Objective To evaluate the efficacy and safety of modified technique of ureteral stent placement during transurethral resection of bladder tumor.Methods Seventeen patients with muscle invasive bladder cancer invading the ureteral orifice from March 2014 to June 2016 in Beijing Friendship Hospital were randomly divided into two groups.In the modified technique group (group A,n =10),tumor was resected until the ureteral orifice was exposed.Then,a guide wire was placed through the tunnel of Electrode loop and the ureteral stent was placed along the guide wire.In control group (group B,7 cases),after ureteral orifice exposed,the guide wire and ureteral stent was placed with cystoscopy.The demographic,oncological baseline and operative factors were evaluated between two groups.Results There was no difference in tumor grade and maximum diameter between two groups (P ＞ 0.05).The operation time in group A was significantly shorter than that in group B [(39.5 ± 14.8)min vs (59.3 ± 16.2) min,P =0.020],and the intraoperative vision clarity score was better in group A as well [(7.7 ± 1.3) vs (5.9± 1.2),P =0.010].There was no statistical difference between the two groups in the complication.Conclusions The modified technique can improve the efficiency of ureteral stent placement during transurethral resection of bladder tumor without any risk enhancement.

Architectural changes with Tianyi cloud storage of China Telecom were made to the up/ down loading of the image-text mega data created in the picture archiving and communication systems (PACS)of the hospital.Thanks to the changes, the data volume uploaded by the PACS of the hospital reached 160G per day, with average upload speed up to 5.3M/second;supporting online query of all image-text data of patients.The authors hold cloud storage technology as safe and reliable, and such other merits as supporting data encryption, automatic offsite redundancy, almost online real-time read/write access,almost infinite extendibility, fast self-healing and off-site disaster-tolerant backup.

Objective To investigate the effect of electroacupuncture at points Xiaohai and Xiajuxu on the expressions of tumour necrosis factor-α (TNF-α) and choline acetyltransferase (ChAT) in serum and nicotinic acetylcholine receptorα 7 (α 7 nAchR) in duodenal tissues in a rat model of duodenal ulcer (DU) and preliminarily explore the relative specificity of He-Sea point in “treating visceral diseases with He-Sea point”.Methods Forty healthy SD rats were randomized into blank (A), model (B), Xiaohai (C) and Xiajuxu (D) groups, 10 rats each. A rat model of DU was made by subcutaneous injection of 10% cysteamine hydrochloride at the right buttock. After successful model making, group C was given electroacupuncture at point Xiaohai and group D, at point Xiajuxu. Duodenal tissue ulcer was macroscopically observed and scored in every group of rats. Rat serum expression of TNF-α was determined by double antibody sandwich enzyme-linked immunosorbent assay (ELISA); rat serum expression of ChAT, by ultraviolet spectrophotometry & colorimetry; rat duodenal expression ofα7 nAchR, by Western blot.Results After model making, the duodenal ulcer score was significantly higher in groups B, C and D than in group A (allP<0.01) and significantly lower in groups C and D than in group B (bothP<0.01) and in group D than in group C (P<0.01). TNF-α expression was significantly higher in group B than in group A (P<0.01) and significantly lower in groups C and D than in group B (bothP<0.01) and in group D than in group C (P<0.01). ChAT expression tended to increase in group C compared with group B but there was no statistically significant difference (P>0.05) and was significantly higher in group D than in group B (P<0.01) or C (P<0.05).α7 nAchR expression was significantly higher in groups C and D than in group B (bothP<0.01). There was a positive correlation between ChAT andα7 nAchR expressions in every group (r=0.444,P=0.007).Conclusions Electroacupuncture at both points Xiaohai and Xiajuxu can reduce the duodenal ulcer score and serum TNF-α expression and increase serum ChAT and duodenalα7 nAchR expressions in DU rats. The results show that the therapeutic effect of electroacupuncture on duodenal ulcer may be produced by regulating TNF-α. Its mechanism may be activating cholinergic anti-inflammatory pathway to produce an anti-inflammatory effect. The effect being better in group D than in group C suggests that Xiajuxu has the relative specificity.

Coronavirus disease-19 (COVID-19) has reached pandemic status, and its pathogeny is the 2019 novel coronavirus (2019-nCoV).2019-nCoV mainly causes human respiratory infection and pulmonary inflammation; however, some COVID-19 patients are found to present viral conjunctivitis.Bilateral viral conjunctivitis is an initial symptom in some other cases.It is therefore, vital to understand whether the eye can be directly infected by the virus, as well as the consequences of the viral infection in the ocular tissue.2019-nCoV invades human cells primarily by binding to the angiotensin-converting enzyme 2 (ACE2) receptors.ACE2 expresses, not only in the lungs, kidneys, and cardiovascular system, but also in human conjunctiva, cornea, aqueous humor, and retina.Therefore, it is crucial to comprehensively expand the present understanding of the COVID-19 infection mechanism and pathogenesis by clarifying the distribution of ACE2 in the eye.ACE2 is not only the receptor of 2019-nCoV, but also a key enzyme in the renin-angiotensin system (RAS). RAS, which appears relatively independent in the eye, plays a modulating role and is associated with many common eye diseases.This article reviews the distribution and clinical significance of ACE2 in ocular tissues.

Objective:To evaluate the safety and efficacy of endoscopic cryoablation (ECA) in patients with upper tract urothelial carcinoma (UTUC).Methods:The clinical data of 9 patients with UTUC treated with ECA from April 2018 to September 2019 were retrospectively analyzed. Patients consisted of 3 males and 6 females, with median age of 76 years old (ranging from 50 to 88 years old). Among the patients, 6 cases had tumors of ureter, 1 case had tumor of renal pelvis and 2 cases had tumors of renal pelvis combined with ureter. Of the 9 patients, two had bilateral UTUC, six were presented with single lesion, three were presented with multiple lesion. The size of tumors were (1.53±0.91)cm. The tumors of all cases were localized (≤stage T 2), and there was no carcinoma or suspicious lymph node/distant metastasis. All patients enrolled in this study had strong will to choose kidney-sparing therapy. Biopsy, resection of intraluminal lesion with laser and cryoablation under ureteroscopy or percutaneous nephroscopy was performed under general aneasthesia.Ureteroscopy was performed 3 months after cryoablation. Perioperative complications and follow-up results were recorded and assessed. Results:Cryoablation was successfully performed in patients under ureteroscopy (n=8) or nephroscopy (n=1). The median cryoablation time was 6 (ranging from 4-16) minutes. The median follow-up was 16 months (ranging from 4-24 months). No tumor recurrence was observed at primary sites during follow-up. Two patients with multiple lesions were observed denovo ureteral neoplasms outside the primary sites 3 months and 6 months after cryoablation and treated with second cryoablation. One case died due to cardiovascular events 4 months after surgery. One patient underwent ureteral stricture during follow-up and received ureteroscopic balloon dilatation. No recurrent stricture was found in this case during the subsequent follow-up of 16 months. The other 5 cases showed no recurrence or complications like stricture during follow-up.Conclusions:ECA could probably be a promising treatment for localized UTUC. No recurrence in primary site and low incidence of ureteral stricture was observed during follow-up. The efficacy and safety of ECA need to be verified with large sample study.

Objective To explore the effects of case nursing combined with cognitive nursing intervention on general status and cognitive function in stroke patients with depression.Methods From October 2016 to April 2018, we selected 96 stroke patients with depression in Department of Neurology of He'nan Provincial People's Hospital. All of the patients were divided into observation group and control group with the random number table, 48 cases in each group. Control group received routine nursing. On the basis of that in control group, observation group applied case nursing combined with cognitive nursing intervention. The investigation was carried out with the Mini-mental State Examination (MMSE), Nurses' Observation Scale for Inpatient Evaluation (NOSIE), Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) before and after intervention. We also observed patients' abnormal body condition and hospital days.Results The incidence of abnormal body condition of patients in observation group was lower than that in control group with a statistical difference (P<0.05). After intervention, the scores of NOSIE of patients in observation group, the scores of personal neatness, interest and social competence were higher than those in control group; the scores of depression, irritability and slowness were lower than those in control group; the differences were all statistical (P<0.01). The incidence of cognitive disorder and the scores of HAMA as well as HAMD all decreased after intervention, and the improvements of observation group were statistically better than those of control group (P<0.05). There was statistical differences in the hospital days between two groups (P<0.05). Conclusions Case nursing combined with cognitive nursing intervention can improve depression, anxiety and cognitive function, and shorten hospital days among stroke patients with depression which is worth further promotion in clinical application.

OBJECTIVE: To investigate the association of phenylethanolamine-N-methyl transferase (PNMT) G-390A genetic polymorphism with risk of essential hypertension (EH) in Changsha Han people. METHODS: A case-control association study was performed in 400 patients with essential hypertension (EH) and 388 normotensive subjects. PNMT G-390A was genotyped using polymerase chain reaction-restriction fragment length polymorphism (PCR-FRLP). RESULTS: The genotype frequencies for the -390 GG, GA, and AA were 39.3%,50.0%, and 10.8%, respectively in EH patients, and were 43.6%,45.6%, and 10.8%, in normal subjects. No significant difference in either genotypic frequency (P=0.433) or allele frequency (P=0.378) of PNMT G-390A between EH patients and normals was observed. When by gender, there was significant difference in genotypic frequency (P<0.05) and allele frequency (P=0.046) of G-390A polymorphism between EH patients and normals in the male, but not in the female (P>0.05). CONCLUSION PNMT G-390A polymorphism is possibly associated with EH risk in male Chinese Han population in Changsha.
Adult ; Aged ; Base Sequence ; Case-Control Studies ; China ; Female ; Genetic Predisposition to Disease ; genetics ; Humans ; Hypertension ; enzymology ; genetics ; Male ; Middle Aged ; Molecular Sequence Data ; Phenylethanolamine N-Methyltransferase ; genetics ; Polymorphism, Genetic ; Sex Factors

OBJECTIVE: To investigate the association of tyrosine hydroxylase (TH) C-824T polymorphism with essential hypertension (EH) susceptibility in Hunan Han population by a case-control study. METHODS: A case-control study was performed on 368 EH patients and 353 healthy controls of Han nationality recruited in Hunan province. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP)was used to genotype the C-824T polymorphism. RESULTS: (1) Genotype frequencies for TH-824CC and -824CT+-824TT genotypes were 89.9% and 10.1%, respectively for EH patients and 88.7% and 11.3%, respectively for the controls. No significant difference in the genotype distribution of C-824T polymorphism between the patients and controls was observed (P=0.579). Allele frequencies of TH C-824T also showed no significant difference between the patients and controls (P=0.515). (2) When adjusted by EH risk factors, results of unconditional logistic regression analysis showed that there was no association between TH C-824T polymorphism and EH susceptibility (P=0.264). (3) When stratified by gender, no significant difference in the genotype distribution of TH C-824T polymorphism was observed between the patients and controls in either male or female subjects (P=0.841 and P=0.288). (4) Diastolic blood pressure (DBP) in individuals with -824 CT+TT genotype was significantly higher than that in individuals with -824 CC genotype in the controls (P=0.015). (5) When stratified by gender, significant difference in DBP between TH C-824T CT+TT genotype and CC genotype was observed in the male (P= 0.018) but not in the female (P=0.083) controls. CONCLUSION There is no association between TH gene C-824T polymorphism and EH susceptibility in Hunan Han population. The TH gene C-824T polymorphism is possibly associated with increased DBP in the males in Hunan Han population.
Adult ; Case-Control Studies ; China ; ethnology ; Female ; Genetic Predisposition to Disease ; Genotype ; Humans ; Hypertension ; enzymology ; genetics ; Male ; Middle Aged ; Polymorphism, Genetic ; Sex Factors ; Tyrosine 3-Monooxygenase ; genetics

Objective To investigate the value of contrast-enhanced ultrasound(CEUS)combined with shear wave elastography(SWE)in the diagnosis of liver tumors.Methods This study was conducted according to the PRISMA guideline,with a PROSPERO registration number of CRD42023491288.PubMed,Embase,the Cochrane Library,CNKI,VIP,and Wanfang Data were searched for articles on CEUS combined with SWE in the diagnosis of liver tumors published from January 2000 to October 2023,and a total of 12 articles were included,with 1 328 patients in total.The QUADAS-2 tool was used to assess the quality of the articles included.Stata 15.0 software was used to calculate pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odds ratio,and heterogeneity.The summary receiver operating characteristic(SROC)curve was plotted,and the area under the SROC curve(AUC)was calculated.Results There were 1 457 lesions for the patients included,among whom there were 764 malignant lesions and 693 benign lesions,with a positive rate of 52.44%and a negative rate of 47.56%.Calculations obtained a pooled sensitivity of 0.94(95%confidence interval[CI]:0.91—0.96),a specificity of 0.92(95%CI:0.87—0.95),a positive likelihood ratio of 12.00(95%CI:7.40—19.40),a negative likelihood ratio of 0.06(95%CI:0.04—0.10),and a diagnostic odds ratio of 191(95%CI:87—417).The tests for heterogeneity showed Q=54.78,df=11.00,P<0.001,and I2=79.92%(95%CI:69.18%—90.66%),with an AUC of 0.98.Conclusion CEUS combined with SWE has a relatively high diagnostic value for benign and malignant liver tumors and thus holds promise for clinical application.

OBJECTIVETo evaluate the safety and efficacy of chimeric antigen receptors T cells (CAR-T) in childhood acute B lymphoblastic leukemia (B-ALL).

METHODSA relapsed B-ALL child after allogeneic hematopoietic stem cell transplantation (allo-HSCT) was treated with CAR-T, and the related literatures were reviewed.

RESULTAn 11-year-old girl with TEL-AML1 fusion gene positive BALL who suffered a bone marrow relapse 28 months after remission from conventional chemotherapy. During the second remission, the patient received haploidentical allo-HSCT. She relapsed with detectable TEL-AML1 fusion gene even after chemotherapy and donor leukocyte infusions. She received an experimental donor-derived fourth generation CD19 CAR-T therapy. After infusion of 1 × 10(6)/kg CAR-T cells, she experienced only mild or moderate cytokine-release syndrome and the minimal residual disease turned negative. Then three maintenance of CAR-T cell infusions [(0.83-1.65)×10(6)/kg] was administered, and the disease-free survival had lasted for 10 months. However, the TEL-AML1 copies in her blood still increased and she died with leukemia relapse after additional CAR-T cell infusion.

CONCLUSIONTreatment of relapsed B-ALL with the fourth generation CAR-T cells directed against CD19 was effective and safe. CAR-T therapy is a novel therapeutic approach that could be useful for patients with relapsed and refractory B-ALL who have failed all other treatment options.

Bone Marrow ; Child ; Core Binding Factor Alpha 2 Subunit ; genetics ; Disease-Free Survival ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; Neoplasm, Residual ; Oncogene Proteins, Fusion ; genetics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; genetics ; therapy ; Receptors, Antigen, T-Cell ; genetics ; Recurrence ; Remission Induction ; T-Lymphocytes ; cytology ; Transplantation, Homologous