Objective To evaluate the value of 18F-FDG PET/CT in diagnosis of renal cell carcinoma (RCC).Methods Totally 32 patients with RCC confirmed by pathology were analyzed retrospectively.The tumor diameter and maximum standard uptake values (SUVrmax) of different pathological types (clear and none clear RCC),different Fuhrman grades (high grade and low grade of clear RCC) and different clinical stages (distant and without distant metastases) were ana lyzed and compared.Results 32 RCC patients including 33 primary tumors,31 lesions were detected by PET/CT and 2 were false negative,the detection rate was 93.94％.The PET/CT findings of 31 primary lesions were mixed density soft tissue masses,and the 18F-FDG uptake accessible,above or below to the normal renal parenchyma;the other 2 lesions of PET/CT findings were normal.18F-FDG uptake of vein tumor thrombus in 8 cases and metastases in 19 cases were higher than the organs affected.The tumor diameter and SUVmax had no statistically significant difference in different pathological types and Fuhrman grades;The tumor diameter had no statistically significant difference,and SUVmax had statistically sig nificant (t=3.852,P=0.001) between different clinical stages.Conclusion The PET/CT findings of RCC primary lesion are varied,and small clear RCC with low Furhman grade may have no obvious abnormality and missed diagnosis;18F-FDG PET/CT has important value in the preoperative staging of RCC.

ObjectiveTo explore the efficacy of Solifenacin in the treatment of children with idiopathic overactive bladder （OAB）. MethodsThe study included 67 children with idiopathic OAB treated in the urology clinic of our hospital from March 2022 to March 2023. After at least 2-week-long behavioral therapy showed no significant therapeutic effect， 52 of the cases in the trial group were given oral Solifenacin 5 mg once daily and the other 15 cases in the control group continued the behavioral therapy. The cases in trial group were subdivided into OAB-dry group （27 cases without urinary incontinence） and OAB-wet group （25 cases with urinary incontinence）. The 3-day micturition diary， OAB Symptom Scores （OABSS） and the adverse reactions were recorded and analyzed before， at Weeks 2， 4， 8 and 12 after the treatment. ResultsOf all the 67 cases who completed a 3-month follow-up， 44 were cured including 41 in the trial group and 3 in the control group， 4 presented with adverse reactions. After the 3-month follow-up， the OABSS declined markedly in trial group than in control group （Z=4.524， P<0.001）； the cure rates in trial group and control group are 78.8% and 20% respectively， with significant difference （χ²=15.367， P<0.001）. At each follow-up，we found increased mean voided volume （F=9.707， P<0.001）， reduced mean voiding frequency during daytime （F=3.837， P=0.009） and decreased voiding urgency （χ²=482.835， P<0.001）. After the 3-month follow-up， the cure rates in OAB-dry group and OAB-wet group are 81.5% and 76% respectively， with no significant difference （χ²=0.234， P=0.629）. ConclusionsIn children with idiopathic OAB， oral Solifenacin 5 mg once daily could significantly increase mean voided volume， reduce mean voiding frequency during daytime， relieve symptoms of urinary urgency and lead to fewer adverse reactions， but is not significantly effective for the treatment of urinary incontinence in OAB-wet children .

AIM: To verify the accuracy of Van Herick method and slit-lamp anterior chamber depth examination in estimating angle closure.

METHODS: Totally 52 patients(100 eyes)over 40 years old were randomly selected from our outpatient department from June 2018 to January 2019.Their anterior chamber depth were examined by the methods of Van Herick method and the improved method to sort out peripheral anterior chamber depth are less than or equal to 1/3 CT and more than 1/4 CT and peripheral anterior chamber depth are less than or equal to 1/4 CT. Van Herick's anterior chamber depth inspection method and improved anterior chamber depth inspection method were checked for consistency, and then gonioscopic inspection and UBM inspection under darkroom were performed to check whether the peripheral angle was closed. In order to know whether there was any difference between gonioscopic and UBM inspection for angle closure, the consistency of the two verification results was checked.

RESULTS: Peripheral anterior chamber depth are less than or equal to 1/3 CT and more than 1/4 CT by the methods of Van Herick, the positive incidence of angle closure in angioscopy and ultrasound biomicroscopy are 39% and 43% respectively, Peripheral anterior chamber depth are less than or equal to 1/3 CT and more than 1/4 CT by the improved methods, the positive incidence of angle closure in angioscopy and ultrasound biomicroscopyare 46% and 42% respectively. In the patients whose peripheral anterior chamber depth checked by angioscopy and ultrasound biomicroscopy is less than or equal to 1/4 CT estimated by Van Herick method, the positive rate of angle closure was 67% and 89%, respectively. In the patients whose peripheral anterior chamber depth checked by angioscopy and ultrasound biomicroscopy is less than or equal to 1/4 CT estimated by the improved method, the positive rate of angle closure was 67% and 89%, respectively. The consistency test of the Van Herick method and the improved method showed good consistency(Kappa value: 0.85), when peripheral anterior chamber depth are less than or equal to 1/3 CT and more than 1/4 CT. peripheral anterior chamber depth(>1/4 CT), and good consistency(Kappa value: 0.83)when estimating peripheral anterior chamber depth ≤1/4 CT. According to the consistency test of the results of angioscopy and ultrasound biomicroscopy, when the Van Herick method estimated the depth of peripheral anterior chamber are less than or equal to 1/3 CT and more than 1/4 CT, the consistency was general(Kappa value: 0.73). When the Van Herick method estimated the depth of peripheral anterior chamber is less than or equal to 1/4 CT, the consistency was general(Kappa value: 0.40). According to the consistency test of the results of angioscopy and ultrasound biomicroscopy, when the improved method estimated the depth of peripheral anterior chamber are less than or equal to 1/3 CT and more than 1/4 CT, the consistency was good(Kappa value: 0.75). When the improved method estimated the depth of peripheral anterior chamber is less than or equal to 1/4 CT, the consistency was poor(Kappa value: 0).

CONCLUSION: The slit lamp anterior chamber depth examination has a certain false negative rate in estimating the angle closure in the population, but its accuracy is high, and it is still suitable for the preliminary examination of estimating the angle closure.

BACKGROUND: Compared with traditional hemostatic methods, absorbable hemostatic materials are more expensive and have lower awareness, but they have greater advantages in certain surgical procedures. OBJECTIVE: To review the classification, clinical use, safety and development status of absorbable hemostatic materials. METHODS: The computer was used to search the PubMed database for relevant literature published from January 2003 to March 2020. The search terms were “Absorbable Hemostatic Agents; Fibrin adhesives; Hemorrhage; Hemostatic dressings; Hemostats; Mechanical hemostats; Sealants”. China National Knowledge Infrastructure was retrieved for relevant literature published from January 2004 to March 2020. The search terms were “absorbable hemostatic material; hemostatic material; clinical research”. RESULTS AND CONCLUSION: Absorbable hemostatic materials mainly produce hemostasis by accelerating the blood coagulation process of wounds. Common hemostatic products include cellulose, starch and other plant polysaccharides, gelatin/collagen, chitosan, and fibrinogen. Different materials have different hemostatic mechanisms. Oxidized regenerated cellulose, starch, gelatin/collagen and chitosan hemostatic materials mainly form platelets by providing platelet activation and aggregation. Fibrinogen hemostatic materials can be used in the coagulation cascade involved in the formation of fibrin clots. The use of absorbable hemostatic materials depends on the doctor’s experience or preference. Clinicians need to choose one or more hemostatic material combinations according to the actual situation of the patient.

Tripterygium wilfordii as the preferred treatment drug for autoimmune diseases such as rheumatoid arthritis, with complicated chemical composition and anti-inflammatory, antitumor, immune regulation, and anti-reproductive function, is one of the hot natural medicines both at home and abroad. However, liver damage caused by T. wilfordii is reported frequently, which greatly limits its clinical application. In this paper, we collect and summarize the researches on the hepatotoxicity and compatibility of T. wilfordii in recent years based on the "detoxicity compatibility" theory of Chinese medicine compatibility. Meanwhile, we propose the principle of prescription to reduce the hepatotoxicity of T. wilfordii by compatibility mechanism, with a view to improve the security of the clinical application of T. wilfordii.

Objective: To investigate the hygroscopic properties of Liuwei Dihuang extract, and the correlation between the tensile strength and physical properties such as moisture content, angle of repose, critical relative humidity (CRH), and Karnofsky index. Methods: Liuwei Dihuang extract was used as a model, added with various excipients in different ways, and their hygroscopic properties were examined. Using the method of multiple linear regression analysis, the correlation between tensile strength and the physical properties of Liuwei Dihuang raw materials was studied. Results: The hygroscopicity of Liuwei Dihuang extract with various excipients was improved, negatively correlated with angle repose, compression index, bulk density, and moisture acceleration, and positively correlated with water solubility, water content, CRH, equilibrium moisture content, and initial velocity of hygroscopicity. Conclusion: The physical properties of Liuwei Dihuang powder affects the tensile strength of its tablets formed directly.

Transitional care is an important step in the process of treating disease. Medication risk during this period of time has become a public safety issue and attracted more attention. It not only threatens patients' health, but also increases the unnecessary cost of medical resources. Through systematically analyzing the medication risk in each link of the transition care, this paper discusses the strategies to improve the medication risk management of patients in the process of transition, and provides references for improving the level of rational medication use and optimizing the allocation of medical resources in transition care.

AIM: To study the establishment of adriamycin nephropathy rat model and the protective effects and mechanisms of dexamethasone implants (DEXI) through renal capsule implantation. METHODS: The adriamycin-induced nephropathy model was built by injecting Adriamycin (4 mg/kg) and Adriamycin (3.5 mg/kg) was injected again after week into tail-vein in SD rats. Renal capsule puncture was performed in model group. The excipient control group injected intra-renal capsule with drug-free excipient (1.4 mg/kg). The experimental group (2.8, 1.4, 0.7 mg/kg) was given by intrarenal capsule injection and positive drug group (0.1 mg/kg, qd × 8 w) was made by intragastric administration. The rat weight, kidney function and blood biochemical were observed and detected during the experiment. After the experiment, rat kidneys were stained with periodic acid-schiff to observe the morphological changes of mesangial and basement and sirius red to observe the renal tissue collagen fibers, expression of podocin and CD2AP were detected by immunohistochemistry. RESULTS: The blood protein content of adriamycin rats decreased, total blood cholesterol, uric acid, blood creatinine and urea nitrogen increased (P<0.05 or P<0.01), mesangium and fibers increased. The expression of Podocin protein in kidney tissue decreased and the expression of CD2AP protein increased (P<0.05 or P<0.01). DEXI increased the weight and blood protein levels of adriamycin rats, reduced blood lipids and blood uric acid levels (P<0.05 or P<0.01), improved renal function and tissue damage, and regulated the abnormal expression and distribution of Podocin and CD2AP proteins (P<0.05 or P<0.01). CONCLUSION: These results suggest that injecting adriamycin into the tail vein can establish a stable kidney disease model. DEXI renal capsule implantation can improve adriamycin nephropathy injury, and its mechanism may be related to restoration the expression and distribution of Podocin and CD2AP proteins on podocyte slit diaphragm.

Based on the experience of our team combined with literature analysis, there were some problems in study of clinical intervention, mainly in the aspects of clinical trial registration, construction of intervention programs, recruitment and compliance of research objects, intervention fidelity, selection of outcome indicators and data collection and analysis. It is necessary to understand the importance of clinical trial registration and follow the registration procedure, establish an intervention program based on the theoretical framework, focus on the factors that impede or promote the recruitment of objects to ensure the sample size, formulate strategies to improve the compliance and intervention fidelity of the intervention objects and select the appropriate outcome indicators， apply appropriate data collection and analysis methods based on the content of the study, and thus improve the quality of intervention researches.

Laccase is a widely-used environment-friendly copper-containing oxidase found in many plants, insects and fungi. Recently, more and more laccases are also found in bacteria. Myxobacteria are an important bacteria resource. However, myxobacteria are much more difficult to isolate and purify than other bacteria. We used bioinformatic approach to screen myxobacteria proteomes available in NCBI. Based on conserved sequences of four copper binding sites in multicopper oxidase, 30 potential laccase sequences were obtained. Among them, nine genes were synthesized and expressed in Escherichia coli BL21 (DE3). Seven proteins showed laccase activity when tested with traditional laccase substrates. One protein, named rSC-2, was chosen for further research because it exhibited the highest activity towards 2,6-dimethyl phenol (DMP). The molecular weight of rSC-2 was 57 kDa. Its specific activity to DMP was 0.27 U/mg. The optimal temperature and the optimal pH were 60 ℃ and 7.0, respectively. About 50% of the original activity was retained after incubation at 60 ℃ and pH 7.0-8.0 for 1 h. Metals showed different effects on rSC-2. rSC-2 activity was enhanced by several metalsat concentration of 1 mmol/L, such as Ca²⁺ and Mn²⁺. With a higher concentration of 5 mmol/L, the activity of rSC-2 was apparently inhibited. This is the first report of bioinformatics screening myxobacteria laccases in combination with expression in E. coli.