Objective To evaluate the predictive values of serum neutrophil gelatinase-associated lipocalin (NGAL), urine NGAL, serum cystatin C (Cys-C) and serum creatinine (Scr) for early delayed graft function (DGF) in kidney transplant recipients. Methods Clinical data, blood and urine samples of 159 kidney transplant recipients were collected. All recipients were divided into the DGF group (n=42) and immediate graft function (IGF) group (n=117) according to the incidence of DGF. Clinical data of all recipients were analyzed. The changes of serum NGAL, urine NGAL, Cys-C and Scr levels were statistically compared between two groups. The predictive values of different markers for early DGF were assessed. Results Among 159 kidney transplant recipients, DGF occurred in 42 cases with an incidence rate of 26.4%. There were statistically significant differences in donor age, cold ischemia time of donor kidney and complement-dependent cytoxicity (CDC) between the two groups(all P < 0.05). Within postoperative 2 weeks, the serum NGAL levels in the DGF group were higher than those in the IGF group (all P < 0.05). The Cys-C, Scr and urine NGAL levels in the DGF group were higher compared with those in the IGF group within 3 weeks after kidney transplantation(all P < 0.001). Serum NGAL, urine NGAL, Cys-C and Scr levels had certain predictive values for early DGF in kidney transplant recipients. Cys-C yielded the highest predictive value with a cut-off value of 4.73 mg/L, sensitivity of 0.833, specificity of 0.812 and area under the curve (AUC) of 0.895. Conclusions Cys-C has higher predictive value for early DGF in kidney transplant recipients compared with serum NGAL, urine NGAL and Scr.

Objective:To understand the application effect of traditional position and oblique supine lithotomy in percutaneous nephroscopy combined with ureteroscopy combined with double lithography, and explore the clinical nursing methods of oblique supine lithotomy.Methods:From January 2018 to January 2019 in our hospital, 82 patients with complicated calculi who underwent percutaneous nephroscopy combined with ureteroscopy and double lithoscopy were selected, and were divided into the control group ( n=40) and the observation group according to the random number table ( n=42). The control group took the lithotomy position after anesthesia, placed the ureteral stent tube and changed it to the prone position to complete the operation; the observation group placed the oblique supine lithotomy position to complete the operation after anesthesia, and there was no need to change the position during the operation. The posture time, blood pressure, heart rate, pulse oxygen, blood transfusion, bleeding, postoperative postural comfort and complications of the two groups were compared. Results:When placed in the position and at the end of the operation, the blood pressure of the control group was (109±31), (106±23) mmHg(1 mmHg=0.133 kPa), and the heart rate was (93 ±10), (95±15)times per minute; the blood pressure of the observation group was (130±19), (125±17)mmHg, the heart rate was (86±12), (85±9) times per minute, the difference between the two groups was statistically significant ( t value was 2.86-4.26, P<0.01). The posture time of the observation group was (12.4±3.0) min and the control group was (21.2±6.9) min with statistically significant difference between two groups( t value was 7.550, P<0.01). The number of uncomfortable patients in the observation group after operation was 3 cases and 7 cases occurred in the control group. The difference was statistically significant ( χ2 value was 2.450, P<0.05). Conclusion:It is safe and feasible to use the oblique supine lithotomy position in double -lens combined stone removal, which can reduce the patient's discomfort and complications, and effectively improve the surgical efficiency and quality.

Objective:To explore the clinical diagnosis and treatment of common bile duct stones (CBDS) in military pilots and the aeromedical assessment.Methods:The detailed diagnosis and treatment process, as well as the aeromedical assessment of 3 military pilots diagnosed as CBDS in Air Force Medical Center, PLA from June 2009 to March 2015 were collected. Then it was analyzed by the new technology.Results:Three pilots were diagnosed as CBDS and obstructive jaundice due to long term cholecystolithiasis or calculus of intrahepatic duct. Case 1 was secondary to cholecystolithiasis, and received laparoscopic cholecystectomy and common bile duct exploration. Case 2 was secondary to intrahepatic cholelithiasis and underwent left lateral lobectomy and common bile duct exploration. Case 3 recurred after cholecystolithotomy and then underwent open cholecystectomy, choledochoplasty and T-tube drainage because of biliary stricture. All 3 cases recovered well. The aeromedical assessment conclusions were as follows: case 1 was qualified to flight 5 months after operation, case 2 was grounded due to hypertension after the operation, case 3 was qualified after 6 months of the operation.Conclusions:CBDS of military pilots is often secondary to cholecystolithiasis or intrahepatic bile duct stones. The operation should be performed as early as possible, and minimally invasive methods should be adopted. The pilots with proper treatment and good postoperative recovery can be qualified to flight.

cFos is one of the most widely-studied genes in the field of neuroscience. Currently, there is no systematic database focusing on cFos in neuroscience. We developed a curated database—cFos-ANAB—a cFos-based web tool for exploring activated neurons and associated behaviors in rats and mice, comprising 398 brain nuclei and sub-nuclei, and five associated behaviors: pain, fear, feeding, aggression, and sexual behavior. Direct relationships among behaviors and nuclei (even cell types) under specific stimulating conditions were constructed based on cFos expression profiles extracted from original publications. Moreover, overlapping nuclei and sub-nuclei with potentially complex functions among different associated behaviors were emphasized, leading to results serving as important clues to the development of valid hypotheses for exploring as yet unknown circuits. Using the analysis function of cFos-ANAB, multi-layered pictures of networks and their relationships can quickly be explored depending on users’ purposes. These features provide a useful tool and good reference for early exploration in neuroscience. The cFos-ANAB database is available at www.cfos-db.net.

cFos is one of the most widely-studied genes in the field of neuroscience. Currently, there is no systematic database focusing on cFos in neuroscience. We developed a curated database-cFos-ANAB-a cFos-based web tool for exploring activated neurons and associated behaviors in rats and mice, comprising 398 brain nuclei and sub-nuclei, and five associated behaviors: pain, fear, feeding, aggression, and sexual behavior. Direct relationships among behaviors and nuclei (even cell types) under specific stimulating conditions were constructed based on cFos expression profiles extracted from original publications. Moreover, overlapping nuclei and sub-nuclei with potentially complex functions among different associated behaviors were emphasized, leading to results serving as important clues to the development of valid hypotheses for exploring as yet unknown circuits. Using the analysis function of cFos-ANAB, multi-layered pictures of networks and their relationships can quickly be explored depending on users' purposes. These features provide a useful tool and good reference for early exploration in neuroscience. The cFos-ANAB database is available at www.cfos-db.net .
Animals ; Fear ; Mice ; Neurons ; Proto-Oncogene Proteins c-fos ; Rats

Objective:To explore the clinical diagnosis and treatment of common bile duct stones (CBDS) in military pilots and the aeromedical assessment.Methods:The detailed diagnosis and treatment process, as well as the aeromedical assessment of 3 military pilots diagnosed as CBDS in Air Force Medical Center, PLA from June 2009 to March 2015 were collected. Then it was analyzed by the new technology.Results:Three pilots were diagnosed as CBDS and obstructive jaundice due to long term cholecystolithiasis or calculus of intrahepatic duct. Case 1 was secondary to cholecystolithiasis, and received laparoscopic cholecystectomy and common bile duct exploration. Case 2 was secondary to intrahepatic cholelithiasis and underwent left lateral lobectomy and common bile duct exploration. Case 3 recurred after cholecystolithotomy and then underwent open cholecystectomy, choledochoplasty and T-tube drainage because of biliary stricture. All 3 cases recovered well. The aeromedical assessment conclusions were as follows: case 1 was qualified to flight 5 months after operation, case 2 was grounded due to hypertension after the operation, case 3 was qualified after 6 months of the operation.Conclusions:CBDS of military pilots is often secondary to cholecystolithiasis or intrahepatic bile duct stones. The operation should be performed as early as possible, and minimally invasive methods should be adopted. The pilots with proper treatment and good postoperative recovery can be qualified to flight.

Since the outbreak of corona virus disease 2019(COVID 19), the epidemic has spread rapidly, which brings great challenge to the surgical diagnosis, treatment and management of lung neoplasm Sichuan International Medical Exchange &Promotion Association organized thoracic surgery experts to sum up experiences from experts in major hospital, and formulated the Guidance suggestion on surgical diagnosis, treatment and management of lung neoplasm during the outbreak of COVID-19 to provide references for thoracic surgeons.

Objective To evaluate the consistency among the results of preoperative midstream urine culture (PMUC), renal pelvis urine culture (RPUC) and renal stone (RSC) culture in patients undergoing percutaneous nephrolithotomy (PNL) and their relationship with postoperative infection. Methods This was a multicenter prospective study. From September 2014 to November 2017, 115 patients undergoing standard channel PNL or microchannel PNL in the First Affiliated Hospital of Soochow University and Yancheng Hospital of Traditional Chinese Medicine were selected. The PMUC, RPUC and RSC were detected. Samples for RPUC and RSC were obtained during PNL. The clinical data, stone configuration, stone burden and results of cultures were recorded. Results In the 115 patients, PMUC positive was in 4 cases (3.5%), RPUC positive was in 17 cases (14.8%), and RSC positive was in 16 cases (13.9% ); both RPUC and RSC positive were in 7 cases (6.1% ), among whom consistent pathogenic bacterium was in 6 cases, and inconsistent pathogenic bacterium was in 1 case; all the 3 cultures were positive in 1 case, but the types of pathogenic bacterium of PMUC were totally different with RPUC and RSC. At least one positive of the 3 cultures was in 29 cases (25.2% ). The types of pathogenic bacterium of PMUC were multidrug susceptible Escherichia coli and Staphylococcus aureus , and the types of pathogenic bacterium of RPUC and RSC were multidrug resistant pathogens and/or fungus. The consistency of pathogenic bacterium between PMUC and RPUC, RSC was very low; while the consistency of pathogenic bacterium between RPUC and RSC was very high (6/7). Postoperative infection occurred in 8 of 115 patients (7.0% , 5 cases of infective fever and 3 cases of urinary sepsis). In the 8 patients, PMUC was negative, PRUC positive in 4 cases, RSC positive in 7 cases, and both PRUC and RSC positive were in 3 cases. Conclusions PMUC can not accurately reflect the true situation of upper urinary tract renal calculi and pyelo-urine pathogenic bacterium. In patients with PNL postoperative infectious complications, the result of PMUC is often negative, but the results of RPUC and RSC are mostly positive. RPUC and RSC are helpful to detecting pathogenic bacterium in time, guiding the application of sensitive antibiotics, preventing and treating PNL postoperative infection.

Objective To investigate the diagnostic accuracy of magnetic resonance imaging and ultrasound (MRI/US) fusion targeted biopsy (TB) and systematic biopsy (SB) in the patients with prostate specific antigen (PSA) in grey area.Methods The patients who received MRI/US fusion TB and SB in the First Affiliated Hospital of Soochow University between October 2015 and March 2018 were retrospectively reviewed.Eligibility criteria included:tPSA ranged 4 to 10 ng/ml;prebiopsy MRI found at least 1 suspected lesion;no prostate-related treatment history;no prostate biopsy history.A total of 93 patients were invloved.The median age,tPSA and prostate volume were 66 (30-85) years,7.18 (4.11-9.95) ng/ml and 42.01 (14.93-119.15) ml,respectively.Prebiopsy MRI found 136 suspected lesions,with the median PI-RADS of 3 (3-5) and lesion size of 7 (3-20) mm.All patients underwent MRI/US fusion TB followed by SB.The comparison of two protocols in detecting any prostate cancer (PCa) as well as clinically significant prostate cancer (CsPCa) were analyzed.Results Cancer detection rates for PCa in TB [34.40％ (32/93)] was not different with SB [36.55％ (34/93),P =0.759].There was no significant difference in the detection rate of CsPCa between TB and SB [20.43％ (19/93) vs.24.73％ (23/93),P=0.483].A total of 1 374 biopsy cores were sampled,among which 266 were TB cores and additional 1108 were SB cores.The positive rate of TB cores [24.81％ (66/266)] was significantly higher than SB cores [9.84％ (109/1 108),P ＜0.001].Conclusions In the patients with PSA in grey area,MRI/US fusion TB achieved similar cancer detection rate compared with SB using only few biopsy cores.Therefore,TB was appropriate for patients with MRI suspicions.Moreover,combination of TB with SB can achieve the highest cancer detection rate.

Objective To study the effect of puncture length per cubic centimeter of prostate biopsy on the detection rate of prostate cancer. Methods The clinical data of 254 prostate cancer patients who had underwent the first prostate biopsy by transrectal ultrasound guidance from September 2013 to November 2017 were retrospectively analyzed. The patients were divided into prostate cancer group and non prostate cancer group according to biopsy pathologic results. The total prostate specific antigen (TPSA), prostate volume, puncture length per needle, puncture length per cubic centimeter of prostate, volume of per needle and percentage of the sampled prostate volume were compared between 2 groups, and the relationship between puncture length per cubic centimeter of prostate and prostate cancer detection rate were analyzed. Results Among the 254 patients, the prostate cancer was in 67 cases (prostate cancer group), and the benign lesion was in 187 cases (non prostate cancer group). The prostate cancer detection rate was 26.4% (67/254). There were no statistical differences in age, puncture length per needle and volume of per needle between 2 groups (P＞0.05). The TPSA, puncture length per cubic centimeter of prostate and percentage of the sampled prostate volume in prostate cancer group were significantly higher than those in non prostate cancer group: (13.8 ± 6.8)×103 ng/L vs. (8.5 ± 3.9)×103 ng/L, (3.42 ± 0.12) mm/cm3 vs. (2.83 ± 0.18) mm/cm3 and (2.75 ± 0.31)% vs. (2.24 ± 0.25)%, the prostate volume was significantly lower than that in non prostate cancer group: (45.8 ± 15.5) cm3vs. (56.3 ± 13.8) cm3, and there were statistical differences (P＜0.05). Receiver operating characteristic curve analysis showed that area under the curve was 0.628, 95% CI 0.561 to 0.695. The cutoff value of puncture length per cubic centimeter of prostate was 3.40 mm/cm3, with the sensitivity of 59.8% and the specificity of 64.8% . Conclusions The puncture length per cubic centimeter of prostate and percentage of the sampled prostate volume are important morphometric parameters in the determination of prostate cancer. The detection rate of prostate cancer is the highest , when puncture length per cubic centimeter of prostate is≥3.40 mm/cm3.