Comparison of mini-percutaneous nephrolithotomy and retroperitoneal laparoscopic ureterolithotomy for treatment of impacted proximal ureteral stones greater than 15 mm / 中华医学杂志(英文版)

BACKGROUND@#The optimal treatment for large impacted proximal ureteral stones remains controversial. The aim of this study was to evaluate the efficacy, safety, and potential complications of mini-percutaneous nephrolithotomy (MPCNL) and retroperitoneal laparoscopic ureterolithotomy (RPLU) in the treatment of impacted proximal ureteral stones with size greater than 15 mm.@*METHODS@#A total of 268 patients with impacted proximal ureteral stones greater than 15 mm who received MPCNL or RPLU procedures were enrolled consecutively between January 2014 and January 2019. Data on surgical outcomes and complications were collected and analyzed.@*RESULTS@#Demographic and ureteral stone characteristics found between these two groups were not significantly different. The surgical success rate (139/142, 97.9% vs. 121/126, 96.0%, P = 0.595) and stone-free rate after 1 month (139/142, 97.9% vs. 119/126, 94.4%, P = 0.245) of RPLU group were marginally higher than that of the MPCNL group, but there was no significant difference. There was no significant difference in the drop of hemoglobin between the two groups (0.8 ± 0.6 vs. 0.4 ± 0. 2 g/dL, P = 0.621). The mean operative time (68.2 ± 12.5 vs. 87.2 ± 16.8 min, P = 0.041), post-operative analgesics usage (2/121, 1.7% vs. 13/139, 9.4%, P = 0.017), length of hospital stay after surgery (2.2 ± 0.6 vs. 4.8 ± 0.9 days, P < 0.001), double J stent time (3.2 ± 0.5 vs. 3.9 ± 0.8 days, P = 0.027), time of catheterization (1.1 ± 0.3 vs. 3.5 ± 0.5 days, P < 0.001), and time of drainage tube (2.3 ± 0.3 vs. 4.6 ± 0.6 days, P < 0.001) of MPCNL group were significantly shorter than that of the RPLU group. The complication rate was similar between the two groups (20/121, 16.5% vs. 31/139, 22.3%, P = 0.242).@*CONCLUSIONS@#MPCNL and RPLU have similar surgical success and stone clearance in treating impacted proximal ureteral stones greater than 15 mm, while patients undergoing MPCNL had a lower post-operative pain rate and a faster recovery.

Moving-average based index to evaluate the epidemic trend of COVID-19 outbreak

[ABSTRACT]A pneumonia outbreak caused by a novel coronavirus (COVID-19) occurred in Wuhan, China at the end of 2019 and then spread rapidly to the whole country. A total of 81,498 laboratory-confirmed cases, including 3,267 deaths (4.0%) had been reported in China by March 22, 2020, meanwhile, 210,644 laboratory-confirmed cases and 9,517 deaths (4.5%) were reported outside China. Common symptoms of COVID-19 pneumonia included fever, fatigue and dry cough. In face of such a sudden outbreak of emerging novel infectious diseases, we have no history to learn from and no evidence to count on. Traditional models often predict inconsistent results. There is an urgent need to establish a practical data-driven method to predict the evolutionary trend of the epidemic, track and prejudge the current epidemic situation after the COVID-19 outbreak. Here we propose a simple, directly and generally applicable index and we name it epidemic evaluation index (EEI), which is constructed by 7-day moving average of the log-transformed daily new cases (LMA). EEI could be used to support the decision-making process and epidemic prevention and control strategies through the evaluation of the current epidemic situation. First, we used SARS epidemic data from Hong Kong in 2003 to verify the practicability of the new index, which shows that the index is acceptable. The EEI was then applied to the COVID-19 epidemic situation analysis. We found that the trend direction of different districts in China changed on different date during the epidemic. At the national level and at local Hubei Province level, the epidemic both peaked on February 9. While the peak occurred relatively earlier, i.e. on February 5 in other provinces. It demonstrated the effectiveness of decisive action and implementations of control measures made by Chinese governments. While local governments should adjust management measures based on local epidemic situation. Although the epidemic has eased since late February, continued efforts in epidemic control are still required to prevent transmission of imported cases in China. However, the global COVID-19 epidemic outside China continues to expand as indicated by the EEI we proposed. Currently, efforts have been made worldwide to combat the novel coronavirus pandemic. People all over the world should work together and governments of all countries should take efficient measures in the light of Chinas experience and according to national circumstances and local conditions.

Isolation and identification of human adipose-derived stem cells and its exosomes / 中国组织工程研究

BACKGROUND: Currently, mesenchymal stem cells have been widely explored and applied in scientific research field, and many studies suggest that the underlying mechanism of mesenchymal stem cells mainly relies on its exosomes. OBJECTIVE: To isolate and identify human adipose-derived stem cells and its exosomes, and to identify their biological characteristics. METHODS: Human adipose tissue was digested with collagenase l, and adipose-derived stem cells were isolated and purified. Immunophenotype, osteogenic and adipogenic abilities of adipose-derived stem cells were identified. Exosomes were isolated by using ultrafiltration method. Morphology of exosomes was observed by Nanosight and electron microscope. Expression of proteins in exosomes was detected by antibody array method. RESULTS AND CONCLUSION: Adipose-derived stem cells exhibited long spindle-like or fibroblast-like appearance, expressed CD73, CD44, CD90, CD105 and had the potential to differentiate into many tissues, including bone and adipose tissues. The exosomes had the similar size, with the diameter of 30-150 nm. They possessed many proteins including FLOT1, ICAM, ALIX, CD81, CD63, ANXA5, TSG101, and so on. Findings from the present study indicate the successful isolation of exosomes from human adipose-derived stem cells.

Relationship between parental exposure to chemicals and risk of childhood acute leukemia / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the relationship between parental exposure to chemicals and the risk of childhood acute leukemia.</p><p><b>METHODS</b>An exploratory case-control study was conducted among 201 new cases of childhood acute leukemia under 15 years old who went to 3 children's hospitals in Shanghai, China from January 1, 2009 to December 31, 2010, as well as 201 sex- and age-matched children (as controls) who went to the child health care clinic or department of orthopedics in the above hospitals. A survey was performed by face-to-face interviews with children's mothers.</p><p><b>RESULTS</b>The risk factors for childhood acute leukemia might include maternal exposure to total chemicals (diesel oil, gasoline, paints, insecticides, pesticides, herbicides, and chemical fertilizers) from 3 months before pregnancy to the end of pregnancy (OR = 2.9, 95%CI = 1.1 ∼ 7.8), paternal exposure to insecticides (OR = 10.1, 95%CI = 1.2 ∼ 82.9) and chemical fertilizers (OR = 9.5, 95%CI = 1.1 ∼ 79.6) within 3 months before pregnancy, maternal working experiences in agriculture and forestry before pregnancy (OR = 8.4, 95%CI = 1.4 ∼ 50.2) and in spinning, leather processing, decoration, and vehicle repair before pregnancy (OR = 3.0, 95%CI = 1.2 ∼ 7.9) and during pregnancy (OR = 3.2, 95%CI = 1.1 ∼ 9.6), and paternal working experiences in agriculture and forestry (OR = 9.6, 95%CI = 2.1-44.8) and in spinning, leather processing, decoration, and vehicle repair (OR = 2.3, 95%CI = 1.1-5.0).</p><p><b>CONCLUSION</b>Parental exposure to chemicals may increase the risk of childhood acute leukemia in their offspring.</p>

Set up drug lymphocyte stimulation test (3H-TdR) and observe its application in drug-induced liver injury / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To set up the drug lymphocyte stimulation test (DLST), as a diagnosis means for DILI which was immunity idiosyncrasy, improve the Diagnosis, level of DILI.</p><p><b>METHOD</b>For the 59 patients who diagnosed as DILI, we separated their PBMC, exploring to the suspicious drug which caused DILI, then use the methods 3H-TdR to test, according to the mixed degree to clear the PBMC count which specific activated by drug.We also set up drug group, negative control and Positive control at the same time. Preliminary experiments was including the best dose of PHA and the best concentration of the drug. We set up 40 healthy group in our experiments as a control, and explore them on the same drug every time. We test the two groups at the same time. We handled the results use t-test.</p><p><b>RESULTS</b>The methods 3H-TdR could be exactly reflect the PBMC's proliferation degree nearly the same when they were be stimulation by PHA or the sensitive drug. When the DILI patients were explore to the suspicious drug, their stimulation index (SI) Obviously higher than 1.8. Form this test, there were 28 in 59 patients of DILI's group were positive (47.46%), SI was from 1.9 to 43.08, the average was 22.49, the healthy group SI was lower than 1.8, the SI of DILI's group was significantly higher than healthy group (5.78+/-0.75/1.16+/-0.25, P less than 0.05). Our test suggested DLST has Higher specificity (94.92%) and sensitivity (47.46%).</p><p><b>CONCLUSION</b>DLST was significance for the patients who diagnosed as immunity idiosyncrasy's DILI, it's reflected these patients' Proliferation of PBMC when explored to the suspicious drug for the second time.</p>

A case-control study on correlation of pesticide exposure with childhood acute leukemia / 中华预防医学杂志

<p><b>OBJECTIVE</b>To evaluate the correlation of pesticide exposure with childhood acute leukemia.</p><p><b>METHODS</b>An exploratory case-control study was conducted among childhood acute leukemia patients under 15 years old in Shanghai, China. From January 1st, 2006 to December 31st, 2008, a total of 80 newly diagnosed acute leukemia patients were recruited from Shanghai Children's Medical Center for the case group. Another 96 age-matched patients who visited the hospital for health examination, pediatric treatment or osteological therapy excluding hematological system diseases and neoplastic disease, were recruited for the control group. A questionnaire survey was conducted in both groups; and a 30 - 40 ml random urine sample was collected from each participant. Five types of organophosphorus pesticide metabolites was then detected among the samples, using Gas Chromatography with Flame Spectrophotometry.</p><p><b>RESULTS</b>According to result of the questionnaire survey, more participants (55.0% (44/80)) in case group than in the control group (33.3% (32/96)) reported using mosquitocidal, which might increase the risk of childhood acute leukemia (OR = 2.444; 95%CI: 1.326 - 4.506). At the same time, the detection showed that the concentration (median) of organophosphate metabolites diethyl phosphate, dimethyl phosphate, dimethyl thiophosphate, diethyl thiophosphate and diethyl dithiophosphate in case group were 0.0682, 0.0082, 0.0183, 0.0233, 0.4259 µg/g Cr, which were all significantly higher than in control group (0.0865, 0.0025, 0.0112, 0.0123, 0.1207 µg/g Cr) except the concentration of diethyl phosphate (Z = -1.081, P = 0.279). The difference showed statistical significance (Z = -5.752, -2.800, -3.316, -8.120, P < 0.05).</p><p><b>CONCLUSION</b>Pesticide exposure may be one of the risk factors for childhood acute leukemia.</p>

Correlation between level of metallic elements in urine and childhood acute leukemia / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the relation between the level of metallic elements in urine and childhood acute leukemia.</p><p><b>METHODS</b>A total of 71 patients under 15 years old who were newly diagnosed with acute leukemia between September 2007 and August 2008 without Downs' syndrome or other tumors, and 113 gender- and age-matched controls without tumors or congenital diseases were enrolled for the case-control study. The general data and potential risk factors were obtained by questionnaires. Inductively coupled plasma mass spectrometry (ICP-MS) was used to determine the metal concentrations in urine, which was collected randomly before chemotherapy. Logistic regression model was performed for univariate and multivariate analysis.</p><p><b>RESULTS</b>The questionnaire showed that there was significant difference in the proportion of children whose mothers had taken iron supplements during or 3 months before pregnancy between case group and control group, which was 28.2% (20/71) and 14.2% (16/113) respectively (Wald χ(2) = 5.438, P = 0.02). Univariate logistic regression analysis showed that levels of vanadium, manganese, iron, cobalt, copper, arsenic, and barium in urine from case group were all higher than those of control group with significant difference. The median values for vanadium in urine from case and control groups were 5.39 and 3.04 ng/mg creatinine (Wald χ(2) = 9.03, P < 0.05); the median values for manganese were respectively 4.46 and 2.44 ng/mg creatinine (Wald χ(2) = 10.57, P < 0.05); the median values for iron were separately 58.69 and 14.09 ng/mg creatinine (Wald χ(2) = 13.41, P < 0.05); the median values for cobalt were respectively 0.98 and 0.77 ng/mg creatinine (Wald χ(2) = 4.46, P < 0.05); the median values for copper were 61.17 and 10.90 ng/mg creatinine (Wald χ(2) = 8.15, P < 0.05); the median values for arsenic were respectively 55.93 and 36.11 ng/mg creatinine (Wald χ(2) = 4.57, P < 0.05); and the median values for barium were 8.55 and 2.87 ng/mg creatinine (Wald χ(2) = 4.82, P < 0.05). Multivariate logistic regression analysis showed that the level of iron in urine had a significantly positive relation with the incidence of childhood acute leukemia (OR = 1.009, 95%CI = 1.002 - 1.016).</p><p><b>CONCLUSION</b>The level of iron in urine might be related to the occurrence of childhood acute leukemia, but its specific role needs further investigation.</p>

Concentration of polybrominated diphenyl ethers in umbilical cord serum and the influence on newborns birth outcomes in Shanghai / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the concentration of polybrominated diphenyl ethers (PBDEs) in umbilical cord serum and analyze the influence of exposure to PBDEs during fetal stage on newborn birth outcomes in Shanghai.</p><p><b>METHODS</b>Fifty delivery women in a Shanghai hospital were surveyed by questionnaire, and the umbilical cord serum were collected from September 2006 to April 2007. All the delivery women were singleton pregnancies, excluding high blood pressure, diabetes, HIV infection and adverse medical history. Seven congeners (BDE-28, BDE-47, BDE-99, BDE-100, BDE-153, BDE-154 and BDE-183) were measured by gas chromatography-negative chemical ionization-mass spectrometry and the influencing factors were analyzed.</p><p><b>RESULTS</b>Newborns' length, weight, chest circumference, head circumference and body mass index (BMI) were (50.15 ± 0.75) cm, (3.49 ± 0.42) kg, (34.76 ± 1.51) cm, (35.03 ± 1.40) cm, (13.76 ± 1.36) kg/m(2), respectively. The median of Σ(7PBDEs) concentration in umbilical cord serum was 14.06 (1.03 - 379.73) ng/g lipid weight (lw). The detection rate of BDE-28, BDE-47, BDE-99, BDE-100, BDE-153, BDE-154 and BDE-183 were 22% (11/50), 22% (11/50), 98% (49/50), 72% (36/50), 76% (38/50), 90% (45/50) and 14% (7/50), respectively. The median (range) of PBDEs (BDE-28, BDE-47, BDE-99, BDE-100, BDE-153, BDE-154, BDE-183) congeners were < LOD (< LOD-137.20 ng/g lw), < LOD (< LOD-33.17 ng/g lw), 7.54 ng/g lw (< LOD-94.01 ng/g lw), 1.57 ng/g lw (< LOD-46.95 ng/g lw), 0.63 ng/g lw (< LOD-79.08 ng/g lw), 0.63 ng/g lw (< LOD-22.30 ng/g lw) and < LOD (< LOD-21.63 ng/g lw), respectively. The newborns' BMI showed a negative correlation with BDE-99 (r = -0.347, P < 0.05) and BDE-154 (r = -0.292, P < 0.05). BDE-99 in low-length group (≤ 50 cm, 10.59 ng/g lw) was significantly higher (t = 2.32, P = 0.03) than that in high-length group (> 50 cm, 3.60 ng/g lw).</p><p><b>CONCLUSION</b>PBDEs were commonly detected in newborns' umbilical cord serum in this study. Our findings indicated that exposure to PBDEs adversely affected the development of the newborns.</p>

Levels of polybrominated diphenyl ethers in human breast milk from a hospital in Shanghai / 中华预防医学杂志

<p><b>OBJECTIVE</b>To measure the concentration of polybrominated diphenyl ethers (PBDEs) in human breast milk from a hospital in Shanghai and analyze the influencing factors.</p><p><b>METHODS</b>Forty-eight puerperal from a hospital in Shanghai were selected to answer a questionnaire, and their breast milk samples were collected from September 2006 to April 2007. All the puerperal were singleton pregnancies, excluding high blood pressure, diabetes, HIV infection and adverse medical history. Seven congeners (BDE-28, BDE-47, BDE-100, BDE-99, BDE-154, BDE-153 and BDE-183) were measured by gas chromatography-negative chemical ionization-mass spectrometry and the influencing factors were analyzed.</p><p><b>RESULTS</b>The median of total PBDEs concentration in breast milk was 8.81 ng/g lipid weight (lw), and the range was 1.92 - 41.55 ng/g lw. The detection rates of seven congeners (BDE-28, BDE-47, BDE-100, BDE-99, BDE-154, BDE-153, BDE-183) were 98% (47/48), 96% (46/48), 86% (41/48), 90% (43/48), 83% (40/48), 98% (47/48), 90% (43/48), and the median of them was 0.88, 0.99, 0.97, 1.39, 1.14, 2.17, 1.41 ng/g lw, respectively. LogΣ(7PBDEs) in breast milk from mothers with different education levels were divided into junior high school or lower (0.89 ± 0.24), senior high school (1.02 ± 0.17), junior college or higher (1.08 ± 0.28). LogΣ(7PBDEs) in breast milk from mothers with different income levels were divided as < 1000 yuan (0.89 ± 0.12), 1000 - 3000 yuan (1.01 ± 0.24), > 3000 yuan (1.13 ± 0.21). Correlation analysis showed that both the mothers' education level (r = 0.322, P < 0.05) and income level (r = 0.388, P < 0.05) have a positive correlation to PBDEs levels in breast milk.</p><p><b>CONCLUSION</b>It is very common to detect PBDEs in human breast milk, however, the education and income levels of the mothers may be the influencing factors.</p>

Levels of hexabromocyclododecane in human breast milk and the daily intake of newborns in a Shanghai hospital / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the level of hexabromocyclododecane (HBCD) in human breast milk of delivery women in a Shanghai hospital, and estimate the daily intake of newborns from breast milk.</p><p><b>METHODS</b>Forty-eight delivery women in a Shanghai suburb hospital (Class A, Grade 3) were surveyed by questionnaires, and their breast milk samples were collected from September 2006 to April 2007. All the delivery women were singleton pregnancies, excluding high blood pressure, diabetes, HIV infection and adverse medical history. Three diastereoisomers (α-HBCD, β-HBCD, γ-HBCD) were measured by the liquid chromatography-electrospray ion source-tandem mass spectrometry, and then estimated the daily intake of the newborns from the breast milk.</p><p><b>RESULTS</b>The total HBCD concentration of breast milk, which was detected in 79% (38/48) of samples, ranged from 0.11 ng/g lipid weight (lw) to 37.75 ng/g lw, with the median at 1.42 ng/g lw. The most abundant diastereoisomer was α-HBCD which detected in 77% (37/48) of samples, with a median of 1.24 ng/g lw; followed by γ-HBCD and β-HBCD, detected in 13% (6/48) and 17% (8/48) of samples respectively, whose median were both under the limit of detection (LOD). The daily intake of the newborns from the breast milk ranged from 0.71 ng/kg to 243.46 ng/kg.</p><p><b>CONCLUSION</b>The concentrations of HBCD in breast milk of delivery women in a Shanghai hospital have been in a high level, and the influence on newborns' health need to be further studied.</p>

Analysis of related factors for medical discipline construction and development / 上海第二医科大学学报

Objective To screen and analyse the dominated related factors for medical discipline construction and development,and provide evidences for the reinforcement of discipline connotation construction.Methods The candidate medical disciplines of State Key Disciplines Evaluation of 2007 were served as study subjects.Disciplines from the results of State Key Discipline Evaluation were divided into "new discipline" group(n=51),"breeding discipline" group(n=33)and "failed discipline" group(n=81).The differences between results of State Key Discipline Evaluation and corresponding data of past years(2001 to 2006)in academic team,scientific research,graduate education and lab construction were analysed by nonparametric Kruskal-Wallis test.Results There were significant differences in academic leader,state key project,prize level,graduates quality and scientific research base among the results of State Key Discipline Evaluation(P≤0.05),and the dominated factors for the unsuccessful result were lack of high-level academic leader,state key discipline,prize,gruaduates and scientific research base.Conclusion The adoption of appropriate measures for the construction of academic team,the reinforcement of scientific research and the establishment of academic achievement evaluation may help to upgrade the academic level.

Relationship between contraceptive use behavior and related knowledge and cognition among vocational high school students / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study the relationship between contraceptive use behaviors and related knowledge and cognition among vocational high school students.</p><p><b>METHODS</b>A computer-administrated anonymous cross-sectional survey was conducted among grade one students from three vocational high schools in a district of Shanghai. Based on Health Belief Model, four cognition indexes including perceived benefits, barriers, sex behavior related risks and self-efficacy were applied.</p><p><b>RESULTS</b>Among 1612 respondents, the students who had sexual experience accounted for 7.01% (113/1612). At first sex, 56.64% (64/113) of respondents reported contraceptives use; and the methods most reported were condom (58.70%, 27/46) and oral contraceptive (27.78%, 5/18) respectively for male and female. Most reasons for non-use were feeling shy to buy it (26.53%, 13/49) and the opposite sex's unwillingness to use (18.37%, 9/49). Among those who had experienced sex, 68.35% (54/79) and 68.42% (52/76) of respondents thought withdrawal and rhythm were effective methods. Only 23.26% (10/43) of subjects who had ever used condom could gain the full score of knowledge on how to use condom. A few respondents (22.86%, 24/105) who had sex experience knew that "If a person is infected with STD, he/she may not have noticeable symptoms". And 40.63% (26/64) of respondents who had not use contraceptive at first sex considered that "Infrequent intercourse cannot cause a girl pregnant even she has experienced her menstruation". The level of perceived risks was lowest among four cognition indexes. Contraceptive related knowledge and cognition may contribute to respondents' contraceptive use behaviors at first sex, and only related cognition contribute to contraceptive use behaviors at recent sex.</p><p><b>CONCLUSION</b>It should be urgent to improve contraception knowledge and cognition among vocational high school students and provide youth-friendly contraceptive services.</p>