cases were included in this study, including 80 cases in the experimental group and 80 cases in the control group, 30 cases in Renji Hospital, 7 cases in Qilu Hospital of Shandong University, 8 cases in Tongji Hospital, 3 cases in Hunan Provincial Hospital, 13 cases in Shanghai Pudong Hospital, 29 cases in Hwa Mei Hospital, 18 cases in Yiyuan County People's Hospital, and 38 cases in Shanghai East Hospital, and 14 cases in Sun Yat-sen Memorial Hospital. At 3 months of post-treatment, Q max in the experimental group increased by a median of 7.50 (3.55, 14.50) ml/s from the baseline value, whereas in the control group it increased by a median of 1.70 (-1.40, 6.00) ml/s, and the difference between the two groups was statistically significant ( P < 0.01, U = 1 083); and at 3 months of post-treatment, IPSS in the experimental group decreased by a median of 12.00 (7.00, 17.00) points in the test group and 6.00 (2.00, 11.00) points in the control group, and the magnitude of improvement in IPSS scores in the test group was significantly higher than that in the control group ( P < 0.01, U = 1 248); at 3 months of post-treatment, the prostate volume decreased by a median of 12.16 (5.69, 18.27) ml in the experimental group and 0 (-3.94, 6.89) ml in the control group, suggesting that H-FIRE significantly reduced prostate gland volume ( P<0.01, U=1 111). The difference in elevated IIEF-5 scores from baseline at 3 months of treatment between the experimental and control groups was not statistically significant[0(-2.00, 1.00) points vs. 0(-2.00, 1.50) points; P=0.54, U=2 338]. There were no serious adverse events in the two groups. Conclusions:H-FIRE could significantly improve both subjective and objective symptoms of BPH with a low risk of severe complications.

Objective To investigate the influencing factors of the course of perioperative prophylactic antibiotics in patients undergoing total hip arthroplasty,and explore management strategies for enhancing perioperative prophylactic medication administration.Methods The clinical data for patients undergoing total hip arthroplasty at Affiliated Hospital of Chengdu University from January,2020 to September,2024 were retrospectively collected.Patients were divided into a 24 h group and a 48-72 h group based on the duration of prophylactic antibacterial therapy.The general characteristics,surgical-related indicators,preoperative and postoperative laboratory test results,and surgical outcome measures between the two groups of patients were compared.Multivariate Logistic regression analysis was performed to identify influencing factors associated with prolonged duration of prophylactic antibacterial therapy.Results A total of 126 patients who underwent total hip arthroplasty were enrolled,including 74 cases in the 24 h group and 52 cases in the 48-72 h group.Univariate analysis results showed that there were statistically significant differences in the following indicators between the two groups:surgical cause,surgical duration,intraoperative blood loss,drainage duration of plasma drainage tubes,preoperative white blood cell count,and preoperative neutrophil count(P<0.05).The results of multivariate Logistic regression analysis showed that the reason for surgery and the duration of plasma drain tube drainage were the influencing factors of antimicrobial treatment course for total hip arthroplasty(P<0.05).The results of receiver operating characteristic curve analysis showed that the prediction model(constructed based on the drainage time of plasma drainage tube)for prophylactic antimicrobial treatment course to 48-72 h was 0.721.When the drainage time of plasma drainage tubes was≥40.56 h,the risk of requiring prophylactic antimicrobial therapy for an extended course of 48-72 h increased significantly.Conclusion The patient's surgical reason and the duration of plasma drain drainage may be related to the prophylactic antimicrobial course of more than 24 hours.Clinical pharmacists may utilize this parameter as a patient-specific characteristic,with the support of information systems,the hierarchical patient management can be implemented,thereby enhancing the effectiveness of medication surveillance and progressively elevating the 24 h discontinuation rate of perioperative prophylactic antibiotics.

Objective:To investigate the efficacy and safety of high-frequency irreversible electroporation (H-FIRE) in treating benign prostatic hyperplasia (BPH).Methods:This randomized controlled open-label multicenter clinical trial enrolled patients from nine medical centers in China between August 2020 and July 2022. Inclusion criteria: age 50–80 years, International Prostate Symptom Score (IPSS) ≥12, maximum urinary flow rate (Q max) >5 ml/min and ≤15 ml/min. Exclusion criteria: prostate malignancy, contraindications to surgery or anesthesia. Patients were randomized 1∶1 into the H-FIRE group (experimental) or the control group (daily oral 0.2 mg tamsulosin hydrochloride sustained-release capsules). Primary outcomes included Q max, IPSS, prostate volume, and International Index of Erectile Function-5 (IIEF-5) scores, measured at baseline, 1 and 3 months post-treatment. Results:A total of 160 cases were included in this study, including 80 cases in the experimental group and 80 cases in the control group, 30 cases in Renji Hospital, 7 cases in Qilu Hospital of Shandong University, 8 cases in Tongji Hospital, 3 cases in Hunan Provincial Hospital, 13 cases in Shanghai Pudong Hospital, 29 cases in Hwa Mei Hospital, 18 cases in Yiyuan County People's Hospital, and 38 cases in Shanghai East Hospital, and 14 cases in Sun Yat-sen Memorial Hospital. At 3 months of post-treatment, Q max in the experimental group increased by a median of 7.50 (3.55, 14.50) ml/s from the baseline value, whereas in the control group it increased by a median of 1.70 (-1.40, 6.00) ml/s, and the difference between the two groups was statistically significant ( P < 0.01, U = 1 083); and at 3 months of post-treatment, IPSS in the experimental group decreased by a median of 12.00 (7.00, 17.00) points in the test group and 6.00 (2.00, 11.00) points in the control group, and the magnitude of improvement in IPSS scores in the test group was significantly higher than that in the control group ( P < 0.01, U = 1 248); at 3 months of post-treatment, the prostate volume decreased by a median of 12.16 (5.69, 18.27) ml in the experimental group and 0 (-3.94, 6.89) ml in the control group, suggesting that H-FIRE significantly reduced prostate gland volume ( P<0.01, U=1 111). The difference in elevated IIEF-5 scores from baseline at 3 months of treatment between the experimental and control groups was not statistically significant[0(-2.00, 1.00) points vs. 0(-2.00, 1.50) points; P=0.54, U=2 338]. There were no serious adverse events in the two groups. Conclusions:H-FIRE could significantly improve both subjective and objective symptoms of BPH with a low risk of severe complications.

Objective To investigate the influencing factors of the course of perioperative prophylactic antibiotics in patients undergoing total hip arthroplasty,and explore management strategies for enhancing perioperative prophylactic medication administration.Methods The clinical data for patients undergoing total hip arthroplasty at Affiliated Hospital of Chengdu University from January,2020 to September,2024 were retrospectively collected.Patients were divided into a 24 h group and a 48-72 h group based on the duration of prophylactic antibacterial therapy.The general characteristics,surgical-related indicators,preoperative and postoperative laboratory test results,and surgical outcome measures between the two groups of patients were compared.Multivariate Logistic regression analysis was performed to identify influencing factors associated with prolonged duration of prophylactic antibacterial therapy.Results A total of 126 patients who underwent total hip arthroplasty were enrolled,including 74 cases in the 24 h group and 52 cases in the 48-72 h group.Univariate analysis results showed that there were statistically significant differences in the following indicators between the two groups:surgical cause,surgical duration,intraoperative blood loss,drainage duration of plasma drainage tubes,preoperative white blood cell count,and preoperative neutrophil count(P<0.05).The results of multivariate Logistic regression analysis showed that the reason for surgery and the duration of plasma drain tube drainage were the influencing factors of antimicrobial treatment course for total hip arthroplasty(P<0.05).The results of receiver operating characteristic curve analysis showed that the prediction model(constructed based on the drainage time of plasma drainage tube)for prophylactic antimicrobial treatment course to 48-72 h was 0.721.When the drainage time of plasma drainage tubes was≥40.56 h,the risk of requiring prophylactic antimicrobial therapy for an extended course of 48-72 h increased significantly.Conclusion The patient's surgical reason and the duration of plasma drain drainage may be related to the prophylactic antimicrobial course of more than 24 hours.Clinical pharmacists may utilize this parameter as a patient-specific characteristic,with the support of information systems,the hierarchical patient management can be implemented,thereby enhancing the effectiveness of medication surveillance and progressively elevating the 24 h discontinuation rate of perioperative prophylactic antibiotics.

OBJECTIVE To assess changes in the demographic characteristics of patients with otitis media with effusion during the COVID-19 epidemic.METHODS This retrospective study analyzed cases of otitis media with effusion in the Department of Otolaryngology Head and Neck Surgery,Beijing Tongren Hospital.The cases were divided into two groups:a pre-Covid-19 group(from December 1,2018,to January 31,2019),and a Covid-19 group(from December 1,2022,to January 31,2023).Patient demographics including age,sex,ear side and audiology results were collected.Additionally,age composition ratio,sex composition ratio,disease-side ratio,and audiological results were analyzed.RESULTS A total of 1 872 patients were included in the pre-COVID group,with an average age of(30.45±23.17)years(949 males and 923 females).Among them,910 were children and 962 were adults.The Covid-19 group included 1 194 patients,with an average age of(48.31±18.92)years(623 males and 571 females).Among them,95 were children and 1 099 were adults.Statistical analysis of the data revealed that the overall age distribution of the disease was different between the two groups(Z=-20.820,P＜0.001).There was a significant difference in the composition ratio of children to adults(χ2=546.838,P＜0.001),with a significant decrease and increase in the prevalence rate of otitis media with effusion in children and adults,respectively,in the COVID-19 group.Compared to the pre-COVID-19 group,the proportion of cases in the age group of 7-18 years was significantly reduced in the children's group(Z=-5.641,P＜0.001),and the proportion of prevalence increased significantly in the adult group aged 46-75 years(Z=-3.134,P=0.002).Additionally,there was a significant increase in the number of male patients in the Covid-19 group(χ2=5.15,P=0.023)when compared to the pre-COVID-19 group.CONCLUSION Compared to the pre-Covid-19 period,a significant change in the age distribution of otitis media with effusion was observed during the COVID-19 epidemic,with a significant decrease in the proportion of children and a signification increase in the proportion of adults.

Objective:To investigate the clinical features, diagnosis, treatment and prognosis of gastrointestinal neurilemmoma.Methods:A descriptive study was conducted to retrospectively analyze the clinical manifestations, endoscopic findings, pathological features, treatment methods and prognosis of patients with gastrointestinal neurilemmima diagnosed from May 2017 to November 2020 in the Second Affiliated Hospital of Xi'an Jiaotong UniversityResults:A total of 19 patients were collected, ranging in age from 45.0 to 70.0 years old, of whom 68.4% (13/19) were female. The clinical symptoms are non-specific, and some patients are asymptomatic (15.8%(3/19)) and may present with abdominal pain (57.9%(11/19)), nausea (31.6%(6/19)), abdominal distension (21.1%(4/19)) and decreased appetite (21.1%(4/19)), and a few with gastrointestinal bleeding (5.3%(1/19)). Tumors were most frequently found in the gastric body (42.1%(8/19)), followed by the duodenum (15.8%(3/19)). Endoscopic submucosal mass is easy to be misdiagnosed as stromal tumor. The pathological type showed shuttle cell tumor, immunohistochemical staining showed positive S100 and Vim, most Ki-67 staining proliferation rate was <5% (57.9%(11/19)), and a small part was ≥10% (10.5%(2/19)). Treatment was either endoscopic or surgical. No tendency to recur and metastasize was found in any of the neurilemmimas.Conclusion:Gastrointestinal neurilemmoma is a very rare submucosal tumor of the digestive tract, most of which are benign and rare in malignancy, and postoperative pathology is the gold standard for its diagnosis. Gastrointestinal neurilemmoma is common in middle-aged female, with diverse and non-specific clinical symptoms, difficult to differentiate from submucosal tumors such as stromal tumors, and its tendency to malignant transformation increases with tumor enlargement. Endoscopic resection is recommended for tumors with tumor diameter <3 cm without serosal invasion, with little trauma and no recurrence.

Objective:To explore the curative effect of Penumbra retrograde semi-retrieval Solitaire stents technique in the treatment of acute basilar artery occlusion.Methods:The clinical data of 15 patients with acute basilar artery occlusion in Shengjing Hospital of China Medical University from January 2017 to December 2019 were analyzed retrospectively. All patients were treated with Penumbra retrograde semi-retrieval Solitaire stents technique. The modified thrombolysis in cerebral infarction (mTICI) was used to evaluate the therapeutic effect.Results:Fifteen patients achieved vascular recanalization of occluded basilar artery, and mTICI 2b grade was in 3 cases, 3 grade in 12 cases. One operation completed vascular recanalization in 11 cases, 2 times in 3 cases,3 times in 1 case. CT images 24 to 48 h after operative showed no intracranial hemorrhage. The National Institutes of Health stroke scale (NIHSS) score at discharge was significantly lower than that before surgery: (4.8 ± 2.1) scores vs. (16.1 ± 5.7) scores, and there was statistical difference ( P<0.01). Conclusions:Penumbra retrograde semi-retrieval Solitaire stents technique can improve the efficiency of thrombus grasping and significantly improve patient symptoms.

Objective To improve the application management efficiency of NSFC and provide reference for the administration of peer hospitals.Methods Using the theory of PDCA cycle manages application work of NSFC and using fishbone diagram to analyses the affecting factors of NSFC management.Countermeasures were developed and implemented based on such analysis.Results The administration work of NSFC is continuingly improved under the guidance of PDCA cycle theory.Conclusions From the long term development of NSFC application management,the method of PDCA cycle theory is an ideal model

Objective To investigate the association between SLC10A1 gene mutations in c.800G>A mutation and c.356 +1098C >T mutation, and the susceptibility to HBV infection by mother-to-child transmission ( MTCT) .Methods Totally 306 individuals born to HBeAg-positive mothers with high load HBV and without receiving nucleotide analogues treatment, including 247 HBV-infected cases and 59 non-HBV-infected ones were enrolled from Southwest Hospital during May 2011 and July 2015.Blood samples were collected from all the subjects, then genomic DNA was extracted and c.800G>A mutation and c.356+1098C>T mutation of SLC10A1 were genotyped .Chi-square test (Pearsonχ2or continuity correctionχ2) was performed to identify the difference in genotypes between two groups.Results Among vaccinated individuals (55 HBV infected and 56 not infected), the frequency of genotype GA of c.800G>A mutation in non-infected ones was 14.3%(8/56), there was a tendency of increasing compared with HBV infected ones (5.5%, 3/55), but the difference was not statistically significant (χ2 =2.424, P =0.119). Similarly, the frequencies of genotypes CC, CT and TT of the c.356+1098C>T mutation in HBV infected ones were 20.0%(11/55), 47.3%(26/55) and 32.7%(18/55), while those in non-infected ones were 12.5% (7/56), 69.6% (39/56) and 17.9% (10/56), and the difference was not of statistical significance (χ2 =5.766, P=0.056).In all subjects (vaccinated and non-vaccinated), the frequency of genotype GA of c.800G>A mutation in non-HBV infected group had an increasing tendency compared with HBV-infected offspring (13.6% vs.6.9%), but the difference was not statistically significant (χ2 =2.010, P=0.156);the frequencies of genotype CC, CT and TT of c.356+1098C>T mutation in HBV infected patients were 20.2%(50/247), 49.8%(123/247) and 30.0%(74/247), while those in non-HBV-infected group were 11.9%(7/59), 69.5%(41/59) and 18.6%(11/59), and the difference was statistically significant (χ2 =7.436, P =0.024 ) .Within the HBV infected group, the frequencies of genotype GA of c.800G>A mutation were 5.5%(3/55) in vaccinated individuals and 7.3%(14/192) in non-vaccinated individuals, and the difference was not of statistical significance (χ2 =0.030, P=0.863);Similarly, the frequencies of genotype CC, CT and TT of c.356 +1098C >T mutation in vaccinated individuals were 20.0%(11/55), 47.3%(26/55) and 32.7%(18/55), while those in non-vaccinated individuals were 20.3%(39/192), 50.5%(97/192) and 29.2%(56/192), and the difference was not of statistical significance (χ2 =0.274, P=0.872).Conclusion c.356+1098C>T mutation in SLC10A1 may be associated with susceptibility to HBV infection of child born in HBeAg positive pregnant women infected with high load HBV.

ObjectiveTo investigate the clinical characteristic and long-term prognosis risk factor of patients with hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF). MethodsThe clinical data of 1116 HBV-ACLF patients who were hospitalized in Southwest Hospital of Third Military Medical University from January 2010 to January 2015 were analyzed retrospectively. The risk factors for 1-year survival time and prognosis were observed, and the Cox regression model was used to determine the independent risk factors for the prognosis of these patients. The t-test or t′-test was applied for comparison of continuous data between groups, and the chi-square test was applied for comparison of categorical data between groups. ResultsA total of 562 patients died within the 1-year follow-up period, and the fatality rate was 50.4%. The comparison between the survival group and the death group showed that age, alanine aminotransferase, total bilirubin, urea nitrogen, serum creatinine, international normalized ratio, serum Na+, white blood cell (WBC), percentage of neutrophils, platelet (PLT), HBV DNA load, Model for End-Stage Liver Disease (MELD) score, ascites, spontaneous bacterial peritonitis, gastrointestinal bleeding, pulmonary infection, sepsis, electrolyte disturbance, hepatic encephalopathy, and acute kidney injury (AKI) were the risk factors for death within 1 year (all P＜0.05). The Cox regression analysis showed that age, WBC, MELD score, hepatic encephalopathy, electrolyte disturbance, AKI, and PLT were the independent risk factors for the 1-year fatality in HBV-ACLF patients (all P＜005). ConclusionOur findings show that HBV-ACLF has a high fatality rate and is often accompanied by serious complications. The major risk factors affecting the 1-year fatality in HBV-ACLF patients are age, WBC, MELD score, hepatic encephalopathy, electrolyte disturbance, AKI, and PLT.