Objective To evaluate the efficacy and safety of single-used flexible ureteroscope lithotripsy(FURL)in the treatment of 2.0-3.0 cm non-lower-pole renal stones in elderly patients.Methods A total of 78 elderly patients with non-lower-pole renal stones measuring 2.0-3.0 cm admitted to our hospital were included in this study.Based on the surgical procedure,the patients were divided into the FURL group(42 cases of FURL with holmium laser lithotripsy)and the MPCNL group[36 cases of minimally invasive percutaneous nephrolithotomy(MPCNL)with holmium caser lithotripsy].Various parameters including operation time,stone fragmentation time,postoperative decrease of hemoglobin(Hb)level,postoperative Visual Analog Scale(VAS)for pain,hospitalization duration,stone-free rate(SFR)at 1 week and 4 weeks after surgery,secondary surgery rate,and incidence of complications were compared between the two groups.Results All the patients successfully underwent surgery.The decrease of Hb in the FURL group was(4.4±1.6)g/L,significantly lower than that in the MPCNL group[(24.7±4.6)g/L,t=-25.342,P=0.000].The postoperative VAS scores of the FURL group was(1.6±0.4)points,significantly lower than that of the MPCNL group[(5.6±0.9)points,t=-25.642,P=0.000].The stone fragmentation time in the FURL group was(82.5±10.2)min,significantly longer than that in the MPCNL group[(53.8±8.4)min,t=13.437,P=0.000].The operation time in the FURL group was(98.3±12.5)min,and there was no statistically significant difference compared to the MPCNL group[(96.7±11.8)min,t=0.555,P=0581].The hospitalization time in the FURL group was(3.5±1.5)d,significantly shorter than that in the MPCNL group[(8.6±1.7)d,t=-13.947,P=0.000].The incidence of complications in the FURL group was 26.2％(11/42),and there was no significant difference compared to the MPCNL group[27.8％(10/36),x2=0.025,P=0.875].The proportion of secondary treatment in the FURL group was 19.0％(8/42),and there was no significant difference compared to the MPCNL group[11.1％(4/36),x2=0.938,P=0.333].At 1 week after surgery,the SFR of the FURL group was 54.8％(23/42),significantly lower than that of the MPCNL group[86.1％(31/36),x2=8.943,P=0.003].At 4 weeks after surgery,there was no significant difference in SFR between the FURL group[90.5％(38/42)]and the MPCNL group[91.7％(33/36),x2=0.000,P=1.000].Conclusions Single-used flexible ureteroscope lithotripsy is highly effective in the treatment of non-lower-pole renal stones measuring 2.0-3.0 cm in elderly patients.It offers advantages such as minimal invasion,rapid recovery,minimal bleeding,low incidence of complications,and shorter hospitalization duration,which is worthy of promotion.

BACKGROUND AND PURPOSE: Encephalitis caused by Listeria monocytogenes (L. monocytogenes) is rare but sometimes fatal. Early diagnosis is difficult using routine cerebrospinal fluid (CSF) tests, while next-generation sequencing (NGS) is increasingly being used for the detection and characterization of pathogens. METHODS: This study set up and applied unbiased NGS to detect L. monocytogenes in CSF collected from three cases of clinically suspected listeria meningoencephalitis. RESULTS: Three cases of patients with acute/subacute meningoencephalitis are reported. Magnetic resonance imaging and blood cultures led to a suspected diagnosis of L. monocytogenes, while the CSF cultures were negative. Unbiased NGS of CSF identified and sequenced reads corresponding to L. monocytogenes in all three cases. CONCLUSIONS: This is the first report highlighting the feasibility of applying NGS of CSF as a diagnostic method for central nervous system (CNS) L. monocytogenes infection. Routine application of this technology in clinical microbiology will significantly improve diagnostic methods for CNS infectious diseases.
Central Nervous System ; Cerebrospinal Fluid ; Communicable Diseases ; Diagnosis ; Early Diagnosis ; Encephalitis ; Humans ; Listeria monocytogenes* ; Listeria* ; Magnetic Resonance Imaging ; Meningitis, Listeria ; Meningoencephalitis* ; Methods

Background::Joint dislocations significantly impact public health. However, a comprehensive study on the incidence, distribution, and risk factors for joint dislocations in China is lacking. We conducted the China National Joint Dislocation Study, which is a part of the China National Fracture Study conducted to obtain the national incidence and risk factors for traumatic fractures, and to investigate the incidence and risk factors for joint dislocations.Methods::For this national retrospective epidemiological study, 512,187 participants were recruited using stratified random sampling and probability-proportional-to-size method from January 19 to May 16, 2015. Participants who sustained joint dislocations of the trunk, arms, or legs (skull, sternum, and ribs being excluded) in 2014 were personally interviewed to obtain data on age, educational background, ethnic origin, occupation, geographic region, and urbanization degree. The joint-dislocation incidence was calculated based on age, sex, body site, and demographic factors. The risk factors for different groups were examined using multiple logistic regression.Results::One hundred and nineteen participants sustained 121 joint dislocations in 2014. The population-weighted incidence rate of joint dislocations of the trunk, arms, or legs was 0.22 (95% confidence interval [CI]: 0.16, 0.27) per 1000 population in 2014 (men, 0.27 [0.20, 0.34]; women, 0.16 [0.10, 0.23]). For all ages, previous dislocation history (male: OR 42.33, 95% confidence interval [CI]: 12.03–148.90; female: OR 54.43, 95% CI: 17.37–170.50) and alcohol consumption (male: OR 3.50, 95% CI: 1.49–8.22; female: OR 2.65, 95% CI: 1.08–6.50) were risk factors for joint dislocation. Sleeping less than 7 h/day was a risk factor for men. Compared with children, women aged ≥15 years (female 15–64 years: OR 0.16, 95% CI: 0.04–0.61; female ≥65 years: OR 0.06, 95% CI: 0.01–0.41) were less likely to sustain joint dislocations. Women with more than three children were at higher dislocation risk than women without children (OR 6.92, 95% CI: 1.18–40.78).Conclusions::The up-to-date data on joint dislocation incidence, distribution, and risk factors can be used as a reference for national healthcare, prevention, and management in China. Specific strategies for decreasing alcohol consumption and encouraging adequate sleeping hours should be developed to prevent or reduce dislocation incidents.Trial Registration::Chinese Clinical Trial Registry, ChiCTR-EPR-15005878.

Aberrant activation of NLRP3 inflammasome in colonic macrophages strongly associates with the occurrence and progression of ulcerative colitis. Although targeting NLRP3 inflammasome has been considered to be a potential therapy, the underlying mechanism through which pathway the intestinal inflammation is modulated remains controversial. By focusing on the flavonoid lonicerin, one of the most abundant constituents existed in a long historical anti-inflammatory and anti-infectious herb