An afferent nerve-like electronic device with somatic mechanical perception and sensation management.

Tactile and pain perception are essential for biological skin to interact with the external environment. This complex interplay of sensations allows for the detection of potential threats and appropriate responses to stimuli. However, the challenge is to enable flexible electronics to respond to mechanical stimuli such as biological skin, and researchers have not clearly reported the successful integration of somatic mechanical perception and sensation management functions into neuro-like electronics. In this work, an afferent nerve-like device with a pressure sensor and a perception management module is proposed. The pressure sensor comprises two conductive fabric layers and an ionic hydrogel, forming a capacitor structure that emulates the swift transition from tactile to pain perception under mechanical stimulation. Drawing inspiration from the neuronal "gate control" mechanism, the sensation management module adjusts signals in response to rubbing, accelerating the discharge process and reducing the perception duration, thereby replicating the inhibitory effect of biological neurons on pain following tactile interference. This integrated device, encompassing somatic mechanical perception and sensation management, holds promise for applications in soft robotics, prosthetics, and human-machine interaction.

A comprehensive prediction model predicts perihematomal edema growth in the acute stage after intracerebral hemorrhage.

BACKGROUND: Perihematomal edema (PHE) is regarded as a potential intervention indicator of secondary injury following intracerebral hemorrhage (ICH). But it still lacks a comprehensive prediction model for early PHE formation. METHODS: The included ICH patients have received an initial Computed Tomography scan within 6 hours of symptom onset. Hematoma volume and PHE volume were computed using semiautomated computer-assisted software. The volume of the hematoma, edema around the hematoma, and surface area of the hematoma were calculated. The platelet-to-lymphocyte ratio (PLR) was calculated by dividing the platelet count by the lymphocyte cell count. All analyses were 2-tailed, and the significance level was determined by P <0.05. RESULTS: A total of 226 patients were included in the final analysis. The optimal cut-off values for PHE volume increase to predict poor outcomes were determined as 5.5 mL. For clinical applicability, we identified a value of 5.5 mL as the optimal threshold for early PHE growth. In the multivariate logistic regression analyses, we finally found that baseline hematoma surface area (p < 0.001), expansion-prone hematoma (p < 0.001), and PLR (p = 0.033) could independently predict PHE growth. The comprehensive prediction model demonstrated good performance in predicting PHE growth, with an area under the curve of 0.841, sensitivity of 0.807, and specificity of 0.732. CONCLUSION: In this study, we found that baseline hematoma surface area, expansion-prone hematoma, and PLR were independently associated with PHE growth. Additionally, a risk nomogram model was established to predict the PHE growth in patients with ICH.

[Network Meta-analysis of Chinese patent medicines in treatment of chronic pulmonary heart disease].

Network Meta-analysis was performed to compare the efficacy and safety of Chinese patent medicines in treating chronic pulmonary heart disease. CNKI, VIP, Wanfang, SinoMed, PubMed, Web of Science, EMbase, and Cochrane Library were searched for randomized controlled trial(RCT) of treating chronic pulmonary heart disease with Chinese patent medicines with the time interval from inception to December 2023. The Cochrane risk-of-bias tool was used for quality assessment of the included articles. RevMan 5.4 and Stata 17.0 were employed to establish the risk of bias map and perform the network Meta-analysis, respectively. Ultimately, a total of 95 RCTs involving 8 787 cases and 11 different Chinese patent medicines were included. Network Meta-analysis yielded the following results based on the surface under the cumulative ranking curve(SUCRA).(1)In terms of cardiac function improves clinical total effective rate, SUCRA the top three were Wenxin Granules + conventional western medicine, Tongxinluo Capsules + conventional western medicine, and Qishen Yiqi Dropping Pills + conventional western medicine.(2)For improving forced expiratory volume in the first se-cond(FEV1), SUCRA the top three were Danting Feixin Granules + conventional western medicine, Tongxinluo Capsules + conventional western medicine, and Bufei Huoxue Capsules + conventional western medicine.(3)Regarding increasing the FEV1/forced vital capacity(FVC%) value, SUCRA the top three were Qili Qiangxin Capsules + conventional western medicine, Shexiang Baoxin Pills + conventional western medicine, and Qishen Yiqi Dropping Pills + conventional western medicine.(4)In terms of increasing the partial pressure of oxygen(PaO_2), SUCRA the top three were Qili Qiangxin Capsules + conventional western medicine, Qishen Yiqi Dropping Pills + conventional western medicine, and Shexiang Baoxin Pills + conventional western medicine.(5)In terms of reducing the partial pressure of carbon dioxide(PaCO_2), SUCRA the top three were Tongxinluo Capsules + conventional western medicine, Qishen Yiqi Dropping Pills + conventional western medicine, and Shexiang Baoxin Pills + conventional western medicine.(6)In terms of increasing left ventricular ejection fraction(LVEF), SUCRA the top three were Bufei Huoxue Capsules + conventional western medicine, Qishen Yiqi Dropping Pills + conventional western medicine, and Shexiang Baoxin Pills + conventional western medicine.(7)In terms of decreasing brain natriu-retic peptide(BNP), SUCRA the top three were Compound Danshen Dropping Pills + conventional western medicine, Qili Qiangxin Capsules + conventional western medicine, and Tongxinluo Capsules + conventional western medicine.(8)In terms of improving the hematocrit level, SUCRA the top three were Qishen Yiqi Dropping Pills + conventional western medicine, Compound Danshen Dropping Pills + conventional western medicine, and Tongxinluo Capsules + conventional western medicine. In terms of safety, 26 RCTs reported adverse reactions, which primarily involved the circulatory and digestive systems. The combination of Chinese patent medicines with conventional western medicine has demonstrated enhanced therapeutic effects on chronic pulmonary heart disease. However, due to the varying quality and sample sizes of included studies and the absence of direct comparisons between Chinese patent medicines, the conclusions should be further validated by multicenter studies with larger sample sizes and higher methodological rigor.

Mycenabrunnescens (Basidiomycota, Mycenaceae), a new species of Mycena sect. Pterigenae from China.

Background: Mycena (Pers.) Roussel (1806) is a large genus of Mycenaceae known for having small to medium-sized basidiomata. It is typified by the species Mycenagalericulata (Scop.) Gray. For years, many mycologists have made important contributions to understanding Mycena and several monographs have been published. Three specimens were collected from China that belonged to the genus Mycena. On the basis of morphological analysis and phylogenetic analyses employing DNA sequences, a new species is described. New information: Mycenabrunnescens sp. nov. is described as a new species from subtropical areas of China. It is characterised by its brown pileus, whitish lamellae that turns brown when bruised, orange to brown lamellae edges, the absence of pleurocystidia and cheilocystidia with simple or branched excrescences at the apex containing yellowish-brown contents. We performed phylogenetic analyses on a concatenated dataset comprising the internal transcribed spacer and large subunit regions of nuclear ribosomal RNA using Bayesian Inference and Maximum Likelihood methods. The result showed that the new taxon clustered in an independent group and is closely related to M.albiceps and M.flosoides.

Case report: Xeroderma pigmentosum Group A with erythropoietic protoporphyria in a young Chinese patient.

Xeroderma pigmentosum is a rare autosomal recessive genodermatoses characterized by a deficiency in nucleotide excision repair. Erythropoietic protoporphyria is a rare inherited metabolic disease caused by the perturbation of heme. Xeroderma pigmentosum-erythropoietic protoporphyria is exceedingly rare. Hereby, we firstly report a young Chinese patient of xeroderma pigmentosum Group A with erythropoietic protoporphyria carrying an XPA Met214AsnfsTer7 frameshift mutation and a homozygous splicing mutation, c.315-48T>C, in the proband's intron3 of FECH.

A Ratiometric Fluorescence Detection Method for Berberine Using Triplex-Containing DNA-Templated Silver Nanoclusters.

Berberine (BBR), as a natural isoquinoline alkaloid, has demonstrated various pharmacological activities, and is widely applied in the treatment of diseases. The quantitative analysis of BBR is important for pharmacological studies and clinical applications. In this work, utilizing the specific interaction between BBR and triplex DNA, a sensitive and selective fluorescent detecting method was established with DNA-templated silver nanoclusters (DNA-AgNCs). After binding with the triplex structure in the template of DNA-AgNCs, BBR quenched the fluorescence of DNA-AgNCs and formed BBR-triplex complex with yellow-green fluorescence. The ratiometric fluorescence signal showed a linear relationship with BBR concentration in a range from 10 nM to 1000 nM, with a detection limit of 10 nM. Our method exhibited excellent sensitivity and selectivity, and was further applied in BBR detection in real samples.

Bactericidal Antibody Responses to Meningococcal Recombinant Outer Membrane Proteins.

Secretin PilQ is an antigenically conserved outer membrane protein that is present in most meningococci and PorA is a major protein that elicits bactericidal immune response in humans following natural disease and immunization. In the present study, BALB/c mice were immunized subcutaneously with rPilQ406-770 or rPorA together with Freund's adjuvant (FA). Serum antibody responses to serogroup A and B Neisseria meningitides whole cells or purified proteins and functional activity of antibodies were determined by ELISA and serum bactericidal assay (SBA), respectively. Serum IgG responses were significantly increased in the immunized group with rPilQ406-770 or rPorA together with FA compared to control groups. IgG antibody response of mice immunized with rPilQ406-770 was significantly more than mice immunized with rPorA (OD at 450 nm was 1.6 versus 0.83). The booster injections were effective in increasing the responses of anti-rPilQ406-770 or anti-rPorA IgG significantly. Antisera produced against rPilQ406-770 or rPorA demonstrated strong surface reactivity to serogroup B N. meningitides in comparison with control groups. Antisera raised against rPorA or rPilQ406-770 and FA demonstrated SBA titers from 1/1024 to 1/2048 against serogroup B. The strongest bactericidal activity was detected in sera from mice immunized with rPilQ406-770 mixed with FA. These results suggest that rPilQ406-770 is a potential vaccine candidate for serogroup B N. meningitidis.

The Main Failure Modes of Hot-Work Die Steel and the Development Status of Traditional Strengthening Methods and Nano-Strengthening Technology.

As an important part of die steels, hot-work die steels are mainly used to manufacture molds made of solid metal or high-temperature liquid metal from heating to recrystallization temperature. In view of the requirements for mechanical properties and service life for hot-work die steel, it is conducive to improve the thermal fatigue resistance, wear resistance, and oxidation resistance of hot work die steel. In this review, the main failure modes of hot-work die steel were analyzed. Four traditional methods of strengthening and toughening die steel were summarized, including optimizing alloying elements, electroslag remelting, increasing the forging ratio, and heat treatment process enhancement. A new nano-strengthening method was introduced that aimed to refine the microstructure of hot-work abrasive steel and improve its service performance by adding nanoparticles into molten steel to achieve uniform dispersion. This review provides an overview to improve the service performance and service life of hot work die steel.

Instant in situ highlighting of latent fingerprints by a green fluorescent probe based on aggregation-induced emission.

Fluorescence sensing of latent fingerprints (LFPs) has gained extensive attention due to its high sensitivity, non-destructive testing, low biotoxicity, ease of operation, and the potential for in situ visualization. However, the realization of in situ visualization of LFPs especially with green emission and rapid speed is still a challenge. Herein, we synthesized an amphibious green-emission AIE-gen TPE-NI-AOH (PLQY = 62%) for instant in situ LFP detecting, which integrates the excellent fluorescence properties of naphthalimide (NI) with a hydrophilic head and the AIE character as well as the donating property of tetraphenylethene (TPE). TPE-NI-AOH in ethanol/water binary solvent was used as an environmentally friendly LFP developer and achieved in situ green-fluorescence visualization of LFPs. The fluorescence signal achieves its 60% saturated intensity in 0.37 s and nearly 100% in 2.50 s, which is an instant process for the naked eye. Moreover, level 3 details and super-resolution images of LFPs could be observed clearly. Besides, the TPE-NI-AOH developer could be stored for at least 6 months, suitable for long-term storage. This instant in situ highlighting method does not require post-processing operations, providing a more convenient, rapid, and efficient detection method of LFPs. This work would inspire the further advancement of fluorescent sensors for fingerprint imaging.

Recovery of ammonia nitrogen from simulated reject water by bipolar membrane electrodialysis.

Ammonia monohydrate (NH3·H2O) is an important chemical widely used in industrial, agricultural, and pharmaceutical fields. Reject water is used as the raw material in self-built bipolar membrane electrodialysis (BMED) to produce NH3·H2O. The effects of electrode materials, membrane stack structure, and operating conditions (current density, initial concentrations of the reject water, and initial volume ratio) on the BMED process were investigated, and the economic costs were analyzed. The results showed that compared with graphite electrodes, ruthenium-iridium-titanium electrodes as electrode plates for BMED could increase current efficiency (25%) and reduce energy consumption (26%). Compared with two-compartment BMED, three-compartment BMED had a higher ammonia nitrogen conversion rate (86.6%) and lower energy consumption (3.5 kW· h/kg). Higher current density (15 mA/cm2) could achieve better current efficiency (79%). The BMED performances were improved when the initial NH4+ concentrations of the reject water increased from 500 mg NH4+/L to 1000 mg NH4+/L, but the performance decreased as the concentration increased from 1000 mg NH4+/L to 1500 mg NH4+/L. High initial volume ratio of the salt compartment and product compartment was beneficial for reducing energy consumption. Under the optimal operating conditions, only 0.13 $/kg reject water was needed to eliminate the environmental impact of reject water accumulation. This work indicates that BMED can not only achieve desalination of reject water, but also generate products that alleviate the operational pressure of factories.

Interfacing Neuron-Motor Pathways with Stretchable and Biocompatible Electrode Arrays.

ConspectusIn the field of neuroscience, understanding the complex interactions within the intricate neuron-motor system depends crucially on the use of high-density, physiological multiple electrode arrays (MEAs). In the neuron-motor system, the transmission of biological signals primarily occurs through electrical and chemical signaling. Taking neurons for instance, when a neuron receives external stimuli, it generates an electrical signal known as the action potential. This action potential propagates along the neuron's axon and is transmitted to other neurons via synapses. At the synapse, chemical signals (neurotransmitters) are released, allowing the electrical signal to traverse the synaptic gap and influence the next neuron. MEAs can provide unparalleled insights into neural signal patterns when interfacing with the nerve systems through their excellent spatiotemporal resolution. However, the inherent differences in mechanical and chemical properties between these artificial devices and biological tissues can lead to serious complications after chronic implantation, such as body rejection, infection, tissue damage, or device malfunction. A promising strategy to enhance MEAs' biocompatibility involves minimizing their thickness, which aligns their bending stiffness with that of surrounding tissues, thereby minimizing damage over time. However, this solution has its limits; the resulting ultrathin devices, typically based on plastic films, lack the necessary stretchability, restricting their use to organs that neither stretch nor grow.For practical deployments, devices must exhibit certain levels of stretchability (ranging from 20 to 70%), tailored to the specific requirements of the target organs. In this Account, we outline recent advancements in developing stretchable MEAs that balance stretchability with sufficient electrical conductivity for effective use in physiological research, acting as sensors and stimulators. By concentrating on the neuron-motor pathways, we summarize how the stretchable MEAs meet various application needs and examine their effectiveness. We distinguish between on-skin and implantable uses, given their vastly different requirements. Within each application scope, we highlight cutting-edge technologies, evaluating their strengths and shortcomings. Recognizing that most current devices rely on elastic films with a Young's modulus value between ∼0.5 and 5 MPa, we delve into the potential for softer MEAs, particularly those using multifunctional hydrogels for an optimizing tissue-device interface and address the challenges in adapting such hydrogel-based MEAs for chronic implants. Additionally, transitioning soft MEAs from lab to fab involves connecting them to a rigid adapter and external machinery, highlighting a critical challenge at the soft-rigid interface due to strain concentration, especially in chronic studies subject to unforeseen mechanical strains. We discuss innovative solutions to this integration challenge, being optimistic that the development of durable, biocompatible, stretchable MEAs will significantly advance neuroscience and related fields.

Asymmetric Synthesis and Biological Evaluation of Platensilin, Platensimycin, Platencin, and Their Analogs via a Bioinspired Skeletal Reconstruction Approach.

Platensilin, platensimycin, and platencin are potent inhibitors of ß-ketoacyl-acyl carrier protein synthase (FabF) in the bacterial and mammalian fatty acid synthesis system, presenting promising drug leads for both antibacterial and antidiabetic therapies. Herein, a bioinspired skeleton reconstruction approach is reported, which enables the unified synthesis of these three natural FabF inhibitors and their skeletally diverse analogs, all stemming from a common ent-pimarane core. The synthesis features a diastereoselective biocatalytic reduction and an intermolecular Diels-Alder reaction to prepare the common ent-pimarane core. From this intermediate, stereoselective Mn-catalyzed hydrogen atom-transfer hydrogenation and subsequent Cu-catalyzed carbenoid C-H insertion afford platensilin. Furthermore, the intramolecular Diels-Alder reaction succeeded by regioselective ring opening of the newly formed cyclopropane enables the construction of the bicyclo[3.2.1]-octane and bicyclo[2.2.2]-octane ring systems of platensimycin and platencin, respectively. This skeletal reconstruction approach of the ent-pimarane core facilitates the preparation of analogs bearing different polycyclic scaffolds. Among these analogs, the previously unexplored cyclopropyl analog 47 exhibits improved antibacterial activity (MIC80 = 0.0625 µg/mL) against S. aureus compared to platensimycin.

Insight into furfural-tolerant and hydrogen-producing microbial consortia: Mechanism of furfural tolerance and hydrogen production.

Furfural-tolerant and hydrogen-producing microbial consortia were enriched from soil, with hydrogen production of 259.84 mL/g-xylose under 1 g/L furfural stress. The consortia could degrade 2.5 g/L furfural within 24 h in the xylose system, more efficient than in the sugar-free system. Despite degradation of furfural to furfuryl alcohol, the release of reactive oxygen species and lactate dehydrogenase was also detected, suggesting that furfuryl alcohol is also a potential inhibitor of hydrogen production. The butyrate/acetate ratio was observed to decrease with increasing furfural concentration, leading to decreased hydrogen production. Furthermore, microbial community analysis suggested that dominated Clostridium butyricum was responsible for furfural degradation, while Clostridium beijerinckii reduction led to hydrogen production decrease. Overall, the enriched consortia in this study could efficiently degrade furfural and produce hydrogen, providing new insights into hydrogen-producing microbial consortia with furfural tolerance.

Influences of bisphenol A on hydrogen production from food waste by thermophilic dark fermentation.

The extensive use of plastic products in food packaging and daily life makes them inevitably enter the treatment process of food waste (FW). Plasticizer as a new pollutant is threatening the dark fermentation of FW. Our study showed that bisphenol A (BPA) at > 250 mg/L had a significant inhibition on hydrogen production from FW by thermophilic dark fermentation. The endogenous ATP content and lactate dehydrogenase (LDH) release showed that high level of BPA not only inhibited the growth of hydrogen-producing consortium, but also led to cell death. In addition, BPA mainly affects the hydrogen-producing consortium by reducing cell membrane fluidity, damaging cell membrane integrity and reducing cell membrane potential, resulting in cell death. This study provides some new insights into the mechanism of the effect of BPA on hydrogen production from FW by thermophilic dark fermentation, and lays the foundation on the utilization of FW.

Tracking-seq reveals the heterogeneity of off-target effects in CRISPR-Cas9-mediated genome editing.

The continued development of novel genome editors calls for a universal method to analyze their off-target effects. Here we describe a versatile method, called Tracking-seq, for in situ identification of off-target effects that is broadly applicable to common genome-editing tools, including Cas9, base editors and prime editors. Through tracking replication protein A (RPA)-bound single-stranded DNA followed by strand-specific library construction, Tracking-seq requires a low cell input and is suitable for in vitro, ex vivo and in vivo genome editing, providing a sensitive and practical genome-wide approach for off-target detection in various scenarios. We show, using the same guide RNA, that Tracking-seq detects heterogeneity in off-target effects between different editor modalities and between different cell types, underscoring the necessity of direct measurement in the original system.

Three-Dimensional Anthropometric Facial Analysis and Fitting Discrepancies Between Stereophotogrammetry and CT.

BACKGROUND: The reliability and repeatability of stereophotogrammetry and CT in 3-dimensional anthropometric facial analysis were investigated in this study, which also explored the clinical application of supine CT. METHOD: In this study, 3D CT and 3dMD stereophotogrammetry were used on 20 healthy volunteers. The fitting distance between stereophotogrammetry and CT scans at landmark points was measured, along with facial feature measurements (Al-Al) face width (Go-Go, Zy-Zy, Ex-Ex), and hemi-face height (Sn-Gn). The intraclass correlation coefficient (ICC) was employed to assess interrater agreement and to verify the reliability of the measurement methods. Paired t -analysis was utilized for analyzing intramethod displacement. RESULTS: The alare, nasion, and pronasale points were found to be minimally influenced by different positions and are more recommended as landmark points for registration. CT demonstrated good interrater reliability on all indicators. In stereophotogrammetry, measurements for Go-Go and Zy-Zy displayed an interclass correlation coefficient (ICC) of less than 0.75. Significant differences between the 2 methods were observed for En-En, Ex-Ex, and Go-Go ( P < 0.05). Specifically, CT analysis for Go-Go showed a measurement 2.34 mm larger than that obtained with the 3dMD method. CONCLUSION: Both CT and stereophotogrammetry were found to be reliable methods for evaluating facial soft tissue. It is speculated that Go-Go measurement is primarily influenced by factors such as different positions, facial expressions, and gravity. These variables should be carefully considered during the evaluation of the mandibular angle region.

A Case of Complex Giant Rhinophyma Treated With Cosmetic Surgery.

ABSTRACT: Rhinophyma leads to severe facial deformities and significant social pressure for patients. Patients often seek medical intervention due to cosmetic defects and functional impairments, such as nasal congestion and airway collapse. Currently, there are numerous treatment modalities for rhinophyma, each with distinct advantages and disadvantages, leading to a lack of consensus in nasal vegetation management. Severe thickening in the nasal area can obstruct breathing through external nasal valve blockage, necessitating appropriate management for relief. This article presents a case study involving severe rhinophyma with respiratory obstruction that was successfully treated using incomplete resection followed by reconstruction to restore normal nasal contour. This not only achieved an upright position for nasal columella but also improved nasal contour to achieve normal appearance levels while completely relieving respiratory tract obstruction and enhancing patients' ventilation function. This method is easily performed without requiring additional expensive equipment, making it economically feasible even in ordinary medical centers while enabling patients to achieve a high quality of life.

Can a nomogram predict apical prostate cancer pathology upgrade from fusion biopsy to final pathology? A multicenter study.

BACKGROUND: This study evaluates the efficacy of a nomogram for predicting the pathology upgrade of apical prostate cancer (PCa). METHODS: A total of 754 eligible patients were diagnosed with apical PCa through combined systematic and magnetic resonance imaging (MRI)-targeted prostate biopsy followed by radical prostatectomy (RP) were retrospectively identified from two hospitals (training: 754, internal validation: 182, internal-external validation: 148). A nomogram for the identification of apical tumors in high-risk pathology upgrades through comparing the results of biopsy and RP was established incorporating statistically significant risk factors based on univariable and multivariable logistic regression. The nomogram's performance was assessed via the receiver operating characteristic (ROC) curve, calibration plots, and decision curve analysis (DCA). RESULTS: Univariable and multivariable analysis identified age, targeted biopsy, number of targeted cores, TNM stage, and the prostate imaging-reporting and data system score as significant predictors of apical tumor pathological progression. Our nomogram, based on these variables, demonstrated ROC curves for pathology upgrade with values of 0.883 (95% CI, 0.847-0.929), 0.865 (95% CI, 0.790-0.945), and 0.840 (95% CI, 0.742-0.904) for the training, internal validation and internal-external validation cohorts respectively. Calibration curves showed good consistency between the predicted and actual outcomes. The validation groups also showed great generalizability with the calibration curves. DCA results also demonstrated excellent performance for our nomogram with positive benefit across a threshold probability range of 0-0.9 for the training and internal validation group, and 0-0.6 for the internal-external validation group. CONCLUSION: The nomogram, integrating clinical, radiological, and pathological data, effectively predicts the risk of pathology upgrade in apical PCa tumors. It holds significant potential to guide clinicians in optimizing the surgical management of these patients.

A Case of Squamous Cell Carcinoma Arising in Disseminated Superficial Porokeratosis.

Porokeratosis (PK), characterized by keratotic lesions with an atrophic center and a prominent peripheral ridge, with a typical histological hallmark, namely, the cornoid lamella, has two forms: disseminated and localized. While PK often converts into squamous cell carcinoma (SCC), conversion from disseminated superficial porokeratosis (DSP) alone is rarely reported except for one case in which DSP and LP coexisted and converted to SCC. Here, we report the case of a patient with SCC converted from DSP alone, presenting with coin-sized macules on the bottom right of his waist that developed into an ulcer at the center. The patient underwent radiation therapy, which effectively treated the SCC but did not resolve the PK. This article highlights regular follow-up and undergo comprehensive diagnosis, both of which are beneficial to enable early detection and management of DSP that has converted to into SCC; in addition, standardized medical treatment may help improve the treatment therapeutic effect of in similar diseases.

New Fiberoptic Choledochoscopy-guided Percutaneous Transhepatic Choledochoscope Lithotomy Combined with Dual-frequency Laser Lithotripsy for the Treatment of Intractable Hepatolithiasis.

Objective: To investigate the clinical effects of new fiberoptic cholangioscopy-guided percutaneous transhepatic choledochoscope lithotomy (PTCSL) combined with dual-frequency laser lithotripsy for the treatment of intractable hepatolithiasis. Methods: Eighty patients with intractable hepatolithiasis who received treatment in the Second Hospital Affiliated to Zhejiang University School of Medicine from December 2020 to December 2022 were grouped according to the surgical methods. Forty-two patients who received hepatectomy were divided into the control group, 38 patients who received new fiber-optic choledochoscope-guided PTCSL combined with dual-frequency laser lithotripsy were divided into the observation group, and the treatment results of the two groups were compared. Results: The operation time, postoperative pain duration, and hospital stay of the observation group were significantly shorter than those of the control group, and intraoperative bleeding was significantly lower than that of the control group, with statistically significant differences (P < .05). Seven days after surgery, the total bilirubin (TBIL), alanine aminotransferase (ALT), and albumin (ALB) levels in the observation group were significantly lower than those in the control group (P < .05). The stone residual rate of 7.89% in the observation group was significantly lower than that of 26.19% in the control group (χ2=4.625, P < .05). The difference in biliary bleeding rate between the two groups was not statistically significant (χ2=0.427, P > .05). Conclusion: Overall results of new fiber-optic choledochoscope-guided PTCSL combined with dual-frequency laser lithotripsy for the treatment of intractable hepatolithiasis.