Objective: To investigate the regional differences in the incidence of urothelial carcinoma among kidney transplant recipients between northern and southern China，so as to provide reference for early diagnosis of this disease. Methods: A comprehensive search was conducted across multiple databases，including CNKI，Wanfang，CBM，and PubMed，using the keywords “kidney transplantation” and “tumor” to collect clinical data from qualified kidney transplant centers.The latest and most complete literature data published by 17 transplant centers in northern China and 14 in southern China were included.Statistical analyses were performed to compare the incidence of post-transplant urothelial carcinoma and non-urothelial malignancies. Results: A total of 37 475 kidney transplant recipients were included，among whom 837 (2.23%) developed post-transplant malignancies，including urothelial carcinoma (366/837，43.73%)，non-urothelial carcinoma (444/837，53.05%)，and malignancies with unspecified pathology (27/837，3.23%).The incidence of malignancies was significantly higher in northern China than in southern China [(2.82±1.39)% vs. (1.67±0.83)%，P=0.011]，with a particularly pronounced difference in the incidence of urothelial carcinoma [(1.68±1.12)% vs. (0.32±0.32)%，P<0.001].No significant difference was observed in the incidence of non-urothelial carcinoma between the two regions [(1.11±0.56)% vs. (1.35±0.65)%，P=0.279].Additionally，female transplant recipients exhibited a higher incidence of malignancies than males in both regions (southern China：2.38% vs. 1.80%; northern China：8.93% vs. 2.52%). Conclusion: The incidence of urothelial carcinoma following kidney transplantation is significantly higher in northern China than in southern China，underscoring the importance of implementing regular tumor screening for kidney transplant recipients，particularly for female patients in northern China，to facilitate early diagnosis and timely intervention.

[摘 要] 目的：探究地塞米松联合阿比特龙对去势抵抗性前列腺癌（CRPC）患者尿流动力学、外周血循环肿瘤细胞雄激素受体剪切变异体7（AR-V7）、人同源盒基因B13（HoxB13）水平及生存预后的影响。方法：回顾性选取本院收治的114例CRPC患者病历资料，根据治疗方案分为对照组（予以0.5 mg地塞米松治疗，n = 51）和观察组（予以0.5 mg地塞米松联合1 000 mg阿比特龙治疗，n = 63）。比较两组疗效、尿动力学、外周血循环肿瘤细胞AR-V7、HoxB13水平以及生存预后。结果：观察组63例，对照组51例。治疗8周后，观察组疾病控制率与客观缓解率（分别为42.86%与96.83%）均显著高于对照组（分别为23.53%与86.27%）（P < 0.05）。观察组的最大尿流率[（14.58 ± 1.02）mL/s vs （11.18 ± 1.16）mL/s）]、平均尿流率[（12.92 ± 1.21）mL/s vs （9.83 ± 0.59）mL/s）]均显著高于对照组，而剩余尿量[（24.12 ± 1.96）mL vs （28.03 ± 1.68）mL）]显著低于对照组（均P < 0.05）。观察组与对照组的AR-V7 mRNA表达水平相近[（1.78 ± 0.32） vs （1.68 ± 0.46）]，差异无统计学意义（P > 0.05）；但观察组的HoxB13 mRNA表达水平显著低于对照组[（1.21 ± 0.27） vs （1.57 ± 0.37），P < 0.05]。观察组的中位无进展生存期[6.22个月（95%CI：5.63~6.63）]显著长于对照组[3.66个月（95%CI：3.01~3.74）]（P < 0.05）；观察组的3年总生存率为12.70%，显著高于对照组的0.00%（P < 0.05）。结论：地塞米松联合阿比特龙治疗CRPC患者具有显著疗效，能明显改善患者尿流动力，下调外周血循环肿瘤细胞中HoxB13的表达，未显著影响AR-V7的表达，还能延长患者PFS，提高3年总生存率。

BACKGROUND: Meningeal metastasis (MM) is a form of malignant metastasis where tumor cells spread from the primary site to the pia mater, dura mater, arachnoid, subarachnoid space, and other cerebrospinal fluid compartments. Lung cancer is one of the most common malignant tumor types with MM. MM not only signifies that the lung cancer has progressed to an advanced stage but also leads to a range of severe clinical symptoms due to meningeal involvement. Currently, the risk factors associated with the development of MM are not fully elucidated. The aim of this study was to investigate the risk factors for MM in patients with lung adenocarcinoma (LUAD) who underwent non-surgical interventions, in order to identify LUAD patients at high risk for MM. METHODS: This retrospective study analyzed the clinical data of patients diagnosed with LUAD at the First Affiliated Hospital of Zhengzhou University from January 2020 to July 2024. Missing data were imputed using multiple imputation methods, and risk factors were identified through LASSO, univariate, and multivariate Logistic regression analyses. RESULTS: A total of 170 patients with LUAD were included in this study and divided into two groups: 87 patients with MM and 83 patients without MM. Univariate and multivariate Logistic regression analyses revealed that younger age at diagnosis (P=0.004), presence of the epidermal growth factor receptor (EGFR) L858R gene mutation (P=0.008), and concurrent liver metastasis at baseline (P=0.004) were independent risk factors for developing MM in LUAD patients who did not undergo surgical intervention. Conversely, higher baseline globulin levels (P=0.039) and the presence of the anaplastic lymphoma kinase (ALK) gene mutation (P=0.040) were associated with a reduced risk of MM development. CONCLUSIONS Age at diagnosis, EGFR L858R mutation status, ALK gene mutation status, concurrent liver metastasis, globulin levels at baseline were significantly associated with the risk of developing MM in patients with LUAD patients who did not undergo surgical intervention. For patients diagnosed at a younger age, carrying the EGFR L858R mutation, or presenting with baseline liver metastasis, early implementation of tertiary prevention strategies for MM is crucial. Regular monitoring of MM status should be conducted in these high-risk groups.
Humans ; Male ; Adenocarcinoma of Lung/therapy* ; Female ; Middle Aged ; Risk Factors ; Lung Neoplasms/therapy* ; Retrospective Studies ; Aged ; Meningeal Neoplasms/genetics* ; Adult

Objective To investigate the effects of PPARδ agonist pretreatment on mice myocardial is-chemia-reperfusion injury(MI/RI).Methods The mice were divided into the control group(sham operation group),model group(ischemia for 30 min,reperfusion for 24 h),experiment group 1(GW501516,3 mg·kg-1·d-1)and experiment group 2(GW501516,10 mg·kg-1·d-1).LVEF,LVFS,serum CK-MB,LDH and cTnI levels in the mice of each group were measured;the wet-dry myocardial tissue weight ratio was de-tected,the myocardial histomorphology was observed by microscope,the myocardial cellular apoptosis rate was detected by in situ end labeling(TUNEL);Bax and Bcl-2 were detected by Western blot;the mRNA ex-pressions of PGC-1,NFR-1 and NFR-2 were detected by PCR.Results Compared with the control group,the wet-dry weight ratio,myocardial cellular apoptosis rate,CK-MB,LDH,cTnI and Bax protein expressions in the model group were increased,and the Bcl-2 protein expression,LVEF,LVFS,PGC-1 mRNA,NFR-1 mR-NA and NFR-2 mRNA were decreased(P＜0.05).Compared with the model group,the wet-dry weight ratio,myocardial cellular apoptosis rate,CK-MB,LDH,cTnI levels and Bax protein expression in the experimental group 1 and 2 were decreased,while the levels of Bcl-2 protein expression,LVEF,LVFS,PGC-1 mRNA,NFR-1 mRNA and NFR-2 mRNA were significantly increased(P＜0.05).There was no statistically significant difference in the above indicators between the experimental group 1 and 2(P＞0.05).Conclusion PPARδ ag-onist reduces the mitochondrial damage possibly through PGC-1/NFRs signaling pathway,thereby reduces the myocardial cellular apoptosis in mice and ameliorates MI/RI.

Objective:To investigate associations of serum nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3), apoptosis-associated speck like protein containing a caspase recruitment domain (ASC), caspase-1 with the outcome in patients with hypertensive intracerebral hemorrhage (HICH) after minimally invasive neuroendoscopic surgery.Methods:Patients with HICH underwent minimally invasive neuroendoscopic surgery at the Affiliated Hospital of Noncommissioned Officer School, Army Medical University between June 2022 and June 2024 were included prospectively. According to the Glasgow Outcome Scale score at 3 months after surgery, the patients were divided into a good outcome group (4-5) and a poor outcome group (1-3). The clinical data and peripheral blood levels of NLRP3, ASC, caspase-1, interleukin (IL)-18, and IL-1β between the two groups were compared. Multivariate logistic regression analysis was used to determine assocations of serum NLRP3, ASC, caspase-1 with the postoperative outcome. Results:A total of 121 patients with HICH were enrolled, including 71 males (58.68), aged 56.11±4.96 years. At 3 months after surgery, 70 patients (57.9%) had good outcome, 51 (42.1%) had poor outcome, and 3 died. Onset to admission time, onset to first CT scan time, onset to surgery time, baseline serum NLRP3, ASC, caspase-1, baseline hematoma volume, and the proportion of patients with hematoma rupture into the ventricles and midline shift in the poor outcome group were significantly higher than those in the good outcome group, while baseline Glasgow Coma Scale (GCS) score and hematoma clearance rate were significantly lower than those in the good outcome group ( P<0.05). Multivariate logistic regression analysis showed that after adjusting for other factors such as onset to surgery time, baseline GCS score, hematoma rupture into the ventricles, and hematoma clearance rate, baseline serum NLRP3 (odds ratio [ OR] 2.018, 95% confidence interval [ CI] 1.502-2.711; P<0.001), ASC [ OR 1.764, 95% CI 1.418-2.195; P<0.001], caspase-1 [ OR 1.901, 95% CI 1.476-2.449; P<0.001]) were significantly independently associated with the poor outcome. Conclusion:The serum levels of NLRP3, ASC, and caspase-1 are significantly higher in HICH patients with poor outcome, and are independently associated with the poor outcome after minimally invasive neuroendoscopic surgery.

Objective:To investigate the predictive value of D-dimer (DD)/platelet count (PLT) ratio (DPR) and fibrinogen (Fg)/C-reactive protein (CRP) ratio for lower extremity deep venous thrombosis (LEDVT) in patients with spontaneous intracerebral hemorrhage (ICH).Methods:Consecutive patients with ICH admitted to the Department of Neurosurgery, the Affiliated Hospital of Noncommissioned Officer School, Army Medical University from February 2023 to November 2024 were included retrospectively. The baseline clinical data and laboratory test results between the LEDVT group and the non-LEDVT group were compared. Multivariate logistic regression analysis was used to evaluate the independent influencing factors of LEDVT. Receiver operating characteristic (ROC) curves were used to evaluate the predictive efficacy of influencing factors for patients with ICH complicated with LEDVT. Results:A total of 156 patients with ICH were enrolled, including 67 males (42.9%), aged 61.54±7.91 years; 47 patients (30.1%) experienced LEDVT during hospitalization. Univariate analysis showed that DD, PLT, DPR, Fg, and CRP in the LEDVT group were significantly higher than those in the non-LEDVT group, while the Fg/CRP ratio was significantly lower than that in the non-LEDVT group (all P<0.05). Multivariate logistic regression analysis showed that DD (odds ratio [ OR] 5.499, 95% confidence interval [ CI] 2.909-10.395; P<0.001), PLT ( OR 1.044, 95% CI 1.026-1.062; P<0.001), Fg ( OR 2.119, 95% CI 1.482-3.031; P<0.001), DPR ( OR 5.924, 95% CI 3.058-11.475; P<0.001), and Fg/CRP ratio ( OR 0.614, 95% CI 0.505-0.746; P<0.001) were the independent influencing factor for the occurrence of LEDVT in patients with ICH. ROC curve analysis showed that the areas under the curves of DD, PLT, Fg, DPR and the Fg/CRP ratio for predicting LEDVT in patients with ICH were 0.784 (95% CI 0.711-0.846), 0.772 (95% CI 0.699-0.836), 0.711 (95% CI 0.633-0.781), 0.782 (95% CI 0.709-0.844), and 0.778 (95% CI 0.705-0.841), respectively. The area under the curve for the combined prediction of DD+PLT+Fg was 0.878 (95% CI 0.816-0.924), and the area under the curve for the combined prediction of DPR+Fg/CRP ratio was 0.921 (95% CI 0.867-0.958). The latter showed a higher predictive value. Conclusion:The combined detection of DPR and Fg/CRP ratio has higher predictive value for LEDVT in patients with ICH.

Objective:To explore the application value of arthroscopic tunnel pulling and suturing methods in West type Ⅱ and Ⅲ lateral meniscus posterior root injuries.Methods:A total of 184 patients with West Ⅱ ( n=92) and Ⅲ ( n=92) lateral meniscus posterior root injuries who underwent surgical treatment in Second Affiliated Hospital of Xi′an Jiaotong University from May 2022 to June 2023 were selected as the study subjects, by adopting a retrospective controlled study method. Using a random number table method, West Ⅱ and Ⅲ patients were divided into a tunnel method group and a suture method group, with 46 patients in each group. There were 23 male and 23 female patients in the West Ⅱ tunnel method group, with an age of (48.36±2.52) years. There were 25 male and 21 female patients in the suture method group, with an age of (48.61±2.21) years. There were 24 male and 22 female patients in the West Ⅲ tunnel method group, with an age of (48.53±2.36) years. There were 24 male and 22 female patients in the suture method group, with an age of (46.38±2.67) years. The tunnel method group used arthroscopic tibial tunnel cable fixation method, while the suture method group used arthroscopic full internal meniscus suture method. Compared the surgical time, length of hospital stay, and first postoperative time of getting out of bed between the tunnel method group and the suture method group of patients with different subtypes. Compared the knee joint function scores (Lysholm, Tegner, IKDC, VAS) before and after surgery. Used MRI to examine the compression of the patient′s lateral meniscus. Compared the incidence of adverse reactions. Measurement data with normal distribution were represented as mean ± standard deviation( ± s), and the comparison between groups was conducted using the t-test; the comparison of count data were represented as [ n(%)] and was conducted by chi-square test or Fisher exact probability. The skewness data were expressed by M( Q1, Q3), and rank-sum test was used for inter-group comparison. Results:There was no significant difference in surgical time, length of hospital stay, and first postoperative bed time between the West type Ⅱ, Ⅲ tunel method group and the suture method group ( P>0.05). At 12 months after surgery, there was no statistically significant difference in the Lysholm score, Tegner score, IKDC score, and VAS score between the West Ⅱ type patients in the tunnel method group and the suture method group ( P>0.05). However, the Lysholm score and IKDC score in the West Ⅲ type tunnel method group were significantly higher than those in the suture method group, and the difference was statistically significant( P<0.05). However, there was no statistically significant difference in the Tegner score and VAS score ( P>0.05). At the 12th months after surgery, there was no statistically significant difference in the overall width of the meniscus between the tunnel method group and the suture method group for patients with different West classifications( P>0.05). However, the relative percentage of meniscus compression in the tunnel method group was significantly lower than that in the suture method group, and the difference was statistically significant ( P<0.05). There was no statistically significant difference in the incidence of postoperative complications between the tunnel method group and the suture method group in patients with different West subtypes ( P>0.05). Conclusions:The arthroscopic tibial tunnel wire fixation method is effective, safe, and reliable in treating patients with West Ⅱ and West Ⅲ lateral meniscus posterior root injuries promoting kneejoint function recovery. It is expected to become a high-quality treatment plan for patients with West Ⅱ and West Ⅲ meniscus injuries.