Exosomes are closely related to the occurrence and development of various diseases. Exosomes from different sources and the bioactive molecules they carry can participate in the formation process of urinary calculi through mechanisms such as regulating inflammatory responses，autophagy，and crystal nucleation. In addition，exosomes can also serve as delivery platforms for precise treatment of urinary calculi patients based on targeted markers，which has become a new hot spot in the research of the mechanism and treatment of urinary calculi in recent years. This article reviews the current research progress of exosomes in the formation mechanism of urinary calculi.

Exosomes are closely related to the occurrence and development of various diseases. Exosomes from different sources and the bioactive molecules they carry can participate in the formation process of urinary calculi through mechanisms such as regulating inflammatory responses，autophagy，and crystal nucleation. In addition，exosomes can also serve as delivery platforms for precise treatment of urinary calculi patients based on targeted markers，which has become a new hot spot in the research of the mechanism and treatment of urinary calculi in recent years. This article reviews the current research progress of exosomes in the formation mechanism of urinary calculi.

Objective:To investigate the efficacy and safety of geritinib in the treatment of acute myeloid leukemia (AML) with FLT3 mutation.Methods:The clinical data of 5 AML patients with FLT3 mutation who were diagnosed in the University of Hong Kong-Shenzhen Hospital, Shenzhen People's Hospital, Shenzhen Second People's Hospital, Shenzhen University General Hospital from March 2020 to April 2021 were retrospectively analyzed. Relapsed patients concurrently received two- or three-drug chemotherapy combined with geritinib. Blood routine was checked once a week; liver function and renal function were checked once every 2 weeks during treatment. Bone marrow puncture was performed once every 1 to 3 months to monitor the bone marrow morphology, minimal residual disease (MRD) and FLT3 mutation expression levels. The efficacy, side effects, overall survival of these patients were analyzed after treatment with geritinib.Results:The white blood cell was increased in all the 5 patients at the initial diagnosis. FLT3 mutations analysis showed FLT3-internal tandem duplication (ITD) (3 cases) and FLT-3 tyrosine-kinase domain (TKD) (2 cases). Among 5 patients, 1 patient was relapse-free with maintenance therapy of oral geritinib after hematological stem cell transplantation (HSCT) for 60 days; among other 4 relapsed and refractory patients, 1 female patient after pregnancy relapsed after transplantation and then achieved complete remission followed by the maintenance therapy with geritinib after oral geritinib, 1 16-year-old patient achieved treatment outcome close to the complete remission after treatment with geritinib, 1 patient achieved complete remission after treatment with geritinib, and then underwent haplo-HSCT followed by the maintenance therapy with geritinib and the other 1 relapsed patient achieved complete remission after treatment with geritinib. After transplantation, 3 patients receiving maintenance treatment of geritinib did not relapse. The main side effects included anemia, decreased neutrophil count, rash, and increased aminotransferase. The median follow-up time of 5 patients was 15 months (6-20 months). All 5 cases survived until the last follow-up in November 2021 and 4 patients were disease-free.Conclusions:Relapsed and refractory AML patients with FLT3 mutation can achieve complete remission after treatment with geritinib and get a chance for transplantation. Geritinib may reduce the risk of recurrence after transplantation and improve survival rate. No serious side effects occur in geritinib treatment.

Objective To investigate nurses' presenteeism and job stressors, and explore the correlation between them. Methods From January to May in 2017, a total of 380 nurses were investigated in one classⅢ grade A hospital in He'nan and totally 349 valid questionnaires were included. Presenteeism Questionnaire and Nurses Job Stressors Scale were used to investigate nurses' presenteeism and job stressors. SPSS 21.0 statistical package was used to organize and analyze the data. Independent sample t-test and ANOVA, Pearson correlation analysis and multivariate linear regression analysis were used. Results For the 349 nurses, the score of presenteeism was(3.25±0.73) points. Presenteeism behavior score of married nurses was higher than that of the unmarried nurses; presenteeism behavior scores of different titles were different (t=2.655, F=2.830;P<0.05). The score of job stressors was (2.50±0.49) points, which belonged to the medium level. Correlation analysis showed that work environment, interpersonal management had no correlation with presenteeism behavior(P> 0.05) and the other relations between the two variables was positive (P< 0.05). Patient care, time allocation and workload, nursing profession and work had predictive effect on presenteeism behavior (P< 0.05). Conclusions The stressors of nurses in this study are at medium level. The stressors of nurses affect their presenteeism. Nursing managers should take measures to prevent and interfere with the stressors of nurses,reduce the frequency of nurses' presenteeism, promote their physical and mental health and improve the quality of nursing.

AIM:To investigate the effect of microRNA-429 (miR-429) on the expression of occludin (Ocln) in intestinal epithelial cells ( IECs) and intestinal epithelial barrier function in diabetic mice.METHODS:Diabetes mel-litus mouse model was induced by intraperitoneal injection of streptozocin.The expression of miR-429 in IECs of diabetic mice was inhibited by antagomiRNA-429 injected via tail vein.The expression of miR-429 and mRNA expression of Ocln were detected by real-time PCR.The protein expression of Ocln was determined by Western blotting and immunohistochem-istry.The urinary lactulose/mannitol ratio was measured by gas chromatography.The plasma LPS concentrations in the mice were measured by chromogenic end-point TAL kit.RESULTS:The results of real-time PCR confirmed that the ex-pression of miR-429 in IECs of diabetic mice was remarkably inhibited by tail-vein administration of antagomiRNA-429, and resumed to similar level of normal mice on the 6th day after the administration.After suppressing the level of miR-429, the expression of Ocln in IECs of diabetic mice increased significantly (P<0.05), while the urinary lactulose/mannitol ra-tio and the plasma LPS concentration decreased obviously ( P<0.05 ) .CONCLUSION:AntagomiRNA-429 effectively suppresses miR-429 expression in IECs of diabetic mice, and then enhances the expression of Ocln and partially resumes the intestinal epithelial barrier function.

Objective To investigate the effects of GR82334 caudal veins injection(iv)or intrathecal injection(ith)on the increase of dopamine (DA)content in rats anterior cingulate gyrus(ACG)induced by heavy current stimulation of saphenous nerve(SN). Methods Totally 42 male Wi-star rats were randomly divided into six groups,including control group,sham stimulation group,SN stimulation group,GR82334(ith)group,NS (ith)group,GR82334(iv)group,and NS(iv)group. At the end of the study,rats of different groups were sacrificed,then the right side ACG were collected and weighted. ACG samples were then homogenized with 0.1 mol/L perchloric acid solution. After spinning at 10 000 r/min(4℃)for 20 min,20μL of the supernatant were harvest from each sample. High performance liquid chromatography electrochemical detection was used to mea-sure DA content. Results Heavy current stimulation of SN caused obvious increase of the DA content in ACG. GR82334(iv or ith)antagonized the significant increase of DA content in ACG induced by the stimulating SN. However,GR82334(ith)did not completely antagonized the increase of DA content in ACG induced by electric stimulating SN. Conclusion The results indicated that there is connection between SN and the dopami-nergic nervous system in ACG,and SN afferent nociceptive signals can activate ACG dopaminergic neurons to release DA. Peripheral and central NK-1 receptors are involved in the process of significant increase of DA content in ACG induced by SN afferent signals. However,there are other central paths of SN information input to ACG to induce obvious increases of DA content,in which other neurotransmitters and receptors may be involved.

Objective To evaluate the therapeutic effect of low-dose,ultra-low-dose and standard dose chemotherapy for elderly acute myeloid leukemia.Methods A retrospective analysis was performed on 77 elderly AML patients aged 60 years or older.The short-term and long-term effects were compared among low-dose,uhtra-low-dose and standard-dose chemotherapy.Results Although patients receiving low-dose or ultra-low-dose chemotherapy were older,with higher PS scores and lower WBC count,there were no significant differences in CR rate,ORR,EFS or OS between patients who received low-dose/ultra-low-dose chemotherapy and standard-dose chemotherapy.By dividing the total samples into subgroups according to age or PS scores,we found out that patients younger than 70 or with a PS score less than 2 showed a much better prognosis,no matter short-term or long-term,in low-dose／ultra-low-dose group rather than in the standard dose group.While in those patients older than 70 or with a PS score more than 2,the differences between those two groups were not significant.Further analysis showed that low-dose chemotherapy did not reduce treatment related mortality,neither did it increase the risk of long-term relapse.Conclusion Low-dose and ultra-low-dose chemotherapy can improve the prognosis of elder AML patients compared with standard-dose chemotherapy,especially for elderly patients who have a better general state.

Objective:To investigate the clinical effect of streptomycin perfusion of the labyrinth (SPL) inthe treatment of Meniere's disease. Method: 13 patients with Meniere′s disease and 3 patients with delayedendolymphatic hydrops (DEH) underwent SPL. The follow－up time was between 5 and 7 years (average 6.3years). Result:Vertigo was completely controlled in 9 patients, substantialy controlled in 4, limitedly controlledin 2 and not controlled in 1. Hearing was improved in 1 patients, stabilized in 5 and worse in 10. Tinnitus wasimproved in 3 patients, stabilized in 5 and worse in 8. Conclusion:SPL is a safe and effective method in thetreatment of Meniere′s disease and DEH, but the hearing may be insulted and tinnitus may be worse in somepatients.