Objective To discuss the prevention and treatment of hemorrhage during or after minimally invasive percutaneous nephrolithotomy (PCNL). Methods Clinical data of 12 cases of hemorrhage during or after minimally invasive percutaneous nephrolithotomy from July 2005 to October 2005 in this hospital were retrospectively analyzed. Results Intraoperative hemorrhage occurred in 10 cases. The bleeding was stopped by pressure in 6 cases and a re-operation of open nephrolithotomy 5 days later was required in 4 cases. Postoperative hemorrhage was seen in 2 cases. The bleeding was successfully stopped by endoscopic electrocoagulation in 1 case and by interventional highly-selected embolization on the 4th day after operation in 1 case. Conclusions Prevention should be put first for hemorrhage during or after minimally invasive percutaneous nephrolithotomy. Accurate puncture and skillful tunnel expansion are the key to minimize the hemorrhage. Interventional embolization should be the first choice in case of massive or repeated bleeding.

Objective: To investigate the possible mechanism of doxycycline inhibiting paraquat-induced pulmonary fibrosis and provide a theoretical basis for its clinical application. Methods: Human lung fibroblast HFL1 cells were selected as the research object in the cell group. Divided into blank group, paraquat group, paraquat+doxycycline group. The expression of TGF-β1, a-SMA, Smad3 and Smad2 protein was detected by ELISA using 40 ml of paraquat 40 umol/L and 3 mg/L of oleic acid 10 mg/L. In the animal group, 120 healthy and clean SD rats were randomly divided into three groups: blank group, paraquat group, paraquat+doxycycline group. The expression of TGF-β1, a-SMA, Smad3 and Smad2 protein in lung tissue of mice at 1 day, 3 days, 7 days, 14 days and 21 days was detected by Elisa method. The expression of TGF-β1, a-SMA, Smad3 and Smad2 protein in lung tissue of 21-day mice was detected by Western Blotting. The pathological changes of lung tissue were observed by HE staining for 1 day, 3 days, 7 days, 14 days and 21 days. Results: In the cell group experiment, the expression of TGF-β1, a-SMA, Smad3 and Smad2 protein increased gradually with paraquat in the paraquat group, and the expression of TGF-β1, a-SMA, Smad3 and Smad2 protein was significantly higher than that in the blank group. The difference was statistically significant (P<0.05) . The expressions of TGF-β1, a-SMA, Smad3 and Smad2 in the paraquat+doxycycline group were significantly lower than those in the paraquat group, but still higher than the blank group, the difference was statistically significant (P<0.05) . Conclusion Doxycycline inhibits paraquat-induced pulmonary fibrosis by inhibiting the expression of TGF-β1, a-SMA and Smad3, Smad2 proteins.

Under the guidance of Chinese Pharmacopoeia (2020 edition), the functionality-related characteristics of hydroxypropyl methylcellulose (HPMC) type 2208 from imported A manufacturer, domestic S manufacturer, domestic T manufacturer and different batches of the same manufacturer were characterized. The principal component analysis was used to comprehensively evaluate the functionality-related characteristics. The results were as follows: hydroxypropyl methylcellulose had no significant difference in viscosity and molecular weight distribution between different manufacturers, and there were significant differences in the cumulative particle size distribution of the sample reaches 50% (d₅₀) and 90% (d₉₀), bulk density, tap density and Carr's index. The HPMC from A manufacturer have the biggest inter-batch difference of particle size and their inter-batch difference of polydispersion coefficientis smaller than S manufacturer. Domestic manufactures have the largest inter-batch difference in other functionality-related characteristics. The three principal components were extracted by principal component analysis, and the variance contribution rate reached 89.44%, indicating that the extracted principal components can explain all the data well. By constructing a comprehensive evaluation model, the comprehensive score ranking of all HPMC samples is obtained: S manufacturer > A manufacturer > T manufacturer.

OBJECTIVETo investigate the changes of upper airway of obstructive sleep apnea syndrome (OSAS) patients after the treatment of Silensor snoreguard.

METHODS42 patients with OSAS were treated with dental appliance. Cephalometric analysis was carried out to compare the changes of upper airway before and after the treatment.

RESULTSSPP-SPPW increased from (9.10 +/- 2.25) mm to (12.24 +/- 2.61) mm. PAS increased from (8.99 +/- 3.20) mm to (11.24 +/- 3.79) mm. CL decreased from (26.26 +/- 6.04) mm to (14.37 +/- 8.14) mm. H-MP decreased from (21.27 +/- 6.12) mm to (12.14 +/- 5.89) mm. V -RGn decreased from (55.15 +/- 5.61) mm to (51.63 +/- 5.87) mm. OPAA increased from (7.01 +/- 1.54) mm2 to (7.85 +/- 1.61) mm2. HPAA increased from (3.02 +/- 0.89) mm2 to (3.61 +/- 1.61)mm2.

CONCLUSIONDental appliance worked with the effect of enlarging upper airway.

Cephalometry ; Female ; Humans ; Male ; Middle Aged ; Sleep Apnea, Obstructive

Magnetic resonance imaging(MRI) can obtain multi-modal images with different contrast, which provides rich information for clinical diagnosis. However, some contrast images are not scanned or the quality of the acquired images cannot meet the diagnostic requirements due to the difficulty of patient's cooperation or the limitation of scanning conditions. Image synthesis techniques have become a method to compensate for such image deficiencies. In recent years, deep learning has been widely used in the field of MRI synthesis. In this paper, a synthesis network based on multi-modal fusion is proposed, which firstly uses a feature encoder to encode the features of multiple unimodal images separately, and then fuses the features of different modal images through a feature fusion module, and finally generates the target modal image. The similarity measure between the target image and the predicted image in the network is improved by introducing a dynamic weighted combined loss function based on the spatial domain and K-space domain. After experimental validation and quantitative comparison, the multi-modal fusion deep learning network proposed in this paper can effectively synthesize high-quality MRI fluid-attenuated inversion recovery (FLAIR) images. In summary, the method proposed in this paper can reduce MRI scanning time of the patient, as well as solve the clinical problem of missing FLAIR images or image quality that is difficult to meet diagnostic requirements.
Humans ; Deep Learning ; Magnetic Resonance Imaging/methods* ; Image Processing, Computer-Assisted/methods*

Objective: To establish an HPLC method for fingerprint analysis of Guanxin Shutong Capsule (GSC) for its quality control. Methods: The chromatographic behaviors were obtained by an Agilent TC-C18 column (250 mm × 4.6 mm, 5 μm) with gradient elution using 0.05% phosphoric acid and acetonitrile as the mobile phase. The column temperature was set at 30 ℃ and the flow rate was 1.0 mL/min. The detection wavelength was set at 280 nm. The common mode of HPLC fingerprint for 10 batches of GSC was established with Similarity Evaluation System for Chromatographic Fingerprint of Traditional Chinese Medicine (2009 edition) and the common peaks were identified by reference compounds. Results: Fingerprints of 10 batches of GSC were established and the similarities to the common mode were above 0.95. Totally 45 common peaks were found, and 34 belonged to herbs. Five mutual peaks were from Choerospondias axillaris, 23 mutual peaks were from Salvia miltiorrhiza, and seven mutual peaks were from Syzigium aromaticum. Based on the retention time of reference substances, 13 constituents including gallic acid (peak 1), danshensu (peak 3), protocatechuic acid (peak 5), procatechuic aldehyde (peak 6), ellagic acid (peak 10), rosmarinic acid (peak 16), salvianolic acid A (peak 19), salvianolic acid B (peak 23), eugenol (peak 24), dihydrotanshinone I (peak 30), cryptotanshinone (peak 34), tanshinone I (peak 35), and tanshinone IIA (peak 39) were identified. Conclusion: This method is specific and reliable, which will be conducive to the quality control of GSC.

Objective: To develop a LC-MS/MS method for the quantification of empagliflozin (EPLZ) impurity X(EPLZ-X) in EPLZ pharmaceutical product. Methods: Isocratic chromatographic separation was performed on a Thermo BDS C18 column (4.6 mm × 100 mm,2.4mm). The mobile phase consisting of acetonitrile-water(75: 25, V/V) was eluted at a flow rate of 0.7 ml/min. ESI source was applied and operated in the positive ion mode. multiple reaction monitoring(MRM) mode with the transitions of m/z 785→m/z 475 and m/z 785→m/z 418 were used to quantify the EPLZ-X. Results: The method was linar in the concentration range from 0.5 to 100.6 ng/ml. The limit of quantification was 0.5 ng/ml. The intra-and inter-day precision values were both below 11.8%, and accuracy was within ±2.5% in all quality control samples. The average recovery was 105.1%,109.8% and 102.6%, respectively. Conclusion: The method provides a sensitive and specific means for the determination of EPLZ-X in EPLZ pharmaceutical substances and completely meets the requirement of European Medicines Evaluation Agency(EMEA) (a limit of not more than 60×10-6 g for the mutagenic impurity EPLZ-X).

Aim To investigate the mechanism of SA-HA-CTSV inducing autophagy and inhibiting the growth of breast cancer MCF-7 cells. Methods Muse cell analyzer was used to screen the optional treatment doses of drug for cells, and real-time PCR and Western blot were to detect the mRNA and protein expressions of CTSV. Then, specific siRNA was transfected in cells for silencing the CTSV function. Immunofluorescent assay was used to detect the distribution of LC3II, and related ATG molecule expressions were assessed. Bafilomycin A1 was used to inhibit autophagy flux, then p62 protein expression and cell viability were detected. Results 5 μmol · L

BackgroundFemales with ST-segment elevation myocardial infarction (STEMI) have higher in-hospital and short-term mortality rates compared with males in China, suggesting that a sex disparity exists. The age of onset of STEMI is ahead of time and tends to be younger. However, there are relatively little data on the significance of sex on prognosis for long-term outcomes for adult patients with STEMI after percutaneous coronary intervention (PCI) in China. This study sought to analyze the sex differences in 30-day, 1-year, and long-term net adverse clinical events (NACEs) in Chinese adult patients with STEMI after PCI.

MethodsThis study retrospectively analyzed 1920 consecutive STEMI patients (age ≤60 years) treated with PCI from January 01, 2006, to December 31, 2012. A propensity score analysis between males and females was performed to adjust for differences in baseline characteristics and comorbidities. The primary endpoint was the incidence of 3-year NACE. Survival curves were constructed with Kaplan-Meier estimates and compared by log-rank tests between the two groups. Multivariate analysis was performed using a Cox proportional hazards model for 3-year NACE.

ResultsCompared with males, females had higher risk profiles associated with old age, longer prehospital delay at the onset of STEMI, hypertension, diabetes mellitus, and chronic kidney disease, and a higher Killip class (≥3), with more multivessel diseases (P < 0.05). The female group had a higher levels of low-density lipoprotein (2.72 [2.27, 3.29] vs. 2.53 [2.12, 3.00], P < 0.001), high-density lipoprotein (1.43 [1.23, 1.71] vs. 1.36 [1.11, 1.63], P = 0.003), total cholesterol (4.98 ± 1.10 vs. 4.70 ± 1.15, t = -3.508, P < 0.001), and estimated glomerular filtration rate (103.12 ± 22.22 vs. 87.55 ± 18.03, t = -11.834, P < 0.001) than the male group. In the propensity-matched analysis, being female was associated with a higher risk for 3-year NACE and major adverse cardiac or cerebral events compared with males. In the multivariate model, female gender (hazard ratio [HR]: 2.557, 95% confidence interval [CI]: 1.415-4.620, P = 0.002), hypertension (HR: 2.017, 95% CI: 1.138-3.576, P = 0.016), and family history of coronary heart disease (HR: 2.256, 95% CI: 1.115-4.566, P = 0.024) were independent risk factors for NACE. The number of stents (HR: 0.625, 95% CI: 0.437-0.894, P = 0.010) was independent protective factors of NACE.

ConclusionsFemales with STEMI undergoing PCI have a significantly higher risk for 3-year NACE compared with males in this population. Sex differences appear to be a risk factor and present diagnostic challenges for clinicians.

Adolescent ; Adult ; China ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Myocardial Infarction ; pathology ; surgery ; Percutaneous Coronary Intervention ; methods ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; ST Elevation Myocardial Infarction ; pathology ; surgery ; Time Factors ; Treatment Outcome ; Young Adult

【Objective】 To study the serological characteristics and genetic background of 20 samples with ABO blood group discrepancies in Shenyang. 【Methods】 Serological test, polymerase chain reaction-sequence specific primer (PCR-SSP) and sequencing of the full coding of ABO gene and the Intron 1 were conducted in 20 samples with ABO blood group discrepancies. 【Results】 Ten subtypes (Am, Bw, Bx, B3,, A2B, AxB, A2Bw, A2Bx, AwB and ABw) were detected in 20 samples, with AB subtype as the dominant. Sixteen ABO alleles were found, including 5 common alleles (A1.01, A1.02, B. 01, O. 01.01 and O. 01.02), nine rare alleles (AW.37, BW.03, BW.08, B3.07, cisAB.02, cisAB.03, cisAB.06, BA.04 and O. 01.04) and two novel alleles (AM.03 and cisAB.07). The AM.03 allele had a nucleotide change at position 912 (C to A) compared with A1.02 allele, which resulted in an amino acid substitution (S304R). The cisAB.07 allele was observed a missense mutation at position 797 (T to C) which resulted in an amino acid substitution (M266R) compared with B. 01 allele. The serologic had been changed, and both A antigen and B antigen were expressed. 【Conclusion】 The study revealed the genetic background of 20 samples with ABO blood group discrepancies, and two new alleles as ABO*AM.03 (912 C to A) and ABO*cisAB.07 (797 T to C) were first reported.