Here, we present a precision oncologic approach for localized prostate cancer (PCa) in a 66-year-old man. Overcoming the limitations of conventional MRI in delineating tumor extent and multifocality, preoperative 68 Ga-PSMA PET/MRI precisely defined the index lesion and excluded metastases. This diagnostic workflow was directly translated into therapy through PET/MRI-US fusion-guided irreversible electroporation (IRE). The procedure targeted the tumor accurately while sparing surrounding functional anatomy. Significant PSA and phi decline post-IRE confirmed therapeutic efficacy. This case demonstrates that integrating molecularly targeted diagnostics with advanced image-guided focal therapy enables maximal precision in oncologic control.

ObjectivePediatric direct inguinal hernia (DIH) is an extremely rare congenital abdominal wall defect, accounting for less than 4% of all pediatric inguinal hernias. Its clinical manifestations overlap highly with indirect inguinal hernia (IIH), leading to frequent diagnostic dilemmas in emergency settings, especially for incarcerated cases. This single-case report aims to describe a case of incarcerated pediatric DIH and elaborate on the emergency diagnostic and therapeutic approach, to provide a detailed reference for managing similar cases.MethodsA 15-month-old male infant with left incarcerated DIH was admitted to the emergency department. Point-of-care ultrasound (POCUS) was performed to confirm the diagnosis by identifying the herniation pathway through Hesselbach’s triangle. Laparoscopic closure of the fascial defect combined with medial umbilical ligament reinforcement was implemented without synthetic mesh implantation, in line with the physiological characteristics of pediatric abdominal wall development.ResultsThe infant was accurately diagnosed via POCUS within 2 h of admission, and emergency laparoscopic surgery was completed within 6 h (including time for diagnosis, preoperative optimization, and mandatory fasting). The operation duration was 15 min with an estimated blood loss of 1 mL. Postoperative recovery was uneventful, and the infant was discharged on postoperative day 1. Follow-up at 1, 2, 3 and 6 months showed no hernia recurrence, with normal abdominal wall development.ConclusionIn this case, POCUS was instrumental in the emergency differential diagnosis. Laparoscopic defect closure combined with medial umbilical ligament reinforcement, which avoids synthetic mesh, appeared to be safe and feasible with good short-term outcomes. This report highlights a diagnostic and therapeutic pathway for a rare condition. As a single-case report, these findings are hypothesis-generating and require validation in larger studies. Future prospective studies with longer follow-up are needed to confirm the efficacy and generalizability of this approach.

SQSTM1/p62 is a multifunctional scaffold protein that plays important roles in selective autophagy and cellular redox homeostasis. While phosphorylation-dependent regulation of p62 has been extensively studied, the functional significance of oxidative modification remains incompletely understood. Our previous studies showed that the natural small compound Alternol induces cancer cell-specific killing via a xanthine oxidase-mediated strong oxidative stress. In this study, we investigated p62-associated oxidative responses under Alternol-induced oxidative stress conditions in prostate cancer cells. Using biochemical assays and cell-based models, we found that Alternol treatment was associated with the accumulation of oxidized and high-molecular-weight p62 species, accompanied by altered KEAP1 association and increased Nrf2-associated signaling. Furthermore, Alternol-induced p62 oxidative modification was associated with autophagy-related responses and adaptive cellular survival under oxidative stress conditions. Disruption of the Cys105/113-dependent oxidative modification response attenuated Nrf2-associated transcriptional activity and increased cellular sensitivity to Alternol treatment. Collectively, our findings support an association between p62 oxidative modification and redox-responsive autophagy- and antioxidant-associated signaling pathways under Alternol-induced oxidative stress conditions, providing new insight into adaptive stress responses in prostate cancer cells.

Background Acute appendicitis is the most common surgical abdominal emergency in children. Its atypical presentations remain a significant source of diagnostic error. The presentation of an appendiceal abscess as an isolated abdominal wall mass, in the complete absence of abdominal pain, represents a misleading manifestation that directly contradicts the classic teaching that peritoneal signs are essential for diagnosis. Case presentation A previously healthy 13-year-old boy presented with a 10-day history of a painful right lower abdominal wall swelling, explicitly denying any abdominal pain. Initially misdiagnosed with a soft tissue infection based on a focused abdominal wall ultrasound, he was referred after 10 days of unsuccessful treatment. A non-contrast computed tomography scan revealed a secondary abdominal wall abscess connected via an inflammatory tract to a large periappendiceal abscess. Management followed a staged strategy: intravenous antibiotics led to resolution, followed by an uncomplicated delayed laparoscopic appendectomy 3 months later. The patient recovered fully. Interpretation This case illustrates a critical diagnostic pitfall where the absence of expected abdominal pain and a prominent local finding led to initial misdiagnosis as soft-tissue infection. This case highlights the diagnostic challenge posed by this presentation and serves to remind clinicians of the importance of considering an intra-abdominal source and obtaining a comprehensive ultrasound evaluation in children with an unexplained abdominal wall mass, even in the absence of abdominal pain. A diagnostic consideration pathway is presented as a teaching schematic to illustrate a systematic approach to evaluation in such ambiguous scenarios. It is crucial to emphasize that this pathway is derived from a single case and is presented for educational purposes, not as a validated clinical tool.

Ultrasound-guided hydrostatic reduction (UGHR) represents the first-line treatment for pediatric intussusception. However, treatment failure remains a persistent clinical challenge, driven largely by unrecognized pathological lead points (PLPs) before intervention. Large-cohort studies with complete surgical and pathological verification of all failed cases under a unified protocol remain scarce, leaving the true etiology and clinical phenotype of UGHR failure incompletely defined. To define the distinct clinicopathological phenotype and surgical findings associated with UGHR treatment failure in a fully verified patient cohort, and to evaluate the safety and efficacy of the standardized protocol within which these failures occurred. We conducted a retrospective cohort study of 2,882 children with acute intussusception managed with a standardized UGHR protocol (fixed pressure parameters, real-time ultrasound monitoring, predefined termination criteria) between 2021 and 2025. All 32 patients with failed reduction underwent mandatory emergency surgical exploration and histopathological examination, establishing a “surgical truth” dataset for comprehensive failure characterization. Analyses were intentionally descriptive and centered on deep phenotyping of this fully verified failure cohort rather than predictive modeling across the entire study population. The standardized protocol achieved an overall success rate of 98.89

QuestionDoes letrozole improve semen-based outcomes in men with spermatogenic failure?FindingsIn this randomized clinical trial of 296 men with spermatogenic failure, 14.3% of participants treated with letrozole (2.5 mg daily) plus vitamins C and E achieved an upgrade in World Health Organization sperm concentration category at 3 months compared with 5.4% in those receiving vitamins C and E alone, a statistically significant difference.MeaningIn this study, letrozole improved sperm concentration categories among men with spermatogenic failure, potentially enabling less invasive reproductive management. This randomized clinical trial evaluates whether treatment with letrozole improves sperm concentration categories among men with spermatogenic failure in China. ImportanceSpermatogenic failure (SPGF) is a severe form of male infertility with limited evidence-based medical treatment options. Aromatase inhibitors represent a promising therapeutic strategy for SPGF, but high-quality evidence is lacking.ObjectiveTo evaluate the efficacy and safety of letrozole for improving sperm concentration categories in men with SPGF.Design, Setting, and ParticipantsThis multicenter, open-label, assessor-blinded randomized clinical trial was conducted at 10 male infertility centers in China from July 2023 to March 2024. Men with SPGF (nonobstructive azoospermia [NOA], cryptozoospermia, or severe oligozoospermia) were enrolled. Follow-up for the primary outcome was completed in June 2024. Data were analyzed from July 2024 to March 2025.InterventionsParticipants were randomized to receive letrozole (2.5 mg daily) plus vitamins C and E or vitamins C and E alone (control group) for 3 months.Main Outcomes and MeasuresThe primary outcome was World Health Organization Sperm Concentration Categories (WHO-SCC) upgrade rate at 3 months after randomization. The secondary outcomes were WHO-SCC grades, Dutch Society of Obstetrics and Gynecology Total Motile Sperm Count Categories (NVOG-TMSCC) upgrade rate, semen parameters, and reproductive hormone levels.ResultsAmong 296 participants (mean [SD] age, 30.2 [3.9] years; 218 [73.6%] with NOA; 147 randomized to the letrozole group and 149 to the control group), 247 (83.4%) completed the trial, and all 296 were included in the primary analysis. WHO-SCC upgrade rates were 14.3% (21 of 147 participants) with letrozole vs 5.4% (8 of 149 participants) with control (risk difference, 9.2% [95% CI, 2.5%-15.8%]; P = .01). Participants in the letrozole group had higher odds of achieving a better WHO-SCC grade than those in the control group (common odds ratio, 2.65 [95% CI, 1.28-5.47]; P = .008). The NVOG-TMSCC upgrade rate was also higher with letrozole. Letrozole significantly increased serum gonadotropins and testosterone while decreasing estradiol. There were no significant between-group differences in semen parameters. Decreased libido (18 [12.2%] vs 8 [5.4%]; P = .04) was more frequent with letrozole than with control.Conclusions and RelevanceIn this randomized clinical trial of men with spermatogenic failure, letrozole significantly improved sperm concentration categories and was well tolerated, supporting its use as an option to downstage infertility severity and potentially enable less invasive reproductive management.Trial Registrationchictr.org.cn Identifier: ChiCTR2300073861

BACKGROUND:Prostate cancer (PCa) is the second most common malignancy in men worldwide. Although radical prostatectomy effectively controls tumor progression, it often causes complications such as urinary incontinence and sexual dysfunction. Irreversible electroporation (IRE), a non-thermal ablation technique that preserves neurovascular structures, has emerged as a promising focal therapy and may induce systemic antitumor immunity through immunogenic cell death. However, the mechanisms and temporal dynamics of systemic immune responses to IRE in humans remain unclear. METHODS:This prospective study enrolled five patients with localized PCa (T2a-T2c). Peripheral blood samples were collected before and 7 days after IRE treatment. Single-cell RNA sequencing and T-cell receptor (TCR) repertoire profiling (10x Genomics) were performed to construct a high-resolution immune landscape. Integrated bioinformatic analyses-including Seurat/Harmony clustering, differential expression, functional enrichment, Gene Set Variation Analysis, transcription factor analysis, cell-cell communication (CellChat), and clonal tracking (Immunarch/scRepertoire)-were used to characterize systemic immune modulation following IRE. RESULTS:IRE induced bidirectional remodeling of the peripheral immune landscape. Myeloid cells, especially non-classical monocytes, increased in proportion and exhibited activation of inflammatory (interleukin-27), antiviral, complement, and antigen presentation pathways. T cells declined and exhibited reduced activation-associated and proliferation-associated transcriptional programs alongside enhanced survival-related signaling, consistent with a relative quiescent state of peripheral adaptive immunity at day 7. Natural killer cells showed elevated cytotoxic activity. TCR profiling revealed increased diversity and antigen-driven clonal expansion, while cell-cell communication shifted toward proinflammatory (TNF/SELPLG) and away from antigen-presenting (major histocompatibility complex (MHC)-I/CD40) interactions, indicating coordinated innate-adaptive rebalancing. CONCLUSION:This study is the first to map systemic immune dynamics after IRE in prostate cancer using single-cell analysis. 1 week after IRE, peripheral blood mononuclear cells show robust innate activation with concomitant attenuation of circulating T-cell activation/proliferation and reduced MHC-I/CD40-related communication, consistent with a time-dependent systemic immune rebalancing phase rather than sustained peak adaptive activation in blood. These findings support time-resolved immune monitoring and may help optimize the timing of IRE-based combination immunotherapy.

BackgroundFailure to identify the appendix during laparoscopic appendectomy is uncommon but challenging. Complete subserosal embedding of the appendix-cecal complex is an exceptionally rare variant that may obscure all conventional laparoscopic landmarks. We describe this anomaly in a pediatric patient and describe a practical exploration strategy derived from this case.Case presentationA 7-year-old boy presented with acute right lower quadrant pain suggestive of appendicitis. Computed tomography showed appendiceal dilatation with periappendiceal inflammation. During laparoscopic appendectomy, the appendix could not be identified despite tracing the teniae coli and complete cecal mobilization. A targeted serosal incision at the teniae convergence revealed a completely embedded appendix-cecal complex. Subserosal dissection and appendectomy were completed successfully (operative time 45 min, blood loss 2 mL). Histopathology confirmed acute suppurative appendicitis. The patient recovered uneventfully with 6-month asymptomatic follow-up.ConclusionComplete subserosal embedding of the appendix-cecal complex is a rare variant presenting as a non-visualized appendix. Systematic exploration and awareness of unusual anatomical variants are essential. Targeted serosal incision may facilitate safe laparoscopic management and avoid unnecessary conversion to open surgery.

BackgroundRetroperitoneal lymphatic malformations (rLMs) are rare congenital anomalies with deep, complex anatomy adjacent to vital structures. Traditional treatments (open surgery, percutaneous sclerotherapy) carry high complication and recurrence rates. This study evaluated laparoscopic intracavitary catheterization combined with bleomycin quadruple sclerotherapy for massive cystic/multiloculated rLMs, aiming to establish a standardized minimally invasive paradigm.MethodsWe retrospectively analyzed 5 pediatric patients with massive rLMs treated at our institution (2022-2023) using this sequential strategy. Perioperative data (operation time, blood loss, cyst fluid volume), postoperative recovery (ambulation, oral intake, hospital stay), sclerotherapy outcomes, and long-term follow-up (recurrence, complications) were reviewed. Complications were formally graded using the Clavien-Dindo classification.ResultsAll 5 patients completed treatment without conversion to open surgery or adjacent organ injury. Mean operation time was 128 ± 25 min, blood loss 2 ± 2 mL, and cyst fluid aspiration 135 mL (80–200 mL). All ambulated within 6 h, resumed oral intake at 20 ± 3 h, and had a mean hospital stay of 12 ± 6 d. No patient required analgesic intervention. According to the Clavien-Dindo classification, one patient experienced a grade I complication (self-limiting abdominal discomfort), with no higher-grade complications observed. During a median follow-up of 46 months (43–48 months), all 5 children achieved clinical cure, defined as the absence of symptoms and complete radiographic resolution on imaging (ultrasound/CT), with no recurrence.ConclusionLaparoscopic intracavitary catheterization combined with bleomycin quadruple sclerotherapy is a minimally invasive, effective, and safe strategy for massive rLMs. It overcomes limitations of traditional treatments with minimal trauma, precision, and a favorable complication profile. The standardized protocol is reproducible, offering a new minimally invasive option for managing this rare retroperitoneal anomaly.

Acute kidney injury (AKI) is a critical clinical condition characterized by rapid loss of renal function and high morbidity. Irisin, a muscle-derived myokine, has been reported to exert protective effects in multiple tissues; however, its role in AKI remains largely unexplored. This study aimed to elucidate the renoprotective effects of irisin and its underlying mechanisms, with a particular focus on PGC-1α activation and autophagy regulation. Male C57BL/6 mice were subjected to lipopolysaccharide (LPS)–induced AKI and treated intravenously with irisin (10 mg/kg). Renal function, histopathological alterations, inflammatory markers, and apoptosis were assessed. In vitro, HK-2 cells were exposed to irisin, PGC-1α-specific siRNA, or the autophagy inhibitor chloroquine (CQ). Autophagic flux, lipid metabolism, mitochondrial function, and oxidative stress were subsequently evaluated. Irisin treatment markedly improved renal function in AKI mice by lowering serum creatinine and blood urea nitrogen levels, attenuating tubular injury, and suppressing inflammation and apoptosis. In HK-2 cells, irisin upregulated PGC-1α expression and enhanced autophagic activity, effects that were abolished by PGC-1α knockdown or CQ treatment. Additionally, irisin promoted lipid catabolism, reduced intracellular ROS accumulation, stabilized mitochondrial membrane potential, and protected cells from LPS-induced injury. Irisin alleviates AKI by activating PGC-1α–mediated autophagy, thereby mitigating inflammation, lipid accumulation, oxidative stress, and cellular damage. These findings highlight irisin as a potential therapeutic candidate for preventing or treating AKI.

It is unknown whether the glucagon-like peptide-1 (GLP-1) receptor agonists have a significant protective effect against acute islet injury. High mobility group box 1 (HMGB1) is a damage-associated molecular pattern (DAMP) molecule released from stressed or injured pancreatic β-cells, which triggers inflammatory responses through toll-like receptor 4 (TLR4) signaling. This study investigated the protective effect and mechanism of liraglutide on acute islet injury induced by low doses of streptozotocin (STZ). The results showed that liraglutide pretreatment preserved the structural integrity of pancreatic islets, improved insulin levels and glucose tolerance, and significantly reduced the incidence of diabetes in STZ-treated mice. Liraglutide was also found to inhibit STZ-induced release of HMGB1 and reduce the expression of TLR4 and inflammatory factors IFN-γ, IL-1β, and CXCL10. Moreover, administration of exogenous HMGB1 or antagonism of the GLP-1 receptor diminished liraglutide’s protective effects. These findings suggest that liraglutide has a strong protective effect on STZ-induced acute islet injury, most likely through the inhibition of HMGB1 release, which provides an experimental basis for the application of liraglutide as a protective agent for acute islet injury.

Background Intestinal malrotation with midgut volvulus is a pediatric surgical emergency, yet ultrasound, computed tomography (CT), and the upper gastrointestinal (UGI) series have rarely been compared. Objective To compare the real-world detection rate of ultrasound, CT, and the UGI series for malrotation in surgically confirmed cases, and to assess how midgut volvulus affects each. Materials and methods We retrospectively studied children with surgically confirmed malrotation at a tertiary children's hospital (2012–2026). Preoperative reports were classified by a rule-based algorithm validated against surgeon review (92% agreement, kappa 0.83). Modalities were compared with a generalized estimating equation (GEE) model, with a paired confirmatory analysis (exact McNemar test) in those undergoing all three. Results Of 465 children (352 [75.7%] male; median age 11 days; volvulus in 400 [86%]), 410 had preoperative imaging. CT and ultrasound had lower odds of detecting malrotation than the UGI series (adjusted odds ratio [OR] 0.29 and 0.27; both p < 0.001), confirmed in 59 undergoing all three (McNemar p ≤ 0.009). Contrast-enhanced CT (82.7%) approached the UGI series (78.7%) in a small subgroup. Detection was lower in neonates, rose over time, and showed no modality-by-volvulus interaction. Conclusion The UGI series had the highest detection rate; CT and ultrasound had similarly lower detection without differing from each other, although contrast-enhanced CT approached the UGI series in a small, non-comparable subgroup. Prior literature, not this study, supports the whirlpool sign as a rule-in finding for volvulus. These are detection rates, not full accuracy; prospective studies with test-negative children are needed.

Importance:Spermatogenic failure (SPGF) is a severe form of male infertility with limited evidence-based medical treatment options. Aromatase inhibitors represent a promising therapeutic strategy for SPGF, but high-quality evidence is lacking. Objective:To evaluate the efficacy and safety of letrozole for improving sperm concentration categories in men with SPGF. Design, Setting, and Participants:This multicenter, open-label, assessor-blinded randomized clinical trial was conducted at 10 male infertility centers in China from July 2023 to March 2024. Men with SPGF (nonobstructive azoospermia [NOA], cryptozoospermia, or severe oligozoospermia) were enrolled. Follow-up for the primary outcome was completed in June 2024. Data were analyzed from July 2024 to March 2025. Interventions:Participants were randomized to receive letrozole (2.5 mg daily) plus vitamins C and E or vitamins C and E alone (control group) for 3 months. Main Outcomes and Measures:The primary outcome was World Health Organization Sperm Concentration Categories (WHO-SCC) upgrade rate at 3 months after randomization. The secondary outcomes were WHO-SCC grades, Dutch Society of Obstetrics and Gynecology Total Motile Sperm Count Categories (NVOG-TMSCC) upgrade rate, semen parameters, and reproductive hormone levels. Results:Among 296 participants (mean [SD] age, 30.2 [3.9] years; 218 [73.6%] with NOA; 147 randomized to the letrozole group and 149 to the control group), 247 (83.4%) completed the trial, and all 296 were included in the primary analysis. WHO-SCC upgrade rates were 14.3% (21 of 147 participants) with letrozole vs 5.4% (8 of 149 participants) with control (risk difference, 9.2% [95% CI, 2.5%-15.8%]; P = .01). Participants in the letrozole group had higher odds of achieving a better WHO-SCC grade than those in the control group (common odds ratio, 2.65 [95% CI, 1.28-5.47]; P = .008). The NVOG-TMSCC upgrade rate was also higher with letrozole. Letrozole significantly increased serum gonadotropins and testosterone while decreasing estradiol. There were no significant between-group differences in semen parameters. Decreased libido (18 [12.2%] vs 8 [5.4%]; P = .04) was more frequent with letrozole than with control. Conclusions and Relevance:In this randomized clinical trial of men with spermatogenic failure, letrozole significantly improved sperm concentration categories and was well tolerated, supporting its use as an option to downstage infertility severity and potentially enable less invasive reproductive management. Trial Registration:chictr.org.cn Identifier: ChiCTR2300073861.

Prostate cancer is a prevalent condition among older males, with radical prostatectomy being the standard treatment. However, this procedure can inevitably impact urinary and sexual functions. Irreversible electroporation represents an innovative therapeutic approach that employs high-voltage electrical pulses to selectively eradicate tumor cells, potentially preserving vital normal tissue. This follow-up study included 11 older prostate cancer patients who underwent IRE therapy from November 2021 to December 2023. The cohort was aged 66–77 years with a median preoperative PSA of 9.46 ng/mL. Based on the EAU risk groups classification, patients were divided into low (n = 4), intermediate (n = 6), and high-risk (n = 1) groups. Follow-up exams were conducted every 3 to 6 months to assess PSA levels, imaging, and urinary/sexual function. Postoperatively, there was a significant decline in PSA levels across all patients, with a mean nadir of 0.78 ng/mL. The cumulative clinically significant prostate cancer recurrence rate was 27.3

Mechanisms by which mucosal regeneration is abrogated in inflammatory bowel disease (IBD) are still under investigation, and a role for an intestinal stem cell (ISC) defect is now emerging. Herein, we report an abnormal ISC death that occurs in Crohn's disease, which exacerbates colitis, limits ISC-dependent mucosal repair, and is controlled through the death factor Transmembrane protein 219 (TMEM219). Large alterations in TMEM219 expression were observed in patients with Crohn's disease, particularly in those with active disease and/or those who were nonresponders to conventional therapy, confirming that TMEM219 signaling is abnormally activated and leads to failure of the mucosal regenerative response. Mechanistic studies revealed a proapoptotic TMEM219-mediated molecular signature in Crohn's disease, which associates with Caspase-8 activation and ISC death. Pharmacological blockade of the IGFBP3/TMEM219 binding/signal with the recombinant protein ecto-TMEM219 restored the self-renewal abilities of miniguts generated from patients with Crohn's disease in vitro and ameliorated DSS-induced and T cell-mediated colitis in vivo, ultimately leading to mucosal healing. Genetic tissue-specific deletion of TMEM219 in ISCs in newly generated TMEM219fl/flLGR5cre mice revived their mucosal regenerative abilities both in vitro and in vivo. Our findings demonstrate that a TMEM219-dependent ISC death exacerbates colitis and that TMEM219 blockade reestablishes intestinal self-renewal properties in IBD.

BACKGROUND:Congenital biliary dilatation (CBD) represents a prevalent congenital anomaly in pediatric surgery, with concurrent choledocholithiasis observed in a notable subset of pediatric patients. Improper management of such cases can compromise early diagnosis of CBD and adversely impact outcomes of radical surgery. This retrospective study evaluated the safety and efficacy of endoscopic retrograde cholangiopancreatography (ERCP) in pediatric patients with common bile duct dilatation complicated by choledocholithiasis, aiming to refine clinical strategies for diagnosis and preoperative management to mitigate long-term complications. METHODS:A retrospective analysis was conducted on pediatric patients diagnosed with common bile duct dilatation and stones who underwent therapeutic ERCP at Wuhan Children's Hospital from August 2019 to July 2024. Clinical data, including demographic characteristics, laboratory tests, imaging findings, and ERCP-related parameters, were reviewed. Further subgroup analyses were performed based on the presence of postoperative adverse events and the coexistence of pancreaticobiliary maljunction (PBM). RESULTS:A total of 58 children with common bile duct dilatation and stones underwent 58 ERCP procedures, achieving a 100% procedural success rate. After ERCP, liver transaminase and bilirubin levels significantly decreased (P < 0.01). Postoperative follow-up showed a choledochal diameter of < 10 mm in 43 patients, with an overall effectiveness rate of 74.1% (n = 43/58). Among patients who did not undergo radical surgery (n = 48), the prognosis during follow-up (mean duration: 29.9 months) was favorable, and Likert scores were not associated with the presence of PBM (P > 0.05). The incidence of postoperative adverse events (n = 11/58, 19.0%) was significantly correlated with cannulation duration (P < 0.01). Patients in the PBM group (n = 21/58, 36.2%) were more likely to be female, younger, and have lower height and weight, with no differences found in other characteristics. CONCLUSION:ERCP is a safe and effective treatment for pediatric common bile duct dilatation with stones. Regardless of whether radical surgery was performed or the presence of PBM, patients showed improved laboratory parameters and symptom relief following ERCP. The effectiveness and incidence of adverse events were not related to PBM, but postoperative adverse events were associated with cannulation duration. Beyond its diagnostic utility in CBD and PBM, ERCP serves as a safe bridging therapy prior to radical surgery.

Prostate cancer (PCa) remains a leading cause of morbidity and mortality among men globally. Irreversible electroporation (IRE), a non-thermal ablation modality, selectively induces tumor cell apoptosis via high-voltage electrical pulses while sparing critical periprostatic structures. 10. (low-risk: 21, intermediate-risk: 21, and high-risk: 7). Serial assessments of PSA, MRI, urinary function (IPSS), and sexual outcomes (IIEF-5) were conducted at intervals of 3 to 6 months postoperatively. Median PSA nadir reached 1.69 ng/mL, with a cumulative clinically significant recurrence rate of 14.28% at a follow-up of up to months. PSA monitoring (>4 ng/ml) demonstrated a true positive rate of 57.1% (4/7 cases) for detecting clinically significant recurrence. Notably, sensitivity for PSA>10 ng/mL was limited to 28.6% (2/7 cases). Risk-stratified analysis revealed clinically significant recurrence rates of 4.8%, 19.0%, and 28.6% for low-risk, intermediate-risk, and high-risk cohorts, respectively. Postoperative complications included urinary incontinence (6.1%) and sexual dysfunction (4.1%), with no metastatic progression observed. These findings position IRE as a promising therapeutic strategy for localized PCa, offering favorable functional preservation and encouraging oncological control, particularly in low-to intermediate-risk patients. However, the elevated clinically significant recurrence rates observed in intermediate-high risk cohorts underscore two critical imperatives: first, the exploration of combined therapeutic regimens to mitigate recurrence risk, and second, establishing risk-stratified PSA thresholds and integrating advanced imaging biomarkers to enable dynamic postoperative surveillance.