Objective To investigate the long-term therapeutic effectiveness of transplantation of adrenals for the treatment of Addison's disease in the past 15 years. Methods Nine cases subject to adrenal transplantation were followed up for a long-term and the outcome after 15 years was evaluated. Results Seven cases of graft adrenal survived. In 6 patients, urine 17-OHCS, urine 17-KS and serum cortisol were normal. The remaining two grafts out of the 9 cases didn't survive and they had abnormal levels of urine 17-OHCS, urine 17-KS and serum cortisol. Conclusion The transplantation of adrenals for the treatment of Addison's disease had a good long-term effectiveness.

Objective To discuss the prognostic value of aspartate aminotransferase (AST) to neutrophils ratio index (ANRI) in patients with hepatocellular carcinoma (HCC) after receiving transarterial chemoembolization (TACE).Methods The clinical data of 107 HCC patients,who were admitted to authors' hospital to receive treatment during the period from January 2008 to June 2011,were retrospectively analyzed.TACE was successfully performed in all patients.Based on the 5-year overall survival rate,ROC curve was drawn and the cutoff value was determined.Preoperative ANRI,AST-lymphocytes ratio index (ALRI),AST-platelet count ratio index (APRI),neutrophil-lymphocytes ratio index (NLR),platelet count-lymphocytes ratio index (PLR) and other clinical pathological parameters were calculated.Univariate analysis,multivariate Logisitc regression analysis and Kaplan-Meier survival analysis were used to assess the value of the above indexes in prejudging the disease-free survival (DFS) and overall survival (OS).Results ANRI bore a close relationship to the presence of HBsAg,AST,presence of cirrhosis,tumor size,portal vein tumor thrombus (PVTT) and recurrence of tumor (P＜0.05).Univariate analysis showed that ANRI,ALRI,APRI,NLR and PLR were significantly correlated with DFS and OS in HCC patients after receiving TACE (P＜0.05).Logisitc regression analysis revealed that ANRI was independent factor influencing DFS and OS (P＜0.05).Kaplan-Meier survival analysis indicated that the prognosis after TACE was poor in patients whose preoperative ANRI ＞7.8.Conclusion Preoperative ANRI level is an independent and effective predictor for judging the prognosis of HCC patients.A high preoperative ANRI level usually suggests a poor prognosis after TACE.

Objective To explore the influence of WeChat platform rehabilitation guidance mode on refracture of osteoporotic fracture patients.Methods Totally 100 osteoporotic fracture patients admitted to the Department of Orthopedics of the hospital from 2018 to 2019 were selected and randomly divided into control group and experimental group with 50 patients in each group.The control group adopted the conventional discharge rehabilitation guidance mode,and the experimental group implemented WeChat platform rehabilitation guidance mode on this basis,including WeChat platform construction and detailed intervention mode.The changes of bone mineral density and the recurrence rate of osteoporotic fracture were compared between the two groups at admission and after 3 years of follow-up.Results There were 7 cases of lost follow-up in the experimental group,and there were 6 cases of lost follow-up in the control group.After 3 years,the bone mineral density of the experimental group was significantly higher than that of the control group,and the recurrence fracture rate was significantly lower than that of the control group(P<0.05).Conclusion The application of WeChat platform rehabilitation guidance mode can effectively improve bone density and reduce the incidence of refracture in osteoporotic fracture patients.

Objective:To evaluate the clinical value of nanopore targeted sequencing (NTS) in pathogens detection in urinary tract by comparing the results of different tests performed on the same urine sample.Methods:The results of NTS and urine culture test collected from 326 patients in the Department of Urology of People's Hospital of Wuhan University from July 2020 to June 2021 were retrospectively analyzed. There were 224 males and 102 females. The average age was (56.88 ± 14.58)years old. χ 2 test and Student’s test and Wilcoxon's sign rank test were used to analyze the differences of the pathogen detection rate, pathogen types results and detection time consuming between NTS and urine culture. The clinical value of the NTS in rapid detection of urinary pathogens was evaluated. Results:Among 326 hospitalized patients, the urinary tract microbes’ detecting rate of NTS was significantly higher than that of urine culture[67.80%(221/326)vs. 23.93%(78/326), χ2=130.25, P<0.01]. The uropathogens detecting rate of NTS was significantly higher than that of urine culture[54.29%(177/326)vs. 23.31%(76/326), χ2=38.95, P<0.01]. The number of urinary tract microbes detected by NTS was significantly higher than that of urine culture ( Z=11.49, P<0.01), the number of uropathogens was significantly higher than that of urine culture ( Z=9.67, P<0.01). The detection time of NTS and urine culture positive samples was (24.29±2.65) h and (49.28±11.30) h, the difference was statistically significant ( t =39.48, P<0.01). The results obtained by using NTS and urine culture were consistent in 135 (41.41%) samples. In 150 (46.01%) samples, NTS could detect the urinary tract microbes while urine culture cannot find, of which 112 cases (34.36%) were uropathogenic. In 27 cases (8.28%), more pathogens were detected by NTS except those from urine culture. In 6 cases (1.84%) re-detecting NTS after antibiotic therapy, the number of reads of primary uropathogen decreased gradually with the growth of colonizing bacteria or opportunistic pathogens appeared in the end. Re-examinations of urine culture could verify the results of NTS detection on admission in 5 cases (1.53%). NTS in 2 cases (0.61%) could cover the uropathogens of subsequent several urine cultures. Conclusions:NTS has the advantages of rapid, sensitive and comprehensive detection of urinary tract infection pathogens. When urine culture is not yet reported or even negative, NTS already has a certain clinical reference value and can be used as an effective supplement to urine culture, which is conducive to the comprehensive judgment of the patient's condition.

Objective:To explore the immune and angiogenesis-related genes in aortic valve stenosis(AS)and potential therapeutic targets, based on bioinformatics and machine learning analysis.Methods:AS data sets from the Gene Expression Omnibus(GEO), immune-related genes from the ImmPort database, and angiogenesis-related genes from the Genecards database and MsigDB were downloaded and combined to determine differentially expressed immune and angiogenesis-related genes(DEGs).Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)functional enrichment analyses were performed.Protein-protein interaction(PPI)was analyzed by using STRING database.The key biomarkers were identified by two machine learning methods including Least Absolute Shrinkage Selection Operator(LASSO)and Support Vector Machine Recursive Feature Elimination(SVM-RFE), validated in training data set and verification data set by receiver operating characteristic curve(ROC), and analyzed by Gene Set Enrichment Analysis(GSEA).The subtypes of immune infiltrating cells were analyzed by CIBERSORT.Based on starBase, miRDB, miRWalk and hTFtarget databases, the mRNA-miRNA-TF was constructed.Finally, Potential therapeutic targets and drugs were analyzed through the CTD database.Results:A total of 90 DEGs related to AS, immune, and angiogenesis were obtained.Enrichment analysis found that DEIRGs were mainly related to immune regulation and cell cycle regulation, such as "leukocyte migration" , "cell chemotaxis" and "cytokine-cytokine receptor interaction" .84 related proteins and 548 interactions were obtained by PPI analysis.Two key biomarkers SecretograninⅡ(SCG2)and Tenascin-C(TNC)were identified by machine learning, which showed high diagnostic value for AS by ROC.SCG2 and TNC are mainly involved in the immune regulation by Enrichment analysis.The infiltration level of macrophage M0 in AS group was significantly higher than that in control group by CIBERSORT analysis.The correlation between macrophage M0 and macrophage M2 and SCG2 was the highest.879 mRNA-miRNA-TF, 253 potential therapeutic agents and 299 relationships were obtained.Conclusions:The key biomarkers, immune characteristics and potential therapeutic targets obtained from the research play a vital role in exploring the pathophysiological progress and new therapeutic strategies of AS.

Objective:To investigate the availability and safety of a domestic disposable digital flexible cystoscope compared with a reusable Olympus digital flexible cystoscope in cystoscopy and removal of double J stent.Methods:From August 2018 to March 2019, patients were enrolled in this prospective, open, multicenter, randomized, parallel positive controlled clinical trial study, which were from department of Urology in Renmin Hospital of Wuhan University, the First Affiliated Hospital of Xiamen University and the First Affiliated Hospital of Guangzhou Medical University. The experimental group and control group were assigned into a 1∶1 ratio by random table method. Inclusion criteria included age≥18 years and have indications for cystoscopy or removal of double J stent. Exclusion criteria included patients having acute genitourinary tract infection, having tuberculous bladder contracture, bladder capacity less than 50ml, having urethrostenosis, female menstrual period, pregnancy and lactation, having difficulty for lithotomy position, having serious cardio-cerebrovascular disease and liver or kidney dysfunction. A domestic disposable digital flexible cystoscope was adopted in the experimental group, whereas a reusable Olympus digital flexible cystoscope was used in the control group. Acceptability of image was defined as primary availability indicator, while success rate of working and performance score were defined as secondary availability indicators and mean operating time was calculated for cystoscopy only and cystoscopy plus removal of double J stent respectively, yet rate of adverse event as well as rate of equipment defects were sorted as safety indicators.Results:A total of 188 cases which were listed in per protocol set completed the clinical trial study successfully. There were 95 cases in the experimental group and 93 cases in the control group. Acceptability of image was 93.68%(89/95) and 96.77%(90/93) respectively in two groups( P=0.52). Success rate of working was 100.00%(95/95) and 98.92%(92/93) respectively in two groups ( P=0.49). Performance score was 14.41±0.93 and 14.56±0.84 respectively in two groups ( P=0.23). Mean operating time (MOT) only for cystoscopy was (15.3±2.6) min and (15.4±3.3)min respectively in two groups ( P=0.93), while MOT for cystoscopy plus removal of double J stent was (21.0±3.2) min and (21.7±3.9) min respectively in two groups ( P=0.69). Rate of adverse event was 8.42%(8/95) and 9.68%(9/93) respectively in two groups( P=0.76). There was no equipment defects in both groups. Conclusions:There is no statistical difference in acceptability of image, success rate of working, performance score, mean operating time for cystoscopy or removal of double J stent, rate of adverse events and rate of equipment defects. A domestic disposable digital flexible cystoscope has shown non-inferiority in the availability and safety compared with a reusable Olympus digital flexible cystoscope.

Since the outbreak of corona virus disease 2019(COVID 19), the epidemic has spread rapidly, which brings great challenge to the surgical diagnosis, treatment and management of lung neoplasm Sichuan International Medical Exchange &Promotion Association organized thoracic surgery experts to sum up experiences from experts in major hospital, and formulated the Guidance suggestion on surgical diagnosis, treatment and management of lung neoplasm during the outbreak of COVID-19 to provide references for thoracic surgeons.

AIM: To investigate the effect of tetramethylpyrazine (TMP) on doxorubicin (Dox) induced cardiotoxicity and the role of 14-3-3γ/Bcl-2 protein expression. METHODS: Primary cultured cardiomyocytes were randomly divided into Control group, Dox group, Dox+TMP group and Dox+TMP+pAD/14-3-3γ-shRNA group. After 48 hours, the cell viability was detected by MST, the activity of LDH in culture medium, the activities of Caspase-3, SOD, GSH-Px and the content of MDA were detected; the expression of 14-3-3γ and mitochondrial Bcl-2 was detected by Western blot; ROS generation, mitochondrial membrane potential and mPTP opening were detected by flow cytometry; apoptosis was detected by TUNEL method. RESULTS: After Dox exposed for 48 hours, the viability of cardiomyocytes decreased significantly, the activity of LDH in culture medium increased, the activities of SOD and GSH-Px decreased, the content of MDA increased, ROS generation increased; the mitochondrial membrane potential decreased, mPTP continued to open, caspase-3 activity and apoptosis increased. TMP pretreatment significantly upregulated the expression of 14-3-3γ and mitochondrial Bcl-2, and reversed the above changes simultaneously; pAD/14-3-3γ-shRNA not only downregulated the expression of 14-3-3γ, but also decreased the expression of Bcl-2 in mitochondria. CONCLUSION: TMP pretreatment upregulates the expression of 14-3-3γ and mitochondrial Bcl-2, inhibits oxidative stress, maintains mitochondrial function and reduces Dox induced apoptosis.