Objective:To investigate the effect of potassium sodium hydrogen citrate in the treatment of renal uric acid calculi with heavy load.Methods:The clinical data of 6 patients with intrarenal high-load uric acid calculi (long diameter >4 cm) treated with potassium sodium hydrogen citrate in our hospital from January 2018 to July 2020 were reviewed. All of the patients were male. Their ages ranged from 42 to 66 years, with an average age of 51.3 years old. The average length to diameter was 6.0(4.1-7.6) cm. The average density of stone was 475 (418-535) HU. The average blood uric acid was 453.3(258.7-570.0)μmol/L, and all patients had a urine pH ≤5.5. The blood uric acid level was higher than normal serum uric acid level before treatment, and 3 cases had a history of gout. Stone composition analysis revealed 100% uric acid stone in two patients before treatment. The remaining patients were more likely to have uric acid calculi before treatment. None of the patients had a history of urinary tract infection. All patients were treated with oral potassium sodium hydrogen citrate. During the treatment, the starting dose was 10g/ day, which was divided into 2.5 g after breakfast, 2.5 g after lunch and 5.0 g after dinner. The dose was adjusted according to the pH value of urine, and the urine pH was maintained between 6.5-7.0. CT plain scan was repeated every 2-3 months during the treatment period to evaluate the treatment effect.Result:After 2.5-8.0 months’ treatment, the stone load of all the patients was reduced to different degrees, and the average length diameter was shortened by 3.2cm, among which two patients’ stones disappeared. CT scan showed the stone edge changed from smooth to rough after the treatment, and there would be worm erosion defect and cavity on the surface and inside of the stone, showing obvious stone dissolution phenomenon.Conclusions:Potassium sodium hydrogen citrate has a good therapeutic effect on renal uric acid calculi with heavy load. Non-infected patients with uric acid calculi should be treated with potassium sodium hydrogen citrate.

The development trend of medical education is comprehensive, which is character-ized by breaking the boundaries among different disciplines, constructing a main line centering on or-gan and system, and implementing student-centered problem-based learning. This paper analyzed the main problems of basic medical education in Wuhan University of Science and Technology, such as insufficient teaching reform to promoting students' autonomous learning and failed to create excellent teaching and research group et al. Also, the paper proposed comprehensive reform measures such as integrating teaching units , establishing Teacher Education Development Center, implementingCourse director andTeam leader system, promoting teaching model ofstudent centered and in-tegrating curriculums of basic medicine to establish course model centering on the organ and system et al, with some success.

OBJECTIVE:To observe clinical efficacy and safety of capecitabine and tegafur gimeracil and oteracil potassium synchronous radiotherapy in the treatment of recurrence after radical resection of colon cancer. METHODS:A total of 150 patients with recurrent after radical resection of colon cancer in our hospital during Jan. 2012-Dec. 2012 were divided into group A and B ac-cording to random number table,with 75 cases in each group. Both groups received three-dimensional conformal radiotherapy. Group A was additionally given capecitabine 2.5 g. Group B was additionally given tegafur gimeracil and oteracil potassium,40 mg,bid for body surface area <1.25 m2,50 mg,bid for body surface area ranged 1.25-1.50 m2 and60mg,bid for body surface ar-ea<1.50 m2. Clinical efficacies of 2 groups were compared;1-year,2-year,3-year survival andⅢ-Ⅳdegree toxic effect were fol-lowed up. RESULTS:The total response rate of group B was 86.67％,which was significantly higher than 66.67％ of group A, with statistical significance(P<0.05). 1-year,2-year,3-year survival rates of group B were 93.335,72.00％,58.67％,which was significantly higher than 74.67％,53.33％,41.33％,with statistical significance(P<0.05). The median disease progression time of group A was 8.0 months,which was significantly shorter than 9.5 months of group B,with statistical significance (P<0.05). There was no statistical significance in Ⅲ-Ⅳ degree toxic effect between 2 groups (P<0.05). CONCLUSIONS:Compared with capecitabine,tegafur gimeracil and oteracil potassium combined with three-dimensional conformal radiotherapy show significant therapeutic efficacy for recurrence after radical resection of colon cancer,can control disease progression,prolong the survival time and don't increase the risk of toxic effects.

OBJECTIVE To observe the increased susceptibility to metabolic syndrome (MS) in offspring adult female rats which experienced prenatal caffeine exposure (PCE) and underwent early postnatal catch-up growth and late chronic stress, and to explore the underlying mechanism. METHODS Starting from gestational day 11, pregnant Wistar rats were intragastrically administered with caffeine at the dose of 120 mg·kg-1 per day until delivery. The female offspring rats were fed a high-fat diet from postnatal week 4 (PW4) to PW24, and then exposed to two weeks of unpredictable chronic stress at PW38-PW40. Blood glucose and serum adrenocorticotropic hormone, corticosterone, insulin, triglycer? ides, total cholesterol, low-density lipoprotein-cholesterol (LDL-C) and high-density lipoprotein-cholesterol (HDL-C) levels were detected. Meanwhile, the mRNA expression of adrenal steroidogenic acute regulatory protein, P450 side- chain cleavage enzyme, 3β- hydroxysteroid dehydrogenase, steroid 11β- hydroxy? lase, steroid 21β- hydroxylase, hepatic insulin receptor, insulin receptor substrate 2 and glucose trans? porter 2 (GLUT2) were examined by real- time quantitative PCR. The morphological changes of the adrenal gland, pancreas and liver were observed using hematoxylin-eosin staining. RESULTS Compared with control group〔(13.9±2.8) g〕, the body mass of the PCE offspring female rats at PW1〔(10.5±1.0) g〕 was significantly lower (P<0.01), which lasted until PW40 (P<0.05, P<0.01). However, the gain rate of body mass was higher in the PCE group at PW4- PW16 (P<0.05, P<0.01). Levels of blood glucose〔(5.9±0.3) mmol·L- 1〕and serum insulin〔(100±31) mU·L-1〕, the insulin resistance index (26.3±5.7), LDL-C〔(0.55±0.05) mmol·L-1〕level and LDL-C/HDL-C ratio (0.87±0.11) were increased compared with (4.3±0.3) mmol·L-1, (45±4) mU·L-1, 8.3±0.9, (0.38±0.04) mmol·L-1 and 0.66±0.07 in the control group, respectively (P<0.05, P<0.01). The mRNA expression of hepatic GLUT2 in the PCE group was lower than in the control group (P<0.05). Furthermore, the thicknesses of the adrenal zona fasciculata was re?duced and the area of pancreatic islets became smaller, but there was no significant change in liver morphology. CONCLUSION PCE offspring adult female rats display high susceptibility to MS, which is mainly manifested as insulin resistance, characterized by hyperglycemia and hyperinsulinemia, lipid metabolism disorder and structural and functional abnormalities of multiple organs. The mechanism is possibly related to the disorder of hypothalamic-pituitary-adrenal axis-associated neuroendocrine meta? bolic programming.

To prolong serum half-life of human kallikrein (hK) and enhance its secretion rate, we modified hK gene and constructed a new form of recombinant hK protein (hK'-Fc). We amplified hK gene and Fc sequence, replaced the signal peptide of hK gene with murine signal peptide, constructed native expression plasmid of pcDNA-hK-Fc and modified expression plasmid of pcDNA-hK'-Fc, then transfected to CHO cells respectively. After the stable cell lines were screened, we compared the secretion rate between native fusion protein and modified fusion protein, purified fusion protein through Protein A+G affinity chromatography column and investigated the bioactivity of fusion protein. The results showed that recombinant vectors encoding fusion protein hK-Fc and hK'-Fc were constructed successfully; CHO cell lines stably secreting fusion protein were obtained, the yield is higher than 11 mg/L; Secretion rate was enhanced by 5-10 times after the signal peptide of fusion protein was modified; Fusion protein has enzymatic activity in vitro. The above results could promote the following researches on serum half-life of the fusion protein and develop a new stroke medicine with better clinical efficacy.
Animals ; CHO Cells ; Cell Adhesion Molecules ; biosynthesis ; genetics ; Cricetinae ; Cricetulus ; Humans ; Mice ; Protein Sorting Signals ; genetics ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; physiology ; Tissue Kallikreins ; biosynthesis ; genetics ; Transfection

OBJECTIVETo set up thalassemia population intervention model in order to decrease the birth of thalassemia major, relying on population and family planning service system.

METHODSPregnant women and their husbands were educated about thalassemia, and participated in screening and prenatal diagnosis if the couple were carriers of thalassemia in the areas of Huangpu, Panyu, Zengcheng and Tianhe districts of Guangzhou.

RESULTSThe network of thalassemia intervention mainly dependent on family planning service system was set up in these regions. A total of 10 695 families participated in thalassemia screening and 16 thalassemia major fetuses were diagnosed in the last two years. No one was thalassemia major in the 8360 newborn.

CONCLUSIONThalassemia population intervention model was set up relying on family planning service system and it significantly decreased the birth of thalassemia major.

Family Planning Services ; methods ; Female ; Genetic Counseling ; Heterozygote ; Humans ; Infant, Newborn ; Male ; Mass Screening ; methods ; Pregnancy ; Prenatal Diagnosis ; methods ; Spouses ; Thalassemia ; diagnosis ; genetics ; prevention & control

ObjectiveTo evaluate the methodological quality of systematic review / Meta analysis （SR/MA） of intervention randomized controlled trial （RCT） published in the Sichuan Mental Health. MethodsThe literature databases such as Wanfang Data， China National Knowledge Infrastructure （CNKI）， VIP Database for Chinese Technical Periodical （VIP） and Chinese Biomedical Literature Database （CBM） were searched for the SRs/MAs of intervention RCTs published in the Sichuan Mental Health from the initial issue to the issue published on 31 June 2021. Then the methodological quality of eligible SRs/MAs were assessed using A Measurement Tool to Assess systematic Reviews 2 （AMSTAR 2）. ResultsThe literature search yielded 24 full-text articles， and the mean AMSTAR 2 score of the included SRs/MAs was （5.21±3.63） with a range from 1 to 11. The total AMSTAR 2 score for SRs/MAs showed difference in terms of the publication date prior to or later than the publication of AMSTAR-2 tool （t=-5.499）， number of authors ≤ 2 or ≥ 3 （t=-6.736）， with or without funding support （t=3.329） and author unit nature （F=7.827）， with statistical significance （P<0.01）. All selected studies had deficiencies on explicit statement of a priori design and registrations， list of excluded studies and reasons for exclusion， sources of funding for the research in systematic review， potential conflicts of interest statement， and funding information of the systematic review. ConclusionThe methodological quality of SRs/MAs of intervention RCTs published in the Sichuan Mental Health varies widely， After the release of AMSTAR 2， the methodological quality has improved， but the report still needs to be further standardized to provide high-quality evidence-based evidence.

OBJECTIVETo summarize the treatment status of gastric gastrointestinal stromal tumor (GIST) in Shandong province,by analyzing the clinicopathological features and prognostic factors.

METHODSClinicopathological and follow-up data of 1 165 patients with gastric GIST between January 2000 and December 2013 from 23 tertiary referral hospitals in Shandong Province were collected to establish a database. The risk stratification of all cases was performed according to the National Institutes of Health(NIH) criteria proposed in 2008. Kaplan-Meier method was used to calculate the survival rate. Log-rank test and Cox regression model were used for univariate and multivariate prognostic analyses.

RESULTSAmong 1 165 cases of gastric GIST, 557 were male and 608 were female. The median age of onset was 60 (range 15-89) years. Primary tumors were located in the gastric fundus and cardia in 623 cases(53.5%), gastric body in 346 cases(29.7%), gastric antrum in 196 cases(16.8%). All the cases underwent resection of tumors, including endoscopic resection (n=106), local resection (n=589), subtotal gastrectomy(n=399), and total gastrectomy(n=72). Based on the NIH risk stratification, there were 256 cases (22.0%) at very low risk, 435 (37.3%) at low risk, 251 cases (21.5%) at intermediate risk, and 223 cases (19.1%) at high risk. A total of 1 116 cases(95.8%) were followed up and the median follow-up period was 40 (range, 1-60) months. During the period, 337 patients relapsed and the median time to recurrence was 34 (range 1-60) months. The 1-, 3-, and 5-year survival rates were 98.6%, 86.1% and 73.4%, respectively. The 5-year survival rates of patients at very low, low, intermediate, and high risk were 93.1%, 85.8%, 63.0% and 42.3% respectively, with a statistically significant difference (P=0.000). Multivariate analysis showed that primary tumor site (RR=0.580, 95%CI:0.402-0.835), tumor size (RR=0.450, 95%CI:0.266-0.760), intraoperative tumor rupture(RR=0.557, 95%CI:0.336-0.924), risk classification (RR=0.309, 95%CI:0.164-0.580) and the use of imatinib after surgery (RR=1.993, 95%CI:1.350-2.922) were independent prognostic factors.

CONCLUSIONSThe choice of surgical procedure for gastric GIST patients should be based on tumor size. All the routine procedures including endoscopic resection, local excision, subtotal gastrectomy and total gastrectomy can obtain satisfactory curative outcomes. NIH classification has a high value for the prediction of prognosis. Primary tumor site, tumor size, intraoperative tumor rupture, risk stratification and postoperative use of imatinib are independent prognostic factors in gastric GIST patients.