Objective:To investigate the diagnostic value of urine pH, serum uric acid and related clinical indicators in the diagnosis of urinary infection stones, and to construct a prediction nomogram.Methods:The clinical data of 432 patients with urinary calculi admitted to Xuzhou Central Hospital from August 2018 to November 2023 were retrospectively analyzed. The study included 289 males and 143 females, with an average age of (52.72±13.46) years old. Among the patients, there were 98 cases of hypertension, 67 cases of diabetes, and 100 cases of recurrent calculi. Kidney stones were present in 152 cases, ureteral stones in 242 cases, and bladder stones in 38 cases. Urine bacterial culture yielded positive results in 97 cases. According to the results of postoperative stone composition analysis, the two groups were categorized as infection and no-infection stone groups, and the differences in general data between the two groups were compared. Univariate and multivariate logistic regression analysis were conducted to assess the diagnostic value of urine pH, serum uric acid, and related clinical indicators for urinary infection stones. Receiver operating characteristic (ROC) curve and area under curve (AUC) were utilized to evaluate the clinical significance of urine pH, serum uric acid, and combined indexes in preoperatively diagnosing urinary infection stones, as well as constructing a nomogram prediction model.Results:There were 127 cases of infection stones and 305 cases of no-infection stones. The infection stone group exhibited a higher urine pH value [7.0(6.5, 7.5) vs. 6.0(5.5, 6.5), P<0.001], lower serum uric acid levels [(301.38±70.12) vs. (358.88±88.99) μmol/L, P<0.001], a higher proportion of females [55.1%(70/127) vs. 23.9%(73/305), P<0.001], younger age [(48.36±14.83)vs. (53.12±12.61)years old, P<0.001], a higher proportion of recurrence stones [34.6 %(44/127) vs. 18.4%(56/305), P<0.001], and a higher rate of positive urine bacteria culture[29.9%(38/127)vs. 19.3%(59/305), P=0.016]and nitrite test results [18.9%(24/127)vs. 6.3%(19/305), P <0.001]. Univariate logistic regression analysis revealed that urine pH value, serum uric acid levels, gender, age, recurrent stones, urine bacterial culture, and urine nitrite were associated with urinary infection stones ( P< 0.05). Multivariate logistic regression analysis revealed that urine pH value ( OR= 4.836, 95% CI 3.342-6.997), female gender( OR=2.320, 95% CI 1.286-4.186), recurrent stones ( OR=2.225, 95% CI 1.208-4.101), positive urine bacterial culture ( OR=2.061, 95% CI 1.094-3.883), serum uric acid ( OR=0.992, 95% CI 0.949-0.989), age ( OR=0.969, 95% CI 0.949-0.990) were independent risk factors for urinary infection stones ( P<0.05). The combined diagnostic value of six indicators was the highest, with an AUC of 0.874 (95% CI 0.837-0.911). Following this, urine pH exhibited an AUC of 0.818 (95% CI 0.778-0.858), while serum uric acid had an AUC of 0.704 (95% CI 0.652-0.756). The nomogram model was successfully constructed based on the six indicators. The mean AUC of the ROC curve after 1 000 resamples of the Bootstrap method was 0.864 (95% CI 0.828-0.900), and the calibration curve showed that the predicted curve fit the ideal curve well, with a mean absolute error of 0.005 and a Hosmer-Lemeshow test of P>0.05. Clinical decision curve analysis (DCA) showed that the model had a higher net clinical benefit when the model had a threshold probability value≥0.01. Conclusions:Urine pH and serum uric acid are closely related to urinary infection stones. A nomogram model combining these factors with gender, age, recurrent stones, and urine culture results can effectively predict the probability of infection-related stones, providing significant clinical value.

Objective:To investigate the diagnostic value of urine pH, serum uric acid and related clinical indicators in the diagnosis of urinary infection stones, and to construct a prediction nomogram.Methods:The clinical data of 432 patients with urinary calculi admitted to Xuzhou Central Hospital from August 2018 to November 2023 were retrospectively analyzed. The study included 289 males and 143 females, with an average age of (52.72±13.46) years old. Among the patients, there were 98 cases of hypertension, 67 cases of diabetes, and 100 cases of recurrent calculi. Kidney stones were present in 152 cases, ureteral stones in 242 cases, and bladder stones in 38 cases. Urine bacterial culture yielded positive results in 97 cases. According to the results of postoperative stone composition analysis, the two groups were categorized as infection and no-infection stone groups, and the differences in general data between the two groups were compared. Univariate and multivariate logistic regression analysis were conducted to assess the diagnostic value of urine pH, serum uric acid, and related clinical indicators for urinary infection stones. Receiver operating characteristic (ROC) curve and area under curve (AUC) were utilized to evaluate the clinical significance of urine pH, serum uric acid, and combined indexes in preoperatively diagnosing urinary infection stones, as well as constructing a nomogram prediction model.Results:There were 127 cases of infection stones and 305 cases of no-infection stones. The infection stone group exhibited a higher urine pH value [7.0(6.5, 7.5) vs. 6.0(5.5, 6.5), P<0.001], lower serum uric acid levels [(301.38±70.12) vs. (358.88±88.99) μmol/L, P<0.001], a higher proportion of females [55.1%(70/127) vs. 23.9%(73/305), P<0.001], younger age [(48.36±14.83)vs. (53.12±12.61)years old, P<0.001], a higher proportion of recurrence stones [34.6 %(44/127) vs. 18.4%(56/305), P<0.001], and a higher rate of positive urine bacteria culture[29.9%(38/127)vs. 19.3%(59/305), P=0.016]and nitrite test results [18.9%(24/127)vs. 6.3%(19/305), P <0.001]. Univariate logistic regression analysis revealed that urine pH value, serum uric acid levels, gender, age, recurrent stones, urine bacterial culture, and urine nitrite were associated with urinary infection stones ( P< 0.05). Multivariate logistic regression analysis revealed that urine pH value ( OR= 4.836, 95% CI 3.342-6.997), female gender( OR=2.320, 95% CI 1.286-4.186), recurrent stones ( OR=2.225, 95% CI 1.208-4.101), positive urine bacterial culture ( OR=2.061, 95% CI 1.094-3.883), serum uric acid ( OR=0.992, 95% CI 0.949-0.989), age ( OR=0.969, 95% CI 0.949-0.990) were independent risk factors for urinary infection stones ( P<0.05). The combined diagnostic value of six indicators was the highest, with an AUC of 0.874 (95% CI 0.837-0.911). Following this, urine pH exhibited an AUC of 0.818 (95% CI 0.778-0.858), while serum uric acid had an AUC of 0.704 (95% CI 0.652-0.756). The nomogram model was successfully constructed based on the six indicators. The mean AUC of the ROC curve after 1 000 resamples of the Bootstrap method was 0.864 (95% CI 0.828-0.900), and the calibration curve showed that the predicted curve fit the ideal curve well, with a mean absolute error of 0.005 and a Hosmer-Lemeshow test of P>0.05. Clinical decision curve analysis (DCA) showed that the model had a higher net clinical benefit when the model had a threshold probability value≥0.01. Conclusions:Urine pH and serum uric acid are closely related to urinary infection stones. A nomogram model combining these factors with gender, age, recurrent stones, and urine culture results can effectively predict the probability of infection-related stones, providing significant clinical value.

OBJECTIVE：To comp are cytotoxicity and anti-inflammatory effects of raw Aconitium kusnezoffii and A. kusnezoffii processed with Terminalia chebula . METHODS ：Using H 9c2 cardiomyocytes isolated from rat as subjects ，CCK-8 assay was used to detect the effects of 0.5，1，2，4，6，8，10 mg/mL raw A. kusnezoffii and A. kusnezoffii processed with T. chebula on cell inhibition rate after cultured for 4，8，12，24 h. Hoechst 33258 staining was used to observe the effects on cell morphology characteristics after treated with 2，4，6 mg/mL raw A. kusnezoffii and A. kusnezoffii processed with T. chebula . Using macrophages RAW264.7 cells as subjects ，CCK-8 assay was used to detect the effects of 0.05，0.1，0.25，0.5，0.75，1，1.5，2 mg/mL raw A. kusnezoffii and A. kusnezoffii processed with T. chebula on cell survival rate after cultured for 24 h. ELISA assay was used to detect the effects of 0.05，0.1，0.25，0.5 mg/mL raw A. kusnezoffii and A. kusnezoffii processed with T. chebula on the release of NO ， TNF-α and IL-6 in RAW 264.7 inflammation cells induced by LPS. RESULTS ：When the mass concentration was 0.5，1 mg/mL， neither raw A. kusnezoffii and A. kusnezoffii processed with T. chebula had no inhibitory effect on H 9c2 cells. When the mass concentration was 2 mg/mL，the inhibitory effects of A. kusnezoffii processed with T. chebula on H 9c2 cells was higher than that of raw A. kusnezoffii （P＜0.05 or P＜0.01）；fluorescence intensity of cells treated for 24 h was stronger than that of raw A. kusnezoffii，but its nucleus was intact. When the mass concentration was 4-10 mg/mL，the inhibitory rate of A. kusnezoffii processed with T. chebula on H 9c2 cells at different time points （except for 24 h culture of 8，10 mg/mL）was significantly lower than raw A. kusnezoffii （P＜0.05 or P＜0.01）. The characteristics of cell morphology also showed that the fluorescence intensity of raw A. kusnezoffii group at 4，6 mg/mL was stronger than that of A. kusnezoffii processed with T. chebula group，and the cell nucleus fragmentation was more serious in the raw A. kusnezoffii group. 0.05-0.5 mg/mL raw A. kusnezoffii and A. kusnezoffii processed with T. chebula had no toxicity to RAW264.7 cells. 0.25，0.5 mg/mL raw A. kusnezoffii and 0.1，0.25，0.5 mg/mL A. kusnezoffii processed with T. chebula showed significant inhibitory effect on the release of NO ，0.05，0.1，0.25，0.5 mg/mL raw A. kusnezoffii and A. kusnezoffii processed with T. chebula showed significant inhibitory effect on the release of TNF-α and IL-6 in RAW 264.7 cell（P＜0.05 or P＜ 0.01）. The inhibitory effects of A. kusnezoffii processed with T. chebula at the same concentration on the release of NO was better than that of raw A. kusnezoffii ，but poorer than raw A. kusnezoffii in the inhibitory effects on the release of TNF-α and IL-6. CONCLUSIONS：The toxicity of A. kusnezoffii can be reduced after processed with T. chebula ，especially the toxicity of it in medium or high concentration and short-term use is lower than that of raw A. kusnezoffii . At the same time ，the anti-inflammatory effect of A. kusnezoffii processed with T. chebula is comparable to that of raw A. kusnezoffii at the same concentration.

Objective To investigate the effect of ERH gene knockdown on the proliferation and apoptosis of human bladder cancer T24 cells. Methods T24 cells infected by lentivirus with interference on ERH gene sequence were cloned to establish stable T24 cells clone in ERH gene suppression. The expression of ERH mRNA gene in bladder cancer was detected by using quantitative real time polymerase chain reaction (qPCR). The effects of ERH knockout on the cell proliferation and apoptosis were examined by using methylthiazolyl tetrazolium (MTT) assay, colony formation assay and flow cytometry. The effect of ERH knockout on the tumorigenic effect of T24 cells in vivo was verified by subcutaneous tumor formation in nude mice. Results After lentiviral transfection, qPCR results showed that the knockdown effect of ERH mRNA in ERH normal group (untreated T24 cells) was better than that in ERH gene knockdown group, and the difference was statistically significant [(1.006±0.126) vs. (0.079±0.007); t=12.72, P=0.0002]. After knocking out ERH gene, MTT assay showed that the proliferation ability of T24 cells in ERH gene knockdown group was weakened compared with ERH normal group, and the difference was statistically significant [A490 value: (0.13±0.00) vs. (0.66±0.01);t=104.61, P<0.0001]. Colony formation assay indicated that the ability of clone in ERH normal group was weakened compared with ERH gene knockdown group [(10.5 ±1.2) vs. (196.4 ±4.0); t= 73.63, P< 0.0001]. Flow cytometry showed that the cell apoptosis rate in ERH gene knockdown group was higher than that in ERH normal group [(11.0 ±0.5) ％ vs. (4.2 ±0.5) ％; t= 16.06, P<0.0001]. Imaging results of subcutaneous tumor formation in nude mice showed that the total fluorescence intensity of the tumor area in ERH gene knockdown group was (4.67 ±0.59) × 1010 μW/cm2, and the corresponding part in ERH normal group was (9.54±4.20) × 1010μW/cm2 (t=3.64, P=0.0051);tumor weight in ERH gene knockdown group was (0.80±0.62) g, and in ERH normal group was (1.79±0.71) g (t=3.33, P=0.0037). Conclusion ERH gene knockout can inhibit the proliferation of human bladder cancer T24 cells, and promote the cell apoptosis.