Objective To evaluate the safety and efficacy of percutaneous nephrolithotomy (PCNL) with B ultrasound-guided renal access in the lateral decubitus flank position for complex renal calculi. Methods From June 2004 to August 2009, 650 patients with renal stones≥20 mm underwent PCNL with B ultrasound-guided renal access in the lateral decubitus flank position. 512 men and 138 women,with a mean age of 38 years(range 11 - 78 years)and a mean stone size of 31 mm(range 20 - 58 mm). Results Successful access was achieved in 650 patients (100%). Minimally PCNL and PCNL were performed in 493 and 157 patients. Complete stone clearance rate was 86. 6% (563/ 650). The mean operative time was 72 min(range 35 - 145 min), and the mean hospital stay was 18d (range 9 - 32 d). There were no visceral injuries. Conclusions PCNL with B ultrasound-guided renal access in the lateral decubitus flank position is safe and convenient, and prevents harmful effects of radiation for the surgeon, the surgical team, and the patient.

ObjectiveTo detect glucose-6-phosphate isomerase (GPI) in knee joint synovial fluid of active rheumatoid arthritis (RA) and explore the correlation between GPI and anti-cyclic citrulline peptide antibody (anti-CCP).MethodsGPI and anti-CCP in the synovial fluid were measured by enzyme linked immunosorbent assay(ELISA) from 22 patients with active RA and 37 patients with active osteoarthritis (OA).Student's t-test was used for intergroup comparison and Spearman's analysis was used for correlation analysis.ResultsThe level of GPI and anti-CCP in the synovial of active RA [ (9.6±8.4) μg/ml,( 14.61 ±18.64) U/ml] was significantly higher than that of active OA[ (0.9±1.8) μg/ml,(1.42±0.09) U/ml)].There was positive correlation between GPI and anti-CCP (r=0.447,P=0.037).ConclusionHigh expression of GPI is shown in active RA synovial fluid.It is suggested that GPI as an antigen that may participate in chronic synovitis,bone destruction and joint malformation.Both GPI and anti-CCP may be the laboratory markers for the diagnosis of RA.

Objective To investigate the role of lysyl oxidase (LOX) in synovitis and cartilage destruction by comparing the expression of LOX in synovial fluid and synovium of active rheumatoid arthritis (RA) and active osteoarthritis (OA).Methods LOX in the synovium was detected by immunohistochemistry from 14 patients with active RA,24 patients with active OA and 20 patients with knee injury (the control group).LOX in the synovial fluid was measured by enzyme linked immunosorbent assay (ELISA) from 14 patients with active RA and 24 patients with active OA.T-test was used for statistical analysis.Results The level of LOX expression in active RA synovium (0.012±0.007) was similar to that in active OA synovium (0.013±0.011,P＞0.05).But the expression of LOX in synovium of active RA and active OA was significantly higher than that in synovium of the control group (0.003±0.004,P＜0.01).The amount of LOX in the synovial fluid of active RA [(1.9±1.4) μg/ml] was significantly higher than that of active OA [(1.0±0.4) μg/ml,P＜0.05].Conclusion High expression of LOX in the synovial fluid and synovium of active RA and active OA suggest that LOX may be involved in chronic synovitis and cartilage destruction,and may be related with the extent of synovitis and cartilage destruction.

Objective To study whether the human bone marrow mesenchymal stem cells (HBMSCs) can repair damaged neural cells induced by okadaic acid (OA).Methods Neuroblastoma cell line SH-SY5Y cells were used to incubate with 20nmol/L okadaic acid for 24h,establishing Alzheimer's Disease cell model;Three groups were set up:normal group,okadaic acid-damaged (OA-damaged) group,hBMSCs-treatment group.The cells were injured for 24h with 20nmol/L OA in OA-damaged group,and treated with conditioned medium obtaining hBMSCs for 24h after 24h OA injury in the treatment group.Then CCK-8 was used for detecting cell vitality,immune fluorescence dyed microtubules and micro filaments for determining the dendritic cell length and fluorescence intensity,in addition,Western blotting for analyzing the protein level of phosphorylated tau and total tau proteins.Results Okadaic acid damaged SH-SY5Y cells,contributed to shrinkage,collapse,cavitation of the SH-SY5Y cell body,dendritic shortening and fracture,and irregular arrangement of microtubule microfilaments;while BMSCs conditioned medium made SHSYSY cell body become round and longer,dendrites restored,and microtubules and microfilaments arranged regularly,fluorescence intensity enhanced.Meanwhile,it also down-regulated the level of OA-induced tau phosphorylation.Conclusion hBMSCs have repair effects on the neural cell damage induced by okadaic acid.

Objective　To analyze and visualize the epidemic changes of schistosomiasis in Wuhan from 2013 to 2022 based on a geographical information system (GIS), providing references for further schistosomiasis control activities. Methods　According to the historical data of the annual reports of schistosomiasis screening and street-level vector map of Wuhan City from 2013 to 2022, a spatial database of epidemic information at the street level was established. The Joinpoint regression model was utilized to analyze the trend of phased changes in blood positivity rate for schistosomiasis. ArcMap 10.8 was employed for the spatial visualization of the positive rate of serological tests for schistosomiasis among the screened population in the endemic areas of Wuhan over the past decade, as well as conducting hot spot analysis (Getis-Ord Gi*) to explore the spatial clustering relationship and spatiotemporal trends. Heatmaps were generated to reflect the changes in the positive rate of blood tests for schistosomiasis over a decade in various streets, and the areas were classified by the ward’s method of hierarchical clustering using the sum of squared deviations. Results　Over the past decade, the overall annual positive rate of schistosomiasis screening in Wuhan declined from 2.23% in 2013 to 0.47% in 2022, showing a general downward trend. The Joinpoint regression model analysis of the blood positive rate indicated the presence of one connection point in 2015; from 2013 to 2015, the annual percent change (APC) of the positive rate was 2.17%, showing an upward trend (P>0.05); from 2015 to 2022, the APC was -23.34%, indicating a downward trend (P<0.05). The map of positive street-level schistosomiasis screening rates for 2013-2022 shows that the positive rate count on the streets of Caidian District and Hannan District in southwestern Wuhan and Huashan Street on the east side, had a significant decrease over the ten years, while the rate in the streets under the jurisdiction of Dongxihu District in the west showed an increase. The hot spot analysis graph revealed that hot spots of the positive rate in Wuhan shifted from the southwest to the west beginning in 2018. The heatmap indicated the largest disparity in trend changes, with the most noteworthy decline in streets under Caidian District and an increasing trend in the streets under Dongxihu District. Conclusions　The overall epidemic situation of schistosomiasis in Wuhan is on a downtrend, although the positive rate of blood tests has increased in some areas. This has been attributed to a reduction in the total number of people participating in the blood tests and the slow decrease of antibodies in certain patients who were repeatedly sampled for testing. It is important to further strengthen the construction of monitoring capabilities, improve the sensitivity of monitoring systems, identify potential risks promptly, and handle them properly.

We proposed a new stitching method based on sift features to obtain an enlarged view of transmission electron microscopic (TEM) images with a high resolution. The sift features were extracted from the images, which were then combined with fitted polynomial correction field to correct the images, followed by image alignment based on the sift features. The image seams at the junction were finally removed by Poisson image editing to achieve seamless stitching, which was validated on 60 local glomerular TEM images with an image alignment error of 62.5 to 187.5 nm. Compared with 3 other stitching methods, the proposed method could effectively reduce image deformation and avoid artifacts to facilitate renal biopsy pathological diagnosis.

Objective:To explore the etiologic characteristics of herpangina (HA) in Shanghai city, so as to provide scientific basis for HA control and prevention.Methods:Throat swabs of HA cases during 2017-2019 from sentinel hospital were collected. Fluorescent quantitative RT-PCR was conducted to detect nucleic acid of enterovirus (EV), EV-A71, coxsackievirus (CV)-A16, CV-A6 and CV-A10. Virus isolation was performed for the other EV-positive samples. The isolates were genotyped using semi-nested RT-PCR(RT-snPCR). The data were statistically analyzed with Excel and IBM SPSS Statistics 22.0.Results:A total of 264 HA cases were included, of whom 32.95%(87/264) were under 1 year of age, the human enteroviruses (HEVs)-positive rate was 69.70%(184/264), eight serotypes of EV including EV-A71, CV-A16, CV-A6, CV-Al0, CV-A4, CV-A2, CV-A5 and CV-B5 were detected. The CV-A6-positive rate was the highest with a percentage of 39.13%(72/184), followed by CV-A10 (17.39%, 32/184) and CV-A4 (16.85%, 31/184). From 2017 to 2019, the proportion of other EV increased year by year, which were 19.23% (10/52), 41.10% (30/73) and 47.46% (28/59), respectively.Conclusions:CV-A6, CV-A10 and CV-A4 were the main common pathogens of HA in Shanghai city during 2017-2019, and the proportion of other EV increased year by year.

We proposed a new stitching method based on sift features to obtain an enlarged view of transmission electron microscopic (TEM) images with a high resolution. The sift features were extracted from the images, which were then combined with fitted polynomial correction field to correct the images, followed by image alignment based on the sift features. The image seams at the junction were finally removed by Poisson image editing to achieve seamless stitching, which was validated on 60 local glomerular TEM images with an image alignment error of 62.5 to 187.5 nm. Compared with 3 other stitching methods, the proposed method could effectively reduce image deformation and avoid artifacts to facilitate renal biopsy pathological diagnosis.

Objective To observe the effects of free-posture parturition on the parturition outcomes and pelvic floor function of puerperae. Methods Totally 270 pregnant women who met the requirements were divided into an observation group (n=135) and a control group (n=135) by the prospective randomized controlled clinic trail. Pregnant women in the observation group adopted free-posture parturition, while pregnant women in the control group delivered in the frequently used supine position. The pregnant women in both groups were managed according to the existing labor standards, and the effects of free-posture parturition on their parturition outcomes and pelvic floor function were observed. Results Totally 133 pregnant women in the observation group delivered naturally and 2 transferred to cesarean parturition in the process, while 102 pregnant women in the control group delivered naturally and 33 transferred to cesarean parturition in the process (χ2=31.55, P<0.001). The uniparae in the observation group spent less time in the first and second stages of labor as well as the whole parturition than the uniparea in the control group (P<0.001). There was no statistically significant difference in the duration of labor stage between the multiparae in the two groups (P> 0.05). The uniparae in the observation group were less likely to show reduced typeⅠand typeⅡ muscle fiber strength than the uniparae in the control group (P<0.05), while there was no statistically significant difference in the incidence of reduced typeⅠand type Ⅱ muscle fiber strength between the multiparae in the two groups (P>0.05). There was no statistically significant difference in the incidence of urinary incontinence between the puerparae in the two groups (P>0.05). Conclusions The use of free-posture parturition can reduce the possibility of cesarean parturition substantially. The duration of labor stage in uniparae can be shortened significantly, and their pelvic floor muscle strength is better than that of the puerparea in the control group. Free-posture parturition does not contribute to negative outcomes of maternals and fetals.

Myelodysplastic syndrome(MDS)is a heterogeneous myeloid tumor that originates from hematopoietic stem cells(HSCs)and is associated with a high risk of progression to acute myeloid leukemia(AML).Studies have shown that 90%of patients with MDS have gene mutations,of whom approximately 25%have SF3B1 mutations.In patients with MDS carrying this mutation,the TGF-β pathway is upregu-lated,inducing cell cycle arrest and thereby leading to erythroid ineffective hematopoiesis and pathological hematopoiesis.Luspatercept can be used as a ligand trap to capture TGF-β ligands,inhibit SMAD2/3 pathway activation,downregulate TGF-β pathway,and promote ad-vanced red blood cell maturation.Currently,it has been approved by the Food and Drug Administration(FDA)for the treatment of anemia in patients with low-risk MDS,and studies have shown that the response rate is higher in patients with SF3B1 mutations.This article will re-view the current status of luspatercept in the treatment of SF3B1 mutation-related MDS;it will also analyze its effectiveness and safety and provide therapeutic strategies for clinical use.