OBJECTIVE: To explore the clinical application value of using needle electrode in transurethral plasmakinetic resection of bladder tumor around ureteral orifice. METHODS: Retrospective analysis was performed on the clinical data of 16 cases who had bladder tumors around ureteral orifice and underwent transurethral resection using plasmakinetic needle electrode in Department of Urology, Peking University International Hospital from June 2015 to December 2019. There were nine cases with the tumor of one to two centimeters from the ureteral orifice. The rest of the seven cases had tumor that was within one centimeter from the ureteral orifice, including two cases whose ureteral orifice was invaded by the tumor. All the patients studied were diagnosed before surgery and contraindications were excluded. The plasmakinetic needle electrode was used to treat the tumor with en bloc resection, and all the excised tissue was sent for pathological examination. Intravesical chemotherapy and postoperative follow-ups were performed. Statistical analysis was performed on the operation time, the incidence of obturator nerve reflex, the peri-operative bleeding, the parameters of indwelling ureteral catheter or double-J stent, the incidence of postoperative hydronephrosis, the clinical stage of tumor, and the recurrence rate. RESULTS: The operation was successfully completed for all the sixteen cases. The operation time was 16 to 57 minutes, with an average of (32.6±11.8) minutes. No obvious obturator nerve reflex and perioperative bleeding occurred in all the patients. Ureteral catheters were indwelled prior to the operation of tumor resection in seven cases. Four of the seven cases had the ureteral catheters remained while the rest three were replaced by double-J stent after surgery. Postoperative pathological analysis showed that all the tumors were urothelial carcinoma, including 9 cases of low grade and 7 cases of high grade. Pathological staging: 10 cases were in Ta stage, 5 cases in T1 stage, and 1 case in T2a stage. All tumor bases and lateral margins were negative. All the patients received 3-56 months, with an average of (26.0±18.1) months of follow-up. There was no case of upper urinary tract hydronephrosis or tumor recurrence. CONCLUSION The transurethral plasmakinetic resection of bladder tumor using needle electrode can realize en bloc tumor resection without obturator nerve reflex and reduce the risk of ureteral orifice injury. It is a safe and effective surgical method for treating bladder tumors around the ureteral orifice.
Carcinoma, Transitional Cell ; Electrodes ; Humans ; Neoplasm Recurrence, Local ; Retrospective Studies ; Urinary Bladder Neoplasms/surgery*

Objective To observe the efficacy of Kang'ai Xiaoshui Cream in the treatment of malignant pleural effusions.Methods Forty-three patients with malignant pleural effusions were randomly recruited into a treatment group and a contrast group..The treatment group included 22 cases were treated by Kang'ai Xiaoshui Cream externally,while the contrast group covered 21 cases were treated by IL-2.Results The effective rate of pleural fluid was 63.64%and 57.14% in the treatment group and the contrast group respectively,not showing distinct difference(P>0.05).The positive reactions of pleura adhesion,improvement of life quality,and the adverse reactions of the treatment group were better than contrast group (P<0.05).Conclusion Kang'ai Xiaoshui Cream Can effectively control the malignant pleural effusions and improve the life quality of patients.

Objective To investigate the correlation between the red blood cell distribution width (RDW) with risk and and severity of noncardiac ischemic stroke.Methods The patients with acute noncardiac ischemic stroke were enrolled retrospetively and were used as a case group,and the non-stroke patients admitted to the Department of Neurology at the same period were served as a control group.The National Institutes of Health Stroke Scale (NIHSS) was used to assess the baseline neurological deficits.The NIHSS score ＜ 8 was defined as mild stroke and ≥ 8 was defined as moderate to severe stroke.The demographics,clinical data,and RDW were collected and compared.Multivariate logistic regression analysis was used to identify the independent risk factors for the risk of disease and severity of stroke in noncardiac ischemic stroke.Receiver operator characteristic (ROC) curve was used to analyze the predictive value of RDW for acute noncardiac ischemic stroke and its severity.Results A total of 1 173 patients with acute noncardiac ischemic stroke were enrolled.Over the same period,996 non-stroke patients were hospitalized in the Department of Neurology.The RDW in the case group was significantly higher than that in the control group (13.1％ ± 1.0％ vs.12.7％ ±0.7％;t=9.545,t ＜0.001).Multivariatelogistic regression analysis showed that RDW (odds ratio [OR] 9.920,95％ confidence interval [CI] 6.286-15.655,P＜ 0.001) was an independent risk factor for acute noncardiac ischemic stroke.ROC curve analysis showed that the RDW cutoff value for predicting acute noncardiac ischemic stroke was 12.55％,the area under the ROC curve was 0.611 (95％ CI 0.588-0.635),the sensitivity was 73.3％,the specificity was 43.7％,the positive predictive value was 60.5％,the negative predictive value was 58.2％,and the accuracy was 59.7％.RDW in the moderate to severe stroke subgroup was significantly higher than that in the mild stroke subgroup (13.7％ ± 1.6％ vs.12.9％ ± 0.6％,t =-13.794,P＜ 0.001).Multivariate logistic regression analysis showed that RDW (OR 3.835,95％ CI 3.002-4.899,P ＜ 0.001) was an independent risk factor for the severity of acute non-cardiac ischemic stroke.ROC curve analysis showed that the RDW cutoff value for predicting moderate to severe non-cardiac ischemic stroke was 13.45％,the area under the ROC curve was 0.713 (95％ CI 0.674-0.752),the sensitivity was 47.7％,the specificity was 86.1％,the positive predictive value was 49.8％,the negative predictive value was 85.1％,and the accuracy was 77.6％.Conclusions RDW is an independent risk factor for acute non-cardiac ischemic stroke.Increased RDW is associated with the severity of acute non-cardiac ischemic stroke.

Objective This study aims to test the hypothesis that low density granulocytes (LDGs) is involved in the pathogenesis of DM associated-Interstitial lung disease (ILD).Methods Forty eight DM patients (28 with ILD) and 19 age-and sex-matched healthy Chinese volunteers were recruited to this study.LDGs percentage in peripheral blood mononuclear cells (PBMCs) was tested by flow cytometry.Neutrophilrelated genes (LL-37,MPO and MMP-8) expressions in PBMCs were tested by quantitative RT-PCR.Myositis disease activity assessment visual analogue scales (MYOACT) was used to assess the disease activity.Percentages of LDGs were compared in patients with ILD and without by using unpaired t test with Welch's correction,the correlations between LDGs and clinical parameters were further analyzed by linear correlation analysis.The expressions of neutrophil-related mRNA and proteins in PBMCs were compared by using MannWhitney U test.Results LDGs percentage in PBMCs was 7.1-fold higher in DM patients than healthy controls [(9.1±11.5)％ vs (1.3±0.7)％,t=4.664,P＜0.01].LDGs percentage in PBMCs was 2.7-fold higher in DM patients with ILD than DM patients without ILD [(12.3±14.1)％ vs (4.5±2.6)％,t=2.835,P=0.008 3].The mRNA expression level of LL-37,MPO and MMP-8 and LL-37 protein levels in the DM group were significantly higher than those in the control group.LDGs percentage positively correlated with MYOACT lung disease activity scores (r=0.439,P=0.010).Conclusion Percentage of LDGs in PBMCs is significantly increased in DM patients with ILD and positively correlated with MYOACT lung disease activity scores,suggesting that abnormall increasing of LDGs is a potential contributor to the pathogenesis of DM-associated ILD.

Objective To evaluate the influence of pressing technique on the malposition of catheter dur- ing the operation of peripherally inserted central catheter (PICC). Methods Totally, 169 patients with lung cancer were randomly divided into treatment group (n = 88), in which the external and internal jugular veins were pressed at the supraclavicular fossa by the assistant when the catheter was navigated in 25 cm, and control group (n = 81), in which the patients were called to turn their angle of mandible to supraclavicular fossa when the cathe- ter was sent in. Results There were only one patient whose catheter was sent in external jugular vein in treatment group and nine patients whose catheters were sent in external and internal jugular vein in control group. The inci- dence of malposition of catheter was significantly different between two groups (1.1% vs. 11. 1% , X2 =7. 3636, P < 0. 01). Conclusion The pressing technique can reduce the incidence of malposition of catheter into external and internal jugular vein during the operation of PICC.

Objective Toinvestigatetherelationshipbetweendifferenttypesofinternalwatershed infarctionandtandemstenosesofinternalcarotidartery(ICA).Methods Atotalof55patientswith internal watershed infarction confirmed by head MRI and diffusion-weighted imaging (DWI )examination were enrolled. They all underwent the extracranial internal carotid artery (ICA ) ultrasonography and intracranial cerebral artery MR angiography (MRA)examinations. According to the findings of imaging,the 55 patients with internal watershed infarction were divided into a simple internal watershed infarction (IWSI)group and an internal watershed infarction accompanied with ipsilateral cortical watershed infarction (C-IWSI)group. The relationship between the two types of internal watershed infarction and tandem stenoses of ICA was analyzed. Results (1 ) Of the 55 patients with internal watershed infarction,24 cases (43. 6%)were in the internal watershed infarction group and 31 cases (56. 4%)were in the C-IWSI group. The ipsilateral vascular stenosis were ICA 20 cases (36. 4%,including extracranial segment 11 cases and intracranial segment 17 cases),middle cerebral artery (MCA)44 cases (80. 0%), and tandem stenoses of ICA 15 cases (27. 3%). (2)Ipsilateral tandem stenoses of ICA:2 cases were in the IWSI group (intracranial ICA+MCA 2 cases);13 cases were in the C-IWSI group (extracranial ICA+intracranial ICA +MCA 4 cases,extracranial ICA + intracranial ICA 1 case,extracranial ICA + MCA 2 cases,and intracranial ICA+MCA 6 cases). (3)Compared with the IWSI group,the incidences of ipsilateral ICA stenosis and tandem stenoses of ICA in patients of the C-IWSI group were higher (54. 8%[n=17]vs. 12. 5%[n=3],41. 9%[n=13]vs. 8. 3%[n =2]),and there were significant differences(P =0. 001, 0.006]). The incidences of extracranial and intercranial ICA stenosis were higher than those of the IWSI group (35. 5%[n=11]vs. 0,45. 2%[n=14]vs. 12. 5%[n=3]),and there were significant differences (P=0.003,0.009).Conclusion Inthedifferenttypesofinternalwatershedinfarction,theincidenceof tandem stenoses of ICA is different. The IWSI patients with ipsilateral cortical watershed infarction often accompany by tandem stenoses of ICA.

BACKGROUND: The formation of long-term memory includes acquisition, consolidation and reconsolidation. Reconsolidation is very important for the new memory transforming into stable memory. Stress is an important environmental factor in the process of learning and memory. Corticosterone is very important for stress response. At present, research about the impact of corticosterone on reconsolidation of novel object recognition memory is less. Thus, it is very important to test the impact of corticosterone on reconsolidation of novel object recognition memory in rats.
OBJECTIVE: To analyze the effects of corticosterone on the reconsolidation of novel object recognition memory in rats.
METHODS: (1) The rats were intraperitoneal y injected with corticosterone (0.1, 1 and 3 mg/kg) immediately after reactivation. The discrimination index was used to assess memory performance and calculated as the difference in time exploring the novel and familiar objects. (2) The rats were intraperitoneal y injected with corticosterone (3 mg/kg) 6 hours after reactivation. The discrimination index was used to assess memory performance and calculated as the difference in time exploring the novel and familiar objects. (3) The rats were intraperitoneal y injected with corticosterone 3 mg/kg without reactivation. The discrimination index was used to assess memory performance and calculated as the difference in time exploring the novel and familiar objects.
RESULTS AND CONCLUSION: Immediate injection of corticosterone 3 mg/kg after reactivation significantly decreased the discrimination index. At 6 hours after reactivation or without reactivation, corticosterone administration did not impact the discrimination index. These results confirmed that corticosterone administration immediately after reactivation impairs the reconsolidation of novel object recognition memory. The damage effect depends on the reactivation experience and the specific time window after reactivation.

Objective To investigate the serum levels of soluble human leukocyte antigen (sHLA)-G in patients with polymyositis (PM) or dermatomyositis (DM),and to analyze its association with clinical features and possible role in the pathogenesis of PM/DM.Methods Serum sHLA-G levels of 26 patients with PM,70 patients with DM and 35 matched healthy controls were measured by ELISA.The relationship between the sHLA-G levels and clinical features or seroimmunological data in the patients with PM/DM was analyzed.Results Serum levels of sHLA-G in PM/DM patients were significantly higher compared to healthy controls [(44±70) U/ml vs (4±5) U/ml,P＜0.01].There was statistically significant difference between DM patients and PM patients [(54±81) U/ml vs (27±41) U/ml,P=0.004].The incidence of dysphagia was significantly higher in sHLA-G elevated group than those in sHLA-G normal group (P=0.001).Additionally,Spearman rank correlation analysis showed that the serum sHLA-G levels were positively correlated with serum C3 (r=0.284,P=0.021),but negatively correlated with CD3+ T cells (r=-0.233,P=0.047) and CD4+ T cells (r=-0.287,P=0.015) in the peripheral blood in patients with PM/DM.Serum levels of sHLA-G in non-treated PM/DM patients were significantly higher compared to treated patients [(77±99) U/ml vs (34±52) U/ml,P=0.021].No relationship between serum sHLA-G levels and PM/DM disease activity,or different drug therapy was found.Conclusion Serum levels of sHLA-G are increased in PM/DM patients.The increased production of sHLA-G,paralleled with higher incidence of dysphagia and lower level of CD3+ T cells and CD4+ T cells,indicates that sHLA-G may play an important role in the pathogenesis of PM/DM.

Objective To determine ff cognitive dysfunction induced by neonatal ketamine anesthesia can persist into adulthood.Methods Thirty 7-day-old SD rats of both sexes were randomly divided into 3 groups.Control group received normal saline 0.2 ml intraperitoneally (IP) (group C),while ketamine groups 1 and 2 received ketamine 25 and 50 mg/kg IP respectively (groups K1,K2 ).Morris water maze test was performed and hippocampal long-term potentiation (LTP) recorded when the rats were 2.5 months old.Results LTP was significantly lower in groups K1 and K2 than in group C.There was no significant difference in LTP between groups K1 and K2.The escape latency and swimming time were comparable among the 3 groups.Conclusion Neonatal ketamine anesthesia can decrease the cognitive function in adult rats.There is no significant difference between light and deep ketamine anesthesia.

AIM To prepare the microemulsions loaded with total flavonoids from Potentilla discolor Bunge and to evaluate the therapeutic effect on diabetic mice.METHODS Total flavonoids,the extract from P.discolor by 70％ ethanol,were made into microemulsions after purification with.macroporous resin.With types and amount of oil phase,emulsifier and co-emulsifier,and addition amount of total flavonoids as influencing factors,together with drug loading,encapsulation efficiency,particle size and Zeta potential as evaluation indices,the formulation was optimized by drawing pseudo-ternary phase diagram.By establishing diabetic mouse models induced by streptozotocin (STZ) and high fat diet,the obtained microemulsions' effects on fasting blood glucose,oral glucose tolerance (OGT),insulin,glycosylated serum protein (GSP),triglyceride (TG),total cholesterol (TC),low density lipoprotein (LDL),high density lipoprotein (HDL),superoxide dismutase (SOD) and malondialdehyde (MDA) in mice were investigated.RESULTS The optimal formulation was determined to be 400 mg for isopropyl myristate (oil phase) amount,400 mg for Cremophor RH 40 (emulsifier) amount,200 mg for polyethylene glycol 400 (coemulsifier) amount,and 80 mg for addition amount of total flavonoids.The spherical-like and uniformly-sized microemulsions shared average drug loading of (7.28 ± 0.12)％,encapsulation efficiency of (91.79 ± 1.02)％,particle size of (36.79 ±0.17) nm and Zeta potential of (-15.77 ±2.89) mV.They could significantly reduce fasting blood glucose level,promote insulin secretion,regulate blood lipid,increase SOD activity,and decrease MDA level in diabetic mice.CONCLUSION Once prepared into microemulsions,the total flavonoids from P.discolor demonstrate an obviously enhanced activity in reducing blood glucose.