Objective:To investigate the effect of potassium sodium hydrogen citrate in the treatment of renal uric acid calculi with heavy load.Methods:The clinical data of 6 patients with intrarenal high-load uric acid calculi (long diameter >4 cm) treated with potassium sodium hydrogen citrate in our hospital from January 2018 to July 2020 were reviewed. All of the patients were male. Their ages ranged from 42 to 66 years, with an average age of 51.3 years old. The average length to diameter was 6.0(4.1-7.6) cm. The average density of stone was 475 (418-535) HU. The average blood uric acid was 453.3(258.7-570.0)μmol/L, and all patients had a urine pH ≤5.5. The blood uric acid level was higher than normal serum uric acid level before treatment, and 3 cases had a history of gout. Stone composition analysis revealed 100% uric acid stone in two patients before treatment. The remaining patients were more likely to have uric acid calculi before treatment. None of the patients had a history of urinary tract infection. All patients were treated with oral potassium sodium hydrogen citrate. During the treatment, the starting dose was 10g/ day, which was divided into 2.5 g after breakfast, 2.5 g after lunch and 5.0 g after dinner. The dose was adjusted according to the pH value of urine, and the urine pH was maintained between 6.5-7.0. CT plain scan was repeated every 2-3 months during the treatment period to evaluate the treatment effect.Result:After 2.5-8.0 months’ treatment, the stone load of all the patients was reduced to different degrees, and the average length diameter was shortened by 3.2cm, among which two patients’ stones disappeared. CT scan showed the stone edge changed from smooth to rough after the treatment, and there would be worm erosion defect and cavity on the surface and inside of the stone, showing obvious stone dissolution phenomenon.Conclusions:Potassium sodium hydrogen citrate has a good therapeutic effect on renal uric acid calculi with heavy load. Non-infected patients with uric acid calculi should be treated with potassium sodium hydrogen citrate.

Objective To investigate the influence of sperm morphology, sperm DNA fragmentation index and seminal plasma zinc on pregnancy outcome of in vitro fertilization and embryo transfer (IVF-ET).MethodsA total of 341 infertile couples underwent IVF-ET were selected from January 2016 to June 2016 in our hospital.Sperm morphology, sperm DNA fragmentation index and seminal plasma zinc level were compared according to pregnancy.ResultsIn 341 cases, 204 cases pregnancy and 137 cases of no pregnancy, with the pregnancy rate of 59.8%(204/341).Compared with the pregnancy group, the percentage of normal sperm percentage was low, the abnormal sperm index was higher in the non-pregnant group (P<0.05), the sperm DNA index was higher (P<0.05).The percentage of normal sperm, sperm DNA fragmentation index and seminal plasma zinc and pregnancy rate in sperm morphology were linear (P<0.05), And there was a negative correlation between abnormal sperm index and sperm DNA fragment index (P<0.05), and other indicators were positively correlated (P<0.05).ConclusionSperm morphology, sperm DNA fragmentation index and seminal plasma zinc levels may influence the outcome of IVF-ET.The above parameters can be used to predict pregnancy outcome of IVF-ET.

In order to further deepen the reform of public hospitals, to improve the qualified personnel training in Qingpu, and to enhance the overall level of medical health development, Qingpu Municipal Commission of Health and Family Planning In October 2011, a new round of disciplinary construction and personnel training project was also started.Moreover, financial support has been provided to the project.By assessing the whole process, not only has the level of discipline personnel training and medical technology shown significant improvement, the tutors who provided the training also express academic interest and have new a vision for talent cultivation.Qingpu Municipal Commission of Health and Family Planning launched a new round of comprehensive program on researcher training and disciplinary construction in 2011, aimed to further deepen the reform of public hospitals,improve the capacity of health research in Qingpu, Shanghai.We have assessed this program and found that this program has significantly improved the quality of training, and medical technology level in those hospitals;in addition, trainees has shown the increase in the interesting in conducting research and raised vision and prospects.

Objective To investigate the protective effects of lentivirus mediated Bcl-2-associated athanogene 1L (BAG-1L) over-expression on human neuroblastoma cells (SH-SYSY) induced by hypoxia/re-oxygenation,and to study its effect on the phosphoinositide 3 kinase serine/threonine protein kinase (PI3K/AKT) pathway.Methods SH-SYSY cells were cultured in vitro,and the cells at logarithmic phase were collected,and they were divided into recombined lentiviral infection group [infected by lentivirus containing BAG-1L and green fluorescent protein (GFP) gene],vector control group (infected by lentivirus containing GFP without BAG-1L gene) and cell control group (non-infection).Western Blot was used to detect the expression of BAG-1L in target cells after infection for 48 hours.SH-SY5Y cells were subjected to hypoxia for 8 hours and re-oxygenation for 24 hours,then the cell counting kit-8(CCK-8) was used to detect the cell activity,and the apoptosis was detected by flow cytometry after allophycocyanin labeled annexin V/7-amino actinomycin D (Annexin V-APC/7-AAD) staining.Western Blot was used to detect the protein expressions of BAG-1L,heat shock protein 70 (HSP70),AKT and phosphorylated AKT (p-AKT).Results After infection for 48 hours,exogenous BAG-1L protein bands were observed in recombined lentiviral infection group,but not observed in cell control group and vector control group.After hypoxia/re-oxygenation treatment,the cell viability in recombined lentiviral infection group was significantly higher than that in cell control group and vector control group (A value:0.689 ± 0.036 vs.0.425 ± 0.013,0.400 ± 0.012),apoptosis was significantly decreased [apoptosis rate:(26.97 ± 1.82)％ vs.(36.60± 1.45)％,(35.77 ± 3.74)％],the protein levels of BAG-1L,HSP70 and p-AKT were significantly increased [BAG-1L protein (gray value):2.405 ± 0.167 vs.0.529 ± 0.141,0.601 ± 0.099;HSP70protein (gray value):0.997±0.123 vs.0.634±0.091,0.584±0.106;p-AKT protein (gray value):1.234±0.118 vs.0.661 ± 0.210,0.712 ± 0.199,all P ＜ 0.01],but the protein level of AKT was slightly increased (gray value:1.103 ± 0.269vs.0.646 ± 0.188,0.791 ± 0.326) without statistically significant differences (both P ＞ 0.05).There was no significant difference in all parameters between cell control group and vector control group (all P ＞ 0.05).Conclusion Lentivirus mediated BAG-1L gene over-expression can protect nerve cells against hypoxic injury and apoptosis,and the protective effect may be related to the activation increase of pathway on PI3K/AKT.

Objective To investigate the protective effects of Bcl-2 associated with athanogene-1 (BAG-1) gene on human neuroblastoma cells (SH-SY5Y) injury induced by hypoxia/reoxygenation,and its influence on heat shock protein 70 (HSP70) expression.Methods The SH-SYSY cells at logarithmic growth phase were collected.Lenti virus mediated RNA interference (RNAi) technology was used to suppress the BAG-1 expression.The cells screened out can be divided into four groups:the cell control group with no lentivirus infection,lentivirus control group (containing only fluorescein protein lentivirus infection),BAG-1 siRNA group (BAG-1 siRNA silencing group),including BAG-1 siRNA-α group and BAG-1 siRNA-β group with lentivirus containing fluorescein protein (GFP) but at different BAG-1 siRNA target sites of silencing.Western Blot was used to detect the protein expression of BAG-1 and HSP70 in target cells after infectious recombination lentivirus for 72 hours;the Cell Counting Kit-8 (CCK-8) was used to detect the activity of four different group cells after hypoxia;the flow cytometry was used to detect the cell apoptosis;the HSP70 mRNA transcription level were detected by real-time fluorescent quantitative reverse transcription-polymerase chain reaction (RT-qPCR) respectively in each group.Results After lentiviral infection for 72 hours,the Western Blot results showed that in the two BAG-1 siRNA silencing groups,the interference effect of BAG-1 siRNA-β group was superior to that of BAG-1 siRNA-α group.The cell viability of each group showed an increase followed by a decrease with the prolongation of hypoxia time,and reaching the peak at 8 hours.After hypoxia for 8 hours being given,the cell viability in BAG-1 siRNA-β group was significantly lower than that of the cell control group,lentivirus control group and BAG-1 siRNA-α group (A value:0.59 ±0.09 vs.0.94±0.12,0.90± 0.11,0.91± 0.14,P ＜ 0.01);the cell apoptosis rate was obviously higher in BAG-1 siRNA-β than that in the above three groups [(34.63 ± 3.46)％ vs.(14.83 ± 3.75)％,(19.93 ± 6.49)％,(16.40± 1.18)％,all P ＜ 0.01].There were no statistically significant differences in the HSP70 protein level and mRNA transcription level between BAG-1 siRNA-3 grroup,and the cell control group,lentivirus control group and BAG-1 siRNA-α group respectively (all P ＞ 0.05).Conclusion BAG-1 gene can play a role in protection of hypoxia nerve cells,reduce the apoptosis,and its protective effect can be independent of HSP70 gene.

Objective To investigate the effects of lentivirus-mediated heat shock protein 70 (HSP70) gene on calcium homeostasis and calcium channels of PC12 cells induced by ischemic and hypoxia and its mechanisms. Methods PC12 cells at logarithmic phase were collected, and they were divided into recombined lentiviral infection group [infected by lentivirus containing HSP70 and green fluorescent protein (GFP) fluorescin gene], lentivirus control group (infected by lentivirus containing GFP without HSP70 gene) and non-infection group. PC12 cells were subjected ischemia/hypoxia for 4, 8, 12, 24 hours, and the cell activity was determined by methylthiazolyl tetrazolium (MTT) assay test inorder to determine the best time for ischemia/hypoxia. The mRNA expressions of HSP70, muscle/endoplasmic reticulum Ca2+-ATP isoforms (SERCA2a, SERCA2b), ryanodine receptor 2 (RyR2), and inositol 1,4,5-triphosphate receptor 1 (IP3R1) were determined by real-time quantitative reverse transcription-polymerase chain reaction (RT-qPCR), and the protein expressions of HSP70, SERCA, and IP3R were determined by Western Blot at 8 hours after ischemic/hypoxia. Flow cytometry was used to determine the levels of intracellular reactive oxygen (ROS) and intracellular Ca2+ ([Ca2+]i). Results With the prolongation of time of ischemia/hypoxia, the cell viability in all groups showed an increase followed by a weakening, and peaked at 8 hours. The cell viability at 8 hours in lentiviral infection group was significantly higher than that of the non-infection group and lentivirus control group [A value (×10-2): 20.3±2.2 vs. 14.1±2.1, 15.0±1.6, both P < 0.01], the mRNA and protein expressions of HSP70 and SERCA in lentiviral infection group were significantly increased [HSP70 mRNA (2-ΔΔCt ): 0.785±0.018 vs. 0.428±0.019, 0.423±0.023; HSP70 protein (gray value): 2.72±0.20 vs. 1.56±0.36, 1.63±0.41; SERCA2a mRNA (2-ΔΔCt ): 0.971±0.037 vs. 0.367±0.014, 0.347±0.012; SERCA2b mRNA (2-ΔΔCt ): 8.869±0.162 vs. 3.015±0.091, 2.941±0.091; SERCA protein (gray value): 2.84±0.18 vs. 1.48±0.26, 1.52±0.29], and IP3R2 mRNA and protein expressions were significantly declined [IP3R2 mRNA (2-ΔΔCt ): 0.183±0.020 vs. 0.439±0.020, 0.433±0.040; IP3R2 protein (gray value): 1.15±0.12 vs. 1.91±0.20, 1.83±0.19], with statistically significant differences (all P < 0.01); no significant difference in RyR mRNA was found [2-ΔΔCt (×10-3): 1.97±0.63 vs. 2.02±0.22, 2.01±0.09, both P > 0.05]; the relative fluorescence intensity of ROS and [Ca2+]i in lentiviral infection group was significantly reduced (ROS: 30.54±1.23 vs. 58.03±1.97, 57.72±2.35; [Ca2+]i: 34.50±2.05 vs. 48.20±3.02, 46.80±2.75, all P < 0.01]. Conclusion Exogenous HSP70 can maintain calcium homeostasis in the endoplasmic reticulum of PC12 cells, affect the Ca2+ channel protein regulated by calcium channel IP3R and calcium pump SERCA, which may cause hypoxia/ischemia intracellular injury.

To investigate the treatment of hyperthyroidism complicated with pretibial myxedema. Three patients with hyperthyroidism complicated with pretibial myxedema were treated with topical injection of corticosteroid at the skin lesion. All 3 patients were cured with pretibial mucous edema by local injection of corticosteroids. Multi-point injection of glucocorticoid combined with maintaining euthyroid state is effective and has little side effect.

Objective To explore the influence of acupuncture point massage combined with limb function exercise on ankle brachial index (ABI) and pulse wave velocity (PWV) in patients with coronary heart disease (CHD). Methods According to scores by grace score scale, 180 CHD patients were divided into three groups: low risk group (n=58), moderate risk group (n=68) and high risk group (n=54). Within the three groups, the patients were divided into the experiment group and the control group by using the random digital table. The control group was treated with routine nursing intervention , while the experiment groups accepted acupuncture point massage and limb function exercise training on the basis of control groups. We collected the values of ABI and PWV at four points-in-time: before intervention, 7 days after intervention, 30 days after intervention and 90 days after intervention. Results Repeated measurement data analysis of the experiment group and control group suggested that:in the moderate and high risk groups, there was statistically significant difference (P<0.05) in the data at the four time points. There was no statistically significant difference (P > 0.05) in time and group interaction effect. The difference between the experiment group and control group was statistically significant (P<0.05). Repeated measurement data analysis showed that there was no statistically significant difference (P>0.05) in ABI&PWV interaction effect at the four time points between the experiment group and control group. In the low-risk group,the differences in time points compared with the main effect were insignificant (all P>0.05). In comparison of main effect at all the four time points, there was significant different in the moderate and high risk group (P<0.05), And it suggested that time and group interaction, namely effect of time factor (1 d, 7 d, 30 d, 90 d), was not decided by the division of groups. In comparison of main effect, the difference was statistically significant (all P < 0.01) in the moderate and high-risk group, which indicated the main effect (intervention) playing main role. However, there was no statistically significant difference (P>0.05) of ABI&PWV before and 90-days after intervention. Conclusion Acupuncture point massage combined with limb function exercise can effectively improve the peripheral artery blood supply in CHD patients, lower ABI and promote PWV.

The aim of the study was to select a suitable pelletisation aid of valsartan immediate-release pellets in the extrusion process and optimized the formulation. The properties of the pellets with five excipients which were microcrystalline cellulose(MCC), low-substituted hydroxypropyl cellulose(L-HPC), crospovidone(PVPP), pregelatinized starch(PCS)and k-carrageenan were evaluated and compared by the single factor test. And the pelletisation aids were chosen preliminary. The properties of the pellets with MCC, L-HPC, k-carrageenan respectively were evaluated and compared and k-carrageenan was determined as the most appropriate pelletisation aid. The Box-Behnken design was employed to optimize the formulation. The optimised formulation was k-carrageenan 16. 98 g, HPMC-E5 2. 03 g, SLS 0. 26 g. The yield and aspect ratio of pellets was 91. 23% and 1. 14, respectively. And there was no significant difference between observed and predictive responses. The results showed k-carrageenan pellets owned properties of a high yield, acceptable sphericity and fast drug release.

AIM:Increasing evidence indicates that inflammation contributes to the initiation and perpetuation of atrial fibrillation ( AF) .Al-though tumor necrosis factor ( TNF)-αlevels are increased in patients with AF , the role of TNF-αin the pathogenesis of AF remains unclear.Recent research has revealed that T-type Ca2+currents ( ICa,T ) play an important role in the pathogenesis of AF .METH-ODS:In this study , we used the whole-cell voltage-clamp technique and biochemical assays to explore the role of TNF-αin the regula-tion of ICa,T in atrial myocytes.RESULTS:We found that compared with sinus rhythm (SR) controls, T-type calcium channel (TCC) subunit mRNA levels were decreased , while TNF-αexpression levels were increased , in human atrial tissue from patients with AF .In murine atrial myocyte HL-1 cells, after cultured for 24 h, 12.5, 25 and 50 μg/L TNF-αsignificantly reduced the protein expression levels of the TCC α1G subunit in a concentration-dependent manner .The peak current was reduced by the application of 12.5 or 25μg/L TNF-αin a concentration-dependent manner [from ( -15.08 ±1.11) pA/pF in controls to ( -11.89 ±0.83) pA/pF and (-8.54 ±1.55) pA/pF in 12.5 and 25 μg/L TNF-αgroups, respectively].TNF-αapplication also inhibited voltage-dependent inactivation of ICa,T shifted the inactivation curve to the left .CONCLUSION:These results suggest that TNF-αis involved in the path-ogenesis of AF, probably via decreasing ICa,T function in atrium-derived myocytes through impaired channel function and down -regula-tion of channel protein expression .This pathway thus represents a potential pathogenic mechanism in AF .