Objective To report the first case of renal calculi in a patient with horseshoe kidney (HSK) treated with simultaneous bilateral minimally invasive percutaneous nephrolithotomy (SB-mPCNL) combined with antegrade flexible ureteroscopy lithotripsy (A-FURS), and to analyze the feasibility of the surgical approach. Case Report A 57-year-old male patient was admitted due to “right lumbago and abdominal pain for 10 days”.Computed tomography urography (CTU) revealed bilateral nephrolithiasis with HSK.The patient underwent SB-mPCNL combined with A-FURS.The operation time was 185 min, with the lithotripsy and stone clearance time accounting for 80 min, and the estimated blood loss being approximately 30 mL.A plain abdominal radiograph conducted on the 4th postoperative day showed complete clearance of stones.Bilateral nephrostomy tubes were removed on the 6th postoperative day.The patient recovered uneventfully and was discharged on the 7th postoperative day.The safety and feasibility of this combined surgical modality were analyzed based on relevant literature. Conclusion SB-mPCNL combined with A-FURS is a safe, effective and feasible therapeutic option for bilateral nephrolithiasis in patients with HSK, which is worthy of further clinical verification.

Objective To explore the efficacy and safety of treatment of intramural ureteral tumors via transurethral resection. Methods A retrospective analysis was conducted on the clinical data of 26 patients with ureteral cancer who underwent transurethral resection of intramural ureteral tumors at the First Affiliated Hospital of Naval Medical University from May 2020 to May 2023. All patients were treated using the “outer-wedge, inner-rotation” resection technique, with ureteral stents placed intraoperatively. Clinical indicators including operation time, intraoperative blood loss, length of postoperative hospital stay, ureteral stent indwelling duration, intraoperative and postoperative complications, postoperative pathological results, and bladder tumor recurrence rate were analyzed. Results All surgeries were successfully completed. The operation time was 45(35, 60) min, intraoperative blood loss was 5(3, 10) mL, length of postoperative hospital stay was 4(3, 5) d, and the ureteral stent indwelling duration was (33.8±9.7) d. All patients did not experience intraoperative complications, the postoperative hydronephrosis rate was 3.8%. Postoperative pathology confirmed urothelial carcinoma in all cases, including 6 cases of stage pT_a, 16 cases of pT₁, and 4 cases of pT_2a. The follow-up period ranged from 12 to 48 months. Intravesical recurrence occurred in 2 patients, and recurrence rate was 7.7%. There were no tumor-related deaths during the follow-up period. Conclusions Transurethral resection of intramural ureteral tumors is minimally invasive, resulting in less blood loss, and has low rates of postoperative complications such as hydronephrosis and hydroureter. It achieves favorable surgical outcomes while better preserving renal function.

The accurate and timely detection of biochemical coagulation indicators is pivotal in pulmonary and critical care medicine. Despite their reliability, traditional laboratories often lag in terms of rapid diagnosis. Point-of-care testing (POCT) has emerged as a promising alternative, which is awaiting rigorous validation. We assessed 226 samples from patients at the First Affiliated Hospital of Guangzhou Medical University using a Beckman Coulter AU5821 and a PUSHKANG POCT Biochemistry Analyzer MS100. Furthermore, 350 samples were evaluated with a Stago coagulation analyzer STAR MAX and a PUSHKANG POCT Coagulation Analyzer MC100. Metrics included thirteen biochemical indexes, such as albumin, and five coagulation indices, such as prothrombin time. Comparisons were drawn against the PUSHKANG POCT analyzer. Bland-Altman plots (MS100: 0.8206‒0.9995; MC100: 0.8318‒0.9911) evinced significant consistency between methodologies. Spearman correlation pinpointed a potent linear association between conventional devices and the PUSHKANG POCT analyzer, further underscored by a robust correlation coefficient (MS100: 0.713‒0.949; MC100: 0.593‒0.950). The PUSHKANG POCT was validated as a dependable tool for serum and whole blood biochemical and coagulation diagnostics. This emphasizes its prospective clinical efficacy, offering clinicians a swift diagnostic tool and heralding a new era of enhanced patient care outcomes.
Humans ; Point-of-Care Testing ; Critical Care ; Blood Coagulation Tests/methods* ; Male ; Blood Coagulation ; Female ; Middle Aged ; Reproducibility of Results ; Prothrombin Time ; Aged ; Adult ; Point-of-Care Systems

Objective:To investigate the efficacy and safety of intravesical injections of botulinum toxin A (BTX-A) for the treatment of pediatric refractory urinary frequency and incontinence (UFI), and to analyze the factors predicting the therapeutic effect of BTX-A injections.Methods:A retrospective case series study was made on 35 children with UFI [(12.3±4.2) years old], including 13 males (37.1%) and 22 females (62.9%), treated in the First Affiliated Hospital of Zhengzhou University from January 2021 to March 2024.Urotherapy and drug treatments were ineffective in all children, who then received intravesical injections of BTX-A.The urodynamic study (UDS) was performed 1 week before treatment and 3 months after treatment, and the Overactive Bladder Symptom Score (OABSS) and Incontinence Quality of Life (I-QOL) were collected.Perioperative and postoperative adverse events were also recorded.A global response assessment (GRA) score of ≥2 at 3 months postoperatively was defined as effective treatment.According to the postoperative GRA score, the patients were divided into effective and ineffective groups to explore the predictive factors affecting the outcome of BTX-A treatment, such as age, gender, preoperative urodynamic parameters, and the types of urinary incontinence. t-test was used to compare quantitative data such as age, UDS parameters, OABSS, and I-QOL scores.The comparison of count data such as gender and urinary incontinence types was conducted using Fisher′s exact test. Results:The bladder compliance, bladder capacity ratio, OABSS and I-QOL scores of patients significantly improved after BTX-A injection (all P<0.05).The 77.1% (27/35) of the patients were satisfied with BTX-A treatment effects.The main adverse event during the follow-up was a temporary increase in postvoid residual urine after injecting BTX-A (7 cases), which was alleviated by the Creade action or clean intermittent catheterization.There was significant difference in age [(13.00±4.32) years vs.(10.00±2.67) years] and preoperative bladder compliance [(11.21±5.74) mL/cmH 2O vs.(5.13±2.42) mL/cmH 2O] between effective (27 cases) and ineffective groups (8 cases) ( t=2.383, 2.899, all P<0.05).The differences in preoperative bladder capacity ratio, maximum filling detrusor pressure, postvoid residual urine, voiding efficiency, gender, and the types of urinary incontinence were not statistically significant between the two groups (all P>0.05). Conclusions:Intravesical injection of BTX-A is a safe and effective treatment for children with refractory UFI.A young age and poor bladder compliance at treatment are associated with poor prognosis of BTX-A treatment.

Objective:To observe the efficacy of external diaphragm pacing (EDP) combined with recombinant human growth hormone (rhGH) in the treatment of severe chronic obstructive pulmonary disease (CDOP).Methods:By the prospective study method, 80 patients with severe COPD were admitted to the Xianju People′s Hospital(Zhejiang Southeast Campus of Zhejiang Provincial People′s Hospital)/Xianju Hospital Affiliated to Hangzhou Medical College from April 2021 to April 2023 were divided into the combined group and the conventional group by the random number table method, with 40 cases in each group. All of them received anti-infection, nutritional support, and other conventional treatment. In addition, the combined group was given EDP+rhGH treatment, and they were intervened for 20 d. The diaphragm function, nutrition, pulmonary function, and serum levels of interleukin (IL-6), IL-23, type Ⅱ alveolar cell surface antigen (KL-6) changes before and after treatment and prognosis were compared between the two groups.Results:After treatment, the diaphragm function index diaphragm maximum expiratory pressure (MIP), diaphragm thickness (DTei), and diaphragm mobility (DE) in the combined group were higher than those in the conventional group: (45.36 ± 7.04) cmH 2O (1 cmH 2O = 0.098 kPa) vs. (42.28 ± 6.43) cmH 2O, (0.32 ± 0.12) cm vs. (0.27 ± 0.06) cm, (3.40 ± 1.02) cm vs. (1.85 ± 0.64) cm, there were statistical differences ( P<0.05). After treatment, the nutritional status indexes of serum albumin (ALB), transferrin (Tf), and total protein (TP) in the combined group were higher than those in the conventional group: (34.62 ± 5.13) g/L vs. (31.75 ± 4.93) g/L, (2.21 ± 0.46) g/L vs. (2.00 ± 0.42) g/L, (63.80 ± 8.25) g/L vs. (60.24 ± 6.97) g/L, there were statistical differences ( P<0.05). After treatment, the percentage of forced expiratory volume in the first second (FEV 1) to the expected value (FEV 1%) and the ratio of FEV 1 to forced vital capacity (FEV 1/FVC) in the combined group were higher than those in the conventional group: (60.17 ± 6.30)% vs. (57.25 ± 6.24)%, (61.30 ± 7.04)% vs. (57.12 ± 7.25)%, there were statistical differences ( P<0.05). After treatment, the levels of IL-6, IL-23, and KL-6 in the combined group were lower than those in the conventional group: (23.13 ± 4.26) ng/L vs. (26.60 ± 4.75) ng/L, (20.84 ± 6.16) μg/L vs. (25.00 ± 5.89) μg/L, (375.10 ± 45.18) kU/L vs. (400.25 ± 46.27) kU/L, there were statistical differences ( P<0.05). The mechanical ventilation time and intensive care unit stay time in the combined group were shorter than those in the conventional group: (150.46 ± 10.24) h vs. (189.67 ± 15.43) h, (7.00 ± 2.03) d vs. (9.84 ± 2.72) d, there were statistical differences ( P<0.05). The rate of extubation within 1 week in the combined group was higher than that in the conventional group, and the 28-day mortality was lower than that in the conventional group: 90.00%(36/40) vs. 72.50%(29/40), 5.00%(2/40) vs. 22.50%(9/40), there were statistical differences ( χ2 = 4.02, 5.16, P<0.05). Conclusions:In the patients with severe COPD, EDP combined with rhGH can significantly improve the diaphragm function, nutritional status, and lung function, decrease serum IL-6, IL-23, and KL-6 levels, shorten the mechanical ventilation time, and reduce the 28-day mortality.

Objective:To observe the efficacy of external diaphragm pacing (EDP) combined with recombinant human growth hormone (rhGH) in the treatment of severe chronic obstructive pulmonary disease (CDOP).Methods:By the prospective study method, 80 patients with severe COPD were admitted to the Xianju People′s Hospital(Zhejiang Southeast Campus of Zhejiang Provincial People′s Hospital)/Xianju Hospital Affiliated to Hangzhou Medical College from April 2021 to April 2023 were divided into the combined group and the conventional group by the random number table method, with 40 cases in each group. All of them received anti-infection, nutritional support, and other conventional treatment. In addition, the combined group was given EDP+rhGH treatment, and they were intervened for 20 d. The diaphragm function, nutrition, pulmonary function, and serum levels of interleukin (IL-6), IL-23, type Ⅱ alveolar cell surface antigen (KL-6) changes before and after treatment and prognosis were compared between the two groups.Results:After treatment, the diaphragm function index diaphragm maximum expiratory pressure (MIP), diaphragm thickness (DTei), and diaphragm mobility (DE) in the combined group were higher than those in the conventional group: (45.36 ± 7.04) cmH 2O (1 cmH 2O = 0.098 kPa) vs. (42.28 ± 6.43) cmH 2O, (0.32 ± 0.12) cm vs. (0.27 ± 0.06) cm, (3.40 ± 1.02) cm vs. (1.85 ± 0.64) cm, there were statistical differences ( P<0.05). After treatment, the nutritional status indexes of serum albumin (ALB), transferrin (Tf), and total protein (TP) in the combined group were higher than those in the conventional group: (34.62 ± 5.13) g/L vs. (31.75 ± 4.93) g/L, (2.21 ± 0.46) g/L vs. (2.00 ± 0.42) g/L, (63.80 ± 8.25) g/L vs. (60.24 ± 6.97) g/L, there were statistical differences ( P<0.05). After treatment, the percentage of forced expiratory volume in the first second (FEV 1) to the expected value (FEV 1%) and the ratio of FEV 1 to forced vital capacity (FEV 1/FVC) in the combined group were higher than those in the conventional group: (60.17 ± 6.30)% vs. (57.25 ± 6.24)%, (61.30 ± 7.04)% vs. (57.12 ± 7.25)%, there were statistical differences ( P<0.05). After treatment, the levels of IL-6, IL-23, and KL-6 in the combined group were lower than those in the conventional group: (23.13 ± 4.26) ng/L vs. (26.60 ± 4.75) ng/L, (20.84 ± 6.16) μg/L vs. (25.00 ± 5.89) μg/L, (375.10 ± 45.18) kU/L vs. (400.25 ± 46.27) kU/L, there were statistical differences ( P<0.05). The mechanical ventilation time and intensive care unit stay time in the combined group were shorter than those in the conventional group: (150.46 ± 10.24) h vs. (189.67 ± 15.43) h, (7.00 ± 2.03) d vs. (9.84 ± 2.72) d, there were statistical differences ( P<0.05). The rate of extubation within 1 week in the combined group was higher than that in the conventional group, and the 28-day mortality was lower than that in the conventional group: 90.00%(36/40) vs. 72.50%(29/40), 5.00%(2/40) vs. 22.50%(9/40), there were statistical differences ( χ2 = 4.02, 5.16, P<0.05). Conclusions:In the patients with severe COPD, EDP combined with rhGH can significantly improve the diaphragm function, nutritional status, and lung function, decrease serum IL-6, IL-23, and KL-6 levels, shorten the mechanical ventilation time, and reduce the 28-day mortality.

Objective:To investigate the efficacy and safety of intravesical injections of botulinum toxin A (BTX-A) for the treatment of pediatric refractory urinary frequency and incontinence (UFI), and to analyze the factors predicting the therapeutic effect of BTX-A injections.Methods:A retrospective case series study was made on 35 children with UFI [(12.3±4.2) years old], including 13 males (37.1%) and 22 females (62.9%), treated in the First Affiliated Hospital of Zhengzhou University from January 2021 to March 2024.Urotherapy and drug treatments were ineffective in all children, who then received intravesical injections of BTX-A.The urodynamic study (UDS) was performed 1 week before treatment and 3 months after treatment, and the Overactive Bladder Symptom Score (OABSS) and Incontinence Quality of Life (I-QOL) were collected.Perioperative and postoperative adverse events were also recorded.A global response assessment (GRA) score of ≥2 at 3 months postoperatively was defined as effective treatment.According to the postoperative GRA score, the patients were divided into effective and ineffective groups to explore the predictive factors affecting the outcome of BTX-A treatment, such as age, gender, preoperative urodynamic parameters, and the types of urinary incontinence. t-test was used to compare quantitative data such as age, UDS parameters, OABSS, and I-QOL scores.The comparison of count data such as gender and urinary incontinence types was conducted using Fisher′s exact test. Results:The bladder compliance, bladder capacity ratio, OABSS and I-QOL scores of patients significantly improved after BTX-A injection (all P<0.05).The 77.1% (27/35) of the patients were satisfied with BTX-A treatment effects.The main adverse event during the follow-up was a temporary increase in postvoid residual urine after injecting BTX-A (7 cases), which was alleviated by the Creade action or clean intermittent catheterization.There was significant difference in age [(13.00±4.32) years vs.(10.00±2.67) years] and preoperative bladder compliance [(11.21±5.74) mL/cmH 2O vs.(5.13±2.42) mL/cmH 2O] between effective (27 cases) and ineffective groups (8 cases) ( t=2.383, 2.899, all P<0.05).The differences in preoperative bladder capacity ratio, maximum filling detrusor pressure, postvoid residual urine, voiding efficiency, gender, and the types of urinary incontinence were not statistically significant between the two groups (all P>0.05). Conclusions:Intravesical injection of BTX-A is a safe and effective treatment for children with refractory UFI.A young age and poor bladder compliance at treatment are associated with poor prognosis of BTX-A treatment.

Objective This study was to develop a"Spleen Deficiency Certificate Scale for County Residents"and test its reliability.It was then developed as an objective tool for Chinese medicine evidence and symptoms for the prevention and control of chronic diseases among county residents.Methods The scale was compiled based on the team's previous foundation.The reliability of the scale was evaluated using internal consistency reliability and split-half reliability,while its validity was evaluated using structural validity,content validity,calibration validity,and discriminant validity.Results The study included 213 adults from Lanxi,of whom 155 were tested for intestinal flora.Seven scale entries were identified:Fatigue,fear of cold,bland mouth,loss of appetite,diarrhea,weak bowel movements,and tooth-marked tongue.In the reliability test,Cronbach's alpha coefficient was 0.828 and McDonald's ω coefficient was 0.825.The"stomach pain"and"bloating"entries did not meet the inclusion requirements and were recommended to be deleted.The Spearman-Brown coefficient was 0.839.The exploratory factor analysis of the two common factors explained 61.6%of the cumulative variance.The calibration validity indicated that the ratio of salivary amylase activity before and after acid stimulation was 0.826±0.253 in the group with spleen deficiency.Significant differences(P<0.05)in the genera Dialister,Shigella,Leuconostoc,Photobacterium,Trabulsiella,and Parvimonas between the spleen deficiency group and the non-spleen deficiency group.Conclusion The Spleen Deficiency Scale for County Residents demonstrates good reliability and validity.

Furry animal allergens, particularly cat and dog hair and dander, are common allergens in indoor environments, affecting the health of people world widely. Key sensitizing components such as Fel d 1 from cats and Can f 1 from dogs have been extensively studied and identified by the scientific community. Component resolved diagnosis (CRD) technology in modern diagnostic methods provides an accurate way to identify and distinguish these components, which is extremely important for the prevention of furry animal allergies and the formulation of personalized treatment strategies. To enhance the understanding of furry animal component diagnosis and promote the alignment of the Chinese discipline of allergology with international standards, this article interprets and explains the content of the "Molecular Allergology User′s Guide 2.0" recently released by the European Academy of Allergy and Clinical Immunology. It focuses on the epidemiological characteristics of furry animal components, the diversity of allergen protein families, and their clinical diagnosis and management.

Furry animal allergens, particularly cat and dog hair and dander, are common allergens in indoor environments, affecting the health of people world widely. Key sensitizing components such as Fel d 1 from cats and Can f 1 from dogs have been extensively studied and identified by the scientific community. Component resolved diagnosis (CRD) technology in modern diagnostic methods provides an accurate way to identify and distinguish these components, which is extremely important for the prevention of furry animal allergies and the formulation of personalized treatment strategies. To enhance the understanding of furry animal component diagnosis and promote the alignment of the Chinese discipline of allergology with international standards, this article interprets and explains the content of the "Molecular Allergology User′s Guide 2.0" recently released by the European Academy of Allergy and Clinical Immunology. It focuses on the epidemiological characteristics of furry animal components, the diversity of allergen protein families, and their clinical diagnosis and management.