A retrospective data collection was conducted on 16 patients who underwent secondary resection of bladder cancers using β-knife resection. The postoperative follow-up period is 12(10, 15)months, and no perioperative complications were detected. Among them, there were 3 cases of tumor recurrence, 2 cases continued to undergo β-knife resection, and 1 case underwent radical cystectomy. The safety of β-knife secondary electric cutting is high, and it can correct the insufficient first TURBT.

A retrospective data collection was conducted on 16 patients who underwent secondary resection of bladder cancers using β-knife resection. The postoperative follow-up period is 12(10, 15)months, and no perioperative complications were detected. Among them, there were 3 cases of tumor recurrence, 2 cases continued to undergo β-knife resection, and 1 case underwent radical cystectomy. The safety of β-knife secondary electric cutting is high, and it can correct the insufficient first TURBT.

Objective:To evaluate the test-retest reliability of MRI criteria in the 2019 Bosniak classification of cystic renal masses (CRMs) and to analyze the impact of lesions′ property, size and readers′ experience on the test-retest reliability.Methods:From January 2009 to June 2019, 207 patients with 207 CRMs were included in this retrospective study. All of them underwent renal MRI and surgical-pathologic examination. According to Bosniak classification, version 2019, all CRMs were independently classified twice by eight radiologists with different levels of experience. All radiologists were blinded to the pathology of the lesions. By using intraclass correlation coefficient (ICC), test-retest reliability was evaluated for all CRMs and for subgroups with different pathological properties (benign and malignant) and different sizes (≤40 mm and>40 mm). The test-retest reliability of 4 senior readers (≥10 years of experience) and 4 junior readers (<10 years of experience) were evaluated respectively. The comparison of ICC was performed using Z test. Results:The 207 CRMs included 111 benign lesions (83 benign cysts, 28 benign tumors) and 96 malignant tumors. There were 87 lesions with maximum diameter ≤40 mm and 120 with maximum diameter>40 mm. The test-retest reliability (ICC) of each reader for all lesions was 0.776-0.888, the overall ICC was 0.848 (95%CI 0.821-0.872). The ICCs of senior and junior readers were 0.853 (95%CI 0.824-0.880) and 0.843 (95%CI 0.811-0.871) respectively, without significant difference between the two groups ( Z=0.85, P=0.374). The ICC of all readers was 0.827 for benign lesions and 0.654 for malignant lesions, showing significant difference ( Z=2.80, P=0.005). The ICC was 0.770 for lesions ≤40 mm and 0.876 for lesions>40 mm, which was significantly different ( Z=-2.36, P=0.018). For CRM subgroups with different pathological properties and different sizes, there was no significant difference in test-retest reliability between senior and junior readers (all P>0.05). Conclusion:The test-retest reliability of MRI criteria in the 2019 Bosniak classification of CRMs is excellent and unaffected by readers′ experience. The reliabilities are not consistent among CRMs of different pathological properties and different sizes, but all reached the level of good and above.

Although primary vesical calculi is an ancient disease, the mechanism of calculi formation remains unclear. In this study, we established a novel primary vesical calculi model with d,l-choline tartrate in mice. Compared with commonly used melamine and ethylene glycol models, our model was the only approach that induced vesical calculi without causing kidney injury. Previous studies suggest that proteins in the daily diet are the main contributors to the prevention of vesical calculi, yet the effect of fat is overlooked. To assay the relationship of dietary fat with the formation of primary vesical calculi, d,l-choline tartrate-treated mice were fed a high-fat, low-fat, or normal-fat diet. Genetic changes in the mouse bladder were detected with transcriptome analysis. A high-fat diet remarkably reduced the morbidity of primary vesical calculi. Higher fatty acid levels in serum and urine were observed in the high-fat diet group, and more intact epithelia in bladder were observed in the same group compared with the normal- and low-fat diet groups, suggesting the protective effect of fatty acids on bladder epithelia to maintain its normal histological structure. Transcriptome analysis revealed that the macrophage differentiation-related gene C-X-C motif chemokine ligand 14 (Cxcl14) was upregulated in the bladders of high-fat diet-fed mice compared with those of normal- or low-fat diet-fed mice, which was consistent with histological observations. The expression of CXCL14 significantly increased in the bladder in the high-fat diet group. CXCL14 enhanced the recruitment of macrophages to the crystal nucleus and induced the transformation of M2 macrophages, which led to phagocytosis of budding crystals and prevented accumulation of calculi. In human bladder epithelia (HCV-29) cells, high fatty acid supplementation significantly increased the expression of CXCL14. Dietary fat is essential for the maintenance of physiological functions of the bladder and for the prevention of primary vesical calculi, which provides new ideas for the reduction of morbidity of primary vesical calculi.

Objective:To investigate the protective effect of somatostatin (SS) on acute kidney injury (AKI) of paraquat (PQ) poisoned mice and its mechanism.Methods:From December 2017 to April 2018, a total of 48 SPF male BALB/C mice were selected and randomly divided into 4 groups, with 12 mice in each group: Control group, SS group (20 mg/kg SS was injected 1 hour before and 3 hours after gavage with normal saline) , PQ group (2% PQ 60 mg/kg by gavage) and PQ+SS group (Intragastric administration was performed with 2% PQ solution of 60 mg/kg, and 20 mg/kg SS was administered 1 h before and 3 h after intragastric administration) , 12 mice in each group were observed for the general situation and behavioral effects. After 24 hours of modeling, mice were sacrificed.Then blood was extracted after eyeball was removed, and both kidneys were removed by laparotomy. Serum IL-6, TNF-α and MPO levels were determined by ELISA. The characteristic pathological changes of toxic renal tubular injury were observed under light microscope and scored accordingly. The changes of NF-κB expression were detected by Western-Blot, SOD, Caspase-3 and malondialdehyde (MDA) were detected by chemical colorimetry.Results:Mice in Control group and SS group showed normal general conditions and behaviors; Mice in PQ group were significantly worse than those in Control group, showing decreased feeding and activity, dry fur, hair shedding and listless spirit; The above symptoms in the mice of PQ+SS group were alleviated compared with the PQ group. Under the light microscope, the renal tissue structure of PQ group was obviously disordered and severely damaged, and the nephropathy score was (6.14±0.72) . The performance of PQ+SS group under light microscope was improved compared with PQ group, and nephropathy score (4.36±0.42) decreased ( P<0.05) . Compared with the Control group, serum TNF-α (39.89±3.32) pg/ml, IL-6 (77.29±4.77) pg/ml, renal NF-κB (2.29±0.097) , MPO (0.31±0.017) μg/ml, MDA (0.91±0.03) mmol/mg prot, and Caspase-3 (376.51±8.24) % levels were significantly increased in the PQ group, while the level of renal SOD (2.36±0.73) U/mg prot was significantly decreased ( P<0.05) . Compared with the PQ group, serum TNF-α (33.82±1.57) pg/ml, IL-6 (58.49±5.89) pg/ml, renal NF-κB (0.84±0.05) , MPO (0.22±0.01) μg/ml, MDA (0.72±0.05) mmol/mg prot, Caspase-3 (327.32±21.93) % decreased significantly, and renal SOD (4.90±0.81) U/mg prot increased significantly in the PQ+SS group ( P<0.05) . Conclusion:PQ poisoning can lead to AKI in mice, while SS can reduce AKI caused by PQ poisoning, improve the general survival state of PQ poisoned mice, and play a certain protective role in kidney injury caused by PQ poisoning, which may be achieved by inhibiting oxidative stress response, inflammatory response and apoptosis caused by poisoning.

Objective:To investigate the protective effect of somatostatin (SS) on acute kidney injury (AKI) of paraquat (PQ) poisoned mice and its mechanism.Methods:From December 2017 to April 2018, a total of 48 SPF male BALB/C mice were selected and randomly divided into 4 groups, with 12 mice in each group: Control group, SS group (20 mg/kg SS was injected 1 hour before and 3 hours after gavage with normal saline) , PQ group (2% PQ 60 mg/kg by gavage) and PQ+SS group (Intragastric administration was performed with 2% PQ solution of 60 mg/kg, and 20 mg/kg SS was administered 1 h before and 3 h after intragastric administration) , 12 mice in each group were observed for the general situation and behavioral effects. After 24 hours of modeling, mice were sacrificed.Then blood was extracted after eyeball was removed, and both kidneys were removed by laparotomy. Serum IL-6, TNF-α and MPO levels were determined by ELISA. The characteristic pathological changes of toxic renal tubular injury were observed under light microscope and scored accordingly. The changes of NF-κB expression were detected by Western-Blot, SOD, Caspase-3 and malondialdehyde (MDA) were detected by chemical colorimetry.Results:Mice in Control group and SS group showed normal general conditions and behaviors; Mice in PQ group were significantly worse than those in Control group, showing decreased feeding and activity, dry fur, hair shedding and listless spirit; The above symptoms in the mice of PQ+SS group were alleviated compared with the PQ group. Under the light microscope, the renal tissue structure of PQ group was obviously disordered and severely damaged, and the nephropathy score was (6.14±0.72) . The performance of PQ+SS group under light microscope was improved compared with PQ group, and nephropathy score (4.36±0.42) decreased ( P<0.05) . Compared with the Control group, serum TNF-α (39.89±3.32) pg/ml, IL-6 (77.29±4.77) pg/ml, renal NF-κB (2.29±0.097) , MPO (0.31±0.017) μg/ml, MDA (0.91±0.03) mmol/mg prot, and Caspase-3 (376.51±8.24) % levels were significantly increased in the PQ group, while the level of renal SOD (2.36±0.73) U/mg prot was significantly decreased ( P<0.05) . Compared with the PQ group, serum TNF-α (33.82±1.57) pg/ml, IL-6 (58.49±5.89) pg/ml, renal NF-κB (0.84±0.05) , MPO (0.22±0.01) μg/ml, MDA (0.72±0.05) mmol/mg prot, Caspase-3 (327.32±21.93) % decreased significantly, and renal SOD (4.90±0.81) U/mg prot increased significantly in the PQ+SS group ( P<0.05) . Conclusion:PQ poisoning can lead to AKI in mice, while SS can reduce AKI caused by PQ poisoning, improve the general survival state of PQ poisoned mice, and play a certain protective role in kidney injury caused by PQ poisoning, which may be achieved by inhibiting oxidative stress response, inflammatory response and apoptosis caused by poisoning.

Objective: To explore the protective effect and mechanism of Somatostatin (SS) on the mice with Paraquat (PQ) poisoning, and to provide theoretical basis for clinical treatment of PQ poisoning. Methods: 48 SPF male BALB/c mice were randomly divided into control group, SS group, PQ group and PQ+SS group, with 12 mice in each group. 20 ml/kg SS solution was intraperitoneally injected into the SS group and PQ+SS group, and the same amount of normal saline was intraperitoneally injected into the PQ group and control group. After 1 hour of the above treatment, PQ group and PQ+SS group were given 60 mg/kg PQ solution by one-time gavage, while the control group and SS group were given the same amount of normal saline by gavage. After the above treatment for 3 hours, the SS group and PQ+SS group were intraperitoneally injected with SS solution (20 ml/kg) again, and the PQ group and the control group were intraperitoneally injected with the same amount of normal saline. 6 eyeballs were randomly selected from each group for blood collection, and the levels of TNF-α, MPO and il-6 in the blood of mice were detected by ELISA and other methods. The left lung was taken after blood collection to calculate the D/W ratio. The levels of SOD, caspase-3 and MDA were detected in some lung tissues by chemical colorimetry, and the amount of NF-κB was detected by Western blot. The lung histopathological changes were observed under light microscope. Results: The mice in the control group and SS group showed normal activity and good general condition; Mice in the PQ group ate less and moved less, responded slowly to stimulation, breathed shallow and fast with thickened breath sound, had messy and dull fur, and had varying degrees of cyanosis on their lips and limbs; The above performance of PQ+SS group was less than that of PQ group. Under the light microscope, the alveolar structure of PQ group was disordered and seriously damaged. The pathological changes of lung tissue in PQ+SS group were significantly improved compared with that in PQ group, and the pathological scores were decreased (all P<0.05) . Compared with the control group, there was no significant change in the levels of various indicators in the SS group (all P>0.05) . While the levels of inflammatory cytokines (IL-6, TNF-α, Protein expression of NF-κB) , oxidative cytokines (MPO, MDA) and apoptotic cytokines caspase-3 in PQ mice were significantly increased, and the levels of oxidative cytokines SOD and lung tissue D/W were significantly decreased (all P<0.05) . Compared with the PQ group, the PQ+SS group, the levels of inflammatory cytokines (IL-6, TNF-α, Protein expression of NF-κB) , oxidative cytokines (MPO, MDA) and apoptotic cytokines caspase-3 decreased, and the levels of oxidative cytokines SOD and lung tissue D/W increased (all P<0.05) . Conclusion PQ poisoning can cause lung injury in mice, while SS can alleviate lung injury in PQ poisoned mice, improve the general survival state of mice, and play a certain protective role in lung injury caused by PQ poisoning, which may be achieved by SS throμgh reducing the inflammatory response, oxidative stress response and lung tissue apoptosis in lung injury caused by PQ poisoning.

Objective: To investigate the application of the flipped classroom based on micro-class versus traditional class in animal surgery teaching, and to provide new thinkings for animal surgery teaching. Methods: A total of 120 undergraduates from Navy Medical University were randomly divided into control group (class A) and experimental group (class B). The students in class A received traditional teaching, and those in class B received flipped classroom teaching. Questionnaire survey and course assessment were performed after teaching, and a comparative analysis was also performed. Results: The self-assessment survey showed that 88.3%, 73.3%, 71.6%, 48.3%, and 73.3% of the students in class A (traditional teaching) filled in the questionnaire with "Very Helpful and Helpful", while 91.7%, 85.0%, 83.3%, 78.3%, and 75.0% of the students in class B (flipped classroom teaching) filled in with "Very Helpful and Helpful"; class B gave better overall evaluation of teaching model than that of class A. The mean total score of class B was 0.91, higher than that of class A (8.43 vs. 7.52, P<0.05), and the mean total score of examination papers in class B was 10.92, higher than that in class A (101.13 vs. 90.21, P<0.05). Conclusion Flipped classroom based on micro-class could improve the teaching effect of debridement course on animal surgery and increase students' self-learning ability.

Skeleton metabolic diseases such as osteoporosis and fracture have posed an detrimental impact on the elderly, which is a primary cause of paralysis and even death in patients. Osteoblast and osteoclast are the two major parts in the regulation of bone homeostasis and imbalance of these two cells, which may result in dysfunction of bone metabolism. Recent researches indicated that bone homeostasis was primarily regulated by endocrine, paracrine, and local mechanical processes. However, increasing evidences have indicated that the significant role of nerve system may involve in bone metabolism via both central and peripheral pathways. Neuropeptide Y(NPY), a neurotransmitter that belongs to a family of peptides,serves as a critical hinge connecting nerve system and skeleton system. Several studies have suggested that NPY generated by both central and peripheral nerve system could regulate bone homeostasis and that NPY-energic nerve fibers distributed on bone surface and in intramedullary cavity and NPY receptors located at osteoblast, chondrocyte, and osteocytes also provide a basis for nerve-skeleton metabolic pathways. NPY can directly regulate osteoprogenitor, involving in the production and differentiation of osteoblast and osteoclast. In addition, as a pivotal molecular of energy homeostasis, NPY may affect glucose and fat homeostasis. Studies of animal models also have further indicated energy metabolism may directly or indirectly participate in the regulation of bone mass. Therefore, further researches on the relationship between NPY and bone homeostasis may facilitate to unveil the central and peripheral regulatory effect of NPY on bone homeostasis and provide a new sight for the treatment of skeleton metabolism-related diseases in the future.

Objective To evaluate the value of the combination of troponin and copeptin in the early diagnosis of acute myocardial infarction(AMI) by a meta-analysis.Methods The studies about the application of the combination of troponin and copeptin in the early diagnosis of AMI were searched from Pubmed,CNKI,Wan Fang and VIP databases during their inception and May 2016,and were analyzed by the Meta-DiSc 1.4 software.Results A total of 19 relevant studies were enrolled,including 11 176 patients.95％ CI was calculated with the random effect model.The sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odds ratio(DOR) and the area under curve(AUCROC) of troponin alone and the combination of troponin and copeptin in the early diagnosis of AMI were 77％ (75％-79％) and 92％ (91％-93％),0.85 (0.85-0.86) and 0.60 (0.59-0.61),5.78 (4.01-8.32) and 2.25 (1.98-2.55),0.22(0.18-0.28) and 0.12 (0.09-0.17),32.21 (23.72-43.75) and 20.23 (14.33-28.55),and 0.911 8 and 0.788 8,respectively.Conclusion The combined detection of troponin and copeptin has high sensitivity,which may reduce the rate of missed diagnosis of AMI.However,the detection of troponin alone has high specificity and diagnostic accuracy.