Methods: This retrospective study analyzed 32 consecutive IDS patients who underwent UEDD surgery. Clinical features, laboratory data (erythrocyte sedimentation rate and C-reactive protein), and treatment outcomes were analyzed. Results: Definite microorganisms were identified in 27 patients (84.3%), with 24 (88.9%) meeting cure criteria. The cure rate was significantly higher in the detected pathogen group compared to the undetected pathogen group (88.9% vs. 80%; χ²=19.36, p<0.0001). Metagenomic next generation sequencing (mNGS) provided faster diagnosis (41.72±6.81 hours) compared to tissue culture (95.74±35.47 hours, p<0.05). The predominant causative pathogen was Mycobacterium tuberculosis, followed by Staphylococcus aureus. Significant improvements were observed in Visual Analog Scale pain scores, from a mean of 7.9 preoperatively to 1.06 at 1 year postoperatively. The Oswestry Disability Index revealed a similar trend, showing significant improvement (p<0.05). Conclusions UEDD is a viable alternative to traditional open surgery for managing IDS in high-risk patients. UEDD offers a dual therapeutic-diagnostic advantage during the initial admission phase, enabling simultaneous debridement, neurological decompression, and targeted biopsy in a single intervention. Compared with traditional tissue culture, mNGS enables rapid microbiological diagnosis and extensive pathogen coverage.

Methods: This retrospective study analyzed 32 consecutive IDS patients who underwent UEDD surgery. Clinical features, laboratory data (erythrocyte sedimentation rate and C-reactive protein), and treatment outcomes were analyzed. Results: Definite microorganisms were identified in 27 patients (84.3%), with 24 (88.9%) meeting cure criteria. The cure rate was significantly higher in the detected pathogen group compared to the undetected pathogen group (88.9% vs. 80%; χ²=19.36, p<0.0001). Metagenomic next generation sequencing (mNGS) provided faster diagnosis (41.72±6.81 hours) compared to tissue culture (95.74±35.47 hours, p<0.05). The predominant causative pathogen was Mycobacterium tuberculosis, followed by Staphylococcus aureus. Significant improvements were observed in Visual Analog Scale pain scores, from a mean of 7.9 preoperatively to 1.06 at 1 year postoperatively. The Oswestry Disability Index revealed a similar trend, showing significant improvement (p<0.05). Conclusions UEDD is a viable alternative to traditional open surgery for managing IDS in high-risk patients. UEDD offers a dual therapeutic-diagnostic advantage during the initial admission phase, enabling simultaneous debridement, neurological decompression, and targeted biopsy in a single intervention. Compared with traditional tissue culture, mNGS enables rapid microbiological diagnosis and extensive pathogen coverage.

Methods: This retrospective study analyzed 32 consecutive IDS patients who underwent UEDD surgery. Clinical features, laboratory data (erythrocyte sedimentation rate and C-reactive protein), and treatment outcomes were analyzed. Results: Definite microorganisms were identified in 27 patients (84.3%), with 24 (88.9%) meeting cure criteria. The cure rate was significantly higher in the detected pathogen group compared to the undetected pathogen group (88.9% vs. 80%; χ²=19.36, p<0.0001). Metagenomic next generation sequencing (mNGS) provided faster diagnosis (41.72±6.81 hours) compared to tissue culture (95.74±35.47 hours, p<0.05). The predominant causative pathogen was Mycobacterium tuberculosis, followed by Staphylococcus aureus. Significant improvements were observed in Visual Analog Scale pain scores, from a mean of 7.9 preoperatively to 1.06 at 1 year postoperatively. The Oswestry Disability Index revealed a similar trend, showing significant improvement (p<0.05). Conclusions UEDD is a viable alternative to traditional open surgery for managing IDS in high-risk patients. UEDD offers a dual therapeutic-diagnostic advantage during the initial admission phase, enabling simultaneous debridement, neurological decompression, and targeted biopsy in a single intervention. Compared with traditional tissue culture, mNGS enables rapid microbiological diagnosis and extensive pathogen coverage.

Objective:To investigate the efficacy and safety of laparoscopic subtotal cystectomy with augmentation ileocystoplasty(SC-CP) and laparoscopic total cystectomy with ileal conduit (TC-IC) for refractory interstitial cystitis/bladder pain syndrome (IC/BPS).Methods:Clinical data of 39 patients diagnosed with refractory IC/BPS treated with SC-CP and TC-IC in Beijing Chaoyang Hospital of Capital Medical University from January 2008 to December 2023 were retrospectively analyzed. All patients were female, and had unsatisfactory results after more than three types of conservative + minimally invasive treatments. There were 12 patients in the SC-CP group and 27 patients in the TC-IC group. In the SC-CP group, the patients had the age of (50.8±14.4) years old, preoperative medical history of (4.7±2.5) years, daytime voiding frequency of 25.0 (18.5, 45.0) times/day, nocturia frequency of 12.5 (10.0, 15.0) times/night, functional bladder capacity of 40.0(18.5, 47.5) ml, and anesthetized bladder capacity of 150.0 (150.0, 195.0) ml. The patients in TC-IC group had the age of (60.3±8.0) years old, preoperative medical history of (6.5±3.6) years, daytime voiding frequency of 30.0 (20.0, 40.0) times/day, nocturia frequency of 10.0 (8.0, 15.0) times/night, functional bladder capacity of 50.0(30.0, 60.0) ml, and anesthetized bladder capacity of 200.0 (150.0, 330.0) ml. SC-CP was performed to resect the bladder wall beyond the trigone and bladder neck, and bladder enlargement was performed by using an ileal segment anastomosed to the remaining bladder. TC-IC was performed to resect the entire bladder, and a segment of free ileum with a mesentery was taken, which was closed proximally and then anastomosed to the ureters on both sides, and a cutaneous ureterostomy was performed at the distal end. The patients in the two groups were followed up after the operation, and the intraoperative conditions and postoperative complications were recorded. The visual analogue scale (VAS) score, quality of life (QOL) score, O′Leary-Sant score, pelvic pain and urgency/ frequency patient symptom scale (PUF) score were recorded before and after the operation, and the differences were compared to evaluate the improvement of symptoms.Results:In the SC-CP group, the operation time was 240.0 (202.8, 293.8) min, the intraoperative hemorrhage was 50.0 (27.5, 50.0) ml, and the postoperative hospital stay was 12.0 (7.3, 16.5) days. In the TC-IC group, the operation time was 300.0 (240.0, 329.0) min, the intraoperative hemorrhage was 100.0 (50.0, 100.0) ml, and the postoperative hospital stay was 10.0 (8.0, 12.0) days. The median follow-up time of 39 patients was 31.0(10.0, 70.0) months, and the follow-up time of SC-CP group and TC-IC group was 11.0 (4.0, 22.0) and 56.0 (13.0, 75.0) months, respectively. Compared with preoperative data of SC-CP group, the postoperative VAS score [10.0 (10.0, 17.5) points vs. 90.0 (90.0, 98.8) points], the QOL score [1.0 (1.0, 2.0) points vs. 6.0 (6.0, 6.0) points], the O′Leary-Sant score [10.0 (8.5, 13.5) points vs. 35.0 (33.3, 35.8) points], and the PUF score [11.0 (7.3, 12.8) points vs. 29.5 (28.3, 32.0) points] of SC-CP group were all significantly reduced ( P < 0.05). Compared with preoperative data of TC-IC group, the postoperative VAS score [0 vs. 95.0 (90.0, 96.0) points], the QOL score [2.0 (1.0, 3.0) points vs. 6.0 (6.0, 6.0) points], the O′Leary-Sant score [1.0 (1.0, 2.0) points vs. 35.0 (35.0, 36.0) points] and the PUF score [3.0 (3.0, 4.0) points vs. 32.0 (29.0, 32.0) points] of TC-IC group were all significantly reduced ( P< 0.05). Two patients in the SC-CP group required postoperative clean intermittent catheterization, and one patient underwent TC-IC for residual bladder pain. Three patients in the TC-IC group had postoperative bowel obstruction relieved by conservative treatment, and two patients had postoperative wound infection cured by dressing change. Conclusions:Both SC-CP and TC-IC have better efficacy in patients with refractory IC/BPS. Although TC-IC has more potent relief of pain symptoms, SC-CP is closer to the normal human urination habit, eliminating the need to carry an ostomy bag, which is especially suitable for young patients with recalcitrant IC/BPS.

Autophagy is a highly conserved mechanism for material degradation and recycling in eukaryote cells, and plays important roles in growth, development, stress tolerance and immune responses. ATG10 plays a key role in autophagosome formation. To understand the function of ATG10 in soybean, two homologous GmATG10 genes, namely GmATG10a and GmATG10b, were silenced simultaneously by bean pod mottle virus (BPMV) induced gene silencing. The carbon starvation induced by dark treatment and Western blotting analysis of GmATG8 accumulation level indicated that concurrent silencing GmATG10a/10b resulted in the impairment of autophagy in soybean; disease resistance and kinase assays demonstrated that GmATG10a/10b participated in the immune responses by negatively regulating the activation of GmMPK3/6, indicating that GmATG10a/10b plays a negative regulatory role in immune response in soybean.
Soybeans/genetics* ; Immunity

Objective:To investigate the value of derived neutrophil-to-lymphocyte ratio (dNLR) in predicting the prognosis of extensive-stage small cell lung cancer (ES-SCLC) patients treated with the first-line atezolizumab immunotherapy and chemotherapy.Methods:From the Project Data Sphere platform, the clinical data and laboratory test data of 53 ES-SCLC patients who received the first-line atezolizumab immunotherapy and chemotherapy in the global multicenter phase Ⅱ prospective study NCT03041311 from February 2017 to February 2022 were collected. The Contal-O'Quigley method was used to calculate the optimal cut-off value of baseline dNLR for determining the overall survival (OS) of patients. The dNLR higher than or equal to the optimal cut-off value was defined as high dNLR, and less than the optimal cut-off value was defined as low dNLR. According to optimal cut-off value, the dNLR levels at baseline and after 4 cycles of chemotherapy were determined, and dynamic dNLR grouping was performed (low risk: low dNLR at baseline and after 4 cycles of chemotherapy; intermediate risk: high dNLR at baseline or after 4 cycles of chemotherapy; high risk: high dNLR at baseline and after 4 cycles of chemotherapy). The differences in clinicopathological features between the baseline high dNLR group and low dNLR group were analyzed. Kaplan-Meier method was used to draw the OS and progression-free survival (PFS) curves, and log-rank test was used to compare the differences between the two groups. Univariate Cox proportional hazards model was used to analyze the influencing factors of OS and PFS. The time-dependent receiver operating characteristic (ROC) curve was used to evaluate the predictive value of baseline dNLR grouping and dynamic dNLR grouping for 1-year OS rate in ES-SCLC patients receiving the first-line atezolizumab immunotherapy and chemotherapy.Results:Among the 53 patients, 34 (64.20%) were male and 19 (35.80%) were female; 27 (50.90%) were < 65 years old and 26 (49.10%) were ≥65 years old. The optimal cut-off value of baseline dNLR for determining the OS was 1.79. There were 17 cases in low dNLR group and 36 cases in high dNLR group at baseline. The proportion of patients with elevated serum lactate dehydrogenase (LDH) in the baseline high dNLR group was higher than that in the baseline low dNLR group [58.33% (21/36) vs. 17.65% (3/17), χ2 = 7.72, P = 0.005]. The 1-year OS rates of the baseline high and low dNLR groups were 44.0% and 81.9%, and the 1-year PFS rates were 2.5% and 17.6%. The differences in OS and PFS between the two groups were statistically significant (both P < 0.05). There were 38 patients with complete dynamic dNLR data, including 9 cases of low-risk, 19 cases of medium-risk and 10 cases of high-risk, and the 1-year OS rates of the three groups were 90.0%, 67.5% and 33.3%, the difference in OS between the three groups was statistically significant ( P = 0.011). Univariate Cox regression analysis showed that baseline dNLR (low dNLR vs. high dNLR) was the influencing factor for OS of patients ( HR = 0.163, 95% CI 0.057-0.469, P = 0.001) and PFS ( HR = 0.505, 95% CI 0.268-0.952, P = 0.035). Time-dependent ROC curve analysis showed that the area under the curve (AUC) of baseline dNLR grouping and dynamic dNLR grouping for predicting 1-year OS rate of ES-SCLC patients receiving the first-line atezolizumab combined with chemotherapy was 0.674 (95% CI 0.575-0.887) and 0.731 (95% CI 0.529-0.765). Conclusions:Baseline and dynamic dNLR grouping may be effective markers for predicting the prognosis of ES-SCLC patients receiving the first-line atezolizumab immunotherapy and chemotherapy.

Accurate classification of the acetabular injuries and appropriate treatment plan are great challenges for orthopedic surgeons because of the irregular anatomical structure of the acetabulum and aggregation of important vessels and nerves around it. Letournel-Judet classification system has been widely applied to classify acetabular fractures. However, there are several limitations, including incomplete inclusion of fracture types, difficulty in understanding and insufficient guidance for surgical treatment, etc. Serious complications such as traumatic arthritis are common due to wrong classification and diagnosis and improper selection of surgical strategy, which brings a heavy burden to the society and families. Three-column classification, based on anatomic characteristics, has advantages of containing more fracture types and being easy to understand, etc. To solve the problems existing in the diagnosis and treatment process based on Letournel-Judet classification, achieve accurate diagnosis and treatment of patients with acetabular fractures, and obtain satisfactory prognosis, the Orthopedic Trauma Emergency Center of Third Hospital of Hebei Medical University and the Trauma Orthopedic Branch of the Chinese Orthopedic Association organized experts from relevant fields to formulate the Expert consensus on the accurate diagnosis and treatment of acetabular fractures based on three-column classification ( version 2023) in terms of principles of evidence-based medicine. Based on the three-column classification, 15 recommendations were proposed, covering the diagnosis, treatment, complication prevention and management, etc, so as to provide reference for accurate diagnosis and treatment of acetabular fractures.

Organoid models are used to study kidney physiology, such as the assessment of nephrotoxicity and underlying disease processes. Personalized human pluripotent stem cell-derived kidney organoids are ideal models for compound toxicity studies, but there is a need to accelerate basic and translational research in the field. Here, we developed an automated continuous imaging setup with the "read-on-ski" law of control to maximize temporal resolution with minimum culture plate vibration. High-accuracy performance was achieved: organoid screening and imaging were performed at a spatial resolution of 1.1 μm for the entire multi-well plate under 3 min. We used the in-house developed multi-well spinning device and cisplatin-induced nephrotoxicity model to evaluate the toxicity in kidney organoids using this system. The acquired images were processed via machine learning-based classification and segmentation algorithms, and the toxicity in kidney organoids was determined with 95% accuracy. The results obtained by the automated "read-on-ski" imaging device, combined with label-free and non-invasive algorithms for detection, were verified using conventional biological procedures. Taking advantage of the close-to-in vivo-kidney organoid model, this new development opens the door for further application of scaled-up screening using organoids in basic research and drug discovery.
Humans ; Kidney ; Organoids ; Pluripotent Stem Cells

Objective:To explore the value of multi-dimensional interaction combined with problem-based learning (PBL) teaching in the nursing practice teaching of emergency and critical care.Methods:A total of 110 nursing students who practiced in the First Affiliated Hospital of Xinjiang Medical University from June 2019 to March 2020 were selected as the control group, and the traditional teaching was adopted. In addition, 89 nursing students who practiced from June 2020 to December 2020 were selected as the research group, and multi-dimensional interaction combined with PBL teaching was adopted. The teaching quality was assessed through the comprehensive scores of the nursing students (departure examination + regular performance assessment) and nursing students' feedback on the teaching. SPSS 22.0 was used for t-test and Chi-square test. Results:The comprehensive scores of the nursing students in the research group were higher than those in the control group, and the difference was statistically significant ( P<0.001). Compared with the control group, the nursing students in the research group believed that multi-dimensional interaction combined with PBL teaching could improve nursing knowledge and skills, overall clinical nursing ability, self-management ability, clinical thinking ability, and the ability to analyze, judge and solve clinical nursing problems, group cooperation ability, communication ability between doctors, nurses and patients, emergency ability and rescue ability, and professional quality, with statistically significant differences ( P<0.001). Conclusion:Multi-dimensional interaction combined with PBL teaching can improve the theoretical and clinical practice level of nursing interns, and at the same time help to cultivate nursing talents with excellent comprehensive quality.

Objective:To investigate the pathological characteristics, treatment and prognosis of synovial sarcoma of head and neck.Methods:The clinical data of 24 patients with synovial sarcoma of the head and neck treated in the First Affiliated Hospital of Zhengzhou University from January 2012 to December 2020 were retrospectively analyzed. There were 16 males and eight females, aged 17 to 75 years. The pathological features, treatment and follow-up were summarized. Cumulative survival was estimated by Kaplan-Meier method.Results:All patients′ diagnoses were confirmed by pathological examinations. Most cases showed the tumors were composed of spindle cells under microscope, with the characteristics of malignant tumor cells, and some tumors also showed epithelioid cell morphology, forming the typical pathological characteristics of biphasic differentiation. Except for one patient who could not tolerate surgery and the diagnosis was only confirmed by biopsy, the remaining 23 patients received surgical treatment, including three patients receiving surgical treatment alone, five patients receiving post-operative adjuvant radiotherapy, seven patients receiving post-operative adjuvant chemotherapy, and eight patients receiving post-operative adjuvant radiotherapy. Follow-up time was 3.0-114.1 months (median follow-up time: 25.2 months), including two cases of loss to follow-up, 10 cases of recurrence, five cases of lung metastases, one case of bone metastasis, and 12 cases of death. The 1-year, 3-year and 5-year survival rates for the 24 patients with synovial sarcoma of head and neck were 74.4%, 58.9% and 39.2%, respectively.Conclusion:Synovial sarcoma of the head and neck has a high recurrence rate, common distant metastasis and poor prognosis. Histopathology and immunohistochemical examinations are an important basis for diagnosis, if necessary, combined with molecular genetics. Surgical resection is the main treatment, preferring radical or expanded resection.