Objective To investigate the impacts of artesunate(Art)on the formation of kidney stones and the phosphatidylinositol 3 kinase(PI3K)/protein kinase B(Akt)signaling pathway.Methods Rats were randomly divided into the Control group,Model group,Artesunate low-dose group(ART-L group),artesunate high-dose group(ART-H group),artesunate high-dose+PI3K in-hibitor group(Art+LY294002 group).The rat model of kidney stone was established by drinking water with ethylene glycol and injecting sodium oxalate intraperitoneally.A kidney stone cell model was established by exposing HK-2 cells to 200 mg/L calcium oxalate mono-hydrate crystals and 2 mmol/L oxalate.The levels of Ca2+and oxalic acid(Ox)in urine and serum creatinine(Scr)and blood urea ni-trogen(BUN)were detected;Pizzolato staining was applied to observe the deposition of calcium salts in renal tissues;the pathological morphology in renal tissues was detected by HE staining;malondialdehyde(MDA)and superoxide dismutase(SOD)kits were used to detect the levels of MDA and SOD in renal tissue and HK-2 cells;ELISA method was applied to detect TNF-α,IL-1βand IL-6 in renal tissue and HK-2 cells;fluorescence quantification was applied to detect the levels of Bax,caspase-3,PI3K and Akt;immunohis-tochemical and Western blot were applied to detect the expression levels of PI3K and Akt proteins in the renal tissues.HK-2 cell apopto-sis was measured by flow cytometry.Results Compared with the Model group,Ca2+,Ox,Scr,BUN,the level of MDA,TNF-α,IL-1 β,IL-6 in renal tissue and HK-2 cells,the expression of Bax,caspase-3 in renal tissue decreased in Art-L and Art-H groups,the level of SOD,PI3K,and Akt in renal tissue and HK-2 cells increased(P＜0.05);compared with the Art-H group,Ca2+,Ox,Scr,BUN,the level of MDA,TNF-α,IL-1 β,IL-6 in renal tissue and HK-2 cells,the expression of Bax,caspase-3 in renal tis-sue increased in the Art+LY294002 group,the level of SOD,PI3K and Akt in renal tissue and HK-2 cells decreased(P＜0.05).Conclusion Artesunate can inhibit the formation of kidney stones;its inhibition of stone formation may be produced through the mecha-nism of up-regulating the PI3K/Akt signaling pathway.

【Objective】 To analyze the clinical data of prostate cancer patients with normal PSA level confirmed with transperineal prostate biopsy or transurethral prostate surgery, in order to improve the diagnostic level of this disease. 【Methods】 The clinical data of 6 patients were retrospectively analyzed. The age,clinical manifestations, body mass index (BMI),prostate specific antigen density (PSAD),blood triglycerides,blood cholesterol,color ultrasound imaging,magnetic resonance imaging (MRI),pathological types and Gleason scores were analyzed. The clinical characteristics and high-risk factors were summarized. 【Results】 Two cases were confirmed with prostate biopsy and four after prostate resection. Three patients had high blood triglycerides, three were negative for bone imaging, and the other three were not examined. PSAD was 0.017 to 1.215. Color ultrasound indicated that two cases had irregular morphology, two uneven echo, and one both irregular morphology and uneven echo; all six cases had calcification. In the three cases who received MRI, two had PIRADS4 nodules, one had PIRADS5 nodules, invasion of seminal vesicle, rectum, posterior wall of urinary bladder,bilateral thickening of NVB, and lymph nodes enlargement. Pathology suggested prostatic acinar adenocarcinoma in five cases, four of which had a Gleason score of 3+3=6 and one had 5+5=10; one case suggested a high-grade neuroendocrine carcinoma. 【Conclusion】 The clinical detection rate is low for prostate cancer with normal PSA. The biopsy indications should be determined by combining the characteristics and high-risk factors to improve the detection rate.

A 62-year-old female patient was admitted to the hospital with a mass in the left kidney finding during medical check-up by color doppler imaging 1 day before admission. Unenhanced and contrast enhanced CT of urinary tract showed a mass on the inferior pole of left kidney. The left kidney cancer was diagnosed preoperatively and a left radical nephrectomy was performed laparoscopically. Postoperative diagnosis was thyroid-like follicular carcinoma of the left kidney and suspected derived from thyroid tumors by metastasis. Color doppler and CT examination of thyroid confirmed a mass in the right thyroid. Thyroid fine needle aspiration confirmed follicular carcinoma of the right thyroid, and follicular carcinoma of the right thyroid was diagnosed subsequently. The patient underwent radical resection of thyroid cancer according to the intraoperative frozen-section pathological results, and postoperative pathological diagnosis confirmed follicular carcinoma of the right thyroid and papillary carcinoma of the left thyroid. I 131 radio-iodine therapy and L-thyroxine tablets were administered based on the postoperative diagnosis of thyroid collision tumor. Seven months after surgery, the follow-up CT scan revealed no recurrence or metastases for renal area. Nine months later, no thyroid carcinoma recurrence was observed and no significant abnormality was detected in I 131 image. The composition of collision tumor is complicated and origin is unknown. Thyroid collision tumor with kidney metastasis is extremely rare, and the prognosis is better than primary renal carcinoma. The diagnosis depends on pathological examination.

[Abstract] Objective:ToinvestigatetheroleofmiR-125a-5pininducingthegefitinib(Gef)-resistance of non-small cell lung carcinoma (NSCLC) cells and its possible mechanism. Methods: Human NSCLC drug-resistant cell line A549/GR and NSCLC cell line A549 were chosen for this study. miR-125a-5p mimic, miR-125a-5p inhibitor, pcDNA3.1-APAF1 and empty vector pcDNA3.1 were transfected into A549/GR cells. The expression level of miR-125a-5p in cell lines was detected by qPCR. MTT, Transwell and Flow cytometry were used to detect the effects of Gef on proliferation, migration and apoptosis of cell lines, respectively. The targeting relationship between miR-125a-5p and APAF1 (apoptotic peptidase activating factor 1) was verified by Dual-luciferase reporter gene system. In addition, the expression of APAF1 protein in A549/GR cells was detected by Western blotting. The expression levels of caspase-3 and caspase-9 were assessed by colorimetry. Results: Expression level of miR-125a-5p was upregulated significantly in Gefresistant A549/GR cells (P<0.01). AndtheinfluencesofGefonA549/GRcellswereenhancedby knockdown of miR-125a-5p, including inhibiting cell proliferation and migration (all P<0.05) and inducing apoptosis (P<0.01). Dual luciferase reporter gene assay confirmed that miR-125a-5p targeted APAF1 and negatively regulated its expression. Furthermore, by targetedly downregulating APAF1, miR-125a-5p alleviated the inhibition of proliferation and migration (all P<0.05) and promotion of apoptosis (P<0.05) of A549/GR cells caused by Gef, and attenuated Gef-induced upregulation of apoptosis-related proteins caspase-3 and caspase-9 (all P<0.05). Conclusion: miR-125a-5p promotes Gef-resistance of A549/GR cells, and the underlying mechanisms are promotion of proliferation, migration and inhibition of apoptosis of non-small cell lung cancer cells by targetingAPAF1.

Objective To evaluate the curative effect of transcatheter arterial chemoembolization (TACE)combined with Antike in the treatment of primary liver cancer. Methods The data of 72 patients with primary liver cancer(90 lesions in total)admitted to the First Affiliated Hospital of Hebei North University from August 2016 to December 2017 were retrospectively analyzed. All patients were divided into the observa-tion group(n = 36)and the control group(n = 36)according to the therapeutic schedule. The patients in the control group(40 foci)were treated with TACE only,and the patients in the observation group(50 foci)re-ceived TCAE treatment,oral Antike capsules were taken at the same time with the frequency of three times a day,two capsules each time,and six weeks were planned for one treatment cycle. A total of four cycles were completed. All patients underwent CT enhancement scans one week before TACE treatment and six months after treatment. According to Response Evaluation Criteria in Solid Tumors,complete remission and partial remission were deemed as effectivity. The imaging data of the change of tumor size,postoperative tumor residual,tumor capsule growth and new intrahepatic metastases were analyzed and used to evaluate the curative effect of patients in the two groups. Results After 6 months of treatment,there were 39 effective lesions in the observation group and 23 in the control group. The total effective rate of the observation group was higher than that of the control group(78. 0％ vs. 57. 5％ ),and the difference was statistically significant(χ2 = 4. 357,P = 0. 037). Twenty-three neoplastic capsule lesions were detected in the observation group and 9 in the control group. The detection rate of neoplastic capsule was higher in the observation group than that in the control group(46. 0％vs. 22. 5％ ),and the difference was statistically significant(χ2 = 5. 356,P = 0. 021). There were 27 residual tumors and 5 new intrahepatic metastases in the observation group,30 residual tumors and 13 new intrahepatic metastases in the control group. The residual tumor rate and neohepatic metastasis rate in the observation group were lower than those in the control group(54. 0％ vs. 75. 0％ ;13. 9％ vs. 36. 1％ ),and the differences were statistically significant(χ2 = 4. 220,P = 0. 040;χ2 = 4. 741,P = 0. 029). Conclusion TACE combined with Antike is safe and effective in the treatment of primary liver cancer. It can improve the total clinical effi-ciency,promote the growth of tumor capsule,and reduce the recurrence rate and metastasis rate of tumor. It is worthy of clinical application.

Objective After the islet transplantation,observed blood glucose and survival time in the islet transplantation mice model to explore the effect of intestinal epithelial γδT cell in islet transplantation rejection.Methods Established the mice model of islet transplantation,divided into wild type mice group,γδ gene knockout mice group and γδ gene knockout γδT cell reinfusion mice group,observed blood glucose in 1,3,5,7,9,11,13,15,17,19,21,23,25,27,29 days after surgery and pathological conditions aft er two weeks of transplantation.Results After transplantation,the rising blood glucose of wild type mice group and γδ gene knockout γδT cell reinfusion mice group were significantly slower than that of γδ gene knockout mice group (P＜0.05),but there was no significant difference in between two groups (P＞0.05).The survival time of wild-type mice group was (27±2) days,and γδ gene knockout γδT cell reinfusion mice group was (24±1) days,they were significantly longer than (17±3) days of γδ gene knockout mice group (P＜ 0.05).Conclusion As a special kind of T cells,γδT intestinal epithelial cell plays an important role in the islet transplantation rejection.

Objective To explore the feasibility of making cystoscope training model with rapid prototyping technology and its training method in cystoscope operation. Methods Constructed a cystoscope training model, and designed a set of corresponding training methods ac-cording to the process and behavioral essentials of cystoscope operation. Selected 20 students who have never learned cystoscope operation and trained them with the new designed cystoscope training mode and training methods, and the training results were verified. Results Compared before and after the training, the operation time of all the trainees were significantly shortened, and their operation steps and skills were more proficient. Conclusion Cystoscope training model can help beginners to grasp the theoretical basis of cystoscopy, operation steps, and behavioral essentials, so as to shorten the learning curve of the cystoscope operation.

Objective To investigate the hemostatic function of biological glue in renal trauma.Methods Establishment of rab-bit kidney scratch,partial nephrectomy and renal injury penetrating wound models were available with a biological glue and hemo-static powder processing,observed and recorded the amount of bleeding and bleeding time.Tissue sample were transected from the wound of kidneys in each group after a month,and the renal wound healing condition was observed by pathological examination.Re-sults The hemostatic function of biological glue was better than styptic powder,the amount of bleeding in biological glue group and hemostatic powder group of kidney scratched model were(1.39±0.09)mL,(1.77±0.44)mL,the difference was not statistically significant(P =0.115);the bleeding time were(5.02 ±0.23)s,(66.40± 7.35)s,the difference was statistically significant(P <0.01);the amount of bleeding in two models of partial nephrectomy and renal penetrating wound were(2.07±0.25)mL,(11.42± 1.33)mL;(2.01 ± 0.36)mL,(3.95 ± 0.39)mL and bleeding time were(6.16 ± 0.69)s,(139.38 ± 8.97)s;(7.68 ± 0.80)s, (144.26±9.27)s,the differences were statistically significant(P <0.01).Pathology results showed that the wounds healed well. Conclusion The hemostatic function of biological glue in renal trauma were remarkable and stable,and was worth to be further promoted.

Obj ective To analyze the difference of positive expression rate of HBsAg and HBeAg among patients with malignant lymphoma,other tumor patients and normal people.Meth-ods A total of 260 patients were collected,including 102 cases in malignant lymphoma group,98 cases in other cancer group and 60 cases in normal group.Clinical materials of patients with malig-nant lymphoma were retrospectively analyzed.The differences of positive expression rate of HBsAg and HBeAg among patients with malignant lymphoma,other tumor patients and normal people were analyzed.The relationship between HBsAg,HBeAg and positive rate with age,gender,histological type,clinical stage were also analyzed.Results The positive expression rates of HBsAg and HBeAg in malignant lymphoma group were significantly higher than other cancer group and normal group.The positive expression rate of HBsAg and HBeAg had no significant correlation with age, gender,histological type,clinical stage.Conclusion The positive expression rates of HBsAg and HBeAg in malignant lymphoma patients are significantly higher than other cancer patients and nor-mal patients.

Obj ective To analyze the difference of positive expression rate of HBsAg and HBeAg among patients with malignant lymphoma,other tumor patients and normal people.Meth-ods A total of 260 patients were collected,including 102 cases in malignant lymphoma group,98 cases in other cancer group and 60 cases in normal group.Clinical materials of patients with malig-nant lymphoma were retrospectively analyzed.The differences of positive expression rate of HBsAg and HBeAg among patients with malignant lymphoma,other tumor patients and normal people were analyzed.The relationship between HBsAg,HBeAg and positive rate with age,gender,histological type,clinical stage were also analyzed.Results The positive expression rates of HBsAg and HBeAg in malignant lymphoma group were significantly higher than other cancer group and normal group.The positive expression rate of HBsAg and HBeAg had no significant correlation with age, gender,histological type,clinical stage.Conclusion The positive expression rates of HBsAg and HBeAg in malignant lymphoma patients are significantly higher than other cancer patients and nor-mal patients.