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Evidence is a core element of evidence-based medicine, with diverse classifications and extensive sources. Most of it is based on journals and is commonly found in databases or websites such as PubMed, Web of Science, and CNKI. The number of literatures is countless, which also puts enormous pressure on researchers to consult and read literature. The field of urology is no exception. This article started with analyzing the characteristics of common clinical questions in the field, introduced the four criteria for their screening and two types of structured templates, clarified the definition, categories, identification, and three requirements for the application of the four evidence classification methods, and explained the selection of retrieval resources, construction of retrieval strategies, specific operational steps, and precautions for the retrieval process to develop and use evidence. In addition, combined with artificial intelligence technology, the future development trend of evidence classification and retrieval in the field of evidence-based urology has been clarified, which provided reference for further promoting the development of evidence-based urology.

Background Knee joint injury is a common military training injury, which seriously affects the combat effectiveness of soldiers. In recent years, the prevention and treatment of military training injury becomes more and more important. Ultrasound therapy and Qingpeng ointment are commonly used to treat sports training injuries. However, the protective effectiveness of ultrasound combined with the external use of Qingpeng ointment for knee injury in sports training injury patients is less reported. Objective To comprehensively assess the clinical efficacy of Qingpeng ointment combined with ultrasound therapy in the treatment of knee injuries caused by military training. Methods Fifty-six patients with knee injury who were treated in the Fifth Pentry Outpatient Clinic, the General Hospital of the Western Theater Command PLA from May to July 2022 were selected and randomly grouped into control group (4 cases fell off during the study, n=24) and treatment group (n=28) using IBM-SPSS 25.0 statistical software to generate random numbers. The control group was given ordinary coupling agent ultrasonic therapy, and the treatment group was given Qingpeng ointment ultrasonic therapy, once a day, 10 times a course, a total of 2 courses. The Lysholm knee joint score, VAS score, Hamilton Depression Scale-17 (HAMD-17), and knee range of motion were compared between the two groups after a twenty-minute intervention. Results Before treatment, there was no significant difference in Lysholm knee joint score, VAS score, HAMD-17 score and knee joint motion between the two groups (P>0.05). After 2 courses of treatment, the passive joint motion of the knee in the treatment group was better than that in the control group (P

Objective Exploring the application effect of Bloom's taxonomy theory of education in the teaching of evidence-based medicine curriculum.Methods Undergraduate students majoring in clinical medicine (5, 5+3) and basic medicine at the Second School of Clinical Medicine of Wuhan University in 2019 were selected as the research subjects. The Bloom's taxonomy of educational objectives was implemented, and a self-made questionnaire was used to investigate their mastery of relevant knowledge content, changes in attitudes, and course satisfaction.Results 75 students were included in the study. After the course, the correct rate of students' understanding of evidence-based medicine, Meta-analysis, experimental design, and other related knowledge ranged from 54.67% to 100.00%, all were significantly higher than those before the course, and the differences before and after the course were statistically significant (P

Endothelial-to-mesenchymal transition (EndMT), a process initiated by activation of endothelial TGF-β signaling, underlies numerous chronic vascular diseases and fibrotic states. Once induced, EndMT leads to a further increase in TGF-β signaling, thus establishing a positive-feedback loop with EndMT leading to more EndMT. Although EndMT is understood at the cellular level, the molecular basis of TGF-β-driven EndMT induction and persistence remains largely unknown. Here, we show that metabolic modulation of the endothelium, triggered by atypical production of acetate from glucose, underlies TGF-β-driven EndMT. Induction of EndMT suppresses the expression of the enzyme PDK4, which leads to an increase in ACSS2-dependent Ac-CoA synthesis from pyruvate-derived acetate. This increased Ac-CoA production results in acetylation of the TGF-β receptor ALK5 and SMADs 2 and 4 leading to activation and long-term stabilization of TGF-β signaling. Our results establish the metabolic basis of EndMT persistence and unveil novel targets, such as ACSS2, for the potential treatment of chronic vascular diseases.

Objective To systematically analyze relevant literature on evidence-based urology (EBU) in China and abroad, and to understand their definitions and methodological research status. Methods The PubMed, Web of Science, CNKI, Wanfang, VIP Database for Chinese Technical Periodicals, and SinoMed were searched, JD.com and Dangdang.com engines are used to assist retrieval. The search was conducted as of August 9, 2023. The connotation and methodological research characteristics of EBU were extracted, and then used content analysis to integrate the extracted information. Results A total of 37 literature were included. There was no literature on the definition of EBU yet, and the research topics involved randomized controlled trials, systematic review, guidelines, evidence grading, Cochrane Library and PubMed database literature retrieval, evidence-based clinical decision-making, etc. 12 articles focused on 11 topics of randomized controlled trials or clinical trials such as subgroup analysis, relative and absolute effects, alternative endpoints; 5 articles introduced 4 themes of systematic review including heterogeneity, publication bias, P-value and confidence interval, and likelihood ratio; 9 literature systematically outlined the key methods of evidence-based medicine and provide evidence support for clinical questions related to the urinary system diseases. In terms of writing format, cases of urinary system diseases were used for explanation. Conclusion The definition of EBU has not yet been clarified, but it has a good foundation of development and constructionn, and the theoretical system EBU needs to be further improved. For example, starting with the complexity of the problems emerging in urology, actively proposing new ways of solving them, enriching research evidence types, innovating grading standards, expanding the clinical decision-making methods of EBU, and accelerating the optimization of subject curriculum system and talent cultivation.

AIM: To compare the clinical effectiveness of using multifocal defocus spectacle lenses, orthokeratology lenses, and single-vision spectacle lenses in patients with myopia and small-angle intermittent exotropia.METHODS: This retrospective study included 150 patients aged 8-15 years with basic intermittent exotropia, strabismus of -10△ to -20△ prism diopters(D)(block lenses), and spherical equivalents of -1.00 to -5.50 D, who visited our hospital from June 2021 to September 2022. They were selected and divided into three groups on a voluntary basis: the HAL group(50 patients with multifocal myopia defocus spectacle lenses), the OK lens group(50 patients with nighttime orthokeratology lenses), and the SVL group(50 patients with regular single-vision spectacle lenses). After wearing the lenses consistently, changes in axial length, prism diopters with the naked eye and lenses(prism at 33 cm), positive fusional vergence of blurred points, and near stereopsis were observed and compared among groups before intervention and after 1 a. The Newcastle control score(NCS)was used to evaluate the eye position control ability of the patients in the three groups.RESULTS: Before the intervention, the axial lengths of the HAL, OK lens, and SVL groups were 24.83±0.91, 24.93±0.97, and 24.98±0.68 mm, respectively(P>0.05). After 1 a, the axial lengths of the three groups were 25.02±0.90, 25.18±0.97, and 25.45±0.65, respectively(P0.05). After 1 year, near stereopsis in the groups were 76.00″±20.40″, 81.20″±18.91″, and 100.60″±51.41″, respectively(P0.05), and it was 17.10±2.02, 13.12±1.41, and 13.26±2.45, respectively, after 1 a(P

C60H140N20O12S4, monoclinic, P2/n (no. 13), a = 15.6996 Å, b = 8.5361 Å, c = 15.8896 Å, β = 94.722°, V = 2122.19(10) Å3, Z = 4, R gt(F) = 0.0440, wR ref(F 2) = 0.1366, T = 296(2) K.

Questions: All else being equal, populations of dioecious species with a 50:50 sex ratio have only half the effective reproductive population size of bisexual species of equal abundance. Consequently, there is a need to explain how dioecious and bisexual species coexist. Increased mean individual seed mass, fecundity, and population density have all been proposed as attributes of unisexual individuals or populations that may contribute to the persistence or resilience of dioecious species. To date, no studies have compared sympatric dioecious and cosexual species with respect to all three components of fitness. In this study, we sought evidence for these compensatory advantages (higher seed mass, greater seed production per unit basal area, and higher population density) in dioecious species. Location: Five 20–25 ha forest dynamic plots spanning a latitudinal gradient in China, including two temperate, two subtropical, and one tropical forest. Methods: We used a phylogenetically corrected generalized linear modelling approach to assess the phylogenetic dependence and joint evolution of sexual system, seed mass and production, and ecological abundances among 48–333 species and 32,568–136,237 individuals per forest. Results: Across all five forests, we detected no consistent advantage for dioecious relative to sympatric cosexual species with respect to mean individual seed mass, seed production or the density of stems in any size class. Conclusions: Our study suggests that seed traits may provide compensatory mechanisms in some forests, but most often the coexistence of sexual systems cannot be explained by advantages of dioecy related to seed quality and demographic parameters. Future investigations of the factors that promote coexistence may increase our understanding by expanding the search to include attributes such as lifespan and tolerance or resistance to herbivores.

Objectives: Polysaccharides from Glycyrrhiza are known to have several bioactive effects. Previous studies have found that low-molecular-weight Glycyrrhiza polysaccharide (GP1) is degraded by MuribaculumH5 and promotes the production of beneficial bacteria and metabolites, which improves immune disorder and intestinal injury, and then enhances the body's immune regulation ability. However, the immune regulation effect of GP1 on a healthy body has not been studied. In this study, we aimed to reveal the immune enhancement effect and mechanism of GP1 on healthy mice. Methods: The cytotoxicity and immunomodulatory activity of GP1 were analyzed by cell experiment; the effects of GP1 on antioxidation, immune regulation and gut microbiota structure of healthy body were studied in vivo. In addition, the mechanism of GP1 enhancing immune response of healthy body was analyzed by multi-omics. Results: The results show that GP1 enhanced the immune function of healthy mice by increasing the index of immune organs, improving the organizational structure of immune organs, and increasing the secretion of immune cytokines and immunoglobulin. GP1 also increased the contents of antioxidant factors such as total antioxidant capacity (T-AOC), glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) in various organs and reduced the content of oxide malondialdehyde (MDA), thus enhancing the body's antioxidant capacity, promoting cell proliferation and prolonging life. Moreover, GP1 promoted the proliferation of beneficial bacteria, including Muribaculaceae_unclassified, Muribaculum, Prevotellaceae_UCG-001, and Paramuribaculum, and the production of characteristic metabolites (collectively referred to as postbiotics), including α-tocopherol, arachidonic acid, melibiose, taurine, and nicotinic acid. These beneficial bacteria and postbiotics have been proven to have health maintaining functions. Conclusions: GP1 promoted the proliferation of beneficial bacteria and increased the production of postbiotics, which should be the mechanism of its beneficial effect. It is expected to be a promising immune dietary supplement. [ABSTRACT FROM AUTHOR]

Background: The burden of cardiovascular disease (CVD) is severe worldwide. Although many studies have investigated the association of particulate pollution with CVD, the effect of finer particulate pollution components on CVD remains unclear. This study aimed to explore the effect of five PM2.5 components ( , sulfate; , nitrate; , ammonium; OM, organic matter; BC, carbon black) on CVD admission in Shanghai City, identify the susceptible population, and provide clues for the prevention and control of particulate pollution. Methods: Daily PM2.5 components data during 2013–2019 in three districts of Shanghai were obtained from Tracking Air Pollution in China. We obtained CVD daily admissions data from relevant departments of Tongji Hospital, including basic information (sex, age, time of admissions, ICD code of root cause of admissions, etc.). First, generalized additive model (GAM) and distributed lag non-linear (DLNM) model were used to evaluate the individual effects of PM2.5 components on CVD admission in three districts of Shanghai. Then, the three regions were pooled for analysis using either a random-effects model or a fixed-effects model. Results: Overall, all five PM2.5 components had significant effects on CVD admission risk. BC and OM were strongly associated with daily CVD admissions, with increasing interquartile range of the concentrations, the maximum values of cumulative RR (95% CI) were 1.318 (95%CI: 1.222–1.415) and 1.243 (95%CI: 1.164–1.322), respectively. The elderly (≥ 65 years old) was more sensitive to the four PM2.5 components than the young population. and BC were strongest associated with CVD admissions in the elderly than in younger people, with increasing interquartile range of the concentrations, the maximum cumulative RR (95% CI) was 1.567 (95% CI: 1.116–2.019) and 1.534 (95% CI: 1.104–1.963), respectively. Conclusions: This study found that five PM2.5 components were significant risk factors for CVD admissions and specific CVD diseases in Shanghai City. The elderly were susceptible to , , OM, and BC. [ABSTRACT FROM AUTHOR]

Floral syndrome is one of the key components of plant pollination syndromes, affecting variety of evolutionary and ecological processes in angiosperms. The evolutionary transition from self-incompatible heterostyly to self-compatible homostyly occurred repeatedly in angiosperm families. Although the evolution of heterostyly and homostyly has been deeply studied, our understanding on their differences in ecological strategies is still lacking. In this work, using the floral syndrome and distributions of the Primula in China we compared the spatial pattern of floral syndrome frequency and its climatic determinants. Our results reveal that distylous and homostylous Primula have similar primary centers of species diversity in southwest China, while distylous species have larger range size than homostylous ones. Temperature seasonality is the dominant climate factor of these geographic patterns, but its effect is much stronger in distylous than in homostylous Primula. Distylous species have larger flower size and number, and fruit size than homostylous ones. Climate, especially temperature seasonality mainly influenced species range size via its effects on floral syndrome. Our study suggests that homostyly is likely derived from heterostylous ancestors in similar geographical context, and larger reproductive investment in floral phenotype may provide compensatory mechanisms for obligate out-breeding heterostyly. Future investigations regarding the evolutionary history and tolerance or resistance to environmental change between distyly and homostyly may greatly advance our understanding of their spatial pattern and adaptative differences. [ABSTRACT FROM AUTHOR]