Objective To compare multiple models and analyze SHAP feature contributions to construct a machine learning risk prediction model for post-reperfusion syndrome (PRS) during adult living donor liver transplantation (LDLT). Methods Clinical data of 390 patients who underwent LDLT due to end-stage liver disease at the First Affiliated Hospital of Anhui Medical University from May 2023 to April 2025 were collected. Five machine learning models, including random forest, logistic regression, XGBoost, decision tree, and AdaBoost, were compared. Feature selection was performed using Lasso regression, and the training set was divided into five folds for stratified cross-validation. The generalization ability of the model was evaluated on the independent test set. The models were comprehensively compared based on key evaluation indicators such as recall rate, accuracy rate, precision rate, area under the curve (AUC) and F1 value, to determine the optimal model. Results Eight potential factors for predicting PRS were selected. The random forest model demonstrated the best prediction performance in both the training set and the test set. Its accuracy rate was as high as 84.2% (AUC = 0.894, 95% confidence interval 0.808-0.964) in the test set. The importance ranking of PRS predictors was determined through SHAP value analysis. Cold ischemia time, K⁺ during the anhepatic period and the model for end-stage liver disease (MELD) score were all identified as the most significant predictors. Conclusions Based on eight key indicators including cold ischemia time, portal vein occlusion time, pre-reperfusion body temperature, alkaline reserve during the anhepatic period, K⁺ during the anhepatic period, MELD score, left ventricular end-diastolic diameter and graft volume to standard liver volume ratio, the PRS prediction model constructed using the random forest algorithm demonstrates the best prediction performance in the test set, providing certain assistance for subsequent clinical predictions.

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 analyze the characteristics of bone and joint injuries-related articles published in Chinese Journal of Trauma (hereinafter referred to as the "Journal") from 1985 to 2024. Methods:Using the VIP Chinese Journal Database and Wanfang Database as data sources, all the articles on bone and joint injuries published in the Journal from 1985 to 2024 were retrieved. Analysis covered publication volume, citation frequency, research hotspot distribution, institutional affiliations, author characteristics, and funding support over the 40-year period.Results:During the 40 years since the Journal′s establishment, a total of 3 696 articles on bone and joint injuries have been published, with a total of 34 568 citations and an average of 9.35 citations per article. In the first decade following its foundation (1985-1994), the Journal mainly focused on research hotspots such as internal fixation of fractures (20.59%, 77/374), fracture classification (14.71%, 55/374), and surgical instruments (12.57%, 47/374); In the second decade (1995-2004), the Journal mainly focused on open fractures (11.56%, 101/874), osteoarthritis (9.73%, 85/874), and biomechanics (9.50%, 83/874) and other research hotspots; Osteoporosis (25.84%, 362/1 401), minimally invasive surgery (17.63%, 247/1 401), and rehabilitation (13.63%, 191/1 401) prevailed in the third decade (2005-2014), while tissue engineering (18.62%, 195/1 047), 3D printing (16.43%, 172/1 047), and intelligent technology (13.18%, 138/1 047) emerged as focal points in the fourth decade (2015-2024). Most publications involved 1-5 institutions, though 21 articles had>10 collaborating institutions. The maximum number of collaborating institutions reached 52, all observed in consensus and guideline documents. The average number of collaborating authors per article ranged from 3 to 7, primarily from renowned medical universities and major Grade A tertiary hospitals. Funding support rates increased progressively over the years: 0.80% (1985-1994), 13.04% (1995-2004), 22.13% (2005-2014), and 53.01% (2015-2024).Conclusion:Over the 40-year period, the Journal′s bone and joint injuries-related articles have exhibited substantial growth in publication volume, shift alongside disciplinary advances, technological innovations, and clinical needs in research hotspots, changes of geographical distribution from concentration to broader expansion in institutional collaborations, significant academic influence in core authors, and consistent upward trend in funding support rates.

Objective To explore CT manifestations of perivascular epithelioid cell tumor(PEComa)of liver and kidney.Methods Totally 18 hepatic PEComa and 5 renal PEComa confirmed by surgical pathology were retrospectively enrolled,and the preoperative CT manifestations were explored.Results Single lesion of liver or kidney was found in all 23 cases,and the main CT manifestations included low or slightly low density lesion(23/23,100％),with irregular morphology(16/23,69.57％),clear boundaries(17/23,73.91％),non-envelope(21/23,91.30％)and enhancement after administration of contrast agents(21/23,91.30％).Among 18 cases of liver PEComa,most lesions(13/18,72.22％)presented as uniform density,while some(5/18,27.88％)presented as non-uniform density lesions often contained with fat components(5/5,100％)and thickened blood vessels(4/5,80.00％)but rare hemorrhagic necrosis(1/5,20.00％)nor calcification(0/5,0).Fast in and fast out of contrast agents were observed in 16(16/18,88.89％)lesions.Uneven density and internal fat components were found in all 5(5/5,100％)renal PEComa,which rarely with hemorrhagic necrosis(1/5,20.00％),blood vessels orientation(1/5,20.00％)and calcification(0/5,0).After enhancement,fast in and fast out,progressive enhancement and non-enhancement was observed in 2(2/5,40.00％),1(1/5,20.00％)and 2(2/5,40.00％)cases,respectively.Conclusion CT manifestations of PEComa in liver and kidney had certain characteristics.

Objective To explore CT manifestations of perivascular epithelioid cell tumor(PEComa)of liver and kidney.Methods Totally 18 hepatic PEComa and 5 renal PEComa confirmed by surgical pathology were retrospectively enrolled,and the preoperative CT manifestations were explored.Results Single lesion of liver or kidney was found in all 23 cases,and the main CT manifestations included low or slightly low density lesion(23/23,100％),with irregular morphology(16/23,69.57％),clear boundaries(17/23,73.91％),non-envelope(21/23,91.30％)and enhancement after administration of contrast agents(21/23,91.30％).Among 18 cases of liver PEComa,most lesions(13/18,72.22％)presented as uniform density,while some(5/18,27.88％)presented as non-uniform density lesions often contained with fat components(5/5,100％)and thickened blood vessels(4/5,80.00％)but rare hemorrhagic necrosis(1/5,20.00％)nor calcification(0/5,0).Fast in and fast out of contrast agents were observed in 16(16/18,88.89％)lesions.Uneven density and internal fat components were found in all 5(5/5,100％)renal PEComa,which rarely with hemorrhagic necrosis(1/5,20.00％),blood vessels orientation(1/5,20.00％)and calcification(0/5,0).After enhancement,fast in and fast out,progressive enhancement and non-enhancement was observed in 2(2/5,40.00％),1(1/5,20.00％)and 2(2/5,40.00％)cases,respectively.Conclusion CT manifestations of PEComa in liver and kidney had certain characteristics.

Objective:To analyze the characteristics of bone and joint injuries-related articles published in Chinese Journal of Trauma (hereinafter referred to as the "Journal") from 1985 to 2024. Methods:Using the VIP Chinese Journal Database and Wanfang Database as data sources, all the articles on bone and joint injuries published in the Journal from 1985 to 2024 were retrieved. Analysis covered publication volume, citation frequency, research hotspot distribution, institutional affiliations, author characteristics, and funding support over the 40-year period.Results:During the 40 years since the Journal′s establishment, a total of 3 696 articles on bone and joint injuries have been published, with a total of 34 568 citations and an average of 9.35 citations per article. In the first decade following its foundation (1985-1994), the Journal mainly focused on research hotspots such as internal fixation of fractures (20.59%, 77/374), fracture classification (14.71%, 55/374), and surgical instruments (12.57%, 47/374); In the second decade (1995-2004), the Journal mainly focused on open fractures (11.56%, 101/874), osteoarthritis (9.73%, 85/874), and biomechanics (9.50%, 83/874) and other research hotspots; Osteoporosis (25.84%, 362/1 401), minimally invasive surgery (17.63%, 247/1 401), and rehabilitation (13.63%, 191/1 401) prevailed in the third decade (2005-2014), while tissue engineering (18.62%, 195/1 047), 3D printing (16.43%, 172/1 047), and intelligent technology (13.18%, 138/1 047) emerged as focal points in the fourth decade (2015-2024). Most publications involved 1-5 institutions, though 21 articles had>10 collaborating institutions. The maximum number of collaborating institutions reached 52, all observed in consensus and guideline documents. The average number of collaborating authors per article ranged from 3 to 7, primarily from renowned medical universities and major Grade A tertiary hospitals. Funding support rates increased progressively over the years: 0.80% (1985-1994), 13.04% (1995-2004), 22.13% (2005-2014), and 53.01% (2015-2024).Conclusion:Over the 40-year period, the Journal′s bone and joint injuries-related articles have exhibited substantial growth in publication volume, shift alongside disciplinary advances, technological innovations, and clinical needs in research hotspots, changes of geographical distribution from concentration to broader expansion in institutional collaborations, significant academic influence in core authors, and consistent upward trend in funding support rates.

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 explore the feasibility and accuracy of neutrophil-to-lymphocyte ratio(NLR)in the prediction of testicular torsion(TT)in children with acute scrotal pain.Methods A retrospective case-control study was performed on 158 pediatric patients with ultrasound suspicion of TT who underwent surgical testicular examination during Jan.2017 and Jan.2024.The patients were divided into TT group and non-TT group.Clinical data and laboratory data at admission were analyzed.Sensitivity and specificity of NLR to TT were determined with the area under the curve(AUC)represented on the receiver operating characteristic(ROC)curves.Results There were with no statistically significant differences in clinical data between the two groups(P＞0.05).The NLR was significantly higher in the TT group than in the non-TT group[(4.82±2.37)vs.(2.85±0.75),P＜0.05].The optimal cut-off value of TT predicted by NLR was 2.07,the AUC was 0.809(95％CI:0.709-0.909),and the sensitivity and specificity were 97.9％and 93.3％,respectively,which were significantly higher than other factors.Conclusion For suspicious ultrasound diagnosis of pediatric acute scrotal pain cases,NLR can be used to predict the possibility of TT and may help to evaluate the urgent surgical treatment in these patients.

AIM:To study the effect of hepatitis B combined with hepatic fibrosis on endogenous and exogenous metabolism of liver and the effect of glycyrrhizic acid combined with tenofovir(TFV)es-ter on anti-HBV efficacy.METHODS:Hepatitis B mouse was induced by chronic CCI4 to form a mod-el of hepatitis B with hepatic fibrosis.H&E staining,Sirius Red Staining,α-SMA immunohistochemistry were used to detect pathological changes in liver tissue.The changes of liver endogenous metabo-lism in mice with hepatitis B and hepatic fibrosis were detected by metabolomics.LC-MS/MS was used to investigate the plasma and liver concentra-tions of TFV and its active metabolite(TFV-DP),for investigating the changes of exogenous metabo-lism.RESULTS:HBV+CCl4 mice showed fibrosis symptoms such as liver injury and collagen deposi-tion.Hepatitis B combined with hepatic fibrosis af-fected nucleotide metabolism,amino acid metabo-lism,tricarboxylic acid cycle,pentose phosphate pathway and other endogenous metabolism,low-ered the hepatic level of TFV-DP,and decreased the antiviral efficacy.By combining with glycyrrhizic acid or forming a self-assembled preparation,the hepatic level of TFV-DP was improved,and the anti-viral efficacy was enhanced.CONCLUSIONS:Hepati-tis B combined with hepatic fibrosis affected both endogenous and exogenous metabolism of liver.Different forms of combination of glycyrrhizic acid and TFV could elevate the level of TFV-DP in liver and improve the antiviral efficacy in HBV+CCI4 mice.

Objective The aim of this study was to investigate the prospective association between physical activity (PA),independently or in conjunction with other contributing factors,and osteoporosis (OP) outcomes. Methods The Physical Activity in Osteoporosis Outcomes (PAOPO) study was a community-based cohort investigation. A structured questionnaire was used to gather the participants' sociodemographic characteristics. Bone mineral density (BMD) measurements were performed to assess OP outcomes,and the relationship between BMD and OP was evaluated within this cohort. Results From 2013 to 2014,8,471 participants aged 18 years and older were recruited from Tangshan,China's Jidong community. Based on their PA level,participants were categorized as inactive,moderately active,or very active. Men showed higher physical exercise levels than women across the activity groups. BMD was significantly higher in the very active group than in the moderately active and inactive groups. Individuals aged>50 years are at a higher risk of developing OP and osteopenia. Conclusion The PAOPO study offers promising insights into the relationship between PA and OP outcomes,encouraging the implementation of PA in preventing and managing OP.