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 investigate the role of α7-nicotinic acetylcholine receptor (α7-nAChR) in the regulation of neuronal activity and expression of synapse-related proteins in the thalamic reticular nucleus (TRN) of insomnia rats treated by acupuncture. METHODS: A total of 36 male Sprague-Dawley (SD) rats of clean grade were randomly divided into a control group, a model group, an acupuncture group, and an acupuncture+antagonist group, with 9 rats in each group. The model group, the acupuncture group, and the acupuncture+antagonist group were treated with intraperitoneal injection of p-chlorophenylalanine (PCPA) to establish insomnia model. After successful modeling, the acupuncture group and the acupuncture+antagonist group received acupuncture at bilateral Neiguan (PC6) and Zusanli (ST36) once daily for 5 consecutive days. Thirty min before each acupuncture session, the acupuncture+antagonist group was intraperitoneally injected with methyllycaconitine citrate (MLA), an α7-nAChR antagonist, at a dosage of 5 mg/kg while the acupuncture group received the same volume of 0.9% sodium chloride solution. The rats' daytime spontaneous activity was observed. Neuronal discharge in the TRN was detected using neuroelectrophysiological methods. Immunofluorescence staining was used to detect parvalbumin-positive (PV⁺) neurons and co-expression of PV⁺ and postsynaptic density protein-95 (PSD-95) in the TRN. RESULTS: Compared with the control group, the model group showed increased daytime spontaneous activity (P<0.01); decreased average fluorescence intensity and positive number of PV⁺ neurons in the TRN (P<0.01); decreased neuronal discharge frequency (P<0.01), prolonged inter-discharge intervals (P<0.01) in the TRN; reduced number of PV⁺/PSD-95 double-positive cells in the TRN (P<0.01). Compared with the model group, the acupuncture group showed decreased daytime spontaneous activity (P<0.01); increased average fluorescence intensity and positive number of PV⁺ neurons in the TRN (P<0.01); increased neuronal discharge frequency (P<0.01), shortened inter-discharge intervals (P<0.01) in the TRN; increased number of PV⁺/PSD-95 double-positive cells in the TRN (P<0.05). Compared with the acupuncture group, the acupuncture+antagonist group exhibited increased daytime spontaneous activity (P<0.01); reduced average fluorescence intensity and positive number of PV⁺ neurons in the TRN (P<0.01); decreased neuronal discharge frequency (P<0.05), prolonged inter-discharge intervals (P<0.05) in the TRN; reduced number of PV⁺/PSD-95 double-positive cells in the TRN (P<0.01). CONCLUSION α7-nAChR are involved in mediating the regulatory effect of acupuncture on circadian rhythm disturbances in PCPA-induced insomnia rats. Blocking α7-nAChR attenuates the activating effect of acupuncture on TRN neurons, and reduces the expression of PSD-95 protein on GABAergic neurons.
Animals ; Male ; Acupuncture Therapy ; alpha7 Nicotinic Acetylcholine Receptor/genetics* ; Rats, Sprague-Dawley ; Rats ; Sleep Initiation and Maintenance Disorders/physiopathology* ; Neurons/metabolism* ; Humans ; Thalamic Nuclei/physiopathology* ; Acupuncture Points ; Disks Large Homolog 4 Protein

Objective : To investigate the expression level of LONP1 in hepatocellular carcinoma(HCC) and its impact on the occurrence and progression of HCC. Methods : The expression of LONP1 in human liver cancer tissues was verified by real-time quantitative PCR(qPCR) and Western blot.LONP1stable knockdown Hep3B and HCCLM3 cell lines were established, and the effects of LONP1 on cell proliferation were explored through CCK-8, EdU incorporation assays, and colony formation assays. The effects of LONP1 on cell migration were assessed using scratch and Transwell migration assays. A Cre-Loxp system was employed to generateLONP1conditional knockout mice, and transcriptomic sequencing of liver tissues was performed to explore the impact ofLONP1deficiency on liver cells. The effects ofLONP1on apoptosis in hepatocellular carcinoma cell lines were explored using Tunel staining and flow cytometry with Annexin V-FITC/PI. Results : Western blot and qPCR experiments confirmed the high expression of LONP1 in human liver cancer tissues. Colony formation assays revealed that the number of cell clones inLONP1knockdown groups was significantly reduced compared to the control(P<0.01). CCK-8 and EdU assays demonstrated thatLONP1knockdown cells had a significantly lower proliferation rate than control cells(P<0.01). Scratch and migration assays showed thatLONP1knockdown liver cancer cells exhibited impaired migration compared to controls(P<0.01). Transcriptomic analysis of liver tissues fromLONP1conditional knockout mice indicated that LONP1 might affect apoptosis pathways in liver cells. Tunel staining and Annexin V-FITC/PI flow cytometry showed thatLONP1knockdown increased apoptosis in hepatocellular carcinoma cells. Conclusion LONP1 is highly expressed in liver cancer tissues. The knockdown ofLONP1in liver cancer cell lines promotes cell apoptosis and inhibits cell proliferation and migration.

Several types of arthritis share the common feature that the generation of inflammatory mediators leads to joint cartilage degradation. However, the shared mechanism is largely unknown. H2BK120ub1 was reportedly involved in various inflammatory diseases but its role in the shared mechanism in inflammatory joint conditions remains elusive. The present study demonstrated that levels of cartilage degradation, H2BK120ub1, and its regulator WW domain-containing adapter protein with coiled-coil (WAC) were increased in cartilage in human rheumatoid arthritis (RA) and osteoarthritis (OA) patients as well as in experimental RA and OA mice. By regulating H2BK120ub1 and H3K27me3, WAC regulated the secretion of inflammatory and cartilage-degrading factors. WAC influenced the level of H3K27me3 by regulating nuclear entry of the H3K27 demethylase KDM6B, and acted as a key factor of the crosstalk between H2BK120ub1 and H3K27me3. The cartilage-specific knockout of WAC demonstrated the ability to alleviate cartilage degradation in collagen-induced arthritis (CIA) and collagenase-induced osteoarthritis (CIOA) mice. Through molecular docking and dynamic simulation, doxercalciferol was found to inhibit WAC and the development of cartilage degradation in the CIA and CIOA models. Our study demonstrated that WAC is a key factor of cartilage degradation in arthritis, and targeting WAC by doxercalciferol could be a viable therapeutic strategy for treating cartilage destruction in several types of arthritis.

Objective:To investigate the short-term clinical efficacy of implantation with a 3D-printed microporous titanium prosthesis in the treatment of large segmental infectious tibial defects.Methods:A retrospective analysis was conducted of the electronic medical records of the 47 patients with large segmental tibial defects who had been treated with 3D-printed microporous titanium prostheses at Department of Orthopaedics, 920th Hospital of Joint Logistics Support Force from January 2019 to February 2024. The cohort included 36 males and 11 females, with an age of (46.2±11.8) years and a mean bone defect length of 12.3 (8.0, 16.8) cm. In the 19 patients complicated with soft tissue defects, the area of soft tissue defects ranged from 10.0 cm × 6.0 cm to 33.0 cm × 10.0 cm. For the 28 patients without soft tissue defects at the lower leg, the bone defects were filled with vancomycin-loaded calcium sulfate bone cement at the first stage; for the 19 patients complicated with soft tissue defects, the soft tissue defects at the lower limb were repaired using an anterolateral thigh flap with vascular anastomosis at the same time when bone defects were filled with vancomycin-loaded calcium sulfate bone cement at the first stage. After infection control at 2 to 8 months after surgery, individualized 3D-printed microporous titanium prostheses were implanted at the second stage to reconstruct the bone defects. Postoperative observations included the patients' first standing time, crutch walking time, full weight-bearing time, osseointegration of the tibial fracture and the prosthesis, and complications during follow-up.Results:The follow-up period for the 47 patients was (34.7±14.3) months. The first standing time was (2.2±0.6) months, crutch walking time (3.8±1.1) months, and full weight-bearing time (5.3±1.2) for this cohort. The evaluation by the Paley's bone healing score resulted in 25 excellent cases, 18 good cases, 1 medium case, and 3 poor cases, giving an excellent and good rate of 91.5% (43/47). One year after operation, the X-ray films showed that the tibial fractures and prostheses were well integrated in the 43 patients. Two patients developed recurrent tibial infection which was responded to replacement of the vancomycin-loaded calcium sulfate spacer. The fixation screws for tibial prosthesis were broken in one patient, but no recurrence of infection was observed after revision. The overall incidence of complications was 6.4% (3/47).Conclusion:In the treatment of large segmental infectious tibial defects, by facilitating rapid functional recovery and ensuring a low incidence of complications, implantation with a 3D-printed microporous titanium prosthesis demonstrates fine short-term clinical efficacy.

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 investigate the effects of prophylactic analgesia using erector spinae plane block (ESPB) combined with ketorolac tromethamine on postoperative analgesia and early recovery of patients undergoing laparoscopic radical gastrectomy.Methods:A prospective randomized controlled study was conducted. A total of 105 gastric cancer patients who underwent laparoscopic radical gastrectomy in Heji Hospital Affiliated to Changzhi Medical College from June 2022 to October 2023 were selected, and the patients were divided into ESPB+ketorolac tromethamine group (T group), ESPB group (C1 group), and ketorolac tromethamine group (C2 group) by using the random number table method, with 35 cases in each group. The prophylactic analgesia method was preoperative ESPB + ketorolac tromethamine in T group, preoperative ESPB in C1 group and preoperative ketorolac tromethamine in C2 group. The intraoperative sufentanil and remifentanil dosage and the postoperative resting pain visual analogue scale (VAS) score, remedial analgesia, recovery status and complication occurrence were compared among the 3 groups.Results:The baseline characteristics and intraoperative conditions of the patients in the 3 groups were compared, and the differences were not statistically significant (all P > 0.05). The intraoperative sufentanil dosage in T group was less than that in C1 and C2 groups [30 (25, 30) μg vs. 35 (30, 35) μg vs. 40 (35, 45) μg], and the difference was statistically significant ( Z = 33.03, P < 0.001); the intraoperative remifentanil dosage in T group was less than that in C1 and C2 groups [0.34 (0.30, 0.40) mg vs. 0.40 (0.30, 0.50) mg vs. 0.70 (0.60, 0.85) mg], and the difference was statistically significant ( Z = 53.84, P < 0.001). The VAS scores at 1, 6, 12, 24, 48 h after surgery in T group were lower than those in C1 and C2 groups, and the differences were statistically significant (all P < 0.001). The press number of analgesic pump in T group was less than that in C1 and C2 groups [1 (0, 2) times vs. 2 (1, 2) times vs. 4 (3, 5) times], and the difference was statistically significant ( Z = 48.10, P < 0.001). The postoperative first time of exhaust and get out of bed and days of hospital stay in T group were shorter than those in C1 and C2 groups, and the differences were statistically significant (all P < 0.001). The differences in the incidence of postoperative nausea and vomiting, dizziness, pruritus, pneumonia, and anastomotic fistula among the 3 groups were not statistically significant (all P > 0.05). None of the 3 groups experienced postoperative drowsiness, hypotension or respiratory depression. Conclusions:Prophylactic analgesia using ESPB combined with ketorolac tromethamine can effectively reduce the postoperative pain of patients undergoing laparoscopic radical gastrectomy, reduce the use of analgesic drugs, and promote the early recovery of the patients in the postoperative period without increasing the postoperative complications.

Objective:To investigate the short-term clinical efficacy of implantation with a 3D-printed microporous titanium prosthesis in the treatment of large segmental infectious tibial defects.Methods:A retrospective analysis was conducted of the electronic medical records of the 47 patients with large segmental tibial defects who had been treated with 3D-printed microporous titanium prostheses at Department of Orthopaedics, 920th Hospital of Joint Logistics Support Force from January 2019 to February 2024. The cohort included 36 males and 11 females, with an age of (46.2±11.8) years and a mean bone defect length of 12.3 (8.0, 16.8) cm. In the 19 patients complicated with soft tissue defects, the area of soft tissue defects ranged from 10.0 cm × 6.0 cm to 33.0 cm × 10.0 cm. For the 28 patients without soft tissue defects at the lower leg, the bone defects were filled with vancomycin-loaded calcium sulfate bone cement at the first stage; for the 19 patients complicated with soft tissue defects, the soft tissue defects at the lower limb were repaired using an anterolateral thigh flap with vascular anastomosis at the same time when bone defects were filled with vancomycin-loaded calcium sulfate bone cement at the first stage. After infection control at 2 to 8 months after surgery, individualized 3D-printed microporous titanium prostheses were implanted at the second stage to reconstruct the bone defects. Postoperative observations included the patients' first standing time, crutch walking time, full weight-bearing time, osseointegration of the tibial fracture and the prosthesis, and complications during follow-up.Results:The follow-up period for the 47 patients was (34.7±14.3) months. The first standing time was (2.2±0.6) months, crutch walking time (3.8±1.1) months, and full weight-bearing time (5.3±1.2) for this cohort. The evaluation by the Paley's bone healing score resulted in 25 excellent cases, 18 good cases, 1 medium case, and 3 poor cases, giving an excellent and good rate of 91.5% (43/47). One year after operation, the X-ray films showed that the tibial fractures and prostheses were well integrated in the 43 patients. Two patients developed recurrent tibial infection which was responded to replacement of the vancomycin-loaded calcium sulfate spacer. The fixation screws for tibial prosthesis were broken in one patient, but no recurrence of infection was observed after revision. The overall incidence of complications was 6.4% (3/47).Conclusion:In the treatment of large segmental infectious tibial defects, by facilitating rapid functional recovery and ensuring a low incidence of complications, implantation with a 3D-printed microporous titanium prosthesis demonstrates fine short-term clinical efficacy.

Objective:To investigate the effects of prophylactic analgesia using erector spinae plane block (ESPB) combined with ketorolac tromethamine on postoperative analgesia and early recovery of patients undergoing laparoscopic radical gastrectomy.Methods:A prospective randomized controlled study was conducted. A total of 105 gastric cancer patients who underwent laparoscopic radical gastrectomy in Heji Hospital Affiliated to Changzhi Medical College from June 2022 to October 2023 were selected, and the patients were divided into ESPB+ketorolac tromethamine group (T group), ESPB group (C1 group), and ketorolac tromethamine group (C2 group) by using the random number table method, with 35 cases in each group. The prophylactic analgesia method was preoperative ESPB + ketorolac tromethamine in T group, preoperative ESPB in C1 group and preoperative ketorolac tromethamine in C2 group. The intraoperative sufentanil and remifentanil dosage and the postoperative resting pain visual analogue scale (VAS) score, remedial analgesia, recovery status and complication occurrence were compared among the 3 groups.Results:The baseline characteristics and intraoperative conditions of the patients in the 3 groups were compared, and the differences were not statistically significant (all P > 0.05). The intraoperative sufentanil dosage in T group was less than that in C1 and C2 groups [30 (25, 30) μg vs. 35 (30, 35) μg vs. 40 (35, 45) μg], and the difference was statistically significant ( Z = 33.03, P < 0.001); the intraoperative remifentanil dosage in T group was less than that in C1 and C2 groups [0.34 (0.30, 0.40) mg vs. 0.40 (0.30, 0.50) mg vs. 0.70 (0.60, 0.85) mg], and the difference was statistically significant ( Z = 53.84, P < 0.001). The VAS scores at 1, 6, 12, 24, 48 h after surgery in T group were lower than those in C1 and C2 groups, and the differences were statistically significant (all P < 0.001). The press number of analgesic pump in T group was less than that in C1 and C2 groups [1 (0, 2) times vs. 2 (1, 2) times vs. 4 (3, 5) times], and the difference was statistically significant ( Z = 48.10, P < 0.001). The postoperative first time of exhaust and get out of bed and days of hospital stay in T group were shorter than those in C1 and C2 groups, and the differences were statistically significant (all P < 0.001). The differences in the incidence of postoperative nausea and vomiting, dizziness, pruritus, pneumonia, and anastomotic fistula among the 3 groups were not statistically significant (all P > 0.05). None of the 3 groups experienced postoperative drowsiness, hypotension or respiratory depression. Conclusions:Prophylactic analgesia using ESPB combined with ketorolac tromethamine can effectively reduce the postoperative pain of patients undergoing laparoscopic radical gastrectomy, reduce the use of analgesic drugs, and promote the early recovery of the patients in the postoperative period without increasing the postoperative complications.

Purpose: Vaccinia virus is widely used as an oncolytic agent for human cancer therapy, and several versions of vaccinia virus have demonstrated robust antitumor effects in breast cancer. Most vaccinia viruses are modified by thymidine kinase (TK) deletion. The function of the cyclin-dependent kinase inhibitor p21 in breast cancer remains controversial. We explored the impact of p21 gene knockdown (KD) on breast cancer cells and whether p21 KD interferes with the antitumor effect of TK-negative vaccinia virus. Methods: p21 KD MDA-MB-231 and p21 KD MCF-7 cells were prepared, and cell proliferation and migration rates were evaluated using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and scratch healing assays. The tumor growth of xenografts originating from p21KD MDA-MB-231 cells and control cells was compared in a mouse model. The colony formation and sphere-forming abilities of p21 KD breast cancer cells were also determined using low-melting agarose and serum-free culture. The tumorkilling effect of the vaccinia virus was determined in breast cancer cells and mouse models using an MTT assay and tumor cell xenografts. Results: p21 KD increased the growth and migration of MDA-MB-231 and MCF-7 cells and promoted the cell growth of MDA-MB-231 cells in mice, while decreasing the colony formation and sphere formation abilities. Expression of TK was reduced in p21 KD MDAMB-231 cells. Oncolytic effects of both wild-type and TK-deleted vaccinia viruses were attenuated in p21KD MDA-MB-231 cells. The tumor-killing effect of TK-deleted vaccinia virus was also weakened in xenografted mice bearing p21 KD MDA-MB-231 cells. Conclusion Targeted inhibition of p21 accelerates the proliferation and migration of breast cancer cells and impairs the tumor-killing effect of vaccinia virus, suggesting that p21 levels in cancer cells interfere with vaccinia virus oncolytic therapy.