Objective To evaluate the clinical efficacy and safety of retroperitoneal laparoscopy and open surgical treatment of simple renal cyst by Meta analysis.Methods Computer retrieval of MED-LINE,Cochrane Library,EMBASE,CNKI,Wanfang and VIP databases,according to the inclusion and exclusion criteria collected and screened out a randomized controlled studies on the treatment of simple renal cysts,published from January 1,2000 to August 31,2015.Two independent authors screened out randomized clinical trials (RCTs),extracted data,assessed quality of data,and then carried out Meta analysis by Revman 5.0 software with related data.Results Twenty one studies met the inclusion criteria with a total of 2 296 patients,including 1 162 patients of retroperitoneal laparoscopy and 1 134 cases of open operation group.Compared to the open operation group,retroperitoneal laparoscopy showed shorter operation time,less bleeding,shorter hospitalization time,and earlier postoperative drainage tube extraction time.No significant difference was found in the recurrence rate of the cyst for two groups.Conclusions The clinical efficacy,safety,and complication of retroperitoneal laparoscopy in the treatment of simple renal cyst is better than the open operation.

Objective To observe the effect of lnng-term in vitro culture on the biological properties of adipose-derived stem cells(ADSCs)as seeding cells of tissue engineering.Methods The surface makers and apoptosis of primary and passaged human ADSCs were identified by flow cytometric analysis.Osteogenic differentiation of ADSCs at different passages were identified by alkaline phosphatase(ALP),Von Kossa staining and RT-PCR respectively.Results The surface marker expression of mesenchymal stem cells on ADSCs was high and did not change with passages of the cells.The early apoptosis rate of the cells was 1% to 2%,and increased insignificantly from passage one to passage nine.The osteogenic potential of ADSCs confirmed by ALP,Von Kossa staining and RT-PCR was maintained to as late as passage eight.Conclusion Since the biological properties of ADSCs are stable,they can be served as optimal seeding cells for tissue engineering and regenerative research.

Objective To explore the risk of pituitary dysfunction for spontaneous subarachnoid hemor -rhage( s-SAH) patients and to evaluate its correlation with clinical data .Methods 63 cases of patients with s-SAH were selected.Indicators(serum adrenocorti cotrophic hormone (ACTH), growth hormone(GH), insulin-like growth factor-1(IGF-1), thyroid stimulating hormone(TSH), thyroxine(T4), triiodothyronine(T3), folli-cle-stimulating hormone(FSH), luteinizing hormone(LH), total testosterone(in males), estradiol(in females) and prolactin)dynamic observation were tested 7 days, 1 year, 2 years, 3 years after the onset.Results Thirty patients( 47.6%) had some type of pituitary dysfunction .ACTH deficiency was the most frequent disorder (14.3%), followed by GH deficiency(12.7%), hypogonadatrophic(6.3%), hypothyroidism(3.2%)and high prolactin(1.6%).six patients(9.5%)showed deficiencies in more than one axis .Hormone deficiency was relat-ed to vasospasm, Fisher grade 4(P<0.05)and recovery time.Conclusions A greater incidence of hormone de-ficiency after s-SAH was related with vasospasm , Fisher grade and recovery time .Follow-up time should be ex-tended.

Objective To investigate the expression levels of tumor necrosis factor alpha (TNF-α),interleukin-6(IL-6) and the change of serum ferritin in patients with intracranial aneurysm and its clinical significance.Methods 22 patients with intracranial aneurysm and 16 cases of traumatic brain injury who recevied operation in Department of Neurosurgery in Quzhou People's Hospital from Jan.2014 to Jan.2015 were enrolled as observation group and control group.The intracranial aneurysm tissues and normal cerebral vascular tissues were collected respectively to detect the situation of inflammatory cell infiltration,and the expression of TNF-α and IL-6 was detected by HE staining and immunohistochemical staining.The serum was collected on hospitalized,postoperative 3 days and postoperative 7 days to detect serum ferritin.Results The positive cells were observed in the observation group after immunohistochemical staining,in which the expression levels of TNF-α [(0.194 ± 0.074) vs.(0.135 ± 0.047),t =2.799] and IL-6 [(0.152 ± 0.057) vs.(0.103 ± 0.028),t =3.494] were significantly higher than those in the control group(P =0.008,0.001).The serum ferritin level in the observation group was significantly higher than that in the control group at postoperative 3d [(232.25 ± 105.26) ng/mL vs.(169.51 ± 66.24) ng/mL,t =2.097] and postoperative 7d[(263.39 ± 114.73) ng/mL vs.(166.57 ± 73.71) ng/mL,t =2.955] (P =0.043,0.005).The difference of serum ferritin on different day in the observation group also was statistically significant(F =8.625,P =0.003).Conclusion The expression levels of TNF-α and IL-6 in intracranial aneurysms were high,which may be one of the important factors in the formation of intracranial aneurysms,and it provides an important reference of early prevention and drug treatment for patients with intracranial aneurysm.The serum ferritin is related to the rupture and hemorrhage of intracranial aneurysm,which can be used to judge prognosis and guide rational treatment,and worth further study to confirm.

OBJECTIVETo study the clinical therapeutic effect of anisodamine on respiratory function after severe brain injury.

METHODSNinety patients with respiratory dysfunction following severe brain injury were divided into two groups: a treatment group (n = 45, treated with routine therapy plus anisodamine) and a control group (n = 45, treated with routine therapy only). The pulmonary ventilation function and oxygenation function were compared between the two groups.

RESULTSIn the treatment group, 12 hours after treatment the respiratory rate reduced, the partial pressure of carbon dioxide (PCO(2)), the partial pressure of oxygen in arterial blood (PaO(2)) and oxygenation exponent increased, the dead space ventilation dose and the pulmonary alveolus-partial pressure of arterial oxygen difference decreased, and the ventilation function of the respiratory tract and pulmonary oxygenation function improved. There was a significant difference between the two groups (P < 0.01). No side-effect was found except a slight increase of intracranial pressure and heart rate.

CONCLUSIONSAnisodamine can improve pulmonary ventilation function and oxygenation function and decrease the incidence of hypoxemia markedly. It is effective in treating respiratory dysfunction after severe brain injury.

Adolescent ; Adult ; Aged ; Brain Injuries ; complications ; diagnosis ; mortality ; Child ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Female ; Follow-Up Studies ; Humans ; Infusions, Intravenous ; Injury Severity Score ; Male ; Middle Aged ; Primary Prevention ; methods ; Probability ; Pulmonary Gas Exchange ; Reference Values ; Respiratory Function Tests ; Respiratory Insufficiency ; etiology ; mortality ; prevention & control ; Solanaceous Alkaloids ; administration & dosage ; Survival Rate ; Treatment Outcome

Objective:To develop a radiomics nomogram model based on CT to distinguish arteriovenous malformation(AVM) intracerebral hemorrhage from primary intracerebral hemorrhage.Methods:One hundred and thirty-five patients with cerebral hemorrhage confirmed by operation in the First Affiliated Hospital of Soochow University were analyzed retrospectively, including 52 patients with AVM cerebral hemorrhage and 83 patients with primary cerebral hemorrhage. Radiomics features were extracted from baseline CT, radiomics score (Radscore) was calculated and radiomic labels were constructed. Multiple logistic regression analysis was used for clinical features combined with CT signs to establish a clinical model. And then the nomogram model was generated according to the Radscore and the clinical model. The ROC curve and decision curve analysis (DCA) were used to evaluate the discrimination performance of the model.Results:Six features were selected and used to establish radiomic labels. The clinical model consisted of age (OR: 4.739, 95%CI 1.382-16.250) and hematoma location (OR: 0.111, 95%CI 0.032-0.385), while the nomogram model consisted of age, hematoma location and Radscore. In the training group, there was a significant difference between the nomogram model [area under curve (AUC) 0.912] and the clinical model (AUC 0.816), the radiomics model (AUC 0.857) ( Z=2.776, 2.034, P=0.006, 0.042, respectively); While in the validation group, there was no significant difference between the nomogram model (AUC 0.919) and the clinical model (AUC 0.788), the radiomics model (AUC 0.810) ( Z=1.796, 1.788, P=0.073, 0.074, respectively). DCA analysis showed that the clinical value of the nomogram model was superior to the clinical model and radiomic model. Conclusion:The radiomics nomogram can effectively distinguish AVM-related cerebral hemorrhage from primary cerebral hemorrhage, which is helpful for clinical decision-making.

OBJECTIVE: To detect the levels of neutrophil gelatinase-associated lipocalin (NGAL), cystatin C (Cys-C ) in blood and the level of kidney injury molecule 1 (KIM-1) in urine in elderly patients with renal calculi at diff erent times, and to explore the eff ect of percutaneous nephrostolithotomy (PCNL) combined with flexible ureteroscopy (FU) on early postoperative renal function. METHODS: A total of 46 patients with renal calculi were selected, and their blood or urine specimens were collected respectively at preoperative and postoperative 2, 12, 24, 48, and 72 h. The concentrations of NGAL, Cys-C, KIM-1 were detected. RESULTS: The levels of NGAL and Cys-C began to increase respectively at postoperative 2 and 12 h, and reached peak at postoperative 12 to 24 h. There was significant difference in the levels of NGAL and Cys-C between the postoperative 12 and 2 h or between postoperative 48 and 24 h (all P<0.05). The levels of NGAL and Cys-C began to decline and eventually returned to preoperative levels respectively at postoperative 48 and postoperative 72 h. The KIM-1 began to increase at postoperative 2 h and peaked at postoperative 24 h, which was significant difference between the postoperative 24 and 12 h or postoperative 48 and 24 h (both P<0.05). The level of KIM-1 began to decline and eventually returned to preoperative levels at postoperative 48 h. CONCLUSION After the combined treatment of percutaneous nephrostolithotomy with flexible ureteroscopy, the concentrations of NGAL, Cys-C and KIM-1 are significantly increased, suggesting injuries on renal function. The time of renal tubular injury and recovery is earlier than that of renal glomerulus.
Acute-Phase Proteins ; urine ; Aged ; Cystatin C ; blood ; urine ; Hepatitis A Virus Cellular Receptor 1 ; Humans ; Kidney ; physiopathology ; Kidney Calculi ; surgery ; Lipocalin-2 ; Lipocalins ; blood ; urine ; Membrane Glycoproteins ; blood ; urine ; Nephrostomy, Percutaneous ; Postoperative Period ; Proto-Oncogene Proteins ; blood ; urine ; Receptors, Virus ; blood ; Ureteroscopy

Objective To systematically review and evaluate the perioperative indicators and surgical curative effect of 980 nm diode laser vaporization of prostate and transurethral resesction of prostate (TURP) in treating benign prostatic hyperplasia (BPH). Methods Retrieved published comparative studies 980 nm diode laser vaporization of prostate versus transurethral resesction of prostate in treating benign prostatic hyperplasia, and pooled the data from eligible studies. The statistical analysis was performed using Revman 5.3 software. Results Six trials including 839 patients were eligible to the criteria (450 in 980 nm diode laser group and 389 in TURP group). The baseline of patients characteristics were comparable in all the studies. Meta analysis showed that: the operative time was not significantly different between the 980 nm diode laser group and TURP group [SMD = 0.11, 95 ~ CI (-0.52,0.74), P > 0.05]; Compared with TURP group, 980 nm diode laser group has shorter hospital stays [SMD = -1.95, 95%CI (-3.42, -0.48), P < 0.05], and shorter catheterization time [SMD = -2.64, 95%CI (-3.92, -1.36), P < 0.05]. There was no significant difference between IPSS [WMD = 0.12, 95%CI (-0.27, 0.51), P > 0.05], QOL [SMD = 0.00, 95%CI (-0.57, 0.57), P > 0.05] and Qmax [SMD = 0.06, 95%CI (-0.26, 0.37), P > 0.05]. Conclusion 980 nm diode laser vaporization of prostate is safe and effective in treating benign prostatic hyperplasia, and compared with TURP, it has advantages in shorter hospital stays and shorter catheterization time.

Objective To investigate the safety and efficacy of wide local excision surgery combined with 5-aminolaevulinic acid(ALA)-photodynamic therapy(PDT)in treating Paget's disease of the scrotum in elderly people.Methods Patients with an average age of 68.4 ± 4.7 years undergoing wide local excision surgery combined with ALA-PDT for Paget's disease of the scrotum from June 2014 to February 2018 were followed up.All patients underwent wide local excision surgical treatment first and were then enrolled in ALA-PDT study after the diagnosis of Paget's disease of the scrotum was confirmed.Four cases were eliminated as a result of two patients refusing photodynamictherapy for various reasons and two patients lost during follow-up after ALA-PDT.A total of 16 patients were included in the study,of whom 6 cases were in Ray stage A1,7 cases in stage A2 and 3 cases in stage B.Patients underwent 3 courses of ALA-PDT after operation.Then the efficacy,shortand medium-term complications were followed up.Results The duration of disease among the 16 patients ranged from 4 to 76 months before diagnosis,with an average of 35.7 months.Surgery was performed immediately after diagnosis.Ten patients underwent resection and suture and 6 patients were treated with skin flap transfers.Of the patients treated with surgery,3 patients received suspicious lymph node dissection and 1 patient underwent reoperation due to skin flap necrosis.Patients were followed up for 3 months to 3 years and 6 months after ALA-PDT.Recurrence and distant metastasis occurred in 2 cases,with 1 case of brain metastasis and 1 case of systemic metastasis,and the overall recurrence rate was 12.5％.During the follow-up,there were no other serious complications except for 1 case(6.3 ％)with lower limb movement disorders.Conclusions Wide local excision surgery combined ALA-PDT has good clinical outcomes,low recurrence rates and few complications for the treatment of Paget's disease of the scrotum in elderly people.

Objective To explore the difference of brain function remodeling in patients with differ-ent motor ability and record the brain function index of patients returning to exercise 2 years after an-terior cruciate ligament reconstruction(ACLR).Methods Patients undergoing ACLR in year 2017 and 2018(2 years after ACLR)were selected and randomly divided into a return-to-exercise(CP,n=7)group,a non-return-to-exercise(NP,n=7)group.Moreover,8 healthy counterparts of the CP group were chosen into a healthy control(HC)group.Resting state functional magnetic resonance imaging(rs-fMRI)was used to obtain the blood oxygen level dependent signals,and the amplitude of low-frequen-cy fluctuation(ALFF)was computed across the typical band(0.01～0.08 Hz),sub-band Slow-4(0.027～0.073 Hz)and Slow-5(0.01～0.027 Hz).Meanwhile,brain maps were obtained and two-sample t-tests were performed among different groups(P<0.005).Results In the typical frequency band,the average ALFF value was higher in the CP and HC groups than the NP group for the Cerebelum_Crus1,but lower in the CP group than the NP group for the Occipital_Mid,higher in the CP group than the HC group for the Putamen and higher in the NP group than the HC group for the Frontal_Mid_Orb.More-over,in the Slow-4 band,the ALEF level was lower in the CP group than the NP group for the Oc-cipital_Mid,higher in the CP group than the HC group for the Putamen,and higher in the NP group than the HC group for the Frontal_Mid_Orb and cerebellum_Crus2.However,in the Slow-5 band,the ALEF values were higher in the CP group than the NP group for the Occipital_Inf and Precen-tral,but lower for the caudate.In the same band,those values were higher in the CP group than in the HC group for the Cerebellum_Crus1,but lower in the NP group than the HC group for the Cere-bellum_Crus1 and Supp_Motor_Area,and higher in the NP group than the HC group for the Fron-tal_Mid_Orb.Conclusion The patients returning to exercise after ACLR have higher cerebellar remodel-ing and lower visual compensation than those not,and display higher basal ganglia and cerebellar nerve remodeling than healthy controls,suggesting that functional compensation occurs in the former pa-tients.Moreover,Slow-4,Slow-5 and other sub-bands can complement the classical frequency bands and are worthy of further study.