Search

In order to ensure that the Mesh network mobile client video,voice and other real-time strong applications without interruption,a secure and efficient handover authentication was very important.To protect the privacy of mobile nodes,an anonymity handover authentication protocol was proposed based on group signature for wireless mesh network.Compared with other handover authentication protocols based on group signature,the proposed scheme did not involve the group signature correlation operation,and the group signature algorithm was only carried out on the router.The pro-posed protocol not only enhances the security but also performs well in authentication efficiency and privacy-preserving.

The clinical data of 33 patients who underwent robot-assisted laparoscopic Vattikuti Institute prostatectomy (VIP) in Cancer Hospital of Chinese Academy of Medical Sciences from October 2020 to April 2022 were reviewed and analyzed. Among them, 18 patients received traditional VIP technique and 15 patients received VIP technique with pre-sutured dorsal venous complex (DVC). The ages of the traditional VIP group and the pre-sutured DVC VIP group were (66.1±7.3) and (66.6±5.7) years, respectively. The body mass index (BMI) of the traditional VIP group and the pre-sutured DVC VIP group was (24.3±2.9) and (25.3±2.6) kg/m 2 , respectively. The medical expenses were (91 797.0±7 029.6) and (87 106.6±7 031.4) yuan, respectively, with no statistical significance (all P >0.05). The operations of all the 33 cases were successfully completed, and no cases were transferred to open surgery. The operation time of traditional VIP group was longer than that of pre-sutured DVC VIP group [(193.0±37.2) vs (171.1±16.1) min]. The amount of intraoperative blood loss was higher than that in the pre-sutured DVC VIP group [(68.3±22.8) vs (44.0±9.1) ml)], all P <0.05. No patients had perioperative blood transfusion, and no patients had complications within 30 days after surgery. All the 33 patients had negative incisal margins. DVC presuture technique can reduce intraoperative bleeding and shorten operative time in robot-assisted laparoscopic VIP radical prostatectomy, and has good curative effect.

Objectives: To evaluate the clinical value of the Paris system for reporting urinary cytology (TPS) in the diagnosis of urothelial carcinoma (UC). Methods: A total of 1 744 cytological diagnostic records (from 751 cases) were collected retrospectively. All specimens were voided urines and histopathology as the gold standard. The sensitivity and specificity of urinary cytological diagnosis of UC and risk of high grade malignant (ROHM) in each diagnostic category were compared. Results: There were 360 cases with histopathology. The percentage of negative for high-grade urothelial carcinoma (NHGUC) was 30.1% (226/751), atypical urothelial cells (AUC) was 29.8% (224/751), suspicious for high-grade urothelial carcinoma (SHGUC) was 16.8% (126/751), high grade urothelial carcinoma (HGUC) was 21.2% (159/751), and non-urothelial malignancy (NUM) was 2.1% (16/751). The histpathologic ROHM corresponding to each cytological diagnosis category were 27.3% for NHGUC, 32.7% for AUC, 74.7% for SHGUC, 96.6% for HGUC and 100.0% for NUM, respectively. ROHM of SHGUC was significantly higher than that of AUC group, and the difference between the two groups was statistically significant ( P ＜0.001). ROHM of HGUC group was significantly higher than that of SHGUC group, and the difference was statistically significant ( P ＜0.001). With SHGUC as the cut-off value, the sensitivity and specificity of cytological diagnosis of HGUC were 76.7% (165/215) and 85.7% (18/21), and with HGUC as the cut-off value, the sensitivity and specificity of cytological diagnosis of HGUC were 53.0% (114/215) and 100.0% (21/21), respectively. Conclusions: Urine cytology has high sensitivity and specificity in the diagnosis of HGUC. The malignant risk of TPS varies with different diagnosis category. The high malignant risk population in cancer hospital leads to the relatively high malignant proportion and ROHM in each diagnosis category. Urinary cytology TPS reporting system is helpful to clinical management and has good clinical application value.

Evaluation of neobladder function in patients with long-term survival and no recurrence after laparoscopic radical cystectomy and intracorporeal Xing's neobladder. The clinical data of laparoscopic radical cystectomy and intracorporeal Xing's neobladder in long-term survival patients with bladder cancer treated in Beijing Chaoyang Hospital from July 2013 to July 2018 were analyzed retrospectively. All 17 patients underwent the surgery by the same surgical team, including 15 males and 2 females, whose mean age at the time of operation was (55.9±7.6) years. Thepostoperative urinary function and renal function were summarized. All operations were successfully completed. The mean operative time was (340±62) min. All patients were followed up for a long time, with a median follow-up time of 80(70, 96) months, Urinary continence was achieved in 17 (100%)casesduring the day and 13 (76.5%) cases at night, with a median bladder volume of 350 (200, 400) ml. All patients had good urinary control after surgery, and no hydronephrosis or creatinine increase was found in reexamination.After the application of Xing's neobladder operation, the patient maintained acceptable urinary control status after the operation, and the long-term follow-up effect was satisfactory.

In this study, the effects of four types of amendments on effective Cd and Cd content in different parts of prickly ash soil and soil enzyme activity were studied, which provided scientific basis for acidification improvement of purple soil and heavy metal pollution control. A field experiment was conducted. Six treatments were set up:no fertilizer (CK), only chemical fertilizer (F), lime + chemical fertilizer (SF), organic fertilizer + chemical fertilizer (OM), biochar + chemical fertilizer (BF), and vinasse biomass ash + chemical fertilizer (JZ). Soil pH; available Cd (DTPA-Cd); Cd content in branches, leaves, shells, and seeds of Zanthoxylum; as well as the activities of catalase (S-CAT), acid phosphatase (S-ACP), and urease (S-UE) in different treatments were studied, and their relationships were clarified. The results showed following:① The two treatments of vinasse biomass ash + chemical fertilizer and lime + chemical fertilizer significantly increased soil pH ( P &lt; 0.05) to 3.39 and 2.25 units higher than that in the control, respectively. Compared with that in the control treatment, the content of available Cd in soil under vinasse biomass ash + chemical fertilizer and lime + chemical fertilizer treatment decreased by 28.91 % and 20.90 %, respectively. ② The contents of Cd in leaves, shells, and seeds of Zanthoxylum were decreased by 31.33 %, 30.24 %, and 34.01 %, respectively. The Cd enrichment ability of different parts of Zanthoxylum was different, with the specific performances being leaves &gt; branches &gt; seeds &gt; shells. Compared with that of the control, the enrichment coefficient of each part of Zanthoxylum treated with vinasse biomass ash + chemical fertilizer decreased significantly( P &lt; 0.05)by 27.54 %-40.0 %. ③ The changes in catalase and urease activities in soil treated with amendments were similar. Compared with those in the control group, the above two enzyme activities were significantly increased by 191.26 % and 199.50 %, respectively, whereas the acid phosphatase activities were decreased by 16.45 %. Correlation analysis showed that soil available Cd content was significantly negatively correlated with soil pH value( P &lt; 0.01), S-CAT and S-UE enzyme activities were significantly positively correlated with soil pH( P &lt; 0.01), and the soil available Cd content was significantly negatively correlated ( P &lt; 0.01); the S-ACP enzyme showed the complete opposite trends. The application of lime and vinasse biomass ash to acidic purple soil had the most significant effect on neutralizing soil acidity. It was an effective measure to improve acidic purple soil and prevent heavy metal pollution by reducing the effective Cd content in soil and improving the soil environment while inhibiting the absorption and transfer of Cd in various parts of Zanthoxylum.

Objective: To evaluate the virulence levels of carbapenem-resistant Acinetobacter baumannii ST191, ST195, and ST208, and to analyze the differences in virulence factors among these epidemic clones. Methods: The study involved the genomic sequencing of 233 Acinetobacter baumannii strains that were isolated from the Fifth Medical Center of the Chinese People's Liberation Army General Hospital (North Hospital) between 2011 and 2019. The genomic data was cross-referenced with the Virulence Factor Database (VFDB) to examine the presence of virulence genes in the strains. Furthermore, a Galleria mellonella infection survival model was used to evaluate the virulence levels of the strains, and the association between virulence levels and virulence genes was analyzed. Results: The study included 38 strains of the ST191 clone, 104 strains of the ST195 clone, and 91 strains of the ST208 clone. In the Galleria mellonella infection survival experiment, the average mortality rate for ST191 was 23.0%, with 3 (7.9%) highly virulent strains. For ST195, the average mortality rate was 53.0%, with 34 (32.7%) highly virulent strains. For ST208, the average mortality rate was 47.0%, with 20 (21.9%) highly virulent strains. There was a significant statistical difference in mortality rates between ST191 and ST195 ( χ 2 =13.9, P <0.001) as well as between ST191 and ST208 ( χ 2 =15.2, P <0.001). A comparison of the strains with the VFDB revealed significant differences in the virulence genes carried by the clones. Specifically, the type Ⅵ secretion system-related genes ( clpV/tssH, hcp/tssD, tagX, tssA, tssB, tssC, tssE, tssF, tssG, tssK, ssL, tssM ) and the sugar transferase gene ACICU&#95;RS00475 were found to be universally absent in ST191 strains (0%) while being prevalent in ST195 (100.0%) and ST208 (>82.0%) strains. Statistical analysis revealed an association between the mortality rate of the clones and the presence of virulence genes( clpV/tssH P <0.001, hcp/tssD P =0.001, tagX P <0.001, tssA P <0.001, tssB P =0.001, tssC P =0.001, tssE P= 0.001, tssF P =0.001, tssG P <0.001, tssK P <0.001, tssL P <0.001, tssM P =0.001, ACICU&#95;RS00475 P =0.001). Conclusion: Among the carbapenem-resistant epidemic clones of Acinetobacter baumannii , the ST191 clone shows lower mortality rates in Galleria mellonella , possibly because of the lack of type Ⅵ secretion system and sugar transferase genes.

The oyster mushroom ( Pleurotus spp.) is one of the most widely cultivated mushroom species globally. The present study investigated the effect of synbiotics on the growth and quality of Pleurotus ostreatus and Pleurotus pulmonarius . Different synbiotics formulations were applied by spraying mushroom samples daily and measuring their growth parameters, yield, biological efficiency, proximate composition, mineral content, total phenolic content (TPC), and diphenyl-1-picryl-hydrazyl (DPPH) radical scavenging activity. Results demonstrated that the most significant yield of oyster mushrooms was harvested from synbiotics sprayed with inulin and Lactobacillus casei (56.92 g). Likewise, the highest biological efficiency obtained with a similar synbiotic was 12.65%. Combining inulin and L. casei was the most effective method of improving the mushrooms' growth performance and nutrient content in both samples. Furthermore, synbiotics that combined inulin and L. casei resulted in the highest TPC (20.550 mg gallic acid equivalent (GAE)/g dry extract (DE)) in white oyster mushrooms ( P. ostreatus ). In comparison, in grey mushroom ( P. pulmonarius ) the highest TPC was yielded by L. casei (1.098 mg GAE/g DE) followed by inulin and L. casei (1.079 mg GAE/g DE). The DPPH results indicated that the oyster mushroom could be an efficient antioxidant. The results revealed that applying synbiotics improved the mushrooms' quality by increasing their antioxidant capacity with higher amounts of phenolic compounds and offering better health benefits with the increased levels of mineral elements. Together, these studies demonstrated the potential of using synbiotics as a biofertilizer, which is helpful for mushroom cultivation; therefore, it might solve the challenge of inconsistent quality mushroom growers face.

The aim of this study was to explore the effects of four amendments on soil fertility and labile carbon fraction characteristics of acid purple soil, so as to provide scientific basis for nutrient management and carbon storage stability in purple soil. Field experiments were carried out, and six treatments were set up:no fertilization (CK), only chemical fertilizer (F), lime + chemical fertilizer (SF), organic fertilizer + chemical fertilizer (OM), biochar + chemical fertilizer (BF), and vinasse biomass ash + chemical fertilizer (JZ). The contents of soil organic matter, pH, available nutrients, soil integrated fertility index (IFI), dissolved organic carbon (DOC), microbial biomass carbon (MBC), particulate organic carbon (POC), their effective rates, and soil carbon pool management index (CPMI) under different treatments were studied to clarify their relationships. The results showed that:① the application of amendments significantly increased soil pH and the contents of organic matter, alkali-hydrolyzed nitrogen, available phosphorus, and available potassium ( P <0.05). The OM and JZ treatments had the most significant increase in soil comprehensive fertility index ( P <0.05), with increases of 1.96 and 0.77 and 170.43% and 66.96%, respectively. ② Compared with those in the control treatment, the contents of POC, MBC, and DOC in JZ and OM increased by 110.30% and 84.81%, 61.08% and 46.56%, and 195.87% and 141.67%, respectively. The application of amendments significantly increased the soil carbon pool index (CPI) and CMPI ( P <0.05), in which the OM treatment showed the most significant increase, with soil CPI and CMPI values increasing by 107.34% and 90.75% compared with those of the control, respectively. ③ Soil organic carbon and its labile fractions were positively correlated with IFI ( P <0.05), and redundancy analysis showed that there were significant differences among different treatments. The interpretation rates of soil IFI, pH, and available potassium to organic carbon and its components reached significant levels, and the order of interpretation rates was IFI(74.6%)>pH (11.7%)>AK(6.5%). The application of vinasse biomass ash and organic fertilizer to acid purple soil had the most significant effect on improving soil fertility and soil quality and was conducive to promoting the accumulation and activation of soil carbon fractions.

Severe acute dichlorvos poisoning is characterized by rapid onset, swift disease progression and serious complications. It frequently involves multiple organ failure (central, respiratory and circulatory systems), severe acidosis, and rare occurrences of gastric perforation. When secondary gastric perforation occurs, treatment becomes difficult and the prognosis of patients is poor. Thus, early and sufficient gastrointestinal decontamination is crucial. This article presented two cases of gastric perforation secondary to dichlorvos poisoning and discussed the causes of gastric perforation, as well is clinical diagnostic and treatment methods.

Objective: Retrospective analysis of the efficacy and influencing factors of bladder preservation integrated therapy for unresectable invasive bladder cancer confined to the pelvis was done, also including the bladder function preservation and adverse effects analysis. Methods: Sixty-nine patients with unresectable locally invasive bladder cancer who received radiotherapy-based combination therapy from March 1999 to December 2021 at our hospital were selected. Among them, 42 patients received concurrent chemoradiotherapy, 32 underwent neoadjuvant chemotherapyand 43 with transurethral resection of bladder tumors (TURBT) prior to radiotherapy. The late adverse effect of radiotherapy, preservation of bladder function, replase and metastasis and survival were followed-up. Cox proportional hazards models were applied for the multifactorial analysis. Results: The median age was 69 years. There were 63 cases (91.3%) of uroepithelial carcinoma, 64 of stage Ⅲ and 4 of stage Ⅳ. The median duration of follow-up was 76 months. There were 7 grade 2 late genito urinary toxicities, 2 grade 2 gastrointestinal toxicities, no grade 3 or higher adverse events occurred. All patients maintained normal bladder function, except for 8 cases who lost bladder function due to uncontrolled tumor in the bladder. Seventeen cases recurred locally. There were 11 cases in the concurrent chemoradiotherapy group with a local recurrence rate of 26.2% (11/42) and 6 cases in the non-concurrent chemoradiotherapy group with a local recurrence rate of 22.2% (6/27), and the difference in local recurrence rate between the two groups was not statistically significant ( P =0.709). There were 23 cases of distant metastasis (including 2 cases of local recurrence with distant metastasis), including 10 cases in the concurrent chemoradiotherapy group with a distant metastasis rate of 23.8% (10/42) and 13 cases in the non-concurrent chemoradiotherapy group with a distant metastasis rate of 48.1% (13/27), and the distant metastasis rate in the non-concurrent chemoradiotherapy group was higher than that in the concurrent chemoradiotherapy group ( P =0.036). The median 5-year overall survival (OS) time was 59 months and the OS rate was 47.8%. The 5-year progression-free survival (PFS) time was 20 months and the PFS rate was 34.4%. The 5-year OS rates of concurrent and non-concurrent chemoradiotherapy group were 62.9% and 27.6% ( P <0.001), and 5-year PFS rates were 45.4% and 20.0%, respectively ( P =0.022). The 5-year OS rates of with or without neoadjuvant chemotherapy were 78.4% and 30.1% ( P =0.002), and the 5-year PFS rates were 49.1% and 25.1% ( P =0.087), respectively. The 5-year OS rates with or without TURBT before radiotherapy were 45.5% and 51.9% ( P =0.233) and the 5-year PFS rates were 30.8% and 39.9% ( P =0.198), respectively. Multivariate Cox regression analysis results showed that the clinical stage ( HR =0.422, 95% CI: 0.205-0.869) was independent prognostic factor for PFS of invasive bladder cancer. The multivariate analysis showed that clinical stages ( HR =0.278, 95% CI: 0.114-0.678), concurrent chemoradiotherapy ( HR =0.391, 95% CI: 0.165-0.930), neoadjuvant chemotherapy ( HR =0.188, 95% CI: 0.058-0.611), and recurrences ( HR =10.855, 95% CI: 3.655-32.638) were independent prognostic factors for OS of invasive bladder cancer. Conclusion: Unresectable localized invasive bladder cancer can achieve satisfactory long-term outcomes with bladder-preserving combination therapy based on radiotherapy, most patients can retain normal bladder function with acceptable late adverse effects and improved survival particularly evident in patients with early, concurrent chemoradiotherapy and neoadjuvant chemotherapy.

Objective: To investigate the status of transfusion-transmissible infection (TTI) among voluntary blood donors in Nanjing in recent five years, in order to provide data support for the recruitment of blood donors and formulation and updating of blood screening strategies., Methods: HIV/HBV/HCV/TP serological markers were detected by ELISA in 487 120 blood donors in Nanjing from 2016 to 2020. Confirmatory assay was applied in anti-HIV positive samples by Nanjing Municipal Center for Disease Control and Prevention. The prevalence of TTI was calculated and the trend of disease was analyzed under different demographic groups., Results: The total positive rate of TTI in blood donors was 0.49% (2 411/487 120), in which the overall seroprevalence rate of HBsAg, anti-HCV, anti-HIV and anti-TP was 0.23%, 0.09%, 0.01% and 0.16%, respectively. The overall prevalence of HIV and TP remained relatively steady (P>0.05), whereas HBV and HCV decreased year by year (P<0.05). The prevalence of TTI was higher among people with lower education level, high age group and first-time blood donation., Conclusion: The prevalence of TTI among voluntary blood donors in Nanjing is at a low level from 2016 to 2020, but the risk still exists. The recruitment of regular donors and the improvement of blood screening technology can effectively reduce the risk of TTI.

The current diagnosis and treatment concept of prostate cancer is that if prostate cancer is suspected through one or more examination methods, prostate biopsy should be performed to confirm the diagnosis of prostate cancer and then subsequent treatment should be given. Nowadays, the application of multi-parameter magnetic resonance imaging (mpMRI) and prostate-specific membrane antigen (PSMA) PET/CT has further improved the imaging diagnosis of prostate cancer, and the diagnostic accuracy of clinically significant prostate cancer has reached almost 100%. In addition, minimally invasive techniques represented by robot-assisted laparoscopic surgery have developed rapidly, and the safety and postoperative recovery of radical prostatectomy have been significantly improved. Therefore, we proposed the concept of radical prostatectomy avoiding biopsy (RPAB), that is, the patients with high suspicion of prostate cancer by multi-parameter MRI and PSMA PET/CT can be directly treated by radical surgery. Preliminary clinical practice confirmed that this concept is feasible. However, RPAB is not suitable for all prostate cancer patients, and any new concept needs to be supported by long-term and high-quality clinical studies. We predict that RPAB will become a new clinical option and produce good economic and social benefits.

Objective: To evaluate the risk of reentry in HBV reactive blood donors and feasibility of HBV reentry strategy., Methods: HBsAg + or HBV DNA + donors who had been quarantined for more than 6 months in Jiangsu Province could propose for reentry application. Blood samples were routinely screened by dual-ELISA for HBsAg, anti-HCV, HIV Ab/Ag, and anti- Treponema pallidum and those non-reactive ones were tested by minipool nucleic acid testing (NAT) for three times. To identify occult HBV donors, samples of NAT non-reactive were further tested by electrochemiluminescence immunoassay (ECLIA) for HBV seromarkers (including HBsAg, HBsAb, HBeAg, HBeAb, and HBcAb). Donors of only 4 ECLIA patterns were accepted to reentry, including all 5 HBV seromarkers negative, anti-HBs only but having history of hepatitis B vaccine injection, HBcAb only, HBsAb + / HBcAb + with HBsAb more than 200 IU/L. Additionally, the detection rate of HBV infection was compared between routine screening mode and ECLIA, as well as the reentry qualified rate of HBsAg + and HBV DNA + blood donors., Results: From Oct. 2016 to Aug. 2019, a total of 737 HBV reactive donors had applied for reentry, including 667 HBsAg + reactive and 70 HBV DNA + reactive donors. Among 3 screening methods, the highest HBV detection rate (43.15%, 318/737) was observed on ECLIA, while only 4.75% (35/737) on ELISA and 3.12% (23/737) on NAT, respectively. Among 4 qualified patterns of HBV serological markers, the highest proportion was found in the all negative group (22.90%, 155/677), followed by the group with HBsAb + only and history of hepatitis B vaccine injection (19.35%, 131/677), and the median concentration of HBsAb was 237.7 IU/L. The unqualified rate of HBV DNA + donors was 82.86%, which was significantly higher than 47.98% of HBsAg + donors., Conclusion: Routine screening tests merely based on ELISA and NAT could miss occult HBV donors and may not be sufficient for blood safety. HBsAb concentration and vaccine injection history should be included in the evaluation of HBV reactive donors who intend to apply for reentry. There is a relatively larger residual risk of occult HBV infection in blood donors quarantined for HBV DNA reactive.

Prostate cancer (PC) is one of the malignant tumors of the genitourinary system that occurs more often in elderly men. Screening, early diagnosis, and treatment of the PC high risk population are essential to improve the cure rate of PC. The development of the guideline for PC screening and early detection in line with epidemic characteristics of PC in China will greatly promote the homogeneity and quality of PC screening. This guideline was commissioned by the Bureau of Disease Control and Prevention of the National Health Commission. The National Cancer Center of China initiated and convened a working group comprising multidisciplinary experts. This guideline strictly followed the World Health Organization Handbook for Guideline Development and combined the most up-to-date evidence of PC screening, China's national conditions, and practical experience in cancer screening. A total of fifteen detailed evidence-based recommendations were provided with respect to the screening population, technology, procedure management, and quality control in the process of PC screening. This guideline aimed to standardize the practice of PC screening and improve the effectiveness and efficiency of PC prevention and control in China.

To summarize professor QIU Xian-ling 's clinical experience of acupuncture for treating chronic prostatitis. Professor QIU Xian-ling believes that the causes of chronic prostatitis are complex and diverse, and the main pathogenesis is kidney deficiency with excess. Professor QIU follows the traditional principles of syndrome differentiation and meridian differentiation, and adopts the combination of replenishing and reducing treatment and regulating the spirit and calming the mind. Guanyuan (CV 4), Huiyin (CV 1), Ciliao (BL 32) and Zhibian (BL 54) are the main acupoints that must be selected for treatment. During clinical treatment, according to the selected acupoints or the specific condition, special acupuncture methods such as deep needling with elongated needle method, lifting acupuncture method, three-in-one-retraction method, penetrating needling method and acupuncture combined with pressing method are used to achieve the purpose of comprehensive improvement of the local and overall state.

Objective To explore the performance of mobile health platform for standardized management of pregnant women with gestational diabetes mellitus(GDM). Methods A randomized controlled trial was conducted,in which 295 women with GDM were randomized into two groups(traditional management group and mobile health management group)by a computer-generated sequence.The traditional management group accepted standardized GDM management,and the mobile health management group was supplemented by mobile health management based on the standardized management.The glycemic control rate and the incidences of low birth weight,macrosomia,preterm birth,premature rupture of membranes,postpartum hemorrhage after cesarean section,neonatal asphyxia,malformation,and admission to the neonatal intensive care unit were compared between the two groups. Results The glycemic control rate in mobile health management group was significantly higher than that in the traditional management group [(67.22±22.76)% vs. (60.69±21.28)%, P =0.004].The incidences of low birth weight,macrosomia,preterm birth,premature rupture of membranes,postpartum hemorrhage after cesarean section,neonatal asphyxia,malformation,and admission to the neonatal intensive care unit demonstrated no significant differences between groups(all P > 0.05). Conclusions Mobile health applied in standardized management is conducive to the glycemic control of GDM women,whereas it does not significantly improve the pregnancy outcomes.Due to the short time of intervention,the effects of mobile health on pregnancy outcomes need further study.

Objective To investigate the clinicopathological features and prognosis of chromophobe renal cell carcinoma(ChRCC). Methods The clinical and pathological data of 126 patients with ChRCC treated in Cancer Hospital of Chinese Academy of Medical Sciences were retrospectively analyzed. Results The patients included 64 males and 62 females,with the age of 22-80 years(median of 52 years).The tumor was located on the right side in 70 cases and on the left side in 56 cases.Ultrasound,CT or magnetic resonance imaging(MRI)were performed.Of the 110 cases receiving ultrasound examination,63,23,13,10,and 1 cases showed hypoecho,hyperecho,isoecho,uneven or mixed echo,and dark hypoecho,respectively.Color Doppler flow imaging showed no blood flow signal in 42 cases and low blood flow signal in 60 cases out of 68 cases with blood flow signal.Among the 54 cases receiving CT,50 cases showed equal density or low density and 4 cases showed high density with clear boundary.The enhanced scanning showed mild to moderate uniform or non-uniform reinforcement,mostly below the renal parenchyma,and still showed reinforcement in the delayed period.Among the 97 cases receiving MRI,96 cases showed hypo-or isointense signals and 1 case showed hyperintense signal in T1 weighted images;71 cases showed hyper-or isointense signals and 26 cases showed hypo-or isointense signals in T2 weighted images;93 cases showed hyperintense signals with obvious limited diffusion and 4 cases showed unobvious limited diffusion in diffusion weighted images.Mild to moderate uniform or non-uniform reinforcement was observed in most of the enhanced scans.All the 126 patients underwent surgical treatment,including 64 cases of nephron sparing surgery and 62 cases of radical surgery.Pathological examinations confirmed ChRCC for all the patients,including 91 cases of T1N0M0,15 cases of T2N0M0,and 20 cases of T3N0M0.The immunohistochemical assay demonstrated the positive expression rate of 48.2%(54/112)for CD10,92.3%(96/104)for CD117,8.0%(9/112)for vimentin,85.6%(95/111)for CK7,and 97.6%(83/85)for colloidal iron.Conclusions ChRCC is less common,with low level of malignancy and good prognosis.Since the clinical symptoms of ChRCC are not typical,MRI is an important means of imaging differential diagnosis,and the disease can be confirmed depending on pathological diagnosis.Surgery is the preferred treatment method,and currently there is no standard treatment regimen for metastatic patients.

The transcription factor X-box binding protein-1 (XBP1) plays a key role in unfolded protein reaction. This study was aimed to investigate the expression pattern and regulation of XBP1 in the mouse uterus during early pregnancy. The methods of immunohistochemistry (IHC) and real time quantitative RT-PCR were used to test XBP1 expression in early pregnancy, artificial decidualization, oestrous cycle and hormone-regulated mouse models. The results showed that XBP1 was spatiotemporally expressed in mouse uterus during early pregnancy. The XBP1 protein was mainly detected in the luminal and glandular epithelia on days 1-4 of pregnancy, and was strongly detected in the decidual area on days 5-8 of pregnancy. Similarly, XBP1 expression was also mainly expressed in decidual cells following artificial decidualization. During the oestrous cycle, Xbp1, Xbp1u, and Xbp1s mRNA was predominantly present in proestrus. In the ovariectomized uterus, the expression of XBP1 in luminal and glandular epithelia was up-regulated after estrogen treatment. These results suggest that XBP1 is associated with embryo implantation and decidualization during early pregnancy in mice, and the expression of XBP1 in luminal and glandular epithelia may be regulated by estrogen.

Alzheimer's disease(AD) is a chronic progressive neurodegenerative disease with recent memory impairment as the main clinical manifestation and senile plaques and neurofibrillary tangles as the main pathological changes. In recent years, the effect of microRNAs on AD has attracted widespread attention. Patients with AD have abnormal expression of miRNA, which is closed related to regulation of AD pathophysiology-related genes. Therefore, this paper first elaborated neuroprotective and toxic effects of microRNA in AD, and then explored relevant traditional Chinese medicines that can regulate miRNA in the treatment of AD, so as to provide basis for revealing the pathogenesis relationship between miRNA and AD and provide ideas for further development of anti-AD traditional Chinese medicine.

Objective: To study the therapeutic effect of lycopene combined with quercetin and curcumin on chronic prostatitis / chronic pelvic pain syndrome (CP/CPPS) in rats and its underlying mechanism., Methods: Thirty-three 6-week-old SD male rats were randomly divided into six groups: normal control (n = 3), CP/CPPS model control (n = 6), quercetin (n= 6), curcumin (n = 6), lycopene (n = 6) and combination therapy (n = 6). CP/CPPS was induced by injection of complete Freund's adjuvant into the ventral lobe of the prostate in the latter five groups of rats. After modeling, the rats in the normal and CP/CPPS model control groups were given corn oil by gavage, and those in the latter four groups treated intragastrically with quercetin at 50 mg/kg/d, curcumin at 50 mg/kg/d, lycopene at 10 mg/kg/d, and quercetin + curcumin + lycopene, respectively, once daily for a course of 4 weeks. Then, cardiac blood and prostate tissue samples were collected from the rats for measurement of related indexes., Results: Histopathological changes in the model rats were basically consistent with the characteristics of CP/CPPS. The expressions of the inflammatory factors IL-1β, IL-2, IL-6, TNFα, MCP1 and MIP-1α in the prostate tissue were all dramatically decreased in the quercetin, curcumin, lycopene and combination therapy groups compared with those in the normal controls (P < 0.01), even lower in the combination therapy group than in the quercetin, curcumin and lycopene groups (P < 0.05). The activities of the oxides CAT, GSH-PX and T-SOD were significantly increased and that of MDA decreased in the four treatment groups (P < 0.05), even more significantly in the combination therapy group than in the other three (P < 0.01). The phosphorylation of MAPKs was inhibited, the activation of NF-kB blocked and the transcriptional activity of Nrf2 enhanced in the four treatment groups (P < 0.05), even more significantly in the combination therapy group (P < 0.01). Conclusions: Lycopene combined with quercetin and curcumin is more effective than any of the three drugs used alone in the treatment of CP/CPPS, which may be associated with its alleviation of inflammatory response and oxidative stress by interaction between the NF-κB, MAPKs and Nrf2 signaling pathways.?

Objective: To investigate the feasibility and safety of minimally invasive radical prostatectomy for prostate cancer patients without preoperative prostate biopsy in the new era of the continuous development of comprehensive new imaging diagnostic mode and minimally invasive surgery technology. Methods: From August 2018 to October 2019, 17 patients with prostate cancer were enrolled in this study in the Cancer Hospital, Chinese Academy of Medical Sciences. All patients were highly suspected of prostate cancer by PSMA-PET/CT-based imaging diagnostic techniques and underwent 3D laparoscopic radical prostatectomy without prostate biopsy. The perioperative data, postoperative pathology, postoperative complications and follow-up results were recorded and analyzed. Results: The average age of 17 patients with prostate cancer was (65±7) years. The body mass index (BMI) average was (24.4±3.0) kg/m(2). The American Society of Anesthesiologists (ASA) score was 1 (1-2) and the Charlson comorbidity index (CCI) score was 1 (0-4). The preoperative value of PSA was (19±11) μg/L. The PSMA PET/CT showed abnormally high expression foci and the great possibility of prostate cancer for all the 17 patients. Prostate puncture biopsy: the results of prostate biopsy were negative in 3 cases. The digital rectal examination found that the prostate volume was Ⅰ or Ⅱ degree large, 10 cases touched hard and the nodule was touched in two cases. Three patients had undergone a previous prostate biopsy, but prostate cancer was not found. All the 17 operations were successfully performed without conversion to open surgery. The surgery time was (85±21) (range from 45 to 120) min, the estimated blood loss was (25±18) (range from5 to 100) ml, the time of intake of liquid diet was (14.3±4.4) h, the intestinal recovery time was (23±10) h, the postoperative activity time was (22±7) h, the drainage duration was (3.7±0.8) d, the postoperative hospital stay was (4.9±1.2) days, and the catheter removal time was (7.4±1.5) days. In the early postoperative period (within 30 days after surgery), no obvious complications occurred. The postoperative final pathology confirmed that all the 17 specimens were prostate cancer. After a median follow-up of 6.5 months, the patient's urinary control rate reached 81.3% at postoperative 1 month, 92.3% at postoperative 3 months after surgery, and the urinary control rate reached 100% at postoperative 6 months. Postoperative PSA value was (0.08±0.08) μg/L, significantly lower than preoperative PSA level ( P <0.001). There was significant difference between the preoperative and postoperative QOL (Quality of life) score (57±5 and 47±5 respectively, P <0.001) which indicated that the patients' postoperative quality of life was greatly improved. Conclusions: It is safe and feasible to perform minimally invasive radical prostatectomy without preoperative prostate biopsy for patients with highly suspected prostate cancer by comprehensive diagnostic mode based on modern new imaging technology.

Objective: To explore the reasons causing the false positive of HBsAg single-ELISA-reactive in blood donors of Jiangsu province so as to provide reference data for the return of blood donors., Methods: Serological test: HBsAg ELISA parallel detection was performed on 319 444 samples of blood donors from 2014 to 2017; the ECLIA was employed to confirm the single-ELISA-reactive (S/CO≥0.5) samples, the nucleic acid test was used to detect the HBV DNA on the all single-ELISA-reactive samples in 6/8 people mixed/single. Reagent evaluation: the Receiver-Operating-Characteristic curve (ROCC) was drawn by the ECLIA/NAT results as the gold standard, and the diagnostic performance of reagents A and B under different cut-off was evaluated., Results: A total of 227 (0.71‰) single-ELISA-reactive samples were detected among 319 444 blood donors, including 39 cases (17.2%) of positive HBsAg and 12 cases (5.3%) of positive HBV DNA; Under the maximum YI, the COI (1.0) employed by the manufacturer recommendation has a better diagnostic value than laboratory COI (0.5), and the capability of reagent A was better than that of reagent B (AUC: 0.661 vs 0.632; Youden: 0.329 vs 0.297), but the specificity of both reagents was restricted (＜60%). Under the maximum YI, the best cut-off value of reagents A and B were 2.4 and 1.4 COI, respectively. Compared with the cut-off value of manufacturer, the sensitivity of reagents A decreased by 33% and the false positive rate decreased by 60% while the sensitivity of reagent B increased by 140% and the false positive rate increased by 36%, respectively., Conclusion: The false positive of HBsAg single-ELISA-reactive in blood donors is caused by the limited specificity of ELISA reagent and the setting of COI values. According to ROCC maximum YI method, the COI can be set as 2.4 COI and (0.5-1.4) COI for reagent A and B to reduce false positive rate.

Objective: To explore the application of Endo-GIA stapler in laparoscopic radical cystectomy, especially in the treatment of lateral bladder ligament, and to evaluate its clinical feasibility and practicability. Methods: A retrospective analysis of clinical data about 38 cases of laparoscopic radical cystectomy (LRC) treated in the Department of Urology, Chaoyang Hospital of Beijing and Cancer Hospital, Chinese Academy of Medical Sciences from July 2017 to June 2019 were conducted. The patients were divided into Endo-GIA stopler group(18 cases) and non-Endo-GIA stopler group (20 cases) according to whether Endo-GIA stapler were used. The basic clinical data, operation time of bladder lateral ligament, operation time of bladder lateral wall, operation time of bladder resection, amount of bleeding during operation, pathological data after operation and related indicators of recovery after operation were compared between the two groups. Results: All 38 patients underwent radical cystectomy (RC) successfully under 3-D laparoscopy without conversion to open surgery. The operation time of bladder lateral ligament in Endo-GIA stapler group was significantly shorter than that in non-Endo-GIA stapler group [(3.25±0.75) min vs (9.20±2.95) min, P= 0.042]; the operation time of bladder lateral wall in Endo-GIA stapler group was significantly shorter than that in non-Endo-GIA stapler group [(8.06±1.66) min vs (14.30±3.37) min, P= 0.016]. The operation time of cystectomy in the Endo-GIA stapler group was significantly shorter than that in the non-Endo-GIA stapler group [(47.06±4.70) min vs (61.60±14.91) min, P= 0.003]. The amount of bleeding in the Endo-GIA stapler group was significantly shorter than that in the non-Endo-GIA stapler group [(37.77±21.30) ml vs (114.50±39.80) ml, P= 0.015]. The time of drainage tube removal in Endo-GIA group was significantly shorter than that in the non-Endo-GIA group [(5.83±1.54) d vs (7.30±3.00) d, P= 0.002]. The length of post-hospitalization in Endo-GIA group was significantly shorter than that in the non-Endo-GIA group [(7.67±1.78) d vs (9.60±3.25) d, P= 0.036]. However, there was no significant difference in other basic clinical data, post-operative pathology and post-operative recovery related indicators. Conclusions: Laparoscopic radical cystectomy using Endo-GIA stapler device is safe and feasible. It is easy to operate, shorten the operation time significantly, and reduce the amount of bleeding. To a certain extent, it is conducive to the recovery of patients after operation to some extent, and worthy of clinical application.

Objective: To investigate the role of Wnt/β-catenin/TCF-4 pathway in renal cancer cells and to analyze its possible mechanism. Methods: β-catenin and TCF-4 were inhibited by siRNA in 786-O cells. The proliferation of transfected cells was detected by CCK8. The cell death of transfected cells was detected by acridine orange -ethidium bromide staining. The expressions of TCF-4, bcl-2, bax and Caspase-3 were detected in transfection group, empty vector group and negative control groups by western blot. Results: The cell proliferation ability of the β-catenin transfection group was significantly lower than that of the control group (0.443±0.145 vs 0.910±0.721), meanwhile, the cell death rate was significantly increased (16.38±5.32 vs 6.61±1.04), the expression level of Caspase 3 and bax was increased, and the expression of anti-apoptotic protein Bcl-2 was decreased. Decreased TCF-4 led to the same results as inhibition of β-catenin (all P <0.05). Conclusion: The Wnt/β-catenin/TCF-4 pathway may play a role in the regulation of proliferation and apoptosis in 786-O renal cancer cells. The mechanism might through regulating of the downstream apoptosis proteins Caspase 3, bax and anti-apoptotic protein Bcl-2.

Abstract: Objective To discuss the application value of CT scanning technology in cause of death determination of medical dispute cases. Methods From July 2017 to December 2018, postmortem CT imaging data of 12 medical dispute cases were collected. CT imaging diagnosis results and anatomy findings as well as differences between antemortem and postmortem CT diagnosis were compared. The advantages and disadvantages of CT routine tests of the cadavers in terms of the diagnosis of disease and damage were analyzed. Results The comparison between CT imaging diagnosis and anatomical findings showed that CT scans had advantages in the diagnosis of disease and damage with large differences in density changes, such as atelectasis, pneumonia, calcification, fracture and hemorrhage, etc. The comparison of CT diagnosis in antemortem and postmortem examination showed that the cadavers of medical dispute cases were well preserved and that postmortem CT scan was meaningful for the diagnosis of antemortem diseases. Conclusion Virtual anatomy technology has a relatively high application value in postmortem examination of medical dispute cases. It can provide effective information for the appraisers before the autopsy and can also provide a reference for cause of death analysis when the anatomy cannot be performed., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Forensic Medicine.)

Pudilan Xiaoyan Oral Liquid has effects in clearing away heat and detoxifying,and is used to treat pharynx and throat swelling caused by the syndrome of excessive heat and toxin accumulation. Its efficacy is to relieve swelling and pain( redness,swelling and hot pain). It is included in the Chinese Pharmacopoeia of 2015 Edition,and has been listed in provincial health insurance directories of Shaanxi,Jiangsu,Liaoning,Hunan,Tianjin,Xinjiang and Hebei. It has been recommended by health departments of Beijing,Chongqing and other provinces as a preferred drug for the prevention and treatment of H1 N1 and HFMD,and listed in the diagnosis and Treatment Guide of HFMD by the Ministry of Health,the Clinical Application Guide of Chinese Patent Medicine edited by the Lung Department Disease Branch of China Association of Chinese Medicine,and the Clinical Practice Guide of Single Administration/Combined Administration of Antibiotics in Treatment of Common Infectious Diseases by China Association of Chinese Medicine. To further improve the clinician&apos;s understanding of drugs and better guide the rational clinical application,we invited front-line clinical experts from respiratory department,infectious department and dermatology of traditional Chinese and Western medicine to develop and compile the expert consensus. The consensus fully considered the clinical evidence and the expert clinical experience to give recommendations for clinical problems with evidence support and consensus suggestions for clinical problems without evidence support by the nominal group method.This consensus is based on clinical research evidence and expert experience in a simple and clear format,which provides a preliminary reference for the clinical use of the drug.

Objective: To study the clinical subtypes of obstructive sleep apnea hypopnea syndrome (OSAHS) by cluster analysis, and to discuss the characteristics and clinical significance of these subtypes. Methods: A retrospective analysis was done among patients who were diagnosed with OSAHS in the Sleeping Center of the Second Affiliated Hospital of Soochow University from January 2010 to June 2018. In this cluster analysis, 16 main symptoms, 7 comorbidities and 3 assessment scales were included. After selecting the best model, the parameters and characteristics of different subtypes were compared and analyzed. Results: A total of 2 592 patients with complete data were included in this study. After cluster analysis, they were divided into 4 groups: sleep apnea group (1 173 cases, 45.3%), daytime sleepiness group (518 cases, 20.0%), insomnia and memory loss group (212 cases, 8.2%), mild symptom group (689 cases, 26.6%). In the sleep apnea group, the patients were found to be younger [(40.2±10.4) years old], with higher body mass index (BMI) [(27.7±3.7) kg/m(2)] when compared to the other groups. In addition, the prevalence of comorbidities of this group was found to be lower, whereas the probability of sleep apnea symptom was the highest (94.7%). In daytime sleepiness group, the Epworth Sleepiness Scale (ESS) score was the highest [(12.4±5.5) points], and the probability of daytime sleepiness symptom was also found to be the highest (88.0%). The age of patients in the insomnia and memory loss group was the highest [(51.1±13.0) points], with the highest percentage of women (19.3%). The probability of insomnia was found to be 70.3%, and memory loss symptoms was 88.2% which were the highest when compared to the other groups. The prevalence of comorbidities was the highest, and the scores of short mental state scale (MMSE) and Montreal cognitive assessment (MoCA) were the lowest with a mean of [(28.5±2.4) points] and [(25.4±3.2) points], respectively, among the 4 groups. The probability of most symptoms and comorbidities were found be the lowest in the mild symptom group. There were significant differences in the main symptoms among the 4 groups ( P< 0.05). Symptoms like sleep apnea, daytime sleepiness, insomnia, memory loss, headache and dry mouth upon awakening were found significantly different in pairwise comparisons among the groups ( P< 0.002). Conclusion: The patients with OSAHS can be divided into four clinical subtypes by cluster analysis, each of which is significantly heterogeneous, and this is helpful to evaluate the condition and guide individualized treatment.

Objective: To explore the characteristics and determining factors of attention and short-term memory impairment in young patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods: A total of 203 eligible patients with snoring were recruited for the study at Sleep Center, Second Affiliated Hospital of Soochow University from July 2016 to July 2017, and they were all monitored with overnight polysomnography(PSG), recording sleep parameters [NREM (Ⅰ+Ⅱ) sleep ratio, NREM Ⅲ sleep ratio, REM sleep ratio] and respiratory parameters (AHI, ODI, LSaO(2), TS90%, RRMAI). Based on apnea/hypopnea index(AHI), the patients were categorized into non-OSAHS group (030/h). All patients were assessed for sleepiness and the Motreal Cognitive Assessment (MoCA) questionnaires, Mini-mental State Examination (MMSE), Epworth Sleepiness Scale(ESS), attention and short-term memory assessment which included Trail Marking Test(TMT), digit span test(DST), and Complex Figure Test(CFT). The PSG parameters, ESS scores, total MoCA scores, attention and short-term memory were compared among groups, and a multivariate logistic regression analysis was conducted to investigate the characteristics of attention and short-term memory impairment in young patients with OSAHS and their determining factors. Results: In the overall cognitive function assessment, severe OSAHS patients's MoCA scores were lower than those of the other two groups [27.0 (25.0, 28.0) vs 27.0 (26.0, 28.0) , 27.0 (26.0, 27.0) , P< 0.01]. In the sleepiness self-assessment, severe OSAHS patients's ESS scores were significantly higher than those of the other groups (11.4±5.4 vs 5.3±4.5, 8.0±5.0, P< 0.01) . In the attention tests, scores on the DST-D (8.1±1.1 vs 8.8±0.9, 8.5±1.0) and DST-B[5.5 (4.0, 7.0) vs 6.0 (5.0, 7.0) , 6.0 (5.0, 7.0) ] were significantly lower in severe OSAHS patients than in the other two groups ( P< 0.01) . In the memory tests, the re-drawing scores of severe OSAHS patients were significantly lower than those of the other two groups [23.0 (16.0, 27.0) vs 26.0 (24.0, 28.0) , 24.0 (20.0, 28.0) , P< 0.01]. In the executive function tests, severe OSAHS patients spent much longer on both TMT-A (46.7±19.0 vs 40.2±17.4, 34.6±17.2) and TMT-B (76.9±32.6 vs 67.2±21.2, 58.6±27.5) than the other two groups ( P< 0.01). Multivariate logistic stepwise regression analysis showed that, AHI, ODI and NREM (Ⅰ+Ⅱ) sleep ratios were the independent determining factors. Conclusion: Attention and short-term memory functions of young patients with OSAHS were impaired. The severity of apnea and hypoxia, NREM (Ⅰ+Ⅱ) ratio were all determining factors.

Objective: To optimize the surgical procedures of laparoscopic radical cystectomy and urinary diversion for the elderly patients with bladder cancer, generalize operating technique, summarize clinical experiences. Methods: From July 2004 to October 2016, laparoscopic radical cystectomy (LRC) and urinary diversion was performed in 68 elderly patients (≥75 years old) diagnosed with bladder cancer in urology department of Beijing Chaoyang Hospital, Capital Medical University, and the relevant clinical and follow-up data were retrospectively reviewed. All the patients were pathologically diagnosed and their perioperative data, postoperative pathological results, postoperative complications and follow-up outcomes were recorded and analyzed. Results: Among 68 elderly patients with bladder cancer, fifty patients were male and 18 were female, the age of whom were (79±4) (range 75 to 91) years old. The Charlson comorbidity index (CCI) score was 6±1 (range 5 to 7). All the 68 operations were successfully performed without conversion to open surgery. There were 26 cases receiving cutaneous ureterostomy, 34 cases receiving ileal conduit (intracorporeal for 16 cases and extracorporeal for 18 cases) and 8 cases receiving orthotopic ileal neobladder (intracorporeal for 4 cases and extracorporeal for 4 cases; Xing's technique for 4 cases, T-Pouch for 2 cases and Studer-Pouch for 2 cases) respectively, and the operation time of these three groups were (221±47) min, (315±70) min and (358±90) min respectively, the estimated blood loss were 100 (87, 200)ml, 300 (250, 500) ml and 250 (113, 725) ml respectively, the time of intake of liquid diet were 3 (2, 4) d, 6 (5, 7) d and 9 (5, 12) d respectively, and the postoperative hospital stay were (12±6) d, (24±11) d, and (27±11) d respectively. Postoperative pathological results showed urothelial carcinoma in 64 patients, squamous cell carcinoma in 2 patients and adenocarcinoma in 2 patients. Sixty patients received laparoscopic pelvic lymphadenectomy and the number of dissected lymph nodes was 17.1±7.0. There were 46 cases with T stage greater than or equal to T2 (46/68, 67.6%), 4 cases of low grade (4/68, 5.9%) and 60 cases of high grade (60/68, 88.2%). All the early postoperative (within 30 days after the operation) complications were grade Ⅰ-Ⅱ mainly manifested as fever, pain and infection that could get better with symptomatic treatment, and the incidence rate were 30.8% for cutaneous ureterostomy, 29.4% for ileal conduit and 37.5% for orthotopic ileal neobladder. The patients were followed up for a median period of 93.5 months without obvious hydronephrosis and impaired renal function. The 5-year cancer specific survival rate and overall survival rate were 57% and 50% respectively. There was significant difference between the preoperative and postoperative QOL (quality of life) score (56.0±10.0 and 47.4±5.8 respectively, P< 0.05) which indicated that the patients' postoperative quality of life was greatly improved. Conclusions: Laparoscopic radical cystectomy and urinary diversion for the elderly patients with bladder cancer is safe and feasible, and owns great therapeutic value.

Objective: To investigate the diagnosis and treatment of the mixed epithelial and stromal tumour family of kidney. Methods: Eight cases of the mixed epithelial and stromal tumour family of kidney were retrospectively analyzed. Before operation, radiologic evaluation was performed in all cases, including CT and MRI scan. Three cases were diagnosed as cystic renal cell carcinoma, 5 cases were diagnosed as renal complex cysts. Radical nephrectomy was performed in 4 cases and partial nephrectomy was performed in 4 cases. Results: The manifestation of the pathological specimens were multilocular cystic or cystic solid tumors grossly. Microscopically, the tumors were composed of two components, epithelial and stromal. Immunohistochemical staining showed that the epithelial components of the tumors were positive for AE1/AE3 (8/8), CK18 (3/3), and CK-7 (1/1). The stromal components were positive for PR (8/8), ER (6/8), Vim (6/6), Desmin (5/5), and SMA (5/5). HB-45 staining were negative (7/7) and Ki-67 staining were negative (7/8). All cases were diagnosed as the mixed epithelial and stromal tumour family of kidney. All patients were followed up for 3-124 months, with a median follow-up of 41 months. No tumour recurrence or metastasis were observed. Conclusion: The mixed epithelial and stromal tumour family of kidney mostly occurs in women, but have no specific clinical manifestations. They were often misdiagnosed as cystic renal cell carcinoma before operation. These following imaging features may be helpful for diagnosis. The definite diagnosis of the disease depends on the pathological examination, and immunohistochemistry plays an important role in differential diagnosis. Surgical treatment is the first choice, and partial nephrectomy is feasible. Most of the tumors are benign, and the patients can be cured after complete excision.

Fever and abdominal pain are common symptoms and could be main manifestations in patients with autoinflammatory diseases. A 48-year-old female patient was admitted with recurrent fever and abdominal pain for 9 years. Serum level of inflammatory markers synchronously fluctuated with fever, and returned to normal when fever subsided. The periodic episodes of fever occurred every 1 to 4 months and failed to respond to empirical antibiotics. Whole exome sequencing showed heterozygous mutation of NOD2 gene q902k, leading to the final diagnosis of autoinflammatory disease. Corticosteroid and tripterygiumglycosides were effective for the disease remission.

Objective: To explore the therapeutic effect of simple posterior reduction and decompression technique for different types of malformations in the craniocervical junction with atlantoaxial dislocation. Methods: The clinical data of 34 cases of different malformations in the craniocervical junction who were treated by the simple posterior internal fixation and decompression surgery in the department of neurosurgery of the first affiliated hospital of Nanchang University from March 2014 to March 2017 were analyzed retrospectively.In 34 cases, including 26 cases of basilar invagination with atlantoaxial dislocation (19 cases with atlanto occipital fusion, 12 cases with Chiari malformation, 13 cases with syringomyelia), 8 cases of odontoid malformation with atlantoaxial dislocation (2 cases with Chiari malformation, 1 case with flat skull base, 1 case with malformation of atlas). All the cases were performed Dynamic position X-ray film, CT scan and Three-dimensional reconstruction, and craniocervical MRI scan before the operation.The enlarged decompression of the occipital foramen, the fixation and fusion of the occipitocervical were performed during the operation, and the patients with cerebellar tonsillar hernia were performed decompression of the occipital small bone window. Results: All patients were followed up after the operation.The symptoms were obviously improved in 29 cases (85.3%), stability and no change in 5 cases (14.7%) and none postoperative neurological deterioration cases. Conclusion: The treatment of craniocervical junction malformation using simple posterior reduction and decompression technique is effective and has few complications, which can obviously improve the life quality of the patients.

Objective: To evaluate the clinical effects of plasmakinetic enucleation of the prostate (PKERP) and holmium laser enucleation of the prostate (HoLEP) in the treatment of BPH., Methods: We retrospectively analyzed the clinical data on 78 BPH patients treated by PKERP (n = 38) or HoLEP (n = 40) from January 2016 to October 2017. We recorded the operation time, intraoperative hemoglobin level, catheter-indwelling time, bladder irrigation time, hospital stay, 6-month postoperative IPSS, quality of life (QOL), maximum urinary flow rate (Qmax), postvoid residual urine (PVR), PSA level, International Index of Erectile Function (IIEF) and postoperative complications, and compared the obtained parameters between the two groups and some of them with the baseline., Results: In comparison with the baseline, both the PKERP and HoLEP groups showed statistically significant differences at 6 months after surgery in the QOL score (4.82 ± 0.56 and 4.70 ± 0.67 vs 2.44 ± 0.69 and 2.92 ± 0.49, P < 0.01), IPSS (19.52 ± 4.96 and 19.44 ± 4.08 vs 9.56 ± 2.5 and 9.81 ± 2.5, P < 0.01), Qmax (［4.54 ± 1.86］ and ［4.42 ± 2.89］ ml/s vs ［17.72 ± 3.46］ and ［17.27 ± 4.42］ ml/s, P < 0.01), and PVR (［83.73±55.33］ and ［109.65 ± 89.58］ ml vs ［19.93 ± 11.07］ and ［18.31 ± 15.03］ ml, P < 0.01). Statistically significant differences were also found between the PKERP and HoLEP groups in the reduced hemoglobin level (［21.04 ± 16.96］ vs ［7.88 ± 6.65］ g/dl, P = 0.01), catheter-indwelling time (［7.67 ± 2.27］ vs ［3.93 ± 2.18］ d, P = 0.01), bladder irrigation time (［1.67 ± 0.62］ vs ［1.3 ± 0.54］ d, P = 0.05), hospital stay (［4.22 ± 1.55］ vs ［3.26 ± 0.9］ d, P = 0.01), and 6-month postoperative QOL score (［2.44 ± 0.69］ vs ［2.92 ± 0.49］, P = 0.05), but not in the other parameters., Conclusions: Both PKERP and HoLEP are safe and effective for the treatment of BPH, the former more feasible in primary hospitals, while the latter with the advantages of less bleeding, shorter catheterization and hospital stay, and higher 6-month postoperative QOL score.

While overweight and obesity have gradually became global concerns. Bariatric surgery is an effective and safe option for improving quality of life and alleviating psychosocial distress in obese individuals. However,body contouring is required to solve skin problems associated with massive weight loss after bariatric surgery. This article reviews the indications,importance,and postoperative complications of body contouring after bariatric surgery.

Chest wall reconstruction is a key approach to restoring the structure and function of the defective chest wall after tumor excision. While autologous flaps have been ideal materials for soft tissue reconstruction,the optimal skeletal reconstructive material still remains controversial. Currently,besides autologous bones,non-biodegradable materials have been used widely,which offer sufficient strength and stability but with some inevitable complications. Many studies have explored the clinical applications of biodegradable materials and the improvements in their characteristics,and some of these materials may be clinically feasible. This article reviews the recent advances in the applications of reconstructive materials.

This study aims at making full use of microbial resources, and screening the active endophytic fungi of anti-rheumatoid arthritis from Zanthoxylum simulans. The endophytic fungi were cultured and isolated by tissue culture and scribing method, and the active strain of inhibiting the proliferation of human rheumatoid arthritis synovial fibroblasts (HFLS-RA) was screened by MTT method. Morphological characteristics and rDNA ITS1-5.8S-ITS2 sequences were applied for the taxonomy of endophytic fungi. Strains were isolated from Z. simulans. Among them, MK-05, MK-17, MK-19, MK-23 having inhibiting activity to HFLS-RA, the IC₅₀ were 0.367, 0.775, 0.689, 0.757 g·L⁻¹, respectively. By classic morphologic classification and sequencing the PCR-amplified rDNA ITS1-5.8S-ITS2 regions, four effective strains were identified as Botryosphaeria dothidea, Phomopsis sp., P. liquidambari and Diaporthe perseae. The active endophyic fungi that inhibited the proliferation of HFLS-RA were screened from Z. simulans for the first time, and the results lay the foundation for the development and utilization of the Z. simulans resources., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Chinese Pharmaceutical Association.)

To evaluate the effectiveness and safety of Xinling Wan on patients with stable angina pectoris, a randomized, double-blinded, placebo parallel-controlled, multicenter clinical trial was conducted. A total of 232 subjects were enrolled and randomly divided into experiment group and placebo group. The experiment group was treated with Xinling Wan (two pills each time, three times daily) for 4 weeks, and the placebo group was treated with placebo. The effectiveness evaluation showed that Xinling Wan could significantly increase the total duration of treadmill exercise among patients with stable angina pectoris. FAS analysis showed that the difference value of the total exercise duration was between experiment group (72.11±139.32) s and placebo group (31.25±108.32) s. Xinling Wan could remarkably increase the total effective rate of angina pectoris symptom score, and the analysis showed that the total effective rate was 78.95% in experiment group and 42.61% in placebo group. The reduction of nitroglycerin dose was (2.45±2.41) tablets in experiment group and (0.50±2.24) tablets in placebo group on the basis of FAS analysis. The decrease of symptom integral was (4.68±3.49) in experiment group and (3.19±3.31) in placebo group based on FAS analysis. Besides, Xinling Wan could decrease the weekly attack time and the duration of angina pectoris. PPS analysis results were similar to those of FAS analysis. In conclusion, Xinling Wan has an obvious therapeutic effect in treating stable angina pectoris, with a good safety and a low incidence of adverse event and adverse reaction in experiment group., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Chinese Pharmaceutical Association.)

The purpose of this study is to compare the differences among neck muscle fatigue evaluation algorithms and to find a more effective algorithm which can provide a human factor quantitative evaluation method for neck muscle fatigue during bending over the desk. We collected surface electromyography signal of sternocleidomastoid muscle of 15 subjects using wireless physiotherapy Bio-Radio when they bent over the desk using memory pillows for 12 minutes. Five algorithms including mean power frequency, spectral moments ratio, discrete wavelet transform, fuzzy approximation entropy and the complexity algorithms were used to calculate the corresponding muscle fatigue index. The least squares method was used to calculate the corresponding coefficient of determination R 2 and slope k of the linear regression of the muscle fatigue metric. The coefficient of determination R 2 evaluates anti-interference ability of algorithms. The maximum vertical distance L max which is obtained by the Kolmogorov-Smirnov test for the slopes k evaluates the ability to distinguish fatigue of algorithms. The results indicate that in the aspect of anti-interference ability, the fuzzy approximation entropy has the largest R 2 when using memory pillows with different heights. When the fuzzy approximate entropy is compared with average power frequency or the discrete wavelet transform, the differences are significant ( P < 0.05). In terms of distinguishing the degree of fatigue, the approximate entropy is still the largest, with a maximum of 0.496 7. Fuzzy approximation entropy is superior to other algorithms in ability of anti-interference and distinguishing fatigue. Therefore, fuzzy approximation entropy can be used as a better evaluation algorithm in the evaluation of cervical muscle fatigue.

Focusing on the defects in the lighting color of LED lamps and the chip heat exists in the traditional LED package which caused phosphor performance degradation, color temperature drift and the uneven light, the remote phosphor package which is emerging in recent years is used in this paper. With yellow-green YGG phosphor and nitrogen red phosphors mixing with silica gel, the remote phosphor is made and then encapsulated as the LED lamps. A lot of experiments were made to determine the best ratio of yellow green phosphor, red phosphor and silica gel, LED lamps with different color temperature was prepared. The lamps were also tested and analyzed with some parameters such as e color coordinates, luminous efficiency, color rendering index (CRI), R9, color quality scale (CQS), color temperature, and the gamut area index (GAI), which provide a more objective and comprehensive evaluation to the high quality LED lighting. Experimental results show that the optimum ratio of red and yellow-green phosphor is 1∶7.6, and total phosphor with silica gel is 1∶5，at this time the white LED lighting color temperature is 4 113 K, the color coordinate (x, y) is (0.375 4, 0.373 1), luminous efficiency is 52.33 lm·w-1, color gamut is 0.981, color rendering index is up to 96, R9 is 97, color quality scale Qa is up to 93, and the gamut area index is 79. Compared with the traditional packaging，the surface temperature ofthe remote phosphor encapsulated fluorescent plate is much lower than that of adhesive dispensing encapsulation, which can effectively avoid the harmful effect caused by high temperature on the LED.

Objective: To understand the epidemiological characteristics of syphilis infection in blood donors of Chinese Nanjing area, to strengthen control of blood quality and to provide the scientific evidence for working out the strategy of prevention and treatment of syphilis infection., Methods: Firstly the double antigen sandwich ELISA was carried out according to its instructions, test results showing positive will be examed by double orifice second-round., Results: A total of 362425 blood samples were collected from 2010 to 2014, among them 1277 positive samples were detected. The average rate of syphilis infection was 0.35％. The positive rates of different old years were statistically different（X(2)=265.679,P<0.001）, and the change trend of 5 years was statistically different(X(2)trend=237.928,P<0.001）. Among all age groups in the detection of treponema pallidema(TP), the most amount of positive samples and the lowest positive ratio 0.23% were found in the group 18 to 29 years old. The highest positive ratio was shown in age 50 years old and above. There was statistical different in all age groups(X(2)=361.620,P<0.001）. The positive ratio of the detection of TP was 0.32% in male donors which was lower than that in female donors(0.42%). There was statistical different in all sex groups(X(2)=24.659,P<0.001）. Peasant group had the highest positive ratio(1.07%) in the detection of TP and the student group had the lowest positive ratio(0.19%). There was statistical different in all occupation groups(X(2)=300.198,P<0.001）. Junior and under group had the highest positive ratio(0.59%) in the detection of TP and the undergraduates group has the lowest positive ratio(0.19%). There was statistical different in all education groups(X(2)=241.734,P<0.001）. Through chi-square test and trend test analysis showed that there was statistical different in sex, age, educational level and occupation differences. The tendency of the groups' statistics in 5 years is equally important., Conclusion: It is necessary to publicize blood donation information consultation scientifically before blood donation, especially for high-risk population. To ensure blood supply safety, it is important to recruit low-risk blood donors and develop permanent voluntary blood donors for reducing blood waste.

Objective: To investigate the effect of electroacupunctrue on ERp57 in non-alcoholic fatty liver disease (NAFLD) rats, and study the therapeutic mechanism of electroacupunctrue in patients with NAFLD., Methods: Sixty male SD rats were randomly divided into common diet group (n = 15) and high-fat diet group (n = 45). 5 weeks later, two rats from the two groups were executed and confirmed that the model was successful. Then 10 rats in common diet group were chosen as control group (Control), and 40 rats in high-fat diet group were randomly chosen and divided into diet group 1 (D1), diet group 2 (D2), electroacupuncture group 1 (EA) and electroacupuncture group 2 (EA2) (n = 10 each). D1 and EA1 were fed by high fat diet; D2 and EA2 were fed with common diet. In EA1 and EA2, filiform needle acupuncture was applied to ST36, SP6 and Liv3 and electroacupunctrue was applied to one-side of ST36, SP6 for 20 min once daily for 4 weeks. The rats in each group were weighed per-week. After the treatment the changes of blood lipid and liver functions of these rats were observed. ERp57 gene expression and protein expression were detected by RT-PCR and Western blot, and expression of ERp57 downstream SREBP-1c was detected., Results: The body mass of D1 increased slowly and were lower than D2 and EA1 (P < 0.05); the body weights of EA2 increased rapidly and were higher than EA1 (P < 0.05), but without significant difference with D2 (P > 0.05). The contents of blood lipid, liver functions and the expression of ERp57 and SREBP-1c were significantly higher than those in Control, D2 and EA1 (P < 0.05). While compared to D2 and EA1 respectively, the index mentioned above in EA2 decreased more significantly (P < 0.05)., Conclusion: Electroacupunctrue can decrease expression of ERp57 to improve endoplasmic reticulum stress (ERS) of rats with NAFLD and then decrease expression of SREBP-1c to regulate rat lipid, which could be one of mechanism to cure NAFLD.

Objective: To detect the effects of quercetin (Que) combined with 2-methoxyestradiol (2-ME) on the proliferation of androgen-dependent LNCaP human prostate cancer cells line and androgen-independent PC-3 human prostate cancer cells line, and to evaluate the antitumor effects of different combos of the two drugs., Methods: After LNCaP and PC-3 cells were treated with different concentration of quercetin (0, 3.125, 6.25, 12.5, 25, 50, 100, 200 μmol/L) or 2-ME (0, 0.312 5, 0.625, 1.25, 2.5, 5, 10 μmol/L) for 48 h, the inhibitory rates of cell growth were tested using trypan blue staining method respectively. Then the concentration-effect curves were drawn and IC(50) values were calculated. According to the fitted dose-effect curves and IC(50) values, appropriate concentrations of quercetin and 2-ME were selected to compose 16 different combos. Then cells were treated with different combos of Que and 2-ME for 48 h, and then the growth inhibitory rates of cell growth were detected. According to the equation and median-effect principle, the CI values of 16 different combos of Que and 2-ME were calculated to evaluate their antitumor effects., Results: The inhibition rate of LNCaP or PC-3 cell growth treated with varying doses of quercetin or 2-ME alone showed a dose-dependent increase respectively. The IC(50) values of quercetin and 2-ME were 23.29 μmol/L and 1.89 μmol/L for LNCaP cells; and 22.12 μmol/L and 1.74 μmol/L for PC-3 cells respectively. After treated with 16 combos of Que (5, 10, 20, 40 μmol/L) and 2-ME (0.5, 1, 3, 5 μmol/L) for 48 h, for LNCaP cells, lower dose of Que (5 and 10 μmol/L) with higher dose of 2-ME (3 and 5 μmol/L) showed synergistic activity, whereas for PC-3 cells, besides the above combination of Que 10 μmol/L and 2-ME 3 μmol/L, higher dose of quercetin (20 and 40 μmol/L) with higher dose of 2-ME (3 and 5 μmol/L) also showed synergistic activity., Conclusions: Both quercetin and 2-methoxyestradiol could inhibit the growth of LNCaP and PC-3 human prostate cancer cells in a dose dependent manner. We confirmed that combinations of quercetin and 2-ME at appropriate concentrations have the potential for synergetic antiproliferative activity in vitro.

Objective: To observe the effect of electroacupunctrue (EA) intervention or EA combined with dietary control on peroxisome proliferator-activated receptor (PPAR)-α, and liver fatty acid-binding protein (L-FABP) levels in non-alcoholic fatty liver disease (NAFLD) rats, so as to reveal its mechanism underlying improvement of NAFLD., Methods: Sixty SD male rats were randomly divided into common diet (control) group (n = 10) and high-fat diet group (n = 45). The NAFLD model was established by feeding the animals with high-fat forage (HFF, including cholesterol, sodium cholate, propylthiouracil, sucrose, lard and common forage) for 5 weeks. Forty NAFLD rats were then randomized into model, EA + HFF, low-fat forage (LFF) and EA+ LFF groups (n = 10 rats in each group). EA (4 Hz/20 Hz, 3 mA) was applied to ipsilateral "Zusanli" (ST 36),"Sanyinjiao" (SP 6) and "Taichong" (LR 3) for 20 min, once daily for 4 weeks. The pathologic changes of the hepatic tissue were detected by H. E. staining. Serum total cholesterol (TC) and triglyceride (TG) contents were determined by using enzymatic methods, serum free fat acids (FFA) content was detected by colorimetry. The expression levels of PPAR-α and L-FABP protein and gene of the liver tissue were determined by Western blot and RT-PCR, respectively., Results: H. E. staining showed that the hepatocytes presented moderate or severe bullous adipose degeneration in rats of the model group, vesicular steatosis in the EA + HFF and LFF groups, turned to almost normal but with small amount of lipid droplets in the EA + LFF group. The contents of serum TC, TG and FFA were significantly higher in the model group than in the control group (P < 0.05), and were obviously decreased in the EA + HFF, LFF and EA + LFF groups in comparison with the model group (P < 0.05). Compared to the control group, hepatic PPAR-α protein and mRNA were markedly down-regulated in the model group, and hepatic L-FABP protein and mRNA considerably up-regulated in the model group (P < 0.05). Following EA intervention and low fat diet feeding, PPAR-α protein and mRNA were markedly up-regulated while L-FABP protein and mRNA remarkably down-regulated in the EA + HFF, LFF and EA + LFF groups (P < 0.05)., Conclusion: EA intervention or EA combined with dietary control can relieve hepatic pathological changes in NAFLD rats, which may be related to its effects in down-regulating blood lipid level and hepatic L-FABP protein and mRNA expression and in up-regulating PPAR-α protein and mRNA expression, and the effect of combined treatment was relatively better than simple EA or LFF treatment.

Metal organic framework, a novel class of organic inorganic hybrid functional materials, has been widely used in the fields of gas adsorption, catalysis, separation, and biological medicine due to its large specific surface area, diverse structural, and adjustable channel. In this work, a new amine-functionalized magnetic metal-organic framework material was synthesized. Nano-Fe3O4 was prepared by a solvothermal method, after which polyvinyl pyrrolidone was employed to modify Fe3O4. Finally, amino groups were introduced to prepare Fe3O4@NH2-MIL-53(Al). The crystal structure and functional groups of the material were characterized by means of X-ray diffraction (XRD) and Fourier transform infrared spectrometry (FT-IR). Combined with flame atomic absorption spectroscopy (FAAS), the adsorption of lead by the magnetic adsorbent was investigated. The magnetic adsorbent possesses high adsorption capacity because of the large specific surface area of Fe3O4@NH2-MIL-53(Al) and the coordination between amino group and lead. Experimental conditions affecting the adsorption percentage were discussed and the experimental operation parameters were optimized (pH value of 6.0 and adsorption time of 120 min). Kinetics and thermodynamics studies were conducted for the adsorption process. Langmuir/Freundlich and pseudo-first-order/pseudo-second-order models were applied to analyze the experimental data. Thermodynamic functions, i. e., changes of Gibbs energy, entropy, and enthalpy, were calculated from temperature experiments. In addition, the regeneration of the adsorbent was considered with hydrochloric acid as the desorption solution. Several adsorption and desorption experiments were carried out, illustrating that the Fe3O4@NH2-MIL-53(Al) adsorbent can be used repeatedly.

Objective: To explore the safety and efficacy of "sandwich" urethra reconstruction in laparoscopic radical prostatectomy (LRP) for the early recovery of continence., Methods: LRP was performed using a urethra surrounding tissue reconstruction in 37 consecutive patients, and without reconstruction procedure in 34 consecutive patients at the same period from March 2012 to January 2013. The baseline data, preoperative data: The patient age, body mass index (BMI, kg/m2), International prostate symptoms score (IPSS), prostate volume, preoperative PSA, Gleason score were assessed retrospectively; Operative data: The neurovascular bundle preservation, operation time, blood loss were assessed; and the primary outcome measure was urinary continence assessed at the end of 1, 2, 4, 12 and 24 weeks after the catheter was removed. Other data recorded were duration of indwelling catheter, positive margin rate and complications., Results: There were no significant differences between the two groups with respect to baseline,preoperative and operative data except of the operative time (P=0.003). Between the two groups, the continence of the reconstruction group was higher than that of the control group at the end of 4 and 12 weeks (P=0.007, P=0.020, respectively)., Conclusion: Urethra surrounding tissue reconstruction in LRP is safe and feasible, and it could improve early recovery of continence.

Objective: To study the chemical constituents from ethyl acetate extraction of Sanicula lamelligera., Methods: Compounds were isolated and purified by silica gel and Sephadex LH-20 column chromatographic method, and their structures were identified by using spectroscopic analysis., Results: Nine compounds were isolated and identified as angelicin (I), isoferulaldehyde (II), 12- hydroxybakuchiol (III), 22-angeloyl-R1-barrigenol (IV), 5,6,7,8,4'-pentamethoxyflavone (V),3,5,6,7,8,3',4'-heptamethoxyflavone (VI), isobavachin (VII), isoliquiritigenin (VIII) and furano (2",3",7,6) 4'-hydroxyflavanone (IX)., Conclusion: All compounds are isolated from this plant for the first time.