0.05). After treatment the incidence of ED in therapy group was decreased to 46.3% vs control group of 63.7%(P

Objective To investigate the risk factors and countermeasure of residual stones after single‐channel percutaneous nephrolithotomy for higher stone‐free rate and better operation result .Methods All patients who underwent single‐channel percu‐taneous nephrolithotomy in our hospital from June 2011 to December 2013 were retrospected and the cause of residual stones were analyzed .Results There were 42 patients who had residual stones after operation among total 262 patients undergone single‐chan‐nel PCNL .21 patients had residual stones because the stones they burdened were too complex .7 patients were concerned with com‐plications such as intraoperative hemorrhage .The stone fragments scattered into the calices in 7 patients with overlarge stone during fragmentation .The other causes concerned with stone residue included anatomic structural abnormalities of the kidneys(3 patients) , operation itself inherent limitations(3 patients) ,insufficient practice and experience in operation(1 patients) .Conclusion The main causes concerned with residual stones of single‐channel PCNL are complexity of urinary calculi ,bleeding ,scattering of stone frag‐ments and anatomic structural abnormalities of the kidney .

Objective The rapid development of radiation equipment has put forward higher requirements for protective facil -ities.The aim of this study was to research the radiation protection status of treatment equipment room in thirty -three medical units from East China area , and to put forward corresponding countermeasures to improve the level of radiation protection . Methods The li-cense and archival of X-ray machine, CT, gamma knife, accelerator, after loading therapy machine were surveyed in the thirty-three medical units .The engine room size , wall thickness , lead equivalent of protection doors , and leakage level of equipment were detec-ted.All the data were evaluated and analyzed on the basis of the corresponding national standards . Results ①The inspection pass rates of radiation treatment equipments in the first class hospitals were afterloader (100%), X-ray apparatus(99%), gastrointestinal machine(98%), CT(98%), medical processing accelerator (98%), gamma knife(97%), DSA(94%), PET-CT(94%), ECT (90%), dental engine(84%)and molybdenum target drone (84%).The inspection pass rates of radiation treatment equipments in other class hospitals were medical processing accelerator (100%), X-ray apparatus(91%), CT(89%), gastrointestinal machine (80%), DSA(80%) and (80%) gamma knife.②The qualified rates of the leakage radiation levels of radiation therapy , diagnostic radiology and nuclear medicine were 100%, 99% and 97%. Conclusion The radiation protection of treatment equipments and facilities in thirty-three medical units from East China area needs to be strengthened . We should strengthen supervision , implement the rules and regulations , strictly perform the regulation of radiation protection evalua-tion, and strengthen the training of radiation protection regulations and skills .

Objective To study apoptosis and antigen presentation changes of monocytes in HBV-related acute-on-chronic liver failure (ACLF) patients under immune dysfunction state.Methods Peripheral blood samples of 26 HBV-related ACLF patients (ACLF group),20 active chronic hepatitis B patients (CHB group) and 18 healthy individuals (control group) were collected.The changes of apoptosis and proliferation (Ki67) in monocytes and the expression of surface markers including human leukocyte antigen (HLA)-DR and B7 molecules (CD86) of monocytes were analyzed by flow cytometry. Results The percentage of Annexin V expressed monocytes of ACLF group (64％) was significantly higher than that of CHB group (28％) and control group (20％),and the difference was statistically significant (x2 value was 11.75 and 27.23 ; both P＜0.01),which indicated that monocytes apoptosis increased.The Ki67 expression in monocytes of ACLF group was lower than that of CHB group and control group,and the difference was statistically significant (x2 value was 4.71 and 4.83; both P＜ 0.05),which indicated that activated monocytes reduced. The mean fluorescence intensity (MFI) of HLA-DR and CD86 of monocytes in ACLF group was 22.85 and 11.63,which was significantly lower than that of CHB group and control group,indicating the antigen presentation ability of monocytes injured. The percentage of Annexin Ⅴ positive monocytes in survivals (62 ％ ) was significantly higher than that of dead patients (46 ％ ) in ACLF group.Conclusion In HBV-related ACLF patients under immune dysfunction state,the apoptosis of peripheral blood monocytes increased,and the quantity of activated cells reduced,resulting in the decline of the antigen presentation ability of monocytes.

Amblyopia is the common disease in the children's growth. There are some disadvantages in traditional treatment to amblyopia, such as poor compliance, easily leading to the healthy eye eyesight problem, the poor recovery of binocular and stereoscopy vision, etc. This paper put forward a new individual amblyopia treatment system to solve these problems. It combined pattern reversal visual evoked potential (P_VEP) feedback and dichoptic training theory and then developed the EEG data acquisition and synchronized trigger circuit using and I/O data col ecting card, realized the raw EEG signal real-time sampling, extracted VEP waveform from the raw EEG data by using digital filtering algorithm, average superposition algorithm and wavelet an lgorithm, finally,the latency and peak of P_VEP wave shape were accurately measured. This system also present an individual treatment solution based on dichoptic training model by searching and obtaining the best spatial frequency of the treatment training picture and combining with 3D display technology.

Objective To establish a lung cancer risk prediction model using data mining technology and compare the performance of decision tree C5.0 and artificial neural networks in the application of risk prediction model, and to explore the value of data mining techniques in lung cancer risk prediction. Methods We collected the data of 180 patients with lung cancer and 240 patients with benign lung lesion which contained 17 variables of risk factors and clinical symptoms. Decision tree C5.0 and artificial neural networks models were established to compare the prediction performance. Results There were 420 valid samples collected in total and proportioned with the ratio of 7:3 for the training set and testing set. The accuracy, sensitivity, specificity, Youden index, positive predictive value, negative predictive value and AUC of artificial neural networks model were 65.3%, 61.7%, 73.3%, 0.350, 54.9%, 73.1% and 0.675 (95%CI: 0.628-0.720) in testing set; those of decision tree C5.0 model were 61.0%, 47.8%, 80.4%, 0.282, 35.3%, 80.6% and 0.641 (95%CI: 0.593-0.687) in testing set. Conclusion The artificial neural networks model is superior to the decision tree C5.0 model at overall performance and it has potential application value in the risk prediction of lung cancer.

Objective:To investigate the relationship between NOD-like receptor protein 3 (NLRP3) gene promoter region-30 single nucleotide polymorphism (SNP) (rs3738448) G/T and dilated cardiomyopathy (DCM) and its related risk factors.Methods:A case-control study method was used to collect 137 patients and 140 healthy controls; polymerase chain reaction-restriction endonuclease fragment length polymorphism technology combined with sequence alignment after DNA sequencing was used for data statistics; After Hardy-Weinberg balance test, the χ 2 test was used for correlation analysis; logistic regression was used to analyze the correlation between multiple risk factors and the SNP site and the incidence of DCM; SNPinfo database was used to predict and analyze the transcription factors affected by the SNP. Results:A total of GG and GT genotypes were detected at this SNP locus, and their genotype distributions were in line with Hardy-Weinberg equilibrium ( P>0.05). At the same time, the difference between the DCM group and the control group was significant ( P<0.05). Multivariate logistic regression analysis indicated that mean arterial pressure, C-reactive protein and B-type brain natriuretic peptide were independent risk factors for the onset of DCM (all P<0.05). The incidence of DCM in -30(RS3738448)G/T genotype GT group was 2.243 times higher than that in GG group (95% CI: 1.043-4.827, P<0.05). Logistic regression analysis under dominant, recessive and additive genetic models showed that there was a correlation between the dominant inheritance of SNP and the occurrence of DCM ( OR=0.44, AIC=370.4, BIC=381.3, P<0.05). Conclusions:The -30 (rs3738448) G/T SNP in the promoter region of the NLRP3 gene is associated with the pathogenesis of DCM, and provides population genetic data for the study of polymorphisms in the promoter region of NLRP3 gene.

Objective:To evaluate the diagnostic value of ultrasonic measurement of artery peak velocity variation (ΔVpeak) on predicting fluid responsiveness in critically ill patients.Methods:Databases of PubMed, Embase, Cochrane Library, SinoMed, Wanfang, CNKI and VIP were retrieved from the establishment of the database to November 2019. The retrieval literatures were about the research of ΔVpeak used to judge fluid responsiveness. According to the inclusion and exclusion criteria, the relevant literatures were screened by two researchers, and the data of the included literatures were extracted. The quality of literatures was evaluated by quality assessment of diagnostic accuracy studies (QUADAS). Meta Dics 1.4 software was used to analyze the literatures that met the quality standard by Meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio ( DOR) were calculated. The summary receiver operating characteristic (SROC) curve was drawn and the area under SROC curve (AUC) was calculated. The χ 2 test and Spearman correlation coefficient were used to analyze heterogeneity, and Deek test was used to analyze publication bias. Results:A total of 1 854 patients were enrolled in 31 studies, including 11 domestic studies and 20 foreign studies. Using 14 items of QUADAS to evaluate the quality of literatures, it was found that the enrolled literatures were all in Grade A, indicating that the overall quality of literatures was high. The scattered distribution of SROC curve was not "shoulder arm shape", and Spearman correlation coefficient was 0.062 ( P = 0.710), so there was no threshold effect. The heterogeneity test showed that I2 = 57.2% ( P = 0.001), indicating that there was a certain degree of heterogeneity among the studies, and the source of heterogeneity was non threshold effect. Meta regression analysis showed that the reason for heterogeneity was the method of volume load test [ DOR = 3.87, 95% confidence interval (95% CI) was 1.56-9.57, P = 0.004 8]. According to the results of heterogeneity analysis, there was no significant heterogeneity ( I2 = 10.6, P = 0.288 5) among the studies after removing the samples of the passive leg raising (PLR) instead of the volume expansion. A meta-analysis was done with random effects model. The results showed that the pooled DOR was 23.85 (95% CI was 17.57 to 32.37), pooled sensitivity was 0.82 (95% CI was 0.80 to 0.85), pooled specificity was 0.83 (95% CI was 0.80 to 0.85), pooled PLR was 4.17 (95% CI was 3.58 to 4.86), and pooled NLR was 0.22 (95% CI was 0.18 to 0.28). The AUC was 0.901 2 (95% CI was 0.88 to 0.93), and Q index was 0.832 5. The results of Deek funnel plot showed that there was no published bias in all the studies ( P = 0.19). Conclusions:Ultrasonic measurement of ΔVpeak has a high value in predicting fluid responsiveness. It is a reliable parameter for the evaluation of shock, critical illness and surgical operation population who need to monitor the fluid responsiveness.

Objective:To systematically review the effect of Tongfu Xiefei method on prognosis and respiratory mechanics parameters in patients with acute respiratory distress syndrome (ARDS).Methods:The randomized controlled trials (RCT) of Tongfu Xiefei method for ARDS published on PubMed, Web of Science, Embase, CNKI and Wanfang database from January 1st 2001 to June 30th 2019 were searched. Conventional treatment for ARDS that included mechanical ventilation, prone ventilation, anti-infection, organ function maintenance and nutritional therapy were used in the control group. While the Tongfu Xiefei method was applied in the experimental group based on the conventional treatment. The main outcome was in-hospital mortality, and the secondary outcomes included mechanic ventilation time, length of intensive care unit (ICU) stay and respiratory mechanics parameters. Two researchers independently searched the literature, collected data and assessed the risk of bias. The bias risk assessment was completed by RevMan 5.3 software. The Meta-analysis was completed by R software. The potential publication bias of main outcome was evaluation.Results:A total of 27 RCTs were included. There were 1 763 patients, including 899 in the experimental group and 864 in the control group. Meta-analysis showed that, compared with the control group, the in-hospital mortality of the experimental group significantly decreased [relative risk ( RR) = 0.46, 95% confidence interval (95% CI) was 0.36 to 0.59, P < 0.000 1], the mechanic ventilation time and the length of ICU stay were significantly shortened [mechanical ventilation time: standard mean difference ( SMD) = -1.92, 95% CI was -2.56 to -1.29, P < 0.000 1; length of ICU stay: SMD = -1.84, 95% CI was -2.49 to -1.18, P < 0.000 1], oxygenation index was significantly improved ( SMD = 2.26, 95% CI was 1.56 to 2.96, P < 0.000 1), airway peak pressure, airway platform pressure, mean airway pressure and airway resistance significantly decreased (airway peak pressure: SMD = -1.26, 95% CI was -2.35 to -0.18, P = 0.021 8; airway platform pressure: SMD = -0.61, 95% CI was -1.08 to -0.14, P = 0.010 7; mean airway pressure: SMD = - 1.67, 95% CI was - 2.93 to -0.42, P = 0.009 1; airway resistance: SMD = -0.88, 95% CI was -1.09 to -0.67, P < 0.000 1), while lung compliance increased ( SMD = 1.57, 95% CI was 0.78 to 2.36, P < 0.000 1). The results of publication bias assessment showed that there was no potential publication bias ( P = 0.499). Conclusion:Tongfu Xiefei method is capable of reducing the in-hospital mortality, shortening the mechanical ventilation time and the length of ICU stay, and improving respiratory mechanics parameters for patients with ARDS.