Objective:To compare the accuracy of different stone scoring systems for predicting the stone-free rate (SFR) after retrograde intrarenal surgery (RIRS).Methods:The clinical data of 227 patients with lithiasis undergoing RIRS from June 2017 to December 2020 in Affiliated Benq Hospital of Nanjing Medical University and Qingdao Fuwai Hospital were retrospectively analyzed. There were 152 males and 75 females. The average age was (53.0±10.4) years old. The average body mass index was (26.9±2.1)kg/m 2. The maximum diameter of the stone was (22.7±12.8)mm. The stone is located in left side in 133 cases and in right side in 94 cases. The stones of 44 cases were located in upper ureter, upper calyceal or renal pelvis, that of 23 cases were in medium calyceal, 157 cases in lower calyceal, and 3 cases in calyceal diverticulum.The average CT value of stone was (778.3±350.4)HU. American Society of Anesthesiology (ASA)scores: 86 cases of grade Ⅰ, 129 cases of grade Ⅱ, 12 cases of grade Ⅲ. Preoperative non-contrast CT was conducted and three-dimensional data were constructed. A single observer reviewed and entered the modified S.T.O.N.E., RUSS, modified S-ReSC, R. I.R.S., SHA.LIN, Ito nomogram, S. O.L.V.E., stone free index (SFI) scores. Logistic analysis were performed between every score and SFR. Receiver operating characteristic (ROC) curve was drawn to detect sensitivity and specificity of every score in predicting the SFR. The predictive accuracies of all scores were compared. Results:The SFR was 83.0%(189/227). There were statistically significant differences in modified S. T.O.N.E.(10.5±1.9 vs. 12.7±1.8), RUSS[1(0, 4) vs. 3(0, 6)], modified S-ReSC (8.2±5.6 vs. 11.8±6.0), R.I.R.S.(6.2±1.4 vs. 8.1±1.2), SHA.LIN (9.9±2.4 vs. 13.0±2.1), Ito nomogram (12.1±5.8 vs. 4.3±3.3), S. O.L.V.E. (6.8±1.6 vs. 8.7±1.2), SFI score (7.9±1.1 vs. 6.3±0.9) between the stone-free group and the stone remaining group ( P <0.05). Logistic regression revealed that modified S.T.O.N.E., RUSS, modified S-ReSC, R. I.R.S., SHA.LIN, Ito nomogram, S. O.L.V.E. and SFI score were significantly associated with SFR( P<0.05). There were no significant differences in the area under the curve (AUC) between the modified S. T.O.N.E., RUSS, R. I.R.S., SHA.LIN, Ito nomogram, S. O.L.V.E. and SFI score( P>0.05), but there were significant differences in the AUC between modified S-ReSC score and other score ( P<0.05). When the cutoff of SHA.LIN, SFI and R. I.R.S. score was determined as 10, 6 and 6 scores, the specificity of SHA.LIN, SFI and R. I.R.S. score was 94.7%, 92.6% and 89.5%, respectively. Conclusions:All score could predict the postoperative SFR of RIRS, while the SHA.LIN, SFI and R.I.R.S. score were more accurate than the other scores. The accuracy of the modified S-ReSC in predicting SFR after RIRS was slightly worse than other scores.

Objective:To investigate the effectiveness and advantage of visual laryngoscope in the treatment of patients with sudden cardiac arrest who need spontaneous respiration tracheal intubation.Methods:Totally 60 patients who suffered from cardiac arrest and needed spontaneous respiration tracheal intubation were enrolled from June 2020 to February 2021 in the Affilicated Hospital of Chifeng University. Theywere randomlydivided into two groups-traditional laryngoscope (TL) group and visual laryngoscope (VL) group, with30 patients in each group. Then the success rate of glottis exposure, the operative time, success rate and complication rate of tracheal intubation were compared between the two groups. Subgroup assessment between the junior emergency resident doctor (A group) and the senior emergency resident doctor (B group) was conducted.Results:According to Cormack Lehan grades, the success rate of glottis exposure in VL group was higher than that in TL group ( P>0.05), and the success rate of Grade I in VL group was significant higer than that in TL group: 56.70%(17/30) vs. 30.00%(9/30), P<0.05. The trial times of successful intubation cases and the operative time of successful intubation cases were significantly less than those in TL group (1.30 vs 1.67, P = 0.049) and (56.37 s vs 67.12 s, P<0.05). In the subgroup, the one-time success rate of tracheal intubation in A-TL group was significantly lower than that in B-TL group (4/15 vs. 11/15, P<0.05), while the one-time success rate of tracheal intubation in A-VL group was 60.00%, which is lower than that in B-VL group ( P>0.05). The operative time consumed for successful intubation in A-TL group was significantly longer than that in B-TL group: 78.00 s vs. 55.57 s, P<0.05, while the operative time in A-VL group was a little longer than that in B-VL group ( P>0.05). Conclusions:Visual laryngoscope used in spontaneous respiration tracheal intubation can not only increase the success rate of glottis exposure, decrease trial times and shorten operative time of intubation, but also improve the success rate and decrease the complication rate of emergency tracheal intubation.

Objective:To investigate the changes of cognitive function and self-care ability in patients with mild cognitive impairment after stroke after sensory integration therapy.Methods:One hundred patients with mild cognitive impairment after stroke were divided into control group and intervention group according to the random number table method. The control group was given the routine health education path and rehabilitation training, and the intervention group was given the cognitive rehabilitation through sensory integration therapy on the basis of the control group. The cognitive function and self-care ability of the patients were evaluated by the Montreal cognitive assessment(MoCA) and daily self-care ability scale(ADL) before and after intervention.Results:After intervention, the total MoCA score, visual space, nominalization, language, abstraction and memory scores of the intervention group were 26.02±1.15, 3.50±0.76, 2.98±0.14, 2.90±0.30, 2.84±0.37 and 3.18±0.69, respectively, while those of the control group were 23.32±1.90, 2.86±1.20, 2.78±0.42, 2.82±0.39, 1.58±0.54 and 2.82±0.94, respectively. The difference between the two groups was statistically significant ( t value was -18.296--2.064, all P<0.05). The scores of attention and directional force in the intervention group were 5.44±0.67 and 5.18±0.85, respectively, while those in the control group were 5.32±0.84 and 5.14±0.78, respectively. There was no statistically significant difference between the two groups ( t value was -1.288, -0.704, P>0.05).After intervention, the total ADL score, stool, urine, toilet, eating, dressing and bathing scores of the intervention group were 65.00±5.98, 5.90±2.19, 6.40±2.27, 7.40±2.72, 7.80±2.70, 7.50±2.53 and 5.50±1.52, respectively, The control group was 53.60±10.20, 3.50±3.23, 5.00±3.50, 5.50±3.23, 5.40±3.76, 5.90±3.45, and 4.40±2.79, respectively. The difference between the two groups was statistically significant ( t value was -7.573~-2.615, all P<0.05). Conclusions:Sensory integration therapy can improve the cognitive function and self-care ability of patients with mild cognitive impairment after stroke.

Objective To evaluate the treatment effect of bladder instillation chemotherapy on glandular cystitis. Methods The clinical data of glandular cystitis of 54 cases were retrospectively analyzed, all cases were treated individually and the applications of chemotherapeutic drugs bladder instillation were not adopted. Results Follow-up period ranged from 2.5 to 9.0 years, and the average was 4.6 years. Lower urinary tract symptoms score before treatment, 3 month , 6 month, 2 years , 4 years after treatment was (8.5 ± 3.7), (5.7 ± 2.3), (3.9 ± 1.3), (4.0 ± 1.9), (4.2 ± 1.9) scores, and the scores after treatment were improved significantly compared with that before treatment (P < 0.05). Recurrence rate 3 months , 6 months, 2 years and 4 years after treatment was 3.7％(2/54), 13.0％(7/54), 5.6％(3/54) and 1.9％(1/54). Conclusions Eliminating the inducements and improvement of symptoms provides a significantly curative effect in glandular cystitis. Postoperative bladder instillation chemotherapy is not recommended.

Objective: To study the detection rate of Streptococcus mutans in oral cavities of 3-5-year-old Han, Uygur and Mongolian children in Bortala Mongolian Autonomous Prefecture, and the correlation between genotype and dental caries of preschool children. Methods : Ninety children were randomly selected from the sample bank of children′s oral epidemiological survey data in the Bozhou area of Xinjiang. Forty-five children were included in the high caries group (more than 5 missing teeth), and 45 children were included in the noncaries group (0 missing teeth); each group comprised 15 children of each of the Han, Uygur and Mongolian nationalities. Plaque samples were collected and cultured with light saliva-bacillin agar medium and brain-heart infusion medium. Streptococcus mutans were cultured, and clinical isolates were further isolated and identified by Gram staining, biochemical identification and polymerase chain reaction. Genotype distribution was detected by random primer polymerase chain reaction. Results : The detection rate of Streptococcus mutans in the 90 included children was 75.5%. The detection rate of Streptococcus mutans in the high caries group was 86.7%, which was significantly higher than that in the caries-free group (64.4%) (P=0.014). There was no significant difference in the distribution of Streptococcus mutans among Han, Uygur and Mongolian nationalities (P=0.457). A total of 549 clinical strains of Streptococcus mutans were obtained, and 113 different genotypes were found. In the high caries group, 61.5% carried more than one genotype of Streptococcus mutans, and 37.9% of the caries-free group had more than one genotype. The genetic polymorphism of Streptococcus mutans in the high caries group was significantly higher than that in the caries-free group (P=0.035). Spearman correlation analysis showed that there was a positive correlation between oral Streptococcus mutans gene polymorphism and caries sensitivity (r=0.258, P=0.034). Conclusion The distribution of Streptococcus mutans in children′s oral cavity in the Bozhou area was different between the high caries group and the caries-free group, but there was no difference among nationalities. Streptococcus mutans in the high caries group had more genotypes than those in the caries-free group. The genetic polymorphism of Streptococcus mutans might be related to the caries-causing ability of Streptococcus mutans.

PURPOSE: Data comparing the long-term efficacy and safety of subcutaneous immunotherapy (SCIT) using house dust mite (HDM) in children and adults with allergic rhinitis (AR) are limited. This study aimed to compare the long-term effects of HDM-SCIT in a cohort of Chinese pediatric and adult patients with AR. METHODS: A total of 124 pediatric and adult AR patients received HDM-SCIT for 3 years, with 118 patients being followed-up for 2 years. Prior to treatment (baseline), at the end of the 3-year treatment periods (third year) and 2 years after the discontinuation of treatment (fifth year), all patients were evaluated for total nasal symptom scores (TNSS), daily medication score (DMS), total combined score (TCS; symptoms [nasal + ocular] + DMS) and quality of life (QoL). Safety was assessed according to adverse events reported. RESULTS: After 3-year treatment, HDM-SCIT significantly improved symptoms and QoL scores at the end of the third and fifth years in both groups. Better improvements were observed in the third and fifth years based on baseline, in children compared to adults (TNSSΔ3: 6.66 vs. 5.41, P = 0.011; TCSΔ3: 4.30 vs. 3.83, P = 0.027 and TNSSΔ5: 6.16 vs. 4.86, P = 0.037; TCSΔ5: 4.11 vs. 3.62, P = 0.044).Shorter duration of AR history before SCIT (<10 vs. ≥10 years) resulted in better improvements at the end of the third and fifth years (TCSΔ3: 4.12 vs. 3.13, P = 0.036; TCSΔ5: 3.90 vs. 3.09, P = 0.033). HDM-SCIT was safe and comparable in both children and adults with AR. CONCLUSIONS: Children with AR may achieve better long-term efficacy of HDM-SCIT than adults with AR.
Adult* ; Asian Continental Ancestry Group ; Child ; Cohort Studies ; Humans ; Immunotherapy* ; Pyroglyphidae ; Quality of Life ; Rhinitis, Allergic* ; Treatment Outcome

Objective: To analyze the effects of green aerobics on serum homocysteine concentration and the morning surge in blood pressure in H-type hypertension patients with ischemic stroke. Methods: The 125 patients who suffer from H-type hypertension as well as ischemic stroke were divided into two groups by random digital table method. The control group (60 cases) accepted neurology normal nursing, while the intervention group (65 cases) accepted green aerobics intervention except the neurology normal nursing. The patients′ homocysteine level and the morning surge in blood pressure were assessed in two groups. Results: Two weeks later, the homocysteine level in the control group was (9.44±2.07) mmol/L, while the intervention group was (11.62±3.03) mmol/L. The difference between the two groups had statistics significance(t=-5.257, P <0.05). The morning surge in blood pressure was (18.75±7.51) mmHg(1 mmHg=0.133 kPa), while the control group was (34.07±2.91) mmHg. The difference between the two groups had statistics significance (t=15.761, P <0.05). Conclusions The green aerobics could effectively lower the homocysteine level and the morning surge in blood pressure of patients who suffer from H-type hypertension as well as ischemic stroke. It was an alternative therapy or assistant therapy without side effects.

Objective The present study aimed to evaluate the effects of isometric resistance training(IRT)conducted using handgrip exercise on blood pressure variability (BPV) and heart rate variability (HRV) in hypertensive patients with minor ischemic stroke (MIS).Methods One hundred and twenty-five hypertensive patients with MIS were included in the present study. Patients were randomized into two groups with random number table. Patients in the control group (n=60) were nursed in the routine care in department of neurology, while patients in the experimental group (n=65) received the IRT.The 24-hour ambulatory blood pressure-monitoring assessment was performed using validated oscillometric recorders (A&D TM- 2430, A&D Inc.,Tokyo,Japan).The 24- hour ambulatory electrocardiography measurement was performed using electrocardiocorder(PI200A-A, QunTian Inc.,Shanghai,China).The BPV ratio and the HRV ratio were assessed in the two groups. Results 24 hours after the intervention, intervention group 24 hours systolic blood pressure variation coefficient and diastolic blood pressure variation coefficient were(10.16 ± 1.95)％,(12.6 ± 7.15)％,the control group, respectively (12.92 ± 2.79)％, (17.38±4.49)％, two groups compare the difference was statistically significant (t=6.450, 4.435, P<0.05). Intervention group of normal sinus R- R period between the standard deviation, to the phase difference between adjacent R- R , root mean square value of the whole difference in more than 50 ms continuous period of percentage between normal R-R and triangle Index were (173.3±58.5) ms, (115.9±74.4), (54.8± 24.1)％, (53.3 ± 15.1).The control group was(128.7 ± 40.2)ms, (82.1 ± 35.2),(39.9 ± 17.1)％, (30.6 ± 14.9), and the difference between the two groups was statistically significant(t=-8.439--3.207, all P<0.05). Conclusions Isometric resistance training conducted using handgrip exercise could increase the HRV and decrease the BPV in hypertensive patients with MIS. These results indicated that the IRT may improve the life quality of hypertensive patients with MIS.

Objective To explore the association between estimated glomerular filtration rate (eGFR) and prognosis of acute ischemic stroke (AIS) patients who were treated by intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA).Methods We consecutively screened AIS patients who were treated by intravenous thrombolysis with rt-PA from January 2006 to September 2016 in Tangshan Gongren Hospital.According to eGFR value of patients at admission,the eligible patients were divided into two groups:normal eGFR group (eGFR ≥ 90 ml ? min-1 ? 1.73 m-2) and decreased eGFR group (eGFR ＜ 90 ml? min-1 ? 1.73 m-2).The incidence of symptomatic intracerebral hemorrhage (SICH),early neurological deterioration (END) at 24 hours and seven days after thrombolysis,mortality within seven days and 90 days,and excellent recovery at 90 days were compared between the two groups.The OR with 95％ CI and the adjusted OR with 95％ CI were analyzed by univariate and multivariate Logistic regression models.Results A total of 258 patients were enrolled,including 182 cases in the normal eGFR group and 76 cases in the decreased eGFR group.After adjusting for the potential confounders,multivariate Logistic regression analysis showed that the rates of SICH (13.2％ (10/76) vs 3.3％ (6/182),OR =3.859,95％ CI 1.313-11.341),END at 24 hours (21.1％ (16/76) vs 8.2％ (15/182),OR =2.958,95％ CI 1.347-6.495) and seven days (32.9％ (25/76) vs 12.6％ (23/182),OR =3.129,95％ CI 1.555-6.293),mortality within seven days (22.4％ (17/76) vs 6.0％ (11/182),OR =4.079,95％ CI 1.588-10.477) and 90 days (23.7％ (18/76) vs 9.9％ (18/182),OR =2.457,95％ CI 1.050-5.749) were higher in the decreased eGFR group than in the normal eGFR group.On the other hand,the chance of excellent recovery at 90 days (22.4％ (17/76) vs 43.4％ (79/182),OR =0.435,95％ CI 0.229-0.824) was less in the decreased eGFR group than in the normal eGFR group.Conclusion Decreased eGFR may not only increase the risks of SICH,END and death,but also reduce the chance of 90-day excellent recovery in AIS patients after intravenous thrombolysis with rt-PA.

Objective: To investigate the distributions of Candida albicans (Ca), which are closely associated to early childhood caries (ECC) of young children, in 3-5-year-old children of Mongolian, Uygur and Han ethnic groups in Bortala Mongol Autonomous Prefecture of Xinjiang Urgur Autonomous Region, so as to provide scientific basis for the early prediction and prevention of caries locally. Methods: Totally 1 089 healthy children aged 3 to 5 years old (Mongolian 136, Uygur 403 and Han 550; 568 males and 521 females) were randomly selected by stratified and cluster sampling method. The children in early childhood caries group were 786 and in caries free group were 303. Dental plaque samples were collected from the carious tooth tissues and supragingival sites, respectively. Samples were isolated and cultured by different media. Ca were identified by Gram stain, germ tube test, PCR method and internal transcribed spacer region sequencing methods. Ca isolated were further typed by using PCR-25SrDNA genotype method. Pearson χ² test and Spearman rank correlation were used to analyze the differences in genotypes of Ca amongst three ethnic groups and the relationship between decayed missing filled tooth (dmft) classification and detection of Ca. Results: The Ca was significantly higher in the ECC group [14.4% (113/786)] than in the caries free group [7.6% (23/303)] (P=0.002). The identified rate of Ca in Mongolian group was [11.8% (16/136)], which was significantly lower than that of Uygur group [17.9% (72/403)] and higher than that of Han group [8.7% (48/550)] (χ²=10.192, P=0.006). Among the male children, the identified rate of Ca in Mongolian group was [10.0% (8/80)], which was significantly lower than that of Uygur group [21.7% (44/203)] and higher than that of Han group [8.4% (24/285)] (χ²=18.887, P=0.000). Among the female children, the detection rates of Ca were [14.3% (8/56)] in Mongolian group, [14.0% (28/200)] in Uygur group and [9.1% (24/265)] in Han group. There were no significant differences among the three ethnic groups (χ²=3.206, P=0.201). The identification rates of oral Ca in Uygur and Han ECC groups were correlated with the decayed, missing and filled teeth (Uygur r=0.195, P=0.001; Han r=0.145, P=0.004). Totally 136 Ca samples were divided into 3 types by PCR-25SrDNA method, and the predominant type was type A [55.1% (75/136)]. Conclusions The distribution of oral Ca among children were ethnically different. Uygur male children carrying Ca were more susceptible to dental caries. Ca might be a risk factor for ECC. There was no specific cariogenic genotype in Ca isolated. There were no associations between ethnic factors and the genotypes of Ca isolated.