【Objective】 To compare the clinical safety and effectiveness of super-mini-percutaneous nephroscope (SMP) combined with flexible ureteroscopic lithotripsy (FURL) in oblique supine lithotomy position and FURL alone in the treatment of 2.0-3.0 cm renal calculi. 【Methods】 Clinical data of 55 patients treated during Jan.2018 and May 2021 were retrospectively analyzed, including 47 cases complicated renal calculi, and 14 cases of lower calyceal calculi with infundibulopelvic angle ≤30°. SMP combined with FURL was performed in 23 cases (combined group), and FURL alone was performed in 32 cases (FURL group). The operation time, hemoglobin reduction, postoperative hospital stay, hospitalization expenses, stone-clearance rate and complications were compared. 【Results】 All operations were successful. Compared with the FRUL group, the combined group had significantly more hemoglobin reduction [(16.30±10.17) g/L vs. (6.94±6.61) g/L], longer postoperative hospital stay [(5.35±1.61) d vs. (3.19±1.26) d], and higher hospitalization expenses [(22 481±2 234) yuan vs. (18 209±2 584) yuan] (P<0.05). However, there was no significant difference in operation time [(79.57±8.52) min vs. (79.22±3.83 min),P>0.05]. One month after surgery, CT results showed that the combined group had higher stone-clearance rate (91.30% vs. 65.63%, P=0.027). There was no difference in the complication rate (21.74% vs. 21.88%, P>0.05). One case (4.35%) in the combined group and 5 cases (15.63%) in the FURL group received retreatment (P>0.05). 【Conclusion】 SMP combined with FURL in oblique supine lithotomy position is safe and effective in the treatment of 2.0-3.0 cm renal calculi, with high stone-clearance rate and low complication rate.

(R)-2-hydroxy-3-phenylpropionic acid (PLA) is an ideal antimicrobial compound with broad-spectrum activity against a wide range of Gram-positive bacteria, some Gram-negative bacteria, and fungi. We studied the bioconversion of phenylpyruvate (PPA) to PLA using whole recombinant Escherichia coli cells in a series of buffer/organic solvent systems. Octane was found to be the best organic solvent. The optimum volume ratio of the water phase to the n-octane phase, conversion temperature, substrate concentration, and cell concentration were 6:4, 40 °C, 12.5 g/L, and 30 g/L wet cells, respectively. Under the optimized conditions, the average PLA productivity in the aqueous/ n-octane system was 30.69% higher than that in the aqueous system, and 32.31 g/L PLA was obtained with the use of a stirred reactor (2-L scale). Taken together, our findings indicated that PLA biosynthesis was more efficient in an aqueous/n-octane biphasic system than in a monophasic aqueous system. The proposed biphasic system is an effective strategy for enhancing PLA yield and the biosynthesis of its analogues.
Buffers ; Escherichia coli/metabolism* ; L-Lactate Dehydrogenase/metabolism* ; Microorganisms, Genetically-Modified ; Octanes/chemistry* ; Phenylpropionates/chemistry* ; Recombinant Proteins/chemistry* ; Solvents/chemistry* ; Stress, Mechanical ; Temperature

AIM:To investigate the effect of 3,5-hydroxy-6,7,3',4'-tetramethoxyflavone (HTMF) isolated from Laggera pterodonta on Hep-2 cell apoptosis and the underlying mechanism.METHODS:The MTT assay was used to observe the cytotoxicity of HTMF to the normal cells and the inhibitory effect of HTMF on the proliferation of tumor cells.The apoptosis was determined by flow cytometry.Western blotting was used to detect the expression of caspase-3 and caspase-9.RESULTS:HTMF significantly inhibited the growth of Hep-2 cells in dose and time dependent manners.HTMF exhibited weak cytotoxicity to the two normal cell lines Vero and EVC304,while showed low effect of anti proliferation on HepG2 cells and A549 cells.The increase in apoptosis of Hep-2 cells by HTMF was observed with dose and time dependent manners.Western blotting showed that HTMF time dependently increased the expression of caspase 3 and caspase-9 in Hep-2 cells.CONCLUSION:HTMF has high inhibitory effect on the proliferation of Hep-2 cells by induction of apoptosis in the tumor cells through caspase-9 and caspase-3 activation.However,the cytotoxicity of HTMF to the normal cells is low.

OBJECTIVETo investigate the risk factors of non-surgical vertebral fracture after percutaneous kyphoplasty (PKP) in patients with single segment thoracolumbar osteoporotic vertebral compression fracture(OVCF).

METHODSThe clinical data of 219 patients with single segment thoracolumbar osteoporotic vertebral compression fracture underwent percutaneous kyphoplasty from January 2010 to December 2015 were retrospectively analyzed. There were 29 cases in non-surgical vertebral body fracture group with 7 males and 22 females aged (67.35±9.92) years. Bone mineral density was(-3.89±0.72)SD, fracture compressed degree was (0.57±0.35)%, bone cement injected volume was (4.53±1.64) ml, and vertebral height recovery was (0.49±0.86)% on average. Ten cases were with vertebral body space fracture, 7 cases with bone cement leakage to the intervertebral disc, 9 cases with bone cement leakage to the peripheral tissue and 14 cases were treated by systemic anti-osteoporosis treatment after operation. Other 190 cases in non-surgical vertebral body without fracture group, and there were 42 males and 148 females, aged (66.98±7.55) years. Bone mineral density was (-3.13±0.59) SD, fracture compressed degree was (0.39±0.60)%, bone cement injected volume was (4.72±1.28) ml, and vertebral height recovery was (0.46±0.94)% on average. Among them, 13 cases were with vertebral body space fracture, 5 cases with bone cement leakage to the intervertebral disc, 29 cases with bone cement leakage to the peripheral tissue and 129 cases were treated by systemic anti-osteoporosis treatment after operation. The factors of gender, age, fracture compressed degree, fractured type, bone mineral density, bone cement injected volume, bone cement leakage, vertebral height recovery, adjacent vertebral fractures, and systemic anti-osteoporosis treatment were studied in the two groups for single factor analysis. For the results with significant differences among above factors, the multivariate logistic regression analysis was used to research the non-surgical vertebral fracture risk factors.

RESULTSAmong the 219 patients with single thoracolumbar fractures, 29 cases occurred non-surgical vertebral fractures. The single factor analysis results showed that there was no significant correlation between non-surgical vertebral fracture occurrecne with age, sex, fracture compressed degree, bone cement injected volume, and vertebral height recovery(>0.05), but there was a significant correlation between non-surgical vertebral fracture occurrence with fractured type, bone cement leakage, systemic anti-osteoporosis treatment, and bone mineral density (<0.05). Multivariate logistic regression analysis showed that fractured type(OR=0.135), whether systemic anti-osteoporosis treatment (OR=3.793), bone cement leakage (OR=8.975), and bone density (OR=57.079) are risk factors for postoperative non-surgical vertebral fractures.

CONCLUSIONSImproving the quality of the people, systemic preventing and treating the osteoporosis, improving the surgical skills and decreasing the bone cement leakage during operation are effective methods to prevent postoperative non-surgical vertebral fractures.

Abdominal aortic aneurysm (AAA) is a life-threatening disorder worldwide. Fibroblast growth factor 21 (FGF21) was shown to display a high level in the plasma of patients with AAA; however, its detailed functions underlying AAA pathogenesis are unclear. An in vitro AAA model was established in human aortic vascular smooth muscle cells (HASMCs) by angiotensin II (Ang-II) stimulation. Cell counting kit-8, wound healing, and Transwell assays were utilized for measuring cell proliferation and migration. RT-qPCR was used for detecting mRNA expression of FGF21 and activating transcription factor 4 (ATF4). Western blotting was utilized for assessing protein levels of FGF21, ATF4, and markers for the contractile phenotype of HASMCs. ChIP and luciferase reporter assays were implemented for identifying the binding relation between AFT4 and FGF21 promoters. FGF21 and ATF4 were both upregulated in Ang-II-treated HASMCs. Knocking down FGF21 attenuated Ang-IIinduced proliferation, migration, and phenotype switch of HASMCs. ATF4 activated FGF21 transcription by binding to its promoter. FGF21 overexpression reversed AFT4 silencing-mediated inhibition of cell proliferation, migration, and phenotype switch.ATF4 transcriptionally upregulates FGF21 to promote the proliferation, migration, and phenotype switch of Ang-II-treated HASMCs.

OBJECTIVETo assess and analyze the risk and community treatment of hypertension in rural population of Changshu city, Jiangsu province.

METHODSA stratified cluster sampling technique was conducted to select a sample of 800 people, aged 35 - 74 years old, in a rural village according to the proportion of the national population in Changshu. Weight, height, blood pressure, serum lipid, blood glucose and other related factors were examined and analyzed.

RESULTSThe prevalence rate of hypertension in the rural area was 32.01%, and significantly higher with the increase of age (P < 0.01). The average systolic blood pressure of hypertension in females was significantly positively correlated while, the average diastolic blood pressure of male and female hypertensives was significantly negatively correlated to age. The proportions of risk factors of cardiovascular diseases (CVD) as senility, hyperlipemia, premature familial history of CVD and overweight of hypertension were significantly high than those without hypertension (P < 0.01). The percentage of medium-low risk on hypertension was 85.72%, but of high risk was 14.28%. The ratio of using medication, exclusive non-medication, comprehensive treatment or total cure were 42.05%, 2.84%, 14.20% and 59.09%, accordingly. The rates of blood pressure control under the above approaches were 35.14%, 40.00%, 36.00% and 39.77%.

CONCLUSIONAssessment on the risk of hypertension in the rural areas suggested that the priority should be given to medium-low risk groups, while the rate of medication and non-medicine intervention was at low level. It is necessary to strengthen a comprehensive intervention program for hypertension control.

Adult ; Age Factors ; Aged ; China ; epidemiology ; Community Health Services ; statistics & numerical data ; Female ; Heart Diseases ; epidemiology ; Humans ; Hypertension ; epidemiology ; therapy ; Male ; Middle Aged ; Prevalence ; Random Allocation ; Risk Factors ; Rural Health Services ; statistics & numerical data ; Rural Population ; statistics & numerical data ; Sex Factors

BACKGROUND:The number of complications after hip replacement, such as infection, implant loosening, fracture prosthesis wear, osteolysis, and recurrent dislocation, had drastical y increased. These complications would induce the increased occurrence of total hip revision.
OBJECTIVE:To analyze the causes and treatment measures of revision after total hip replacement. METHODS:The reasons for revision, the prosthesis selection, the treatment of bone defect and the postoperative rehabilitation were discussed in 33 cases after total hip replacement. The prosthesis for revision included general metal ring and lining (21 cases), large head and cup (8 cases), polyethylene cup (4 cases), general femoral components (15 cases, including 11 cases fixed by bone cement), and lengthening femoral components (18 cases, including 9 cases fixed by bone cement and 6 cases of combined components).
RESULTS AND CONCLUSION:Al 33 patients were fol owed up for 24-60 months, averagely 36.5 months. After revision, wound healed perfect, and the prosthesis was reliable. No case suffered from infection or dislocation. Hip joint function was greatly improved. Harris score was increased from 37.1 preoperatively to 91.3 postoperatively. Medium-or short-period clinical fol ow-up results demonstrated that if the indication of revision was right, bone defects were handled perfectly, prosthesis was chosen correctly, one-stage total hip revision can get a good clinical efficacy.

Objective:To explore the clinical efficacy and safety of modified Heweitang in the treatment of functional dyspepsia （FD） due to liver-stomach disharmony and its regulation of gastrointestinal hormones and brain-gut peptides. Method:One hundred and twenty-six eligible patients were randomized into a control group （62 cases） and an observation group （64 cases）. Patients in the observation group took the modified Heweitang granules with warm water 30 min after meals， 10 g/time， 3 times/day， while those in the control group took the corresponding placebo granules at the same dose in the same manner. The treatment in both groups lasted for four weeks. Before and after treatment， the four main symptoms including postprandial satiety， early satiety， upper abdominal pain， and upper abdominal burning sensation were scored， followed by the examination of gastric emptying （GE） and the scoring of the functional digestive disorders quality of life questionnaire （FDDQL）， 7-point global overall symptom scale （GOSS）， and liver-stomach disharmony syndrome. The cholecystokinin （CCK）， motilin （MTL）， gastrin （GAS）， serotonin （5-HT）， vasoactive intestinal peptide （VIP）， and substance P （SP） levels before and after treatment were detected， and then the safety was evaluated. Result:After treatment， the scores of the four main symptoms， GOSS， and liver-stomach disharmony syndrome in the observation group were lower than those in the control group （P<0.01）， while the GE rate and FDDQL scores in the observation group were higher （P<0.01）. The CCK， GAS， 5-HT， and VIP levels of the observation group declined as compared with those of the control group （P<0.01）， whereas the MTL and SP levels were elevated （P<0.01）. After treatment， the overall response rate in the observation group was （51/57）89.47%， higher than （15/56）26.79% in the control group （χ²=45.696， P<0.01）. No drug-related adverse reactions were found during the trial. Conclusion:The modified Heweitang is efficient and safe in relieving the main and related symptoms and traditional Chinese medicine （TCM） syndrome， regulating the secretion of gastrointestinal hormones and brain-gut peptides， promoting GE rate， and improving the quality of life of patients with FD due to liver-stomach disharmony.

Objective: To explore the characteristics of the default memory network (DMN) and working memory network (WMN) at resting state brain functional network of exercise addiction people. Methods: Twenty-nine sports addicts and 26 non-sports addicts matched by sex, age, average education level and sports dependence were screened by the exercise addiction index (EAI). Resting status brain scanning was performed with 3.0T magnetic resonance scanner.Sparse approximation coefficients independent component analysis (SACICA) model was used to analyze the independent components of brain networks. Results: Compared with the DMN template, four features were extracted, including " basic conformity" , " less frontal lobe" , " more frontal lobe" and " less occipitoparietal lobe" . Compared with the parameters of " basic conformity" , the proportion of exercise addiction group (33.3%, 9/27) was higher than that of control group (18.2%, 4/22). In the other three parameters, the proportion of exercise addiction group (37.0%, 10/27; 3.7%, 1/27; 22.2%, 6/27) was lower than those of control group (45.5%, 10/22; 22.7%, 5/22; 27.3%, 6/22). But Chi-square test showed that there was no significant difference between the two groups(all P>0.05). Compared with the WMN template, six features were extracted, including " basic conformity" , " more frontal and parietal lobes" , " more parietal lobes" , " more frontal lobes" , " less frontal lobes" and " less parietal lobes" . The percentages of the first three features in exercise addiction group (22.2%, 6/27; 7.4%, 2/27; 7.4%, 2/27) were less than those in the control group (45.5%, 10/22; 22.7%, 5/22; 9.1%, 2/22), while the percentages of the last three features in the exercise addiction group (7.4%, 2/27; 37.0%, 10/27; 14.8%, 4/27) were higher than those in the control group (4.5%, 1/22; 13.6%, 3/22; 0, 0). Chi-square test showed that there was no significant difference in all features between the two groups was statistically(P>0.05). Conclusion No significant characteristic changes are found in DMN and WMN networks of exercise addiction population.

Objective To explore the correlation between the incidence of abdominal and pelvic artery distortion and age using dig-ital three-dimensional reconstruction,in order to assess risk in uterine artery embolization surgical approach.Methods Collecting the CTA datasets of 475 patients,group A aged 11-27 (n=40),group B aged 28-44(n=218),group C aged 45-61(n=197), group D aged 62-78(n=20).The 3D model of pelvic arteries was reconstructed by mimics software,and the arterial distortion was recorded by rotating and observing the 3D model,which was further classified into three categories.One was the distortion of the aorta only,the second was the distortion of iliac artery,and the third being distortion of both sturctures.the number of cases appeared arterial distortion in every age group was calculated and the ratio of the total cases to each age group was counted.Results There were 128(26.9%)cases appeared arterial distortion,the last 347(73.1%)were not found distortion in any artery.Of the 128 cases,the occurrence rates of arterial distortion in each age group were 2.5%、11.9%、44.7%、65% for group A,B,C and D respec-tively.Pearson linear correlation analysis showed that the incidence of arterial distortion positively correlated with age (r=0.404,help of three-dimensional reconstruction.The occurrence rate of artery distortion is increased with age and the iliac artery distortion occurrence is higher than that of the aorta artery.