Objective To evaluate of the clinical efficacy of two kinds of methods extracorporeal shock wave lithotripsy in treatment of ureteral calculi. Methods A retrospective analysis was conducted on the data of 108 patients with acute renal colic and ureteral stones (calculi diameter<2 cm) from March 2011 to April 2013. The patients were divided into two groups. 69 cases in A group underwent emergency positioning urography ureteral catheterization combined extracorporeal shock wave lithotripsy, 39 cases in B group underwent emergency extracorporeal shock wave lithotripsy. Results A group:lithotripsy was successful in 63 cases among 69 cases at the first time,the first success rate was 91.33% (63/69), the second success rate was 94.2%(65/69),2 cases of retrograde ureteroscopy failed, 2 cases of self-discharge after intubation stones, the recurrent renal colic rate was 14.3%(9/63),the use of analgesic drugs rate was 11.1%(7/63) . B group:the first success rate of stone clearance rate was 74.4%(25/39),the second success rate of stone clearance rate was 87.2%(34/39),5 cases underwent ureteroscopy lithotripsy, the renal colic recurrence rate was 20.5% (8/39), the use rate of analgesic drugs was 15.4% (6/39) . Conclusion Extracorporeal shock wave lithotripsy assisted by urography through retrograde ureteral catheterization has satisfying therapeutic effect in treatment of patients with ureteral calculi.

AIM: To investigate the feasibility and infection efficiency of MSCs as the target cells of gene delivery mediated by adenoviral vector carrying CTLA4Ig gene, and to study the mechanism of transgenic MSC to inhibit immune response ex vivo. METHODS: The recombinant adenovirus containing CTLA4Ig gene was constructed, by which rat MSCs with various multiplicity of infection (MOI) were conducted. The infection efficiency was analyzed with FACS and fluorescence microscope. The expression of CTLA4Ig protein in transgenic MSCs was detected by FACS and western blot. Co-culturing the transgenic MSCs with mixed lymphocytes, the inhibitory effect of transgenic MSCs on lymphocyte proliferation was also observed. RESULTS: The adenoviral vector delivered CTLA4Ig gene with high efficiency to MSCs. The expression of CTLA4Ig protein was detected in transgenic MSCs. The gene modified MSCs inhibited the proliferation of mixed lymphocytes and maximal inhibition rate was observed on day 4 of MLR. The inhibition induced by CTLA4Ig was donor-specific. CONCLUSION: MSCs is a promising target cell for gene delivery. The expressed CTLA4Ig specifically inhibits the lymphocyte proliferation ex vivo.

Purpose To evaluate the application value of ERCC2 gene polymorphism ( rs3916840 C/T, rs1799793 G/A and rs238416 G/A) detection in molecular pathological diagnosis of breast cancer. Methods The polymorphisms of ERCC2 ( rs3916840, rs1799793 and rs238416) were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay in 101 patients with breast cancer and in 101 cancer-free controls. Results Analysis of the data showed a 0. 287-fold increased risk of breast cancer due to the deletion of genotype GA at rs238416 (P<0. 001, 95%CI: 0. 153 ~0. 537). However, polymorphisms of rs3916840 and rs1799793 were not associated with breast cancer risk (P>0. 05). Furthermore, Heterozygous genotype of rs3916840 was significantly associated with tumor size (P=0. 049), heterozygous genotype of rs1799793 was significantly associated with PR sta-tus and triple negative breast cancer (P=0. 037). Remarkably, the genotype frequency of GA in p53-positive patients was lower than that in p53-negiative patients (P=0. 026). Conclusions These results indicate that the polymorphism of rs238416 of ERCC2 is sig-nificantly associated with breast cancer risk. Tumor size, PR status, triple negative breast cancer, and p53 protein expression are asso-ciated with polymorphisms of ERCC2 (rs3916840, rs1799793 and rs238416) respectively. ERCC2 gene polymorphism detection is useful for the early diagnosis and prognosis evaluation of breast cancer.

Objective To investigate the efficacy and safety of citrate anticoagulation for continuous renal placement therapy (CRRT) in patients at high risk of bleeding. Methods Forty-seven patients who needed to CRRT and were admitted into the department of critical care medicine from January 2015 to October 2016 were enrolled in this study. According to the patient′s actual condition, they were divided into citrate groups (24 cases) and saline group (23 cases). Patients in saline group were given saline wash. The efficacy and safety were compared between the two groups. The filter lifetime, after treatment the activated partial thromboplastin time (APTT), hemoglobin (Hb), blood gas indexes were compared between the two groups. Results The citrate group used 76 filters while the 0.9% sodium chloride group used 87 filters. The average filter lifetime in citrate group was (22.4 ± 12.7) h which was longer than (8.6±3.3) h in 0.9%sodium chloride group (t=9.79, P<0.01). The incidence of coagulation in extracorporeal circulation was 3.9%(3/76) which was lower than 16.1%(14/87) in 0.9%sodium chloride group(χ2=5.20, P<0.05). Conclusions Regional citrate anticoagulation is a safe and effective option for CRRT in patients at high risk of bleeding.

Objective To explore the effects of different extracts of modified Siwu Siteng Decoction (TFT-Ⅰ, TFT-Ⅱ) on rat models with hyperuricemia. Methods Rat model with hyperuricemia was induced by hypoxanthine and oxonic acid potassium salt. Seventy rats were randomly divided into 7 groups:normal group, model group, allopurinol group, TFT-Ⅰ high and low dose groups, TFT-Ⅱhigh and low dose groups. Each dose group was given lavage with related medicine, and blank group and model group were given lavage with distilled water for one week, respectively. Uric acid in serum (SUA) was measured through fully automatic biochemical analyzer, and xanthine oxidase (XOD) activity in serum and liver tissue was measured through colorimetric method. Results Compared with model group, TFT-Ⅰ and TFT-Ⅱ high dose groups significantly reduced the level of SUA, serum and liver XOD activity (P<0.05), with significant statistical difference between the two groups (P<0.05). TFT-Ⅰ and TFT-Ⅱ low dose groups had no significant effects on SUA, and XOD activity in serum and liver (P>0.05). Conclusion Alcohol soluble ingredients of astragalus membranaceus and Siwu decoction in modified Siwu Siteng Decoction can effectively reduce the level of blood uric acid.

Objective To observe the alterations of vascular density of superficial or deep retinal vascular plexus and the area of foveal avascular zone (FAZ) in acute central serous chorioretinopathy (CSC) eyes. Methods This is a retrospective study including 22 patients with unilateral CSC in acute stages. The patients were divided into group A (22 affected eyes) and B (22 fellow eyes). Twenty eyes of 20 age and gender-matched healthy volunteers (group C) were enrolled in this study. All subjects underwent optical coherence tomography (OCT) angiography examinations. The observation index included signal intensity of blood flow in choroidal capillary, vessel density and FAZ on the superficial capillary plexus (SCP) and deep capillary plexus (DCP). Results The FAZ on DCP in group A was larger than that in group B and C (t=4.28, 5.57; P=0.00、0.00), but there was no significant difference of FAZ on SCP among 3 groups (t=0.28, 0.80; P=0.78, 0.43). The vessel density of SCP and DCP in group A and B were decreased than those in group C (t=-4.40, -2.91; P=0.00, 0.00). The type of choroidal capillaries dilation had two different manifestations by OCTA, which was circumscribed in 12 eyes and diffuse in 10 eyes. The subretinal fluid in macular area which presented dark chamber with weak reflection was observed by en-face OCT. Conclusions The vessel density of SCP and DCP in both eyes of acute CSC are lower than those in normal eyes. The FAZ of DCP in affected eyes of acute CSC is larger than that in fellow eyes and normal eyes. The blood flow of dilated choroidal capillary can be manifested as different morphological enhancements.

Objective To explore the clinical effects of cognitive behavioral therapy on the quality of life in patients after percutaneous coronary intervention ( PCI ) .Methods Eighty patients after PCI treatment were randomly divided into the experimental group and control group .The patients in the control group received cardiology conventional nursing , while the patients in the experimental group received cognitive behavioral therapy .The psychological status , quality of life ( QOL) , readmission rate and the major adverse cardiovascular events ( MACE) of the two groups were observed and compared .Results The score of QOL of the experimental group and the control group were (118.2 ±18.5) and (111.4 ±17.1), and there was no significant difference (t=1.71, P >0.05).After six month of intervention, the score of QOL of the experimental group was (131.2 ±18.3), which was significantly higher than (118.3 ±11.2) of the control group ( t=3.80, P>0.05).After one year of intervention , the score of QOL of the experimental group was (158.2 ±14.5), which was significantly higher than (121.7 ±10.3) of the control group (t=12.98, P>0.05).In the experimental group, 2 patients (5.0%) had re-stenosis in coronary artery;6 patients (15.0%) readmitted to the hospital. Those in the control were 8 patients (12.5%), 14 patients (35.0%), respectively.There were significant differences in each of these four events between the two groups (χ2 =4.10, 4.27, respectively;P<0.05). Conclusions The cognitive behavioral therapy can effectively improve the QOL in patients with PCI .

Objective:To analyze Helicobacter pylori ( Hp) resistance in Xiaoshan area from 2013 to 2020 and to provide reference for the selection of clinical antibiotics for the eradication of Hp in this area. Methods:Non-repetitive Hp strains isolated from patients treated in the First People′s Hospital of Xiaoshan District, Hangzhou from January 2013 to December 2020 and the drug susceptibility test results of these strains were collected. The patients were grouped by every 10 years of age to analyze the drug resistance of Hp in different groups and its changing trends. Results:A total of 54 912 Hp strains were isolated and cultured. The resistance rates of Hp isolates to amoxicillin, metronidazole, clarithromycin and levofloxacin were 0.42%, 92.94%, 22.41% and 29.83%, respectively. The drug resistance rates to clarithromycin and levofloxacin were increasing year by year. The resistance rates to levofloxacin, clarithromycin and metronidazole increased with age. The resistance rates to clarithromycin, levofloxacin and metronidazole in women were higher than those in men, especially in the 21-60 age group. The resistance rate to clarithromycin was significantly higher in people under 20 years old. In 2017 to 2019, the resistance rate to amoxicillin was higher in people under 20 years old than in other age groups. In 2020, the resistance rates to levofloxacin and clarithromycin in people over 70 years old both exceed 57% and increased rapidly. Conclusions:The resistance rates of Hp to levofloxacin, clarithromycin and metronidazole in Xiaoshan area were all at a high level. It was recommended to use individualized treatments for the eradication of Hp. In addition, attention should be paid to the young and older people.

Long noncoding RNAs (lncRNAs) are expressed in different species and different tissues, and perform different functions, but little is known about their involvement in the synthesis or secretion of follicle-stimulating hormone (FSH). In general, we have revealed lncRNA‍‒‍microRNA (miRNA)‍‒‍‍messenger RNA (mRNA) interactions that may play important roles in rat primary pituitary cells. In this study, a new lncRNA was identified for the first time. First, we analyzed the gene expression of lncRNA-m18as1 in different tissues and different stages by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and observed the localization of lncRNA-m18as1 with fluorescence in situ hybridization, which indicated that this lncRNA was distributed mainly in the cytoplasm. Next, we used RT-qPCR and enzyme-linked immunosorbent assay (ELISA) to analyze the regulation of FSH synthesis and secretion after overexpression or knockdown of lncRNA-m18as1 and found that lncRNA-m18as1 was positively correlated with FSH synthesis and secretion. In addition, mothers against decapentaplegic homolog 2 (Smad2) was highly expressed in our sequencing results. We also screened miR-18a-5p from our sequencing results as a miRNA that may bind to lncRNA-m18as1 and Smad2. We used RNA immunoprecipitation-qPCR (RIP-qPCR) and/or dual luciferase assays to confirm that lncRNA-m18as1 interacted with miR-18a-5p and miR-18a-5p interacted with Smad2. Fluorescence in situ hybridization (FISH) showed that lncRNA-m18as1 and miR-18a-5p were localized mainly in the cytoplasm. Finally, we determined the relationship among lncRNA-m18as1, miR-18a-5p, and the Smad2/3 pathway. Overall, we found that lncRNA-m18as1 acts as a molecular sponge of miR-18a-5p to regulate the synthesis and secretion of FSH through the Smad2/3 pathway.
Animals ; Cell Line, Tumor ; Cell Proliferation ; Follicle Stimulating Hormone/metabolism* ; Gene Expression Regulation, Neoplastic ; In Situ Hybridization, Fluorescence ; MicroRNAs/metabolism* ; RNA, Long Noncoding/metabolism* ; Rats