Objective To compare the safety and efficacy of greenlight photos selective vaporization and RevoLix 2 micron continuous wave laser vaporesection for the treatment of superficial bladder tumor. Methods Under sacral anesthesia or epidural anesthesia,a total of 42 patients with superficial bladder tumor were treated with greenlight photos selective vaporization while the other 42 patients received the RevoLix 2 micron continuous wave laser Vaporesection. The clinical stage of the patients was T1-T2,and the pathology grade was G1-G2. Results The greenlight photos selective vaporization and RevoLix 2 micron continuous wave laser vaporesection were successfully completed in all of the patients. No patients required blood transfusion. No complications such as obturator nerve reflex,bladder perforation or overhydration occurred. No significant difference was noticed in the operation time [(15.3?10.5) min vs (14.3?6.5) min,t=0.525,P=0.601],catheterization time [(6.3?0.5) d vs (6.3?1.2) d,t=0.000,P=0.999],and postoperative hospital stay [(6.3?3.5) d vs (7.2?2.4) d,t=-1.374,P=0.173]. The patients were followed up for 6 months,during the period the recurrence rate was 11.9%(5/42) and 7.1%(3/42) respectively in the greenlight group and RevoLix group (?2=0.138,P=0.710). Conclusions Both greenlight photos selective vaporization and RevoLix 2 micron continuous wave laser vaporesection are effective and safe for superficial bladder tumor and lead to low rates of postoperative complications and recurrence. Further studies are necessary to evaluate its long-term effect. For T2 and higher grades of bladder tumors,open surgery should be performed.

ObjectiveTo investigate the therapeutic effects, safety of pneumatic lithotripsy and 2 μm laser via transurethral ureteroscope for ureteral calculi accompanied with granulation. Methods27 cases (30 sides) of ureteral calculi accompanied with granulation treated with 2 μm laser and pneumatic lithotripsy via ureteroscope were reviewed. Results28 sides were fragmented successfully in a single procedure. The operation time was 15～45 min (mean 25 min). The intraoperative blood loss was 3～15 ml (mean 5 ml). The postoperative hospitalization time was 3～7 d (mean 5.5 d). 1 upper ureteral stone was pushed back to the renal pelvis and extracorporeal shock wave lithotripsy was needed. The insertion of the ureteroscope was failed in 1 cases, who accepted open operation finally. Double-J tubes were pulled out in all the patients after 1 month, and 26 sides were stone-free. They were followed-up for 3～15 months (mean 8 months), no ureteral stenosis or urinary infection was found. Conclusion2 μm laser and pneumatic lithotripsy via ureteroscope is an effective and safe therapy for ureteral calculi with granulation, especially for those on middle or lower levels.

Objective To compare the effect of difierent combinatio of mannitol, furesemide and albumin in reducing intracranial pressure in 451 patients with severe traumatic brain injury (sTBI). Methods A total of 451 patients with an admissiou Glasgow Coma Scale of or less from 5 medical centers were randomly divided into 5 groups, ie, Group A(250 ml 20% mannitol each time as control), Group B(125 ml 20% mannitol each time), Group C(alternate use of 250 ml 20% mannitol each time or 40 mg furosemide), Group D(alternate use of 125 ml 20% mannitol each time and 20 mg furosemide)and Group E(alternate use of 125 ml 20% mannitol and moderate or large dose of albumin). We monitored intracraniai pressure continuously and observed the changes of intracranial pressure, electrolytes, hemato-crit and renal function after use of 5 combinations of mannitol. Furosemide and albumin. Results Man-nitol and furosemide could independently reduce intracranial pressure after 1-3 hours (P<0. 05). Semis mannitol plus furosemide or albumin could more signifieantly reduce intracranial pressure, with statistical difference compared with full dose of mannitol. Semis mannitol and alternate use of mannitol and furose-mide in aspect of intracranial pressure reduction and persistence time(P<0. 05). Alternate use of man-nitol and furosemide begot higher incidence rate of electrolyte abnormality, compared with the other com-binations (P<0. 05). Rebound rate of intracranial pressure was higher in full dose of mannitol than other combinations (P<0. 05). Incidence of renal function abnormality was higher in combination involved al-bumin than alternative use of mannitol and furosemide as well as combination of semis mannitol and furo-semide (P<0. 05). Abnormality of electrolyte and renal function wag reversible. Conclusion The use of 125 ml 20% mannitol each time plus 20 mg furesemide is more reasonable than other combina-tions. Meanwhile, semis mannitol combined with moderate or large dose of albumin has certain advantages too.

Objective To investigate the therapeutic effects, safety of ureteral calculus accom panied with granulation treated with pneumatic lithotripsy and two-macron laser via transurethral uret eroscopic. Methods From June 2007 to March 2010, 38 cases of ureteral calculus accompanied with granulation were treated with 2 μm laser and pneumatic lithotripsy via ureteroscope. All the patients had middle to severe hydronephrosis. The granulation under the calculus was vaporized with the 2 μm laser, and then the ureteral stone was fragmented with pneumatic lithotripsy. The clinical datum,stone disintegration rate, lithagogue rate and complication were retrospectively analyzed. Results Among 38 cases of ureteral stones, rate of successful fragmentation in a single procedure was 92%(35/38). The operation time ranged from 15 to 45 min, mean (23.0±6.5)min. Estimated the intraoperative blood loss was (7.0±4.5)ml. The postoperative hospitalization time was (5.2±0.6)d. Two upper ureteral stones were pushed back to the renal pelvis and a conversion to extracorporeal shock wave lithotripsy (ESWL) was needed. The insertion of the ureteroscope was failed in 1 case who was accepted open operation finally. Among the 37 cases treated via ureteroscopy, stone clearance rate was about 86% after operation 1 month. Follow-up examinations for 3-15 months (mean 8 months)showed no ureteral stenosis or urinary infection. Conclusion 2 μm laser and pneumatic lithotripsyvia ureteroscope could be a highly effective and safe therapy for treatment of ureteral stone with granulation.

Chitosan has natural abundance, unique bioactivity and attractive physicochemical properties. Recent years, the synthesis of chitosan-based metal nanomaterials has attracted increasing attention. The synthesis of metal nanoparticles utilizing biomolecular or organism offers a mild medium, and thus a greater degree of control over the nanoparticles produced, along with higher reproducibility. In particular, preparation of metal nanoparticles based on biomolecular or organism has its unique facility in integrating "minimum feature sizes" into labile biological components to an excellent synergy and bifunctional effect and consequently a more broad application. Herein, we review the new development of chitosan, chitosan-based synthesis of metal nanomaterials, and their application.
Catalysis ; Chitosan ; chemistry ; Metal Nanoparticles ; chemistry ; Oxidation-Reduction

Objective To summarize our experience with surgical management of renal neoplasm involving inferoir veno cava.Methods We review the data of 115 patients,including 74 male patients and 41 female patients,with renal neoplasm involving venous system between March 1993 and December 2015.The mean age was 52 years old,ranging 22 to 77 years old.The tumor was found in right side in 77 cases and left side in 38 cases.There were 15 patients (13.0％) with renal vein thrombus,38 (33.1％) with infrahepatic thrombus,29 (25.2％) with low retrohepatic thrombus,20 (17.4％) with high retrohepatic thrombus,and 13 (11.3％) with supradiaphragmatic thrombus.The mean age was 52 years old,ranging 22 to 77 years old.The tumor was found in right side in 77 cases and left side in 38 cases.All patients accepted the radical nephrectomy.Primary outcomes were overall survival (OS),and cancer special survival (CSS) in patients with renal cell carcinoma (RCC) estimated by Kaplan-Meier method.Secondary outcome included operative and oncological features,past-operative complications and hospital mortality.Cox proportional hazard model was used to univariate and multivariate analysis for risk factor impacting on OS of RCC patients.Results Complete resections of renal neoplasm with tumor thrombus were achieved in 113 patients (98.3％),2 patients died intraoperatively due to the dropping of thrombus.Postoperative complication rate was 16.8％.Hospital mortality was 2.6％.Mean follow-up interval was 48 months.OS rates at 5-,and 10-year in RCC patients were 66.5％,and 61.8％,respectively.Metastasis was an independent risk factor affecting on OS (P =0.000).However,the level of thrombus was not an risk factor affecting the prognosis.Conclusions Radical resection of renal tumor and caval thrombus is an effective treatment for prolonging survival in patients with RCC extending into venous system.Retrohepatic caval tumor thrombus below or above the main hepatic vein should be dichotomized and managed respectively with diverse techniques.Metastatic rather than the level of thrombus was a risk factor impacting on RCC patient survival.

Objective: To investigate the implementation of GBZ/T 201.3-2014 Radiation Shielding Specification for Radiotherapy Room--Part 3: Radiotherapy Room of γ-ray Sources (hereinafter referred to GBZ/T 201.3-2014). Methods: A total of 129 personnels, who were involved in the approval and supervision of radiation diagnosis and treatment construction projects in 19 provincial administrative agencies, engaged in radiation protection testing and evaluation of γ-ray radiotherapy rooms in radiation health technology service institutions, and used GBZ/T 201.3-2014 in other institutions (environmental impact assessment, education and scientific research), were selected as the participants using a stratified random sampling method. A questionnaire survey was conducted to assess their awareness and application of the standard. Results: The participants' awareness of GBZ/T 201.3-2014 was ≥63.6%, but the training rate was only 9.1% to 50.0%. The familiarity with the various chapters of the standard was over 86.4%. And 42.6% of the participants reported using the standard at least once a year. Regarding the applicability of the standard, all of the participants believed that the standard meets the needs of approval, supervision, testing, or evaluation, and adapts to the updated development of radiotherapy equipment and technology. And 94.6% of the participants believed that the use of the standard could improve the level of protection design and management, and 92.2% believed that the standard was widely applied. Regarding the adequacy of the standard, 97.7% of the participants believed that the standard's reference for ambient dose equivalent rate was reasonable, while 34.1% believed that the standard needs revision. Conclusion: The participants are satisfied with the standard and believe its applicability. They have a good level of awareness of the standard, but there is a room for improvement in their familiarity with the shielding calculation related content of the standard. The promotion, training, and practicality of the standard need to be strengthened.

Echinococcus granulosus is an important zoonotic parasite globally causing cystic echinococcosis (CE) in humans and animals. In this study, prevalence of CE and variation of cox1 gene sequence were analyzed with isolates E. granulosus collected from different areas in northern Xinjiang, China. The survey showed that 3.5% of sheep and 4.1% of cattle were infected with CE. Fragment of cox1 was amplified from all the positive sheep and cattle samples by PCR. In addition, 26 positive samples across the 4 areas were included. The isolates were all E. granulosus sensu stricto (s.s.) containing 15 haplotypes (Hap1-15), and clustered into 2 genotypes, G1 (90.1%, 91/101) and G3 (9.9%, 10/101). Hap1 was the most common haplotype (48.5%, 49/101). Hap9 were found in humans samples, indicating that sheep and cattle reservoir human CE. It is indicate that E. granulosus may impact on control of CE in livestock and humans in the region.
Animals ; Cattle ; China ; Cross-Sectional Studies ; Echinococcosis ; Echinococcus granulosus ; Echinococcus ; Genotype ; Haplotypes ; Humans ; Livestock ; Parasites ; Polymerase Chain Reaction ; Prevalence ; Sheep

Objective:To compare the differences in the prevalence of mild micro-hepatic encephalopathy (MHE) among patients with cirrhosis by using the psychometric hepatic encephalopathy score (PHES) and the Stroop smartphone application (Encephal App) test.Methods:This prospective, multi-center, real-world study was initiated by the National Clinical Medical Research Center for Infectious Diseases and the Portal Hypertension Alliance and registered with International ClinicalTrials.gov (NCT05140837). 354 cases of cirrhosis were enrolled in 19 hospitals across the country. PHES (including digital connection tests A and B, digital symbol tests, trajectory drawing tests, and serial management tests) and the Stroop test were conducted in all of them. PHES was differentiated using standard diagnostic criteria established by the two studies in China and South Korea. The Stroop test was evaluated based on the criteria of the research and development team. The impact of different diagnostic standards or methods on the incidence of MHE in patients with cirrhosis was analyzed. Data between groups were differentiated using the t-test, Mann-Whitney U test, and χ2 test. A kappa test was used to compare the consistency between groups. Results:After PHES, the prevalence of MHE among 354 cases of cirrhosis was 78.53% and 15.25%, respectively, based on Chinese research standards and Korean research normal value standards. However, the prevalence of MHE was 56.78% based on the Stroop test, and the differences in pairwise comparisons among the three groups were statistically significant (kappa = -0.064, P < 0.001). Stratified analysis revealed that the MHE prevalence in three groups of patients with Child-Pugh classes A, B, and C was 74.14%, 83.33%, and 88.24%, respectively, according to the normal value standards of Chinese researchers, while the MHE prevalence rates in three groups of patients with Child-Pugh classes A, B, and C were 8.29%, 23.53%, and 38.24%, respectively, according to the normal value standards of Korean researchers. Furthermore, the prevalence rates of MHE in the three groups of patients with Child-Pugh grades A, B, and C were 52.68%, 58.82%, and 73.53%, respectively, according to the Stroop test standard. However, among the results of each diagnostic standard, the prevalence of MHE showed an increasing trend with an increasing Child-Pugh grade. Further comparison demonstrated that the scores obtained by the number connection test A and the number symbol test were consistent according to the normal value standards of the two studies in China and South Korea ( Z = -0.982, -1.702; P = 0.326, 0.089), while the other three sub-tests had significant differences ( P < 0.001). Conclusion:The prevalence rate of MHE in the cirrhotic population is high, but the prevalence of MHE obtained by using different diagnostic criteria or methods varies greatly. Therefore, in line with the current changes in demographics and disease spectrum, it is necessary to enroll a larger sample size of a healthy population as a control. Moreover, the establishment of more reliable diagnostic scoring criteria will serve as a basis for obtaining accurate MHE incidence and formulating diagnosis and treatment strategies in cirrhotic populations.