Objective:To study the moxibustion at Guanyuan(CV 4)and Tianshu(ST 25)on intestinal dvsbacteriosis in rats.Methods:Fifty Wistar rats,clearing grade,were randomly divided into 5 groups,a normal group,a model group,a medical group,and a Guanyuan(CV 4)group and a Tianshu(ST 25)group,with 10 rats in each group.The rats were treated with Lincomycin Hydrochloride via intragastric administration for developing models.The model rats were treated with medicine and moxibustion respectively.0.1 g fresh rat feces in each group were cultured on the selective culture medium of bifidobacterium species(BS),lactobacillus(LBS),enterobactefiaceae(EB)and enterococcus(EC).The growth and quantity of the bacterial colony were tested by biochemical identification tubes and turbidimetry.Results:Moxibustion at Guanyuan(CV 4)increased BS and LBS while moxibustion at Tianshu(ST 25)improved EB and EC.Conclusion:Moxibustion at Front-Mu points Of different body parts selectively regulated advantaged probiotics for treating intestinal dysbactenosis.

BACKGROUND: Dialysis-related amyloid may occur during long-term dialysis for patients with uraemia, of which the main evocator is β_2-microglobulin (β_22M); therefore, how to eliminate 132M from blood is always the focus of research. OBJECTIVE: To observe ability of removal of β_2-microglobulin (β_2M) from serum using two kinds of polyethersulfone (PES) membrane materials with various degrees of sulfonation.METHODS: These materials were incubated in radio-labeled β_2M (~(125)Ⅰ-β_2M) solution and human serum respectively at appointed time at 37 ℃, and then the amounts of ~(125)Ⅰ-β_2M and serumβ_2M adsorbed by materials were measured by radio immunoassay. RESULTS AND CONCLUSION: In the ~(125)Ⅰ-β_2M system, amounts of ~(125)Ⅰ-β_2M adsorbed by the materials decreased in the following sequence PES with high degree of sulfonation > PES with low degree of sulfonation > PES, whatever the source of PES was. In the serum system, amounts of β_2M adsorbed reached maximums at 30 minutes and the final adsorptions decreased in sequence of PES with high degree of sulfonation > PES with low degree of sulfonaUon > PES. Sulfonated PES removed β_2M more than PES did and the adsorption of β_2M increases with the increase in the degree of sulfonation. Its ability to remove significant amount of β_2M may result in less β_2M available for incorporation into amyloid. The use of sulfonated PES membranes may lessen the likelihood of development of dialysis-related amyloidosis, which remains a major source of morbidity for patients treated with long-term hemodialysis.

Objective To evaluate the safety and efficacy of bipolar plasmakinetic system in exfoliative tran-surethral resection of bladder tumors .Methods Clinical data of 72 patients with non muscle invasive bladder cancer (NMIBC) were retrospectively analyzed.Transurethral bipolar plasmakinetic system was used ,30°viewer,F27 outer sheath was pushed off and bladder tumor was cut .When the bladder filling state ,pushed off bladder mucosa distance from tumor basal 2cm,then electricity cut the exfoliative bladder tumor .When bladder half filling state electricity cut the base of the bladder muscle layer of bladder tumor .Results This group of 72 cases were successfully completed surgery,surgery time 37~93 min,without intraoperative bladder perforation ,slight obturator nerve reflex in 5 cases. The keeping intact pathologic specimens was good for pathological staging .Conclusion Exfoliative transurethral resection of bladder tumors with bipolar plasma is a safe , practical and effective way of operation , which can avoid severe obturator reflex occurred in the operation , and greatly reduce the occurrence of bladder perforation , without TURS,surgical removal of the pathological specimens is specification .

Objective: To investigate the prevalence of hyperactive behavior and risk factors among preschool children, and to provide a reference for early intervention of problem behavior. Methods: A total of 7 982 children aged 3-6 were selected from 30 kindergartens by multi stage stratified cluster random sampling in 5 areas, Anhui Province, and their parents were surveyed with Conners Parent Rating Scales(PSQ) and Related factors questionnaire from June to July 2020. Results: A tollay of 126 children were detected with hyperactivity behaviors, with a detection rate of 1.6%. The detection rate of boys (2.2%) was higher than that of girls (0.8%). The difference was statistically significant ( χ 2=26.51, P <0.01). Among 126 hyperactive children, 40(31.7%)had another type of behavior problem, and 82(65.1%)had two or more additional behavior problems. The results of Logistic regression analysis showed that boy( OR =2.85, 95% CI =1.88-4.30), sleep deprivation( OR =1.87, 95% CI =1.31-2.68), occupation of mother being farmer or otherwise( OR =1.81, 95% CI =1.11-2.94) were associated with more hyperactivity behavior. While, living with parents in the past six months ( OR =0.61, 95% CI =0.40-0.92) was associated with less hyperactivity behavior( P <0.05). Conclusion Early intervention of preschool children s behavior problems should focus on boys, maintain reasonable sleep time and increase parental care.

This study was performed to evaluate the adsorption of beta2-microglobulin(beta2 M) by blood dialysis membrane materials which are polyethersulfone (PES), sulfonated polyethersulfones, (PES-SO3Na-I and PES-SO3Na-I ) in vitro incubated in human serum and radiolabeled beta2M (125I-beta2 M) solution respectively. In these experiments, the materials were incubated in 125I-beta2 M solution and human serum at the appointed time ranging from 15 minutes to four hours at 37 degrees C, and then the amounts of 125I-beta2M and serum beta2M adsorbed by materials were measured by radioimmunoassay (RIA). In the 125I-beta2 M system, amounts of 125I-beta2M adsorbed by the materials decreased in sequence of PES-SO3 Na-II > PES-SO3Na-I > PES. In the serum system, amounts of beta2M adsorbed reached maximums at 30 minutes and the final adsorptions decreased in sequence of PES-SO3Na-II > PES-SO3Na-I > PES. Sulfonated PES removes beta2M more than PES does and the adsorption of beta2M increases with the increase in the degree of sulfonation. Its ability to remove significant amount of beta2M may result in less beta2M available for incorporation into amyloid. The use of PES-SO3Na membranes lessens the likelihood of dialysis-related amyloidosis (DRA) development, which remains a major source of morbidity for patients treated with long-term hemodialysis.
Adsorption ; Amyloidosis ; blood ; Humans ; Polymers ; chemistry ; Renal Dialysis ; adverse effects ; Sulfones ; chemistry ; beta 2-Microglobulin ; blood

The prognosis of metastatic renal cell carcinoma is relatively poor. With the development of molecular biology, the treatment of metastatic renal cell carcinoma is undergoing a transformation from cytokine therapy to targeted molecular therapy or immunotherapy, and the prognosis has been improved. This study summarized and discussed the treatment progress of metastatic renal cell carcinoma.

Objective To investigate the causes and preventive measures for deviation of guide needle in orthopedics robot surgery.Methods A robotic surgery was simulated on a wooden stick.The guide needle was inserted under the guidance of the robot.A lateral deviation force was applied respectively onto the tail and tip of the needle.The actual offset distance at the guide needle tip was measured and compared with the 1mm offset allowed by robot monitoring.Results The offset distance of the guide needle tip was 0,5+0.07 mm when the deviation force was applied onto the tail,significantly smaller than the 1 mm offset allowed by the robot monitoring(l=22.588,P<0.001).The offset distance of the guide needle tip was 4.92+0.16 mm when the deviation force was applied onto the tip,significantly larger than the 1 mm offset allowed by the robot monitoring(t=17.416,P<0.001).Conclusions The deviation of guide needle may be caused chiefly by the deviation force onto the tip.As the actual offset distance of the guide needle tip may be larger than that shown on the robot monitor in orthopedics robotic surgery,the intraoperative monitoring should serve only as a reference to the deviation of the guide needle.The operative details may be the key to prevention of such deviations.

Objective To investigate the diagnosis and treatment of ipsilateral multiple renal malignant tumors.Methods 4 patients with multiple renal malignant tumors were retrospectively reviewed from May 2013 to November 2017.All cases were males,with average age of 64 years old (ranging 54-82 years old).Two cases were found thai tumor located in right side.The duration of disease ranged from 7 days to 6 months,with an average of 2 months.One case was found the tumor due to the complaining of lumbar discomfort,and other 3 cases were found by physical examination.The number of tumors was 2 in 1 case,and 3 in 3 cases.The sonographic features of the tumors were iso-echoic nodules.CT showed irregular soft tissue shadow,partially prominent outside the kidney,and heterogeneous enhanced after enhancement.3 cases were undergone laparoscopic radical nephrectomy and 1 case which was solitary kidney,was undergone laparoseopic partial nephrectomy.Results All operations were performed successfully.3 cases were undergone laparoscopic radical nephrectomy,which the operative time was 189-271 min (average,230 min),and blood loss was 50-100 ml (mean 83 ml).Postoperative hospitalization time was 5-14 days,average 9.7 days.1 case occurred intestinal obstruction after surgery,which was improved after treatment.1 case was found the close distance of 3 tumors during the laparoscopic surgery.In order to short the ischemic duration,open surgery conversion was performed in this case.The total operation time was 207min.The ischemic time was 15min and blood loss was 50 ml.The postoperative hospital stay was 6 days.Pathological reported that 3 cases were clear cell carcinoma,another 1 case was clear cell carcinoma with papillary carcinoma.All patients were followed up for 2-55 months (mean 38 months).No recurrence sign was recorded in all cases.Conclusion Ipsilateral multiple renal malignant tumors are rare,laparoscopic radical nephrectomy is effectie.Meanwhile,partial nephrectomy can also be chosen in some optimal cases.

Objective To compare the biomechanical characteristics of lengthened sacroiliac screw and long sacroiliac screw fixated in different ways for the treatment of central vertical sacral fractures to provide reference for clinical practice.Methods A finite element model with three dimensions of Tile type C pelvic ring injury (central type Denis Ⅲ fracture of sacrum) was produced.The central sacral fractures were fixated with lengthened sacroiliac screw or long sacroiliac screw in 7 types of models respectively as follows.(1) One long sacroiliac screw was fixated in S1 segment from the right (C1);(2) One long sacroiliac screw was fixated in S2 segment from the right (C2);(3)Two long sacroiliac screws were fixated in S1 and S2 segments respectively from the right (C12);(4) One long sacroiliac screw was fixated in S1 segment from the right and one long sacroiliac screw was fixated in S2 segment from the left (C12hybrid);(5) One lengthened sacroiliac screw was fixated in S1 segment from the right (J1);(6) One lengthened sacroiliac screw was fixated in S2 segment from the right (J2);(7)Two lengthened sacroiliac screws were fixated in S1 and S2 segments respectively from the right (J12).The shift and angle displacement of the central superior surface of sacrum in the case of standing on both feet were measured and compared.The maximum Von Mises stresses in different positions were measured.And various mechanical indices (including stresses of various parts and stress distribution of screws and pelvis,etc) were also quantified and compared.Results The stability of the posterior ring-screw complex was optimal when the sacrum was fixated with S1 & S2 lengthened sacroiliac screws.The maximum Von Mises stresses of screw were affected by sacral segments,namely,S1 ＞ S2 ＞ S1& S2.The maximum Von Mises stress of screws in S1 and S2 segments were similar.The maximum stress of the lengthened sacroiliac screw was lower than that of the long sacroiliac screw.The maximum Von Mises stress of bilateral sacroiliac joints in the lengthened sacroiliac screw fixation model was similar to that of normal pelvis.The maximum stress in the left sacroiliac joint of the long sacroiliac screw fixation model was larger than that of the normal pelvis.The maximum Von Mises stress of screw-bone interface of the long sacroiliac screw fixation model was larger than that of the lengthened sacroiliac screw fixation model.The screw stress distribution of the lengthened sacroiliac screw was superior to that of the long sacroiliac screw,and the screw stress distribution of the double segment fixation was superior to that of the single segment fixation.There was relatively less difference between the pelvic stress distribution of double segment fixation model and that of the normal pelvic model.Conclusion The fixation of S1 & S2 lengthened sacroiliac screws utilized in central sacral fractures of Tile C pelvic ring injury results in a more stable posterior pelvic ringscrew complex,more dispersed screw stress and better pelvic stress distribution which is closed to normal,and can also reduce the risk of internal fixation failure as well as lower back pain.

Objective:To investigate the safety and effectiveness of cytoreductive nephrectomy and tumor thrombectomy in patients with metastatic renal cancer with renal vein or inferior vena cava tumor thrombus.Methods:From February 2015 to May 2019, 56 cases of metastatic renal cell carcinoma with venous tumor thrombus were analyzed retrospectively, including 44 male (78.6%) and 12 female (21.4%)cases, and the average age was (59.2±10.7)(22-82). The clinical presentations covered local symptoms in 26 cases (46.4%), systemic symptoms in 8 cases (14.3%), both local symptoms and systemic symptoms in 12 cases (21.4%), and asymptomatic in 10 cases (17.9%). Among them, renal tumors were located in 35 cases (62.5%) on the right and 21 cases (37.5%) on the left. The average tumor diameter was (10.1±3.8)(1.5-21.1) cm. Forty-five cases (80.4%) scored 2 points and 11 cases (19.6%) scored 3 points by the American Society of anesthesiologists(ASA). Preoperative hemoglobin was (118.2±23.1)(72-178) g/L, and albumin was (37.9±5.6)(23-50) g/L, total protein was (67.7±6.7)(43-81) g/L, serum creatinine was (111.3±119.6)(32-958) μmol/L. There were 16 cases of Mayo 0 (28.6%), 14 cases of Mayo Ⅰ(25.0%), 17 cases of Mayo Ⅱ(30.4%), 4 cases of Mayo Ⅲ(7.1%), and 5 cases of Mayo Ⅳ(8.9%). Fourteen cases (25.0%) were in the stage of cN 0 and 42 cases (75.0%) in the stage of cN 1. Five cases (8.9%) had simple bone metastasis, 16 cases (28.6%) had simple lung metastasis, 2 cases (3.6%) had simple adrenal metastasis, 6 cases (10.7%) had simple liver metastasis, and 27 cases (48.2%) had 2 or more multiple system metastasis. According to the location of the organ system, 91 metastatic lesions were found in 56 patients. Among them, 37 cases (40.7%) had lung metastasis, 18 cases (19.8%) had liver metastasis, 21 cases (23.1%) had bone metastasis and 15 cases (16.5%) had adrenal metastasis. All 56 patients belonged to IMDC prognosis score model medium risk group. The surgical treatment of Mayo grade 0 tumor thrombus was the same as that of routine radical nephrectomy. The tumor thrombus of Mayo grade Ⅰ was removed after IVC was partially blocked by Satinsky′s forceps. The Mayo Ⅱ tumor thrombus was removed, after blocking the distal vena cava, the contralateral renal vein and the proximal vena cava. Mayo grade Ⅲ tumor thrombus needed pringer's method to block the first porta hepatis. For grade Ⅳ tumor thrombus the diaphragm could be cut directly, or the thrombus could be removed by cardiopulmonary bypass. Laparoscopic surgery was performed in 22 cases (39.3%) and open surgery in 30 cases (53.6%). Six cases (10.7%) underwent IVC wall resection because of tumor invasion. 32 cases (57.1%) underwent ipsilateral adrenalectomy because of tumor invasion or adrenal metastasis, and 23 cases (41.1%) underwent ipsilateral lymphadenectomy. In this study, there were 11 cases of solitary metastasis, 8 cases of which were operated on and 3 cases of which were not operated on. Forty-three patients were treated with sunitinib after palliative nephrectomy, 9 patients were treated with pazopanib, 3 patients were treated with acitinib, and 1 patient was treated with sorafenib. Results:The operations were successfully completed in 56 patients. Four cases (7.1%) changed from laparoscopic surgery to open surgery. The operation time was (326.8±114.9)(108-589) min. Intraoperative hemorrhage was (1 435.2±1 513.4)(20-6 000) ml, intraoperative red blood cells transfusion was (1 456.7±832.8)(400-3 600) ml in 30 cases, and intraoperative plasma transfusion was (700.0±473.6)(200-1 800) ml in 15 cases. The postoperative hospital stay was (10.6±4.6)(5-26) days. The serum creatinine one week after operation was (109.5±98.7) (47-772) μmol/L. There were 46 cases (82.1%) of renal clear cell carcinoma, 7 cases (12.5%) of papillary renal cell carcinoma and 3 cases (5.4%) of unclassified renal cell carcinoma. One case was WHO/ISUP 2016 nuclear grade 1 (1.8%), 20 cases(36.4%) was grade 2, 18 cases(32.7%)was grade 3, and 16 cases(29.1%)was grade 4. Early postoperative complications occurred in 22 cases (39.3%). Among them, 1 case of Clavien gradeⅠ was wound infection. There were 16 cases with Clavien gradeⅡ, including 5 cases who received blood transfusion due to anemia, 3 cases with chylous fistula, 4 cases with postoperative pulmonary infection, 2 cases with postoperative lower extremity venous thrombosis, 1 case with atrial fibrillation and 1 case with epididymitis. Clavien gradeⅢ a was found in 1 case with pneumothorax. Clavien gradeⅣ was found in 2 cases, including 1 case of acute cerebral infarction and 1 case of renal insufficiency.There were 2 cases with Clavien gradeⅤ with perioperative death. Among the 56 patients, 5 lost the follow-up, 2 died during the perioperative period, and the other 49 patients were followed up for 1-39 months, with a median follow-up of 14 months. The mean survival time was (25.6±2.5) months, and the median survival time was 25 months.Conclusions:It was relatively safe and effective to perform cytoreductive nephrectomy and tumor thrombectomy in patients with metastatic renal cancer with tumor thrombus. For the patients with clinical symptoms, IMDC prognosis score model medium risk group, and strong desire for surgery, the combination of cytoreductive nephrectomy with tumor thrombectomy and postoperative targeted medical therapy was recommended.