ObjectiveTo explore the efficacy and indications of three kinds minimally invasive surgery treatment of upper ureteral calculus (UUC) complicating hydronephrosis.MethodsFour hundred and ninety-two patients with UUC complicating hydronephrosis were divided into three groups:minimally percutaneous nephrolithotomy (mPCNL) group (310 patients),ureteroscopy lithotripsy(URSL) group ( 130 patients) and retroperitoneal laparoscopic ureterolithotomy (RLU) group (52 patients).The operation time,blood loss,length of stay,stone-free rate and postoperative complications in three groups were compared.ResultsThe stone-free rate was 91.0％(282/310) in mPCNL group,78.5％(102/130) in URSL group and 100.0％(52/52) in RLU group,mPCNL group and RLU group were significantly higher than URSL group (P ＜0.01 ).URSL group and RLU group had the advantage of less operation time,blood loss,length of stay and postoperative complications compared with mPCNL group [ RLU group:(55.8 ± 20.5 ) min,( 10.8 ± 3.2)ml,(6.3 ± 2.1 ) d,1.9％(1/52) ;URSL group:(56.5 ± 15.2) min,(8.6 ± 1.4) ml,(5.7 ± 1.6) d,1.5％(2/130);mPCNL group:(113.8 ±42.5) min,(132.8 ±40.2) ml,(12.5 ±2.4) d,8.4％(26/310),P＜ 0.01 ].Conclusions Minimally invasive surgery on the treatment of UUC is safe and effective.URSL is preferred to treating the small UUC,RLU can improve the success rate for larger UUC.Contrary to mPCNL,which is best for merger kidney calculus,has higher stone-free rate,can be used as supplement of URSL after treatment failure.

Patients with moyamoya disease often have cognitive impairment.The specific mechanisms are unclear.Surgical intervention relieving low perfusion state of cerebral blood flow may be the only effective way in the treatment of moyamoya disease,maintain or improve cognitive function at present; however the related surgical indications,timing of surgery,postoperative hyperperfusion syndrome,as well as long-term efficacy and other issues must be resolved.

Objective To investigate the effect of repeat transurethral resection for superficial bladder cancer. Methods One hundred and twenty patients who were newly diagnosed superficial bladder cancer were divided randomly in to two groups by mechanical sampling method,60 patients underwent second of prostate TUPKVP 4 weeks after initial transurethral and received adjuvant MMC intravesically (experiment group) and the other 60 patients received adjuvant MMC following the initial TUPKVP(control group). The two groups were followed up by cystoscopy at 3-month intervals,and then compared the recurrences between the two groups. Carcinoma in situ or muscle invasive disease were excluded from the study. Results Mean following up time was 6-24 (12.0 ±6.5) months, within the following up period,recurrence was observed in 13 (21.7%, 13/60) patients in experiment group and in 38 (63.3%,38/60)patients in control group, there was signiticantly statistical difference between the two groups (P＜ 0.01). Of all the recurrences, the recurrence rate of high grade tumor was 26.2% (11/42) in experiment group and 70.0% (35/50) in control group,the recurrence rate in experiment group was obviously less than that in control group (P ＜ 0.01). Conclusions Repeat transurethral resection can lower the recurrence of superficial bladder cancer (especially for the high grade tumor) which with initial resection, it can improve the classification of malignant rumor, and find the residual tumor, so it has value in clinical treatment.

Objective To study the relation of the porin at the out membrane with resistance to cefoxitin in Enterobacter cloaceae. Methods The extended spectrum beta lactamase(ESBLs) was detected by phenotypic confirmatory test according to NCCLS M100 S9;the beta lactamase and out membrane protein(OMP) was extracted by ultrasonication,the beta lactamase was detected by ultraviolet spectrophotometer,the composition of OMP was analyze by SDS PAGE. Results The 6 strains in 9 strains of Enterobacter cloaceae with resistance to cefoxitin lost 18 kda protein band and did not product hydrolase to cefoxitin and 5 strains was ESBLs positive. 2 strains producing hydrolase to cefoxitin did not lose the 18 kda protein. One strain with resistance to cefoxitin was producing ESBLs but did not defect the 18kda protein band and product hydrolase to cefoxitin. Conclusion The defect of the 18 kda protein band is nearly relation with resistance to cefoxitine in Enterobacter cloaceae.

Objective To investigate risk factors for the development of advanced schistosomiasis. Methods The case\|control study was designed with a match of 1∶1 and 1∶2. Healthy persons and chronic schistosomiasis patients were used as control. Each group was composed of 213 cases. Items investigated included: history of schistosomiasis and treatment, exposure to the contaminated water, social\|economical condition and nutritional status, other concomitant diseases. Cellular and humoral immunity, HBVMs and ABO blood groups were also detected. Statistical analysis was performed by 1∶1 and 1∶2 matched single and stepwise conditional logistic regression analysis with SAS software. Results By stepwise conditional logistic regression analysis, it was revealed that number of schistosomiasis examination(OR=1\^168-1\^311), interval from first infection to last treatment(OR=1\^142), interval from first infection to this investigation (OR=1\^089), \{HBsAg\++\}(OR=4\^683-10\^759), \{HBcAb\++\} (OR=2\^873), \{HBsAg\++\}+\{HBeAb\++\}+\{HBcAb\++\}(OR=7\^64) were risk factors of developing advanced schistosomiasis. The average living space and cellular immunity were lower in advanced schistosomiasis patients than others. No association was found between advanced schistosomiasis and ABO blood groups. Conclusion The development of advanced schistosomiasis is associated with repeated infections, and delayed or incomplete treatment. Combined infection with hepatitis B, poor socio\|economic conditions and impaired cellular immunity may increase the pathogenetic risk of schistosomiasis.

Objective:To evaluate spectral CT metal artifacts reduction (MAR) technique in reducing metal artifacts of spinal implants in a phantom.Methods:Ovine spines were chosen as anthropomorphic phantom. The phantom including the pedicle screws, 3D-printed vertebral body (VB) and mesh cage were examined using spectral CT. Postoperative CT images were reconstructed at 70—140 keV with 10 keV interval of MAR and non-MAR. Artifact index (AI) and signal-to-noise ratio (SNR) were evaluated by CT and SD values in ROIs around the implants. Visibility of bony structures, the artifacts of pedicle screw, 3D-printed VB and mesh cage were subjectively evaluated. Plotting curves of AI and SNR with the increasing keV were drawn. The AI and SNR were compared at lower (70 keV), medium (100 keV) and high (130 keV) level between MAR and non-MAR images using the paired t-test, and the subjective scores were compared using Wilcoxon signed rank-sum test. Results:The AI values around pedicle screws (anterior, posterior and lateral), 3D-printed VB and mesh cage decreased with the increase of keV, while SNR improved in MAR and non-MAR images. The AI values in the anterior, lateral and posterior pedicle screws and lateral titanium implants were significantly lower in MAR than those in non-MAR ( P<0.05). The AI value in posterior 3D-printed vertebral was lower in MAR than that of non-MAR only at 70 keV ( P<0.001). The SNR values in the anterior and posterior pedicle screws, 3D-printed VB increased with the increase of keV, but decreased in other ROIs. In the subjective evaluation, the image scores of MAR were higher than those of non-MAR ( P<0.05). Conclusion:Spectral CT using the MAR reconstruction can effectively reduce metal artifacts of spinal implants. The effect is better in pedicle screw and mesh cage than 3D-printed VB.

Objective:To construct an automatic recognition system for PD patients with freezing of gait (FOG) based on mobile phone videos by recording the gait videos of PD patients with FOG.Methods:Forty-nine PD patients with FOG, admitted to our hospital from December 2020 to May 2021, were chosen in our study. Their clinical data were collected. The processes of these patients accepted "3-meter-round trip" and "3-meter-round trip through narrow (0.6 m)" were recorded and 87 valid gait videos were extracted. Position signals of key points in the video were extracted, and featured data were extracted after signal preprocessing. From the featured data, action recognition model, straight FOG recognition model and turn FOG recognition model were established respectively, and finally end-to-end FOG recognition model was formed. Leave-one-subject-out (LOSO) method was used to evaluate the performance of the above models.Results:A total of 22 066 non-FOG window samples and 3815 FOG window samples were obtained from 87 valid videos, which constituted the training sample pool of this study. LOSO method showed that the motion recognition model enjoyed 83.27% sensitivity, 91.38% specificity, and 89.28% accuracy; the straight FOG recognition model enjoyed 57.69% sensitivity and 88.12% specificity; the turn FOG recognition model enjoyed 61.54% sensitivity and specificity 98.72%; and the end-to-end FOG recognition model enjoyed 85.71% sensitivity and 75.73% specificity.Conclusion:The automatic recognition system for PD patients with FOG based on mobile phone videos has relatively high sensitivity and specificity, which can realize remote assessment and is convenient for screening and follow-up of PD patients with FOG.

Objective:To summarize the clinical and genetic characteristics of Potocki-Shaffer syndrome (PSS).Methods:A retrospective study was conducted to analyze the clinical data of 1 patient diagnosed with PSS in the Department of Pediatrics of the Sixth Affiliated Hospital, Sun Yat-Sen University at February 2021.The data analyzed included clinical manifestations, biochemical tests and gene tests.Meanwhile, studies were retrieved from the China National Knowledge Internet database, Wanfang database, and PubMed database from the establishment of the database to December 2021 by taking " Potocki-Shaffer syndrome" " EXT2 gene" " AlX4 gene" and " PHF21A gene" as key words.Besides, genes were searched from the Online Frontal Analysis Mendelian Inheritance in Man.The clinical and genetic features of PSS patients were summarized. Results:The patient was 5 months and 21 days old, male, who was admitted to the hospital due to excessive growth in body mass for the past 3 months.The patient showed mental and motor retardation, overgrowth, concealed penis, hearing loss, and hypotonia.Whole exon sequencing of this patient revealed heterozygous deletions in the Chr11: 44069455-48188946 region, including the deletions of 3 autosomal dominant genes: EXT2, ALX4, and PHF21A.The patient was diagnosed with PSS.A total of 14 articles published in English were collected, involving this boy and other 35 patients.In these patients, 14 cases had point mutations, and 22 cases had large deletions. PHF21A gene variation was detected in 23 cases (dysgnosia in 22 cases, dyskinesia in 21 cases, language development delay in 18 cases). EXT2 gene variation was observed in 22 cases (exostoses in 13 cases). ALX4 gene variation was found in 19 cases (bilateral parietal foramina in 15 cases). Of 36 cases, 27 cases had craniofacial anomalies. Conclusions:The main clinical symptoms of PSS are language and motor developmental delay, intellectual disability, exostoses, bilateral parietal foramina, and craniofacial anomalies, which are closely related to 3 autosomal dominant genes ALX4, EXT2 and PHF21A.Genetic testing facilitates the clinical diagnosis of PSS, and the mutation types are dominated by point mutations and large deletions.