【Objective】 To compare the clinical safety and effectiveness of super-mini-percutaneous nephroscope (SMP) combined with flexible ureteroscopic lithotripsy (FURL) in oblique supine lithotomy position and FURL alone in the treatment of 2.0-3.0 cm renal calculi. 【Methods】 Clinical data of 55 patients treated during Jan.2018 and May 2021 were retrospectively analyzed, including 47 cases complicated renal calculi, and 14 cases of lower calyceal calculi with infundibulopelvic angle ≤30°. SMP combined with FURL was performed in 23 cases (combined group), and FURL alone was performed in 32 cases (FURL group). The operation time, hemoglobin reduction, postoperative hospital stay, hospitalization expenses, stone-clearance rate and complications were compared. 【Results】 All operations were successful. Compared with the FRUL group, the combined group had significantly more hemoglobin reduction [(16.30±10.17) g/L vs. (6.94±6.61) g/L], longer postoperative hospital stay [(5.35±1.61) d vs. (3.19±1.26) d], and higher hospitalization expenses [(22 481±2 234) yuan vs. (18 209±2 584) yuan] (P<0.05). However, there was no significant difference in operation time [(79.57±8.52) min vs. (79.22±3.83 min),P>0.05]. One month after surgery, CT results showed that the combined group had higher stone-clearance rate (91.30% vs. 65.63%, P=0.027). There was no difference in the complication rate (21.74% vs. 21.88%, P>0.05). One case (4.35%) in the combined group and 5 cases (15.63%) in the FURL group received retreatment (P>0.05). 【Conclusion】 SMP combined with FURL in oblique supine lithotomy position is safe and effective in the treatment of 2.0-3.0 cm renal calculi, with high stone-clearance rate and low complication rate.

Ketoprofen is widely used as non-steroidal anti-inflammatory drug. A potential sustained release ketoprofen tablet formulation was designed by orthogonal experiment on formulations composed of differential common excipients and homemade polymerides, and was screened by dissolution in vitro. The dissolution rate (%) of the ketoprofen tablet in simulated intestinal fluid was 16.6, 26.7, 42.2, 63.6, 83.1, 93.4, at 30min, 1, 2, 4, 6, 8 h, respectively. The plasma ketoprofen concentrations in six male volunteers were assayed after administration of a single oral dose (100 mg) of the sustained release tablet. It was found that the tablet formulation screened in vitro had sustained release effect in vivo too. This study suggests that there was a close correlation between the dissolution of sustained release ketoprofen tablet in vitro and the percent of dose absorbed in vivo, and the correlation coefficient was 0.9689. The influence of tablet hardness on the release rate of ketoprofen was also observed..

OBJECTIVETo investigate the epidemiological features of the pathogens responsible for prostatitis in the Changshu area, and offer some evidence for the clinical treatment of prostatitis.

METHODSThis study included 2 306 cases of prostatitis that were all clinically confirmed and subjected to pathogenic examinations in 3 hospitals of Changshu area from 2008 to 2012. Neisseria gonorrhoeae, mycoplasma urealyticum and chlamydia trachomatis were detected by nucleic acid amplification ABI 7500, the bacterial data analyzed by VITEK-2 Compact, the drug-resistance to antibacterial agents determined using the WHONET 5.6 software, and the enumeration data processed by chi-square test and curvilinear regression analysis using SPSS 19.0.

RESULTSThe main pathogens responsible for prostatitis were found to be Staphylococcus haemolyticus (30%), Staphylococcus epidermidis (12%), Enterococcus faecalis (9%), Escherichia coli (6%), Staphylococcus warneri and Staphylococcus aureus (3%), Mycoplasma urealyticum (8%), chlamydia trachomatis (5%) and Neisseria gonorrhoeae (6%). Statistically significant increases were observed in the detection rates of Escherichia coli (chi2 = 17.56, P<0.05), Mycoplasma urealyticum (chi2 = 8.73, P<0.05), Chlamydia trachomatis (chi2 = 8.73, P<0.05) and Enterococcus (chi2 = 8.22, P<0.05), but not in other pathogens. The resistance rates of Gram-positive bacteria to erythromycin and benzylpenicillin G were both above 45%, but with no significant difference between the two, those of Oxacillin (chi2 = 10.06, P<0.05) and Cefoxitin (chi2 = 9.89, P<0.05) were markedly increased, but those of quinolones, gentamycin and clindamycin remained low, except rifampicin (chi2 = 11.09, P<0.05). The resistance rates of Gram-negative bacteria to cefazolin and ampicillin were relatively high (mean 57.3%), and those to ceftriaxone (chi2 = 11.26, P<0.05) and trimethoprim sulfamethoxazole (chi2 =11.00, P< 0.05) significantly high; those to amikacin, cefepime, piperacillin/tazobactam and imipenem remained at low levels with no significant changes. However, the resistance rates of mycoplasma urealyticum to ciprofloxacin (chi2 = 11.18, P<0.05) and azithromycin (chi2 = 9.89, P<0.05) were remarkably increased.

CONCLUSIONGram-positive bacteria are the major pathogens responsible for prostatitis, but Escherichia coli, enterococcus and sexually transmitted disease pathogens are found to be involved in recent years. Quinolones and aminoglycosides are generally accepted as the main agents for the treatment of Gram-positive bacterial infection. However, rational medication for prostatitis should be based on the results of pathogen isolation and drug sensitivity tests in a specific area.

Anti-Bacterial Agents ; pharmacology ; Drug Resistance, Bacterial ; Gram-Negative Bacteria ; drug effects ; Gram-Positive Bacteria ; drug effects ; Humans ; Male ; Prostatitis ; epidemiology ; microbiology

Adult ; Bone Plates ; Female ; Femoral Fractures ; surgery ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged

Objective:To explore the clinical efficacy and safety of modified Heweitang in the treatment of functional dyspepsia （FD） due to liver-stomach disharmony and its regulation of gastrointestinal hormones and brain-gut peptides. Method:One hundred and twenty-six eligible patients were randomized into a control group （62 cases） and an observation group （64 cases）. Patients in the observation group took the modified Heweitang granules with warm water 30 min after meals， 10 g/time， 3 times/day， while those in the control group took the corresponding placebo granules at the same dose in the same manner. The treatment in both groups lasted for four weeks. Before and after treatment， the four main symptoms including postprandial satiety， early satiety， upper abdominal pain， and upper abdominal burning sensation were scored， followed by the examination of gastric emptying （GE） and the scoring of the functional digestive disorders quality of life questionnaire （FDDQL）， 7-point global overall symptom scale （GOSS）， and liver-stomach disharmony syndrome. The cholecystokinin （CCK）， motilin （MTL）， gastrin （GAS）， serotonin （5-HT）， vasoactive intestinal peptide （VIP）， and substance P （SP） levels before and after treatment were detected， and then the safety was evaluated. Result:After treatment， the scores of the four main symptoms， GOSS， and liver-stomach disharmony syndrome in the observation group were lower than those in the control group （P<0.01）， while the GE rate and FDDQL scores in the observation group were higher （P<0.01）. The CCK， GAS， 5-HT， and VIP levels of the observation group declined as compared with those of the control group （P<0.01）， whereas the MTL and SP levels were elevated （P<0.01）. After treatment， the overall response rate in the observation group was （51/57）89.47%， higher than （15/56）26.79% in the control group （χ²=45.696， P<0.01）. No drug-related adverse reactions were found during the trial. Conclusion:The modified Heweitang is efficient and safe in relieving the main and related symptoms and traditional Chinese medicine （TCM） syndrome， regulating the secretion of gastrointestinal hormones and brain-gut peptides， promoting GE rate， and improving the quality of life of patients with FD due to liver-stomach disharmony.

OBJECTIVETo investigate the clinical effects of two surgical approaches for the treatment of thoracolumbar fracture without neurological symptoms.

METHODSFrom January 2008 to December 2009, 40 cases with thoracolumbar fractures without neurological symptoms treated by surgery were respectively analyzed. Among the patients, there were 13 males and 27 females, with an average age of 46 years (ranged, 26 to 61 years). Twenty patients in group A treated through posterior median approach; twenty patients in group B were treated through paraspinal muscle approach. All the patients were received the same posterior spinal internal fixation (Sofamor Inc (Basis)). Operating time, blood loss, postoperative drainage, postoperative bed time, VAS score 24 and 72 hours after operation, postoperative Cobb angle correction rate, correction rate of vertebral collapse were analyzed.

RESULTSThere were no significant difference in postoperative Cobb angle correction rate and vertebral collapse rate (P < 0.05); while the index such as operating time, blood loss, postoperative drainage, postoperative bed time and VAS score 24 h and 72 h after operation in group B is better than group A.

CONCLUSIONTreatment of thoracolumbar fracture through posterior median approach has an advantage of minimal invasive, less bleeding and rapidly recovery, but the patients with neural symptoms and intraspinal occupying more than 1/3 is not suggested.

Adult ; Case-Control Studies ; Female ; Humans ; Lumbar Vertebrae ; injuries ; Male ; Middle Aged ; Pain Measurement ; Retrospective Studies ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries

In the present study, the performance of the liquid nitrogen frozen and thinned bovine pericardium was studied and compared with the porcine pericardium. The microstructure and mechanical properties of the bovine pericardium were observed and tested by hematoxylin-eosin (HE) staining and tensile test respectively. In all conditions, porcine pericardium was selected as a control group. The results showed that there was little difference in the performance of bovine pericardium after being frozen by liquid nitrogen. The secant modulus and ultimate strength of the thinned bovine pericardium were similar to those of porcine pericardium, however, the elastic modulus was a little higher than porcine pericardium. The study suggested that the performance of the thinned bovine pericardium was similar to those of porcine pericardium. It was easy for the thinned bovine pericardium to obtain a relatively ideal thickness and expected performance, therefore, the thinned bovine pericardium can be used as the materials of transcatheter aortic valve leaflets.
Animals ; Aortic Valve ; Bioprosthesis ; Cattle ; Elastic Modulus ; Freezing ; Heart Valve Prosthesis ; Nitrogen ; Pericardium ; physiology ; Swine

Objective: To investigate the association between long-term fasting blood glucose (FPG) variability and all-cause mortality in patients with type 2 diabetes. Methods: A total of 7 174 type 2 diabetic patients included in National Basic Public Health Service Program in Changshu of Jiangsu Province were recruited as participants. Long-term glucose variability was assessed using standard deviation (SD), coefficient of variation (CV), average real variability (ARV), and variability independent of the mean (VIM) across FPG measurements at the more than three visits. Death information were mainly obtained from the death registry system in Jiangsu. Then Cox proportional hazards regression models were used to estimate the associations of four variability indicators and all-cause mortality's hazard ratios (HRs) and their 95%CIs. Results: Among 55 058.50 person-years of the follow-up, the mean follow-up time was 7.67 years, and 898 deaths occurred during the follow-up period. After adjustment, compared with T₁ group, the Cox regression model showed that HRs of T₃ group in SD, CV, ARV and VIM were 1.24 (95%CI: 1.03-1.49), 1.20 (95%CI: 1.01-1.43), 1.28 (95%CI: 1.07-1.55) and 1.20 (95%CI:1.01-1.41), respectively. HRs of per 1 SD higher SD, CV, ARV and VIM were 1.13 (95%CI: 1.06-1.21), 1.08 (95%CI: 1.01-1.15), 1.05 (95%CI: 1.00-1.12) and 1.09 (95%CI: 1.02-1.16) for all-cause mortality, respectively. In the stratified analysis, age, gender, hypoglycemic agent and insulin uses had no effect on the above associations (all P for interaction >0.05). Conclusion: Long-term FPG glycemic variability was positively associated with the risk of all-cause mortality in type 2 diabetes patients.

Objective: To investigate the relationship between socioeconomic status (SES) and all-cause mortality in patients with type 2 diabetes. Methods: A total of 17 553 patients with type 2 diabetes were recruited under the National Basic Public Health Service Project in Changshu county, Qingjiangpu district, and Huai'an district in Huai'an city of Jiangsu province as participants. Latent class analysis was applied to classify the individuals based on five socioeconomic indicators. Then, Cox proportional hazards regression models were used to estimate the associations of different levels of SES with all-cause mortality, and stratified analysis was performed according to age and area. Results: Among 100 529.08 person-years of the fo1low-up, the median follow-up time was 5.7 years, and 1 829 deaths occurred during the follow-up period. According to the relevant results of the latent class model, the model of the "three classes" was the best. The related population was then divided into low SES (8 256 people, 47.0%), medium SES (4 427 people, 25.2%), and high SES groups (4 870 people, 27.8%). Compared to patients with high SES, the multivariate-adjusted hazard ratio (95%CI) of all-cause mortality associated with low SES for males and females were 1.84 (1.53-2.21) and 1.41 (1.51-1.72), respectively. Stratified analysis showed that the hazard ration (95%CI) of all-cause mortality associated with low SES for males and females were 1.99 (1.12-2.95) and 2.01 (1.20-3.23), respectively, in people younger than 60 years old, and were 1.90 (1.57-2.31) and 1.40 (1.13-1.73) in people over 60 years old. The HR values (95%CI) for all-cause mortality associated with low SES for the male and females were 1.54 (1.17-2.04) and 1.27 (1.02-1.59) in the urban population with 2.11 (1.55-2.85) and 2.64 (1.17-3.35) in rural population, respectively. Conclusions: Lower SES increased the risk of all-cause mortality in type 2 diabetic patients, which is more significant in younger and rural populations.
United States ; Female ; Humans ; Male ; Middle Aged ; Latent Class Analysis ; Diabetes Mellitus, Type 2 ; Prospective Studies ; Social Class ; Income

Objective To investigate the effect of different calcification patterns on the outcome of transcatheter aortic valve implantation (TAVI) by the finite element method. Methods Three calcified human aortic root models (coaptation line calcification model, attachment line calcification model and circular calcification model) were developed according to the location of calcified plaques on the aortic valve leaflets. The processes of self-expanding transcatheter aortic valve implanted into the 3 calcified models were simulated by ABAQUS software. The effects of different calcification patterns on the aortic root stresses, valve frame distortions and paravalvular gaps were analyzed. Results Circular calcification model had the largest maximum principal stress on calcified plaques (18.42 MPa), which might result in a higher risk of stroke after implantation; the circular calcification model also had the greatest distortion of the valve frame, which might lead to worse prosthetic durability; the paravalvular gaps area of the attachment line calcification model was 37.2 mm2, which was more than twice that of the other 2 models, causing more serious paravalvular regurgitation. Conclusions Different aortic valve calcification patterns are related to aortic root stresses, valve frame distortions and paravalvular gaps after TAVI, which will have an impact on postoperative complications and prothesis durability. The research findings provide references for the prediction of clinical outcome after TAVI.