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The incidence and recurrence rates of urinary stone diseases have remained high recently, and stone analysis is of great significance for further understanding of the pathophysiological processes of urinary stones and to develop effective prevention strategies and precise treatment. Imaging evaluation is the main method of preoperative stone analysis, and dual-energy CT has shown its potential in identifying common main components of stones. The emergence of photon counting spectral CT is expected to achieve accurate analysis of stone components at the pixel level. The intraoperative stone analysis mainly relies on the automatic recognition of endoscopic images, and using machine learning algorithms can more reliably predict common stone composition. It is of great significance for stone analysis and assessment of metabolic causes by introducing morpho-constitutional classification (MCC)and observing and describing the papillary renal lesions during operation. This article reviews the progress of preoperative and intraoperative stone analysis, in order to improve clinicians' understanding of the importance of stone analysis, and provide a direction for further clinical research.
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Objective:To compare the consistency of tomographic infrared spectrum analysis with conventional infrared spectrum analysis for the composition analysis of large-volume of urinary stones in vitro.Methods:Postoperative urinary stone specimens collected from 105 patients admitted to Beijing Tsinghua Changgung Hospital from January 2019 to June 2021 were analyzed, including 81 (77.14%) kidney stones, 16 (15.24%) ureteral stones, and 8 (7.62%) bladder stones. All stones measured ≥0.8 cm in maximum diameter on preoperative imaging. Eighty-four specimens, which were mainly stone fragments, were collected from percutaneous nephrolithotomy and ureteroscopic lithotripsy. These 84 specimens were analyzed and retested for stone composition using conventional infrared spectrum analysis by random multiple sampling. Other 21 renal stone specimens were obtained by laparoscopic lithotomy or standard percutaneous nephrolithotomy after November 1, 2020. These 21 specimens had a maximum diameter of ≥0.8 cm measured postoperatively. Based on intraoperative observation, stone specimens with typical layered structures were chosed. Then, all 21 samples were analyzed and retested by conventional infrared spectrum analysis and tomographic infrared spectrum analysis, respectively. When using tomographic infrared spectrum analysis, we need to take two maximum cross sections with a vertical spacing of these sections >2 mm, then perform multiple points sampling according to the morphological stratification of the first section. If the section's structure was homogeneous, we equidistantly took 2 to 3 samples from the center to the periphery. Otherwise, every layer needed to take a stone sample according to the stratification. Putting all the results of one section together, we obtained complete tomographic infrared spectrum analysis data. Take another coaxial cross-section of the same specimen for retesting. We recorded the characteristics of the three-dimensional distribution of stone composition in 21 stone specimens. Meanwhile, we compared the consistency of the results of conventional infrared spectrum analysis and tomographic infrared spectrum analysis for the same sample.Results:The consistency rate of the conventional infrared spectrum analysis was 56.19% (59/105), and that of tomographic infrared spectrum analysis was 80.95% (17/21). The difference in consistency between two methods was statistically significant ( χ2=4.447, P=0.035). Among 21 specimens, the consistency rate of conventional infrared spectrum analysis was 38.10% (8/21), which was significantly lower than that of tomographic infrared spectrum analysis ( χ2=7.814, P=0.005). Regarding the characteristics of the three-dimensional distribution of the components, the color and crystal morphology of five common types of stone components were different, and layered structure in the cross-section of the stones were observed. When the calculi were of the same composition, they were displayed in different morphology. We observed a trending change in the composition ratio between sublayers from the center to the edge in some compound-composition stones. Conclusions:For the composition analysis of larger-volume urinary stones, tomographic infrared spectrum analysis showed a higher consistency of retesting than conventional infrared spectrum analysis, and the three-dimensional distribution of stone composition had some characteristic features.
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@#Among current novel druggable targets, protein–protein interactions (PPIs) are of considerable and growing interest. Diacylglycerol kinase α (DGKα) interacts with focal adhesion kinase (FAK) band 4.1-ezrin-radixin-moesin (FERM) domain to induce the phosphorylation of FAK Tyr397 site and promotes the malignant progression of esophageal squamous cell carcinoma (ESCC) cells. Chrysin is a multi-functional bioactive flavonoid, and possesses potential anticancer activity, whereas little is known about the anticancer activity and exact molecular mechanisms of chrysin in ESCC treatment. In this study, we found that chrysin significantly disrupted the DGKα/FAK signalosome to inhibit FAK-controlled signaling pathways and the malignant progression of ESCC cells both in vitro and in vivo, whereas produced no toxicity to the normal cells. Molecular validation specifically demonstrated that Asp435 site in the catalytic domain of DGKα contributed to chrysin-mediated inhibition of the assembly of DGKα/FAK complex. This study has illustrated DGKα/FAK complex as a target of chrysin for the first time, and provided a direction for the development of natural products-derived PPIs inhibitors in tumor treatment.
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Objective To assess the value of three-dimensional double echo steady state with water excitation (3D-DESSwe) MR sequence in depicting the normal anatomy of facial nerve. Methods 3D-DESSwe MR sequence was performed in 15 healthy volunteers on a 1.5T MR. The 3D datasets obtained were constructed in relation to the course of the facial nerve using multi-planar reconstruction (MPR) and thin slice maximum intensity projection (MIP) programs, and the images acquired were compared with anatomical textbook diagrams. Two doctors analyzed the images in collaboration and recorded on an arbitrary scale of 0-2 grades (grade 2, homogeneity and facial nerve identified with certainty;grade 1, mild inhomogeneity and facial nerve probably identified;grade 0, severe inhomogeneity and facial nerve not identified). Results In all subjects, 3D-DESSwe images provided reliable definition of the normal facial nerve anatomy bilaterally and high contrast between the facial nerve and adjacent structures were obtained. The cisternal segment of facial nerve showed high signal intensity while the moving CSF flow surrounding it showed low signal intensity. The internal auditory canal (IAC) segment of facial nerve showed relatively low signal intensity while the stationary CSF surrounding it showed high signal intensity. The labyrinthine, tympanic, mastoid and extracranial segments of facial nerve showed high signal intensity while the bone and soft tissue surrounding it showed low signal intensity, and parts of facial nerve branches could be demonstrated. Conclusion 3D-DESSwe sequence can display the complete course of the normal facial nerve, especially for the intratemporal and extracranial parts.
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Objective To study the effective treatment for severe hypertensive cerebral hemorrhage. Methods 102 cases of severe hypertensive cerebral hemorrhage were randomly divided into two groups: One group with minimally invasive surgery and intravenous drip of wintermine started 1 ～ 5 days after operation, another only with minimally invasive surgery. The 55 subjects with conservative treatment were selected as control group. Results The quality of life in the survival group was better than in group B and C (P < 0.05, or P < 0.01), the mortality of group A was also significantly lower than the other two groups (P < 0.05, or P < 0.01). Conclusion Minimally invasive surgery combined with intravenous drip of wintermine can be a safe and effective method for severe hypertensive cerebral hemorrhage.
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Objective To study the changes of AKP activity and its cytochemistry position during liver regeneration following partial hepatectomy. Methods Using colorimetry to analyze AKP activity; using non-denatured electrophoresis technique to analyze the kinds and activity of AKP; using electron microscope cytochemistry to analyze its position. Results During liver regeneration, AKP activity had two peaks at 16*!h and 19*!h and followed by decline dramatically; Three hepatic-derived AKP isoenzymes were detected, and 180*!kD AKP appeared only in liver regeneration; AKP appeared in different part with the process of liver regeneraion.Conclusion AKP plays an important role in liver regeneration and it may involve in cell metabolism, material transportation, DNA synthesis and cell differentation.