OBJECTIVETo compare the efficacy and safety of staged retrograde flexible ureteroscopic lithotripsy (FURS) and miniaturized percutaneous nephrolithotomy (m-PCNL) for treatment of renal stones of 2-4 cm in diameter.

METHODSThis randomized controlled trial was conducted in 70 patients with renal stones of 2-4 cm in diameter admitted in our hospital between January 2013 and December 2015. The patients were randomized to receive staged FURS (35 cases) or m-PCNL (35 cases), and the total treatment time, total hospital stay after procedure, total medical cost, treatment success, decrease in hemoglobin level and complications were compared between the two groups.

RESULTSThe treatment success rate was 100% in both groups, but the complete stone-free rate was significantly lowered in FURS group than m-PCNL group (65.71% vs 94.29%, P<0.01). The average decrease in hemoglobin level was 3.37∓1.56 g/L in FURS group and 11.93∓2.24 g/L in m-PCNL group (P<0.01). The overall complication rates in the two groups were 6.25% and 9.37%, respectively (P>0.05). Minor complications (grade I by Clavien-Dindo classification) occurred in one case in FURS group (fever) and two cases in m-PCNL group (self-limiting hematuria); major complications (grade II) occurred in one case in FURS group (steinstrase) and one case in m-PCNL group (blood transfusion). In staged FURS and m-PCNL groups, the mean total treatment time was 4.06∓1.11 vs 1.26∓0.47 weeks (P<0.01), the mean hospital stay after procedure was 3.66∓1.29 vs 5.13∓0.43 days (P<0.01), and the mean total medical cost was 54 291.00 RMB ∓6149.00 vs 23 482.00 RMB ∓2317.00 (P<0.01), respectively.

CONCLUSIONFURS is safe and effective for treatment of renal stones of 2-4 cm in diameter, and a staged procedure is necessary to achieve a stone-free status for large calculi. Both sophisticated equipment and rich surgical experience are essential to ensure treatment success.

China ; Humans ; Maximum Allowable Concentration ; Occupational Exposure ; prevention & control

BACKGROUNDIgA nephropathy is the major cause of end-stage renal failure in patients with primary glomerular diseases. Tumor suppressor cylindromatosis (CYLD), the recently identified member of the deubiquitinating enzymes, has been actively involved in regulation of inflammation. This study was undertaken to investigate the CYLD expression profile in IgA nephropathy and identify factors associated with CYLD expression.

METHODSForty-one cases of IgA nephropathy were selected. CYLD expression in the kidney biopsy tissue was measured by immunohistochemical staining. Relevant clinical and pathological data were analyzed, and Logistic regression analysis was carried out to identify factors associated with CYLD expression.

RESULTSCYLD was specifically expressed in renal tubular epithelial cells in 70% of the studied patients with IgA nephropathy. All patients with positive CYLD staining had proteinuria, while only 72.7% of patients with negative CYLD had proteinuria (P = 0.003). Among studied proteinuric patients, those with positive CYLD had significantly less tubulo-interstitial lesions and higher estimated glomerular filtration rate (eGFR) levels when compared with those patients showed negative CYLD results. Logistic regression analysis indicated that the urinary protein excretion and eGFR were identified as predictors for the CYLD expression.

CONCLUSIONCYLD is expressed in renal tubular epithelial cells and appears to be associated negatively with tubulointerstitial lesions, however, its exact functional role remains to be clarified in further experiments.

Deubiquitinating Enzyme CYLD ; Glomerular Filtration Rate ; Glomerulonephritis, IGA ; metabolism ; Humans ; Immunohistochemistry ; Kidney Diseases ; metabolism ; Logistic Models ; Proteinuria ; metabolism ; Tumor Suppressor Proteins ; metabolism

OBJECTIVETo investigate the long-term effects of non-surgical treatment on clinical and hematologic states of patients with generalized aggressive periodontitis (GAgP).

METHODSPatients with GAgP (n = 25) and healthy controls (n = 28) were recruited. The clinical parameters, including probing depth (PD), bleeding index (BI), attachment loss (AL) were examined and recorded. Blood cell variables, including white blood cells (WBC), leukocyte, neutrophil, and lymphocyte counts, as well as serum triglycerides, fasting glucose and protein parameters, including total protein, albumin, globulin, and albumin/globulin ratio (A/G), were analyzed. Twenty-five GAgP patients received non-surgical treatment and the clinical and blood parameters 3 to 7 years after treatment were re-evaluated. Clinical and hematological parameters of the two groups were compared. Comparisons of clinical and hematologic parameters pre- and post-treatment in GAgP group were performed through one-way ANOVA and paired-t test.

RESULTSElevated white blood cells, neutrophil numbers and serum total protein, globulin levels were observed in patients with GAgP compared to controls[(6.3 ± 2.0)×10(9)cell/L vs.(5.4 ± 1.0)×10(9)cell/L, (4.1 ± 1.8)×10(9) cell/L vs.(3.0 ± 0.9)×10(9) cell/L, (78.2 ± 4.4) g/L vs. (75.6 ± 4.6) g/L and (29.3 ± 3.8) g/L vs.(26.5 ± 3.9) g/L respectively, P < 0.05]. A/G ratio was lower in the GAgP group than in the control group (1.7 ± 0.2 vs.1.9 ± 0.3, P < 0.01). Three to seven years after periodontal treatment, the reduction of PD and BI was observed in GAgP group(P < 0.05). There were significant decreases of WBC count, neutrophil count, serum total protein and globulin level, and significant increases of albumin level and A/G at 3 to 7 years after treatment(P < 0.05).

CONCLUSIONSNon-surgical treatment may have long-term beneficial effect on the periodontal clinical status and hematologic parameters of generalized aggressive periodontitis.

Adult ; Aggressive Periodontitis ; blood ; therapy ; Blood Glucose ; metabolism ; Blood Proteins ; metabolism ; Body Mass Index ; Case-Control Studies ; Dental Scaling ; Female ; Follow-Up Studies ; Humans ; Leukocyte Count ; Longitudinal Studies ; Male ; Neutrophils ; pathology ; Periodontal Attachment Loss ; blood ; Periodontal Index ; Root Planing ; Serum Albumin ; metabolism ; Serum Globulins ; metabolism ; Tooth Extraction ; Treatment Outcome ; Triglycerides ; blood ; Young Adult

Objective To investigate the efficacy and tolerability of a recombinant human tumor necrosis factor:Fc fusion protein (rhTNFR:Fc,with a trade name of Yisaipu) in the treatment of moderate to severe psoriasis vulgaris.Methods A multicentre,randomized,double blind,and parallel-controlled trial was performed.One hundred and forty-four patients with moderate to severe psoriasis vulgaris from four centres were randomly assigned and treated with either once-weekly subcutaneous injection of rhTNFR:Fc (50 mg) or oral methotrexate (MTX)(7.5 mg) for 12 weeks.Patients were followed up at 2,4,8,12 weeks after the treatment.Results One hundred and twenty-four patients finished the 12-week course of treat- ment.At 12 weeks after the treatment,a 50%,75%,90% improvement in psoriasis area and severity index (PASI) was achieved by 86.11%,76.39%,52.78% respectively of rhTNFR:Fc-treated patients,and by 63.89%,44.44%,22.22% respectively in MTX-treated patients,and all the three improvement rates were of significant difference between the two groups of patients (all P0.05).Conclusion Compared with MTX,rhTNFR:Fc acts more quickly with a higher cure rate and less toxic reactions in the treatment of psoriasis vulgaris.

OBJECTIVETo investigate the effects of platelet-rich plasma (PRP) on the proliferation of dermal papilla cells (DPCs) and hair follicle regeneration.

METHODSPRP was prepared using the double-spin method and applied to DPCs. The proliferative effect of activated PRP on DPCs was measured using MTT assay. To understand the influence of activated PRP on the hair-inductive capacity of DPCs, freshly isolated epidermal cells and DPCs of passage 4 were resuspended, mixed with various concentrations of a PRP (0%, 5% or 10%) and were then transferred to a grafting chamber, which was implanted onto the dorsal skin of nude mice. The chambers were removed 1 week after grafting and HF formation was monitored for 4 weeks; the graft site was harvested and processed for histological examination.

RESULTSActivated PRP increased the proliferation benefited the aggregative growth of DPCs. There are significant difference in the yield of hair follicles compared with 10% PRP (344 +/- 27) with 0% PRP (288 +/- 35) in the area of reconstituted skin (P < 0.05). The areas treated with PRP demonstrated an increase in hair follicles density of 19.4%. Ten percent PRP (18 +/- 1) d also can significantly shorten the time of hair formation, compared with 0% PRP (20 +/- 1) d (P < 0.05).

CONCLUSIONSThere is a considerable effect of PRP on the time of hair formation and the yield of hair follicles reconstitution.

Animals ; Cell Proliferation ; Cells, Cultured ; Female ; Hair Follicle ; cytology ; growth & development ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Mice, Nude ; Platelet-Rich Plasma ; Regeneration ; Skin ; cytology ; Skin, Artificial

This study was purposed to investigate the proliferation, differentiation and apoptosis of human promyelocytic leukemia HL-60 cells induced by proanthocyanidin (PAC). HL-60 cells were incubated with 20 mg/L PAC for 24 h, the cell growth was evaluated by CCK-8 assay. the effect of PAC on HL-60 cells was evaluated and the cells morphology was observed by optical microscopy. Expression of CD14 and CD11b, and cell cycle were analyzed by flow cytometry. The results showed that the growth of HL-60 cells was inhibited after treatment with PAC of different concentration in a dose-dependent manner (P < 0.05). 20 mg/L PAC displayed significant effect on HL-60 cells with inhibition ratio (72.3 ± 1.8)% for 24 h. Microscopy displayed that some cells differentiated to relative mature cells after treating for 48 h. Expression of CD14 increased and the expression of CD11b increased a little after treating with 20 mg/L PAC for 24 h, the ratio of cells in G0/G1 phase increased, but the ratio of cells in S phase decreased. The mRNA and protein expression of P21 gene increased, but the protein expression of CDK4 and Cyclin D1 decreased. It is concluded that PAC may inhibit the proliferation of HL-60 cells in vitro, induces the differentiation of HL-60 cells, and arrests the cells in G0/G1 phase. The possible mechanism may be related to up-regulation of P21 gene expression and down-regulation of the protein expression of CDK4 and Cyclin D1.
Cell Cycle Checkpoints ; drug effects ; Cell Differentiation ; drug effects ; Cyclin D1 ; metabolism ; Cyclin-Dependent Kinase 4 ; metabolism ; Cyclin-Dependent Kinase Inhibitor p21 ; metabolism ; Gene Expression Regulation, Leukemic ; HL-60 Cells ; Humans ; Proanthocyanidins ; pharmacology

Based on standard carotid endarterectomy, we performed modified carotid endarterectomy in two cases of carotid artery stenosis by changing the direction of the carotid artery incision to avoid restenosis of the internal carotid artery without using a patch. The two patients recovered smoothly without any complications. Compared with eversion or patch endarterectomy, this modified carotid endarterectomy avoids restenosis of the carotid artery and shortens operation time.

OBJECTIVETo explore the methods for constructing the digital three-dimensional model of fetal heart.

METHODSOriginal two-dimensional CT image data sets were collected from 4 abortion fetuses with fetal malformations but not heart malformation or chromosomal abnormalities. The three-dimensional fetal heart model was reconstructed using Mimics14.0 software.

RESULTSIn the reconstructed three-dimensional fetal heart, the left atrium, left ventricle, right atrium, right ventricle, the ascending aorta, the main pulmonary and their branches, the superior cava and inferior vena cava were marked with different colors, and these structures could be displayed individually or with other structures. This model also allowed three-dimensional arbitrary scaling, shifting or rotation at any angle, and the diameter of the each vessel could be measured with the software.

CONCLUSIONThe fetal heart model can be successfully reconstructed from the CT datasets using three-dimensional reconstruction software to facilitate clinical and anatomical teaching.

Female ; Fetal Heart ; anatomy & histology ; Heart Atria ; anatomy & histology ; Heart Defects, Congenital ; Heart Ventricles ; anatomy & histology ; Humans ; Imaging, Three-Dimensional ; Models, Anatomic ; Pregnancy ; Software ; Tomography, X-Ray Computed ; Vena Cava, Inferior ; anatomy & histology

OBJECTIVETo explore the effects of hydrogen sulfide (H(2)S) on myocardial fibrosis and expressions of MAPK1/3 and MMP-8 in diabetic rats.

METHODSForty adult male SD rats were randomized into 4 groups, namely the control group, diabetes mellitus group (STZ group), diabetes mellitus with H(2)S treatment group (STZ+H(2)S group), and normal rats with H(2)S treatment group (H(2)S group). Diabetes was induced by intraperitoneal injections of 40 mg/kg streptozotocin (STZ). The rats in the control group received daily intraperitoneal injections of saline, and those in STZ+H(2)S group and H(2)S group were given NaHS (100 µmol/kg) injections. After 8 weeks, the pathologies of cardiac fibrosis were examined with HE staining, and the expressions of collagen I, MAPK1/3 and MMP-8 were analyzed with Western blotting.

RESULTSCompared with the control group, the diabetic rats showed increased collagen content and obvious interstitial fibrosis in the myocardial tissue with significantly increased expression levels of collagen I, MAPK1/3 and MMP-8 (P<0.05); all these changes were obviously reversed by treatment with H(2)S (P<0.05). Collagen I, MAPK1/3 and MMP-8 expression levels and the degree of myocardial fibrosis were comparable between H(2)S group and control group (P>0.05).

CONCLUSIONHydrogen sulfide can attenuate cardiac fibrosis in diabetic rats, and the mechanism may involve the inhibition of MAPK1/3/MMP-8 signal pathway.

Animals ; Collagen Type I ; metabolism ; Diabetes Mellitus, Experimental ; metabolism ; pathology ; Fibrosis ; Hydrogen Sulfide ; pharmacology ; Injections, Intraperitoneal ; Male ; Matrix Metalloproteinase 8 ; metabolism ; Mitogen-Activated Protein Kinase 1 ; metabolism ; Mitogen-Activated Protein Kinase 3 ; metabolism ; Myocardium ; pathology ; Rats ; Rats, Sprague-Dawley