【Objective】 To investigate the efficacy and safety of 450 nm blue laser with 6 o’clock positioning in the treatment of middle lobe hyperplasia of prostate, in order to promote the clinical application of this surgery. 【Methods】 Clinical data of 20 patients with middle lobe hyperplasia of prostate treated with 450 nm blue laser with 6 o’clock positioning during Mar.and Aug.2023 were retrospectively analyzed.The operation time, postoperative bladder irrigation time, catheter indwelling time, hospital stay, and complications were recorded.The maximum urinary flow rate (Qmax), post-void residual volume (PVR), quality of life scale (QoL), international prostate symptom score (IPSS) before surgery and 1 month after surgery were compared. 【Results】 The operation time was (26.80±7.22) min, and bladder irrigation time was (20.50±1.79) h.The catheter was removed on the next day after surgery and all patients were discharged 2 days after operation.Compared to preoperative, one month after surgery, the Qmax [(7.40±1.05) mL/s vs.(19.60±1.76) mL/s] was significantly higher, PVR [(73.50±12.26) mL vs.(9.25±4.94) mL], QoL [(4.55±1.19) vs.(1.95±0.95)], and IPSS [(26.55±1.88) vs.(10.05±1.36)] were significantly lower, the differences being statistically significant (P<0.05).No complications occurred during operation and 1-month follow-up. 【Conclusion】 The 450 nm blue laser with 6 o’clock positioning is a new, safe and effective surgical treatment of middle lobe hyperplasia of prostate, which is worthy of clinical promotion and application.

OBJECTIVE To observe the preventive and therapeutic effect of Ganoderma lucidum spore powder on cancer-related fatigue in postoperative adjuvant chemotherapy patients with breast cancer, and to provide a basis for using traditional Chinese medicine processed by modern processing to effectively improve the quality of life of cancer patients. METHODS Seventy-four female patients who received postoperative adjuvant chemotherapy for breast cancer in Zhejiang Cancer Hospital from November 2021 to March 2023 were randomly divided into either treatment(n=37) or control group(n=37). Both groups were given 4 cycles of epirubicin(or liposomal doxorubicin) combined with cyclophosphamide adjuvant chemotherapy and corresponding symptomatic treatment: the treatment group was treated with sporoderm-removed Ganoderma lucidum spore powder 2 g·d–1, and the control group was treated with placebo. The incidence and severity of cancer-related fatigue, the changes in T lymphocyte subsets, serum inflammatory factors, intestinal flora, and the effects of drugs on blood routine, liver, and kidney function were compared between the two groups after treatment. RESULTS The incidence of cancer-related fatigue and the score of the Piper correction scale in the treatment group were significantly lower than those in the control group(P<0.05), the proportion of CD3+, CD4+, and CD3-CD56+ was significantly higher than that in the control group(P<0.05), while the proportion of CD8+ was significantly lower than that in the control group(P<0.05). The counts of IL-2 and IL-10 were higher than those in the control group, while the counts of IL-6, IL-8, and CRP were lower than those in the control group(P<0.05). The counts of leukocytes, neutrophils, and platelets in the control group were significantly higher than those in the control group(P<0.05), and the abundance of intestinal microflora in the control group was higher than that in the control group. There was no significant difference in liver and kidney function between the 2 groups. CONCLUSION Sporoderm-removed Ganoderma lucidum spore powder can significantly reduce the incidence and level of cancer-related fatigue in breast cancer patients during adjuvant chemotherapy, inhibit inflammatory factors, regulate intestinal flora and body immunity.

【Objective】 To explore the effects of sexual function-preserving 450 nm blue laser vaporization of the prostate on the postoperative sexual function of patients with benign prostatic hyperplasia (BPH), and to evaluate the clinical efficacy, safety and feasibility of this procedure. 【Methods】 The clinical data of 20 BPH patients treated in our department during Jan. and Mar.2023 were analyzed. The International Prostate Symptom Score (IPSS), Quality of Life Scale (QoL) score, maximum urinary flow rate (Qmax), residual urine volume (PVR) and International Index of Erectile Function (IIEF-5) data were compared before and after the operation. The operation time, postoperative catheter indwelling time, and hospital stay were recorded. The ejaculation status 2 months after operation was followed up. 【Results】 All 20 patients completed the operation successfully. The operation time was (13.41±4.30) min, catheter indwelling time (1.2±0.4) d, and hospital stay (3.0±0.6) d. The IPSS, QoL, PVR and Qmax data 1 month after operation were significantly improved compared with those before operation (P<0.01). Two months after operation, all patients had sex and ejaculated, and no retrograde ejaculation occurred. The erection function remained unchanged (P>0.05). 【Conclusion】 The modified 450 nm blue laser vaporization of the prostate can improve the urination symptoms of BPH patients while retaining sexual function. It is a safe and feasible technique for BPH patients who have sexual needs, and provides an alternative surgical approach for those looking to preserve sexual function.

Objective: To explore the epidemic characteristics of injury related deaths in children and adolescents aged 1-24 years old in China from 2010 to 2020, so as to provide a basis for the formulation of policies and measures related to the control of injuries and deaths among children and adolescents. Methods: The data were sourced from the China Death Cause Monitoring Dataset from 2010 to 2020. Annual percentage change (APC) and average annual percentage change (AAPC) of injury deaths in China in this age group during the period 2010 to 2020 were analyzed by Join point regression. Results: From 2010 to 2020, the standardized death rate of injury showed a decreasing trend (AAPC=-6.90%, t =4.58, P <0.01). The standardized death rates of male and rural injuries showed an overall downward trend, with AAPC rates of -8.37% and -7.79%( t =11.87, 10.34, P <0.01). An increasing trend was observed in the 20-24 year-old age group during 2010-2018 (APC=18.11%, t =6.50, P <0.01). The death rate from injuries was higher in males than females, and higher in rural areas compared with urban areas ( χ 2=16 483.64, 3 268.65 , P <0.01). A downward trend was observed in accidental falls and suicide, the overall standardized mortality rate of traffic accidents, accidental poisoning, fire, drowning, homicide and other injuries (AAPC=-10.22%, -6.21%, -7.50%, -7.94%, -9.01% , -10.97%, t =16.23, 7.29, 2.53, 9.32, 7.88, 4.58, P <0.05). Conclusion From 2010 to 2020, the overall injury standardized mortality rate in the 1-24 year-old age group shows a decreasing trend, but it remains at a relatively high level. Prevention efforts should be continuously strengthened, especially for urban areas, and should focus on women and those aged 20-24 years old, as well as accidental falls and suicide prevention.

In addition to respiratory symptoms, COVID-19 can also cause acute and long-term symptoms of the central nervous system, peripheral nervous system and muscular system. This article reviews the epidemiological characteristics, clinical manifestations and treatment methods of acute COVID-19 related cerebrovascular diseases, nervous system inflammatory diseases and encephalopathy, in order to provide references for clinical management of COVID-19 patients.

Background::The dermoscopic features of rosacea have already been reported. However, the current findings are incomplete, and little is known about phymatous rosacea. Hence, this study aimed to summarize and compare the dermoscopic features and patterns of three rosacea subtypes (erythematotelangiectatic [ETR], papulopustular [PPR], and phymatous [PHR]) in the Chinese Han population and to evaluate whether these features differ with patients’ genders, ages, and durations.Methods::Dermoscopic images of 87 rosacea patients were collected in non-polarized and polarized dermoscopy contact modes at 20-fold magnification. Dermoscopic features, including vessels, scales, follicular findings, and other structures, were summarized and evaluated.Results::The reticular linear vessels and red diffuse structureless areas of ETR were distinctive. For PPR, red diffuse structureless areas, reticular linear vessels, yellow scales, follicular plugs, and follicular pustules were typical dermoscopic criteria. The common dermoscopic features of PHR were: orange diffuse structureless areas, linear vessels with branches, perifollicular white color, orange focal structureless areas, and white lines. The following features statistically differed among the three rosacea subtypes: reticular linear vessels ( P < 0.001), unspecific linear vessels ( P= 0.005), linear vessels with branches ( P < 0.001), yellow scales ( P = 0.001), follicular plugs ( P < 0.001), perifollicular white color ( P < 0.001), red diffuse structureless areas ( P = 0.022), orange diffuse structureless areas ( P < 0.001), red focal structureless areas ( P = 0.002), orange focal structureless areas ( P = 0.003), white lines ( P < 0.001), follicular pustules ( P < 0.001), and black vellus hairs ( P < 0.001). Conclusions::The dermoscopic patterns of ETR are red diffuse structureless areas and reticular linear vessels. For PPR, the pattern comprehends combinations of red diffuse structureless areas, reticular linear vessels, yellow scales, follicular plugs, and follicular pustules. Meanwhile, PHR is characterized by remarkable orange diffuse structureless areas, linear vessels with branches, perifollicular white color, orange focal structureless areas, and white lines.

Objective:To investigate the effects of intravenous thrombolysis with alteplase on immune function and quality of life in patients with cerebral infarction.Methods:Sixty-nine patients with cerebral infarction who received treatment in Rizhao Central Hospital, China between January 2014 and January 2019 were included in this study. They were randomly assigned to receive either intravenous thrombolysis with urokinase (control group, n = 34) or intravenous thrombolysis with alteplase (observation group, n = 35). Therapeutic efficacy and cerebral blood perfusion, immune function and quality of life before and after treatment were evaluated. Results:Effective rate in the observation group was significantly higher than that in the control group [82.86% (29/35) vs. 58.82% (20/34), χ2 = 4.840, P < 0.05]. After treatment, the transit time and peak time in the ischemic area in the observation group were (131.25 ± 25.41) seconds and (99.52 ± 17.50) seconds respectively, which were significantly shorter than those in the control group [(165.33 ± 31.05) seconds, (108.45 ± 12.52) seconds, t = 6.580, 3.215, both P < 0.05). The cerebral blood flow and cerebral blood volume in the observation group were (72.51 ± 21.35) mL/100 mg and (95.36 ± 31.25) mL/100 mg, respectively, which were significantly higher than those in the control group [(62.42 ± 19.35) mL/100 mg, (84.20 ± 28.05) mL/100 mg, t = 2.712, 2.243, both P < 0.05). After treatment, the proportion of CD 8+ cells in the observation group was significantly lower than that in the control group [(25.37 ± 3.73)% vs. (27.42 ± 3.25)%, t = 4.261, P < 0.05]. The proportions of CD 3+, CD 4+, CD 3-CD 16+CD 56+ cells in the observation group were (56.32 ± 6.57)%, (34.69 ± 3.44)%, (13.34 ± 3.75)%, respectively, which were significantly higher than those in the control group [(53.32 ± 4.05)%, (31.69 ± 3.72)%, (11.28 ± 3.06)%, t = 5.395, 3.694, 4.179, P < 0.05]. After treatment, the scores of all dimensions of Short Form 36 Health Status Questionnaire in the observation group were significantly higher than those in the control group (all P < 0.05). Conclusion:Intravenous thrombolysis with alteplase is superior to intravenous thrombolysis with urokinase in the treatment of cerebral infarction because it can better improve immune function and quality of life.

Objective:To explore effects of intervention based on story theory on self-management behavior and emotional state of patients with rectal cancer undergoing anus-preserving surgery.Methods:Using the convenient sampling method, a total of 80 patients with rectal cancer who underwent anus preserving surgery in Henan Provincial People's Hospital from January to September 2019 were selected as the research objects. The patients were randomly divided into 42 cases in the control group and 38 cases in the observation group. The patients in the control group adopted perioperative routine nursing methods for patients with rectal cancer, while patients in the observation group adopted an intervention program based on story theory at basis of the control group. Profile of Mood States-Short Form (POMS-SF) and Bowel Symptoms Self-Management Behaviors Questionnaire For Rectal Cancer Patients After Anus Preservation were used for evaluation.Results:In the end, the control group recovered 40 valid questionnaires and the observation group recovered 38 valid questionnaires. After intervention, scores of all dimensions of POMS-SF of the two groups were compared and the differences were statistically significant ( P<0.05) . In the observation group, scores of dimensions of stress-anxiety, depression-depression, anger-hostility, fatigue-dullness and bewilderment-disorder were lower than those of the control group, and the score of energy-vitality was higher than that of the control group. After intervention, there was no statistically significant difference in the score of treatment management dimension in Bowel Symptoms Self-Management Behaviors Questionnaire For Rectal Cancer Patients After Anus Preservation between the two groups ( P>0.05) . The scores of diet management, perianal skin management, seeking help from others and self-emotional adjustment in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Intervention based on story theory can effectively improve the emotional state of patients with rectal cancer undergoing anus-preserving surgery and improve dietary management, perianal skin management, seeking others' help and self-emotional regulation behaviors in patients' intestinal self-management behaviors, which has good clinical application values.

Objective:To analyze the expression of mismatch repair genes MLH1 and PMS2 in elderly colorectal cancer patients and its association with the clinicopathological features.Methods:This study was a single-center retrospective cohort study.According to the loss of MLH1 and PMS2 gene expression, elderly patients with colorectal cancer admitted to Beijing Hospital from January 2014 to December 2018 were consecutively enrolled and divided into the MLH1 group(n=65)and the PMS2 group(n=80). Pathological features were compared between the MLH1 group, the PMS2 group and patients with normal MLH1 and PMS2 gene expression.Results:Among patients with the loss of MHL1 protein expression, pathological features were similar in males and females.A minority of patients(16.9%)had a family history of tumors.Most lesions were either moderately differentiated(63.1%)or poorly differentiated(24.6%). Regarding staging, 44.6% were in stage T4, 27.7% were in stage T3, 61.5% were in N0, 89.2% were in M0, and most patients were in TNM stage Ⅲ.Lesions were mostly located in the ascending colon(61.5%). Compared with patients with normal expression of MHL1, patients with the loss of MHL1 protein expression were younger[(74.6±8.8) years old vs.(77.3±6.2) years old, t=-2.072, P=0.040]and had greater maximal tumor length[(5.7±2.3) cm vs.(4.4±1.3) cm, t=3.753, P<0.001], and there were significant differences in lesion differentiation, T staging and tumor location between the two groups( P<0.05). Conclusions:Loss of MLH1 or PMS2 gene expression in elderly colorectal cancer patients is associated with an early age of onset, rapid tumor progression, poor differentiation, and pathological staging.