Objective To compare the application of multifunctional ureterostomy stent and traditional ureterostomy internal stent in patients with total ureterostomy.Methods Prospectively,102 patients with bladder cancer and undergoing elective radical cystectomy with urinary diversion admitted to our hospital from March 2019 to March 2023 were selected for the study.According to the random number rank method,the patients were divided into the study group(51 cases)and the control group(51 cases).The control group was given a traditional single-J ureteral stomy stent drainage device,and the research group was given a multifunctional ureteral stomy stent drainage device.The differences of OAI score,renal function index(eGFR),recent complications,long-term complications and quality of life(FACT-BL score)were compared between the two groups.Results OAI scores 1 month,3 months and 6 months after surgery(study group:49.33±4.07,57.29±3.90,68.25±3.76;control group:44.25±4.61,52.31±4.58,59.06±4.37)and before surgery(study group:32.71±4.32;control group:33.18±4.74)compared with higher levels(P＜0.05),but the study group was higher than the control group(P＜0.05).Repeated measurement ANOVA results showed that eGFR at 3 months and 6 months after surgery(study group:86.07±4.07,88.01±3.01;control group:83.09±3.06,85.06±5.09)and before surgery(study group:82.05±6.04;control group:81.03±5.06)compared with higher levels(P＜0.05),but the study group was higher than the control group(P＜0.05).The total rate of recent complications in the study group was lower than that in the control group(7.84％VS 23.53％,P＜0.05).The total incidence of long-term complications in the study group was lower than that in the control group(43.14％VS 78.43％,P＜0.05).Emotional status score,physical status score,functional status score,social and family status score,BSS score,FACT-BL total score of the two groups 6 months after surgery(study group:20.25±2.36,24.92±1.87,25.65±1.11,26.02±1.14,32.75±1.76,129.59±5.74;Control group:18.65±3.10,20.18±3.02,23.51±1.29,21.51±2.24,30.26±3.07,114.10±10.37)and preoperative(study group:14.27±3.56,16.57±3.58,17.27±2.35,17.49±2.64,23.41±5.25,89.02±13.62;Control group:14.39±3.44,16.47±3.25,17.22±2.34,17.55±2.59,23.43±5.25,89.25±13.62)were increased(P＜0.05),and the study group was higher than the control group(P＜0.05).Conclusion The application of multifunctional ureteral stent in patients with ureteral cutaneous stomy with total cystotomy can effectively improve the adaptability of stomy,promote the recovery of renal function,reduce the risk of short-term and long-term complications,and improve the quality of life of patients.

Objective:To compare the clinical value of visual analogue scale （VAS）, Lebel scale and total nasal symptom scores （TNSS） in evaluating nasal allergen provocation test （NAPT）. Methods:A total of 151 patients suspected of allergic rhinitis admitted to the Department of Otolaryngology-Head and Neck Surgery of our hospital from April 2020 to September 2020 were included, of which 76 were positive for house dust mites and 75 were negative for allergens. Nasal airway resistance（NAR） was measured by active anterior nasal manometry. Nasal symptoms were evaluated by VAS, Lebel and TNSS. House dust mite allergen was used for NAPT by spray method. An increase≥40% in NAR was used as the gold standard for objective evaluation of NAPT. ROC curves of VAS, Lebel and TNSS were drawn to compare the evaluation effectiveness of different subjective evaluation methods, and the optimal critical point of each ROC curve was obtained. Results:With NAR increased by ≥40% as the gold standard, the area under ROC curve of VAS was 0.884, and the sensitivity and specificity were 97.75% and 80.65%, respectively. The area under ROC curve of Lebel was 0.773, and the sensitivity and specificity were 68.54% and 75.81%, respectively. The area under ROC curve of TNSS was 0.792, and the sensitivity and specificity were 68.54% and 79.03%, respectively. There was no significant difference between Lebel and TNSS（P>0.05）. The VAS differed significantly from Lebel and TNSS（P<0.05）. The Kappa values of VAS, Lebel, TNSS and NAR were 0.803, 0.432 and 0.459, respectively. Conclusion:The VAS, Lebel, TNSS subjective scale and NAR are consistent in evaluating the efficacy of NAPT, with the VAS assessment showing highest consistency with NAR. As objective assessment instruments are not widely used in China, subjective assessment method could be adopted to evaluate the efficacy of NAPT in clinical practice, and VAS scale is recommended as a priority.
Animals ; Humans ; Allergens ; Nasal Provocation Tests/methods* ; Rhinitis, Allergic/diagnosis* ; Nose ; Pyroglyphidae

Objective:To investigate the application value of establishing the differential diagnosis model of pulmonary tuberculosis using routine laboratory data.Methods:The retrospective study was conducted. The routine laboratory data of newly diagnosed patients with pulmonary tuberculosis and other pulmonary diseases in Beijng Jishuitan Hospital and Beijing Hepingli Hospital from May 2015 to November 2021were collected. According to the random numbers showed in the computer, all the 11516 patients were divided into training dataset and test dataset with a ratio of 9∶1. Four machine learning algorithms, Support Vector Machine, Random Forest, K-Nearest Neighbor and Logistic Regression, were used to build models and select features. The diagnostic accuracy of each model was verified by using the 10-fold cross-validation method and the performance of each model was evaluated by using the receptor operator of characteristic (ROC) curve.Results:Random Forest was selected as the optimal machine learning algorithm to build the best feature model in the study. According to importance scale of factors, the differential diagnosis model of pulmonary tuberculosis consisting of 37 non-specific test indexes. In the validation set and test set the accuracy and area under curve (AUC) of the models were 0.747 and 0.736, the sensitivity, specificity and accuracy were 68.03% and 68.75%, 70.91% and 67.90%, 70.30% and 68.12%, respectively.Conclusion:A key tool in the differential diagnosis model of pulmonary tuberculosis was established by routine laboratory data in combination with machine learning. The results of this study need to be further verified by more data from medical institutions.

Objective:To investigate the pathological characteristics and the clinical significance of novel coronavirus (2019-nCoV)-infected pneumonia (termed by WHO as coronavirus disease 2019, COVID-19).Methods:Minimally invasive autopsies from lung, heart, kidney, spleen, bone marrow, liver, pancreas, stomach, intestine, thyroid and skin were performed on three patients died of novel coronavirus pneumonia in Chongqing, China. Hematoxylin and eosin staining (HE), transmission electron microcopy, and histochemical staining were performed to investigate the pathological changes of indicated organs or tissues. Immunohistochemical staining was conducted to evaluate the infiltration of immune cells as well as the expression of 2019-nCoV proteins. Real time PCR was carried out to detect the RNA of 2019-nCoV.Results:Various damages were observed in the alveolar structure, with minor serous exudation and fibrin exudation. Hyaline membrane formation was observed in some alveoli. The infiltrated immune cells in alveoli were majorly macrophages and monocytes. Moderate multinucleated giant cells, minimal lymphocytes, eosinophils and neutrophils were also observed. Most of infiltrated lymphocytes were CD4-positive T cells. Significant proliferation of type Ⅱ alveolar epithelia and focal desquamation of alveolar epithelia were also indicated. The blood vessels of alveolar septum were congested, edematous and widened, with modest infiltration of monocytes and lymphocytes. Hyaline thrombi were found in a minority of microvessels. Focal hemorrhage in lung tissue, organization of exudates in some alveolar cavities, and pulmonary interstitial fibrosis were observed. Part of the bronchial epithelia were exfoliated. Coronavirus particles in bronchial mucosal epithelia and type Ⅱ alveolar epithelia were observed under electron microscope. Immunohistochemical staining showed that part of the alveolar epithelia and macrophages were positive for 2019-nCoV antigen. Real time PCR analyses identified positive signals for 2019-nCoV nucleic acid. Decreased numbers of lymphocyte, cell degeneration and necrosis were observed in spleen. Furthermore, degeneration and necrosis of parenchymal cells, formation of hyaline thrombus in small vessels, and pathological changes of chronic diseases were observed in other organs and tissues, while no evidence of coronavirus infection was observed in these organs.Conclusions:The lungs from novel coronavirus pneumonia patients manifest significant pathological lesions, including the alveolar exudative inflammation and interstitial inflammation, alveolar epithelium proliferation and hyaline membrane formation. While the 2019-nCoV is mainly distributed in lung, the infection also involves in the damages of heart, vessels, liver, kidney and other organs. Further studies are warranted to investigate the mechanism underlying pathological changes of this disease.

Objective To investigate the expression of paired box 2 (Pax2) and E-cadherin in human renal cell carcinoma (RCC) and their correlation with clinicopathologic parameters.Methods The RCC tissue microarrays containing 85 renal cell carcinoma specimens and 35 normal kidney tissue specimens were used to detect Pax2 and E-cadherin expressions by immunohistochemistry.Results The positive expression rate of Pax2 was 77.6％ (66/85) in RCC specimens,which was significantly higher than that in 35 normal kidney tissue specimens (P ＜ 0.01).The positive expression rate of E-cadherin was 30.6％ (26/85) in RCC specimens,which was significantly lower than that in 35 normal kidney tissue specimens (P ＜ 0.01).The expression of Pax2 in RCC was significantly related to histological classification and pathological grade (P ＜ 0.05),while it was not related to the size of tumor and clinical stage (P ＞ 0.05).The expression of E-cadherin in RCC was significantly related to the size of tumor,histological classification,pathological grade and clinical stage (P ＜ 0.05).The positive expression rate of E-cadherin in survival group was significantly higher than that in death group (P ＜ 0.05).Conclusions The abnormal expressions of Pax2 and E-cadherin may play a crucial stage in development of human RCC.Detection of the expressions of Pax2 and E-cadherin can be used in the evaluation of malignant degree and prognosis of RCC.

Objective To investigate the expression of epidermal growth factor receptor (EGFR) and multidrug resistance protein, and it's relationship with efficacy of chemotherapy in NSCLC.MethodsThe immunohistochemical (EnVision method) was used to detect the expression of EGFR and LRP, P-gp, MRP, GST-π in 95 cases of NSCLC tissues and 15 cases of normal lung samples.ResultsEGFR in NSCLC tissues was significantly correlated with the history of smoking, pathological types of cancer(squamous cell carcinoma vs adenocarcinoma), presence of lymph node metastasis, and TNM stages (P< 0.05).The positive expression rate of LRP and MRP in adenocarcinoma were higher than squamous cell Carcinoma (P< 0.05), and MRP in high differentiate cancer was higher than low differentiate cancer (P< 0.05).The expression of MRP and LRP, PGP and GST-π in NSCLC were positive correlation(r=0.341, P=0.001;r=0.213, P=0.038), there is no correlation between EGFR with LRP, P-gp, MRP, GST-π.EGFR-negative chemotherapy efficiency (62.5%) was significantly higher than EGFR-positive(37.5%, P< 0.05).ConclusionEGFR and multi drug resistance proteins are overexressed in NSCLC tissues.multi drug resistance proteins have a synergistic to drug resistance.EGFR could be used to objectively predict chemotherapy effect and prognosis of NSCLC.

Objective To investigate the effect of three kinds of skin external use in the prevention and treatment of radiation dermatitis in patients with nasopharyngeal carcinoma. Methods 120 patients with nasopharyngeal carcinoma who were treated form August 2014 to October 2015 were divided into three groups by random number table method, namely, aloe vera gel group, triethanolamine cream group, radiation treatment of skin protectants (lifuning) group. Except for different medications among the groups, the other conditions remained relatively consistent. 3 groups were compared in the radiotherapy classification, area, local pain score, and topical drug costs during the radiotherapy and the radiation dose when radiation dermatitis occurred the first time. Results Three kinds of skin external use had a preventive effect, but the effect was different. Three groups′ patients with radiation dermatitis incidence was 100%, but occurred at different levels. Aloe vera gel cream group and triethanolamine group were mainly for gradeⅡradiation dermatitis, grade IV radiation dermatitis occurred in 2 cases and 4 cases, lifuning group were mainly for grade Ⅰ and grade Ⅱ radiation dermatitis, grade Ⅲ radiation dermatitis only occurred 2 cases, noⅣgrade radiation dermatitis occurred. Comparison among the three groups, the difference was statistically significant (H=8.758,P<0.05). 3 groups of patients after treatment all suffered pain, 12 patients in triethanolamine cream group , 7 patients in lifuning group , only 2 cases in aloe vera gel group (H=8.586,P<0.05). The average cost of skin external used in 3 groups was different, triethanolamine cream group was 546.0 yuan, lifuning group was 458.2 yuan, and aloe vera gel group was 157.5 yuan. Among the three groups pairwise comparison, the differences in triethanolamine cream group and aloe vera gel group were statistically significant in pain (χ2=9.62,P<0.05), aloe vera gel group was better than the group of triethanolamine cream, the differences among radiation dermatitis grade, size and radiation dose of radiation dermatitis occurred the first time were not statistically significant (P>0.05). The difference between in lifuning group and triethanolamine cream group in pain had no statistically significant (χ2=2.47,P>0.05), other indexes had significant differences (P < 0.05). Lifuning was better than the triethanolamine cream to reduce and delay the onset and deterioration of radiation dermatitis and could prevent a widening of the area of radiation dermatitis;aloe vera gel group and lifuning group had a significant difference in radioepidermitis grade (χ2=6.32,P<0.05). Lifuning was better than the aloe vera gel and was more conducive to reduce and delay the occurrence of radiation dermatitis, other indexes differences had no statistically significant (P>0.05). Conclusions Considering the efficacy, pain and price three aspects which skin external use prevention and treatment radiation dermatitis patients with nasopharyngeal carcinoma, lifuning as the mixture of triethanolamine and aloe can effectively reduce and delay the chance of radiation dermatitis, reduce the radiation field experience of local pain, and affordable, the patients are more acceptable, it′s worthy of clinical use.

Bone Neoplasms ; pathology ; Carcinoma, Neuroendocrine ; pathology ; Humans ; Osteosarcoma ; pathology ; Ureter ; pathology ; Ureteral Neoplasms ; pathology

OBJECTIVETo establish the HPLC fingerprint for Halenia elliptica herbs, a traditional Tibetan medicine, in order to study constituents contained in H. elliptica from different habitats and compare their differences.

METHODHPLC analysis was made on a Welchrom-C18 (4.6 mm x 250 mm, 5 microm) with water and acetonitrile as mobile phase. The wavelength was detected as 265 nm, the flow rate was 1.0 mL x min(-1), and the column temperature was 40 degrees C. The software for chromatographic fingerprint was applied to analyze the similarity. And principal component analysis was conducted.

RESULTTwelve common chromatographic peaks were identified by fingerprint, showing a low similarity in constituent and variety. The significant difference in the proportion between xanthones and aglycones in each batch of herbs indicated no notable correlation between constituent characteristics and geographic locations of habitats.

CONCLUSIONThe method is so simple, exclusive, stable and highly repeatable that it can provide reference for identification and quality assessment of H. elliptica herbs.

Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; Ecosystem ; Gentianaceae ; chemistry ; classification

OBJECTIVEThe non-allergy of chlorogenic acid was demonstrated by the study result of allergy with different purity of chlorogenic acid and comprehensive analysis of literature.

METHODThe allergies of different samples, which contained the different purity of chlorogenic acid extracts, chlorogenic acid for injection, interior solution of dialysis, external solution of dialysis, post-term chlorogenic acid for injection and chlorogenic acid for injection with degradation, were validated with active systemic anaphylaxis and passive cutaneous anaphylaxis on rats and guinea pigs respectively. The range of molecular weight of macromolecular remains after dialysis were identified by LC-MS.

RESULTAllergic reactions were happened in dialysis isolated macromolecular substances, which were identified by LC-MS, and lower purity extracts (purity of chlorogenic acid < or = 40%), while the reactions were not happened in isolated micromolecular substances and high purity samples (purity of chlorogenic acid > or = 92%).

CONCLUSIONMacromolecules in lower purity of chlorogenic acid extracts were relative closely to the allergen causing anaphylaxis, but not the chlorogenic acid, which was demonstrated according to the study result and analysis of literatures home and abroad.

Anaphylaxis ; chemically induced ; Animals ; Chlorogenic Acid ; adverse effects ; Female ; Guinea Pigs ; Hypersensitivity ; etiology ; Male ; Medicine, Chinese Traditional ; adverse effects ; Rats ; Toxicity Tests ; methods