[Objective] To compare the clinical efficacy and safety of flexible ureteroscope lithotripsy (FURL) combined with flexible vacuum-assisted urethral access sheath (FV-UAS) and traditional UAS in the treatment of 1-2 cm lower renal calyceal stones, so as to provide reference for clinical practice. [Methods] Clinical data of 157 patients with 1-2 cm lower renal calyceal stones treated with FURL during Mar.2021 and Oct.2023 were retrospectively analyzed, including 80 treated with traditional UAS, and 77 with FV-UAS.General and clinical information of the two groups were compared. [Results] The immediate stone-free rate (SFR) (84.4% vs.67.5%, P=0.013) and final SFR (88.3% vs. 75.0%, P=0.032) of the FV-UAS group were significantly higher than those of the traditional UAS group, with significant difference.The incidence of postoperative complications such as fever, renal colic, and perirenal hematoma was significantly higher in the traditional UAS group than in the FV-UAS group (15.0% vs.5.2%, P=0.042). After treatment with anti-infective and analgesic drugs, both groups were improved, and no severe sepsis or septic shock occurred after surgery.The hospitalization expenses of the FV-UAS group were significantly lower than those of the traditional UAS group [ (18 341±1519)yuan vs.(19 152±1826)yuan, P=0.003]. [Conclusion] Compared to the traditional UAS, the combination of FURL and FV-UAS for the 1-2 cm lower renal calyceal stones has a high SFR and low incidence of complications.Patients experience less pain, recover faster and spend less.It's a new treatment option for inferior calyceal calculi.

[Objective] To explore the efficacy of disposable flexible ureteroscopic lithotripsy (FURL) with flexible vacuum-assisted ureteral access sheath (FV-UAS) in the treatment of 2-3 cm upper urinary tract stones, so as to provide reference for the treatment selection. [Methods] Clinical data of 178 patients with upper urinary tract stones who received FURL or minimally invasive percutaneous nephrolithotomy (MPCNL) at our hospital during Apr. 2022 and Oct. 2023 were retrospectively analyzed. The patients were divided into FV-UAS group (n=90, received FV-UAS combined with diaposable FURL treatment) and MPCNL group (n=88, received MPCNL). The general information, perioperative data, and postoperative stone-free rate (SFR) of the two groups were compared. [Results] All operations were successfully completed. The operation time was significantly longer in the FV-UAS group than in the MPCNL group [(66.5±6.7) min vs. (63.9±7.4) min, P=0.015]. However, the intraoperative hemoglobin reduction [(7.3±3.1)g/L vs.(11.4±5.9)g/L], postoperative hospital stay (P<0.001) [(2.2±0.7)d vs.(5.4±1.3)d], and visual analogue score (VAS) [(2.7±0.9)vs.(5.6±1.1)] were significantly lower in the FV-UAS group than in the MPCNL group (P<0.001). The incidence of persistent gross hematuria was significantly higher in the MPCNL group than in the FV-UAS group (12.5% vs. 3.3%, P=0.023). The FV-UAS group had a similar postoperative immediate (83.3%) and final SFR (95.6%) to those of the MPCNL group (89.8%, 96.6%, P>0.05). [Conclusion] The combination of FURL with FV-UAS for 2-3 cm upper urinary tract stones has a higher SFR and a lower complication rate.Patients experience endurable pain and fast recovery, which is worth promoting and applying in clinical practice.

【Objective】 To explore the application value of scrotoscopy in the treatment of testicular hydrocele. 【Methods】 The clinical data of 27 patients with testicular hydrocele who were successfully treated with minimal hydrocelectomy with the aid of scrotoscope (MHS group) and 32 patients with traditional open surgery (TH group) during Dec.2017 and Dec.2021 were retrospectively analyzed and compared. 【Results】 Compared with TH group, the MHS group needed shorter average operation time [(32.22±5.25) min vs.(57.34±8.71) min, P<0.01], shorter incision length [(0.95±0.15) cm vs.(5.09±0.55) cm, P<0.01], shorter hospital stay [(3.63±0.97) d vs.(4.72±0.89) d,P<0.01] and lower postoperative incision visual analogue scale (VAS) (P<0.01), and milder degree of edema on the 3rd and 7th day after operation (P<0.05), but higher recurrence rate (14.81% vs.3.13%, P=0.256) 24 weeks after operation. 【Conclusion】 Scrotoscopy is safe in the treatment of testicular hydrocele, which has the advantages of short operation time, small incision, mild postoperative incision pain, mild scrotal edema and short hospital stay, but the recurrence rate tends to be higher than that of traditional open surgery.

Objective: To observe the clinical effect of massage combined with warm acupuncture and moxibustion on primary frozen shoulder. Methods: From April 2018 to April 2019, 30 patients with primary frozen shoulder admitted and treated in Wenzhou Hospital of Traditional Chinese Medicine were selected in theresearch.According to different admission time, they were divided into observation group and control group, with 15 patients in each group.The control group was treated with warm acupuncture and moxibustion, while the observation group was combined with massage.The total effective rate and VAS pain score after treatment were compared and observed. Results: The total effective rate in the observation group was 93.33%, which was higher than 73.33% in the control group (χ²=3.294, P<0.05). The VAS score of the observation group was (1.05±0.22)points after treatment, which was lower than (3.13±0.43)points of the control group, the difference between the two groups was statistically significant(t=2.493, P=0.000). Conclusion Massage combined with warm acupuncture and moxibustion in the treatment of primary frozen shoulder is more effective than the single treatment method, which can relieve the pain of patients and is a safe and effective treatment.

Objective: To investigate blood pressure and vascular remodeling of OSAS by establishing the chronic-intermittent hypoxia model in rat. Methods: Experiments were performed on 35 adult male Sprague-Dawley rats. Animals were randomly divided into four groups: unhandled control group (with 5 rats in it), CIH group at 9/6/3 weeks (with 10 ratsin each group). Rats in CIH group went through 8-hour intermittent hypoxia everyday, and those in control group were raising normally. After 9-week experiment, blood pressure was measured. The changes of the following indexes were observed: pathological changes of aorta and the middle aorta thickness (HE staining), the collagen of aorta wall (Masson staining). The experimental data were analyzed by SPSS 24.0 statistical software. The variance was analyzed by one-way analysis of variance, and the irregularity was selected using the calibration t test. Results: The systolic and diastolic blood pressures of the CIH9, 6, and 3 weeks groups and the control group were: (127±13) and (79±9), (124±11) and (81±7), (101±11) and (75±9), (91±10) and (65±9) mmHg (1 mmHg=0.133 kPa). The systolic blood pressure and diastolic blood pressure of the rats in the week of CIH 9 and 6 weeks were significantly higher than the control group (F=14.64, P=0.000; F=6.81, P=0.000). There was no significant difference in the mean blood pressure between the three groups of CIH and the control group. Membrane thickness in CIH9, 6 and 3 weeks and control group were: (20±2), (19±2), (14±2), (13±3) μm. Compared with the control group, the aortic pathology and thickness of the middle layer of the CIH9 and 6 weeks group were significantly thicker (F=20.24, P=0.000), but there was no significant difference between the CIH3 week group and the control group; the collagen deposition was unchanged compared with the control group. Conclusion Intermittent hypoxia for 6 weeks or more in rats resulted in the increasement of blood pressure, morphological changes of aorta and vascular remodeling in thickened media.

Objective To evaluate the efficacy of lumbar discectomy,radiofrequency ablation and annuloplusty performed with Disc-FX system under the guidance of C-arm in treatment of discogenic low back pain.Methods Twenty-eight patients with discogenic low back pain,with VAS score greater than 7,aged 27-73 yr,underwent lumbar discectomy,radiofrequency ablation and annuloplusty performed using Disc-FX system under the guidance of C-arm.The patients were followed up for 2 months after surgery and pain was assessed using VAS score.VAS scores were recorded before surgery,and at 7 and 14 days and 1 and 2 months after surgery.The effective analgesia was recorded according to VAS scores.The therapeutic effect was evaluated according to Macnab standard 2 months after surgery.Results VAS scores were significantly lower at each time point after surgery than before surgery (P ＜ 0.05).The rate of effective analgesia was 93 % at 2 months after surgery.The excellent and good rate of the therapeutic effect evaluated was 93 %.One female patient developed injury to lumbar venous plexus,and no patients developed infection of intervertebral disk,nerve root injury or spinal cord injury.Conclusion The excellent and good rate is 93 % when lumbar discectomy,radiofrequency ablation and annuloplusty performed using Disc-FX system is used for treatment of discogenic low back pain under the guidance of C-arm,with fewer side effects.

OBJECTIVE: To study the correlation of CD44 with epithelial-mesenchymal transition(EMT) and metastasis in nasopharyngeal cancer cells, and explore the possible mechanism of CD44 regulates EMT and metastasis in nasopharyngeal cancer cells. METHOD: The CD44 and EMT-associated proteins in 5-8F and 6-10B nasopharyngeal cancer cell lines were assayed by Western blotting. The erasion trace test was performed to observe the migratory ability of 5-8F and 6-10B nasopharyngeal cancer cells. Using lipid-mediated DNA transfection technique, the low metastatic nasopharyngeal cancer cells 6-10B were transfected in vitro with plasmid which contained CD44 gene, and then new nasopharyngeal cancer cells were obtained. The CD44 and EMT-associated proteins in 6-10B, empty vector transfected and CD44-transfected cells were assayed by Western blotting. The erasion trace test was performed to observe the alteration of migratory ability of nasopharyngeal cancer cells before and after CD44 transfection. RESULT: The expression of CD44 and EMT-associated protein MMP-9 in 5-8F was higher than that in 6-10B, but EMT-associated protein E-Cadherin in 5-8F was lower than that in 6-10B. The migratory ability of 5-8F was higher than that of 6-10B. The expression of CD44 and MMP-9 were significantly higher in the CD44-transfected nasopharyngeal cancer cells than in the control groups. Compared with control groups, the migratory ability of CD44-transfected nasopharyngeal cancer cells was significantly increased. CONCLUSION CD44 positively regulates the metastatic ability of nasopharyngeal cancer cells, which is relevant to the process of EMT.
Carcinoma ; Cell Line, Tumor ; Epithelial-Mesenchymal Transition ; Humans ; Hyaluronan Receptors ; genetics ; metabolism ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; metabolism ; pathology ; Neoplasm Metastasis ; Transfection

ObjectiveTo investigate the effect of combined therapy with external use of wishful golden cream and oral use of glucosamine hydrochloride on knee osteoarthritis.Methods200 patients with knee osteoarthritis were divided into treatment group and control group according to the order of treatment.Control group were given one piece of oral glucosamine at a time,three times a day.It consisted of six weeks treatment for lcowrse,two courses per year.Treatment group were given oral glucosamine plus external usage of wishful golden cream every other day with a new one.It consisted of 14 days for a course,two courses per year.ResultsAll patients were followed up for 1year.The efficien rate of the treatment group was 85.0％,and significantly higher than than of the control group (73.0％) ( x2 =4.34,P ＜ 0.05 ).ConclusionCombined therapy with wishful golden cream and oral usage of glucosamine hydrochloride on knee osteoarthritis could significantly improve the clinical symptoms.It was more effective than oral treatment with glucosamine hydrochloride alone and it had great clinical value.

OBJECTIVE: To identify the genetic characteristics in patients with nonsydromic hearing loss (NSHL) in Hunan province, to determine the prevalence and spectrum of mutations in GJB2 gene, and to explore the pathogenic mechanism. METHODS: A total of 140 sporadic patients with NSHL were enrolled after clinical examination. Molecular studies were performed by amplifing the coding region of GJB2 gene, purifying the PCR products, and sequencing directly. Sequences were analysed by DNAStar software to determine GJB2 mutations in the patients. Special method was designed to confirm the unreported mutation. RESULTS: We detected GJB2 mutation in 56 out of the 140 patients (40%, 56/140). Both of the 2 alleles were mutated in 29 patients and 1 allele in the other 27 patients, and the rate of allele mutation was 30.4%(85/280). Ten variations were detected, including 7 mutations and 3 polymorphisms. The deaf-causing mutations were nonsense mutation c.139G>T; frameshift mutation c.235delC and c.176-191del16; and missense mutation c.109G>A, c.344T>G, c.550C>T and c.571T>C. The unreported missense mutation was c.344T>G. The c.235delC mutation was the most prevalent mutation found in the 27 patients (19.3%, 27/140). The frequency of c.109G>A mutation was next to c.235delC found in 25 patients (17.9%, 25/140). CONCLUSION GJB2 mutation is a major cause for NSHL. The most common-spot in Chinese patients with NSHL is c.235delC. The unreported missense mutation is c.344T>G.
Base Sequence ; China ; Connexin 26 ; Connexins ; genetics ; DNA Mutational Analysis ; Gene Deletion ; Hearing Loss ; genetics ; Humans ; Molecular Sequence Data ; Mutation, Missense ; Point Mutation ; genetics