The CyberKnife, an acronym for the stereotactic radiosurgery platform, represents an image-guided stereotactic radiotherapy technique. This technology precisely delivers ionizing radiation to tissues, effectively damaging tumor cells, and is suitable for radiotherapy of both intracranial and extracranial tumors. This article reports the first performance of CyberKnife by radiotherapy at Peking Union Medical College Hospital, including a patient with uncontrolled pituitary adenoma after surgery and radiotherapy, and another patient with vertebral metastasis following targeted therapy for lung adenocarcinoma. The application of CyberKnife technology in radiotherapy has achieved highly accurate dose delivery, enabling targeted irradiation of tumor lesions while minimizing damage to surrounding normal tissues, thereby yielding relatively ideal clinical outcomes.

Objective:To screen the active components, target genes and signaling pathways of Shaoteng Decoction in the treatment of Sjogren's syndrome by network pharmacology; To conduct relevant experimental verification to explore the mechanism of action of Shaoteng Decoction in the treatment of Sjogren's syndrome.Methods:The active components and targets of Shaoteng Decoction were collected by retrieving TCMSP. The target genes of Sjogren's syndrome were collected through the GeneCards database. The intersection targets of drugs and diseases were obtained by using Venn. The intersection targets were imported into the STRING database to obtain PPI networks, and the "drug-active component -therapeutic target-disease" network was constructed by Cytospace 3.7.2 software. The DAVID database was used for GO function enrichment analysis and KEGG pathway analysis. The 18 NOD mice were divided into model group, TCM group, hydroxychloroquine group, with 6 mice in each group, and 6 Balb/C mice were set as normal control group. TCM group was gavaged with 2.3 g/kg of Shaoteng Decoction, hydroxychloroquine group was gavaged with 60 mg/kg of hydroxychloroquine, and model group and normal control group were gavaged with equal volume of deionized water once a day for 4 consecutive weeks. The daily water intake of mice during the administration period was recorded, the pathological changes of submandibular gland tissue were observed by HE staining, and the levels of serum inflammatory factors IL-17 and TNF-α were determined by ELISA method.Results:39 main active components of Shaoteng Decoction, 1 062 targets of Sjogren's syndrome, and 64 targets of drug and disease intersection were obtained, including TNF, IL6, NCOA1, AKT1, TP53, etc. The treatment targets of Sjogren's syndrome mainly affected biological processes such as response to bacterium and cellular response to lipid, and regulated TNF-α pathway and IL-17 signaling pathway. The experimental results showed that the levels of TNF-α and IL-17 in the TCM group were lower than those in the model group ( P<0.05). Conclusion:Shaoteng Decoction can regulate IL-17 and TNF-α signaling pathways, inhibit inflammation, delay submandibular gland disruption, and alleviate the symptoms of Sjogren's syndrome.

The clinical data of 160 elderly patients with upper urinary tract stones who underwent flexible ureteroscopic lithotripsy (FURL) in Beijing Hospital from May 2021 to November 2022 were retrospectively analyzed, including 80 patients with ambulatory surgery (study group) and 80 patients with the traditional surgery (control group). The efficacy and safety were compared between two groups. There were no significant differences in the rate of complete stone removal (91.3% (73/80) vs. 90.0% (72/80), P>0.05), operation time (60.0 (41.0, 90.0)min vs.61.0(50.0, 96.5)min, P>0.05), and incidence of postoperative systemic inflammatory response syndrome (SIRS) (8.8% (7/80) vs.12.5% (10/80), P>0.05) between two groups, while the postoperative length of hospital stay (5.0 (5.0, 6.0)h vs. 18.0 (16.2, 30.0)h, P<0.05) was shorter and the medical expenses ((20 696.7±4 645.5)Yuan vs. (31 030.8±6 275.1)Yuan, P<0.05) was less in the study group than those in the control group. The study indicates that the day surgery mode of flexible ureteroscopic lithotripsy has advantages of faster recovery and less cost over the traditional surgery mode for elderly patients.

Objective To compare the effects of 20 mg qd and 10 mg bidadministration of iprrazole enteric-coated tablets on the control of gastric acid in healthy subjects.Methods A randomized,single-center,parallel controlled trial was designed to include 8 healthy subjects.Randomly divided into 2 groups,20 mg qd administration group:20 mg enteric-coated tablets of iprrazole in the morning;10 mg bid administration group:10 mg enteric-coated tablets of iprrazole in the morning and 10 mg in the evening.The pH values in the stomach of the subjects before and 24 h after administration were monitored by pH meter.The plasma concentration of iprazole after administration was determined by HPLC-MS/MS.The main pharmacokinetic parameters were calculated by Phoenix WinNonlin(V8.0)software.Results The PK parameters of iprrazole enteric-coated tablets and reference preparations in fasting group were as follows:The Cmax of 20 mg qd group and 10 mg bid group were(595.75±131.15)and(283.50±96.98)ng·mL-1;AUC0-t were(5 531.94±784.35)and(4 686.67±898.23)h·ng·mL-1;AUC0-∞ were(6 003.19±538.59)and(7 361.48±1 816.77)h·ng·mL-1,respectively.The mean time percentage of gastric pH＞3 after 20 mg qd and 10 mg bid were 82.64％and 61.92％,and the median gastric pH within 24 h were 6.25±1.49 and 3.53±2.05,respectively.The mean gastric pH values within 24 h were 5.71±1.36 and 4.23±1.45,respectively.The correlation analysis of pharmacokinetic/pharmacodynamics showed that there was no significant correlation between the peak concentration of drug in plasma and the inhibitory effect of acid.Conclusion Compared with the 20 mg qd group and the 10 mg bid group,the acid inhibition effect is better,the administration times are less,and the safety of the two administration regimes is good.

Objective To explore the mechanism of electroacupuncture pretreatment(EP)for relieving post-stroke spasticity in rats.Methods Eighteen rats were randomized equally into sham-operated group,middle cerebral artery occlusion(MCAO)group,and MCAO+EP group.In MCAO+EP group,the rats received electroacupuncture at the acupoints Qubin and Baihui for 3 consecutive days prior to MCAO.Neurological deficits and cognitive function of the rats were evaluated,and pathologies in the hippocampus were examined using HE,Nissl,and TUNEL staining.The expressions of IL-4,IL-6,TNF-α,and TMAO in the brain tissues were detected with ELISA,and the mRNA and protein expression levels of NF-κB p65,NLRP3,caspase-3,and caspase-9 were determined with qRT-PCR,Western blotting,and immunohistochemistry.Results The rats receiving MCAO had significantly increased neurological deficit scores and showed increased muscle tension,number of apoptotic neurons,and expressions of IL-6,TNF-α,NF-κB p65,NLRP3,caspase-3 and caspase-9 in the hippocampus and significantly reduced length of time for new object recognition.Microscopically,the cells in the hippocampus of the MCAO rats showed uneven and loosened arrangement and unclear cell boundaries.In contrast,the rats in I/R+EP group showed significantly lowered neurological deficit scores and dystonia rating scores,reduced cell apoptosis,lowered hippocampal expressions of IL-6,TNF-α,caspase-3,caspase-9,and NF-κB p65,increased time for new object recognition,tightly arranged and uniformly stained hippocampal cells with clear boundaries,with also an increased number of active neurons and enhanced expression of IL-4 in the hippocampus.Conclusion EP alleviates post-stroke spasticity in rats by inhibiting inflammatory responses and hippocampal neuronal apoptosis mediated by the NF-κB/NLRP3 signaling pathway.

Objective To explore the diagnosis and treatment method of peripelvic cysts.Methods A retrospective analysis was conducted on 65 patients with peripelvic cysts admitted to the Department of Urology at Shanghai Xuhui Central Hospital from January 2019 to January 2023.The diagnostic value of ultrasound,intravenous urography(IVU),and computed tomography urography(CTU)for peripelvic cysts was compared,and the efficacy of different surgical treatments for peripelvic cysts was further evaluated.Results All 65 patients underwent ultrasound examination,which indicated cystic lesions at the renal hilum.55 patients underwent IVU examination,but no cyst enhancement was found.Among them,7 patients underwent retrograde pyelography due to poor imaging of the affected renal pelvis.All 53 patients who underwent CTU examination,which clearly showed the renal pelvis and cysts.Among the 65 patients,5 did not undergo surgical treatment and were followed up,while 60 underwent surgery.Four patients were considered for radical nephrectomy due to suspected malignancy.56 cases underwent renal cysts decompression surgery,including 11 open surgeries,37 laparoscopic surgeries,and 8 Da Vinci robot-assisted laparoscopic surgeries.The operative time in the open surgery group was significantly shorter than that in the laparoscopic surgery group and robot-assisted laparoscopic surgery group.Compared with the open surgery group and laparoscopic surgery group,the robot-assisted laparoscopic surgery group had less intraoperative blood loss,lower postoperative analgesic use,shorter time to first ambulation after surgery,and shorter hospital stay.Conclusions Ultrasound,IVU,and CTU are commonly used effective diagnostic tools for peripelvic cysts.Ultrasound can be used as a routine examination,while CTU is more accurate and has a higher diagnostic accuracy than IVU for this condition.Compared with open surgery,laparoscopic and robot-assisted laparoscopic cyst decompression surgery for peripelvic cysts result in less intraoperative blood loss and faster postoperative recovery.

Objective:To explore the relationship between BMI and levels of plasma amino acids and acylcarnitines in Chinese adults.Methods:Based on 2 182 individuals with targeted mass spectrometry metabolomic measurements from the first resurvey of the China Kadoorie Biobank, we assessed the linear and nonlinear associations between BMI and plasma levels of 20 amino acids and 40 acylcarnitines using linear regression models and restricted cubic spline models, and identified BMI-related metabolic pathways. We conducted one-sample Mendelian randomization (MR) with BMI genetic risk scores as the instrumental variable further to explore the potential causal relationships between BMI and 20 amino acids and 40 acylcarnitines, and tested for horizontal pleiotropy using the MR-Egger method.Results:Observational analyses found that BMI was associated with increased plasma levels of 3 branched-chain amino acids (isoleucine, leucine, and valine), 2 aromatic amino acids (phenylalanine and tyrosine), 3 other amino acids (cysteine, glutamate, lysine), and 7 acylcarnitines (C3, C4, C5, C10, C10:1, C14, and C16), and with decreased circulating levels of asparagine, serine, and glycine. Pathway analysis identified 7 BMI-related amino acids metabolic pathways (false discovery rate corrected all P<0.05), including branched-chain amino acids and aromatic amino acids biosynthesis, glutathione metabolism, etc. BMI showed a nonlinear relationship with leucine, valine, and threonine, and a linear relationship with other amino acids and acylcarnitines. One-sample MR analyses revealed that BMI was associated with elevated levels of tyrosine and 4 acylcarnitines [C5-DC(C6-OH), C5-M-DC, C12-DC, and C14], with tyrosine and acylcarnitine C14 positively correlated with BMI in both observational [the β values (95% CIs) were 0.057 (0.044-0.070) and 0.018 (0.005-0.032), respectively] and One-sample MR analyses [the β values (95% CIs) were 0.102 (0.035-0.169) and 0.104 (0.036-0.173), respectively]. The MR analyses of the current study satisfied the 3 core assumptions of instrumental variable. Conclusions:BMI was associated with circulating 11 amino acids and 7 acylcarnitines in Chinese adults, involving several pathways such as branched-chain amino acid and aromatic amino acid metabolism, fatty acid metabolism, and oxidative stress. There may be a causal relationship between BMI and tyrosine and acylcarnitine C14.

Objective To observe the clinical efficacy of"three modulation acupuncture"combined with repeated functional magnetic stimulation(rFMS)in the treatment of neurogenic bladder with detrusor muscle weakness after spinal cord injury.Methods A total of 120 patients with neurogenic bladder with detrusor muscle weakness after spinal cord injury were divided into conventional treatment group,"three modulation acupuncture"treatment group,rFMS treatment group and comprehensive treatment group according to the random number table method,with 30 patients per group.The conventional treatment group was given conventional rehabilitation treatment,the"three modulation acupuncture"treatment group was treated with"three modulation acupuncture"(modulating spirit,modulating reflex arc,and modulating lower jiao and waterway)based on conventional rehabilitation treatment,the rFMS treatment group was treated with rFMS based on conventional rehabilitation treatment,and the comprehensive treatment group was treated with"three modulation acupuncture"and rFMS based on conventional rehabilitation treatment.The first desire to void(FDV),maximum cystometric capacity(MCC),maximum detrusor pressure of urine storage period(Pdet.max),maximum intravesical pressure of urine storage period(Pves.max),average daily urination frequency,average daily urine leakage,residual urine volume,and neurogenic bladder symptom scores of the patients were compared before and after treatment,and the clinical effectiveness of each group was evaluated.Results After treatment,the FDV,MCC,and Pdet.max of the four groups were all increased compared with those before treatment,and Pves.max,the average daily urination frequency,the average daily frequency of urine leakage,the residual urine volume,and the neurogenic bladder symptom scores were all decreased(P<0.05).After treatment,the FDV,MCC,and Pdet.max of the"three modulation acupuncture"treatment group,the rFMS treatment group and the comprehensive treatment group were all higher than those of the conventional treatment group,and Pves.max,the average daily urination frequency,the average daily frequency of urine leakage,the residual urine volume,and the neurogenic bladder symptom scores were all lower(P<0.05).After treatment,the comprehensive treatment group had a higher FDV,MCC,and Pdet.max than the"three modulation acupuncture"treatment group and rFMS treatment group,and Pves.max,the average daily urination frequency,the average daily frequency of urine leakage,the residual urine volume,and the neurogenic bladder symptom scores were lower(P<0.05).The curative efficiency rates were 86.2%(25/29)in the"three modulation acupuncture"treatment group,85.7%(24/28)in the rFMS treatment group,and 92.6%(25/27)in the comprehensive treatment group,which was higher than that of the conventional treatment group,which was 75.9%(22/29).Conclusion"Three modulation acupuncture"and rFMS can effectively improve the functional status of the bladder in patients of neurogenic bladder with detrusor muscle weakness after spinal cord injury,and their combined application has a synergistic effect.

This study was performed to explore the effects of berberine(BBR)and berbamine(BA)on the apoptosis and activity of eosinophils,and to provide new ideas for the treatment of eosinophil-related diseases.Anticoagulated whole blood was taken from hospitalized patients,and eosinophils were purified by magnetic bead sorting technology,and the cell purification rate was compared by using flow cytometry.The purified eosinophils were cultured and stimulated with different concentrations of BBR and BA,and the apoptosis of eosinophils was observed using immunofluorescence microscopy.Flow cytometry was used to detect the apoptosis rate,reactive oxygen species(ROS)release,mitochondrial membrane potential,and CD11b,CD62L and CD63 molecular expression of eosinophils.Data showed that 10 μmol/L BBR displayed significant anti-apoptosis effect on eosinophils at 18 h,24 h,48 h,however,100 μmol/L and 150 μmol/L BBR displayed significant apoptosis-promoting effects on eosinophils at 24 h,48 h,especially in the early stage.BA at 5 μmol/L,15 μmol/L and 25 μmol/L showed significant apoptosis-promoting effects on eosinophils at 24 h,48 h,especially in the late stage.In eosinophils,BA stimulated the production of ROS and the decrease of mitochondrial membrane potential in a concentration-dependent manner,reaching the maximum effect at 25 μmol/L,while BBR stimulation did not change mitochondria and ROS.Pretreatment with 25 μmol/L BA significantly inhibited the increase of CD11b expression and the decrease of CD62L expression in eosinophils after eotaxin-2 stimulation.In conclusion,berberine has a bidirectional regulatory effect on the quantity of eosinophils,while berbamine promotes eosinophil apoptosis and inhibits eosinophil activation.Both compounds hold significant potential for regulating the progression of eosinophil-associated diseases,and their regulatory mechanisms need further investigation.

Objective:To evaluate the efficacy of modified corporeal rotation technique in the treatment of congenital penile downward curvature.Methods:A retrospective analysis was conducted on the clinical data of 32 patients with congenital penile curvature who underwent surgical procedure in Beijing Hospital from June 2021 to December 2022. The patients' age was (25.3±5.4) years old, preoperative erect penile length was (14.0±1.4) cm, preoperative erect penile circumference was (12.3±0.6) cm, preoperative erect penile downward curvature angle was (41.8±9.3)°, and preoperative International Index of Erectile Function(IIEF-5) score was (19.6±2.8). All 32 cases underwent modified corporeal rotation technique with local anesthesia, while the surgical instruments and suturing techniques employed in this study aimed to minimize damage to the penile neurovascular bundle by utilizing plastic surgery instruments and magnifier. Additionally, the use of inverted horizontal mattress sutures, with knots embedded within the tissue, was implemented to reduce their impact on postoperative patient satisfaction. Surgical time, preoperative and immediate postoperative penile length, circumference, and curvature angle were recorded. Follow-ups were conducted at 1, 3, and 6 months postoperatively, and IIEF-5 scores, postoperative penile sensation scores, and surgery-related complications (wound pain, infection, poor incision healing, etc.)were recorded.Results:The immediate postoperative erect penile length was (13.9±1.4) cm, with no statistically significant difference compared to preoperative length( P=0.127).The immediate postoperative erect penile curvature angle was (2.1±1.1) °, with a statistically significant difference compared to preoperative angle, ( P<0.01). IIEF-5 scores at 1, 3, and 6 months postoperatively were (20.4±1.7), (22.0±1.0), and (22.3±0.8) respectively, compared with preoperative scores, the differences were statistically significant ( P<0.001). The proportions of patients with fully restored glans sensation at 1, 3, and 6 months postoperatively were 0, 31.2% (10/32), and 68.8% (22/32), respectively, with sensation scores of (1.1±0.8), (3.2±0.6), and (3.7±0.5). Three patients (9.0%) experienced poor ventral wound healing postoperatively, but fully recovered after regular wound dressing. Conclusions:The modified corporeal rotation technique effectively corrects congenital penile downward curvature without significant loss of penile length, no adverse effects on erectile function or neurological damage were found, presenting high surgical safety and clinical value.