With the development of population aging, the incidence of lower limb artery ischemic diseases is gradually increasing. Although various treatments such as medication and endovascular surgery are currently available, patients with compromised microcirculation in the distal limbs and poor outflow pathways often do not achieve satisfactory results. Additionally, these treatments can be costly, and long-term patency rates are not ideal. The amendment in situ autologous great saphenous vein arterialization surgery utilizes the patient′s great saphenous vein to provide arterial blood in a retrograde manner and re-establishes blood supply to the tissues through the venous microcirculation system in the distal foot. This approach can achieve good limb salvage results and long-term patency. Therefore, this article aims to elaborate on the methods and value of amendment in situ autologous great saphenous vein arterialization surgery.

Small cell carcinoma of the prostate is a rare and highly malignant tumor of the urinary system. It is less common for prostate small cell carcinoma coexisting with bladder carcinoma. One such case was reported in this paper. The patient underwent ultrasound-guided transrectal prostate biopsy, and transurethral bladder endoscopy + bladder tumor electric resection. Postoperative pathology and immunohistochemistry showed prostate small cell carcinoma accompanied by high-grade invasive urothelial carcinoma of the bladder and small cell carcinoma. The patient underwent local bladder perfusion chemotherapy, relying on etoposide plus lobaplatin systemic chemotherapy and toripalimab immunotherapy. Prostate MRI, cystoscopy, and prostate-specific antigen (PSA) were performed 12 months after operation. The size of the lesions in the prostate and seminal vesicles had decreased, and there was a significant reduction in PSA levels. Additionally, no masses were detected in the bladder.

BackgroundDepression， anxiety， impulse control disorders， insomnia are prevalent non-motor symptoms of Parkinson's disease， severely impairing the quality of life of patients. Cognitive behavioral therapy （CBT） is a common psychological intervention for various clinical psychological conditions， which can improve anxiety， insomnia and depression in patients with Parkinson's disease. However， the current research evidence on the effects of CBT in improving quality of life in patients with Parkinson's disease remains inconsistent. ObjectiveTo assess the effects of CBT on the quality of life among patients with Parkinson's disease， so as to provide references for the clinical application of CBT in this population. MethodsOn May 25， 2023， a systematic search was conducted across PubMed， PsycINFO， Embase， CNKI， Wanfang Database and VIP Database to identify randomized controlled trials investigating the impact of CBT on the quality of life in patients with Parkinson's disease. Literature screening， quality evaluation and data extraction were performed， focusing on variables related to quality of life， anxiety， and depression. Meta-analysis was performed using Stata 13.0 and RevMan 5.3. ResultsA total of 11 studies with 456 participants were included， comprising 241 in the CBT group and 215 in the control group. The CBT group exhibited significantly higher quality of life compared with the control group （SMD=0.47， 95% CI： 0.27~0.67， P<0.01）. Anxiety and depression scores in CBT group were significantly lower than those in the control group （SMD=-0.63，95% CI：-0.84~-0.43， P<0.01； SMD=-0.83， 95% CI： -1.15~-0.51， P<0.01）. Among the 11 studies， 6 studies delivered CBT remotely and 5 studies implemented CBT face-to-face. Meta-analysis results revealed that remote CBT group yielded significantly higher quality of life （SMD=0.43， 95% CI： 0.17~0.70， P<0.01）， and lower anxiety and depression scores （SMD=-0.62， 95% CI： -0.91~-0.34， P<0.01； SMD=-0.78， 95% CI： -1.34~-0.21， P<0.01） compared with the control group. Similarly， face-to-face CBT group showed better outcomes than the control group in terms of quality of life， anxiety and depression （SMD=0.51， 95% CI： 0.22~0.81， P<0.01； SMD=-0.64， 95% CI： -0.93~-0.35， P<0.01； SMD=-0.90， 95% CI： -1.20~-0.60， P<0.01）. ConclusionCBT may contribute to alleviating anxiety and depression levels of patients with Parkinson's disease， and improving their quality of life.｛Funded by Shanghai 13th Five-Year Key Specialty Construction Project （number， shslczdzk04901）； Nature Fund Project of Shanghai Science and Technology Commission （number， 22ZR1459300）； Shanghai Municipal Health Commission Traditional Chinese Medical Science Non-drug Therapy Demonstration Center Project ［number， ZY（2021-2023） -0204-03］｝

Objective:To evaluate iliac vein balloon dilation for the treatment of superficial varicose veins of grade C3 and beyond.Methods:A total of 568 patients with superficial varicose veins of C3 or above at our department were enrolled and divided into interventional ball expansion group, the stretch socks treatment group and the ablation surgery group. The VCSS score was used to evaluate the treatment efficacy.Results:Forty out of 47 cases in the interventional ball expansion group were evaluated as effective while the other 7 cases were ineffective; 39 out of 82 cases in the elastic socks treatment group were effective while the other 43 cases were ineffective. 280 out of 439 cases in the ablation surgery group were effective while the other 159 cases were ineffective. The improvement degree of the interventional ball expansion group was statistically better than that of the other two groups ( P<0.05). Conclusion:Interventional balloon dilatation of iliac vein is better than traditional treatment to improve the subjective feelings of patients with superficial varicose veins above grade C3.

Research on the deposition of inhaled particles in human pulmonary acinus region is important to the pathogenesis investigation, prevention and treatment of lung diseases. Most of the current research focus on the final deposition fraction of inhaled particles in human acinar region, but little is involved in their dynamic deposition characteristics. In this paper, five multi-alveolar models, G3-G7, were built. The evaluation parameter 1/4 deposition time was introduced to study the particle deposition speed. The deposition characteristics of particles in the diameter ranging 0.1-5 μm were numerically simulated and summarized under the influence of factors such as the generation and structure of model, particle diameter and respiratory mode, shedding some new light on the further research of transport of inhaled particles. The results showed that the generation and structure of model had a significance effect on the deposition of particles. 0.1 μm particles were dominated by Brownian diffusion, which experienced a high deposition fraction, a fast deposition speed and a logarithmic deposition curve, while 5 μm particles were dominated by gravitational sedimentation, with a high deposition fraction, a fast deposition speed and an S-shaped deposition curve. The deposition of 0.3-1 μm particles were influenced greatly by convention and varied with the change of respiratory mode. The research methods and results in this paper can provide theoretical basis and data support for the further exploration of the mechanism, prevention and treatment of lung diseases.
Aerosols ; Computer Simulation ; Humans ; Lung ; Models, Biological ; Particle Size

The inhalation and deposition of particles in human pulmonary acinus region can cause lung diseases. Numerical simulation of the deposition of inhaled particles in the pulmonary acinus region has offered an effective gateway to the prevention and clinical treatment of these diseases. Based on some important affecting factors such as pulmonary acinar models, model motion, breathing patterns, particulate characteristics, lung diseases and ages, the present research results of numerical simulation in human pulmonary acinus region were summarized and analyzed, and the future development directions were put forward in this paper, providing new insights into the further research and application of the numerical simulation in the pulmonary acinus region.
Aerosols ; Computer Simulation ; Humans ; Lung ; physiology ; Models, Biological ; Particle Size ; Pulmonary Alveoli ; physiology

Research on the deposition of inhalable particles in the alveoli of the lungs is important to the causes, development for common respiratory diseases such as emphysema, and even the optimization of clinical treatment and prevention programs of them. In this paper, an experimental model was established to simulate the deposition of terminal bronchioles and pulmonary acinus particles. The deposition rate of inhalable particles with different particle sizes in the pulmonary acinus was studied under different functional residual capacity. The results showed that the particle diameter was an important factor affecting the deposition of particles in the lung alveoli. Particles with 1 μm diameter had the highest deposition rate. With the functional residual capacity increasing, particulate deposition rate significantly reduced. The results of this study may provide data support and optimization strategy for target inhalation therapy of respiratory diseases such as emphysema and pneumoconiosis. The established model may also provide a feasible experimental model for studying the deposition of inhalable particles in the pulmonary alveoli.

BACKGROUND:The limb ischemia model in rats has been widely applied in China to study the pathological process and treatment method of limb ischemia, but there are some controversies on the model construction and evaluation, so a reliable, convenient and economical disease model is needed for the related research. OBJECTIVE:To compare limb ischemia degree, duration and changing rule of acute hind limb ischemia models prepared by different ways in Sprague-Dawley rats, and find a method to prepare models that have moderate and stable limb ischemia and maintain a longer time. METHODS: 72 Sprague-Dawley rats were randomly divided into four groups, with 18 rats in each group. Group A: sham operation group, abdominal aorta below renal artery and iliolumbar artery, right superficial femoral artery, popliteal artery, saphenous artery were separated. Group B: the right superficial femoral artery, popliteal artery, saphenous artery were cut off, and the right femoral artery was resected to establish acute hind limb ischemic model. Group C: abdominal aorta and bilateral abdominal perineal artery were ligated to establish acute hind limb ischemic model. Group D: abdominal aorta, iliolumbar artery and lumbar artery were ligated to establish acute hind limb ischemic model. RESULTS AND CONCLUSION:Right hind limb muscle strengths of rats in groups B, C, D were weaker than that in group A at weeks 2, 4, 6 after operation; muscle strengths in group D was weaker than that in groups B, C at week 4 after operation; muscle strengths in groups B, D was stil weaker than that in group C at week 6 after operation. The partial venous oxygen pressure of right hind limbs in groups B, C, D was lower than that in group A at weeks 2, 4, 6 after operation; the partial venous oxygen pressure in group D was lower than that in groups B and C at weeks 2, 4 after operation; and group D was stil lower than group C at week 6 after operation. At weeks 2, 4 after operation, some muscle cels in the right hind limb muscle tissue were disrupted, fibrous connective tissue hyperplasia and capilary hyperplasia were detected, inflammatory cels infiltrated in the groups B, C, D. These pathological findings were more apparent in group D. Fiber connective tissue hyperplasia was attenuated, capilary hyperplasia, expansion and congestion were found in each group at week 6 postoperatively. The method of ligating abdominal aorta, iliolumbar artery and lumbar artery below renal artery for hind limb ischemia model can obtain moderate and stable ischemia conditions, maintain a long time, and is convenient to prepare.

The research on cycle change form of the pressure and the wall shear in human upper respiratory tract can strengthen understanding of the characteristics of the airflow in the place and provide us with a scientific basis for analyzing the diffusion, transition and deposition patterns of aerosol there. In our study, we used large eddy simulation to emulate the pressure and wall shear in human upper respiratory tract in conditions of the low intensive respiratory patterns, and discussed the distributing disciplinarian of the pressure and wall shear in mouth-throat model and trachea-triple bifurcation. The results showed that the pressure gradient variation in human upper respiratory tract was mainly fastened from root of epiglottis to trachea. The minimum pressure at the interim of inspiration was a duplication of the interim of expiration, and located on the posterior wall of the glottis. The pressure gradient variation was evident on trachea and its fork. The wall shear changed with the velocity of the air flow, and its direction changed periodically with breath cycle.
Biomechanical Phenomena ; Bronchi ; physiology ; Computer Simulation ; Epiglottis ; physiology ; Humans ; Mouth ; physiology ; Nose ; physiology ; Pharynx ; physiology ; Pressure ; Pulmonary Ventilation ; physiology ; Respiratory Mechanics ; physiology ; Respiratory Physiological Phenomena ; Respiratory System ; Shear Strength ; Stress, Mechanical ; Trachea ; physiology

BACKGROUND:Large randomized trials have demonstrated carotid endarterectomy or stenting for symptomatic and asymptomatic extracranial carotid stenosis is effective.
OBJECTIVE:Using the meta analysis method, to evaluate efficacy and safety of carotid stenting and carotid endarterectomy for the treatment of carotid stenosis.
METHODS:Computer-based retrieval of databases both at home and abroad was performed for randomized control ed trials related to carotid stenting and carotid endarterectomy for the treatment of carotid stenosis. According to exclusion criteria, literature screening was done fol owed by quality evaluation. Then, the enrol ed literatures were analyzed by Cochrane col aboration with RevMan5.0 Meta analysis software.
RESULTS AND CONCLUSION:There were 14 enrol ed studies, including 7 693 patients among whom, 3 835 cases were in stenting group and 3 858 in carotid endarterectomy group. Compared with the carotid endarterectomy group, the stroke event rate within 30 days postoperatively, death and stroke event rate within 30 days postoperatively, myocardial infarction event rate within 1 year postoperatively and non-disabling stroke event rate within 30 days postoperatively were higher in the stenting group (P ≤0.000 1);the myocardial infarction event rate within 30 days postoperatively was lower in the stenting group (P=0.001 0). There were no significant differences in the death event rate and disabled stroke event rate within 30 days postoperatively between the two groups. These two treatments are complementary rather than antagonistic. We should optimize the treatment choice based on the comprehensive analysis of each patient's condition.