Objective To compare the efficacy of three procedures,extracorporeal shock wave lithotripsy(ESWL),ureteroscopic lithotripsy(URL) combined with ESWL,and minimally invasive percutaneous nephrolithotomy(MPCNL),for the treatment of complicated upper ureteral calculi.Methods Two hundred and thirty-four cases of complicated upper ureteral calculi were treated in this hospital from December 2002 to December 2003,including 76 cases of ESWL,78 cases of combined use of URL and ESWL,and 80 cases of MPCNL.Results In the ESWL cases,the stone fragmentation rate on one session was 56.6%((43/76),) the stone-free rate one month after operation was 46.1%(35/76),the mean hospitalization expenditure was 912 yuan,and the incidence of postoperative complications was 15.8%(12/76).In the URL combined with ESWL cases,the stone fragmentation rate on one session was 100%(78/78),the stone-free rate one month after operation was 83.3%(65/78),the mean hospitalization expenditure was 7 720 yuan,and the incidence of postoperative complications was 15.4%(12/78).In the MPCNL cases,the stone fragmentation rate on one session was 100%(80/80),the stone-free rate one month after operation was 100%(80/80),the mean hospitalization expenditure was 10 253 yuan,and the incidence of postoperative complications was 13.8%(11/80).The operation time,intraoperative blood loss,length of hospital stay,stone-free rate one month after operation,and hospitalization expenditure were significantly greater in the MPCNL cases than in the ESWL cases and the URL combined with ESWL cases.The stone fragmentation rate on one session was not significantly different between the MPCNL cases and the URL combined with ESWL cases,and was significantly higher in the MPCNL cases and the URL combined with ESWL cases than in the ESWL cases.The incidence of postoperative complications was not significantly different among the three groups.Conclusions Minimally invasive percutaneous nephrolithotomy should be used as the first choice for complicated upper ureteral calculi.

Objective To analyze the expression of long non-coding RNA ( lncRNA) in renal clear cell carcinoma ( RCCC ) , the association of lncRNA with RCCC, as well as the role of lncRNA in the diagnosis and treatment of RCCC.Methods Forty fresh RCCC tissues and their normal adjacent tissues were collected from March 2012 to June 2013, and total RNA was extracted using Trizol reagents, purified and tested by denaturing agarose gel electrophmesis and NanoDrop 1000.Through Arraystar Human LncRNA Microarray, the different expression of lncRNA between RCCC and normal adjacent tissues was screened. RT-qPCR was used to verify the expression of lncRNA in 40 pair RCCC tissues and normal adjacent tissues. The receiver-operating characteristic ( ROC ) curve was adopted to verify the diagnostic efficiency of the selected lncRNA.Results LncRNA expression profile showed 1 787 lncRNA with expression alteration in two fold or above, up-regulated and down-regulated candidate lncRNAs were 941 and 846 respectively. Compared with the adjacent tissues, NR_034095 and NR_038974 were up-regulated in RCCC, and ENST00000571724 and ENST00000566575 were down-regulated, which were consistent with the microarray analysis.By the ROC curves of NR_034095, NR_038974, ENST00000571724 and ENST00000566575 to discriminate the RCCC from normal adjacent tissue, the area under curve was 0.928 ( 95%CI 0.873 -0.984), 0.759 (95%CI 0.647-0.871), 0.833 (95%CI 0.747-0.919) and 0.887 (95%CI 0.815-0.959 ) , respectively.Conclusions NR _ 034095, NR _ 038974, ENST00000571724 and ENST00000566575 are significantly differently expressed in RCCC.The different expressed lncRNA might be closely related to the process of RCCC, and may be used as a new candidate target for molecular diagnosis and gene therapy of RCCC.

Objective : To investigate the clinical and molecular epidemiological characteristics of 10 patients with enterovirus (EV)-D68 infections in the respiratory tract in Shaoxing City, Zhejiang Province, so as to provide insights into formulation of control interventions for EV-D68 infections. Methods: Clinical specimens were sampled from patients with acute respiratory tract infections (ARTIs) admitted to sentinel hospitals in Shaoxing City from 2021 to 2022, and EV-D68 was detected using real-time fluorescent PCR assay and sequencing of the VP1 region of enterovirus. The epidemiological and etiological characteristics of EV-D68 infected cases were descriptively analyzed. Results: A total of 3 009 specimens were sampled from patients with ARTIs from 2021 to 2022, and the detection of EV-D68 was 0.33%. Of all EV-D68-infected patients, there were 6 men and 4 women, and 5 cases under 18 years of age, 2 cases at ages of 18 to 60 years and 3 cases at ages of over 60 years. EV-D68 infection predominantly occurred in summer (5 cases detected between May and July) and autumn (5 cases detected between September and October). The main clinical symptoms included fever (10 cases), sore throat (9 cases) and cough (8 cases), and all 10 cases recovered well, with no deaths reported. Sequencing identified D3 subtype in all 10 specimens positive for EV-D68. Conclusions The ARTIs caused by EV-D68 occurred predominantly among children under 18 years of age in Shaoxing City, and was highly prevalent in summer and autumn. D3 was the predominant enterovirus subtype.

Objective To explore the etiology and the fungi distribution in patients with complex renal calculi,as well as the therapeutic efficacy of minimally invasive percutaneous nephrolithotomy(MPCNL).Methods The mid-stream urine culture was underwent in 891 cases of patients with complex renal calculi.The MPCNL were performed in patients with complex renal calculi combined with fungous infection.Results Of 891 patients with complex renal calculi,3.7%(33/891) patients were presented with fungous infection,including 60.61%(20/33) with Candida albicans and 39.39%(13/33) with Candida glabrata.All the 33 patients had long-term use of broad spectrum antibiotics from 25 to 92 days(averaged 45.8 days).The patients with complex renal calculi combined with fungous infection were treated with MPCNL.The stone-free rate was 87.88%(29/33) and the insignificance stone-residual rate was 12.12%(4/33).Conclusion The patients with complex renal calculi are apt to fungous infection and the abuse of broad spectrum antibiotics should be avoided.The MPCNL is safe and reliable for the treatment of the patients with complex renal calculi combined with fungous infection.

BACKGROUND: Thoracolumbar segments (T11-L2) prone to damage due to its special anatomical and biomechanical characteristics. Therefore, fully understanding the shape of pedicle of vertebral arch and finding the visible, constant, and the point of insertion of the pedicle axis is very important to the safety of pedicle screw placement.OBJECTIVE: To measure the surgically relevant parameters of thoracolumbar pedicles between Han and Uygur males using computed tomography (CT) scan to provide some anatomic reference data for pedicle screw fixation.METHODS: The vertebral bodies and pedicles of adult males were scanned (60 cases of Han people and 60 cases of Uygur people) from T10-L3 with CT. The parameters were processed by three-dimensional reconstruction. Transverse pedicle width, pedicle axis length, transverse pedicle angle, and sagittal pedicle angle were measured by using length and angle measurement tool of browser in bone-window CT images. The age and stature information were recorded. All the data above were processed by SPSS 13.0 software.RESULTS AND CONCLUSION: (1) The mean transverse pedicle width of T12 and L1 in Han was bigger than that in the Uygur. (2) The mean transverse pedicle angle of T12 and L2 in Han was bigger than that in the Uygur. (3) The mean pedicle axis length and sagittal pedicle angle of T11 and L1 in Han were bigger than that in the Uygur (P < 0.05). (4) There were some differences among some parameters of the thoracolumbar pedicles between the Han and Uygur people.Data from any study only can be used as a guide for pedicle screw fixation. Preoperative CT evaluation may provide an individualized strategy to reduce the incidence of postoperative complications caused by misplacement.

Objective: To investigate the epidemiological and etiological characteristics of viral diarrhea among children under 5 years of age in Shaoxing City, Zhejiang Province, so as to provide insights into management of viral diarrhea. Methods: The surveillance data on viral diarrhea among children under 5 years of age in Shaoxing City from 2019 to 2022 were collected, including demographics and stool testing results. The epidemiological and etiological characteristics of viral diarrhea were analyzed using a descriptive epidemiological method. Results: A total of 763 diarrheal children under 5 years of age were reported in Shaoxing City from 2019 to 2022, and 236 children were tested positive for virus (30.93%). The detection of virus was 49.01%, 31.61%, 20.43% and 21.89% from 2019 to 2022, which appeared an overall tendency towards a decline (P<0.05). The incidence of viral diarrhea peaked from November to March of the next year and from May to July, and the detection of virus was lower among children with diarrhea living in urban areas (Yuecheng District, Keqiao District and Shangyu District) than among those in suburb areas (Zhuji City, Shengzhou City and Xinchang County) (30.22% vs. 52.00%, P<0.05). There were 206 children tested positive for a single virus, and the detection rates of rotavirus (RV), enteric adenovirus (EAdV), norovirus (NoV), and sapovirus (SaV) were 9.57%, 8.91%, 8.39%, and 0.13%, respectively. There were 25 children with virus co-infections, and the positive rates of EAdV and NoV, RV and EAdV and RV and NoV co-infections were 1.31%, 1.18% and 0.79%, respectively. There were 5 children with triple infections of RV, EAdV and NoV (0.66%). The highest detection of EAdV was seen in April, the highest detection of RV and NoV was seen in January, while SaV was only detected in April. Conclusion The incidence of viral diarrhea among children under 5 years of age peaked in winter and spring in Shaoxing City from 2019 to 2022, and the cases predominantly occurred in urban areas. The detection of virus appeared an overall tendency towards a decline, with high detection of RV, EAdV and NoV.

OBJECTIVE:To study the improvement effects of Rouganbao granules on liver fibrosis of model rats,and to provide experimental evidence for further development of this preparation. METHODS:Totally 45 male SD rats were divided into normal group,model group,positive control group(Fuzheng huayu capsules,0.4 g/kg)and Rouganbao granules high-dose and low-dose groups(16.8,8.4 g/kg by crude drug)according to random number table,with 9 rats in each group. Except for normal group,other groups were given CCl4sub cutaneously and high lipid diet+15% ethanol solution for 12 weeks to establish liver fibrosis model. After modeling,medication groups were given relevant medicine intragastrically,once a day,for consecutive 12 weeks. Normal group and model group were given corresponding volume of water intragastrically. The pathology change of liver tissues of rats was observed by inverted microscope. The levels of liver function indexes (ALT,AST,ALB) and liver fibrosis indexes(HA,Ⅳ-C,LN,Ⅲ-PC)were determined by ELISA. RESULTS:Compared with model group,liver cell vacuolation and liver fibrosis of rats were improved significantly in Rouganbao granule high-dose and low-dose groups;central vein was clearly visible,and no dilation and atrophy were found,especially in high-dose group;the serum levels of ALT and AST were decreased significantly,while the level of ALB was increased significantly(P＜0.05 or P＜0.01),of which the protective effect for liver was similar to positive control drug but better in increasing ALB(P＜0.05 or P＜0.01);the serum levels of HA,Ⅳ-C,LN and Ⅲ-PC were all decreased in varying degree,especially in high-dose group(P＜0.05 or P＜0.01),of which the effect of relieving liver fibrosis was similar to positive control drug. CONCLUSIONS:Rouganbao granules can improve liver function and delay the progression of liver fibrosis in model rats.

Since the performance appraisal of national tertiary public hospitals was carried out, higher requirements have been put forward for the operation and management of hospitals. Under the premise of ensuring the quality of medical service and medical safety, how to save hospital operating costs and improve the efficiency is an urgent problem for hospital managers. Supported by information upgrading, a tertiary hospital in Guangzhou reformed the treatment process and carried out pre-hospitalization in surgical departments. Data showed that pre-hospitalization can significantly shorten the length of stay, reduce hospitalization costs, and improve the operation efficiency of the hospital.

Objective:To investigate whether astragaloside IV (AS-IV) exerts neuroprotective effects via zinc ion (Zn 2+) modulation of mitochondria-associated endoplasmic reticulum membranes (MAMs) and to elucidate the possible mechanisms. Methods:PC12 cells (rat adrenal pheochromocytoma cells) were routinely cultured; they were divided into 7 groups: control group (routinely cultured), 2-DG group (treated with 2-DG at 50 μmol/L for 30 min), astragaloside IV+2-DG group (treated with 50 μmol/L astragaloside IV for 20 min, and then treated with 50 μmol/L 2-DG for 30 min), astragaloside IV group (treated with 50 μmol/L astragaloside IV for 20 min), N,N,N',N'-tetrakis(2-pyridylmethyl)ethylenediamine (a zinc chelator, TPEN)+astragaloside IV+2-DG group (treated with 10 μmol/L TPEN for 10 min, 50 μmol/L astragaloside IV for 20 min, and then 50 μmol/L 2-DG for 30 min); TPEN group (treated with 10 μmol/L TPEN for 10 min), TPEN+2-DG group (treated with 10 μmol/L TPEN for 10 min and then treated with 50 μmol/L 2-DG for 30 min). The expressions of glucose-regulated protein (GRP)78, GRP94, cysteine-containing aspartate proteolytic enzyme caspases-8, B cell receptor associated protein 31 (BAP31) and mitochondrial fission protein 1 (Fis1) were detected by Western blotting. Annexin V-FITC/PI kit was used to detect the apoptosis level. Immunofluorescence was used to detect the Fis1 protein expression, and mitochondrial fluorescence probe TMRE was used to detect the opening of mitochondrial permeability transition pore (mPTP).Results:(1) Compared with the control group, the 2-DG group had significantly increased expressions of GRP78, GRP94, Caspase-8, Bap31 and Fis1, and green fluorescent intensity of Annexin V-FITC ( P<0.05); compared with the 2-DG group, the astragaloside IV+2-DG group had significantly decreased expressions of GRP78, GRP94, Caspase-8, Bap31 and Fis1, and green fluorescent intensity of Annexin V-FITC ( P<0.05); compared with the astragaloside IV+2-DG group, the TPEN+astragaloside IV+2-DG group had significantly increased expressions of GRP78, GRP94, Caspase-8, Bap31 and Fis1, and green fluorescent intensity of Annexin V-FITC ( P<0.05). (2) Compared with the control group, the 2-DG group had significantly enhanced Fis1 protein fluorescent intensity ( P<0.05); the astragaloside IV+2-DG group had significantly decreased Fis1 protein fluorescent intensity compared with 2-DG group ( P<0.05); Compared with astragaloside IV+2-DG group, TPEN+astragaloside IV+2-DG group had significantly enhanced Fis1 protein fluorescence intensity ( P<0.05); compared with the control group, the TPEN+2-DG group had significantly enhanced Fis1 protein fluorescent intensity ( P<0.05). (3) TMRE fluorescence intensity in 2-DG group was significantly decreased compared with control group ( P<0.05); TMRE fluorescence intensity in astragaloside IV+2-DG group was significantly enhanced compared with 2-DG group ( P<0.05); TMRE fluorescence intensity in TPEN+astragaloside IV+2-DG group was significantly decreased compared with astragaloside IV+2-DG group (P<0.05); TMRE fluorescence intensity in TPEN+2-DG group was significantly decreased compared with the control group ( P<0.05). Conclusion:Astragaloside IV can exert neuroprotective effects through Zn 2+ inhibiting endoplasmic reticulum stress-induced apoptosis and preventing mPTP opening in PC12 cells, whose mechanism may be related to Fis1 and Bap31 expressions.

Bladder diverticulum is a hernia formed by the protrusion of the mucosa through the weak muscularis propria of the bladder wall. It can be divided into congenital and acquired. Most patients are asymptomatic, and be found by physical examination or incidentally during the diagnosis and treatment of other diseases. The majority of bladder diverticula occur in male patients, mostly due to lower urinary tract obstruction. Severe diverticula may cause recurrent urinary tract infection or even malignant transformation, which requiring surgical treatment.