Benign prostatic hyperplasia （BPH） is a common chronic progressive disease in middle-aged and elderly men， characterized by prostate enlargement and bladder outlet obstruction， leading to symptoms such as frequent urination， urgency， and difficulty urinating. The pathogenesis of BPH involves factors such as aging， hormonal metabolic abnormalities， inflammatory responses， and imbalances in cell proliferation and apoptosis. Currently， the main treatment methods for BPH include medication， physical therapy， and surgical intervention. However， medication may cause side effects like sexual dysfunction and hypotension， physical therapy has limited efficacy， and surgery carries risks and postoperative complications. Therefore， there is an urgent need to find safer and more effective treatment options. Traditional Chinese medicine （TCM）， with its focus on treatment based on syndrome differentiation and a holistic approach， offers therapeutic advantages through multiple pathways and mechanisms. Recent studies have shown that TCM regulates pathways such as phosphoinositide-3-kinase/protein kinase B （PI3K/Akt）， nuclear factor-κB （NF-κB）， mitogen-activated protein kinases （MAPK）， nuclear factor E₂-related factor 2/antioxidant response element （Nrf2/ARE）， androgen receptor （AR）， transforming growth factor-β （TGF-β）/Smad， and hypoxia-inducible factor-1α/vascular endothelial growth factor （HIF-1α/VEGF） to inhibit oxidative stress and inflammatory response， reduce prostate cell proliferation， and promote apoptosis， thus exerting therapeutic effects. This article summarizes and analyzes the roles of these signaling pathways in the occurrence and development of BPH and the mechanisms of TCM intervention， aiming to provide scientific evidence for clinical treatment and drug development for BPH.

Benign prostatic hyperplasia （BPH） is a common chronic progressive disease in middle-aged and elderly men， characterized by prostate enlargement and bladder outlet obstruction， leading to symptoms such as frequent urination， urgency， and difficulty urinating. The pathogenesis of BPH involves factors such as aging， hormonal metabolic abnormalities， inflammatory responses， and imbalances in cell proliferation and apoptosis. Currently， the main treatment methods for BPH include medication， physical therapy， and surgical intervention. However， medication may cause side effects like sexual dysfunction and hypotension， physical therapy has limited efficacy， and surgery carries risks and postoperative complications. Therefore， there is an urgent need to find safer and more effective treatment options. Traditional Chinese medicine （TCM）， with its focus on treatment based on syndrome differentiation and a holistic approach， offers therapeutic advantages through multiple pathways and mechanisms. Recent studies have shown that TCM regulates pathways such as phosphoinositide-3-kinase/protein kinase B （PI3K/Akt）， nuclear factor-κB （NF-κB）， mitogen-activated protein kinases （MAPK）， nuclear factor E₂-related factor 2/antioxidant response element （Nrf2/ARE）， androgen receptor （AR）， transforming growth factor-β （TGF-β）/Smad， and hypoxia-inducible factor-1α/vascular endothelial growth factor （HIF-1α/VEGF） to inhibit oxidative stress and inflammatory response， reduce prostate cell proliferation， and promote apoptosis， thus exerting therapeutic effects. This article summarizes and analyzes the roles of these signaling pathways in the occurrence and development of BPH and the mechanisms of TCM intervention， aiming to provide scientific evidence for clinical treatment and drug development for BPH.

Objective To investigate the value of liver imaging reporting and data system version 2018(LI-RADS v2018)features in predicting microvascular invasion(MVI)of hepatocellular carcinoma(HCC).Methods Ninety-two patients diagnosed as LR-5 and pathologically confirmed HCC were included and divided into MVI positive group and MVI negative group.The major and ancillary features of LI-RADS v2018 were compared between the two groups.Logistic univariate and multivariate regression analyses were used to obtain the independent risk factors for MVI,and the value of differential features in predicting MVI was also assessed using the receiver operating characteristic(ROC)curve.Results In the MVI positive group,the pathological grade of HCC was higher than that in the MVI negative group,with larger tumor diameter and higher incidence of mosaic architecture and corona enhancement.However,there was no difference in any other features.In logistic univariate analysis,tumor diameter,mosaic architecture and corona enhancement were independent risk factors for predicting the MVI,with area under the curve(AUC)values of 0.763 and 0.628 and 0.670 for the diagnosis of MVI,respectively.Conclusion In high-risk LR-5 population,tumor diameter,mosaic architecture and corona enhancement can help to predict the MVI.Accurate identification of LI-RADS v2018 features may facilitate personalized management of HCC patients.

Prostate cancer （PCa） is one of the most common malignant tumors in the male genitourinary system. The phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway is a carcinogenic pathway responsible for the migration， proliferation， and drug resistance of various cancers. In recent years， as the research on the pathogenesis of PCa is deepening， the role of the PI3K/Akt signaling pathway in the development of PCa has attracted much attention. Traditional Chinese medicine， comprehensively regulating multiple components， targets， and pathways， has shown great potential in the treatment of PCa. This article reviews the research progress of traditional Chinese medicine targeting the PI3K/Akt signaling pathway in the treatment of PCa and discusses the expression of the PI3K/Akt signaling pathway in PCa， which involves inhibiting apoptosis of PCa cells， promoting the cell cycle， invasion， and migration of PCa cells， promoting tumor tissue angiogenesis， and mediating the androgen receptor. Additionally， it summarizes the single Chinese medicines that target and regulate this pathway， including Hedyotis diffusa， Taxus chinensis， Bovisc Alculus， and Atractylodis Macrocephalae Rhizoma. The active ingredients of these Chinese medicines mainly include flavonoids， alkaloids， terpenes， polyphenols， lignans， and other compounds. The Chinese medicine compound prescriptions targeting the PI3K/Akt pathway mainly include Wenshen Sanjie prescription， Jianspi Lishi Huayu prescription， Yishen Tonglongtang， Qilan prescription， Xihuangwan， and modified Shenqi Dihuangtang. This review is expected to provide a scientific basis for deeply understanding the pathogenesis of PCa and identifying potential therapeutic targets， as well as to provide new ideas for clinical research and drug development for PCa.

Diabetes mellitus erectile dysfunction(DMED)is a common diabetic-related vascular,endo-crine and neuropathy in clinical practice,and patients with DMED often present with symptoms such as difficulty in erection,prolonged erection time,poor hardness,and short sexual intercourse.The etiological mechanism is complex,and it is often closely related to many factors such as oxidative stress(OS),inflammatory response,and neurological and endocrine lesions,which often cross-react and promote the progression of DMED lesions.In recent years,relevant studies have shown that OS and ferroptosis play a key role in DMED:OS can cause neuro-logical and Abnormal endocrine function,decreased synthesis or bioavailability of penile vascular endothelium,spongy endothelial cell dysfunction and decreased smooth muscle diastolic function,resulting in penile erectile dysfunction,and ferroptosis has also been confirmed to be closely related to DMED,controlling OS and ferroptosis to improve erectile function in diabetic patients is a reasonable and effective treatment pathway,but the mechanism of action of ferroptosis leading to DMED needs to be further studied.Therefore,this article reviews the latest infor-mation on the correlation between OS and ferroptosis and DMED,aiming to provide a useful reference for exploring the mechanism of DMED,clinical prevention and treatment of DMED,and providing potential directions for future research in this field.

Objective:To compare the application effects of three different extubation techniques in patients with mechanical ventilation in intensive care unit (ICU).Methods:A prospective randomized controlled study was conducted. Mechanical ventilation patients admitted to the critical care department of the First Affiliated Hospital of Guangxi Medical University from July to November 2023 were enrolled. According to the random number table generated by Excel, the patients were divided into negative pressure group, positive pressure group 1 and positive pressure group 2, with 45 cases in each group. On the basis of routine nursing, the negative pressure group used the negative pressure extubation technique to remove the tracheal catheter. In the positive pressure group, the pressure support (PS) and positive end-expiratory pressure (PEEP) of the positive pressure group 1 were 7 cmH 2O (1 cmH 2O≈0.098 kPa) and 5 cmH 2O, and the PS and PEEP of the positive pressure group 2 were 15 cmH 2O and 10 cmH 2O. The main outcome measures were extubation related complications, including tachypnea, severe cough, sore throat, upper airway obstruction spasm, extubation failure, hypoxemia, and hypercapnia. The secondary outcome measures were the variation of heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure and blood oxygen saturation before and 1, 15 and 30 minutes after extubation. Results:Finally, 42 patients were included in each group. There were no significant differences in gender, age, catheter retention days, duration of mechanical ventilation, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), catheter model and diagnosis among the three groups, which were comparable. There were statistically significant differences in the incidence of tachypnea, severe cough, sore throat, upper airway obstruction spasm, hypoxemia and hypercapnia among the three groups, while there was no statistically significant difference in the failure rate of extubation. The incidence of tachypnea, severe cough, sore throat, upper airway obstruction spasm, hypoxemia and hypercapnia after extubation in positive pressure group 1 and positive pressure group 2 were lower than those in negative pressure group (7.14%, 9.52% vs. 33.33%; 7.14%, 4.76% vs. 28.57%; 61.90%, 52.38% vs. 88.10%; 11.90%, 19.05% vs. 45.24%; 7.14%, 7.14% vs. 30.95%; 4.76%, 2.38% vs. 28.57%; all P < 0.05). There were no significant differences in extubation related complications between group 1 and group 2. There were significant differences in the time effect of heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure and blood oxygen saturation 30 minutes after extubation among three groups ( F values were 145.792, 49.749, 22.486, 23.622 and 242.664, respectively, all P < 0.01). The intergroup effect of blood oxygen saturation was statistically significant ( F = 3.835, P = 0.024), and the blood oxygen saturation in positive pressure group 1 and positive pressure group 2 were higher than those in negative pressure group 1 minute and 30 minutes after extubation (1 minute after extubation: 0.97±0.02, 0.97±0.02 vs. 0.95±0.02; 30 minutes after extubation: 1.00±0.01, 1.00±0.01 vs. 0.99±0.02, all P < 0.05). The interaction effects of heart rate and blood oxygen saturation were statistically significant ( F values were 3.512 and 7.226, respectively, both P < 0.01). Conclusions:Compared with negative pressure extubation, positive pressure extubation can effectively reduce extubation related complications in ICU mechanically ventilated patients. It is beneficial to maintain stable blood oxygen saturation within 30 minutes after extubation, and has better clinical application effects. It is recommended to use low pressure extubation.

Objective:To analyze the abnormal dose monitoring result of radiation staff in medical institutions and provide a basis for standardizing the personal dose management of radiation staff in medical institutions.Methods:Through the occupational radiation disease monitoring subsystem of the National Radiation Health Information Platform, 516 individual dose monitoring abnormal result of 410 radiation workers in a single monitoring period, which in 168 medical institutions under the 18 cities in Henan province were collected from 2020 to 2022 as research objects. Based on gender, age, length of service, occupational category, medical institution level, whether the dosimeter wearing standard, the abnormal result of radiation workers were grouped to analyze the influencing factors of individual dose monitoring result.Results:The incidence of abnormal individual dose monitoring result in 2020-2022 was 6.83 × 10 -3, 5.22 × 10 -3 and 6.30 × 10 -3, respectively. Abnormal results were mainly distributed in male radiology workers (66.83%), diagnostic radiology (59.51%) and interventional radiology (34.63%), tertiary (54.39%) and secondary medical institutions (36.34%). In the case of wearing personal dosimeter in a standard or irregular way, there were statistically significant differences in the incidence of abnormal outcomes between different levels of medical institutions and different occupational categories( χ2=14.42, 6.56, 32.96, 177.15, P<0.05). The median annual individual dose of radiology workers with " abnormal exposure dose" due to increased workload was 3.95 mSv, and the annual individual dose of interventional radiology workers was higher than that of radiotherapeutic workers ( Z=5.07, P<0.05). Conclusions:The education and training of radiological protection should be strengthened, and the wearing of individual dosimeters should be standardized; focus on the occupational exposure of interventional radiology staff, and take effective measures to reduce their exposure dose.

Glaucoma is one of the most common optic neuropathies, featuring progressive retinal ganglion cell damage and visual field loss (Tham et al., 2014; Xu et al., 2020). Currently, the only effective treatment for this condition is the reduction of intraocular pressure (IOP) (Palmberg, 2001; Heijl et al., 2002). Canaloplasty is a proven bleb-independent surgery with good efficacy and safety profiles in primary open-angle glaucoma (POAG) (Gołaszewska et al., 2021). However, early transient postoperative IOP elevation has been reported in up to 30% of cases (Riva et al., 2019), similar to that commonly observed in other internal drainage glaucoma surgeries such as implantation using iStent (0%-21.0%), CyPass (10.8%), and Hydrus (4.8%-6.5%) (Lavia et al., 2017). This complication may be a predictor of poor reserve in the outflow system and is potentially associated with surgical failure. Nonetheless, the exact pathophysiology of glaucoma remains unknown, and studies clarifying the risk factors for postoperative IOP elevation have been scarce.
Humans ; Intraocular Pressure ; Glaucoma, Open-Angle/surgery* ; Incidence ; Treatment Outcome ; Risk Factors

Objective:To observe multiple locus variable-number tandem repeat analysis (MLVA) typing of Brucella isolated from Himalayan marmot in Qinghai-Tibet Plateau of Qinghai Province, and to explore the relationship between the strains and strains previous isolated from Qinghai Province. Methods:Blood samples of Himalayan marmot were collected in Qinghai-Tibet Plateau of Qinghai Province from March 2019 to October 2020. Pathogens were isolated and cultured from Brucella antibody positive samples identified by using the rose bengal test (RBT). Conventional biological methods and molecular biological methods (BCSP31-PCR and AMOS-PCR) were used for strain identification. At the same time, MLVA method was used to genotype the isolated strains, and cluster analysis was used to analyze the genetic relationships between the strains based on the genotype of 70 Brucella isolated from different hosts in Qinghai Province. Results:A total of 1 466 blood samples of Himalayan marmot were collected from Qinghai-Tibet Plateau. Two strains of Brucella were isolated and cultured from 64 RBT-positive samples, named QH2013054 and QH2013062, respectively. They were identified as Brucella ovis biotype Ⅲ by conventional and molecular biological methods. The MLVA genotyping results showed that QH2013054 and QH2013062 were different at the Bru16 locus, indicating different MLVA genotypes. Cluster analysis showed that strain QH2013054 had the same MLVA genotype as 7 strains, among which 6 strains were from 3 farmers and 3 sheep from the same family in Gonghe County, and 1 strain was from a farmer in Menyuan Hui Autonomous County. The strain QH2013062 had the same MLVA genotype as 4 strains, including 3 strains from 3 farmers in Menyuan Hui Autonomous County and 1 strain from a farmer in Tu Autonomous County of Huzhu. Conclusions:The strains of Brucella isolated from Himalayan marmot in Qinghai-Tibet Plateau of Qinghai Province have the same MLVA genotype as some strains of Brucella isolated from humans and sheep in Qinghai Province. It is speculated that the host humans, sheep and Himalayan marmot in Qinghai-Tibet Plateau may have a common source of infection.

Objective:To learn about the epidemic situation and trend of human brucellosis in Menyuan Hui Autonomous County (referred to as Menyuan County) of Qinghai Province, and to provide reference for formulating brucellosis prevention and control measures in Menyuan County.Methods:Data on human brucellosis in Menyuan County reported by the Infectious Disease Reporting Information Management System of China Disease Control and Prevention Information System from 2013 to 2020 were collected and analyzed by descriptive epidemiological analysis (three distribution).Results:A total of 186 cases of brucellosis were confirmed from 2013 to 2020, with an average annual incidence of 14.553/100 000. The annual incidence rate was increasing year by year(χ 2trend = 22.08, P = 0.002). The cases were distributed in 67 villages of 12 towns; cases were more common in the age group of 15-< 65 years old (96.24%, 179/186), and there were more men than women cases (sex ratio was 3.89∶1.00, 148/38). Conclusions:The incidence rate of brucellosis cases in Menyuan County is increasing year by year, and the scope of its impact is constantly expanding. A multi-sectoral joint prevention and control mechanism should be established to strengthen management, increase the prevention and control of brucellosis, and stop the spread of the epidemic to surrounding counties and cities.