Objective： To analyze the symptoms, diagnosis and treatment of upper urinary tract calculi patients combined with mild and moderate benign prostatic hyperplasia (BPH) after ureteral stent implantation. Methods： One hundred and six BPH patients who were hospitalized for upper urinary tract calculi and had ureteral stents retained from January 2019 to December 2022 were selected and divided into 2 weeks group and 4 weeks group according to the time of removal of ureteral stents after surgery. Their general clinical data were analyzed and compared. International Prostatic Symptom Scale (IPSS), postoperative ureteral Stent Symptom Questionnaire (USSQ), and incidence of adverse events after ureteral stent removal were recorded before and after removal. Results： The scores of IPSS were significantly increased in all patients, and symptoms in urinary tract had improved significantly after discharge (P<0.05). Compared with the 2 weeks group, the USSQ score of the 4 weeks group was significantly increased (P<0.05). And no significant adverse event was observed in the 2 weeks group after the removal of ureteral sten. Conclusion： IPSS score and USSQ score increased significantly during stent implantation in BPH patients with lithiasis. And complications increased significantly over time. Following thorough clinical assessment, early ureteral stent removal demonstrates both safety and efficacy, representing an optimal therapeutic approach in selected cases.
Humans ; Male ; Prostatic Hyperplasia/surgery* ; Stents ; Ureter/surgery* ; Aged ; Middle Aged ; Urinary Calculi/surgery* ; Ureteral Calculi/surgery*

Objective To explore the potential mechanism of action of paeoniflorin in diabetes mellitus,the related targets and pathways were preliminarily discussed,based on the network pharmacology and molecular docking technology.Methods Analyze the potential targets of paeoniflorin using the Swiss Target Prediction database.Genecards and OMIM databases yielded the genes of diabetes-related illnesses.After taking the intersection of the two,protein-protein interaction network(PPI)was established using STRING and Cytoscape programs to search for key genes with strong correlation and complete gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis.Use AutoDockTools and Pymol programs to complete protein molecule docking validation.Results The pharmacologically-related study revealed 63 targets associated with paeoniflorin,4 758 genes related to diabetes,and 50 intersection targets.15 key genes including vascular endothelial growth factor A(VEGFA),epidermal growth factor receptor(EGFR),V-Ha-ras harvey(HRAS),V-src sarcoma(SRC)and heat shock protein hs 90-alpha(HSP90AA1)were screened.RAs-associated protein 1,Ras,calcium and other signaling pathways were obtained by KEGG pathway analysis.Molecular docking results showed that paeoniflorin had good binding ability with key genes.Conclusion Paeoniflorin can treat diabetes through multiple targets and pathways,and this mechanism can provide a basis for the application of paeoniflorin in anti diabetes and drug research and development.

Background Nitrogen dioxide (NO₂), a crucial component of traffic pollutants, has been shown in studies to exert toxic effects on the nervous system. However, there is a limited body of research examining the relationship between NO₂ exposure and neurological disorders in children. Objective To explore the impact of short-term NO₂ exposure on the outpatient visits due to pediatric neurological diseases in Shijiazhuang. Methods From 2013 to 2021, we collected outpatient data related to neurological diseases at the Children's Hospital in Shijiazhuang, Hebei Province. We also collected air pollution data and meteorological data of the same city. The air pollution data included daily average concentrations of inhalable particles (PM₁₀), fine particulate matter (PM_2.5), sulfur dioxide (SO₂), NO₂, carbon monoxide (CO), and daily maximum 8-hour average concentration of ozone (O₃). The meteorological data comprised daily average atmospheric pressure, temperature, relative humidity, wind speed, and sunshine duration. Employing a time-stratified case-crossover design, we used conditional logistic regression models to analyze the association between NO₂ and pediatric outpatient visits for neurological diseases. Stratification analyses were conducted based on gender (male, female) and age groups (0-6 years, 7-14 years). Results The study included a total of 154348 valid pediatric outpatient visits for neurological diseases. The daily average concentration of NO₂ was 49.3 μg·m⁻³ for the study period. The results from the single-pollutant model indicated that NO₂ increased the risk of pediatric neurological outpatient visits, with the highest association observed at lag0. Specifically, for every 10 μg·m⁻³ increase in atmospheric NO₂ exposure, there was a 1.40% increase (95%CI: 1.05%, 1.74%) in pediatric neurological outpatient visits. The stratification analyses revealed that increased atmospheric NO₂ exposure was associated with an elevated risk of neurological outpatient visits for girls (ER=1.54, 95%CI: 1.01, 2.08) and children aged 7-14 years (ER=2.35, 95%CI: 1.68, 3.02). Even after introducing PM_2.5 (ER=1.96, 95%CI: 1.49, 2.43), SO₂ (ER=2.09, 95%CI: 1.62, 2.55), and O₃ (ER=1.40, 95%CI: 1.06, 1.74) to the models, the impact of NO₂ exposure on pediatric neurological outpatient visits remained statistically significant. The results of the multi-pollutant model also indicated a significant association (ER=2.53, 95%CI: 1.97, 3.08). Conclusion The effect of short-term exposure to atmospheric NO₂ on the outpatient visits of children with neurological diseases in Shijiazhuang is acute and independent, especially for children aged 7-14.

Objective:To report the results of national surveillance on the distribution and antimicrobial resistance profile of clinical Gram-negative bacteria isolates from bloodstream infections in China in 2022.Methods:The clinical isolates of Gram-negative bacteria from blood cultures in member hospitals of national bloodstream infection Bacterial Resistant Investigation Collaborative System（BRICS）were collected during January 2022 to December 2022. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical and Laboratory Standards Institute（CLSI）. WHONET 5.6 and SPSS 25.0 software were used to analyze the data.Results:During the study period，9 035 strains of Gram-negative bacteria were collected from 51 hospitals，of which 7 895（87.4%）were Enterobacteriaceae and 1 140（12.6%）were non-fermenting bacteria. The top 5 bacterial species were Escherichia coli（ n=4 510，49.9%）， Klebsiella pneumoniae（ n=2 340，25.9%）， Pseudomonas aeruginosa（ n=534，5.9%）， Acinetobacter baumannii complex（ n=405，4.5%）and Enterobacter cloacae（ n=327，3.6%）. The ESBLs-producing rates in Escherichia coli， Klebsiella pneumoniae and Proteus spp. were 47.1%（2 095/4 452），21.0%（427/2 033）and 41.1%（58/141），respectively. The prevalence of carbapenem-resistant Escherichia coli（CREC）and carbapenem-resistant Klebsiella pneumoniae（CRKP）were 1.3%（58/4 510）and 13.1%（307/2 340）；62.1%（36/58）and 9.8%（30/307）of CREC and CRKP were resistant to ceftazidime/avibactam combination，respectively. The prevalence of carbapenem-resistant Acinetobacter baumannii（CRAB）complex was 59.5%（241/405），while less than 5% of Acinetobacter baumannii complex was resistant to tigecycline and polymyxin B. The prevalence of carbapenem-resistant Pseudomonas aeruginosa（CRPA）was 18.4%（98/534）. There were differences in the composition ratio of Gram-negative bacteria in bloodstream infections and the prevalence of main Gram-negative bacteria resistance among different regions，with statistically significant differences in the prevalence of CRKP and CRPA（ χ2=20.489 and 20.252， P<0.001）. The prevalence of CREC，CRKP，CRPA，CRAB，ESBLs-producing Escherichia coli and Klebsiella pneumoniae were higher in provinicial hospitals than those in municipal hospitals（ χ2=11.953，81.183，10.404，5.915，12.415 and 6.459， P<0.01 or <0.05），while the prevalence of CRPA was higher in economically developed regions（per capita GDP ≥ 92 059 Yuan）than that in economically less-developed regions（per capita GDP <92 059 Yuan）（ χ2=6.240， P=0.012）. Conclusions:The proportion of Gram-negative bacteria in bloodstream infections shows an increasing trend，and Escherichia coli is ranked in the top，while the trend of CRKP decreases continuously with time. Decreasing trends are noted in ESBLs-producing Escherichia coli and Klebsiella pneumoniae. Low prevalence of carbapenem resistance in Escherichia coli and high prevalence in CRAB complex have been observed. The composition ratio and antibacterial spectrum of bloodstream infections in different regions of China are slightly different，and the proportion of main drug resistant bacteria in provincial hospitals is higher than those in municipal hospitals.

Aim To investigate the protective poten-tial of paeoniflorin 6-oxy-benzenesulfonate(CP-25)in preserving knee cartilage integrity in osteoarthritis mice through inhibition of GRK2 activity.Methods The posttraumatic osteoarthritis model was established fol-lowing DMM surgery.The experiment consisted of a sham operation group,a model group,a CP-25 admin-istration group,and a paroxetine positive control group.Intragastric administration commenced after the surgery.After 12 weeks of administration,the animals were euthanized.Micro-CT imaging was used to ob-serve the knee cartilage degeneration and abnormal bone remodeling,and the joint histopathology of mice was observed by staining with ferrubens solid green.Immunohistochemistry and immunofluorescence were used to detect the expression level of related molecules in cartilage tissue.Furthermore,Western blot was em-ployed to determine GRK2 and EP4 membrane protein expression levels as well as total protein levels of GRK2 and MMP13 following CP-25 treatment.Results Compared with the sham operation group,the articular cartilage in the model group was significantly degrad-ed,with the cartilage surface calcifying and osteo-phytes forming.CP-25 could significantly reduce the number of osteophytes and the thickness of the sub-chondral plate of articular cartilage,promote the regen-eration of the cartilage matrix,reduce the expression of cartilage matrix degradation protein,and have a signifi-cant protective effect on knee cartilage.Immunohisto-chemical and immunofluorescence results showed that compared with the model group,CP-25 treatment sig-nificantly decreased the expressions of GRK2,AD-AMTS5 and MMP13 in knee tissue and increased the expressions of Col Ⅱ and Aggrecan in knee tissue.The results of in vitro experiments showed that CP-25 ad-ministration could significantly reduce the expression levels of GRK2 membrane protein and total protein,in-crease the level of EP4 membrane protein,and de-crease the level of MMP13.Conclusions The ad-ministration of CP-25 can significantly promote the re-generation of articular cartilage matrix in OA mice,re-duce the degradation of cartilage matrix,and exhibit therapeutic effects on OA.The mechanism behind this is related to the inhibition of GRK2-mediated cartilage matrix metabolism.

Objective:To report the results of national surveillance on the distribution and antimicrobial resistance profile of clinical Gram-positive bacteria isolates from bloodstream infections in China in 2022.Methods:The clinical isolates of Gram-positive bacteria from blood cultures in member hospitals of National Bloodstream Infection Bacterial Resistant Investigation Collaborative System（BRICS）were collected during January 2022 to December 2022. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical and Laboratory Standards Institute（CLSI）. WHONET 5.6 and SPSS 25.0 software were used to analyze the data.Results:A total of 3 163 strains of Gram-positive pathogens were collected from 51 member units，and the top five bacteria were Staphylococcus aureus（ n=1 147，36.3%），coagulase-negative Staphylococci（ n=928，29.3%）， Enterococcus faecalis（ n=369，11.7%）， Enterococcus faecium（ n=296，9.4%）and alpha-hemolyticus Streptococci（ n=192，6.1%）. The detection rates of methicillin-resistant Staphylococcus aureus（MRSA）and methicillin-resistant coagulase-negative Staphylococci（MRCNS）were 26.4%（303/1 147）and 66.7%（619/928），respectively. No glycopeptide and daptomycin-resistant Staphylococci were detected. The sensitivity rates of Staphylococcus aureus to cefpirome，rifampin，compound sulfamethoxazole，linezolid，minocycline and tigecycline were all >95.0%. Enterococcus faecium was more prevalent than Enterococcus faecalis. The resistance rates of Enterococcus faecium to vancomycin and teicoplanin were both 0.5%（2/369），and no vancomycin-resistant Enterococcus faecium was detected. The detection rate of MRSA in southern China was significantly lower than that in other regions（ χ2=14.578， P=0.002），while the detection rate of MRCNS in northern China was significantly higher than that in other regions（ χ2=15.195， P=0.002）. The detection rates of MRSA and MRCNS in provincial hospitals were higher than those in municipal hospitals（ χ2=13.519 and 12.136， P<0.001）. The detection rates of MRSA and MRCNS in economically more advanced regions（per capita GDP≥92 059 Yuan in 2022）were higher than those in economically less advanced regions（per capita GDP<92 059 Yuan）（ χ2=9.969 and 7.606， P=0.002和0.006）. Conclusions:Among the Gram-positive pathogens causing bloodstream infections in China， Staphylococci is the most common while the MRSA incidence decreases continuously with time；the detection rate of Enterococcus faecium exceeds that of Enterococcus faecalis. The overall prevalence of vancomycin-resistant Enterococci is still at a low level. The composition ratio of Gram-positive pathogens and resistant profiles varies slightly across regions of China，with the prevalence of MRSA and MRCNS being more pronounced in provincial hospitals and areas with a per capita GDP≥92 059 yuan.

Aim To explore the effect of cuminaldehyde in cumin fruit on gastric ulcer and the protective mechanism via establishing the gastric ulcer model of rats was by ethanol injury. Methods Thirty-six male R. norregicus were divided into six groups: control group, model group, omeprazole positive control group and cuminaldehyde low, medium and high dosage groups. After seven days of continuous intragastric administration, the acute gastric ulcer of R. norregicus was tested by absolute alcohol. Gastric ulcer area, inhibition rate, gastric tissue antioxidant activity, serum inflammatory factors and gastric mucosal protective factors were detected in different groups. Results The results showed that cuminaldehyde significantly reduced the area of gastric ulcer and increased the inhibition rate of gastric ulcer. The inhibition rate of cuminaldehyde at high dose group was up to 74.65%, the activities of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH) in gastric tissue significantly increased, and the contents of serum prolandin E

Objective To explore the association between triglyceride glucose(TyG)index and TyG-body mass index(TyG-BMI)and the prevalence of metabolic associated fatty liver disease(MAFLD)in the elderly men.Methods Totally 2290 elderly men were selected from January to December in 2021 in the Second Medical Center of Chinese PLA General Hospital,and divided into MAFLD group(n=1322)and non-MAFLD group(n=968).Multivariate logistic regression was used to analyze the association between TyG index,TyG-BMI and MAFLD.The receiver operating characteristic(ROC)curve was drawn to explore the predictive value of TyG index and TyG-BMI with MAFLD in the elderly men.Results Two thousand two hundred and ninety elderly men were(74.3±10.1)years old,and an average BMI of(24.63±2.70)kg/m2.BMI,γ-glutamyl transaminase(γ-GT),alanine aminotransferase(ALT),aspartate aminotransferase(AST),serum creatinine(Scr),thyroid stimulating hormone(TSH),free triiodothyronine(FT3),the rate of smoking and drinking,and the prevalence of hypertension,diabetes,hyperuricemia,high triglyceride(TG),low high density lipoprotein cholesterol(HDL-C),hyperuricemia,thyroid nodules and cholelithiasis were all significantly higher in non-MAFLD group than those in MAFLD group(P<0.05),while the age of MAFLD group was lower than that of non-MAFLD group(P=0.003).Multivariate logistic regression analysis showed that the risk of MAFLD in patients of TyG quartile groups Q2,Q3,Q4 was 1.667(95%CI 1.257-2.236,P<0.001),2.004(95%CI 1.482-2.710,P<0.001)and 5.420(95%CI 3.266-8.995,P<0.001)times higher than that of TyG Q1,respectively.The risk of MAFLD in patients of TyG-BMI Q2,Q3,Q4 was 2.215(95%CI 1.549-3.167,P<0.001),2.809(95%CI 1.723-4.580,P<0.001)and 2.513(95%CI 1.253-5.040,P=0.009)times higher than that of TyG-BMI Q1,respectively.The ROC curve showed that areas under the curve(AUC)of MAFLD predicted by TyG index and TyG-BMI were 0.717(95%CI 0.696-0.738)and 0.840(95%CI 0.823-0.856),and the best cut-off values were 8.63 and 205.20,respectively.Moreover,the ROC curve showed that AUC of MAFLD in the elderly men without hyperlipidemia or diabetes predicted by TyG index and TyG-BMI were 0.653(95%CI 0.622-0.684)and 0.840(95%CI 0.818-0.862),and the best cut-off values were 8.42 and 202.66,respectively.In addition,AUC,accuracy,specificity,sensitivity,positive predictive value and negative predictive value predicted by TyG-BMI were higher than those by TyG index.Conclusions TyG index and TyG-BMI are significantly associated with MAFLD in the elderly men.Both TyG index and TyG-BMI have certain predictive value for the prevalence of MAFLD in the elderly men,and TyG-BMI may be better.

AIM: To prepare the model of diabetic retinopathy(DR)on the basis of the model of type 2 diabetes mellitus(T2DM)in rats, observe the preventive and protective effect of metformin on DR in T2DM rats and the effect on serum Cystatin C(Cys C), and discuss its mechanism.METHODS: A total of 120 male SD rats were selected and 30 rats were randomly divided into blank control group A(10 rats), T2DM group(10 rats)and metformin intervention group A(10 rats). The remaining 90 rats were randomly divided into three groups: blank control group B(30 rats), DR group(30 rats)and metformin intervention group B(30 rats). Except for blank control groups A and B, T2DM models were constructed in all other groups. After modeling, rats in metformin intervention group A were given metformin by gavage, and rats in blank control group A and T2DM group were given normal saline by gavage. After 3mo of intervention, fasting blood glucose(FBG)and fasting serum insulin(FINS)indexes of the three groups were measured respectively, and the homeostasis model assessment of insulin resistance(HOMA-IR)was calculated and analyzed; The serum Cys C, tumor necrosis factor-α(TNF-α), the levels of Interleukin-8(IL-8), vascular endothelial growth factor(VEGF)and reactive oxygen species(ROS)were measured, and we observed the retinal tissue and vascular morphology of rats by FFA, HE staining and transmission electron microscopy; rats in metformin intervention group B began to give metformin by gavage 3mo after the course of T2DM, and other rats were given normal saline. According to the length of intervention, 10 rats were taken from each group and observed at 4, 5 and 6mo respectively. Serum levels of Cys C, TNF-α, IL-8, VEGF and ROS were measured in each group. We observed the retinal tissue and vascular morphology of rats by FFA, HE staining and transmission electron microscopy.RESULTS: The expressions of serum FBG, FINS, HOMA-IR, Cys C, TNF-α, IL-8, VEGF and ROS were statistically significant among the blank control group A, T2DM group and metformin intervention group A(P<0.05), which were the highest in T2DM group, and the metformin intervention group A were lower than T2DM group; The expression of Cys C, TNF-α, IL-8, VEGF and ROS of rat serum were statistically significant among the blank control group B, DR group and metformin intervention group B within the same age groups at 4, 5 and 6mo respectively(P<0.05), and were all the highest in DR group. The expressions of metformin intervention group B were lower than those of the DR group. With the prolongation of DR course, the expression of Cys C, TNF-α, IL-8, VEGF and ROS also increased further; FFA results showed that compared with the corresponding blank control group, the retinal blood vessels of each model group were tortuous, and microaneurysms and fluorescence leakage were visible with the prolongation of the disease course; HE staining results showed that compared with the corresponding blank control group, the retinal cells of each model group were arranged disorderly, and abnormal dilated blood vessels were visible with the prolongation of the disease course; Transmission electron microscopy results showed that compared with the corresponding blank control group, the retinal capillaries in each model group were seriously damaged; However, compared with the corresponding model group, the results of FFA, HE and transmission electron microscopy of rats in each metformin intervention group had different degrees of improvement.CONCLUSIONS: Metformin can improve retinal tissue lesions by down-regulating serum Cys C-mediated levels of inflammation and oxidative stress, thus playing a preventive and therapeutic role in the retinopathy in T2DM rats.

OBJECTIVE To evaluate the effectiveness， safety， economy， innovation， suitability and accessibility of recombinant Mycobacterium tuberculosis fusion protein （EC）， and to provide evidence for selecting skin detection methods for tuberculosis infection diagnosis and auxiliary diagnosis of tuberculosis. METHODS The effectiveness and safety of EC compared with purified protein derivative of tuberculin （TB-PPD） were analyzed by the method of systematic review. Cost minimization analysis， cost-effectiveness analysis and cost-utility analysis were used to evaluate the short-term economy of EC compared with TB-PPD， and cost-utility analysis was used to evaluate the long-term economy. The evaluation dimensions of innovation， suitability and accessibility were determined by systematic review and improved Delphi expert consultation， and the comprehensive score of EC and TB-PPD in each dimension were calculated by the weight of each indicator. RESULTS The scores of effectiveness， safety， economy， innovation and suitability of EC were all higher than those of TB-PPD. The affordability scores of the two drugs were consistent， while the availability score of EC was lower than those of TB-PPD. After considering dimensions and index weight， the scores of effectiveness， safety， economy， innovation， suitability， accessibility and the comprehensive score of EC were all higher than those of TB-PPD. CONCLUSIONS Compared with TB-PPD， EC performs better in all dimensions of effectiveness， safety， economy， innovation， suitability and accessibility. However， it is worth noting that EC should further improve its availability in the dimension of accessibility.