[Objective] To analyze the clinicopathological characteristics of treatment-naive patients with highly suspected prostate cancer (PCa) with prostate-specific antigen (PSA) level ≥20 ng/mL, to provide reference for promoting early screening of PCa. [Methods] A retrospective analysis was conducted on the clinical data of treatment-naive patients with PSA level ≥20 ng/mL, undergoing prostate biopsy for highly suspected PCa at the Department of Urology, Tianjin Medical University Second Hospital during Jan.2013 and Jun.2023. The correlation between patients' age, body mass index (BMI), PSA, prostate volume (PV), prostate cancer-specific antigen density (PSAD), prostate imaging reporting and data system (PI-RADS) score, and International Society of Urological Pathology (ISUP) grade with highly suspected PCa metastasis and PSA stratification were analyzed. [Results] A total of 1778 suspected patients were enrolled. Pathological findings confirmed PCa in 1465 cases (82.4%), with 487(33.2%) diagnosed as metastatic PCa. Over the past decade, the number of patients undergoing prostate biopsy for highly suspected PCa and being confirmed has been increasing annually, with the proportion of metastatic cases remaining at around 30%. Compared with those with PSA level being 20-50 ng/mL, patients with PSA level >50 ng/mL had older age, lower BMI, higher PSAD, higher PI-RADS, higher ISUP, more diverse pathological types, and a higher incidence of metastasis (P<0.05) with lower proportion of urban residents. Additionally, analysis of metastatic PCa cases showed that 46.8%(228/487) had oligometastasis (≤5 metastatic lesions), including 99.0% bone metastasis, 4.1% extraregional lymph node metastasis, and 4.3% other organ metastasis. [Conclusion] Over the past 10 years, there has been a continuous increase in the number of treatment-naive biopsied cases and newly diagnosed cases of highly suspicious PCa with PSA level ≥20 ng/mL, while the proportion of metastatic cases remains high. Therefore, proactive efforts should be made to promote early screening of high-risk suspected cases.

Objective:To explore the dosimetric differences of different dose accumulation method for brachytherapy combined with external beam radiation therapy (EBRT) of cervical cancer and establish clinical prediction models for radiation-induced late rectal injury (RLRI) after radiotherapy.Methods:A retrospective analysis was conducted for the clinical data of patients who received radical concurrent chemoradiotherapy (CCRT) for cervical cancer in the Department of Oncology of the Affiliated Hospital of North Sichuan Medical College from January 1, 2020 to November 30, 2021. EBRT combined with brachytherapy was employed for the patients, and dose assessment was performed in two means: the direct accumulation using equivalent dose in 2-Gy fractions (EQD2) and deformable image registration (DIR)-based dose accumulation of 3D planning images. The toxicity criteria of the Radiation Therapy Oncology Group were adopted as the RLRI grading criteria. The prediction models of RLRI using both dose assessment method were constructed. The areas under the receiver operating characteristic (ROC) curves were calculated to assess the predictive accuracy of the different dose assessment method.Results:In the case of brachytherapy, the D95% and D90% EQD2 doses to high-risk clinical target volumes (HR-CTVs) were 2.18 and 2.92 Gy higher respectively and the D2 cm 3, D1 cm 3, and D0.1 cm 3 EQD2 doses to the rectal were 1.74, 2.28, and 2.26 Gy higher, respectively compared to DIR-based dose accumulation ( t = 3.82, 5.21, 4.58, 5.17, 2.05, P < 0.05). For EBRT combined with brachytherapy, the D2 cm 3, D1 cm 3, and D0.1 cm 3 EQD2 doses to the rectal were 6.22, 7.61, 9.56 Gy higher than DIR-based doses, respectively, and the dosimetric differences were statistically significant ( t = 9.40, 10.59, 7.87, P < 0.001). The joint prediction model yielded an area under the ROC curve of 0.788. The sensitivity and specificity of the optimal cut-off value were 0.850 and 0.660, respectively. Furthermore, the Hosmer-Lemeshow goodness-of-fit tests indicated high goodness-of-fit ( P > 0.05). The prediction model for DIR-based dose accumulation of traditional predictors yielded areas under the ROC curves for D2 cm 3 and D1 cm 3 to the rectal of 0.784 and 0.763, respectively. The sensitivities of the optimal cut-off values were 0.850 and 0.750, respectively, and the specificities were 0.679 and 0.717, respectively. Conclusions:There are dosimetric differences between the direct dose accumulation using EQD2 and DIR-based dose accumulation of 3D planning images for brachytherapy combined with EBRT. Both the joint prediction model and the DIR-based dose accumulation of D2 cm 3 and D1 cm 3 to the rectal are effective in predicting RLRI. Given the complex calculation of the joint prediction model, it is recommended that RLRI should be predicted through DIR-based dose accumulation of D2 cm 3 and D1 cm 3 to the rectal clinically.

Objective:To explore the clinical characteristics of superficial neoplasia associated with submucosal tumor (SMT) located at the same position and the efficacy of endoscopic super minimally invasive surgery (SMIS).Methods:Data of 9 patients who were diagnosed as having superficial neoplasia associated with SMT at the same position in the upper digestive tract and treated with digestive endoscopic SMIS at the First Medical Center of PLA General Hospital from January 2011 to December 2021 were retrospectively analyzed. Data including basic information, endoscopic diagnosis and treatment, pathological results and follow-up of these patients were collected to analyze their clinicopathological characteristics. The postoperative pathology and incidence of complications were used as the gold standard to assess the effectiveness and safety of SMIS.Results:In the 9 patients, there were 8 males and 1 female with mean age of 61.6±11.7 years. The main symptoms were abdominal pain in 3 cases, abdominal discomfort in 2 cases, and dysphagia in 1 case. Seven patients were diagnosed as having superficial neoplasia before surgery, while SMT was found during surgery. One patient with superficial neoplasia associated with SMT and 1 with SMT were diagnosed before the surgery. The common sites of the lesion were esophagus (3 cases), gastric antrum (3 cases), cardia (2 cases) and fundus (1 case). The Paris classification of all lesions was type Ⅰ, Ⅱa or combinations. The most common pathological type was early cancer with leiomyoma in 5 cases. All lesions met the criteria of en bloc resection. One lesion had positive lateral margin with low-grade intraepithelial neoplasia, four were all completely resected. No complications such as bleeding, perforation or infection occurred in this study. Follow-up date were available in all cases with a mean period of 19-81 months and no recurrence or metastasis was discovered.Conclusion:The symptoms of patients with superficial neoplasia associated with SMT located at the same position are often atypical. The endoscopic type of lesions is usually protrusion or partial protrusion. Most are diagnosed as having superficial neoplasia before the surgery, and SMT are usually found coincidentally. The most common pathological type is early cancer with leiomyoma. SMIS is safe and effective for the complex lesion.

At present, hepatic resection (HR) and radiofrequency ablation of (RFA) are the main radical treatment methods for small hepatocellular carcinoma (sHCC), while stereotactic body radiotherapy (SBRT) is developing rapidly and there is an increasing number of reports on the effective treatment of sHCC with SBRT. This article introduces the technical advantages, therapeutic dose, and fractionation scheme of SBRT in the treatment of sHCC, as well as the limit of normal liver tissue and the protection of surrounding organs at risk. This article also compares the efficacy of SBRT versus HR and RFA in the treatment of sHCC and briefly describes the adverse reactions of SBRT in the treatment of sHCC. Previous studies have shown that for some sHCC cases, SBRT has an equal or even better clinical effect than HR and RFA, with controllable toxicity. Therefore, SBRT is expected to become another radical treatment method for sHCC.

The severe fever with thrombocytopenia syndrome virus (SFTSV),a new RNA virus,was discovered in recent years,which can lead to fever,thrombocytopenia and multiple organ dysfunction.Picks is the main media A case of a SFTSV-related encephalitis diagnosed by second-generation gene sequencing was reported here.The patient had fever,disturbance of consciousness,convulsions,with thrombocytopenia and enzymatic indicators increased significantly.After active anti-virus and supportive treatment,the prognosis was good.It is our aim to suggest that,in the epidemic season,when you meet thesimilar patients like this,you should consider the possibility of SFTSV-related encephalitis.Virus nucleic acid detection and second-generation gene sequencing technology are helpful for timely diagnosis and treatment and reducing mortality of the disease.

There are many problems in the humanistic education of medical students, such as the decoupling of teaching content and clinical practice, the irrational structure of teachers and the shortage of teaching hours, which leads to a great gap between teaching effect and expectation. Through the combina-tion of humanistic education and clinical practice of medical students and through the optimization of cur-riculum, teaching materials and teaching methods, as well as teachers' structure, we have established and improved the relevant security system, and gradually improved the medical school docking system, the humanistic quality assessment system for medical students and three-dimensional evaluation mechanism of hospital teaching teachers,and constantly raise the level of humanistic quality of medical students.

Objective To investigate the value of MR diffusion tensor imaging (DTI) quantitative parameters in evaluating the injury of the tibial nerve and the common peroneal nerve in patients with Guillain-Barre syndrome(GBS). Methods Sixteen healthy volunteers and sixteen patients with GBS underwent DTI examination of the tibial nerve and the common peroneal nerve. The denervation of skeletal muscles controlled by the tibial nerve and the common peroneal nerve was observed. The apparent diffusion coefficient (ADC) value, fractional anisotropy (FA) value, axial diffusivity (AD) value and radial diffusivity (RD) value were measured respectively,and diffusion tensor tractography (DTT) of the tibial nerve and the common peroneal nerve was performed. Between-groups comparison was made with the independent sample t test and receiver-operating characteristic (ROC) analysis was used to evaluate the diagnostic efficacy of the parameters. Results (1)The MR features of denervated skeletal muscles comprehend hyperintensity on T2WI SPAIR sequence and the instinct boundary, muscle atrophy occationally. (2)Compared with the healthy volunteer group, the ADC value of the tibial nerve and the common peroneal nerve of GBS group was increased and the FA value, AD value, RD value were decreased, and there was significant difference between the ADC value, FA value, AD value and RD value of GBS and volunteer groups respectively(P<0.05). The area under the curve (AUC) of FA value was higher than that of the corresponding ADC value in the tibial nerve and the common peroneal nerve. (3)DTT showed that the number of fibers decreased in patients with GBS compared to the normal volunteers. Conclusion MR can clearly show the denervated skeletal muscles controlled by the tibial nerve and the common peroneal nerve. The ADC value, FA value, AD value and RD value, the quantitative parameters of DTI, can evaluate the injury of the tibial nerve and the common peroneal nerve in patients with GBS.

In the perspective of the theory of intersubjectivity, the educators and the educated in the mental health education of college students establish a subject-subject relationship by experience teach-ing as an intermediary. By focusing on the needs of students, mobilizing the students ' active participation, adopting the experience teaching in small class, the way of formative evaluation, the relationship of mutual integration and mutual promotion are established , which realizes the validity of the College Students ' Mental Health Educationcourse.

It is unable to cultivate students' ability of application and innovation by the traditional teaching form in pharmaceutics for the pharmaceutics is fragmented and intersective with other disciplines. This paper analyzes the characteristics and shortcomings of traditional teaching methods of pharmaceutics. The flipped classroom is applied to pharmaceutics teaching with SPOC, world coffee and hacker. The results shows that the flipped classroom can effectively improve the motivation and learning efficiency of students, especially improve their self-study and innovation ability. It can realize the diversity of teaching evaluation.

Objective To explore the value of contrast-enhanced ultrasound(CEUS) in the evaluation of the renal cortical perfusion in rabbits in low temperature conditions.Methods 20 New Zealand rabbits were randomly divided into five groups,4 rabbits in each group:1) with the first group as the control group (under the conditions of room temperature) ; 2)The second group was treated under-15℃--23℃ for 8hours; 3)the third group was treated under-15℃--23℃ for 4 hours; 4)the fourth group was treated under-6℃--14℃ for 8 hours; 5) the fifth group was treated under-6℃--14℃ for 4 hours.SonoVue was injected via the ear vein at a dose of 0.1 ml/kg,the renal perfusion imaging was made,observing the dynamic image of 0-3 min after the injection and analyzing the time-intensity curves(TIC)obtained from the following parameters:the slope rate of ascending curve(A),the slope rate of descending curve(α),area under the curve (AUC),time to peak (TTP),and derived peak intensity(DPI).Results Compared with the control group,the A,α of the second and the fourth group were significantly decreased (P ＜ 0.05),while the AUC was significantly increased (P ＜ 0.05) and the TTP was significantly prolonged(P ＜0.05),for the third and the fifth group,only the A was decreased (P ＜0.05),and the DPI in each group showed no significant difference.Compared with the third and the fourth group,the AUC of the second group was increased and the TTP was prolonged (P ＜0.05).Conclusions Contrast-enhanced ultrasound can reflect the earlier renal cortical hemodynamic changes in rabbits in the low-temperature conditions,and is of great value for the early diagnosis of renal damage caused by low temperature.