Background::Dual-energy computed tomography (DECT) is purported to accurately distinguish uric acid stones from non-uric acid stones. However, whether DECT can accurately discriminate ammonium urate stones from uric acid stones remains unknown. Therefore, we aimed to explore whether they can be accurately identified by DECT and to develop a radiomics model to assist in distinguishing them.Methods::This research included two steps. For the first purpose to evaluate the accuracy of DECT in the diagnosis of uric acid stones, 178 urolithiasis patients who underwent preoperative DECT between September 2016 and December 2019 were enrolled. For model construction, 93, 40, and 109 eligible urolithiasis patients treated between February 2013 and October 2022 were assigned to the training, internal validation, and external validation sets, respectively. Radiomics features were extracted from non-contrast CT images, and the least absolute shrinkage and selection operator (LASSO) algorithm was used to develop a radiomics signature. Then, a radiomics model incorporating the radiomics signature and clinical predictors was constructed. The performance of the model (discrimination, calibration, and clinical usefulness) was evaluated.Results::When patients with ammonium urate stones were included in the analysis, the accuracy of DECT in the diagnosis of uric acid stones was significantly decreased. Sixty-two percent of ammonium urate stones were mistakenly diagnosed as uric acid stones by DECT. A radiomics model incorporating the radiomics signature, urine pH value, and urine white blood cell count was constructed. The model achieved good calibration and discrimination {area under the receiver operating characteristic curve (AUC; 95% confidence interval [CI]), 0.944 (0.899–0.989)}, which was internally and externally validated with AUCs of 0.895 (95% CI, 0.796–0.995) and 0.870 (95% CI, 0.769–0.972), respectively. Decision curve analysis revealed the clinical usefulness of the model.Conclusions::DECT cannot accurately differentiate ammonium urate stones from uric acid stones. Our proposed radiomics model can serve as a complementary diagnostic tool for distinguishing them in vivo.

Objective:To evaluate the efficacy and safety of acupuncture combined with antihypertensive drugs in the treatment of essential hypertension through meta-analysis.Methods:RCTs about acupuncture combined with antihypertensive drugs in the treatment of essential hypertension were retrieved from CNKI, VIP, WANFANG, CBM, PubMed, Embase and Web of Science from the establishment of the databases to January 28, 2022. The risk and quality of literature publication bias were evaluated according to Cochrane 5.1.0 System Evaluation Manual, and relevant data were extracted. RevMan 5.4 software was used for meta-analysis.Results:A total of 36 RCTs involving 2 905 patients were included. Meta-analysis results showed that compared with antihypertensive drugs, acupuncture alone demonstrated advantages in reducing systolic blood pressure [ SMD=-0.70 (-1.05, -0.36), P<0.01], diastolic blood pressure [ SMD=-0.69(-1.06, -0.32), P<0.01], antihypertensive efficacy [ RR=1.11 (1.04, 1.19), P<0.01], symptomes efficacy [ RR=1.21 (1.11, 1.31), P<0.01] and comprehensive efficacy [ RR=1.35 (1.16, 1.57), P<0.01], without serious adverse reactions. Conclusion:Acupuncture alone has good clinical efficacy and safety in the treatment of essential hypertension, compared with antihypertensive drugs alone. However, researches with large samples and high quality are still needed to support the conclusion.

Objective:To explore the correlation between intraoperative cooling temperature and postoperative neurological prognosis in aortic arch surgery.Methods:We observed and collected data from 118 patients who underwent open arch replacement surgery by a single surgeon with mild-to-moderate hypothermic circulatory arrest, from January 2017 to December 2020, in Beijing Anzhen Hospital. According to the bladder temperature during the circulation arrest, 118 patients were divided into 3 groups: T1 group[n=39, (25.58±0.64)℃]; T2 group[n=39, (28.21±0.77)℃]; T3 group[n=40, (30.95±0.97)℃]. Clinical data and operative data were analyzed to assess difference between these 3 groups. Analyze the risk factors of postoperative neurological complications, and explore further the correlation between intraoperative core temperature and postoperative neurological prognosis.Results:Among the 118 patients, the average operation, cardiopulmonary bypass (CPB), block, circulatory arrest, and selective cerebral perfusion (SCP) time were 6.64 h, 188.5 min, 104.19 min, 23.93 min, 28.81 min, respectively. The in-hospital death occurred in 8 patients(6.78%), and permanent neurological dysfunction (PND) in 13 patients(11.02%), transient neurological dysfunction (TND) in 25 patients(21.19%). There was no significant difference in the deaths among the three groups. The incidence of TND and PND in the T3 group was significantly reduced ( P=0.042; P=0.045). In addition, the volume of drainage during the first 24 h and the incidence of re-exploration for bleeding had a relatively obvious decreasing trend ( P=0.005; P=0.012). Through multiple regression analysis, under the adjusted model, the core temperature was independently correlated with the incidence of postoperative PND ( OR=0.51; 95% CI: 0.27-0.97; P=0.0389); in group comparison, the relatively higher core temperature was an independent protective factor for postoperative PND ( OR=0.04; 95% CI: 0.00-0.91; P=0.0434). Conclusion:Our research had preliminary proved that in the open arch replacement surgery, mild hypothermia can reduce the incidence of some complications of deep hypothermia, at the same time improve the prognosis of the neurological prognosis, reduce the incidence of postoperative PND.

Transforming growth factor-β1 (TGF-β1) acts as a tumor promoter in advanced prostate cancer (PCa). We speculated that microRNAs (miRNAs) that are inhibited by TGF-β1 might exert anti-tumor effects. To assess this, we identified several miRNAs downregulated by TGF-β1 in PCa cell lines and selected miR-3691-3p for detailed analysis as a candidate anti-oncogene miRNA. miR-3691-3p was expressed at significantly lower levels in human PCa tissue compared with paired benign prostatic hyperplasia tissue, and its expression level correlated inversely with aggressive clinical pathological features. Overexpression of miR-3691-3p in PCa cell lines inhibited proliferation, migration, and invasion, and promoted apoptosis. The miR-3691-3p target genes E2F transcription factor 3 (E2F3) and PR domain containing 1, with ZNF domain (PRDM1) were upregulated in miR-3691-3p-overexpressing PCa cells, and silencing of E2F3 or PRDM1 suppressed PCa cell proliferation, migration, and invasion. Treatment of mice bearing PCa xenografts with a miR-3691-3p agomir inhibited tumor growth and promoted tumor cell apoptosis. Consistent with the negative regulation of E2F3 and PRDM1 by miR-3691-3p, both proteins were overexpressed in clinical PCa specimens compared with noncancerous prostate tissue. Our results indicate that TGF-β1-regulated miR-3691-3p acts as an anti-oncogene in PCa by downregulating E2F3 and PRDM1. These results provide novel insights into the mechanisms by which TGF-β1 contributes to the progression of PCa.

Objective: To validation and optimization the indicator system of risk assessment for mechanical cuts. Methods: The risk assessment index system of mechanical cutting injury established earlier was used to assess the risk of mechanical cutting injury in 40 cases of mechanical cutting injury registered from January 2015 to December 2017 and 40 similar positions without accidents in the same period. The multiple stepwise regression analysis was used to screen the indicator system, and to adjust the weight coefficient of each index. The total coincidence rate and Kappa value were compared between before and after optimization respectively. Results: The new index system has 3 first-class indicators, 10 second-class indicators and 14 three-class indicators, fewer than the old index system which has 3 first-class indicators, 10 second-class indicators, 34 three-class indicators. There three indicators have revamped in the first-class. The total of coincidence rates of the new and old indicator systems were 67.50% and 90.00%, the difference was statistically significant (P<0.01). The Kappa value were 0.35 and 0.80, respectively. Conclusion The evaluation results with new indicator systems is more consistent with the actual hazard detection the the old indicator systems, and scientific, reasonable and practical, and the indicator system of risk assessment for mechanical cuts can be used for the risk assessment of mechanical cutting injuries.

ObjectiveTo explore the clinical selection and application of cell suspension examination (CSE) or histopathological technique (HPT) in detecting sperm in the testis tissue obtained by testicular sperm aspiration (TESA) in patients with non-obstructive azoospermia (NOA).

METHODSTotally, 1 006 NOA patients underwent TESA and their testis tissues were subjected to CSE or HPT for sperm detection. Based on the results of CSE, the testicular tissue samples were divided into groups A (with sperm, n = 567) and B (without sperm, n = 439) and the results were compared with those of HPT.

RESULTSHPT showed 508 cases with but 59 without sperm in group A, and 403 with and 36 without sperm in group B. The consistency rate of CSE with that of HPT was 90.56% (Kappa =0.809), and CSE exhibited a significantly higher rate of sperm detection than HPT (56.36% vs 54.08%, P=0.023).

CONCLUSIONSCSE combined with HPT for detecting sperm in the testis tissue of NOA patients undergoing diagnostic TESA helps clinical diagnosis and treatment. The results of CSE have a decisive significance for assisted reproductive therapy, while those of HPT may provide some definite etiological evidence for drug therapy or surgery.

OBJECTIVE:To establish HPLC fingerprints of Miao medicine Ardisia crenata.METHODS:HPLC method was adopted.The determination was performed on Diamonsil C18 column with mobile phase consiste of methanol-water (gradient elution) at the flow rate of 1.0 mL/min.The detection wavelength was 220 nm,and column temperature was maintained at 30 ℃.The sample size was 10 μL.Using 11-O-(3',4',5'-three-o-galloylhyperin)-bergeninum as reference,HPLC fingerprints of 16 batches of samples were determined.Common identification and similarity evaluation were performed by using TCM Chromatographic Fingerprint Similarity Evaluation Software (2012 edition).Cluster analysis of fmgerprrints was conducted.RESULTS:There were 6 common peaks in HPLC fingerprints of 16 batches of samples.The similarity among 8 batches was more than 0.9.The 16 batches of samples could be clustered into 4 categories.CONCLUSIONS:Established fingerprints can provide reference for identification and quality evaluation ofA.crenata.

Objective To study the relationship between renal failure and severe postoperative hypoxemia of patients received surgical procedure for Stanford A aortic dissection.Methods Clinical data of 411 consecutive patients from January 2014 to April 2015,who received surgical procedure for Stanford A aortic dissection in Department of Cardiovascular Surgery of Beijing Anzhen Hospital,were collected retrospectively.The appearance of severe postoperative hypoxemia was recorded in all the cases.All the data about potential prognostic factors was put into the database and analyzed by univariate and multivariate Logistic regression respectively.Results Severe postoperative hypoxemia(PO2/FiO2＜100 mmHg,1 mmHg=0.133 kPa)happened on 69 cases within 48 hours after procedures,with the incidence rate of 17.1％.Both univariate and multivariate Logistic regression indicated the influence that preoperative creatinine clearance rate had on severe postoperative hypoxemia showed no statistical significance.However,the influence of preoperative serum creatinine showed statistical significance(OR=1.009,95％CI:1.000 to 1.018,P=0.048).Conclusions The preoperative creatinine clearance rate of patients has no direct relationship with severe postoperative hypoxemia.But the preoperative serum creatinine could be regarded as an independent predictor of severe postoperative hypoxemia.

Objective To study the relationship between renal failure and severe postoperative hypoxemia of patients received surgical procedure for Stanford A aortic dissection.Methods Clinical data of 411 consecutive patients from January 2014 to April 2015,who received surgical procedure for Stanford A aortic dissection in Department of Cardiovascular Surgery of Beijing Anzhen Hospital,were collected retrospectively.The appearance of severe postoperative hypoxemia was recorded in all the cases.All the data about potential prognostic factors was put into the database and analyzed by univariate and multivariate Logistic regression respectively.Results Severe postoperative hypoxemia(PO2/FiO2＜100 mmHg,1 mmHg=0.133 kPa)happened on 69 cases within 48 hours after procedures,with the incidence rate of 17.1％.Both univariate and multivariate Logistic regression indicated the influence that preoperative creatinine clearance rate had on severe postoperative hypoxemia showed no statistical significance.However,the influence of preoperative serum creatinine showed statistical significance(OR=1.009,95％CI:1.000 to 1.018,P=0.048).Conclusions The preoperative creatinine clearance rate of patients has no direct relationship with severe postoperative hypoxemia.But the preoperative serum creatinine could be regarded as an independent predictor of severe postoperative hypoxemia.