To evaluate the features of carotid web (CW) by ultrasonography.

A total of 66 patients with CW were retrospectively enrolled from January 2018 to June 2019 at Xuanwu Hospital, Capital Medical University. All patients were examined by both ultrasonography and CTA, and were divided into either a<50% stenosis group (54 cases) or a ≥50% stenosis group (12 cases). The ultrasonographic characteristics of CW, including the length, thickness, direction (forward or backward to the flow), acute angle between the web and carotid wall, and thrombus between the web and carotid wall were compared between the two groups. The stenosis degrees of carotid artery were compared between patients with and without ischemic stroke.

Forty-two (42/66, 63.6%) patients were diagnosed with CW by initial CDFI examination, of whom 21 (21/66, 31.8%) were diagnosed with ulcerative plaque and 3 (3/66, 4.5%) were diagnosed with carotid dissection at first but confirmed by second examination. There were no differences in the web length, thickness, direction, or thrombus detected between the two groups (P>0.05). The angle between the web and carotid wall in the<50% stenosis group was significantly smaller than that of the ≥50% stenosis group (median angel 39o vs 73o, P=0.002), and the percentage of patients with an angle≤ 60o in the<50% stenosis group was significantly higher than that of the ≥50% stenosis group (74.1% vs 41.7%, P=0.042). The diameter of the residual carotid artery at CW location in the<50% stenosis group was significantly larger and peak systolic velocity was significantly higher in the<50% stenosis group than in the≥50% stenosis group (P<0.001). The stenosis degrees of carotid artery were not statistically different between patients with and without ischemic stroke (P=0.321).

Ultrasonography can be used to evaluate the characteristics of carotid web in 2D and color mode. When the angle between the CW and carotid wall is large, the carotid artery stenosis ≥ 50% is more likely to happen, but carotid artery stenosis is not the main cause of ischemic stroke.

The aim of the present study was to evaluate the efficiency of sling exercise, therapeuticultrasound, therapeuticultrasound and sling exercise in patients to alleviate pain and improve lumbar function with lumbar disc herniation.

Individuals were selected from a list of patients being followed at the department of Rehabilitation in the third hospital of Hebei Medical University. 30 patients who were diagnosed with lumbar disc herniation were collected, the diagnoses were established upon medical history, physical examination, and results of imaging studies. The patients were randomly divided into three groups: therapeuticultrasound group received 14 sessions of ultrasonic therapy to the lumbar region, Sling exercise group received 14 sessions of sling exercise, and therapeuticultrasound and sling exercise group received therapeuticultrasound and sling exercise therapy 14 sessions of therapeuticultrasound to the lumbar region,7 sessions per week, 2 weeks. The VAS and ODI were compared with the assessment of the patients before and at the end of the therapy.

At the end of treatment, three groups VAS scores (F=3.069, P=0.043) and ODI scores (t=12.676, P<0.001) was lower than that at the beginning of treatment (P<0.05), at the end of treatment the VAS scores (F=59.400, P<0.001) and of the ODI scores (t=12.737, P<0.001) of ultrasonic and sling exercise therapy group was lower than the other group, the difference is significantly.

All three groups could reduce pain and improve lumbar function, and the ultrasonic and sling exercise therapy was most effective for lumbar disc herniation treatment in the three groups.

To analyze the treatment of different types of traumatic cerebral infarction in children, and explore its pathogenesis in combination with literature so as to improve the cure rate and reduce disability rate.

The clinical data of 42 cases of traumatic cerebral infarction in children were retrospectively analyzed in The Hospital of 81^st Group Army PLA from January 2015 to December 2019. The diagnosis of traumatic cerebral infarction in children was made by CT scan and MRI scan. According to different conditions, children with traumatic cerebral infarction were classified, and different treatment strategies were selected. Children with lacunar infarction were treated with calcium antagonists and neurotrophic drugs, supplemented by hyperbaric oxygen and exercise rehabilitation. The children of focal cerebral infarction and complex cerebral infarction treated by junior dehydrant and hormone also included the calcium antagonist and nutritional nerve drugs. The therapeutic regimen perhaps adjusted by the evolution of the disease. The children of extensive cerebral infarction underwent emergency cranial decompression, and was treated by reducing intracranial pressure and preventing complications after operation. The treatment results and recovery were observed.

In 42 cases of traumatic cerebral infarction in children, 35 cases (83.3%) were good recovery, 4 cases (9.5%) were moderate disability, 2 cases (4.8%) were severe disability, 1 case (2.4%) died, and no vegetative state. The good recovery rate of lacunar infarction was 100%, that of focal cerebral infarction was 62.5%, that of mixed cerebral infarction was 60%, and that of extensive cerebral infarction was 50%.

It is of great significance to improve the therapeutic effect and prognosis of children with traumatic cerebral infarction to adopt different treatment schemes for different types of cerebral infarction.

To characterize the patients with supratentorial hypertensive intracerebral hemorrhage (ICH) in the Tibetan Plateau over an altitude of 4000 meters.

A total of 68 cases with supratentorial hypertensive ICH were retrospectively included in Ali Regional People’s Hospital from January 2017 to September 2018. The clinical and laboratory data were collected. A simple linear correlation analysis was applied to analyze the correlation between the amount of bleeding and sex, age, nationality, time from onset , systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), serum triglyceride (TG), and cholesterol. According to computed tomography (CT) findings, 68 cases were divided into the basal ganglia ICH group (33 cases) and the lobar ICH group (35 cases). The characteristics between two groups were analyzed using t-test or χ² test.

The data of sex, age, nationality, time from onset, SBP, DBP, Hb, TG, and cholesterol of 68 cases on admission did not show any definitive correlation with the hematoma volumes (P＞0.05). The SBP and DBP of patients in the basal ganglia ICH group were significantly higher than that in the lobar ICH group, respectively [(184.9±28.5) mmHg vs (164.6±24.4) mmHg; (113.0±18.1) mmHg vs (103.0±18.4) mmHg] (t=0.499, 0.486; P=0.002, 0.033).

The relevant factors of hematoma volumes in patients with ICH in plateau area were not yet clear. Diastolic and systolic blood pressure of patients in the basal ganglia ICH group was higher than that in those in lobar ICH group.

To compare the efficacy evaluation of electrospun composite biomaterials and a porcine small intestine submucosa mesh for hernia repair.

A randomized, single-blind, controlled multicenter trial was performed in 3 hospitals in Shanghai. Eligible adult patients with primary unilateral reducible groin hernias were randomly assigned (1∶1) to electrospun composite biomaterials (experimental group) or porcine small intestine submucosa (control group) mesh groups. Patients were treated with the tARB technique and assessed at 1,3 and 6 months after the surgery. The primary endpoint was hernia recurrence. The secondary endpoints were postoperative complications including groin pain and operative site infections.

172 patients were assigned to experimental (n=86) and control (n=86) groups. At 6 months follow-up, postoperative complications occurred in 5 patients (5/86, 5.95%) and 2 (2/86, 2.35%) patients in the control and experimental groups, respectively (P>0.05). There was no significant difference in VAS or SVS score between the two groups.

We demonstrate that electrospun composite biomaterial mesh can be used as a ideal choice for inguinal hernia repair. Electrospun composite biomaterial has the characteristics of low recurrence rate, absorbability and long-term comfort.It can be further applied in clinical practice in the future.

Pancreaticoduodenectomy(PD)remains one of the most complicated hepatobiliary operations. The development of minimally invasive surgery for PD has always been an hot spot. Laparoscopic pancreaticoduodenectomy(LPD) has not been widespread carried out due to its difficulty and long learning curve. LPD accounts for 9% of all PD, according to the National Cancer Data base. Compared with laparoscopic surgery, robotic surgery system has significant advantages in the field of minimally invasive PD, including stereotactic amplified vision, filtering hand tremor and simulating the wrist. The article would review the surgical techniques and notes, which could provide clinical reference for other surgeons.

To explore the clinical manifestations, renal histopathological features, and prognosis of pediatric lupus nephritis (LN) patients with positive serum antineutrophil cytoplasmic antibody (ANCA).

A total of 53 newly diagnosed LN children who were hospitalized in the Department of Nephrology, Capital Center for Children′s Health, Capital Medical University between January 2015 and February 2024 were selected. Based on the serum ANCA results, the children were divided into study group (n=9, with positive serum ANCA) and control group (n=44, with negative serum ANCA). A retrospective analysis was conducted to collect clinical data on the two groups, including clinical manifestations, laboratory test results, renal histopathological characteristics, and prognosis. Statistical comparisons were performed using independent samples t-test, Mann-Whitney U test, chi-square test, and Fisher′s exact test. This study was approved by the Ethics Committee of the Capital Center for Children′s Health, Capital Medical University (Approval No. SHERLL2021052).

①Among 53 children with LN, 19 were male and 34 were female, with onset age of (11.2±2.8) years. There were no statistically significant differences in general clinical data such as gender ratio and age of onset between the study group and control group (P>0.05). ②Compared with the control group, the study group had lower levels of hemoglobin (Hb) [79.0 g/L (68.0, 88.5 g/L) vs 102.0 g/L (84.3, 113.8 g/L), Z=2.90, P=0.003], and higher systemic lupus erythematosus disease activity index 2000 (SLEDAI-2000) scores [23.0 points (18.0, 30.0 points) vs 18.0 points (16.0, 20.8 points), Z=-2.55, P=0.010], as well as higher erythrocyte sedimentation rate (ESR) [(86.1±43.5) mm/h vs (38.7±27.7) mm/h, t=-4.22, P<0.001]. There were no statistically significant differences in anti double stranded DNA (dsDNA) antibody titers, complement 3 and 4 levels, and incidence of extrarenal organ involvement between the two groups (P>0.05). The study group had higher levels of urine protein, and the difference was statistically significant (Z=-2.11, P=0.034). There were no statistically significant differences between the two groups in pyuria, gross hematuria, incidence of renal insufficiency, serum creatinine (SCr), blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), and the distribution of renal pathological classification (P>0.05). Compared with the control group, the study group had a higher incidence of glomerular necrosis and a higher proportion of cells and cellular fibrous crescents (P=0.012; Z=-2.16, P=0.030). ③The median follow-up time for the study group and control group were 42.0 months (21.5, 63.5 months) and 16.5 months (6.0, 36.8 months), respectively. The complete remission (CR) time in the study group and control group were 2.5 months (2.0, 5.8 months) and 4.5 months (2.3, 6.8 months), respectively, and the difference was not statistically significant (Z=-1.37, P=0.185), and there were no statistically significant differences in the CR rate, the recurrence rate of LN, and the proportion of progress to end-stage renal disease (ESKD) (P>0.05). There were no statistically significant differences in the sustained CR and survival (non-progression to ESKD) curves between the two groups of children (P>0.05).

Compared with LN children with negative serum ANCA, LN children with positive serum ANCA have higher LN activity, more severe anemia and more serious renal damage, requiring timely diagnosis and treatment. However, the relationship between serum ANCA and the long-term prognosis of kidney disease in LN children remains unclear.

To summarize the clinical characteristics, treatment strategies and prognosis of pediatric eosinophilic gastroenteritis (EGE) in children presenting with edema and hypoproteinemia as the main clinical manifestations.

A total of 8 children with EGE (labeled as child 1 to child 8) presenting with edema and hypoproteinemia as the main clinical manifestations, who were diagnosed and treated at the Capital Center for Children′s Health, Capital Medical University from January 2015 to December 2022, were selected as the research subjects. Clinical medical records and follow-up data of all patients were retrospectively analyzed to summarize the clinical characteristics of EGE. This study was approved by the Ethics Committee of the Capital Center for Children′s Health, Capital Medical University (Approval No. SHERLLM2024010).

The diagnosis, treatments, follow-up and prognosis of the 8 children with EGE in this study were as follows. ① Among 8 children with EGE, 4 cases were boys and 4 cases were girls, with an average age of 4 years and 7 months. ② Every child initially presented with edema as the primary symptom: 3 cases had isolated edema; 3 cases had edema with vomiting, abdominal pain, diarrhea and bloating; 1 case had edema with pale complexion; 1 case had edema with black stools. ③ Laboratory testing showed that all patients had reduced serum albumin (14.0-23.4 g/L) and serum globulin (9.1-14.5 g/L). We also found elevated peripheral blood eosinophil (EOS) counts in 7 children, elevated total serum immunoglobulin (Ig)E in 2 children, and low protein levels with anemia in 4 children. ④ Imaging and endoscopic workups revealed that 5 children had lesions in the stomach and duodenum, 1 child in the ileocecal area, and 2 children in the colon and rectum. Endoscopic results were non-specific across the cohort, with the most common findings being mucosal congestion, swelling, redness and erosions; 1 child had no remarkable findings on endoscopy. ⑤ Biopsies taken from multiple parts of the digestive tract demonstrated chronic inflammation of the mucosa in the stomach, duodenum, colon and rectum, with EOS infiltrating the lamina propria in all cases. ⑥ All 8 children required albumin infusions during their hospital stay. For first-line treatment, 7 children were managed with dietary therapy, including 5 children followed a targeted elimination diet based on allergy testing, 2 children avoided 6 common high-allergy foods including seafood, red meat, nuts, eggs and shellfish, and child 7 was given an amino acid-based formula due to his young age. Alongside first-line treatment, 7 children were also prescribed glucocorticoids once EGE was definitively diagnosed. ⑦ Within 1 to 4 weeks of starting these treatments regimen, all children had complete resolution of edema and other gut symptoms, and their peripheral blood EOS levels dropped back to normal.⑧ We followed the 8 children for 12 to 18 months, 7 children had sustained improvement in their clinical symptoms, while child 8 continued to have symptom flares after 15 months of follow-up.

For children with EGE presenting with edema and hypoproteinemia as the main clinical manifestations, no specific clinical symptoms or endoscopic signs can be observed. The diagnosis of this disease mainly relies on the histopathological examination of the gastrointestinal mucosa, for which multiple deep biopsies from different sites should be performed to avoid missed diagnosis. Patient with this disease have a favorable therapeutic response to dietary avoidance therapy and glucocorticoid therapy.

To evaluate the safety and efficacy of endoscopic retrograde cholangiopancreatography (ERCP) in pediatric patients with pancreaticobiliary diseases.

From May 2014 to April 2025, a total of 128 children with pancreatobiliary diseases who underwent ERCP at West China Hospital, Sichuan University, were retrospectively enrolled into this study. Among them, 59 were boys and 69 were girls. According to age, the patients were divided into four groups: toddler group (n=12, 1-3 years old), preschool group (n=24, 4-6 years old), school-age group (n=54, 7-12 years old), and adolescent group (n=38, 13-14 years old). The preoperative disease spectrum, indications for ERCP, procedural success rate, diagnostic and therapeutic outcomes, and postoperative complications were retrospectively analyzed among different age groups. This study was approved by the Biomedical Ethics Committee of West China Hospital, Sichuan University [Approval No. 2025 Review (1621)]. Written informed consent for ERCP was obtained from the legal guardians or authorized representatives of all children.

①Among the 128 children, 70 were preoperatively diagnosed with biliary diseases and 58 with pancreatic diseases. A total of 154 ERCP procedures were performed, of which 132 were successful, with an overall procedural success rate of 85.7% (132/154). Among the successful procedures, 129 were therapeutic ERCP, accounting for 97.7% (129/132). The preschool group had the highest procedural success rate (96.4%, 27/28). ② The main indications for ERCP were bile duct stones (36.7%, 47/128), chronic pancreatitis (21.1%, 27/128), and acute pancreatitis caused by pancreaticobiliary duct obstruction (19.5%, 25/128). Among the 70 children preoperatively diagnosed with biliary diseases, 80 ERCP procedures were performed, with a biliary cannulation success rate of 95.0% (76/80) and a procedural success rate of 91.3% (73/80). Among the 58 children preoperatively diagnosed with pancreatic diseases, 74 ERCP procedures were performed, with a pancreatic duct cannulation success rate of 94.6% (70/74) and a procedural success rate of 79.7% (59/74). In addition, congenital pancreaticobiliary duct anomalies were confirmed by ERCP in some children, including congenital choledochal cysts in 7 cases, pancreaticobiliary maljunction in 9 cases, and pancreas divisum in 2 cases. After ERCP treatment, bile duct stones and pancreatic duct stones were successfully removed, pancreaticobiliary duct obstruction was relieved, and related clinical symptoms were alleviated. Among the 154 ERCP procedures, postoperative complications occurred in 10 procedures, with an overall complication rate of 6.5% (10/154). Post-ERCP pancreatitis (PEP) was the most common complication, occurring in 8 procedures, with an incidence of 5.2% (8/154). Biliary tract infection and stent dislodgement each occurred in 1 procedure, with an incidence of 0.6% (1/154). No bleeding, perforation, or procedure-related mortality was observed.

ERCP showed favorable efficacy and safety in the diagnosis and treatment of pediatric pancreatobiliary diseases and may serve as an important minimally invasive diagnostic and therapeutic approach for these diseases in children.

To explore the willingness of women in Shanghai to participate in cervical and breast cancer screening (hereinafter referred to as " Two-cancer screening" ) and its influencing factors.

From January to June 2025, a two-stage mixed sampling method was adopted to select 779 women participating in the " Two-cancer screening" across 16 districts of Shanghai as research subjects. A field questionnaire survey was conducted using the self-designed Questionnaire on Standardized Management Path of Cervical and Breast Cancer Screening in Shanghai for Service Recipients (hereinaffter referred to as " the Survey Questionnaire" ). The Survey Questionnaire mainly covered four dimensions: ①general information of respondents; ②basic status of respondents′ participation in " Two-cancer screening" ; ③awareness level of respondents regarding prevention and treatment knowledge of the " Two-cancer screening" ; ④respondents′ willingness to underwent " Two-cancer screening". Based on the total score of willingness to underwent " Two-cancer screening", the respondents were divided into low willingness group (n=399, total score of willingness to underwent " Two-cancer screening" < 4 points) and high willingness group (n=380, total score of willingness to underwent " Two-cancer screening" ≥ 4 points). Independent-samples t test or chi-square test was used for statistical comparison of the questionnaire survey results between two groups. Variables with statistically significant differences in univariate analysis (P<0.05) were further included in multivariate unconditional logistic regression analysis to identify the influencing factors of women′s willingness to participate in the " Two-cancer screening". This study was reviewed and approved by the Medical Ethics Committee of Shanghai Municipal Center for Women and Children′s Health (Approval No. 2025-F003-001), and informed consent for the survey were obtained from all participants.

①A total of 800 questionnaires were distributed, and 779 valid questionnaires were recovered, with an effective recovery rate of 97.38%. ②Among the 779 respondents in this study, the satisfaction rates with screening items, procedures, environment and staff attitude of the " Two-cancer screening" service were 99.36% (774/779), 99.74% (777/779), 99.23% (773/779), and 99.36% (774/779), respectively; 97.56% (760/779) of respondents considered regular " Two-cancer screening" necessary. The main factors influencing respondents′ participation in " Two-cancer screening" were: their own health needs (56.48%, 440/779), the convenience of " Two-cancer screening" (38.90%, 303/779), and the screening cost (27.09%, 211/779). ③There were statistically significant differences between the low willingness group and high willingness group in terms of age, residential location, employment status, educational level, menstrual status, and per capita monthly household income (all P<0.05). Taking the willingness to participate in " Two-cancer screening" as the dependent variable and the statistically significant variables in univariate analysis as independent variables, multivariate unconditional logistic regression analysis showed that respondents residing in outer suburban areas (OR=0.652, 95%CI: 0.448-0.950, P=0.026), unemployed individuals (OR=0.418, 95%CI: 0.219-0.798, P=0.008), those with junior high school education or below (OR=0.413, 95%CI: 0.261-0.655, P<0.001), and those with per capita monthly household income of 2 000-4 999 yuan (OR=0.537, 95%CI: 0.321-0.897, P=0.018) or less than 2 000 yuan (OR=0.397, 95%CI: 0.190-0.831, P=0.014) had lower willingness to participate in the screening.

Unemployed women, those with low income or low educational attainment, and residents of outer suburban districts exhibit lower willingness to participate in " Two-cancer screening". These groups should be given more attention in the future.

To explore the clinical manifestations, diagnosis, and treatment of recurrent endometriosis (EMS) that has undergone malignant transformation into vaginal stump adenosarcoma.

A patient with vaginal stump adenosarcoma arising from recurrent EMS, who was treated at West China Second University Hospital, Sichuan University, in December 2024 (patient 1), was selected into this study. A retrospective analysis of the patient′s clinical records was conducted, including medical history, clinical presentation, imaging findings, pathological characteristics, treatment, and follow-up results. Using Chinese and English keywords such as " adenosarcoma" " vaginal stump" and " endometriosis", we searched the CNKI, Wanfang, and VIP databases, as well as PubMed and Web of Science (WoS), for relevant literature on the malignant transformation of endometriosis into vaginal stump adenosarcoma, and conducted a comprehensive analysis of the medical history, clinical manifestations, imaging findings, pathological characteristics, treatment, and follow-up outcomes of these patients. The procedures followed in this study complied with the standards set by the Ethics Committee of West China Second University Hospital, Sichuan University, and were approved by the Ethics Committee [Approval No.2025(315)].

① Patient 1, a 51-year-old woman (G₃P₁), presented to the Gynecology Department of our hospital on December 18, 2024, with a chief complaint of " a mass at the vaginal stump discovered over a year ago". Patient 1 has a history of EMS and was admitted to our hospital due to a gradually enlarging mass at the vaginal stump accompanied by vaginal bleeding. A pelvic MRI performed prior to admission revealed multiple nodular and mass-like lesions in the vaginal stump and the left pelvis. Elevated levels of carbohydrate antigens (CA) 125 and CA19-9 were observed; however, a needle biopsy of the vaginal stump lesion did not reveal any definitive evidence of malignancy. Following admission, the patient underwent resection of the vaginal stump lesion by laparotomy. Postoperative pathological examination confirmed that the polypoid EMS had undergone malignant transformation into adenosarcoma, with the sarcomatous component consisting of endometrial stromal sarcoma and rhabdomyosarcoma. Postoperatively, the patient received pelvic external beam radiation therapy combined with six cycles of chemotherapy. Seven months after the last cycle of chemotherapy, no residual tumor or recurrence was observed. ②Literature review results: Using the literature search strategy established in this study, a total of 7 research articles related to the malignant transformation of EMS into vaginal stump adenosarcoma were identified. Including patient 1, a total of 8 relevant patients were included in the study. A comprehensive analysis of their medical histories, clinical presentations, imaging findings, pathological characteristics, treatment, and follow-up results is presented below.The median age of these 8 patients was 48.5 years old. The primary clinical manifestation was vaginal bleeding (patients 1-3, and 5); pelvic masses were present in 3 cases (patients 6-8); and urinary incontinence and vaginal mass prolapse were present in 1 case (patient 4). In addition, three cases (patients 1, 5, and 8) exhibited heterotopic differentiation of the sarcomatous component, and two cases (patients 2 and 3) showed overgrowth of the sarcomatous component. All 8 patients underwent surgical treatment. One patient (patient 2) died following a recurrence; 3 patients (patients 5, 6, and 8) achieved remission following treatment after recurrence; and the remaining 4 patients (patients 1, 3, 4, and 7) did not experience recurrence during the follow-up period after their initial treatment.

Vaginal stump adenosarcoma arising from the malignant transformation of EMS is a relatively rare clinical condition, and lacks specific clinical and imaging features. Definitive diagnosis mainly relies on histopathological examination. Surgical resection remains the primary treatment, and the decision to administer adjuvant radiation therapy and/or chemotherapy after surgery should be made based on a comprehensive assessment of pathological characteristics and individual patient circumstances.

To investigate the analgesic efficacy, block characteristics, and adverse reactions of dural puncture epidural (DPE) for labor analgesia.

A total of 135 parturients with singleton pregnancies who entered labor and planned to receive neuraxial labor analgesia at Wanyuan People′s Hospital from June 1 to December 31, 2025 were selected into this study. They were assigned to DPE group (n=43), epidural analgesia (EP) group (n=47) and combined spinal-epidural analgesia (CSE) group (n=45) using a random number table method. The following outcomes were compared among the three groups: uterine contraction parameters during six consecutive contractions after drug administration, including uterine contraction pressure, contraction duration, and contraction interval; visual analogue scale (VAS) scores and lower-limb motor block, assessed by the modified Bromage score, at 5, 10, 20, and 30 min after analgesia; the number of effective patient-controlled epidural analgesia (PCEA) bolus attempts, duration of analgesia, total consumption of analgesic solution, duration of labor stages, anesthesia and obstetric interventions, maternal satisfaction score, labor analgesia-related adverse events, neonatal Apgar scores, and arterial blood gas analysis results. The procedures of this study complied with the regulations of the Medical Ethics Committee of Wanyuan People′s Hospital and were approved by the committee (Approval No. LLSC-KY-202201). All participants signed informed consent forms for trial of vaginal delivery, neuraxial labor analgesia, and participation in this clinical study.

①There were no statistically significant differences in general characteristics, including maternal age, body weight, and height, among the three groups (P>0.05). ② In terms of analgesic efficacy, there were statistically significant differences in the overall comparison of VAS scores among the three groups at 5, 10, 20, and 30 min after analgesia (P<0.05). Further pairwise comparisons showed that, at each time point, VAS scores in the CSE group were lower than those in the EP and DPE groups, and VAS scores in the DPE group were lower than those in the EP group, with statistically significant differences (P<0.017). ③In terms of uterine contraction-related parameters, there were statistically significant differences in the overall comparisons of the 3rd, 5th, and 6th uterine contraction pressures and the 1st and 3rd uterine contraction intervals after drug administration among the three groups (P<0.05). Further pairwise comparisons showed that the 3rd and 6th uterine contraction pressures were lower in the CSE group than those in the EP and DPE groups; the 5th uterine contraction pressure was higher in the DPE group than that in the EP and CSE groups; the 1st uterine contraction interval was shorter in the CSE group than that in the EP and DPE groups; and the 3rd uterine contraction interval was longer in the DPE group than that in the EP and CSE groups, with statistically significant differences (P<0.017). There were no statistically significant differences in the overall comparisons of the durations of six consecutive uterine contractions among the three groups (P>0.05). ④In terms of labor analgesia-related parameters and labor duration, there were no statistically significant differences in the number of effective PCEA bolus attempts, duration of analgesia, total consumption of analgesic solution, or durations of the first, second, and third stages of labor among the three groups (P>0.05). ⑤In terms of lower-limb motor block, the modified Bromage scores in the CSE group were higher than those in the EP and DPE groups at 5 and 10 min after analgesia, and higher than those in the EP group at 20 min after analgesia, with statistically significant differences (P<0.017). ⑥In terms of adverse events and interventions, there were no statistically significant differences in the incidences of maternal hypotension, fever, pruritus, or anesthesia intervention among the three groups (P>0.05). There were statistically significant differences in the overall comparisons of the incidence of fetal heart rate abnormalities and the rate of obstetric intervention (P<0.05); however, further pairwise comparisons showed no statistically significant differences (P>0.017). ⑦There were no statistically significant differences in maternal satisfaction scores, neonatal Apgar scores at 1, 5, and 10 min after birth, or arterial blood gas analysis results among the three groups (P>0.05).

DPE for labor analgesia can improve the early analgesic efficacy of EP and is associated with less early lower-limb motor block than CSE, without increasing the risk of maternal and neonatal adverse events. DPE has certain advantages in analgesic efficacy, preservation of motor function, and maternal and neonatal safety, and may provide a reference for the selection of neuraxial labor analgesia techniques.

To explore the research hotspots, developmental trajectory, and frontier trends in the field of pediatric gut microbiota in China through bibliometric analysis.

Relevant Chinese literature on pediatric gut microbiota, retrieved from the CNKI, Wanfang Medical Online, and VIP database from the inception of each database to December 31, 2025, was selected as the research subjects. CiteSpace 6.4R1 software was used to perform author collaboration network, keyword co-occurrence, clustering, timeline, and burst detection analyses on the retrieved and screened literature, and to construct visualized maps.

According to the retrieval strategy established in this study, a total of 3 173 Chinese literature articles related to research on pediatric gut microbiota were retrieved. After screening, 2 747 articles were ultimately included for analysis. The number of publications in this field in China exhibited a three-stage growth trend of " initiation-development-explosion", reaching a peak of 563 articles in 2025. Up to December 31, 2025, the results of this study were as follows. ①A core author collaboration network was formed, centered around Zhang Lin, Zheng Yuejie, Li Yuxia, and so on. ②High-frequency keywords included gut microbiota, children, probiotics, and so on. ③Keyword cluster analysis revealed the top three cluster labels as #0 immunity, #1 gut microbiota, and #2 infants. ④The keyword timeline map analysis indicated that recent research hotspots focused on the association between gut microbiota and pediatric digestive, neurological, and other multisystem diseases, covering clinical topics such as functional constipation, bronchial asthma, autism spectrum disorder, and tic disorders in children. Meanwhile, the research interest in high-throughput sequencing and pediatric massage techniques continued to rise. ⑤Keyword burst analysis showed high burst intensity for terms like diarrhea, pediatric diarrhea, and infant diarrhea, while functional dyspepsia, obesity, and recurrent respiratory infections emerged as new research hotspots in the field in recent years.

Research on pediatric gut microbiota in China continues to gain momentum, with current research focusing on the association between gut microbiota and digestive, neurological, immune and other multisystem diseases, as well as intervention studies. Traditional Chinese medicine therapies, such as pediatric massage, are a distinctive feature of this research in China. Future research should delve deeper into the mechanisms underlying these themes, driving the field to shift from phenomenological correlations to precise interventions.

Ureteral stricture (US) is a common urinary system disease that seriously affects the quality of life of patients. Traditional surgical procedures involve greater trauma, more postoperative complications, and carry a higher risk with certain limitations. In recent years, endoscopic treatment has received widespread attention as a new treatment method. This article provides a review of the research progress on intracavitary treatment of US, summarizing the advantages and limitations of intracavitary treatment in treating US. The aim is to provide guidance and inspiration for research and clinical applications in this field.

As a morphological alteration of the prostate, intravesical prostatic protrusion (IPP) is conventionally utilized to assess lower urinary tract symptoms, particularly in benign prostatic hyperplasia (BPH). However, a growing body of recent evidence indicates that IPP exerts a significant influence on the diagnosis and treatment of prostate cancer (PCa). Diagnostically, IPP may serve as an auxiliary indicator for PCa detection. Therapeutically, IPP can impact the efficacy of radical prostatectomy, modulate postoperative complication rates, and consequently affect long-term prognosis. Therefore, it is imperative for surgeons to conduct precise preoperative assessments of IPP and formulate individualized surgical strategies to mitigate adverse outcomes and harness the clinical utility of IPP in the management of PCa.

Urological diseases commonly cause dysuria, local pain and other symptoms, and conventional drug treatment has certain limitations. With the advantages of minimal invasiveness, safety and adjustability, electrophysiological techniques have been widely used in various clinical departments. This article systematically reviews the application status and research progress of electrophysiological monitoring, electrophysiological therapy, combined therapies and novel electrophysiological technologies in urology. Electrophysiological monitoring can be applied to preoperative functional evaluation and intraoperative nerve protection, which effectively reduces the risk of surgical complications. Therapies including spinal cord stimulation and transcutaneous electrical nerve stimulation have achieved satisfactory effects on overactive bladder, urinary incontinence, chronic prostatitis, and male diseases, as well as postoperative rehabilitation. The combination of electrophysiological techniques with western medicine, traditional Chinese medicine and acupuncture can further improve the therapeutic efficacy. In addition, new technologies such as visualized precise electrophysiology, novel electrode materials and deep brain stimulation are under continuous exploration. At present, there are still some challenges in this field, including unclear action mechanisms, lack of unified treatment protocols and insufficient positioning accuracy. Further researches focusing on action mechanisms, optimization of stimulation parameters, development of electrode materials and targeted precise therapy are required in the future, so as to promote the standardized and precise clinical application of electrophysiological techniques in urology.

To explore the potential risk factors for mortality within 30 days after orthotopic liver transplantation (OLT) and provide scientific basis for formulating individualized perioperative intervention strategies and predicting postoperative risks.

This retrospective study included recipients who underwent OLT at Beijing Chao-Yang Hospital, Capital Medical University. Death within 30 days after surgery was defined as early postoperative mortality, and patients were grouped accordingly. General patient information, preoperative laboratory indicators, and intraoperative data were collected. Receiver operating characteristic (ROC) curves were used to determine the optimal cutoff values for each indicator. Least absolute shrinkage and selection operator (LASSO) regression was applied to screen factors relevant to early postoperative mortality, followed by univariate and multivariate Logistic regression analysis to identify independent risk factors. Restricted cubic spline (RCS) analysis was employed to examine the dose-response relationships between these factors and the risk of early mortality.

A total of 535 OLT recipients were included, among whom 36 (6.7%) experienced early postoperative mortality. Multivariate Logistic regression analysis revealed that intraoperative erythrocyte transfusion >1 650 ml (OR=3.313, 95% CI: 1.397-7.857), intraoperative urine volume≤1 115 ml (OR=3.245, 95% CI: 1.409-7.473), preoperative platelet count≤24.5×10⁹/L (OR=3.437, 95% CI: 1.194-9.895), and preoperative blood glucose≤4.8 mmol/L (OR=2.955, 95% CI: 1.286-6.791) were independent risk factors for early postoperative mortality after OLT. RCS analysis indicated that intraoperative erythrocyte transfusion volume and urine volume showed linear correlations with the risk of early postoperative mortality, while preoperative platelet count exhibited a nonlinear correlation with the risk of early postoperative mortality.

Low preoperative platelet count, preoperative hypoglycemia, high intraoperative erythrocyte transfusion volume, and low intraoperative urine volume are independent risk factors for early postoperative mortality. Preoperative measures should be taken to increase platelet counts above 24.5×10⁹/L, while the optimal range for perioperative blood glucose requires further clarification.