Objective To evaluate the efficacy and safety of percutaneous micro-channel approach in treatment of pelvis side cyst and ureteropelvic junction obstruction simultaneously. Methods 32 patients with unilateral solitary parapelvic cyst complicated with UPJO, including 25 cases with ipsilateral kidney stones. After percutaneous holmium laser lithotripsy for patients complicated with calculi, then performed incision and drainage through the channels for parapelvic cyst by holmium laser, and antegrade high pressure balloon dilatation for UPJO, drainage by hippocampal tube in 3 ~ 6 months postoperatively. The operation time of fenestration drainage of cyst, narrow hypertensive dilatation and postoperative hospital stay were analyzed. Results Compared with 1 month (46.17 ± 6.33), 3 months (40.47 ± 6.06), 6 months (33.81 ± 7.05), 9 months (28.95 ± 7.92) after surgery, there was a marked improvement of the separation coefficient of renal convergence, the difference was statistically significant (P < 0.05). And compared with 6 months after surgery, the data of 9 months after surgery has statistical significant differences (P < 0.05). The separation coefficient of renal convergence decreases as time goes on. Conclusions Percutaneous micro-channel approach in treatment of pelvis side cyst and ureteropelvic junction obstruction by the same time can effectively relieve symptoms and decrease the separation coefficient of renal convergence. It is safe and effective.

Objective:To investigate the predictive value of the clinicopathological features of breast cancer for pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) and to establish a predictive model based on the clinicopathological features.Methods:Clinicopathological data collected from 182 patients who underwent NAC and surgical treatment in Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine from Jan. 2013 to Dec. 2019 were retrospectively analyzed. The univariate and multivariate analysis were used to analyze the relationship between clinicopathological features and pCR after neoadjuvant chemotherapy. The predictive value in predicting the efficacy of NAC was evaluated, the receiver operating characteristic (ROC) curve and Nomogram prediction model were constructed.Results:Multivariate Logistic regression analysis showed that progesterone receptor (PR) , human epidermal growth factor 2 (HER2) and platelet distribution width (PDW) were independent predictors of pCR after NAC for breast cancer. The area under the curve (AUC) of model for predicting efficacy of NAC was 0.810 (95% CI:0.745-0.864) and the sensitivity and specificity was 68.75% and 82.67% respectively when the Jordan Index is at its maximum. Conclusion:ER-, HER2+ and PDW≤13.4% show better efficacy of NAC. The Nomogram model based on them can accurately predict the efficacy of NAC and can provide a reference for the selection of treatment options in clinical diagnosis and treatment.

Objective To investigate the clinical efficacy and safety of visual standard channel combined with visual ultrafine channel PCNL precision puncture in treatment of complex renal calculi. Methods From June 2015 to October 2016, 48 cases of complicated renal calculi were treated with multi-channel lithotripsy with visual standard channel ultrasonic pneumatic lithotripsy combined with visual superfine channel PCNL precision puncture holmium laser lithotripsy. Including 10 cases of staghorn stone, 38 cases of multiple renal stones. Results 110 channels were established in 48 patients. 4 cases of preoperative renal insufficiency with infection in the puncture found in the pus and stones load larger, intraoperative diarrhea and PCNL simple treatment of obstruction site stones; 44 cases to complete one of the surgery: There were single channel established in every one of 5 cases, and double channels established in every one of 24 cases, three channels in established in every one of 15 cases; There were two cases of surgery in 8 cases and there were 12 new channels established. The average time of unilateral first operation was 75 (35 ~ 125) min. The first clearance rate was 79.2% (38/48), and the total clearance rate of postoperative stone was 87.5% (42/48). 6 cases of residual stone combined with ESWL and drug row of stone, followed up for 3 months, 6 cases of stone row net, the total stone clearance rate of 100.0% (48/48). Two consecutive postoperative no sepsis, bleeding, ureteral injury and other serious complications. Conclusions Visual standard channel combined with visual superfine channel PCNL precise puncture for the treatment of complex renal calculi is safe and effective, with high fruiting rate and low complication, which can be popularized in clinical practice.

Objective To explore the feasibility and safety of visualization puncture combined with flexible ureteroscopy in the treatment of lower calyx stones.Method Visualization puncture combined with flexible ureteroscopy to treat the lower calyx stones was done in our center from January to August 2016 in our hospital.32 cases of patients were enrolled to have a retrospective analysis.There were 18 males and 14 females,aged from 25 to 65 years,with an average age of 43 years.The diameter of stone was 1.0-2.0 cm,with an average of (1.4 ± 0.6) cm.We used general anesthesia and then adjusted the surgery bed to operation side lateral elevation was 30 °-35.Flexible ureteroscopy with 200μm holmium laser was used firstly to break calculi as much as possible.Ultrasound-guided F4.8 visualization puncture system was used to establish F4.8 channel.The power option was 2001μm hohnium laser to crush calculus of the renal calculi to treat the calculus of the distal end of soft lens which still can not be touched by ureteroscopy.Routine nephrostomy tube was not placed.The soft ureter sheath F5 double-J tube,and indwelling balloon catheter were routinely placed.We removed the catheter after 1-2 days and the double J tube after 4 to 6 weeks.Results The flexible ureteroscopy lithotripsy operation time was 8-25 mins in all of the 32 patients.Visualization puncture channels were successfully established in 3-7 mins,and the visualized puncture stone search rate of 100％ (32/32).The success rate of first stage lithotripsy was 93.8％ (30/32).Two cases of lower calyx stones diverticulum diverted to PNCL due to poor visibility by bleeding.The operation time was 30-60 mins and the average of 45 mins.KUB review at day one after the surgery showed that there were residual stones in 5 cases.The stone free rate at one month after the surgery is 100.0％.The average postoperative hospital stay was (2.0 ± 1.5) days.There were uo bleeding,ureteral avulsion and perforation,septic shock,pleural effusion and intestinal injury and other serious complications.Conclusions Navigation ultrasound-guided visualization puncture combined with flexible ureteroscopy is safe and effective to treat lower calyx stones.

Objective:To investigate the efficacy of the intelligent version of the Montreal Cognitive Assessment Scale(MoCA)in identifying mild cognitive impairment(MCI)in elderly inpatients.Methods:Seventy-five patients diagnosed with mild cognitive impairment(MCI group)from the Neurology and Geriatrics Departments of a tertiary hospital in Changsha City, along with 195 patients with normal cognitive function(normal control group), were selected between July 2020 and December 2022.Both groups underwent evaluations using the intelligent version of the Montreal Cognitive Assessment(MoCA)and the Mini Mental State Examination(MMSE), and the results were analyzed.Results:The MCI group showed significantly lower total MoCA scores and MMSE scores[(19.73±2.42) vs.(24.8±2.33)]compared to the normal control group[(24.47±2.02) vs.(26.50±1.65)], with a statistically significant difference( P<0.01).The optimal cut-off score for the MoCA was found to be 23.5 points in diagnosing MCI, showing higher sensitivity, specificity, and kappa value(96.0%, 82.1%, and 0.690)compared to the MMSE scale(90.0%, 62.6%, and 0.428). Conclusions:The intelligent MoCA has a high screening accuracy for identifying MCI in this population, demonstrating superior sensitivity and specificity compared to the MMSE.

OBJECTIVETo clone and identify the gene encoding human ubiquitin binding enzyme 2 and study its expression pattern.

METHODSAccording to the sequence of human EST, which is highly homologous to the mouse ubiquitin binding/conjugating enzyme (E2), primers were synthesized to screen the human fetal brain cDNA library. The gene was analyzed by bioinformatics technique and its expression pattern was studied by using multiple-tissue Northern blot.

RESULTSTwo cDNA clones encoding human ubiquitin conjugating enzyme have been isolated and identified. Both containing the ubiquitin conjugating domain, the 2 cDNA clones are 88% identical in amino acid sequences and splicing isoforms to each other only with an exon excised to form the short sequence. They belong to a highly conserved and widely expressed E2 enzyme family. Northern blot shows that they are expressed exclusively in adult human heart, placenta, and pancreas but no transcripts can be detected in brain, lung, liver, skeletal muscle or kidney.

CONCLUSIONSThe gene encoding human ubiquitin binding enzyme is expressed under temporal control. As a key enzyme in the degradation of proteins, ubiquitin conjugating enzymes play a central role in the expression regulation on the level of post-translation.

Amino Acid Sequence ; Animals ; Base Sequence ; Cloning, Molecular ; DNA, Complementary ; genetics ; Female ; Humans ; Mice ; Molecular Sequence Data ; Myocardium ; metabolism ; Pancreas ; metabolism ; Placenta ; metabolism ; Rats ; Sequence Alignment ; Sequence Analysis, DNA ; Ubiquitin ; genetics ; Ubiquitin-Conjugating Enzymes ; biosynthesis ; chemistry ; genetics

Promoting wound healing is a common clinical challenge faced by surgeons, with a variety of repair method and materials currently available for clinical use. In recent years, with the continuous development of disciplines such as tissue engineering, regenerative medicine, and materials science, research on wound repair materials has progressed rapidly. This article will organize the classification, advantages and disadvantages, and the latest advancements in the preparation processes of wound repair materials. It will also discuss the current challenges faced by wound repair materials and future research directions, with the aim of providing a reference for related studies in wound repair.

Promoting wound healing is a common clinical challenge faced by surgeons, with a variety of repair method and materials currently available for clinical use. In recent years, with the continuous development of disciplines such as tissue engineering, regenerative medicine, and materials science, research on wound repair materials has progressed rapidly. This article will organize the classification, advantages and disadvantages, and the latest advancements in the preparation processes of wound repair materials. It will also discuss the current challenges faced by wound repair materials and future research directions, with the aim of providing a reference for related studies in wound repair.

Psychotherapy is one of the widely used therapies for depression.Yet there are currently no definitive biological markers as indicators of effectiveness.Using functional magnetic resonance imaging(fMRI)to assess the neuroimaging biomarkers before and after different psychological treatments for depression reveals corresponding changes in brain region activation and functional connectivity.For example,after cognitive-behavioral therapy,the prefrontal cortex of patients may be activated and dynamic functional connectivity variability may change,while mindfulness therapy may show alterations in specific temporal lobe regions.Additionally,studies exploring special populations and internet-based psychological intervention have also found changes in brain region activation and functional connectivity,providing guidance for the efficacy evaluation of corresponding psychotherapies.This article reviews the characteristic brain region or network changes in fMRI activity after different psychotherapies in depressed patients,aiming to discuss future directions for research that integrates neuroimaging with psychological treatment for depression.

Syndrome of dampness-heat of spleen and stomach is one of the complex syndromes of the spleen and stomach,which is difficult to differentiate and treat in TCM.According to the theoretical connotation of"attacking it according to its combination",it is suggested that the syndrome of dampness-heat of spleen and stomach should be comprehensively differentiated and treated from five aspects,including"attacking the visible pathogens combined with the invisible ones"(removing dampness and warming yang),"treating the fu-organs sharing interior-exterior relationship with zang-organs"(clearing away damp-heat pathogens of stomach with drugs of bitter taste and cold property),"formulating the treatment according to the likes and dislikes of the five internal organs"(developing a life adjustment plan favored by the spleen and stomach),"administrating drug according to the five organs"(medications according to the spleen and stomach),"weighing the severity and applying the treatment"(pay attention to the details,and treating according to syndrome differentiation).A clinical case is exampled,with the purpose to provide reference for the prevention and treatment of syndrome of dampness-heat of spleen and stomach.