The advancement of microbiome technologies has facilitated a growing interest in the interactions between urinary microbiota and urinary stone formation. This article systematically reviews the technological evolution, and the reciprocal mechanism of microbiota involvement in lithogenesis and its clinical significance. It specifically highlights the changes within the urinary microbiota of calcium oxalate stone patients, notably a depletion of Lactobacillus populations and an enrichment of pathogenic taxa such as Enterobacteriaceae. Furthermore, it delineates the mechanisms whereby microbes participate in stone formation through metabolic regulation, physical adhesion, and inflammatory processes. The article also explores the influence exerted by distinct stone types on the structural composition and functional dynamics of the urinary microbiota. Integrated multi-omics analyses offer novel perspectives for unraveling the intricate microbiome-host interaction network. This approach is anticipated to facilitate significant advances in developing precision-focused prophylactic and therapeutic strategies for urinary stones from a microecological standpoint.

A 34-year-old male patient was admitted to the hospital on October 6, 2023 due to fall from a high place. Physical examination showed blood pressure 96/53 mmHg (1 mmHg=0.133 kPa), heart rate of 105 beats/min, slight bulge in the right kidney area, and positive percussion pain in the right kidney area. CT examination showed complete rupture of the lower pole of the right kidney, thrombosis of the right renal vein, and contusion and laceration of the right posterior lobe of the liver. According to the American Association for the Surgery of Trauma renal injury classification, he was diagnosed as grade Ⅳ renal rupture. After blood transfusion and fluid infusion, vital signs were stable. Laparoscopic nephrectomy plus renal vein thrombectomy plus liver rupture repair were performed. The operation took 90 minutes, and about 300 ml of blood clots and fresh blood were aspirated during the operation. The patient's vital signs were stable after the operation, and he could get out of bed 3 days after the operation. CT reexamination 1 month after the operation showed right kidney resected and the liver healed well. This operation is feasible if the patient's vital signs are stable, with the advantages of small surgical incision, short operation time, less bleeding, fast postoperative recovery and good surgical effect.

The aim of this study is to establish an gene editing method of Mesomycoplasma hyo-pneumoniae(Mhp)based on the homologous recombination principle.The restriction enzyme di-gestion and ligation method combined with gene synthesis were used to construct a shuttle plasmid to achieve replication in both Mhp and Escherichia coli(E.coli).The pGEM?-T vector was used as the skeleton.The oriC sequence of Mhp which can achieve the replication of the plasmid in Mhp was inserted into the vector.Sequences of the Spiroplasma promoter and puromycin resistance gene were then inserted into the above constructed plasmid to screen recombinant clones.The up-stream and downstream homologous arms of p97 were constructed to initiate homologous recombination.The recA gene of E.coli is inserted to improve the efficiency of homologous recom-bination.The obtained shuttle plasmid was then delivered into Mhp by electro-transformation or chemical transformation.A shuttle plasmid,pGEM?-Mhp-oriC-p 97,which can replicate in both Mhp and E.coli was constructed.With the transformation of this plasmid,the carried puromycin gene and recA gene can be expressed,the p97 gene can be edited.Finally,the genetically unstable p97 gene mutant was initially obtained.In this study,a tool for Mhp gene editing based on the principle of homologous recombination was established,which laid a foundation for the develop-ment of tools for studying the pathogenesis of Mhp.

Objective To observe the rehabilitation treatment effect of using a comprehensive quality control model based on ICF concept and PDCA cycle management mode to intervene in stroke recovery patients.Methods The time segmenta-tion method was employed for grouping.A total of 114 stroke patients admitted to the hospital from June 1,2022 to February 28,2023 were selected as the control group,and 109 patients admitted from March 1,2023 to November 1,2023 were chosen as the study group.There was no statistically significant difference in the clinical data of the two groups of patients before treatment.The control group received conventional rehabilitation treatment,while the study group implemented the rehabilitation treatment based on the ICF concept and the PDCA"big loop with small loops"cyclic management mode on the basis of the control group.The basic information of the two groups of patients was compared,and the rehabilitation effects of the patients were comprehensively e-valuated by using the Fugl-Meyer assessment of upper and lower limb functions(with a total of 100 indicators),the Functional Independence Measure(FIM)score of daily activity ability(including 13 motor quality of life indicators and 5 cognitive quality of life indicators),and the satisfaction evaluation.Results After treatment,the scores of upper and lower limb function assess-ment and daily activity ability in both groups were significantly higher than those before treatment.Among them,all the scores of the study group were significantly better than those of the control group(P＜0.01),and the satisfaction of the study group was also significantly improved compared with that of the control group(P＜0.05).Conclusion The comprehensive quality control model based on the ICF concept and the PDCA cycle can significantly improve the rehabilitation effects and patient satisfaction of stroke patients in the recovery period.

The aim of this study is to establish an gene editing method of Mesomycoplasma hyo-pneumoniae(Mhp)based on the homologous recombination principle.The restriction enzyme di-gestion and ligation method combined with gene synthesis were used to construct a shuttle plasmid to achieve replication in both Mhp and Escherichia coli(E.coli).The pGEM?-T vector was used as the skeleton.The oriC sequence of Mhp which can achieve the replication of the plasmid in Mhp was inserted into the vector.Sequences of the Spiroplasma promoter and puromycin resistance gene were then inserted into the above constructed plasmid to screen recombinant clones.The up-stream and downstream homologous arms of p97 were constructed to initiate homologous recombination.The recA gene of E.coli is inserted to improve the efficiency of homologous recom-bination.The obtained shuttle plasmid was then delivered into Mhp by electro-transformation or chemical transformation.A shuttle plasmid,pGEM?-Mhp-oriC-p 97,which can replicate in both Mhp and E.coli was constructed.With the transformation of this plasmid,the carried puromycin gene and recA gene can be expressed,the p97 gene can be edited.Finally,the genetically unstable p97 gene mutant was initially obtained.In this study,a tool for Mhp gene editing based on the principle of homologous recombination was established,which laid a foundation for the develop-ment of tools for studying the pathogenesis of Mhp.

Objective To observe the rehabilitation treatment effect of using a comprehensive quality control model based on ICF concept and PDCA cycle management mode to intervene in stroke recovery patients.Methods The time segmenta-tion method was employed for grouping.A total of 114 stroke patients admitted to the hospital from June 1,2022 to February 28,2023 were selected as the control group,and 109 patients admitted from March 1,2023 to November 1,2023 were chosen as the study group.There was no statistically significant difference in the clinical data of the two groups of patients before treatment.The control group received conventional rehabilitation treatment,while the study group implemented the rehabilitation treatment based on the ICF concept and the PDCA"big loop with small loops"cyclic management mode on the basis of the control group.The basic information of the two groups of patients was compared,and the rehabilitation effects of the patients were comprehensively e-valuated by using the Fugl-Meyer assessment of upper and lower limb functions(with a total of 100 indicators),the Functional Independence Measure(FIM)score of daily activity ability(including 13 motor quality of life indicators and 5 cognitive quality of life indicators),and the satisfaction evaluation.Results After treatment,the scores of upper and lower limb function assess-ment and daily activity ability in both groups were significantly higher than those before treatment.Among them,all the scores of the study group were significantly better than those of the control group(P＜0.01),and the satisfaction of the study group was also significantly improved compared with that of the control group(P＜0.05).Conclusion The comprehensive quality control model based on the ICF concept and the PDCA cycle can significantly improve the rehabilitation effects and patient satisfaction of stroke patients in the recovery period.

A 34-year-old male patient was admitted to the hospital on October 6, 2023 due to fall from a high place. Physical examination showed blood pressure 96/53 mmHg (1 mmHg=0.133 kPa), heart rate of 105 beats/min, slight bulge in the right kidney area, and positive percussion pain in the right kidney area. CT examination showed complete rupture of the lower pole of the right kidney, thrombosis of the right renal vein, and contusion and laceration of the right posterior lobe of the liver. According to the American Association for the Surgery of Trauma renal injury classification, he was diagnosed as grade Ⅳ renal rupture. After blood transfusion and fluid infusion, vital signs were stable. Laparoscopic nephrectomy plus renal vein thrombectomy plus liver rupture repair were performed. The operation took 90 minutes, and about 300 ml of blood clots and fresh blood were aspirated during the operation. The patient's vital signs were stable after the operation, and he could get out of bed 3 days after the operation. CT reexamination 1 month after the operation showed right kidney resected and the liver healed well. This operation is feasible if the patient's vital signs are stable, with the advantages of small surgical incision, short operation time, less bleeding, fast postoperative recovery and good surgical effect.

Temporomandibular disorders (TMD) are a heterogeneous group of diseases that affect the temporomandibular joint, chewing muscle system, dental occlusion, and even various structures throughout the body, with significant characteristics of biological-psychological-social pattern. TMD related chronic pain, as the most important clinical symptom, can result in negative emotions seriously affecting patients′ quality of life and physical and mental health. Although a variety of therapies have been previously reported to treat TMD related chronic pain, there is a lack of widely recognized therapies. Professor Jason W Busse (from Michael G DeGroote National Pain Centre, McMaster University, Hamilton ON, Canada) took the lead and collaborated with multiple internationally renowned schools/hospitals of stomatology to develop an international consensus on the management of chronic pain associated with TMD, a clinical practice guideline, which took two years and was published in December 15th, 2023 in a global top journal of clinical research The British Medical Journal. This clinical practice guideline explored the comparative effectiveness of available therapies for chronic pain associated with TMD, conditionally recommended the specific intervention for different treatment or pain relief, proposed a comprehensive, agreed, and standardized clinical practice guideline. This present article describes the methodology and key elements of the clinical practice guideline to help clinicians fully understand and appropriately apply this guidance, which could provide the references for clinical practice of TMD associated chronic pain in China.

Objective:To study the correlation between smoking and clinicopathology in patients with upper tract urothelial carcinoma(UTUC), and to evaluate the effect of smoking on the prognosis of patients with UTUC treated with adjuvant chemotherapy for Gemcitabine plus Cisplatin (GC).Methods:A retrospective cohort study was used to select 91 patients who underwent resection of the kidney and ureter, and sleeve cystectomy in Beijing Friendship Hospital, Capital Medical University from January 2013 to December 2021, all patient received GC adjuvant chemotherapy after surgery. Patients were divided into smoking group ( n=33) and non-smoking group ( n=58) according to their smoking history. The median follow-up time was 38 months (3-83 months). The age, gender, presence or absence of hydronephrosis, tumor stage, multifocality, lymphatic vascular invasion, lymphatic metastasis, tumor grade, overall survival (OS) and cancer-specific survival (CSS) were statistically analyzed. The measurement data were expressed as mean ± standard deviation ( ± s), and the t-test was used for comparison between groups; the count data were expressed as the number of cases and percentage, and the Chi-square test was used for comparison between groups. Kaplan-Meier curve was used for survival analysis and comparison, and Long-rank test was used for comparison between groups. Cox proportional risk regression model was introduced to explore the independent influencing factors of OS and CSS by univariate and multivariate Cox regression analysis. Results:Among 91 patients, 41 were males and 50 were females, with a median age of 65 years, and 19 patients (20.9%) died, of which 17 patients (18.7%) died of UTUC. The comparison of clinical indicators between the two groups showed that smoking was associated with male, tumor stage, multifocality, lymphatic vascular invasion, lymphaitc metastasis, and tumor grade and hydronephrosis ( P<0.05). Multivariate Cox regression analysis showed that smoking, male, higher tumor stage, and lymphatic vascular invasion were independent risk factors for OS and CSS. For the subgroup of patients who smoked, smoking duration significantly affected CSS, with each additional year of smoking duration increasing the risk of death by 0.065. Conclusion:Smoking is associated with adverse pathology in patients with UTUC, and smoking is an independent factor affecting the prognosis of postoperative adjuvant chemotherapy with GC in UTUC.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.