Objective To investigate the approach and safety of minimally invasive surgical procedures treating symptomatic caliceal diverticular calculi. Methods Clinical data of 21 cases with symptomatic caliceal diverticular calculi were retrospectively reviewed. Twelve females and 9 males aged 22 to 57 years old. The average diameter of caliceal diverticulum was 3.7 cm (2.5-7.0 cm) and average diameter of calculi was 2.3 cm (0.8-3.5 cm). The patients underwent flexible ureteroscopic lithotripsy, PCNL or mPCNL, laparoscopic techniques and laparoscopy-assisted transperitoneal PCNL, respectively. Four cases underwent flexible ureteroscopic lithotripsy. PCNL (2 cases) or mPCNL(5 cases)were performed in 7 cases. Nine cases underwent laparoscopic techniques. Laparoscopyassisted transperitoneal PCNL was performed in 1 case. Results The operations were performed successfully in 21 cases. No case need to transfer to open surgery during the operation and no major complications like perforation or organic injury were noted. One case with iatrogenic arteriovenous fistula of the kidney after 1 week postoperative was cured by delayed hemorrhage 2 days later, while clinical symptoms of 2 cases with residue calculi relieved. 19 cases without residue calculi were followed up for 6 to 12 month without recurrence. Conclusions After handling indication of treatment efficiently and creating advisable therapeutic decision-making, minimally invasive surgical procedures treating symptomatic caliceal diverticular calculi appears to be effective and safe.

Objective:To explore the efficacy and safety of Rasburicase therapy in critically ill children su-ffering from advanced Burkitt′s lymphoma.Methods:A retrospective analysis of children with advanced Burkitt′s lymphoma was admitted to Pediatric Intensive Care Unit, the First Affiliated Hospital of Sun Yat-Sen University, from January 2015 to May 2020 and accepted treatment.According to the uric acid-lowering therapies, patients were divided into 2 groups, namely Rasburicase group (Group R) and traditional treatment group (Group T), to compare the effects of hypouricemic treatment and the prognosis between the 2 groups.Results:Twenty-nine children with advanced Burkitt′s lymphoma were included in this study, with 13 cases (44.83%) of stage Ⅲ and 16 cases (55.17%) of stage Ⅳ.Abdominal mass/ abdominal distension (13 cases, 44.83%) and abdominal pain (7 cases, 24.14%) were the main reasons of initial medical visit attendance.The most common primary tumor site was abdominal/ pelvic cavity (21 cases, 72.41%), followed by head or neck (6 cases, 20.69%). There were 15 cases in Group R and 14 cases in group T. No significant differences in serum creatinine, lactate dehydrogenase and uric acid were detected between the 2 groups (all P>0.05). The proportion of serum uric acid recovery rate of 24 hours and 72 hours after initial treatment in Group R were significantly higher than those in T group (85.71% vs.25.00%, 100.00% vs.25.00%, all P<0.01). Although there were no obvious differences in the incidence of tumor lysis syndrome between the 2 groups (33.33% vs.64.29%, P=0.096), the incidence of acute renal injury, renal replacement therapy requirement, serious complications and the 28 day mortality in Group R were remarkably lower than those in Group T (33.33% vs.85.71%, 13.33% vs.64.29%, 20.00% vs.78.57%, 0 vs.35.71%, all P< 0.05). Conclusions:Rasburicase can effectively reduce the serum uric acid level and decrease the incidence of acute kidney injury and other severe complications, thus improving the prognosis of children experiencing advanced Burkitt′s lymphoma.

Objective To evaluate the effect of transurethral feedback microwave thermotherapy with the ProstaLund CoreTherm Device(PLFT) in high risk patients with benign prostate hyperplasia (BPH). Methods Sixty-six high risk patients diagnosed with BPH, including aged ≥80 in 32 pa-tients, hypertension in 31 patients, diabetes in 5 patients, heart failure in 8 patients, chronic obstruc-tive pulmonary disease in 8 patients, cerebral infarction in 11 patients, fracture, amputation or joint stiffness unsuitable for lithotomy position in 3 patients, abnormal blood coagulation in 4 patients, pan-creatitis in 2 patients, cardiac arrhythmia in 6 patients and malignant tumor in 3 patients, were treated with PLFT using individual power at urethral local anesthesia, resulting in coagulation necrosis in 15%-30% of prostate tissue around urethra. Meanwhile, real-time monitoring the temperature of prostate and the tissue around it was used. All patients were evaluated by comparing volume of pros-tate, maximal urinary flow (Q_max), international prostate symptom score (IPSS) and quality of life questionnaire (QOL) in pre-treatment and three months after respectively. Results All of patients well tolerated PLFT. There was bleeding lightly, infection lightly and temporary incontinence. There was no severe surgical complication. After three months, the volume of prostate reduced from 62. 2 ml to 44.5 ml; IPSS decreased from 23. 4 to 11.7; QOL decreased from 4.5 to 2.4; Q_max rised from 4, 2 ml/s to 11.2 ml/s. All differences reached significance. Conclusion PLFT is one of effective and safe treatments for patients with BPH especial BPH complicating with severe conditions.

Objective To evaluate the effect of transurethral feedback microwave thermotherapy with the ProstaLund CoreTherm Device (PLFT) in benign prostate hyperplasia ( BPH ) patients with high risk factors 24 months after treatment.MethodsSixty-two BPH cases with high risk factors of aged ≥ 80or complicating severe conditions of no less than one organ or system,were treated with PLFT under urethral local anesthesia.The average pre-treatment prostate volume,international prostate symptom score (IPSS),quality of life score (QOL) and maximal urinary flow (Qmax) were 62.03 ml,23.19,4.58 and 4.33 ml/s,respectively.The changes of prostate volume,IPSS,QOL and Qmax at 3 months,12 months and 24 months after treatment were analyzed.ResultsAll patients tolerated well of PLFT performed in common therapy room except lightly bleeding,minor infection and temporary incontinence.There was no severe surgical adverse event.After 3 months,the prostate volume reduced to 43.85 ml,IPSS decreased to 11.63,QOL decreased to 2.44,Qmax rose up to 11.44 ml/s； The average values were 45.10 ml,12.23,2.61 and 10.91ml/s at 12 months after treatment.The corresponding values were 45.80 ml,12.37,2.66 and 10.82 ml/s,respectively at 24 months after treatment.Compared with pre-treatment,all the parameters showed significant improvement ( P ＜ 0.01 ).ConclusionsPLFT is one of the effective and safe treatment options for BPH patients with high risk factors.It can be safely used on day-surgery patients.The best effect appears at 3 months after treatment.

Objective To investigate the effects of in situ venous arterialization on extensive artery obliterans occlusion of the lower extremity. Methods Lumbar sympathetic ganglionectomy and one stage in situ arterialization of the great saphemous vein were performed in 104 ischemic limbs of 88 patients with extensive arterial occlusion. Results Eighty-two of 104 limbs were followed-up from 6 months to over 6 years. The intermittent claudication, night pain improved in all cases, with satisfactory wound healing and no swelling of the lower limbs. Conclusions Arterial blood flow through venous conduit improves and reconstructs the blood circulation of the ischemic limbs.

A model for screening the yeast which can ferment xylose to produce the ethanol was constructed.An ethanol yeast was obtained using the lignocellulose as substrate production the ethanol.By malt extract medium pre-culturing,soil samples use the plate with xylose as sole carbon source as the primary screening,then finally screen by the potassium dichromate color-displaying method.A strain named Y2-3 was screened from the soil.Phenotypic analysis including morphology and physiology and biochemical characteristics and 26D1/D2 sequence analysis were carried out.Based on taxonomy results,the Y2-3 was identified as Pichia caribbica.The strain Y2-3 ferments using xylose as sole carbon source: biomass 23.5 g/L,xylose utilization rate 94.7 %,ethanol final yield 4.57 g/L;using mixture sugar:biomass 28.6 g/L,xylose utilization rate 94.2 %,glucose utilization rate 95.6%,ethanol final yield 20.6 g/L.Pichia caribbica is a yeast which can utilize xylose and mixture sugar as substrate.It established the foundation for further research fermentation of ethanol by yeast using lignocellulose.

OBJECTIVETo study the effect of behavioral training on the learning and memory abilities and changes of NR2B and GluR1 expressions in the hippocampus of offspring rats with fetal growth retardation (FGR).

METHODSA FGR model was established in SD rats by passive smoking. The offspring rats were divided into FGR group and control group, each then randomized into training and untrained group. Morris water maze behavioral training was carried out in postnatal months 2 and 4, and the learning and memory abilities of the young rats were assessed using dark-avoidance test and step-down test. NR2B and GluR1 expression in the hippocampus of the rats were detected by immunohistochemistry.

RESULTSIn the dark-avoidance and step-down tests, the FGR rats showed deteriorated learning and memory performance in comparison with the control group, but behavioral training resulted in improved performance of the rats. The performance in FGR group was much improved after behavioral training, and the model factor and the training factor showed a significant interaction (P<0.05). The expression of NR2B and GluR1 in CA1 and CA3 regions of the hippocampus decreased in FGR group, then the their expressions in the CA1 region increased after training in both FGR and control groups, and the increment was especially obvious in GluR1 expression in the CA1 region at postnatal month 2. The two factors showed a significant interaction (P<0.05).

CONCLUSIONBehavioral training can improve the learning and memory abilities of FGR offspring rats, the mechanism of which is probably related to increased expression of NR2B and GluR1 in the CA1 region of the hippocampus.

Animals ; Animals, Newborn ; Avoidance Learning ; Behavior, Animal ; Female ; Fetal Growth Retardation ; chemically induced ; physiopathology ; Hippocampus ; metabolism ; Male ; Memory ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Receptors, AMPA ; genetics ; metabolism ; Receptors, N-Methyl-D-Aspartate ; genetics ; metabolism ; Tobacco Smoke Pollution

Objective:To investigate the expression differences of miR-200c, miR-19a and miR-155 in gefitinib sensitive and resistant non-small cell lung cancer (NSCLC) patients, and to analyze the effects of miR-200c, miR-19a and miR-155 expression differences on the prognosis of patients.Methods:From August 1, 2015 to August 1, 2019, 80 patients with stage Ⅲ-Ⅳ NSCLC who were treated with gefitinib in the Fourth Affiliated Hospital of Nanjing Medical University were selected as the research objects. Among them, 36 cases were sensitive to gefitinib as the sensitive group, and 44 cases were resistant to gefitinib as the drug-resistant group. The general data, serum levels of miR-200c, miR-19a and miR-155 were compared between the two groups, and the sensitive factors of gefitinib in NSCLC patients and the correlations between serum miR-200c, miR-19a, miR-155 and clinicopathological characteristics of NSCLC patients were explored. The survival of the patients was analyzed.Results:Compared with the drug-resistant group, the number of smoking cases in the sensitive group was less ( χ2=5.541, P=0.019), the number of clinical stage Ⅲ cases was more ( χ2=8.984, P=0.003), the number of well-differentiated cases was more ( χ2=8.673, P=0.003), the number of patients with lymph node metastasis was less ( χ2=6.082, P=0.014), and the levels of serum miR-200c, miR-19a and miR-155 were higher ( t=7.249, P<0.001; t=8.222, P<0.001; t=10.467, P<0.001). Multivariate logistic regression analysis showed that smoking ( OR=0.355, 95% CI: 0.149-0.845, P<0.001), clinical stage ( OR=0.494, 95% CI: 0.274-0.892, P=0.021), degree of differentiation ( OR=6.062, 95% CI: 3.258-11.279, P=0.013), lymph node metastasis ( OR=0.422, 95% CI: 0.245-0.726, P=0.019), the levels of serum miR-200c ( OR=5.521, 95% CI: 3.126-9.752, P<0.001), miR-19a ( OR=5.384, 95% CI: 2.947-9.836, P<0.001) and miR-155 ( OR=5.325, 95% CI: 3.058-9.274, P<0.001) were all influencing factors of gefitinib sensitivity in NSCLC patients. The levels of serum miR-200c, miR-19a and miR-155 were significantly correlated with clinical stage ( t=3.230, P=0.002, r=-0.578; t=3.188, P=0.002, r=-0.612; t=3.123, P=0.003, r=-0.594), degree of differentiation ( t=2.586, P=0.012, r=0.610; t=4.009, P<0.001, r=0.632; t=4.773, P<0.001, r=0.594) and lymph node metastasis ( t=2.902, P=0.005, r=-0.587; t=3.721, P<0.001, r=-0.629; t=3.391, P=0.001, r=-0.614) of NSCLC patients. Compared with the patients with low levels of serum miR-200c, miR-19a and miR-155, the 1-year survival rates of the patients with high levels of serum miR-200c (63.19% vs. 4.37%, χ2=32.562, P<0.001), miR-19a (61.01% vs. 4.75%, χ2=37.807, P<0.001) and miR-155 (57.82% vs. 0, χ2=44.454, P<0.001) were higher, with statistically significant differences. Conclusion:The levels of serum miR-200c, miR-19a and miR-155 are significantly increased in gefitinib-sensitive NSCLC patients, which are important influencing factors of gefitinib sensitivity, and are closely related to clinicopathological characteristics such as clinical stage, differentiation degree and lymph node metastasis of NSCLC patients, and the prognosis is better in patients with high serum levels.

Objective To study the effects of Yiqi Huayu Jiedu Prescription on the migration ability of MHCC97-H and the expressions of CXCL12, CXCR4 and CXCR7; To discuss its relevant mechanism of action. Methods Setting Sorafenib as a positive control, CCK-8 method was used for determining the effects of Yiqi Huayu Jiedu Prescription on the cell proliferation of MHCC97-H and the optimum concentration. Scratch assay was used to observe the migration ability of MHCC97-H. The protein expressions of CXCL12, CXCR4 and CXCR7 were detected by Western blot after 24 h of medicine intervention. Results Yiqi Huayu Jiedu Prescription and Sorafenib can inhibit the cell proliferation of MHCC97-H , and the inhibitory concentration was 0.095 g/mL and 10 μmol/mL at 24 hours. Yiqi Huayu Jiedu Prescription can inhibit migration ability of MHCC97-H. The protein expressions of CXCL12, CXCR4 and CXCR7 in hepatocellular carcinoma cells decreased after the action of Yiqi Huayu Jiedu Prescription. Conclusion Yiqi Huayu Jiedu Prescription can inhibit MHCC97-H cell proliferation and migration, which may be realized by down-regulating chemokine axis of CXCL12/CXCR4/CXCR7.

Objective To explore how to achieve isolation of clinical trial fees and general medical expenses of hospitalized subjects through information technology.Methods This article analyzed various methods for separating clinical trials fees from medical insurance and suggested that all methods need to protect subjects'medical insurance reimbursement rights and ensure that they do not occupy medical insurance funds.Based on this principle,A clinical trial cost segregation information module was developed based on inpatient's workstation.Results Through this information module,subjects could choose their medical status according to the actual medical situation.Doctors could issue medical orders in hospital information system(HIS)according to normal medical or trail needs,change the nature of the orders by adding or deleting clinical trial tags.The system automatically intercepts the clinical trial orders for reimbursement of medical insurance,while other expenses are reimbursed according to rules of medical insurance.Conclusion The application of this information module has improved the subjects'enthusiasm and compliance to participate in clinical trials,reduced their economic burden,and ensured their rights to enjoy reimbursement of medical insurance,which can be used as a reference example for newly registered clinical trial institution.