Objective To study the relationship between serum trace elements and renal cell carcinoma.Methods The serum concentrations of multi-elements in 34 patients with renal cell carcinoma and 28 healthy volunteers were determined by inductively coupled plasma mass spectrometry(ICP-MS).The results were analyzed by partial least square discriminant analysis (PLS-DA) and Fisher discriminant.Results Compared with healthy voluteers,the levels of vanadium (5 034.56 ng/L:4 401.23 ng/L ),cobalt (211.34 ng/L:158.67 ng/L),nickel(l 850.55 ng/L:1 587.12 ng/L),manganese(1 873.35 ng/L:932.68 ng/L) and cadmium(95.63 ng/L:36.43 ng/L) were significantly higher in patients with renal cell carcinoma (P ＜ 0.05 ).While,the concentrations of calcium( 10.83 mg/L:11.78 mg/L) and zinc(67.11 μg/L:70.92 pg/L)were significantly lower ( P ＜ 0.05 ).Discriminant analysis showed that the serum elements levels in the patients with renal cell carcinoma were significantly different from the healthy volunteers.The scores plot showed distinct clustering between patients and controls,the points of patients were obviously offset from the controls.The classification accuracy of Fisher discriminant function was 97.61％.Conclusion Trace elements in serum are significantly different in patients with renal cell carcinoma and healthy volunteers.Discriminant analysis of serum samples based on trace element levels is possible.Thus,it is feasible for early diagnosis of renal cell carcinoma by determination of trace elements and discriminant analysis.

Objective To evaluate the influence of successful revascularization by percutaneous coronary intervention(PCI)on heart function of patients with heart dysfunction combined with chronic total occlusion(CTO).Methods The clinical data of 272 patients with heart dysfunction combined with CTO were analyzed.The patients were divided into PCI success group(246 cases)and PCI failure group(26 cases)respectively according to the results of PCI.Six months after PCI,the patients underwent cardiac ultrasound examination to compare the heart function between the two groups.Results Cardiac ultrasound examination was successfully performed in 229 patients in PCI success group and 24 patients in PCI failure group at 6 months after PCI.The left ventricular ejection fraction(LVEF)and left ventricular end-diastolic volume index(LVEDVI)showed no significant difference in PCI failure group at 6 months after PCI compared with that before PCI(P＞0.05).In PCI success group,LVEF and LVEDVI were significantly increased at 6 months after PCI compared with that before PCI and compared with that in PCI failure group at 6 months after PCI[(51±5)％ vs.(43±6)％ and(45±2)％,(77±13)ml/m2 vs.(86±12)ml/m2 and(86±10)ml/m2,P＜0.05].The cardiac functional grading in PCI failure group had no significant difference compared with that before PCI(P＞0.05),but in PCI success group it had significant difference compared with that before PCI and compared with that in PCI failure group at 6 months after PCI(P＜0.05).Conclusion Successful revascularization by PCI can improve heart function in patients with heart dysfunction combined with CTO.

Objective To discuss the etiology and clinical characteristics of human rhinovirus (HRV) as pathogen of central nervous system infection .Methods Two hundred and five cerebrospinal fluid (CSF) specimens were collected from children with fever and convulsions who were admitted to the pediatric intensive care unit with suspicion of central nervous system infection from June 2011 to December 2012 .Genome Lab Genetic Analysis System (GeXP) was applied to detect HRV from CSF .Specimens with positive results were amplified by nested reverse transcription‐polymerase chain reaction and followed by gene sequencing . Clinical data of HRV positive cases were analyzed . Results Of the 205 CSF specimens ,7 samples were positive for HRV ,which were composed of 2 HRV‐A ,1 HRV‐B and 4 HRV‐C (including 1 HRV‐Ca) .There were 6 boys and 1 girl among the 7 positive cases for HRV .Six children were less than 3 years old ,except one was 9 years old .The onset time was mainly concentrated between September and October . The main clinical manifestations were fever and convulsions . The clinical diagnosis before the pathogen confirmation included viral encephalitis ,epilepsy ,febrile convulsion ,benign infantile convulsions with mild gastroenteritis (CwG ) and hand‐foot‐and‐mouth disease ( HFMD ) . Although the disease severity of the 7 cases varied ,all ended with favorable prognosis .Conclusions HRV is one of pathogens of viral central nervous system infection .All types of HRV can cause central nervous system infection ,among which HRV‐C accounts for the majority .The clinical manifestations of HRV central nervous system infection could mimic febrile convulsion ,CwG and HFMD .

Objective:To identify the current situation of contract signing for family physician services in Luohu District, Shenzhen, and to explore the associated factors with contract signing and access to services.Methods:Using the WeChat official account of"People′s Hospital of Luohu", an online survey was conducted to investigate the status of family physician′s contract services for residents in Luohu District from May 19th to 25th, 2019. A total of 14 487 valid responses were received. Chi-square test and Logistic regression models were used to analyze the contract signing of family physician services and the related factors.Results:8 560 (59.09%) of the participants had signed with a family physician, and 12 696 of them had learnt about the service before. The awareness rate of family doctor services was 87.64%. The contract signing rate of those unemployed, who living or working in Luohu less than 5 years, who living alone, having no Shenzhen medical insurance, or having not heard of family physicians signing services were less than 50%. The signing rate was positively correlated with the awareness of family physician contract service, as well as the possibility of accepting signed medical examination, traditional Chinese medicine services and health information. Only 9.70% of the contractors received health services information.Conclusions:The contract Signing rates and awareness rate of family physicians among young and middle-aged residents in Luohu District are relatively high. However, access to contract services varies considerably. The signing rate and accepted services are mainly affected by job, length of residence in Shenzhen, type of medical insurance, and understanding of contract.

Objective:To compare the clinical efficacy and safety of Shuo Tong ureteroscopy(ST-URS) and flexible ureteroscope(FURS)combined with holmium laser lithotripsy in the treatment of upper ureteral calculi with CT numerical value ≥ 1000 HU.Methods:A retrospective analysis of the clinical data of patients of upper ureteral calculi with CT numberical value≥1000 HU in the First Affiliated Hospital of Xiamen University was made from January 2018 to November 2020.There were 61 cases treated with ShuoTong ureteroscopy holmium laser lithotripsy (ST-URS group), including 45 males and 16 females, with 40 on the left and 21 on the right, age of(48.3±12.7) years, body mass index of(24.7±2.7)kg/m 2, the diameter of stone of(1.50±0.45)cm, and the CT numberical value of(1 288.8±179.0)(1 017-1 738)HU. There were 87 cases were treated with flexible ureteroscopy holmium laser lithotripsy (FURS group), including 58 males and 29 females, with 56 on the left and 31 on the right, age of(48.5±13.0) years, body mass index of(24.1±3.8)kg/m 2, the stone diameter of(1.45±0.40)cm, and the CT numberical value of(1 311.3±188.9)(1 009-1 817)HU. There were no significant differences in gender, age, body mass index, the location of stone, the diameter of stone and the CT numberical value of stone( P>0.05)between the two groups. For ST-URS group, a rigid ureteral channel sheath and standard mirror(F7.5/11.5)were placed under direct vision, exiting the standard mirror, leaving the channel sheath, inserting a lithotripsy mirror(F4.5/6.5)and a holmium laser[Power: 8-30 W(0.4-1.0 J/20-30 Hz)], and withdrawing the stone fragments after crushing the stone by "nibbling method" . For FURS group, a hard ureteroscope(F8/9.8)was used to explore the lesion side of the ureter, inserting a guide wire and placing a soft ureteral sheath, then inserting a flexible ureteroscope(F8)for holmium laser lithotripsy, and useing a stone basket to remove larger stone fragments. Ureteral stent was routinely indwelled after the operation. On the day 1 and 1 month after the operation, imaging examinations were performed to evaluate the stone-free rate. No residual stones or the diameter of stone was ≤0.4 cm and no urinary tract infection or any symptoms were defined as stone free. The operation time, blood loss, success rate of stage Ⅰ ureteral access sheath placement, incidence of postoperative complications, stone-free rate(SFR) at 1 day after operation, SFR at 1 month after operation, postoperative hospital stay and hospitalization costs were compared between the two groups. According to the size of calculi, the 2 groups were divided into 2 subgroups(≥1.5 cm and <1.5 cm)in order to make further analysis. The operation time, stone-free rate(SFR) at day 1 after operation and SFR at 1 month after operation were compared between the two groups. Results:The operation time of the ST-URS group was shorter than the FURS group(40.10 min vs. 49.43 min, P=0.020), and the incidence of postoperative complications was lower than the FURS group[3.28%(2/61)vs. 13.79%(12/87), P=0.031]. The SFR at day 1 after operation was significantly higher than the FURS group[60.7%(37/61)vs. 25.3%(22/87), P<0.01], and the hospitalization cost was lower than that of the FURS group(27 686 yuan vs. 32 281 yuan, P<0.010). There were no significant differences in the blood loss[(4.92±9.51)ml vs.(3.95±6.04)ml, P=0.452], success rate of stageⅠureteral access sheath placement[ 96.7%(59/61)vs. 96.6%(84/87), P=1.000], SFR at 1 month after operation[81.97%(50/61) vs. 75.86%(66/87), P=0.375] and postoperative hospital stay[(2.5±1.4)d vs.(2.4±0.8)d, P=0.543] between the two groups. When the size of calculi was ≥1.5cm, the operation time of the ST-URS group was shorter than the FURS group (43.67 min vs 55.00 min), the SFR at 1 day after operation was higher than the FURS group[40.00%(12/30)vs. 9.38%(3/32)], and the above differences are all statistically significant ( P<0.05). Conclusions:Compared with the FURS, for the treatment of upper ureteral calculi with CT numerical value ≥1000 HU, the ST-URS has shorter in operative time, lower in hospitalization cost and incidence of postoperative complications and higher SFR at day 1 after operation. The ST-URS is a safe and effective surgical technique, which is superior in the treatment of larger(≥1.5 cm) stones.

The Guangdong Province Laboratory Animals Ordinance (the GPLAO), officially enacted and implemented in October 2010, marked a new phase of legal management in the administration of laboratory animals in Guangdong Province. The GPLAO clearly authorizes the laboratory animal monitoring institutes in Guangdong Province to conduct laboratory animal quality monitoring and assume corresponding legal responsibilities. It also specifies the standards for the production and use of laboratory animals, while bringing attention to laboratory animal welfare and ethics. Through the formulation of supporting documents, the active promotion of the standardization and regulation of administrative law enforcement, and the implementation of measures to delegate power, streamline administration, and optimize government services, significant improvements have been made in the standardized management of laboratory animals in Guangdong Province and in supporting the innovative development of biomedicine. Moreover, notable achievements have been made in areas such as the construction of experimental animal technology platforms, standardization work, the preservation and development of unique resources, and talent pool development. However, with the advancements in science and technology, social economy, and legislative work, some aspects in the GPLAO have been identified for improvement. These include the need for clearer provisions on laboratory animal welfare, more specific guidelines for the management of genetically engineered animals, improved regulations on the safety and welfare of practitioners, further refined implementation of the "one-vote veto system", continued promotion of laboratory animal standardization, and the exploration of effective mechanisms for resource sharing. This paper reviews and summarizes the institutional characteristics, post-legislation implementation, and effectiveness of the GPLAO, as well as the issues and countermeasures identified during the implementation. It concludes the laboratory animals management practices in Guangdong Province during the past 10 years, aiming to provide a reference for laboratory animal legislation.

Objective To evaluate the clinical value of holographic image navigation in urological laparoscopic and robotic surgery.Methods The data of patients were reviewed retrospectively for whom accepted holographic image navigation laparoscopic and robotic surgery from Jan.2019 to Dec.2019 in Beijing United Family Hospital and other 18 medical centers,including 78 cases of renal tumor,2 cases of bladder cancer,2 cases of adrenal gland tumor,1 cases of renal cyst,1 case of prostate cancer,1 case of sweat gland carcinoma with lymph node metastasis,1 case of pelvic metastasis after radical cystectomy.All the patients underwent operations.In the laparoscopic surgery group,there were 27 cases of partial nephrectomy,1 case of radical prostatectomy,2 cases of radical cystectomy and 2 cases of adrenalectomy.In the da Vinci robotic surgery group of 54 cases,there were 51 cases of partial nephrectomy,1 case of retroperitoneal lymph node dissection,1 case of retroperitoneal bilateral renal cyst deroofing and 1 case of resection of pelvic metastasis.There were 41 partial nephrectomy patients with available clinical data for statistic,with a median age of 53.5 years (range 24-76),including 26 males and 15 females.The median R.E.N.A.L score was 7.8 (range 4-11).Before the operation,the engineers established the holographic image based on the contrast CT images and reports.The surgeon applied the holographic image for preoperative planning.During the operation,the navigation was achieved by real time fusing holographic images with the laparoscopic surgery images in the screen.Results All the procedures had been complete uneventfully.The holographic images helped surgeon in understanding the visual three-dimension structure and relation of vessels supplying tumor or resection tissue,lymph nodes and nerves.By manipulating the holographic images extracorporeally,the fused image guide surgeons about location vessel,lymph node and other important structure and then facilitate the delicate dissection.For the 41 cases with available clinical data including 23 cases of robotic-assisted partial nephrectomy and 18 cases of laparoscopic nephrectomy,the median operation time was 140 (range 50-225) min,the median warm ischemia time was 23 (range 14-60) min,the median blood loss was 80(range 5-1 200) ml.In the robotic surgery group,the median operation time was 140 (range 50-215)min,the median warm i schemia time was 21 (range 17-40)min,the median blood loss was 150(range 30-1 200)ml.In the laparoscopic surgery group,the median operation time was 160(range 80-225)min,the median warm ischemia time was 25 (range 14-60)min,the median blood loss was 50 (range 5-1 200) ml.All the patients had no adjacent organ injury during operation.There were 2 cases with Clavien Ⅱ complications.One required transfusion and the other one suffered hematoma post-operation.However,the tumors were located in the renal hilus for these 2 cases and the R.E.N.A.L scores were both 11.Conclusions Holographic image navigation can help location and recognize important anatomic structures during the surgical procedures..This technique will reduce the tissue injury,decrease the complications and improve the success rate of surgery.

BACKGROUND: LY01005 (Goserelin acetate sustained-release microsphere injection) is a modified gonadotropin-releasing hormone (GnRH) agonist injected monthly. This phase III trial study aimed to evaluated the efficacy and safety of LY01005 in Chinese patients with prostate cancer. METHODS: We conducted a randomized controlled, open-label, non-inferiority trial across 49 sites in China. This study included 290 patients with prostate cancer who received either LY01005 or goserelin implants every 28 days for three injections. The primary efficacy endpoints were the percentage of patients with testosterone suppression ≤50 ng/dL at day 29 and the cumulative probability of testosterone ≤50 ng/dL from day 29 to 85. Non-inferiority was prespecified at a margin of -10%. Secondary endpoints included significant castration (≤20 ng/dL), testosterone surge within 72 h following repeated dosing, and changes in luteinizing hormone, follicle-stimulating hormone, and prostate specific antigen levels. RESULTS: On day 29, in the LY01005 and goserelin implant groups, testosterone concentrations fell below medical-castration levels in 99.3% (142/143) and 100% (140/140) of patients, respectively, with a difference of -0.7% (95% confidence interval [CI], -3.9% to 2.0%) between the two groups. The cumulative probabilities of maintaining castration from days 29 to 85 were 99.3% and 97.8%, respectively, with a between-group difference of 1.5% (95% CI, -1.3% to 4.4%). Both results met the criterion for non-inferiority. Secondary endpoints were similar between groups. Both treatments were well-tolerated. LY01005 was associated with fewer injection-site reactions than the goserelin implant (0% vs . 1.4% [2/145]). CONCLUSION: LY01005 is as effective as goserelin implants in reducing testosterone to castration levels, with a similar safety profile. TRIAL REGISTRATION ClinicalTrials.gov, NCT04563936.
Humans ; Male ; Antineoplastic Agents, Hormonal/therapeutic use* ; East Asian People ; Gonadotropin-Releasing Hormone/agonists* ; Goserelin/therapeutic use* ; Prostate-Specific Antigen ; Prostatic Neoplasms/drug therapy* ; Testosterone