Efficacy of transurethral ureteroscopic lithotripsy versus retroperitoneal laparoscopic ureterolithotomy in the treatment of upper ureteral calculi / 中国基层医药

Objective:To explore the effects of retroperitoneal laparoscopic ureterolithotomy (RLU) and urethral ureteroscopic lithotripsy (URL) on renal function, oxidative stress, and immunoglobulin levels in patients with upper ureteral calculi.Methods:The clinical data of 78 patients with upper ureteral calculi, who received treatment in Yiwu Central Hospital from June 2017 to April 2020, were collected for this study. The patients were divided into URL group ( n = 38, URL treatment) and RLU group ( n = 40, RLU treatment) according to different surgical methods. Renal function (creatinine, urea nitrogen, neutrophil gelatinase-associated lipocalin), oxidative stress (superoxide dismutase, malondialdehyde), immunoglobulin (Ig) (IgA, IgM, IgG), and complications were compared between the two groups. Results:At 1 day after surgery, creatinine, urea nitrogen, neutrophil gelatinase-associated lipocalin in the RLU group were (79.59 ± 6.02) μmol/L,(6.93±1.17) mmol/L,(4.78±0.61) μg/L, respectively, which were significantly lower than those in the URL group [(86.98 ± 8.27) μmol/L, (7.62 ± 1.24) mmol/L, (6.03 ± 0.79) μg/L, t = 4.53, 2.53, 7.85, P < 0.001, P = 0.014, P < 0.001). At 1 day after surgery, IgA, IgM, and IgG in the RLU group were (1.94 ± 0.25) g/L, (1.55 ± 0.24) g/L, (6.59 ± 1.25) g/L, respectively, which were significantly lower than those in the URL group [(2.38 ± 0.23) g/L, (1.82 ± 0.27) g/L, (7.89 ± 1.36) g/L, t = 8.08, 4.67, 4.40, P < 0.001, 0.001, 0.001]. At 1 day after surgery, malondialdehyde level was significantly lower in the RLU group than in the URL group [(7.49 ± 1.26) mmol/L vs. (8.93 ± 1.38) mmol/L, t = 4.817, P < 0.001]. At 1 day after surgery, superoxide dismutase level was significantly higher in the RLU group than in the URL group [(72.18 ± 7.55) mg/L vs. (63.49 ± 6.69) mg/L, t = 5.37, P < 0.001). There was no significant difference in the incidence of postoperative complications [15.79% (6/38) vs. 7.50% (3/40), χ2 = 1.31, P = 0.252]. Conclusion:RLU for the treatment of upper ureteral calculi has fewer effects on renal function, oxidative stress, and immunoglobulin level in patients with upper ureteral calculi compared with URL and does not increase the incidence of complications.

Laparoscopic surgery in colon cancer patients with end-stage renal disease / 中华普通外科杂志

Objective:To explore the efficacy and safety of laparoscopic colon cancer surgery for patients with end-stage renal disease .Methods:Thirty-one end-stage renal disease patients (continuous hemodialysis) underwent laparoscopic colon cancer surgery from Jan 2014 to May 2019 in Tianjin First Central Hospital compared to 35 colon cancer patients with normal renal function.Result:Compared with the control group, the operation time in laparoscopic group was longer[(187±20) min vs. (174±21) min, t=2.381, P=0.020], the intraoperative blood loss was more[90 (80-110) ml vs. 50(40-60) ml, Z=-6.580, P<0.001], the postoperative drainage volume was more[(417±89) ml vs.(208±67) ml, t=10.858, P<0.001], the postoperative hospitalization time was longer[(13.68±2.10) d vs.(9.09±1.65) d, t=9.918. P<0.001], and the total hospitalization costs were higher[9.2 (8.8-9.6) ten thousand yuan vs. 6.1 (5.8-6.5) ten thousand yuan, Z=-6.976, P<0.001]. There was no significant difference in overall morbidity between the two group (23% vs. 9%, P=0.170). Sixty-one patients (92%) were followed up for a median time of 6 months. One case of liver metastasis was found in each group. Conclusion:Laparoscopic colon cancer surgery can be a safe and effective procedure in patients with end-stage renal disease .

Factors influencing long-term survival after hepatectomy in patients with a single large hepatocellular carcinoma / 中华肝胆外科杂志

Objective To study the prognostic factors which affected the long-term survival in patients with a single large hepatocellular carcinoma (SLHCC) after hepatectomy.Methods The clinical data of 138 SLHCC patients who underwent hepatectomy in the Tianjin Hospital from January 2008 to December 2013 were retrospectively analyzed.There were 115 males and 23 females.Age ranged from 23 to 81 years (median 56.8 years).The impact of an array of clinicopathological factors was analyzed using a variety of statistical methods which included the Kaplan-Meier estimator and the Log-rank test.Results The 1,3,5 year overall survival rates for all the patients were 86.4％,64.8％ and 54.1％,respectively,and the 1,3,5 year disease free survival rates were 68.8％,41.4％ and 33.2％,respectively.Univariate analysis indicated that microvascular invasion,preoperative AFP≥400 μg/L,a maximum tumor diameter ≥ 10 cm,and preoperative AST ≥40 U/L were risk factors of overall survival (all P ＜ 0.05),and microvascular invasion,preoperative AFP≥400 μg/L,and preoperative AST ≥40 U/L were risk factors of disease free survival (all P ＜ 0.05).Multivariate analysis showed that microvascular invasion,preoperative AFP ≥400 μg/L and preoperative AST ≥40 U/L were independent prognostic factors of overall survival and disease free survival for these patients (all P ＜ 0.05).Conclusion Microvascular invasion,preoperative AFP ≥400 μg/L and AST ≥40 U/L were independent prognostic factors of long survival of SLHCC patients.

Analysis of Feasibility of Opportunistic Screening for Colorectal Cancer in High Risk Population / 胃肠病学

Background:Screening of colorectal cancer (CRC) and colorectal adenoma (CRA), the precursor of CRC, is crucial for CRC prevention.It is believed that opportunistic screening of CRC in high risk population would narrow down the screening scope and save the health resources, and is suitable for the present status in China.Aims:To analyze the performance of high risk factors in predicting CRC/CRA, for exploring the feasibility of opportunistic screening for CRC in high risk population.Methods:A total of 1 862 outpatients and health examination subjects undergoing colonoscopy from Feb.2015 to Aug.2016 at the PLA 281 Hospital were recruited and asked to complete a questionnaire of high risk factors for CRC and CRA before colonoscopy.The questionnaire was designed based on the updated consensus on the screening and management of early colorectal cancer and precancerous lesion in China.Using the results of colonoscopy as gold standard, the predictive performance of high risk factors for CRC/CRA was analyzed.Results:Four hundred and sixty-eight (25.1%) individuals with high risk factors for CRC/CRA were screened out by the questionnaire.The detection rate of CRC in individuals with high risk factors was significantly higher than those without (17.5% vs.0.9%, P=0.000).The sensitivity, specificity, positive and negative predictive values of high risk factors in predicting CRC were 87.2%, 78.2%, 17.5% and 99.1%, respectively, and the missed diagnosis rate was 12.8%.For CRC/CRA, the corresponding figures were 83.2%, 87.0%, 57.3%, 96.1% and 16.8%, respectively.The risk ratios (RR) of high risk factors for CRC and CRC/CRA were 20.35 and 14.78, respectively.Conclusions:Opportunistic screening of CRC in high risk population is feasible and applicable in China under present condition.

Protective role and the mechanism of rapamycin against concanavalin A (ConA) induced autoimmune hepatitis in mice / 中华微生物学和免疫学杂志

Objective To investigate the therapeutic effects of rapamycin (RAPA) on concanavalin A (ConA)-induced acute autoimmune hepatitis in a mouse model and to analyze the possible mechanism.Methods Thirty eight-week-old female C57BL/6 mice were randomly divided into three groups including control group,ConA model group and ConA + RAPA treatment group.The levels of alanine transaminase (ALT) and aspartate aminotransferase (AST) in serum samples were measured after injection of mice with ConA for 24 hours for assessing the liver function.Hematoxylin-eosin (HE) staining was used to observe the hepatic pathological changes in mice.Splenocytes were harvested 24 h after ConA injection for the detection of the percentages of splenic DCs,CD4+T,CD8+T and CD4+ Foxp3+ Treg cells as well as the expression of co-stimulatory molecules (CD40,CD80 and CD86) on DCs by using flow cytometry.Results The levels of ALT and AST in mice from the RAPA treatment group were significantly lower than those of the ConA model group.Results of the HE staining assay showed that the liver damages in RAPA treated mice were less severe than those in mice from the ConA model group.Compared with mice form the ConA model group,those treated with RAPA showed decreased percentages of splenic CD4+ and CD8+ T cells,inhibited expression of CD80 and CD86 on splenic DCs,but increased percentages of splenic CD4+ Foxp3+ Treg cells.No statistically significant differences in the percentages of splenic DCs and the expression of CD40 were observed between the RAPA treatment group and the ConA model group.Conclusion The immunosuppressive effects of RAPA on mice with ConA-induced hepatitis might be achieved through the regulation of immune cells including DCs and T cells in spleen tissues.This study might pave the way for further investigation on the prevention and treatment of autoimmune hepatitis.

Hinting Effect of Clinical Symptoms for Colorectal Polyp and Carcinoma in Patients Undergoing Colonoscopy / 胃肠病学

Background:Detection and removal of colorectal polyp by colonoscopy is of great importance for prevention of colorectal carcinoma. Aims:To investigate whether the clinical symptoms of patients undergoing colonoscopy may hint colorectal polyp and carcinoma,and provide reference for candidate selection in colonoscopic screening. Methods:A total of 2 366 patients undergoing colonoscopy were recruited and the history information such as symptoms at outpatient visits, site and nature of the lesions was collected for analyzing the detection rates of colorectal polyp and carcinoma and the correlations of clinical symptoms with the risk and site of the disease. Results:The overall detection rates of colorectal polyp and carcinoma were 20. 5% and 5. 4% ,respectively,in 2 366 patients. The detection rates were significantly higher in symptomatic patients than those in asymptomatic patients(24. 2% vs. 4. 5% for polyp and 6. 4% vs. 0. 9% for carcinoma,P all = 0. 000). Moreover,when patients were classified by major symptoms,the detection rate of colorectal polyp was significantly increased in patients with diarrhea(OR = 1. 213),hematochezia(OR = 2. 076),and changing of stool consistency(OR = 1. 503)(P all < 0. 05),and the detection rate of colorectal carcinoma was significantly increased in patients with abdominal pain( OR = 1. 568),hematochezia( OR = 2. 837),changing of stool consistency( OR =2. 206),and tenesmus( OR = 1. 735)( P all < 0. 05). The major symptoms being hematochezia,changing of stool consistency and tenesmus were associated with lesions locating at rectum or left hemicolon(P all < 0. 05). Conclusions:Diarrhea, hematochezia and changing of stool consistency hints risk for colorectal polyp, while abdominal pain, hematochezia,changing of stool consistency and tenesmus hints risk for colorectal carcinoma. Colonoscopy is strongly recommended for patients with these symptoms.

Investigation on the therapeutic effects and the mechanism of mesenchymal stem cells on acute immune liver injury in mice / 中华消化杂志

Objective To explore the mechanisms of mesenchymal stem cells (MSC) in the treatment of concanavalin A (ConA)-induced acute immune liver injury in mice.Methods MSC were isolated and cultured from bone of the four limbs of three-week-old C57BL/6 mice.The specific surface markers were identified and osteogenic,adipogenic differentiation ability were tested.A total of 15 six to seven-week old C57BL/6 mice were divided into control group,MSC treatment group and phosphate buffer saline (PBS) treatment group,five mice in each group.The mice of MSC treatment group was injected through tail firstly with ConA and then MSC,PBS treatment group was injected through tail firstly with ConA and then PBS,control group was injected through tail with PBS twice.The mice were sacrificed in 14 to 16 hours after injection.The level of alanine aminotransferase (ALT),aspartate transaminase (AST) in peripheral blood were detected and the pathological change in liver tissue was scored by Knodell score system.Activation rate of splenic CD4+ T cells and the proportion changes of T hepler cell (Th)1,Th2,Th17 and regulatory T cells (Treg) were detected by flow cytometry and the ratio of Th17/Treg was calculated.The levels of tumor necrosis factor α (TNF-α),interferon (IFN)-γ and interleukin (IL)-4 in peripheral blood were detected by enzyme linked immunosorbent assay (ELISA).Independent-sample t test was used for comparison between groups of measurement data.Results ALT,AST and Knodell score of MSC treatment group was (174.2± 46.9) U/L,(185.6± 71.6) U/L and 3.4±1.3,respectively,which were better than those of PBS treatment group ((647.0± 118.0) U/L,(749.0± 104.0) U/L and 5.2 ±0.8,respectively),and the differences were statically significant (t =8.33,9.98 and 2.55,all P＜0.05).The activation rate of splenic CD4+ T cell of PBS treatment group was (26.10±2.17) ％,the proportion of Th1 and Th2 in CD4+ T cell was (5.81±0.79) ％ and (5.98± 1.22)％,the ratio of Th17/Treg was 0.29±0.03,the levels of TNF-α,IFN-γ and IL4 in peripheral blood were (1 281.95±88.61) U/L,(1 838.66±196.91) U/L and (1 192.36±163.94) U/L,which were higher than those of control group ((13.74±1.59)％,(1.35±0.17)％,(2.13±0.17)％,0.15± 0.05,(21.71±2.50) U/L,(11.84±1.28) U/L and (24.46±3.96) U/L),and the differences were statistically significant (t=10.26,12.37,7.02,5.30,31.79,15.93 and 20.75,all P＜0.01).There was no statistically significant difference in the activation rate of splenic CD4+T cell between MSC treatment group and PBS treatment group ((26.20±3.09)％ vs (26.10±2.17)％,P＞0.05).However,in MSC treatment group,the proportion of Th1 and Th2 in CD4+ T cell ((1.83±0.52) ％ and (2.75±1.06％)),the ratio of Th17/Treg (0.18±0.02) and the levels of TNF-α,IFN-γ and IL-4 in peripheral blood ((760.71± 73.19) U/L,(742.49±76.46) U/L and (825.76±101.74) U/L) significantly decreased compared with those of PBS treatment group,and the differences were statistically significant (t=9.45,4.48,6.41,10.14,5.56 and 10.22,all P＜0.01).There was no significant difference in the ratio of Th17/Treg between MSC treatment group and control group (P＞0.05).Conclusions The therapeutic effects of MSC on ConA induced acute immune liver injury were through influence splenic CD4+ T cell subsets by decreasing the proportion of Th1 and Th2 and then declining the levels of secreted cytokines such as TNF,IFN-γ and IL-4 in peripheral blood,increasing the proportion of Treg and decreasing the proportion of Th17 and keeping the balance of Th17/Treg.

Effect of core stabilization exercises on knee osteoarthritis / 中国综合临床

Objective To investigate the effect of core stabilization exercises( CSE) on knee osteoarthritis. Methods Sixty cases patients with knee osteoarthritis were randomly divided into treatment group (n = 30)and control group(n = 30). Patients in control group were accepted conventional therapy including conventional physiotherapy,acupuncture,and massage,while in treatment group were accepted CSE besides conventional therapy. All patients were assessed with Lysholm Knee Scoring Scale(LKSS)and Visual Analogous Scale(VAS)before and after treatment. Results VAS in treatment group before and after treatment were(8. 31 ± 1. 16)and(3. 37 ± 0. 97),and the difference was statistically significant( t = 16. 30,P = 0. 00). VAS in control group before and after treatment VAS were(8. 26 ± 1. 22)and(5. 06 ± 0. 82),and the difference was statistically significant( t = 12. 19,P = 0. 000. VAS in two groups after treatment was statistically significant (t = - 6. 98,P = 0. 00). LKSS in treatment group before and after treatment were(32. 92 ± 4. 21),(60. 19 ± 4. 42),and the difference was statistically significant(t = - 30. 44,P = 0. 00). LKSS in control group before and after treatment was(34. 82 ± 5. 58),(53. 49 ± 3. 66),and the difference was statistically significance (t = - 14. 82,P = 0. 00). After the treatment,LKSS in the two groups was significant difference(t = 7. 16,P= 0. 00). Conclusion The core stability training can improve the patients with knee osteoarthritis of knee joint function,relieve pain.

Application of acetic acid-indigo carmine dyeing in diagnosis of early gastric cancer and precancerous lesions in basic level hospital / 局解手术学杂志

Objective To explore the approaches to improve the detection of early gastric and precancerous lesions for basic level hospi-tals. Methods The 72 patients with abnormal gastric mucosa observed by gastroscope arranged with pathology after acetic acid-indigo car-mine dyeing were considered as the dyeing group, and 68 patients with abnormal gastric mucosa observed by gastroscope directly arranged with pathology were considered as the control group. The dyeing conditions of gastric mucosa were observed and compared to pathology detec-tion. The detection rate of early gastric cancer and precancerous lesions in the two groups were compared. Results After acetic acid-indigo carmine dyeing, there were 16. 7% of demonstrated discoloration, 63. 9% of poor dyeing, and 14. 3% of even dyeing. The detection rate of early gastric cancer and high grade intraepithelial neoplasia in patients with mucosa discoloration (91. 7%) was obviously higher than that in patients with poor dyeing (8. 6%) or even dyeing (0. 0%). The detection rate of low grade intraepithelial neoplasia or intestinal metaplasia in patients with poor dyeing (82. 6%) was obviously higher than that in patients with mucosa discoloration (8. 3%) or even dyeing (14. 3%). The detection rate of early gastric cancer and precancerous lesions in dyeing group (13. 9%,63. 9%) was obviously higher than that in control group (2. 9%,29. 4%). Conclusion The acid-indigo carmine dyeing could increase the diagnosis of early gastric cancer and precancerous lesions in basic level hospital. It is adaptable to extend approach in basic level hospital for its low cost and simple operation.

Effect of Chronic Alcohol Consumption on Left Ventricular Myocardial Collagen Content and Diastolic Function in Rats / 天津医药

Objective:To investigate the effect of chronic alcohol consumption on both left ventricular myocardial collagen and diastolic function in rats,and their relationship thereof.Methods:Twenty-four male Wistar rats were randomly divided into 2 groups:control group(n=12)and ethanol group(n=12).The changes in cardiac diastolic function were evaluated by echocardiography and tissue Doppler imaging(TDI).The value of myocardial hydroxyproline content was determined by hydroxyproline reagent kit.The expressions of collagen Ⅰ and collagen Ⅲ mRNA were detected by RT-PCR analysis.Results:It was found that mitral E and mitral annulus Ea were decreased,mitral annulus Aa was increased,and isovolumic relaxation time(IVRT)was prolonged in the ethanol group compared with those in control group(P＜0.05).The value of Ea/Aa ratio was greater than 1 in control group and less than 1 in ethanol group(P＜0.01).It was found that myocardial hydroxyproline content,collagen Ⅰ,collagen Ⅲ mRNA expression and their ratio significantly increased in ethanol group compared with those in the control group(P＜0.01).There was positive correlation between hydroxyproline content,collagen Ⅰ,collagen Ⅲ mRNA expression,and collagen Ⅰ /collagen Ⅲ mRNA ratio with IVRT(P＜0.05),and negative correlation between hydroxyproline content,collagen Ⅰ,collagen Ⅲ mRNA expression,and collagen Ⅰ /collagen Ⅲ mRNA ratio with the Ea/Aa ratio(P＜0.01).Conclusion:Chronic ethanol consumption can induce increase in left ventricular myocardial collagen synthesis and impairment in diastolic function in rats.Left ventricular diastolic dysfunction correlates with increase in myocardial collagen synthesis positively.

Design optimization of endovascular stent by finite element method / 生物医学工程学杂志

Stent implantation is now the favorable therapy of coronary heart disease, but the restenosis occurring in association with the currently used stents device has become the main obstacle limiting the further development of stent. To change the expanding behavior of endovascular stents by way of design optimization is considered one of the effective approaches for reducing the damage to the intima of blood vessel and thereby decreasing the in-stent restenosis. So in this paper, the finite element method was used to systematically simulate and analyze the influences of different width of ring supporter and the non-symmetrical design of stent on its transitorily expanding behavior. The results show that among the structure parameters, the width of ring supporter of stent influences its expanded pressure remarkably. When designing the endovascular stent, we make its ring supporter unsymmetrical, i. e., we make the width of ring supporter of stent change degressively from its central part to end part. By this means, the dogboning, which normally happens in the expanding process of the balloon/stent system, can be effectively controlled and the acute vascular injuries can be reduced.

Finite element analysis of the mechanical property of the resistance to compressing of the coronary stent / 生物医学工程学杂志

Since coronary stent is an important device used in percutaneous support the stenosed artery, its ability to expant the diseased artery wall shall be one of the most significant prerequisites for optimal stent performance. In this paper, the finite element model of coronary stent to resist compressing was set up based on the stent prototype testing. Using the numerical simulation, it was systematically analyzed that the influence of the size of the dilatation of stent and stent strut width and thickness on the stent mechanical properties of the resistance to compressive force applied by two opposite planes. The results show that this resistibility is weakened with the increasing of the final expanded diameter of stent, but increasing the stent strut width or thickness can improve it, and it is equivalent to this improvement to increase the dimension of strut cross section of the stent in the two directions. Experiment result is well consistent with simulation which indicates that the finite element method can substitute for the stent prototype testing to some extent.

Finite element analysis of the expansion behavior of coronary stents / 生物医学工程学杂志

Coronary stent is an important device used in Percutaneous Transluminal Coronary Angioplasty (PTCA) which is usually implanted to support the stenosed artery. Its expansion behavior depending on inflating of balloon and characters of recoil happening while the balloon is retrieved is the most important aspects which should be concerned in operation. In this paper, the finite element method was applied to systematically analyze the influence of strut width and thickness and the scale of dilatation of stent on its performance in expansion. The results show that increasing the strut width or thickness can improve the critical internal pressure needed for stent to expand fast. And the change of stent length while expanded is only associated with its structure and final dilatation state. If stent geometry is the same, it is the stent material that may be the main aspect to affect the recoil of stent. Experiment result is well consistent with simulation which indicates that the finite element method can substitute for the stent prototype testing to some extent.

Effects of(S,S)ZX-5 on gene expression of eNOS in ECV304 / 中国药理学通报

Aim To investigate the effects of(S,S)ZX-5 and(R,R)ZX-5 on eNOS mRNA and protein levels.Methods Cell culture was used for the experiments in vitro.The effects of eNOS mRNA were investigated by RT-PCR.The effects of eNOS protein levels were investigated by Western blot.Results(S,S)ZX-5 in concentration of 30 mg?L-1 up-regulated eNOS expressions at protein and mRNA levels significantly in cultured ECV304(P

Protective effect of glutamine on acute hepatic injury / 第三军医大学学报

Objective To explore the roles and clinical significance of glutamine(GLN) in carbon tetrachloride(CCl_(4)) induced acute hepatic injury.Methods The SD rats were divided into model group,GLN pretreated group and control group.The animal model was established by CCl_(4) intraperitoneal injection.GLN at dose of 1 g/kg was intragastrically administrated for 7 d before intraperitoneal injection of CCl_(4) in the rats of GLN pretreated group.The rats were executed 4,8,12,16,24 h after injure.To evaluate the hepatic injury,the serum alanine aminotransferase(ALT) and aspartate aminotransferase(AST) were detected by automatic biochemistry analysator.The liver tissue was observed by light microscope and transmission electron microscope(TEM).The expression of nuclear factor-?B(NF-?B) was detected by immunohistochemistry and the tumor necrosis factor?(TNF-?) was detected by reverse transcription polymerase chain reaction(RT-PCR).The apoptosis of hepatocyte was detected by TUNEL.The oncosis index was detected by TEM.Results The levels of ALT,AST,NF-?B,TNF-? mRNA in model group were apparently elevated as compared to control group(P