Objective:To explore the effect of postoperative stent placement time on flexible ureteroscopy lithotripsy (FURL) in the treatment of kidney calculi.Methods:A retrospective analysis of 126 patients with kidney calculi admitted to Guangyuan Central Hospital from April 2017 to November 2018. All patients were treated with FURL. The patients were divided into two groups according to the time of stent placement after FURL: conventional tube placement group ( n=91) and short-term tube placement group ( n=35). The postoperative stent placement time of patients in the conventional tube placement group was 4 weeks, and the postoperative stent placement time of patients in the short-term tube placement group was 2 weeks. The postoperative outcome indicators (hospitalization time and stone-free rate), postoperative complication indicators (postoperative hematuria, renal hematoma, urinary tract infection and fever) and postoperative pain were compared between the two groups. The measurement data was expressed as mean±standard deviation ( Mean± SD), and the Student′s t test was used for comparison between groups; the Chi-square test was used for comparison between counting data. Results:There were not significant differences in hospitalization time [(7.22±1.02) d vs (7.26±1.22) d], stone-free rate 1 month after surgery (84.6% vs 82.8%), stone-free rate 2 month after surgery (93.4% vs 88.5%), postoperative hematuria (10.9% vs 11.4%), renal hematoma (3.3% vs 0) and fever (2.2% vs 0) between the conventional tube placement group and short-term tube placement group ( P>0.05). Compared with the conventional tube placement group, the short-term tube group had lower urinary tract infection rates (17.6% vs 2.9%), the difference was statistically significant ( P<0.05). There was not significant difference in the average use rate of opioids [(1.05±0.45) vs (1.00±0.50), P>0.05], acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) [(1.52±0.55) vs (1.45±0.45), P>0.05] between the two groups during hospitalization. There was not statistically significant difference in the incidence of abdominal pain after discharge from the hospital [(1.25±0.55) vs (1.15±0.45)]. The number of applications of acetaminophen and NSAIDs in the conventional tube placement group was greater than that in the short-term tube placement group [(1.45±0.46) vs (1.25±0.30)] after one month, the difference was statistically significant ( P<0.05). Conclusions:Short-term tube placement after renal FURL surgery is as effective as traditional long-term stenting, achieving the same stone-free effect and reducing early postoperative complications. For the reduction of postoperative infection and postoperative pain, short-term stenting has certain advantages.

Objective:To investigate the clinical, imaging and endoscopic characteristics of idiopathic mesenteric phlebosclerosis (IMP).Methods:From January 2010 to December 2020, 14 patients with IMP diagnosed and treated at the Quzhou Hospital Affiliated to Wenzhou Medical University (Quzhou People′s Hospital) were enrolled. All patients underwent abdominal X-ray, contrast enhanced computed tomography (CT) and endoscopy. Three cases accepted double-contrast barium enema and 11 cases underwent endoscopic biopsy. Three of the 14 IMP patients underwent surgery and pathological examination because of intestinal perforation or intestinal obstruction that failed conservative treatment. The general data (such as gender, drinking history, etc.), clinical symptoms, complications, imaging (abdominal X-ray, CT, double-contrast barium enema) and endoscopic features were retrospectively analyzed. Descriptive method was used for statistical analysis.Results:Among the 14 IMP patients, 13 cases were male and one case was female. All the 13 male cases had long history of drinking Chinese herbal medicine wine, among them, 8 patients consumed acanthopanax bark wine. Complications occurred in 7 cases, including 5 cases of intestinal obstruction and 2 cases of intestinal perforation. The clinical symptoms of 14 IMP patients were nonspecific, mostly manifested as abdominal pain (11 cases), abdominal distension (6 cases), diarrhea (6 cases), nausea and vomiting (4 cases), and constipation (2 cases). Abdominal X-ray images mainly showed multiple irregular calcifications along involved colon. The images of 3 patients received double-contrast barium enema demonstrated shallowness or disappearance of semilunar folds, rigid colonic wall, narrowed lumen and " thumb printing". The typical CT images indicated edema and thickening of the involved intestinal wall, blurred mesenteric fat space, spot, thread-like, and curved calcification of mesenteric vein and colonic wall. Typical endoscopic findings included dark-purple colored mucosa, congestion, edema, erosion and ulceration, and focal nodular surface and visible varicose veins.Conclusions:IMP has typical imaging and endoscopic characteristics, and the combination of them can diagnose and evaluate IMP more accurately.

【Objective】 To investigate the effects of naringenin on the polarization of high-glycemic RAW264.7 macrophages and its related mechanism. 【Methods】 The mother solution of NAR was prepared with dimethyl sulfoxide (DMSO), and the log-growth phase macrophage RAW264.7 was pre-tested. DMEM medium with different glucose concentrations (1, 2, 4, 5 and 6 g/L) was used for cultivation for 24 h. Before the experiment, DMEM was diluted into NAR mixture with different final concentrations, and the effect of NAR on RAW264.7 cell activity was detected by CCK-8 method; nitric oxide synthase (NOS) type classification determination of checkerboard induced nitric oxide synthase (iNOS) active filter was used to control the concentration of sugar and high-sugar stimulation. The control group were subdivided into normal control (NG) and osmotic pressure control (NG+M). The high-glucose stimulation group was divided into normal high glucose (HG), high glucose + naringenin (HG+NAR), high glucose + Fasudil (HG+F), and high glucose +C3 transferase (HG+C3). RAW264.7 was cultured for 24 h in each group; the expression levels of supernatant cytokines, namely, interleukin6 (il-6), tumor necrosis factor -α (TNF-α) and interleukin10 (IL-10), were detected by ELISA. Western blotting was used to determine the RhoA/ROCK pathway related proteins, iNOS and Arg-1 protein levels. Type (M1, M2) and proportion (M1/M2) of macrophages were analyzed by flow cytometry. 【Results】 Compared with those in NG group, in HG group RhoA/ROCK pathway-related proteins and iNOS expression were increased, while Arg-1 expression was decreased (P<0.05). The secretion of pro-inflammatory cytokines IL-6 and TNF-α was increased while anti-inflammatory cytokine IL-10 was decreased (P<0.05). The number of M1-type cells and M1/M2 ratio increased (P<0.05). Compared with HG group, RhoA/ROCK pathway related proteins and iNOS expression were decreased in HG+NAR group, HG+F group and HG+C3 group, while Arg-1 expression was increased, IL-6 and TNF- α secretion was decreased, IL-10 was increased, M2-type macrophages were increased, and M1/M2 was decreased (P<0.05). 【Conclusion】 NAR may promote the M2-type differentiation of macrophages stimulated by high glucose by down-regulating RhoA/ROCK signaling pathway.