Objective To systematically review the efficacy and safety of mini-percutaneous nephrolithotomy (MPCNL) and flexible ureteroscopic lithotripsy (FURL) in management of lower pole kidney stones.Methods PubMed, Embase, Scopus, Cochrane library, CNKI, VIP and Wanfang Data were searched from the beginning of database to September 2016 and clinical trials that compared the two above operation for treatment of lower pole stones were collected.Two researchers independently filtered literature,extracted data and evaluated the methodological quality of research papers.The meta-analysis was performed using the RevMan 5.3 software.Results One randomized and seven non-randomized studies were analyzed, which consists of 621 patients including MPCNL group 327 cases, FURL group 294 cases.The results of meta-analysis showed that MPCNL was better than FURL in stones clearance (OR =2.65,95％ CI 1.58-4.46,P ＜ 0.01) and operative time (WMD =-21.86,95％ CI-28.52--15.20, P ＜ 0.01).FURL was better in hospital stay time (WMD =2.28,95％ CI 0.29-4.28, P =0.02), decrease in haemoglobin levels (WMD =0.78,95 ％ CI 0.68-0.89, P ＜ 0.01), bleeding (OR =5.11,95 ％ CI 1.12-23.31,P =0.04), transfusion(OR =7.04,95％ CI 1.59-31.15, P =0.01).There was no significant difference in fever,urinary tract infection, hematuria (P ＞ 0.05).Conclusions Both MPCN and FURL are safe and effective for the treatment of lower pole stones, MPCNL can get higher stone clearance rates and shorter operation time.However, FURL can get shorter hospitalization time and lower complication rates.

Objective To investigate the value of tracing thyroglobulin(Tg)in predicting metastasis of post-operative patients with differentiated thyroid carcinoma(DTC)before its first pre-ablation with 131I. Methods 106 cases with DTC, undergoing total thyroidectomy and lymphadenectomy, were assigned to 2 groups as M0 group (without metastasis)and M1 group(with metastasis). Clinical data including pre-ablation stimulated thyroglobulin (sTg)and pre-operative Tg were determined. sTg, pre-operative Tg, Tg variation(△Tg), and Tg variation rate (△Tg/pre-operative Tg)between 2 groups were compared. The ROC curve and the diagnostic critical point(DCP) were analyzed. Results sTg, Pre-operative Tg, Tg variation, and Tg variation rate were significantly higher than those of M0(all P<0.01). The corresponding areas under the ROC curve(AUC)to differentiate the two groups were 0.913,0.702,0.773,and 0.943,respectively. The best diagnostic value points(DCP)were 40.60 ng/ml and-72.5%. The sensitivity and specificity were 70. 21%, 100. 00%, and 89. 36%, 88. 13%, respectively. Conclusion The pre-ablation sTg seems to be a useful diagnostic marker for predicting metastasis before the first 131I ablation. The sTg value can be effectively corrected by the Tg variation rate,and the sensitivity and accuracy of sTg for metastasis in DTC patients can be improved,finally providing evidence for pre-ablative assessment as well as strategies of 131I therapy.

Objective Assessment of short?term and mid?term changes of knee cartilage in non?professional long?distance runners before and after marathon using T2 mapping imaging. Methods Twenty?four knee joints of 12 healthy volunteers (5 males and 7 females) who participated in the marathon were examined by 3.0 T MRI one week before the race, within 12 hours after the race and two months after the race, respectively. The age ranged from 21.0 to 37.0 years. Athletes run more than three times a week, and each time was about 30 minutes. From T2 mapping we can obtain T2 value of 6 cartilage subregions of knee joint. Paired t?test was used to compare the T2 values of cartilage before and after the marathon. The comparison between the superficial and deep T2 values of cartilage was performed by independent sample t test. Results T2 mapping imaging showed that the T2 value of the superficial articular cartilage was higher than that of deep articular cartilage in pre?competition, within 12 hours after competition and 2 months follow?up, respectively (t=11.095, 10.385 and 10.102, P<0.01). The T2 value of superficial articular cartilage decreased after the competition compared with that of pre?competition (t=2.18,P<0.05), while the T2 value of deep articular cartilage showed no significant difference compared with that of pre?competition (t=1.832, P> 0.05). Except for the MTP?DZ, the T2 value of the remaining cartilage subregions showed a trend of decrease within 12 hours after the competition. There were significant differences in the subregion of MFC?DZ (t=2.110,P<0.05). At the follow?up of 2 months, cartilage T2 values of the MTP?SZ,LTP?SZ,LTP?DZ,MFC?DZ, Patella?SZ, Patella?DZ, Trochlea?SZ, Trochlea?DZ subregions showed a trend of recovery, and there was no significant difference compared with pre?competition(t=0.857,0.573, 0.146, 0.510,-0.594,-1.135,-0.812,-0.679; P>0.05). The T2 values of the LFC?SZ and LFC?DZ were lower than those before the race, with statistical significance (t=2.378, 3.147,P<0.05). Conclusion T2 value could reflect the change process of articular cartilage tissue composition in marathon runners from T2 mapping imaging. Under stress, the changes of superficial T2 value are more significant. The T2 value of knee cartilage can gradually recover to the pre?run level 2 months after running.

Objective: Assessment of short-term and mid-term changes of knee cartilage in non-professional long-distance runners before and after marathon using T₂ mapping imaging. Methods: Twenty-four knee joints of 12 healthy volunteers (5 males and 7 females) who participated in the marathon were examined by 3.0 T MRI one week before the race, within 12 hours after the race and two months after the race, respectively. The age ranged from 21.0 to 37.0 years. Athletes run more than three times a week, and each time was about 30 minutes. From T₂ mapping we can obtain T₂ value of 6 cartilage subregions of knee joint. Paired t-test was used to compare the T₂ values of cartilage before and after the marathon. The comparison between the superficial and deep T₂ values of cartilage was performed by independent sample t test. Results: T₂ mapping imaging showed that the T₂ value of the superficial articular cartilage was higher than that of deep articular cartilage in pre-competition, within 12 hours after competition and 2 months follow-up, respectively (t=11.095, 10.385 and 10.102, P<0.01). The T₂ value of superficial articular cartilage decreased after the competition compared with that of pre-competition (t=2.18,P<0.05), while the T₂ value of deep articular cartilage showed no significant difference compared with that of pre-competition (t=1.832, P> 0.05). Except for the MTP-DZ, the T₂ value of the remaining cartilage subregions showed a trend of decrease within 12 hours after the competition. There were significant differences in the subregion of MFC-DZ (t=2.110,P<0.05). At the follow-up of 2 months, cartilage T₂ values of the MTP-SZ,LTP-SZ,LTP-DZ,MFC-DZ, Patella-SZ, Patella-DZ, Trochlea-SZ, Trochlea-DZ subregions showed a trend of recovery, and there was no significant difference compared with pre-competition (t=0.857,0.573, 0.146, 0.510, -0.594, -1.135, -0.812, -0.679; P>0.05). The T₂ values of the LFC-SZ and LFC-DZ were lower than those before the race, with statistical significance (t=2.378, 3.147,P<0.05). Conclusion T₂ value could reflect the change process of articular cartilage tissue composition in marathon runners from T₂ mapping imaging. Under stress, the changes of superficial T₂ value are more significant. The T₂ value of knee cartilage can gradually recover to the pre-run level 2 months after running.

Objective To investigate the clinical efficacy of CT-guided 125I seeds implantation combined with gemcitabine + cis-platinum (GP) in the treatment of unresectable non-small cell lung cancer (NSCLC).Methods From January 2013 to January 2017,62 patients with unresectable Ⅱ b-Ⅲb NSCLC were randomly divided into 2 groups.In the study group,32 patients (17 males,15 females,age (62.7± 8.9) years) underwent 125I seeds implantation combined with 4 courses of GP chemotherapy,and 30 patients (18 males,12 females,age (61.9±7.0) years) in the control group underwent concurrent radiotherapy combined with 4 courses of GP chemotherapy.The short-term effects at 3 and 6 months after treatment were compared between 2 groups,as well as the survival time.Log-rank test was used to analyze the data.Results The effective rates at 3 and 6 months after treatment in the study group and control group were statistically significant (90.62％ (29/32) vs 70.00％ (21/30),96.88％ (31/32) vs 66.67％ (20/30);x2 values:3.00 and 7.22,both P＜0.05).The median survival time of the study group and control group were 17 and 15 months (x2 =2.194,P＞0.05).The 1-year survival rates of 2 groups were 87.50％ (28/32) and 76.67％ (23/30),respectively (x2=1.24,P＞0.05),and the 2-year survival rates were 40.62％ (13/32)and 20.00％(6/30),respectively (x2=4.00,P＜0.05).Conclusions 125I seeds implantation combined with GP chemotherapy is a significant treatment for unresectable NSCLC.The short-term efficacy is better than concurrent radiotherapy combined with GP regimen.

Objective:To analyze the value of maximum standardized uptake value (SUV max) of 18F-fluorodeoxyglucose (FDG) PET/CT in differentiating the malignant solitary pulmonary nodules (SPN) from benign ones. Methods:18F-FDG PET/CT imaging data of 84 patients (39 males, 45 females; age: 34-81(average: 61.1) years) with SPN in the First People′s Hospital of Lianyungang between September 2017 and June 2019 were retrospectively analyzed. The pathological results were taken as the gold standard. Differences of SUV max between benign and malignant SPN were analyzed with Mann-Whitney U test, and the best cut-off value for the diagnosis of benign and malignant SPN was measured by receiver operating characteristic (ROC) curve. The diagnostic efficacy was analyzed based on SUV max. Results:The pathological results confirmed 54 patients with malignant SPN, and 30 patients with benign SPN. SUV max of malignant group was significantly higher than that of benign group (5.48±4.08 vs 1.70(0.73, 3.33); U=443.50, P=0.001). The 84 SPN included 58 solid SPN and 26 subsolid SPN. SUV max of malignant subsolid SPN and benign ones were not significantly different ( U=56.00, P>0.05). The diagnostic value of SUV max in 58 cases of solid nodules were analyzed based on ROC curves, and the optimal cut-off value was 1.85. The corresponding diagnostic sensitivity, specificity, accuracy, negative predictive value and positive predictive value were 97.06%(33/34), 62.50%(15/24), 82.76%(48/58), 15/16, 78.57%(33/42), respectively. Conclusions:18F-FDG uptake of malignant SPN were higher than benign ones. The diagnosis of benign and malignant solid SPNs based on SUV max 1.85 has high sensitivity, negative predictive value and accuracy. SUV max has limited diagnostic value on subsolid SPN.

Objective:To analyze the clinical characteristics of necrotizing otitis externa(NOE) and to discuss its clinical staging and treatment.Methods:A retrospective case series study was conducted in the Otorhinolaryngology Head and Neck Surgery Center of Beijing Friendship Hospital. Patients hospitalized in our department with diagnosis of NOE between June 2015 to December 2021 were included. There were 23 patients (23 affected ears), with 19 males and 4 females, aged 32-85 years (the median age was 68 years old). We analyzed and summarized the main symptoms and signs, laboratory examinations, imaging examinations, treatments and prognosis of the patients, and established a database for data collection and sorting.Results:All the 23 patients had various complications. There were 19 cases of type 2 diabetes, 5 cases of anemia, 3 cases of hypoalbuminemia, 2 cases of chronic renal insufficiency, and 1 case of uremia. The main symptoms on admission were otalgia, otorrhea, hearing loss, angular deviation, limited mouth opening, dysphagia and hoarseness. Physical examination showed swelling of the external ear canal (EEC), granulation tissue of the EEC, thin purulent secretion of the EEC, facial paralysis, restricted mouth opening, and decreased vocal cord movement. Etiological results showed 15 cases of Pseudomonas aeruginosa, 5 cases of Staphylococci and 3 cases of Aspergillus fumigatus. Imaging mainly showed abnormal soft tissue shadows of the EEC and middle ear, and temporomandibular joint, parapharyngeal space, skull base, intracranial and other adjacent structures were involved according to the different invasion directions of the lesions. According to the characteristics of these patients, we summarized a diagnostic criteria and clinical staging. All patients received systematic anti-infection, surgery and symptomatic support treatment. Until January 30, 2022, 4 patients died, including 1 case of extensive intracranial infection caused by NOE, and 3 cases of other systemic diseases after the affected ears were recovered and discharged from hospital. The other 19 patients′ ears were cured, the symptoms of otalgia and otorrhea disappeared, and the epithelization of the surgical cavity was good. Conclusion:The clinical manifestations of NOE lack specificity, and the diagnosis should be made according to the medical history, physical examination and auxiliary examination. According to different clinical stages, corresponding treatment measures should be formulated. The treatment is based on multidisciplinary comprehensive treatment, mainly surgical treatment. Early intervention has a good prognosis, otherwise, multiple-group of cranial nerve injury or intracranial infection implies poor prognosis.

Objective:To retrospectively analyze the treatment status of tyrosine kinase inhibitors (TKI) in newly diagnosed patients with chronic myeloid leukemia (CML) in China.Methods:Data of chronic phase (CP) and accelerated phase (AP) CML patients diagnosed from January 2006 to December 2022 from 77 centers, ≥18 years old, and receiving initial imatinib, nilotinib, dasatinib or flumatinib-therapy within 6 months after diagnosis in China with complete data were retrospectively interrogated. The choice of initial TKI, current TKI medications, treatment switch and reasons, treatment responses and outcomes as well as the variables associated with them were analyzed.Results:6 893 patients in CP ( n=6 453, 93.6%) or AP ( n=440, 6.4%) receiving initial imatinib ( n=4 906, 71.2%), nilotinib ( n=1 157, 16.8%), dasatinib ( n=298, 4.3%) or flumatinib ( n=532, 7.2%) -therapy. With the median follow-up of 43 ( IQR 22-75) months, 1 581 (22.9%) patients switched TKI due to resistance ( n=1 055, 15.3%), intolerance ( n=248, 3.6%), pursuit of better efficacy ( n=168, 2.4%), economic or other reasons ( n=110, 1.6%). The frequency of switching TKI in AP patients was significantly-higher than that in CP patients (44.1% vs 21.5%, P<0.001), and more AP patients switched TKI due to resistance than CP patients (75.3% vs 66.1%, P=0.011). Multi-variable analyses showed that male, lower HGB concentration and ELTS intermediate/high-risk cohort were associated with lower cytogenetic and molecular responses rate and poor outcomes in CP patients; higher WBC count and initial the second-generation TKI treatment, the higher response rates; Ph + ACA at diagnosis, poor PFS. However, Sokal intermediate/high-risk cohort was only significantly-associated with lower CCyR and MMR rates and the poor PFS. Lower HGB concentration and larger spleen size were significantly-associated with the lower cytogenetic and molecular response rates in AP patients; initial the second-generation TKI treatment, the higher treatment response rates; lower PLT count, higher blasts and Ph + ACA, poorer TFS; Ph + ACA, poorer OS. Conclusion:At present, the vast majority of newly-diagnosed CML-CP or AP patients could benefit from TKI treatment in the long term with the good treatment responses and survival outcomes.

Rats ; Animals ; Urinary Bladder Neck Obstruction/pathology* ; Survivin/genetics* ; Urinary Bladder/pathology* ; Fibrosis