Objective Based on the propensity score matching(PSM),the effect of flexible ureteroscopy combined with flexible negative pressure suction sheath in the treatment of infectious renal calculus lithotomy was analyzed.Methods From April 2022 to April 2024,87 patients with infectious renal calculus in our hospital were selected retrospectively.All patients were treated with flexible ureteroscopic lithotripsy(FURL).According to the different choice of ureteral access sheath(UAS)during operation,they were divided into negative pressure sheath group(n=43)and conventional sheath group(n=44).In the negative pressure sheath group,the flexible negative pressure suction sheath was used for FURL,and in the conventional sheath group,the conventional sheath was used for FURL.The general data of patients with infectious renal calculus between groups were compared,and the indicators were balanced by PSM.The clinical efficacy,perioperative indicators,levels of procalcitonin(PCT)and white blood cell count(WBC)and postoperative complications of patients with infectious renal calculus were compared between the two groups.Results After 1∶1 ratio matching by PSM,42 pairs of patients with infectious renal calculus were obtained,.The stone clearance rate of negative pressure sheath group[90.48%(38/42)]was significantly higher than that of conventional sheath group[71.43%(30/42)](P<0.05).The minimum intrapelvic pressure,average intrapelvic pressure and maximum intrapelvic pressure in the negative pressure sheath group were lower than those in the conventional sheath group,operation time and hospitalization time in the negative pressure sheath group were shorter than those in the conventional sheath group(P<0.05).The levels of PCT and WBC in the negative pressure sheath group were lower than those in the conventional sheath group at 2 h after operation,and the time for PCT and WBC to recover to the normal level were shorter than those in the conventional sheath group(P<0.05).The total incidence of postoperative complications in negative pressure sheath group[9.52%(4/42)]was significantly lower than that in conventional sheath group[28.57%(12/42)](P<0.05).Conclusion Flexible ureteroscopy combined with flexible negative pressure suction sheath is effective in the treatment of renal calculus,which is helpful to reduce intra-operative renal pelvis pressure,shorten operation time,reduce PCT and WBC levels after operation,and promote patients'early recovery with good safety.

Objective Based on the propensity score matching(PSM),the effect of flexible ureteroscopy combined with flexible negative pressure suction sheath in the treatment of infectious renal calculus lithotomy was analyzed.Methods From April 2022 to April 2024,87 patients with infectious renal calculus in our hospital were selected retrospectively.All patients were treated with flexible ureteroscopic lithotripsy(FURL).According to the different choice of ureteral access sheath(UAS)during operation,they were divided into negative pressure sheath group(n=43)and conventional sheath group(n=44).In the negative pressure sheath group,the flexible negative pressure suction sheath was used for FURL,and in the conventional sheath group,the conventional sheath was used for FURL.The general data of patients with infectious renal calculus between groups were compared,and the indicators were balanced by PSM.The clinical efficacy,perioperative indicators,levels of procalcitonin(PCT)and white blood cell count(WBC)and postoperative complications of patients with infectious renal calculus were compared between the two groups.Results After 1∶1 ratio matching by PSM,42 pairs of patients with infectious renal calculus were obtained,.The stone clearance rate of negative pressure sheath group[90.48%(38/42)]was significantly higher than that of conventional sheath group[71.43%(30/42)](P<0.05).The minimum intrapelvic pressure,average intrapelvic pressure and maximum intrapelvic pressure in the negative pressure sheath group were lower than those in the conventional sheath group,operation time and hospitalization time in the negative pressure sheath group were shorter than those in the conventional sheath group(P<0.05).The levels of PCT and WBC in the negative pressure sheath group were lower than those in the conventional sheath group at 2 h after operation,and the time for PCT and WBC to recover to the normal level were shorter than those in the conventional sheath group(P<0.05).The total incidence of postoperative complications in negative pressure sheath group[9.52%(4/42)]was significantly lower than that in conventional sheath group[28.57%(12/42)](P<0.05).Conclusion Flexible ureteroscopy combined with flexible negative pressure suction sheath is effective in the treatment of renal calculus,which is helpful to reduce intra-operative renal pelvis pressure,shorten operation time,reduce PCT and WBC levels after operation,and promote patients'early recovery with good safety.

Tanshinones are the bioactive components of the Chinese medicinal herb Salvia miltiorrhiza, while its biosynthetic pathway remains to be characterized. Rapid identification and characterization of the genes correlated to tanshinones biosynthesis is very important. As one of the intermediates of tanshinones biosynthesis, the ferruginol content is relative low in both root and engineered bacteria. It is urgent to construct an efficient system for conversion of miltiradiene to ferruginol to obtain large amount of ferruginol as the substrates for further identifying other downstream genes involved in tanshinones biosynthesis. In this study, we constructed the whole-cell yeast biocatalysts co-expressing miltiradiene oxidase CYP76AH1 and cytochrome P450 reductases (SmCPR1) from Salvia miltiorrhiza, and then characterized it with RT-PCR. After permeabilization, the yeast whole-cell could catalyze turnover of miltiradiene to ferruginol efficiently through single-step biotransformation with a conversion efficiency up to 69.9%. The yeast whole-cell biocatalyst described here not only provide an efficient platform for producing ferruginol in recombinant yeast but also an alternative strategy for identifying other CYP genes involved in tanshinones biosynthesis.