Objective To evaluate the safety of tubeless micro-percutaneous nephrolithotomy (MPCNL). Methods Forty patients who met the criteria(single percutaneous tract, no serious bleeding or perforation in the collecting system and absence of insignificant residual fragments under B-US)were included. After the operation of stone fragmentation, all patients were randomly divided into 2 groups. Twenty patients underwent standard MPCNL(group A), 16 eases had stones in kidney and 4 in upper ureter. Longitudinal sizes of calculi were 1.3-8. 6 era(mean 3.4 era). Twenty patients in group B were with tubeless procedures, 14 patients had stones in kidney and 6 in upper ureter. Longi-tudinal sizes of calculi were 1.1-7. 9 era(mean 3.1 era). Double J stents were placed in all eases. Changes of hemoglobins, pain and complications were recorded and ststistieally analyzed. Results There were no differences in stone size(P=0. 23), operation time (98±29 rain vs 92±31 min, P=0. 63) between the 2 groups. The changes of hemoglobin had no significant difference between 2 groups[(3.3±1.6)% vs (3.1±1.6)%, P=0. 49]. Postoperative pain was assessed using a visual analog scale. The scores of both groups on the first postoperative day were 3.6±1.8(group A) and 3.3±1.5(group B,P=0. 66). On the third day the scores were 1.6±1.2 and 1.8±1.3(P=0. 62). Both groups had 1 patient suffered from mild fever. No transfuaion was performed and no renal colic happened in 2 groups. Conclustion Under certain circumstance, tubeless MPCNL is a safe procedure for patients with urolithiasis.

Background and purpose: It was reported that activins, members of transforming growth factor-β superfamily, could induce several tumor cells into apoptosis. This study was designed to observe the effects of recombination human activin A on proliferation and apoptosis ofA549 cells. Methods: A549 cells were cultivated by routine method, then treated with different concentrations of recombination human activin A. Inhibitory effect of activin A on A549 cell proliferation was detected by MTT assay, and apoptosis of A549 cells was determined by flow cytometry. The expression of type Ⅱ receptors of activin (ActR Ⅱ and ActR Ⅱ B) was detected by Western blot. Results: Recombination human activin A inhibited the proliferation ofA549 cells in time-dependent and dose-dependent manners. Increases of apoptosis in A549 cells and expression of ActR I] and ActR ⅡB occurred dose-dependently after treated with acfivin A. Conclusion: Recombination human activin A inhibited cell proliferation and induced apoptosis in A549 cells, at least in part, by inducing expression of type Ⅱ receptors of activin and activation of its downstream signaling.

Objective To investigate the ch an ges of gastric intramucosal pH (pHi) during orthotopic liver transplantation (OL T) without venovenous bypasss. Methods Twenty patients (14 males and 6 females) aged (46.7 ?4.6) years, undergoing orthotopic liver transplantation without venovenous byp asss, were included in this study. A gastric tube technique was used to draw gas tric juice 3～5 mL to determine pHi and PiCO 2 before OLT, at 20 min preanhep atic phase, 30 min anhepatic phase, 30 min new hepatic phase and at 2 h and 2 4 h after operation. The arterial blood samples collected taken for the measure ments of PaCO 2, PO 2, pH, BE and HCO 3- at the same time point s as above. pHi was calculated through Henderson-Hasselbach equation. Results The gastric intraumucosal pH (pHi) was decreased significant ly at the time points of 30 min anhepatic phase and 30 min new hepatic phase c ompared with before operation (P

OBJECTIVETo evaluate the clinical effect of urethral dilation with a zebra guidewire-guided fascia dilator in the treatment of complex urethral stricture after hypospadias surgery.

METHODSThis study included 12 cases of complex urethral stricture after hypospadias surgery that had failed to respond to other urethral dilation therapies. A zebra guidewire was put into the urethra via a ureteroscope placed in through a suprapubic puncture hole. Then a fascia dilator was inserted along the zebra guidewire for urethral dilation. A silicone catheter was reserved for 2 weeks after the dilation.

RESULTSAll the 12 patients achieved smooth urination after removal of the catheter. During the 6 - 28 months follow-up, 8 of the cases were cured after 1 - 6 regular urethral dilations and the other 4 experienced no more dysuria.

CONCLUSIONUrethral dilation with a zebra guidewire-guided fascia dilator is a safe and effective method for the treatment of complex urethral stricture after hypospadias surgery.

Adolescent ; Child ; Child, Preschool ; Dilatation ; instrumentation ; methods ; Fasciotomy ; Humans ; Hypospadias ; surgery ; Male ; Treatment Outcome ; Urethral Stricture ; etiology ; surgery ; Urologic Surgical Procedures ; instrumentation ; methods

Objective To evaluate the long-term efficacy and safety of endoscopic mucosal resection (EMR) for lesions at gastroesophageal junction (GEJ). Methods A total of 51 lesions located at GEJ from 51 patients, with an average size of 10. 9±4. 0 mm (3-28 mm), were treated with EMR between November 2005 and March 2009, among which 39 were diagnosed as low grade dysplasia and 12 as high grade dysplasia pathologically after EMR. The histopathologic results were compared between biopsies and EMR samples. All patients were followed up endoscopically. Results Complete resection was achieved in 44 ( 86. 3% ). The histopathologic diagnosis of 25 cases (49. 9% ) was inconsistent between biopsy and EMR samples, with 24 exhibited higher grade dysplasia after EMR. Main complication during EMR was bleeding in 17 patients ( 33. 3% ), all of which were successfully managed. No perforation or postoperative stenesis occurred. Endoscopic follow-up was carried out in 8 patients for more than 3 years, in 17 for 2-3 years, in 12 for 1-2 years and in 14 for less than 1 year. No death occurred during follow-up. Conclusion EMR can be adquately adopted as an effective treatment for pre-cuncerous lesions at GEJ, which is important in blocking malignant progression of dysplastic lesions.

BACKGROUND: Thermotherapy has achieved remarkable therapeutic effect on patients with esophageal cancer. However, there are still some problems which cannot be answered today, such as the damage of esophageal mucosa during deep thermotherapy when metal stent is placed in esophagus. OBJECTIVE: To study the metal stent-caused damages to esophageal mucosa of pigs in radiofrequency hyperthermia. DESIGN, TIME AND SETTING: Observational study which was performed in the Department of Tumor, Affiliated Hospital of Luzhou Medical College from October 2004 to January 2005. MATERIALS: 13 pigs weighing 35-40 kg were used in this study. Esophagus stent of memory alloy with membrane was provided by Zhiye Medical Apparatus Institute of Changzhou, China METHODS: Five points were located for measurement, i.e. the middle of the stent, the exit of the stent, 2 cm and 4 cm a distance from the exit and 4 cm from the entrance. Esophagus of 13 pigs was heated for 30 minutes by SR-1000 radiofrequency hyperthermia machine in frequency of 40.82 MHz, pole plate of 25 cm Ⅱ 25 cm and power of 500-700 W. MAIN OUTCOME MEASURES: The esophageal mucosa was observed with naked eyes. And optical microscopy was used to observe the changes of the esophageal mucosa. RESULTS: Because one pig died of anesthesia and there were troubles of thermal detector lines in 4 pigs, only 8 pigs were included in the final analysis. Level of damage of esophageal mucosa on five temperature checkpoints was observed from grade 0 to 1 in naked eyes, and the difference of damaged level between five checkpoints was not obvious in statistics (H=2.0, P=0.157). Level of the damage was observed from grade 0 to 2 in microscope, and the difference was not obvious in statistics too (H=2.734, P=0.255). CONCLUSION: Influence of the metal stent on esophageal mucosa can be neglected in radiofrequency hyperthermia, and metal stent does not cause obvious mechanical damage or thermal damage to esophageal mucosa of pigs. It is safe and feasible to carry out radiofrequency hyperthermia on placed metal stent esophagus.

Objective To study the effect of bel-2 siRNA on apoptosis of HL-60 cells.Methods bcl-2 siRNA was synthesized in vitro transcription with silencer siRNA construction kit.The synthesized siRNA was transfected into HL-60 cells with Amine siPORT transfection.We used MTT flow cytometer and hoechst 33258 flourescence stainning t0 evaluate cell proliferation and apoptosis. Results.Bcl-2 siRNA could partially inhibit the growth of HL-60 cells.After incubated with bcl-2 siRNAl for 48 hours,HL-60 cells exhibited morphologic characteristic of apoptosis including chromatin condensation,crescents formation and nuclear fragmentation.Conclusion Effective bcl-2 siRNA can induce apoptosis and inhibit cell proliferation.

Methods: From September 3, 2018, to March 23, 2024, participants with essential hypertension (receiving antihypertensive medication treatment, hypertension group) and normal blood pressure (control group) were recruited from the Cardiology Department of Shanghai Hospital of Traditional Chinese Medicine, the Coronary Care Unit of Shanghai Tenth People's Hospital, the Physical Examination Center of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, and the Gaohang Community Health Service Center. This study employed the propensity score matching (PSM) method to reduce study participants selection bias. Spectral information in the facial visible light spectrum of the subjects was collected using a flame spectrometer, and the spectral chromaticity values were calculated using the equal-interval wavelength method. The study analyzed the differences in spectral reflectance across various facial regions, including the entire face, forehead, glabella, nose, jaw, left and right zygomatic regions, left and right cheek regions as well as differences in parameters within the Lab color space between the two subject groups. Feature selection was conducted using least absolute shrinkage and selection operator (LASSO) regression, followed by the application of various machine learning algorithms, including logistic regression (LR), support vector machine (SVM), random forest (RF), Naïve Bayes (NB), and eXtreme Gradient Boosting (XGB). The reduced-dimensional dataset was split in a 7 : 3 ratio to establish a classification and assessment model for facial coloration related to primary hypertension. Additionally, model fusion techniques were applied to enhance the predictive power. The performance of the models was evaluated using metrics including the area under the curve (AUC) and accuracy. Shapley Additive exPlanations (SHAP) was used to interpret the outcomes of the models. Results: A total of 114 participants were included in both hypertension and control groups. Reflectance analysis across the entire face and eight predefined areas revealed that the hypertensive group exhibited significantly higher reflectance of corresponding color light in the blue-violet region (P < 0.05) and a lower reflectance in the red region (P < 0.05) compared with control group. Analysis of Lab color space parameters across the entire face and eight predefined areas showed that hypertensive group had significantly lower a and b values than control group (P < 0.05). LASSO regression analysis identified a total of 18 facial color features that were highly correlated with hypertension, including the a values of the chin and the right cheek, the reflectance at 380 nm and at 780 nm of the forehead. The results of the multi-model classification showed that the RF classification model was the most effective, with an AUC of 0.74 and an accuracy of 0.77. The combined model of RF + LR + SVM outperformed a single model in their classification performance, achieving an AUC of 0.80 and an accuracy of 0.76. SHAP model visualization results indicated that the top three contributors to ideal prediction results based on the characteristics from the facial spectrum were the reflectance at 380 nm across the entire face and of the nose as well as the a value of the chin. Conclusion Within the same age group, patients with essential hypertension exhibited significant and regular changes in facial color and facial spectral reflectance parameters after the administration of antihypertensive drugs. Furthermore, facial reflectance indicators, such as the overall reflectance at 380 nm and the a value of the chin, could offer valuable references for clinically assessing the drug efficacy and health status of patients with essential hypertension.

OBJECTIVETo explore the feasibility of urethroplasty with transection of the urethral orifice and preservation and lengthening of the urethral plate in the treatment of hypospadias.

METHODSForty-eight patients with hypospadias (18 of the coronal type, 21 the penile type, 8 the penoscrotal type and 1 the perineal type) underwent urethroplasty with transection of the urethral orifice and preservation and lengthening of the urethral plate. The surgical effects were observed by following up the patients for 3-27 months.

RESULTSOne-stage surgical success was achieved in 44 of the cases, with satisfactory functional and cosmetic results but no complications. Two cases developed urinary fistula and another 2 urethral stricture, but all cured by the second surgery.

CONCLUSIONUrethroplasty with transection of the urethral orifice and preservation and lengthening of the urethral plate is a simple, safe and effective surgical procedure for the treatment of hypospadias.

Adolescent ; Child ; Child, Preschool ; Humans ; Hypospadias ; surgery ; Male ; Urethra ; surgery ; Urologic Surgical Procedures ; methods

Objective To investigate the effect of urinary training on urination control in infants using nappies after birth.Methods Stratified sampling method was used to investigate the daytime urination control and the using of diapers by children in kindergartens of 6 prefecture-level cities in Henan Province,China.The survey was conducted among parents of healthy children.Results In a total of 12 250 questionnaires,11 697 had response,and 10 562 valid questionnaires were collected,and the effective recovery rate was 86.22％.After the birth of infants,the age of toilet training was divided into 6 groups (0-＜ 3 months old group,3-＜ 6 months old group,6-＜ 12 months old group,12-＜ 18 months old group,18-＜ 24 months old group and no toilet training group).Results showed that toilet training within 12 months leads to higher urinary control rate compared with toilet training after 12 months and no toilet training till the age of 2 years old,70.56％ (4 831/6 847 cases) in contrast with 59.02％ (1 545/2 618 cases) and 42.48％ (466/1 097 cases),and the differences were statistically significant (x2 =114.76,335.48,all P ＜ 0.000 1).Within 12 months,there was no statistical difference in the urinary control rate between subgroups at 2 years of age(all P ＞0.05).After 12 months,the urination control rate decreased with the start time delayed till 2 years of age,and the urinary control rate at the age of 2 years old n different groups was 59.97％ (1 314/2 191 cases) and 54.10％ (231/427 cases) respectively.The results of other ages(0.5,1.0,1.5 years old) were similar to those of 2 years old.There was no difference between the groups of different genders (all P ＞ 0.05).Conclusions The use of diapers in infants before the age of 1 year to start urinary training is conducive to the development of urinary control in infants.