Objective To study the effect of lactobacillus on serum histamine ,interleukin‐5(IL‐5) ,interleukin‐12(IL‐12) and tissue intercellular cell adhesion molecule‐1(ICAM‐1) on the rats of allergic rhinitis model .Methods Totally 48 male SD rats were randomly divided into control group ,model group ,Lactobacillus (LBA) group (1 × 1010 CUF/kg) and loratadine (LRD) group (5 mg/kg) ,there were 12 SD rats in each group .LBA Group administered once daily for a total of 6 weeks ;LRD group administered once daily for seven days .Then the clinical symptoms indexes ,the content of serum histamine ,IL‐5 ,IL‐12 ,the changes of tissue pathological ,the mRNA and protein of ICAM‐1 were compared .Results Lactobacilli can significantly improve symptoms score of allergic rhinitis in rats ,the pathological score ,reduce serum histamine ,IL‐5 levels ,ICAM‐1 mRNA and protein expression of tissue , and increase IL‐12 proportion ,thus it showed significant efficacy .Conclusion Long‐term (approximately six weeks) given lactoba‐cilli played a therapeutic role of allergic rhinitis by reducing serum histamine ,IL‐5 levels and ICM A‐1 expression in tissues ,in‐creased serum IL‐12 level .

Objective To investigate the safety and feasibility of flexible ureteroscope/holmium laser therapy of parapelvic cyst complicating with renal calculi.Methods The clinical data of 8 patients diagnosed as parapelvic cyst with renal calculi and hospitalized in our hospital from Nov.2012 to Nov.2014 were retrospectively analyzed.They were 5 males and 3 females,aged 54 78 years,with an average of 63 years old.The largest kidney calculis were at the size of (1.2 cm× 1.1 cm) to (1.5cm×2.0 cm),and the size of parapelvic cysts ranged between (3.2 cm×3.6 cm) and (5.1 cm×4.2cm).Waist pain was found in 6 patients,hematuria in 3 patients,hydronephrosis in 1 patient,circumscribed hydrocalycosis in 2 patients,hypertension in 3 patients,and infection of urinary tract in 3 patients.Incision and internal drainage of parapelvic cyst and lithotripsy for renal calculi were conducted by flexible ureteroscope/holmium laser under general anesthesia.Results All of the 8 patients had successful operations without any complications such as massive haemorrhage,pararenal hematoma,extravasation of urine,infectious shock and kidney atrophy during or after the operation.The operation time ranged between 52 to 120 minutes,with the average of 76 minutes.All patients showed no residual renal calculus during a follow-up period of 3 to 12 months.Renal cysts were disappeared in 6 patients,and the size of renal cysts was significantly decreased in the other 2 cases.No parapelvic cyst and renal calculus recurred during the follow-up.Conclusions Flexible transurethral ureteroscope/Holmium laser therapy is a good method with the advantages of minimal trauma,quick recovery,simple operation,economic,safety and effectiveness in treating parapelvic cyst complicating with renal calculus.

Objective To evaluate the efficacy and safety of amrubicin for small-cell lung cancer (SCLC ) . Methods PubMed ,Embase ,the Cochrane Library and CNKI were searched to collect amrubicin data in the treatment of SCLC .A Meta-analysis was performed over the published clinical trials .The efficacy and safety of amrubicin were evaluated based on overall survival (OS) ,progression-free survival (PFS) ,overall response rate (ORR) and toxicity .Results Our anal-ysis for 6 clinical trials indicated that amrubicin had significantly higher ORR than control group [RR 1 .72 ,95% CI (1 .39 , 2.14) ,P=0 .000] ,the OS ,PFS and toxicity were no-inferior to the control group(P=0 .405 ,P=0.456) .Conclusion Am-rubicin can be considered as a good second-line treatment for relapsed SCLC .

ObjectiveTo investigate the clinical features and treatment of ascending paralysis after thoracolumbar fracture.MethodsThree male patients with 2 fracture levels at T12 and one at L1 were retrospectively studied.Their mean age was 41.3 years(range,39-42 years).All 3 cases were undertaken open decompression,reduction and internal fixation.Paralysis level began to ascend at 2-5 days after injury,with 2 cases up to C2,3 and 1 case up to T7.Two patients suffered irritating pain over the paralysis level before onset of ascending.Postoperative MRI images demonstrated well reduction and no compression of spinal cord.In the early phase after ascending,MRI obviously showed swelling in spinal cord and long T1 and long T2 signals shaped patchy and stripy distribution in the central area.One patient's MRI displayed that the spinal cord shrinked 16 days after trauma with abnormal high signal in the central area.ResultsTwo cases died of respiratory muscle paralysis and 1 case suffered paraplegia with no recovery 5 years after surgery.ConclusionAscending paralysis after thoracolumbar fracture is a rare complication with very poor prognosis.MRI is available for evaluating operational effects and affected level.The exact mechanism and effective treatment are still unclear and need further investigated.

Objective To analyze tumor immune microenvironment and related mechanisms in liver cancer.Methods We included 10 cases of hepatocellular carcinoma,hepatitis B patients and healthy volunteers from January 2015 to December 2017 in Shanxi Grand Hospital.We first detected the peripheral and local GM-CSF level in each group,detected myeloid-derived suppressor cells (MDSCs) GM-CSF and pathway-related protein expression.from liver cancer,tumor margin and normal liver tissue through flow cytometry and immunohistochemistry,Finally,we transfected the CCR4-NOT transcriptional complex subunit 7 (CNOT7) recombinant plasmid in the hepatoma cell line,and then detected the related protein expression.Results There was no significant difference for peripheral blood GM-CSF level between liver cancer group,hepatitis group and control group (P＞0.05).The level of local GM-CSF was (32.2±8.9) ng/L,which was higher than that of hepatocellular carcinoma (9.7±2.7) ng/L and normal liver tissue (11.6±2.9) ng/L.The difference was statistically significant (P＜0.05).The proportion of MDSCs at the edge of the tumor was (9.9 ±3.6) ％,which was higher than that of liver cancer (4.0± 1.5) ％ and normal liver tissue (6.3±2.3) ％,and the difference was statistically significant (P＜0.05).Immunohistochemistrydata was consistent with previous data.Compared with normal liver tissue,CNOT7 and STAT3 were highly expressed in liver cancer tissues,while STAT1 was lowly expressed.HepG2 human hepatoma cells were selected for transfection.Compared with the empty plasmid group,CNOT7 expression was decreased in the knocking out group at the same time STAT1 expression was increased,STAT3 and GM-CSF expression was decreased.Conclusion In hepatocellular carcinoma,the secretion of GM-CSF increased and the number of MDSCs increased.Knocking out CNOT7 reduced GM-CSF secretion and activate the JAK/STAT signaling pathway.

Objective: To investigate the safety and efficacy of needle-tract assisted standard percutaneous nephrolithotomy (PCNL) for the treatment of complicated upper urinary tract calculi. Methods: The clinical data of 1 562 patients with complicated upper urinary calculi who received standard PCNL from December 2013 to December 2017 at Department of Urology, the First Affiliated Hospital of Xiamen University were retrospectively analyzed. There were large residual stones in 256 patients through B-ultrasound exploration after standard PCNL, could′t be detected with nephoscope in standard PCNL tracts. 16 F mini PCNL tract were established in 120 cases for treatment of residual stones, while needle-tract were established in order to guide nephroscope to find residual stones in 126 cases. Needle-tract were transferred to 16 F mini PCNL tract for treatment of residual stones in 10 patients if these residual stones could′t be detected through needle-tract. Operation time, change of hemoglobin level after operation, incidence of postoperative complications, time of hospitalization and rate of stone clearance were measured in two groups. The statistical methods used included t test, Wilcoxon rank sum test, and χ² test. Results: There were 1 to 3 mini tracts (M(Q_R): 1(1)) established in the mini tracts group and 1 to 7 needle-tracts (M(Q_R): 3(2)) established in the needle-tract group (Z=-10.57, P=0.000). Compared with mini tract group, the operation time ((62.0±18.0) minutes vs. (84.0±15.5) minutes, t=10.242, P=0.000), hospitalization time ((4.40±0.86) days vs. (5.20±0.81) days, t=7.570, P=0.049), hemoglobin dropped ((1.31±0.47) g/L vs. (2.74±0.63) g/L, t=20.12, P=0.000), and incidence of postoperative complications (7.9% (10/126) vs. 19.2% (23/120), χ²=6.674, P=0.01) of needle-tract group were lower, while postoperative stone clearance rate was higher (89.7% vs. 76.7%, χ²=7.497, P=0.006). No perioperative severe complications such as pleural injury, pneumatothorax, perforation of renal, trauma of abdominal organ occurred in two groups. Conclusion Needle-tract assisted standard PCNL for the treatment of complicated upper urinary calculi can significantly improve stone clearance rate, reduce operation time, decrease risk of kidney and surrounding organs damage.

Objective To investigate the serum γ-glutamyl transferase(γ-GT)level and its clinical significances in hepatitis B virus(HBV)-liver failure(LF)patients.Methods γ-GT levels were detected in 89 LF patients,30 cases with cirrhosis and 30 healthy controls.Difference of serum γ-GT between survival group and death group in LF patients and dynamics of γ-GT after hospitalization were studied. Survival rate between γ-GT increase group and decrease group were compared.The associations of γ-GT with model for end stage live disease(MELD)and prealbumin were calculated.Results At baseline,the γ-GT levels in LF,cirrhosis and healthy control groups were(149.61 ± 69.86),(123.96 ± 59.52)and (48.28 ± 10.25)U/L,respectively,the difference among groups was significant(F= 178.150,P<0.05).The survival group in LF patients showed significant increase of γ-GT one week after hospitalization compared with death group([75.27 ± 10.34]vs[29.47 ± 5.05],t=5.40,P<0.05). The γ-GT increase group showed higher survival rate than γ-GT decrease group[76.19%(48/63)vs 23.08%[6/26],χ2=21.76,P<0.05].Serum γ-GT level in LF patients was positively correlated with both MELD score and prealbumin(r=0.709 and -0.627,respectively,both P<0.05).Conclusions The rise of γ-GT may indicate a better prognosis in LF patients.Serum γ-GT positively correlates with prealbumin and both could reflect the regeneration of hepatocytes.

Objective:To investigate the clinical characteristics and change trend of patients with perianal lesions before or after Crohn′s disease (CD) diagnosed.Methods:From January 2008 to September 2018, at The Tenth People′s Hospital Affiliated to Tongji University, the clinical data of 747 hospitalized CD patients were retrospectively collected, 293 patients were PCD patients. The clinical characteristics of PCD patients before or after CD diagnosed were analyzed and the change trend was followed. T test, Mann-Whitney U test, and Chi-square test were performed for statistical analysis. Multivariate logistic regression analysis was used to analyze factors associated with perianal lesions onset time. Spearman correlation analysis was used to analyze the change trend of clinical characteristics. Results:Before CD diagnosis, 86.3% (253/293) PCD patients had perianal lesions. The median follow-up time (range) was 72 months (36 to 108 months). Compared with the patients presented with perianal lesions after CD diagnosis, the onset age of patients with perianal lesions before CD diagnosis was younger ((36.0±12.6) years vs. (24.2±10.2) years), and the rates of male (62.5%, 25/40 vs. 77.9%, 197/253), non-structuring and non-penetrating type (32.5%, 13/40 vs. 56.9%, 144/253) and perianal surgery (55.0%, 22/40 vs.76.7%, 194/253) were high, but low rate of abdominal surgery (37.5%, 15/40 vs. 13.0%, 33/253), and the differences were statistically significant ( t=2.630, χ2=4.442, 8.379, 8.379 and 15.081; all P<0.05). The results of logistic multivariate analysis showed that before CD diagnosis, non-structuring and non-penetrating type was more common than structuring type (odds ratio ( OR)=0.447, 95% confidence interval ( CI) 0.207 to 0.962, P=0.039) and penetrating type ( OR=0.264, 95% CI 0.089 to 0.780, P=0.016). The short disease duration of CD ( OR=0.981, 95% CI 0.968 to 0.995, P=0.008), structuring type ( OR=2.239, 95% CI 1.040 to 4.822, P=0.039) and penetrating type ( OR=3.788, 95% CI 1.281 to 11.198, P=0.016) were the risk factors of perianal lesions after CD diagnosed. The number of PCD patients ( r=0.964, P<0.01) and the proportion of biological agents ( r=0.879, P<0.01) increased with years, while PCD duration ( r=-0.828, P<0.01) and the rate of abdominal surgery significantly decreased with years ( r=-0.882, P<0.01). The proportion of biological agents was negatively correlated with the rate of abdominal surgery ( r=-0.770, P=0.006). Conclusions:The perianal lesions should be closely monitored in adult CD patients with short disease duration, structuring type and penetrating type for early diagnosis and treatment. Biological agents can improve the clinical outcomes of PCD.

Objective To compare the long-term outcomes of the retropubic tension-free vaginal tape (TVT) versus the transobturator tension-free vaginal tape (TVT-O) for women with stress urinary incontinence (SUI).Methods From July 2001 to June 2011,data of 120 female patients with SUI were retrospectively reviewed,of which 45 patients received TVT treatment,while 75 patients received TVT-O.The median age in TVT group was 45.1 years (range 35-72 years),and the median age in TVT-O group was 50.5 years (range 39-76 years).We retrospectively analyzed the long-term subjective effect,objective effect and the rate of complications in the two groups.Results Median follow-up period was 121 months (range 72-192 months).The complete satisfaction rate was 89％ (40/45) in TVT group,and 92％(69/75) in TVT-O group,with no statistical difference between the two groups.The negative rate of cough test was 84.4％ (38/45) in TVT group,and 76.0％ (57/75)in TVT-O group,with a statistically significant difference.The rate of urinary tract injury was 8.9％ (4/45) in TVT group,and 4.0％ (3/75) in TVT-O group.The rate of thigh pain was 0 in TVT group,and 6.7％ (3/45) in TVT-O group.The rate of micturition frequency and urinary incomplete emptying after operations was 6.7％ (5/75) in TVT group,and 5.3％ (4/75) in TVT-O group.Conclusions The long-term subjective effect between TVT and TVT-O groups was similar.The objective effect in TVT group was better.There was no statistical difference in complication rate between the two groups,which showed different types of complications in different procedures.

Objective To explore the effectiveness of virtual autopsy-based postmortem computed tomography(PMCT)liver three dimensional slicer(3D slicer)artificial intelligence(AI)volume reconstruction to assist forensic practice.Methods Twenty cases of the deceased who underwent both virtual autopsy and traditional autopsy in our center were selected and subjected to liver volume segmentation by 3D slicer method,Tada's formula method and literature method,and the data obtained from the traditional autopsy were compared and analyzed to obtain the accuracy rate.Results The 3D slicer method yielded higher consistency(95%confidence interval),lower volumetric variability(standard deviation),and a smaller region(variance)of uncertainty than the Tada formula method and the methods mentioned in the literature.Conclusion 3D slicer AI reconstruction based on virtual autopsy can visualize virtual anatomy,help increase the diagnostic accuracy of traditional autopsy,assist in pathological diagnosis,and provide new directions and tools for the development of imaging histology of virtual autopsy.