Objective To investigate the efficacy and feasibility of percutaneous puncture and catheterization sclerotherapy for the treatment of kidney cyst under ultrasonographic guidance. Methods Fifty-seven patients with simple renal cysts were divided into study group (30 cases) and control group (27 patients) according to the therapies. In study group, patients who had the cyst diameter ≤6.0 cm( 17 cases) received direct puncture sclerotherapy, while ＞6.0 cm (13 cases) received catheterization puncture sclerotherapy. In control group, patients who had performed laparoscopic surgery. Observed and compared the efficacy, hospitalization time, operative time and complications of two groups. Results Both groups had no case of recurrence after surgery. The effective rates in study group and control group were 93.3%(28/30 ) and 96.3% (26/27) respectively, and there was no statistical difference between two groups (P ＞ 0.05). The hospitalization time and operative time in study group [( 2.3 ± 1.7 ) d, ( 13.5 ± 3.7 ) min] were significantly shorter than those in control group [(5.8 ±2.2) d, (57.7 ±8.9) min] (P＜0.05); but the incidence of complications had no statistical difference between two groups (P ＞ 0.05). Conclusions Percutaneous puncture and catheterization sclerotherapy for the treatment of kidney cyst under ultrasonographic guidance has some advantages as good efficacy, less traumatic, rapid recovery and fewer complications. It is especially suitable to be used in the primary hospital.

Objective To study the role of PI3K-Akt-GSK-3β signaling in the apoptosis of renal tubular cells after ischemia-reperfusion injury and the protective mechanism of recombinant human erythropoietin(rHuEPO). Methods The human kidney tubular epithelial cells(HK-2)were cultured in vitro in different conditions as control group with serum, ischemia-reperfusion(IR)group, LY294002 group with LY294002(AKT inhibitor)10 μmol/L 30 minutes before IR treatment, LiCl group with LiCl(GSK-33 inhibitor)20 μtmol/L 30 minutes before IR treatment, rHuKPO group with EPO 20 U/ml 30 minutes before IR treatment, rHuEPO + LY294002 group with EPO 20 U/ml and in the presence of LY294002(10 μmol/L)30 minutes before IR treatment, rHuEPO +LiCl group with EPO 20 U/ml and in the presence of LiCl(20 μmol/L)30 minutes before IR treatment. Akt, GSK-33 and caspase-3 activation were measured by Western blotting. The apoptotic ratio of HK-2 cells was measured by flow cytometry. Cell viability was detected by MTT. Results In comparison with the control group, the apoptotic ratio raised up to 15.20%±1.43%, the expression of Akt activity decreased, GSK-33 activity and caspase-3 activity markedly elevated in IR group(P<0.05). LY294002 group up-regulated the apoptotic ratio(18.20%±2.06%), decreased the expression of Akt activity, increased GSK-33 activity and caspase-3 activity, however, LiCl group down-regulated the apoptotic ratio(12.30%±0.85%), increased the expression of Akt activity, decreased GSK-33 activity and caspase-3 activity compared with IR group(P<0.05). rHuEPO group remarkably decreased the apoptotic ratio(11.10%±1.62%), increased the expression of Akt activity, decreased GSK-33 activity and caspase-3 activity compared with IR group(P<0.05). rHuEPO+LY294002 group elevated the apoptotic ratio(13.40%±1.94%), decreased the expression of Akt activity, increased GSK-33 activity and caspase-3 activity, meanwhile, rHuEPO +LiCl group down-regulated the apoptotic ratio(7.50%±1.31%), increased the expression of Akt activity, decreased GSK-33 activity and caspase-3 activity compared with rHuEPO group(P<0.05). Conclusions PI3K-Akt-GSK-3β signaling pathway is involved in HK-2 cells apoptosis induced by ischemia-reperfusion injury and rHuEPO may be used as a new therapy.

Through the construction practice of the optic nerve disease picture database,the paper discusses the system architecture,database field,data content,picture processing,organization and implementation,and other issues about the construction of the clinical case picture database,states and analyzes the operation effect,points out deficiencies,and provides reference for the construction of relevant picture databases.

Objective:To investigate the clinical value of echocardiography in the diagnosis of fetal arrhythmia.Methods:1 500 pregnant women who underwent a regular prenatal examination in Cangnan Hospital Affiliated to Wenzhou Medical University from March 2018 to March 2020 were included in this study. These pregnant women underwent fetal echocardiography in the second trimester of pregnancy (24-26 weeks). We evaluated the condition of, and calculated the incidence of, fetal arrhythmia complicated by fetal cardiac structure abnormality . The diameters of the descending aorta, umbilical artery, and middle cerebral artery were compared between normal fetuses and arrhythmia fetuses.Results:Fetal arrhythmia was found in 131 pregnant women who were in the second trimester of pregnancy, with an incidence of fetal arrhythmia of 8.73%. Fetal arrhythmia and cardiac structure abnormality were detected in 19 pregnant women, with an incidence of fetal arrhythmia and cardiac structure abnormality of 1.27%. Fetal arrhythmia was detected in 131 (8.73%) pregnant women who were in the second trimester of pregnancy and it was detected in 32 (2.13%) pregnant women who were in the third trimester of pregnancy. Arrhythmia was detected in 18 (1.2%) newborns. Only 5 (0.33%) fetuses died during the perinatal period. Four (0.27%) fetuses had arrhythmia complicated by cardiac structure abnormality. One (0.07%) fetus was normal. The diameters of the descending aorta and middle cerebral artery were greater in normal fetuses than in arrhythmia fetuses in pregnant women who were in the second trimester of pregnancy, and the diameter of the umbilical artery was significantly smaller in normal fetuses than in arrhythmia fetuses ( t = -8.27-19.62, all P < 0.001). Conclusion:Echocardiography can effectively help diagnose fetal arrhythmia and observe abnormal cardiac structure. The imaging technique is of great clinical value in improving the diagnosis and treatment of fetal arrhythmia.

Objective:To establish an interpretive reporting system for urinalysis based on artificial intelligence (AI).Methods:Urine tests were collected from the First Affiliated Hospital, College of Medicine, Zhejiang University from 2008 to 2018, including 2 899 917 patient tests and 710 971 physical check-up tests. Then we set up a large population distribution with the frequency of different results of each item and established a health index of each sample and an abnormal level of each item according to data distribution, importance and degree of abnormality. We collected data of seven diseases, such as diabetes mellitus, urinary tract infection, glomerulonephritis and nephrotic syndrome, and matched them with a same number of healthy control group by gender and age. An integrated learner based on the AdaBoost algorithm was used to establish a diagnostic model and assess its algorithm performance. JAVA was used to develop data presentation software. The accuracy of the AI model for disease judgment was assessed by manual verification using 199 abnormal urine tests.Results:Each report could be graded as four levels: normal, abnormal, ill and critical. Each item could be judged as normal, mild, moderate, severe or extreme and the population distribution was provided with big data. The training accuracy, true positive rate and area under the curve were ≥88.3%, ≥80.0%, and ≥0.954 respectively using the machine learning model based on AdaBoost. The developed JAVA software presented the above results and displayed medical records and results, historical results, personalized advice, patient education and position in large population data. By manual verification, the accuracy rate of the AI model for disease judgment was 82.41% (166/199).Conclusion:This study established an intelligent interpretive reporting system for urine test results. It can distinguish the abnormality of each report, predict the disease of patients, and make personalized clinical decisions.