Objective To evaluate the efficacy and safety of 450 nm blue laser vaporization enucleation of the prostate in the treatment of benign prostatic hyperplasia(BPH)complicated with urinary retention, so as to promote its clinical application. Methods A retrospective analysis was conducted on the clinical data of 60 patients with BPH and urinary retention who underwent 450 nm blue laser vaporization enucleation of the prostate in our hospital during Feb. 2023 and Apr. 2024. All patients had urinary catheters indwelt preoperatively due to urinary retention. The perioperative indicators and complications were recorded. The maximum urinary flow rate(Qmax), postvoid residual(PVR), international prostate symptom score(IPSS), and quality of life score(QoL)were compared before surgery and 3 months after surgery. Results All procedures were completed successfully without conversion to transurethral resection of the prostate(TURP). No cases of severe intraoperative bleeding or transfusion were reported. The average operation time was(60.5±21.5)min, postoperative hemoglobin reduction(3.2±0.8)g/L, catheterization time(3.1±0.4)days, and hospital stay(3.2±0.4)days. No bladder perforation or urethral injury occurred. At 3 months postoperatively, Qmax [(19.2±4.9)mL/s vs.(3.5±2.3)mL/s], PVR [(50.8±20.1)mL vs.(369.2±163.2)mL], IPSS [(9.7±0.9)vs.(21.8±3.2)], and QoL [(1.4±0.5)vs.(4.9±0.1)]were significantly improved compared with preoperative values(P＜0.001). Urinary retention occurred in 2 patients after catheter removal on postoperative day 3, which was resolved one week after re-catheterization. Conclusion The 450 nm blue laser vaporization enucleation of the prostate is a safe and effective treatment for BPH complicated with urinary retention. It can significantly improve the short-term voiding function and quality of life with a low incidence of postoperative complications, demonstrating promising potential for clinical adoption.

Objective:To evaluate the clinical effect of different types of aortic root replacement in adolescent patients with aortic root aneurysm by analyzing the perioperative and follow-up conditions of surgical treatment for adolescent aortic root aneurysm.Methods:The clinical data of patients aged ≤18 years who were admitted to the Beijing Anzhen Hospital from November 2012 to February 2025, diagnosed with aortic root aneurysm by ultrasound or aortic computed tomography angiography (CTA) and requiring surgical intervention, were collected retrospectively. They were divided into the valve-sparing aortic root replacement group (David operation group) and the aortic root replacement group (Bentall operation group) according to the surgical method. The perioperative results and long-term follow-up results of the two groups were analyzed. Kaplan-Meier survival curves were drawn to compare the reoperation intervention rate between the two groups.Results:A total of 25 patients were included in this study, including 17 in the Bentall group and 8 in the David group. There were no statistically significant differences in gender, age, blood routine, liver and kidney function, coagulation function, and electrolyte internal environment between the two groups (all P>0.05). There were no statistically significant differences in operation time and intensive care unit stay between the two groups (all P>0.05). Compared with the Bentall operation group, the intraoperative blood loss in the David operation group was more ( P<0.05). During the follow-up, no reoperation occurred in the Bentall operation group, while 3 patients in the David operation group had long-term re-intervention. The long-term reoperation intervention rate in the David operation group was higher than that in the Bentall group ( P=0.042), but there was no statistically significant difference in the aortic valve-related surgical intervention rate between the two groups ( P=0.15). Conclusions:For adolescent patients with aortic root aneurysm, although David operation may face long-term reoperation intervention, this intervention may not be due to the difference in surgical methods. Both Bentall operation and David operation are safe and reliable, with good perioperative results and stable medium and long-term prognosis.

Objective:To investigate the effect of betaine in oxygen-glucose deprivation injury of rat brain microvascular endothelial cells(BMECs),and to clarify the regulatory effect of betaine on phosphoinositide 3-kinase(PI3K)/protein kinase B(AKT)pathway.Methods:Five SD rats aged 7 d were selected and the rat BMSEs were obtained.The oxygen-glucose deprivation model of rat BMECs was prepared under hypoxic and hypoglycemic conditions;the experiment was divdided into model group,and low dose,medium dose,and high dose of betaine groups and positive control group,at the same time,blank control group(without modeling)was set up.The BMECs in blank control group and model group were treated with fresh medium,the BMECs in positive control group were given a final concentration of 10 μmnol·L-1 nimodipine,and the BMECs in low,medium and high doses of betaine groups were treated with betaine at final concentration of 0.5,1.0 and 2.0 mmol·L-1,respectively.The survival rates of BMECs in various groups were determined by CCK-8 method at 12,24 and 48 h after culture;the activities of lactate dehydrogenase(LDH)and the levels of adenine ribonucleoside triphosphate(ATP)in the rat BMECs in various groups were determined using kits,and the levels of tumor necrosis factor-α(TNF-α),interleukin(IL)-6,IL-1β,and IL-18 in supernatants of the BMECs in various groups were determined by enzyme-linked immunosorbent assay(ELISA);the activities of superoxide dismutase(SOD)and levels of malondialdehyde(MDA)in the BMECs in various groups were determined by kits;the transendothelial resistance(TEER)values of rat BMSCs in various groups were determined by TEER analyzer,and the horseradish peroxidase(HRP)permeabilities of BMECs in various groups were determined by an insertion cell culture apparatus.TUNEL staining was used to determine the apoptotic rates of rat BMECs in vaisous groups,and Western blotting method was used to determine the ratios of phosphory lated PI3K(p-PI3K)/PI3K and phosphorylated AKT(p-AKT)/AKT in the rat BMECs in various groups.Results:Compared with blank control group,the survival rate of BMECs,activity of SOD,and level of ATP,value of TEER,and ratios of p-PI3K/PI3K and p-AKT/AKT of the rat BMECs in model group were significantly decreased(P＜0.05),while the activity of LDH,the levels of TNF-α,IL-6,IL-1β,IL-18,and MDA,the apoptotic rate of the BMECs,and HRP permeability were significantly increased(P＜0.05).Compared with model group,the survival rates of the BMECs,activities of SOD,and levels of ATP,values of TEER,and ratios of p-PI3K/PI3K and p-AKT/AKT of the BMECs in low,medium,and high doses of betaine groups and positive control group were significantly increased(P＜0.05),while the activities of LDH,the levels of TNF-α,IL-6,IL-1β,IL-18,and MDA,the apoptotic rates of BMECs and HRP permeabilities were significantly decreased(P＜0.05).Conclusion:Betaine can significantly repair the oxygen-glucose deprivation/reperfusion injury in the rat BMECs,inhibit the oxidative damage and apoptosis of BMECs,and improve the permeability of the cells;its mechanism may be related to the regulation of the PI3K/AKT pathway.

Objective:To evaluate the clinical effect of different types of aortic root replacement in adolescent patients with aortic root aneurysm by analyzing the perioperative and follow-up conditions of surgical treatment for adolescent aortic root aneurysm.Methods:The clinical data of patients aged ≤18 years who were admitted to the Beijing Anzhen Hospital from November 2012 to February 2025, diagnosed with aortic root aneurysm by ultrasound or aortic computed tomography angiography (CTA) and requiring surgical intervention, were collected retrospectively. They were divided into the valve-sparing aortic root replacement group (David operation group) and the aortic root replacement group (Bentall operation group) according to the surgical method. The perioperative results and long-term follow-up results of the two groups were analyzed. Kaplan-Meier survival curves were drawn to compare the reoperation intervention rate between the two groups.Results:A total of 25 patients were included in this study, including 17 in the Bentall group and 8 in the David group. There were no statistically significant differences in gender, age, blood routine, liver and kidney function, coagulation function, and electrolyte internal environment between the two groups (all P>0.05). There were no statistically significant differences in operation time and intensive care unit stay between the two groups (all P>0.05). Compared with the Bentall operation group, the intraoperative blood loss in the David operation group was more ( P<0.05). During the follow-up, no reoperation occurred in the Bentall operation group, while 3 patients in the David operation group had long-term re-intervention. The long-term reoperation intervention rate in the David operation group was higher than that in the Bentall group ( P=0.042), but there was no statistically significant difference in the aortic valve-related surgical intervention rate between the two groups ( P=0.15). Conclusions:For adolescent patients with aortic root aneurysm, although David operation may face long-term reoperation intervention, this intervention may not be due to the difference in surgical methods. Both Bentall operation and David operation are safe and reliable, with good perioperative results and stable medium and long-term prognosis.

Objective To establish a hybrid deep learning lung sound classification model based on convolutional neural network(CNN)-long short-term memory(LSTM)for electronic auscultation.Methods Wavelet transform was used to extract features from the dataset,transforming lung sound signals into energy entropy,peak value and other features.On this basis,a classification model based on hybrid algorithm incorporating CNN and LSTM neural network was constructed.The features extracted by wavelet transform were input into CNN module to obtain the spatial features of the data,and then the temporal features were detected through LSTM module.The fusion of the two types of features enabled the classification of lung sounds through the model,thereby assisting in the diagnosis of pulmonary diseases.Results The accuracy rate and F1 score of CNN-LSTM hybrid model were significantly higher than those of other single models,reaching 0.948 and 0.950.Conclusion The proposed CNN-LSTM hybrid model demonstrates higher accuracy and more precise classification,showcasing broad potential application value in intelligent auscultation.

OBJECTIVE To investigate the intervention effect and mechanism of Wuwei baogan pill on mice with non- alcoholic fatty liver disease （NAFLD）. METHODS The mice were given high-fat and high-sugar diet for 19 weeks to induce NAFLD model. The model mice were randomly grouped into model group， positive control group （polyene phosphatidylcholine capsules， 23.30 mg/kg）， Wuwei baogan pill low-dose， medium-dose and high-dose groups （0.11， 0.23， 0.45 g/kg）， with 8 mice in each group； the normal group was additionally set up without modeling. Administration groups were given relevant medicine intragastrically， and model group and normal group were given constant volume of normal saline， once a day， for consecutive 4 weeks. After the last administration， glucose metabolism （including fasting blood glucose， fasting insulin， insulin resistance index）， liver function [liver index， alanine aminotransferase （ALT）， aspartate aminotransferase （AST），liver tissue pathological score]， lipid metabolism [triglyceride （TG）， total cholesterol （TC）， low-density lipoprotein cholesterol （LDL-C）， and high- density lipoprotein cholesterol （HDL-C）] were measured； the pathological morphology of liver tissue， as well as fibrosis， lipid droplet formation， and glycogen synthesis were observed； the levels of free fatty acid （FFA） in serum and inflammatory factors in liver tissue [tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6） and IL-1β] were detected； the expressions of insulin receptor substrate/phosphoinositide 3-kinase/protein kinase B/ glycogen synthase kinase 3β （IRS/PI3K/AKT/GSK3β） signaling pathway-related protein in liver tissue were investigated. RESULTS After intervention with high-dose Wuwei baogan pill， liver index of NAFLD mice， serum levels of ALT， AST， FFA， TC， TG and LDL-C， the levels of TNF-α， IL-6 and IL-1β in liver tissue， fasting blood glucose， fasting insulin， insulin resistance index， liver tissue pathological score， proportions of fibrotic staining area and lipid droplet staining area all significantly decreased （P＜0.05）； the level of HDL-C， proportion of glycogen staining area， the phosphorylation of IRS1， PI3K， AKT and GSK3β protein increased significantly （P＜0.05）； the degree of liver cell necrosis and steatosis was reduced， and the fibrotic lesions were alleviated. The above indexes of mice were improved in Wuwei baogan pill low-dose and medium-dose groups， but there was no statistically significant difference in some indexes. CONCLUSIONS Wuwei baogan pill can regulate lipid and glucose metabolism disorders in the liver of NAFLD mice， and improve liver injury， the mechanism of which may be associated with the activation of IRS/PI3K/AKT/GSK3β signaling pathway.

OBJECTIVE To investigate the intervention effect and mechanism of Wuwei baogan pill on mice with non- alcoholic fatty liver disease （NAFLD）. METHODS The mice were given high-fat and high-sugar diet for 19 weeks to induce NAFLD model. The model mice were randomly grouped into model group， positive control group （polyene phosphatidylcholine capsules， 23.30 mg/kg）， Wuwei baogan pill low-dose， medium-dose and high-dose groups （0.11， 0.23， 0.45 g/kg）， with 8 mice in each group； the normal group was additionally set up without modeling. Administration groups were given relevant medicine intragastrically， and model group and normal group were given constant volume of normal saline， once a day， for consecutive 4 weeks. After the last administration， glucose metabolism （including fasting blood glucose， fasting insulin， insulin resistance index）， liver function [liver index， alanine aminotransferase （ALT）， aspartate aminotransferase （AST），liver tissue pathological score]， lipid metabolism [triglyceride （TG）， total cholesterol （TC）， low-density lipoprotein cholesterol （LDL-C）， and high- density lipoprotein cholesterol （HDL-C）] were measured； the pathological morphology of liver tissue， as well as fibrosis， lipid droplet formation， and glycogen synthesis were observed； the levels of free fatty acid （FFA） in serum and inflammatory factors in liver tissue [tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6） and IL-1β] were detected； the expressions of insulin receptor substrate/phosphoinositide 3-kinase/protein kinase B/ glycogen synthase kinase 3β （IRS/PI3K/AKT/GSK3β） signaling pathway-related protein in liver tissue were investigated. RESULTS After intervention with high-dose Wuwei baogan pill， liver index of NAFLD mice， serum levels of ALT， AST， FFA， TC， TG and LDL-C， the levels of TNF-α， IL-6 and IL-1β in liver tissue， fasting blood glucose， fasting insulin， insulin resistance index， liver tissue pathological score， proportions of fibrotic staining area and lipid droplet staining area all significantly decreased （P＜0.05）； the level of HDL-C， proportion of glycogen staining area， the phosphorylation of IRS1， PI3K， AKT and GSK3β protein increased significantly （P＜0.05）； the degree of liver cell necrosis and steatosis was reduced， and the fibrotic lesions were alleviated. The above indexes of mice were improved in Wuwei baogan pill low-dose and medium-dose groups， but there was no statistically significant difference in some indexes. CONCLUSIONS Wuwei baogan pill can regulate lipid and glucose metabolism disorders in the liver of NAFLD mice， and improve liver injury， the mechanism of which may be associated with the activation of IRS/PI3K/AKT/GSK3β signaling pathway.

Objective To propose a method for mitigate the impact of anomaly points(such as dust,bubbles,scratches on the chip surface,and minor indentations)in images on the results of digital droplet PCR(ddPCR)detection to achieve high-throughput,stable,and accurate detection.Methods We propose a Filter Faster R-CNN ddPCR detection model,which employs Faster R-CNN to generate droplet prediction boxes followed by removing the anomalies within the positive droplet prediction boxes using an outlier filtering module(Filter).Using a plasmid carrying a norovirus fragment as the template,we established a ddPCR dataset for model training(2462 instances,78.56%)and testing(672 instances,21.44%).Ablation experiments were performed to test the effectiveness of 3 filtering branches of the Filter for anomaly removal on the validation dataset.Comparative experiments with other ddPCR droplet detection models and absolute quantification experiments of ddPCR were conducted to assess the performance of the Filter Faster R-CNN model.Results In low-dust and dusty environments,the Filter Faster R-CNN model achieved detection accuracies of 98.23%and 88.35%for positive droplets,respectively,with composite F1 scores reaching 99.15%and 99.14%,obviously superior to the other models.The introduction of the filtering module significantly enhanced the positive accuracy of the model in dusty environments.In the absolute quantification experiments,a regression line was plotted using the results from commercial flow cytometry equipment as the standard concentration.The results show a regression line slope of 1.0005,an intercept of-0.025,and a determination coefficient of 0.9997,indicating high consistency between the two results.Conclusion The ddPCR detection technique using the Filter Faster R-CNN model provides a robust detection method for ddPCR under various environmental conditions.

Objective To propose a method for mitigate the impact of anomaly points(such as dust,bubbles,scratches on the chip surface,and minor indentations)in images on the results of digital droplet PCR(ddPCR)detection to achieve high-throughput,stable,and accurate detection.Methods We propose a Filter Faster R-CNN ddPCR detection model,which employs Faster R-CNN to generate droplet prediction boxes followed by removing the anomalies within the positive droplet prediction boxes using an outlier filtering module(Filter).Using a plasmid carrying a norovirus fragment as the template,we established a ddPCR dataset for model training(2462 instances,78.56%)and testing(672 instances,21.44%).Ablation experiments were performed to test the effectiveness of 3 filtering branches of the Filter for anomaly removal on the validation dataset.Comparative experiments with other ddPCR droplet detection models and absolute quantification experiments of ddPCR were conducted to assess the performance of the Filter Faster R-CNN model.Results In low-dust and dusty environments,the Filter Faster R-CNN model achieved detection accuracies of 98.23%and 88.35%for positive droplets,respectively,with composite F1 scores reaching 99.15%and 99.14%,obviously superior to the other models.The introduction of the filtering module significantly enhanced the positive accuracy of the model in dusty environments.In the absolute quantification experiments,a regression line was plotted using the results from commercial flow cytometry equipment as the standard concentration.The results show a regression line slope of 1.0005,an intercept of-0.025,and a determination coefficient of 0.9997,indicating high consistency between the two results.Conclusion The ddPCR detection technique using the Filter Faster R-CNN model provides a robust detection method for ddPCR under various environmental conditions.

ObjectiveTo identify and clarify the key issues faced by tertiary hospitals in responding to public health emergencies. MethodsA literature review index system was constructed， and key issues were identified using hierarchical analysis. ResultsAfter a systematic literature review， 20 types of problems faced by tertiary hospitals in responding to public health emergencies were identified. Three key issues were ultimately identified by prioritizing the issues that needed to be addressed. ConclusionThe key issues of tertiary hospitals in responding to public health emergencies are concentrated in the areas of emergency response capabilities and competencies of medical staff， the number of emergency response personnel， and the standardization and specificity of training and drills. Tertiary hospitals should focus on these issues in developing public health emergency response systems to improve the effectiveness of their emergency response.